NUR 2502 / NUR2502 ·
M U LT I D I M E N S I O N A L C A R E I I I · M D C 3
Exam 2
Review
A 120-question comprehensive examination with
an embedded answer key and detailed
rationales, aligned with the Rasmussen
University NUR 2502 syllabus, the NCLEX-RN
test plan, QSEN competencies, and
Multidimensional Care III nursing standards.
Rasmussen College
1 2 0 Q U E S T I O N S · A N S W E R S W I T H R AT I O N A L E S · 2 0 2 6
/ 2027 EDITION
,NUR 2502 / NUR2502: Multidimensional Care III / MDC 3 - Exam 2 Review (Latest )
NUR 2502 / NUR2502: MULTIDIMENSIONAL CARE III / MDC 3
EXAM 2 REVIEW (LATEST ) - RASMUSSEN
COLLEGE
Comprehensive Examination - 120 Questions with Answer Key and Detailed Rationales
Aligned with the NUR 2502 Course Syllabus, NCLEX-RN Test Plan, QSEN Competencies, and Multidimensional Care III Nursing
Standards ( Edition)
Section 1: Complex Cardiovascular Disorders
Questions 1 - 20 of 120
Q1: The nurse is reviewing the electrocardiogram of a client admitted with crushing substernal
chest pain radiating to the left arm. Which ECG finding should the nurse recognize as
characteristic of an acute ST-elevation myocardial infarction (STEMI)?
A. Diffuse ST-segment depression with an isolated aVR elevation
B. Peaked, narrow T waves with a shortened QT interval
C. ST-segment elevation in two or more contiguous leads *[CORRECT]*
D. Deep pathologic Q waves in the lateral leads only
Correct Answer: C
Rationale: ST-segment elevation in two or more contiguous leads indicates complete coronary occlusion and
transmural myocardial injury, which defines a STEMI and triggers emergency reperfusion protocols. Peaked T
waves are associated with hyperkalemia, ST depression with subendocardial ischemia or NSTEMI, and isolated
pathologic Q waves reflect prior completed infarction rather than acute injury. This correlates with the NUR
2502 complex cardiovascular content and the NCLEX-RN Physiological Adaptation blueprint area.
Q2: A client reports chest pressure that began 30 minutes ago while at rest. The client is alert,
blood pressure 148/88 mm Hg, pulse 96, respirations 20, SpO2 95% on room air. Which action
should the nurse take first?
A. Administer prescribed chewable aspirin and obtain IV access
B. Draw serial cardiac biomarkers and notify the charge nurse
C. Obtain a 12-lead electrocardiogram within 10 minutes of the report
*[CORRECT]*
D. Schedule the client for an immediate stress echocardiogram
Correct Answer: C
Rationale: A 12-lead ECG obtained within 10 minutes of symptom report is the priority because it
differentiates STEMI from non-STEMI and determines eligibility for emergent reperfusion, consistent with
NUR 2502 acute coronary syndrome protocols. Aspirin, IV access, and biomarkers are all appropriate but
follow the ECG, and a stress test is contraindicated during active ischemic symptoms. Time-critical sequencing
reflects the NCLEX-RN emphasis on management of the deteriorating client.
Rasmussen College - NUR 2502 Multidimensional Care III 1
,NUR 2502 / NUR2502: Multidimensional Care III / MDC 3 - Exam 2 Review (Latest )
Q3: A client admitted with chest discomfort has the following laboratory results: troponin I 4.2
ng/mL (normal less than 0.04), CK-MB 38 ng/mL (normal 0-5), myoglobin normal. How
should the nurse interpret these findings?
A. Results are inconsistent with myocardial injury and suggest skeletal muscle strain
B. Findings confirm a completed remote infarction with no active injury
C. Elevated troponin I with elevated CK-MB indicates acute myocardial injury
*[CORRECT]*
D. Isolated myoglobin elevation is the most specific marker of cardiac necrosis
Correct Answer: C
Rationale: Troponin I is the most specific and sensitive biomarker of myocardial cell injury, and concurrent
elevation of CK-MB supports an acute infarction rather than noncardiac injury. Skeletal muscle strain elevates
myoglobin without a proportional troponin rise, pathologic Q waves rather than biomarkers identify remote
infarction, and myoglobin is the least cardiac-specific marker listed. Interpretation of cardiac markers is a core
NUR 2502 laboratory concept under the NCLEX-RN Physiological Adaptation area.
Q4: Which assessment findings should the nurse expect in a client with isolated right-sided
heart failure?
A. Orthopnea, moist cough with pink frothy sputum, and crackles
B. Dyspnea on exertion with resting hypoxemia and fine bibasilar crackles
C. Pulsus alternans with S3 gallop and progressive fatigue on exertion
D. Elevated jugular venous distention, dependent peripheral edema, and
hepatomegaly *[CORRECT]*
Correct Answer: D
Rationale: Right-sided failure causes venous congestion behind the failing right ventricle, producing jugular
venous distention, dependent edema, hepatomegaly, ascites, and abdominal discomfort. Orthopnea, crackles,
and frothy sputum are manifestations of left-sided failure with pulmonary congestion, not isolated right-sided
failure. Differentiating ventricular failure profiles is essential NUR 2502 content mapped to the NCLEX-RN
Physiological Adaptation blueprint.
Rasmussen College - NUR 2502 Multidimensional Care III 2
, NUR 2502 / NUR2502: Multidimensional Care III / MDC 3 - Exam 2 Review (Latest )
Q5: The nurse is teaching a client with newly diagnosed heart failure about self-management at
home. Which client statement indicates a correct understanding of daily weight monitoring?
