C O M P R E H E N S I V E F I N A L E X A M I N AT I O N
NUR 2755
Multidimensional
Care IV
A 150-question comprehensive examination
spanning ten body-system sections, aligned
with the NCLEX-RN Test Plan, QSEN
competencies, and Rasmussen NUR 2755
curriculum standards.
Rasmussen University · School of Nursing
150 Questions · 10 Sections · NCLEX-RN Test Plan Aligned
Multidimensional Care IV (MDC 4) · Edition
L AT E S T 2 0 2 0 2 7 E D I T I O N · M D C 4
,NUR 2755 Final Exam | Multidimensional Care IV (MDC 4) Latest Edition
NUR2755 / NUR 2755 FINAL EXAM (LATEST )
MULTIDIMENSIONAL CARE IV / MDC 4 - RASMUSSEN
Aligned with the Rasmussen University NUR 2755 Course Syllabus, the NCLEX-RN Test Plan, QSEN
Competencies, and Multidimensional Care IV Nursing Standards (2026/2027 Edition)
150 Questions | 10 Sections | 20 Priority-Setting Items | 15 Pharmacology Items | 10 Laboratory Interpretation Items
Cognitive Levels: 20% Recall, 50% Application, 30% Analysis | Format: 75% Scenario-Based, 25% Direct Knowledge
Table of Contents
Section 1: Complex Cardiovascular & Hematological Disorders (Questions 1-20) 2
Section 2: Complex Respiratory & Acid-Base Disorders (Questions 21-38) 8
Section 3: Neurological & Neurosurgical Disorders (Questions 39-56) 14
Section 4: Renal, Genitourinary, & Fluid/Electrolyte Disorders (Questions 57-71) 20
Section 5: Endocrine & Metabolic Disorders (Questions 72-86) 25
Section 6: Gastrointestinal & Hepatic Disorders (Questions 87-101) 30
Section 7: Oncological & Immunological Disorders (Questions 102-116) 35
Section 8: Multisystem & Critical Care Concepts (Questions 117-128) 39
Section 9: Emergency Preparedness & Disaster Nursing (Questions 129-140) 43
Section 10: Pharmacology & Medication Management (Questions 141-150) 47
Rasmussen University 1 150 Questions
,NUR 2755 Final Exam | Multidimensional Care IV (MDC 4) Latest Edition
Section 1: Complex Cardiovascular & Hematological Disorders Questions 1-20
Q1. A 58-year-old client arrives at the emergency department reporting crushing chest pressure
that radiates to the left jaw, accompanied by diaphoresis and nausea for the past 40 minutes. Which
prescription should the nurse anticipate being completed FIRST?
A. Immediate coronary angiography with possible percutaneous intervention
B. Serial cardiac troponin levels drawn at 6 and 12 hours only
C. A 12-lead electrocardiogram obtained within 10 minutes of arrival [CORRECT]
D. An oral beta-blocker administered before any other assessment
Correct Answer: C
Rationale: Guidelines for acute coronary syndrome require a 12-lead ECG within 10 minutes of arrival because it
drives immediate reperfusion decisions, and this aligns with the NUR 2755 cardiovascular module on early
recognition of myocardial infarction (NCLEX-RN: Physiological Adaptation). Coronary angiography is indicated
but only after the ECG identifies ST changes. Troponin may not be detectable this early, and delaying it to 6-12
hours alone would miss the diagnosis window. An oral beta-blocker is never prioritized before diagnostic
evaluation in the unstable presentation.
Q2. A client with heart failure tells the clinic nurse he has gained 3 pounds (1.4 kg) in the past 24
hours and feels more short of breath when lying flat. What is the nurse's best response?
A. Encourage the client to increase daily fluid intake to improve circulation
B. Notify the provider, because rapid weight gain indicates fluid retention requiring prompt
adjustment of therapy [CORRECT]
C. Advise the client to wait until his scheduled monthly weigh-in to report changes
D. Reassure the client that weight fluctuates normally and no action is needed
Correct Answer: B
Rationale: A gain of 3 pounds in 24 hours or 5 pounds in 1 week is an evidence-based red flag for fluid retention
and worsening heart failure, a key self-management concept taught in the NUR 2755 fluid balance curriculum
(QSEN: Evidence-Based Practice). Early notification allows diuretic adjustment before decompensation and
readmission. Increasing fluids would worsen volume overload, and delaying reporting ignores a classic warning
sign.
Q3. A client admitted with chest pain has a cardiac troponin I level of 0.8 ng/mL (reference less
than 0.04 ng/mL) drawn 3 hours after symptom onset. How should the nurse interpret this finding?
A. Myocardial injury consistent with an acute myocardial infarction [CORRECT]
B. An expected finding caused by skeletal muscle injury
C. A normal result that should simply be repeated in 24 hours
D. An invalid specimen most likely caused by hemolysis
Correct Answer: A
Rationale: Cardiac troponin I is the most specific biomarker for myocardial injury, and any value above the 99th
percentile with clinical symptoms confirms myocardial infarction, a core interpretation skill in the NUR 2755
cardiac diagnostics unit (NCLEX-RN: Reduction of Risk Potential). Troponin is detectable within 2-4 hours of
injury, so the 3-hour draw is reliable. Unlike CK-MB, troponin does not rise with skeletal muscle damage, and
hemolysis is not the explanation here.
Rasmussen University 2 150 Questions
, NUR 2755 Final Exam | Multidimensional Care IV (MDC 4) Latest Edition
Q4. The nurse receives the following four clients at shift change. Which client should the nurse
assess FIRST?
A. A client with new sustained ventricular tachycardia at 180/min, BP 88/60, reporting dizziness
[CORRECT]
B. A client with a non-ST-elevation MI awaiting serial troponin results, pain 2/10
C. A client with heart failure due for the scheduled morning furosemide dose
D. A client 2 hours post-cardiac catheterization requesting to use the bathroom
Correct Answer: A
Rationale: Ventricular tachycardia with hypotension and dizziness is an unstable, life-threatening dysrhythmia
that can deteriorate into ventricular fibrillation, so ABC priority directs the nurse to this client for immediate
synchronized cardioversion readiness (NCLEX-RN: Management of Care; ACLS algorithms). The NSTEMI
client is stable on scheduled monitoring. The furosemide and bathroom requests are important but not
immediately life-threatening; however, the post-catheterization client should be assessed for groin bleeding before
ambulating when the nurse becomes available.
Q5. Two days after a massive myocardial infarction, a client develops BP 82/50 mmHg, HR
118/min, cool and clammy skin, bilateral crackles, distended neck veins, and urine output of 20
mL/hr. The nurse recognizes these findings as consistent with which condition?
A. Hypovolemic shock from inadequate circulating volume
B. Septic shock from distributive vasodilation
C. Cardiogenic shock from severe pump failure [CORRECT]
D. Neurogenic shock from loss of sympathetic tone
Correct Answer: C
Rationale: Cardiogenic shock following MI produces the combination of hypotension, hypoperfusion (cool skin,
oliguria), and congestion (crackles, JVD) because the failing ventricle cannot eject blood despite adequate volume,
as taught in the NUR 2755 hemodynamics module (NCLEX-RN: Physiological Adaptation). Hypovolemic shock
presents with dry mucous membranes and flat neck veins, while septic and neurogenic shock produce warm,
flushed skin early from inappropriate vasodilation.
Q6. A client's cardiac monitor shows an irregularly irregular rhythm with no discernible P waves.
Which dysrhythmia and priority complication should the nurse identify?
A. Sinus arrhythmia, with no significant risk
B. Atrial fibrillation, with risk of thromboembolic stroke [CORRECT]
C. First-degree AV block, with progression to complete heart block
D. Supraventricular tachycardia, with risk of sudden cardiac arrest
Correct Answer: B
Rationale: The absence of discrete P waves with an irregularly irregular rhythm defines atrial fibrillation, and
blood stasis in the fibrillating atria creates thrombi that can embolize to the brain, a primary NUR 2755
anticoagulation teaching point (NCLEX-RN: Physiological Adaptation). This risk drives anticoagulation decisions
using the CHA2DS2-VASc score. Sinus arrhythmia varies with respiration, first-degree AV block maintains P
waves, and SVT is characteristically regular.
Rasmussen University 3 150 Questions
NUR 2755
Multidimensional
Care IV
A 150-question comprehensive examination
spanning ten body-system sections, aligned
with the NCLEX-RN Test Plan, QSEN
competencies, and Rasmussen NUR 2755
curriculum standards.
Rasmussen University · School of Nursing
150 Questions · 10 Sections · NCLEX-RN Test Plan Aligned
Multidimensional Care IV (MDC 4) · Edition
L AT E S T 2 0 2 0 2 7 E D I T I O N · M D C 4
,NUR 2755 Final Exam | Multidimensional Care IV (MDC 4) Latest Edition
NUR2755 / NUR 2755 FINAL EXAM (LATEST )
MULTIDIMENSIONAL CARE IV / MDC 4 - RASMUSSEN
Aligned with the Rasmussen University NUR 2755 Course Syllabus, the NCLEX-RN Test Plan, QSEN
Competencies, and Multidimensional Care IV Nursing Standards (2026/2027 Edition)
150 Questions | 10 Sections | 20 Priority-Setting Items | 15 Pharmacology Items | 10 Laboratory Interpretation Items
Cognitive Levels: 20% Recall, 50% Application, 30% Analysis | Format: 75% Scenario-Based, 25% Direct Knowledge
Table of Contents
Section 1: Complex Cardiovascular & Hematological Disorders (Questions 1-20) 2
Section 2: Complex Respiratory & Acid-Base Disorders (Questions 21-38) 8
Section 3: Neurological & Neurosurgical Disorders (Questions 39-56) 14
Section 4: Renal, Genitourinary, & Fluid/Electrolyte Disorders (Questions 57-71) 20
Section 5: Endocrine & Metabolic Disorders (Questions 72-86) 25
Section 6: Gastrointestinal & Hepatic Disorders (Questions 87-101) 30
Section 7: Oncological & Immunological Disorders (Questions 102-116) 35
Section 8: Multisystem & Critical Care Concepts (Questions 117-128) 39
Section 9: Emergency Preparedness & Disaster Nursing (Questions 129-140) 43
Section 10: Pharmacology & Medication Management (Questions 141-150) 47
Rasmussen University 1 150 Questions
,NUR 2755 Final Exam | Multidimensional Care IV (MDC 4) Latest Edition
Section 1: Complex Cardiovascular & Hematological Disorders Questions 1-20
Q1. A 58-year-old client arrives at the emergency department reporting crushing chest pressure
that radiates to the left jaw, accompanied by diaphoresis and nausea for the past 40 minutes. Which
prescription should the nurse anticipate being completed FIRST?
A. Immediate coronary angiography with possible percutaneous intervention
B. Serial cardiac troponin levels drawn at 6 and 12 hours only
C. A 12-lead electrocardiogram obtained within 10 minutes of arrival [CORRECT]
D. An oral beta-blocker administered before any other assessment
Correct Answer: C
Rationale: Guidelines for acute coronary syndrome require a 12-lead ECG within 10 minutes of arrival because it
drives immediate reperfusion decisions, and this aligns with the NUR 2755 cardiovascular module on early
recognition of myocardial infarction (NCLEX-RN: Physiological Adaptation). Coronary angiography is indicated
but only after the ECG identifies ST changes. Troponin may not be detectable this early, and delaying it to 6-12
hours alone would miss the diagnosis window. An oral beta-blocker is never prioritized before diagnostic
evaluation in the unstable presentation.
Q2. A client with heart failure tells the clinic nurse he has gained 3 pounds (1.4 kg) in the past 24
hours and feels more short of breath when lying flat. What is the nurse's best response?
A. Encourage the client to increase daily fluid intake to improve circulation
B. Notify the provider, because rapid weight gain indicates fluid retention requiring prompt
adjustment of therapy [CORRECT]
C. Advise the client to wait until his scheduled monthly weigh-in to report changes
D. Reassure the client that weight fluctuates normally and no action is needed
Correct Answer: B
Rationale: A gain of 3 pounds in 24 hours or 5 pounds in 1 week is an evidence-based red flag for fluid retention
and worsening heart failure, a key self-management concept taught in the NUR 2755 fluid balance curriculum
(QSEN: Evidence-Based Practice). Early notification allows diuretic adjustment before decompensation and
readmission. Increasing fluids would worsen volume overload, and delaying reporting ignores a classic warning
sign.
Q3. A client admitted with chest pain has a cardiac troponin I level of 0.8 ng/mL (reference less
than 0.04 ng/mL) drawn 3 hours after symptom onset. How should the nurse interpret this finding?
A. Myocardial injury consistent with an acute myocardial infarction [CORRECT]
B. An expected finding caused by skeletal muscle injury
C. A normal result that should simply be repeated in 24 hours
D. An invalid specimen most likely caused by hemolysis
Correct Answer: A
Rationale: Cardiac troponin I is the most specific biomarker for myocardial injury, and any value above the 99th
percentile with clinical symptoms confirms myocardial infarction, a core interpretation skill in the NUR 2755
cardiac diagnostics unit (NCLEX-RN: Reduction of Risk Potential). Troponin is detectable within 2-4 hours of
injury, so the 3-hour draw is reliable. Unlike CK-MB, troponin does not rise with skeletal muscle damage, and
hemolysis is not the explanation here.
Rasmussen University 2 150 Questions
, NUR 2755 Final Exam | Multidimensional Care IV (MDC 4) Latest Edition
Q4. The nurse receives the following four clients at shift change. Which client should the nurse
assess FIRST?
A. A client with new sustained ventricular tachycardia at 180/min, BP 88/60, reporting dizziness
[CORRECT]
B. A client with a non-ST-elevation MI awaiting serial troponin results, pain 2/10
C. A client with heart failure due for the scheduled morning furosemide dose
D. A client 2 hours post-cardiac catheterization requesting to use the bathroom
Correct Answer: A
Rationale: Ventricular tachycardia with hypotension and dizziness is an unstable, life-threatening dysrhythmia
that can deteriorate into ventricular fibrillation, so ABC priority directs the nurse to this client for immediate
synchronized cardioversion readiness (NCLEX-RN: Management of Care; ACLS algorithms). The NSTEMI
client is stable on scheduled monitoring. The furosemide and bathroom requests are important but not
immediately life-threatening; however, the post-catheterization client should be assessed for groin bleeding before
ambulating when the nurse becomes available.
Q5. Two days after a massive myocardial infarction, a client develops BP 82/50 mmHg, HR
118/min, cool and clammy skin, bilateral crackles, distended neck veins, and urine output of 20
mL/hr. The nurse recognizes these findings as consistent with which condition?
A. Hypovolemic shock from inadequate circulating volume
B. Septic shock from distributive vasodilation
C. Cardiogenic shock from severe pump failure [CORRECT]
D. Neurogenic shock from loss of sympathetic tone
Correct Answer: C
Rationale: Cardiogenic shock following MI produces the combination of hypotension, hypoperfusion (cool skin,
oliguria), and congestion (crackles, JVD) because the failing ventricle cannot eject blood despite adequate volume,
as taught in the NUR 2755 hemodynamics module (NCLEX-RN: Physiological Adaptation). Hypovolemic shock
presents with dry mucous membranes and flat neck veins, while septic and neurogenic shock produce warm,
flushed skin early from inappropriate vasodilation.
Q6. A client's cardiac monitor shows an irregularly irregular rhythm with no discernible P waves.
Which dysrhythmia and priority complication should the nurse identify?
A. Sinus arrhythmia, with no significant risk
B. Atrial fibrillation, with risk of thromboembolic stroke [CORRECT]
C. First-degree AV block, with progression to complete heart block
D. Supraventricular tachycardia, with risk of sudden cardiac arrest
Correct Answer: B
Rationale: The absence of discrete P waves with an irregularly irregular rhythm defines atrial fibrillation, and
blood stasis in the fibrillating atria creates thrombi that can embolize to the brain, a primary NUR 2755
anticoagulation teaching point (NCLEX-RN: Physiological Adaptation). This risk drives anticoagulation decisions
using the CHA2DS2-VASc score. Sinus arrhythmia varies with respiration, first-degree AV block maintains P
waves, and SVT is characteristically regular.
Rasmussen University 3 150 Questions