A. I will weigh myself each morning after voiding, before breakfast, and call the
clinic if I gain 2 to 3 pounds in one day *[CORRECT]*
B. I will weigh myself each evening after dinner and report any weight that is 2 pounds
above my ideal body weight
C. I will weigh myself once a week on the same scale and call the clinic only if my shoes
no longer fit
D. I will weigh myself every morning and evening and average the two values to track my
fluid balance
Correct Answer: A
Rationale: Daily weights taken after voiding, before eating, at the same time each day detect fluid retention
earliest; a gain of 2 to 3 pounds in 24 hours or about 5 pounds in a week must be reported because it signals
worsening fluid overload before symptoms appear. Evening weights, weekly weights, or averaging values delay
detection and allow decompensation. This reflects the QSEN safety competency and NUR 2502 heart failure
self-management standards.
Q6: A client taking digoxin 0.25 mg daily and furosemide 40 mg daily reports nausea and
seeing yellow-green halos around lights. Which laboratory result should the nurse identify as
the most likely contributing factor?
A. Magnesium 2.0 mg/dL
B. Potassium 3.1 mEq/L *[CORRECT]*
C. Sodium 138 mEq/L
D. Calcium 9.4 mg/dL
Correct Answer: B
Rationale: Hypokalemia from loop diuretic therapy potentiates digoxin binding at the myocardium and
precipitates toxicity, which presents with gastrointestinal upset, visual disturbances, and dysrhythmias. Normal
magnesium, sodium, and calcium values do not explain the findings, and in fact hypercalcemia rather than
normal calcium can also sensitize the myocardium to digoxin. Recognizing electrolyte potentiation of drug
toxicity aligns with NUR 2502 pharmacology content and the NCLEX-RN Pharmacological Therapies area.
Rasmussen College - NUR 2502 Multidimensional Care III 3
M U LT I D I M E N S I O N A L C A R E I I I · M D C 3
Exam 2
Review
A 120-question comprehensive examination with
an embedded answer key and detailed
rationales, aligned with the Rasmussen
University NUR 2502 syllabus, the NCLEX-RN
test plan, QSEN competencies, and
Multidimensional Care III nursing standards.
Rasmussen College
1 2 0 Q U E S T I O N S · A N S W E R S W I T H R AT I O N A L E S · 2 0 2 6
/ 2027 EDITION
,NUR 2502 / NUR2502: Multidimensional Care III / MDC 3 - Exam 2 Review (Latest )
NUR 2502 / NUR2502: MULTIDIMENSIONAL CARE III / MDC 3
EXAM 2 REVIEW (LATEST ) - RASMUSSEN
COLLEGE
Comprehensive Examination - 120 Questions with Answer Key and Detailed Rationales
Aligned with the NUR 2502 Course Syllabus, NCLEX-RN Test Plan, QSEN Competencies, and Multidimensional Care III Nursing
Standards ( Edition)
Section 1: Complex Cardiovascular Disorders
Questions 1 - 20 of 120
Q1: The nurse is reviewing the electrocardiogram of a client admitted with crushing substernal
chest pain radiating to the left arm. Which ECG finding should the nurse recognize as
characteristic of an acute ST-elevation myocardial infarction (STEMI)?
A. Diffuse ST-segment depression with an isolated aVR elevation
B. Peaked, narrow T waves with a shortened QT interval
C. ST-segment elevation in two or more contiguous leads *[CORRECT]*
D. Deep pathologic Q waves in the lateral leads only
Correct Answer: C
Rationale: ST-segment elevation in two or more contiguous leads indicates complete coronary occlusion and
transmural myocardial injury, which defines a STEMI and triggers emergency reperfusion protocols. Peaked T
waves are associated with hyperkalemia, ST depression with subendocardial ischemia or NSTEMI, and isolated
pathologic Q waves reflect prior completed infarction rather than acute injury. This correlates with the NUR
2502 complex cardiovascular content and the NCLEX-RN Physiological Adaptation blueprint area.
Q2: A client reports chest pressure that began 30 minutes ago while at rest. The client is alert,
blood pressure 148/88 mm Hg, pulse 96, respirations 20, SpO2 95% on room air. Which action
should the nurse take first?
A. Administer prescribed chewable aspirin and obtain IV access
B. Draw serial cardiac biomarkers and notify the charge nurse
C. Obtain a 12-lead electrocardiogram within 10 minutes of the report
*[CORRECT]*
D. Schedule the client for an immediate stress echocardiogram
Correct Answer: C
Rationale: A 12-lead ECG obtained within 10 minutes of symptom report is the priority because it
differentiates STEMI from non-STEMI and determines eligibility for emergent reperfusion, consistent with
NUR 2502 acute coronary syndrome protocols. Aspirin, IV access, and biomarkers are all appropriate but
follow the ECG, and a stress test is contraindicated during active ischemic symptoms. Time-critical sequencing
reflects the NCLEX-RN emphasis on management of the deteriorating client.
Rasmussen College - NUR 2502 Multidimensional Care III 1
,NUR 2502 / NUR2502: Multidimensional Care III / MDC 3 - Exam 2 Review (Latest )
Q3: A client admitted with chest discomfort has the following laboratory results: troponin I 4.2
ng/mL (normal less than 0.04), CK-MB 38 ng/mL (normal 0-5), myoglobin normal. How
should the nurse interpret these findings?
A. Results are inconsistent with myocardial injury and suggest skeletal muscle strain
B. Findings confirm a completed remote infarction with no active injury
C. Elevated troponin I with elevated CK-MB indicates acute myocardial injury
*[CORRECT]*
D. Isolated myoglobin elevation is the most specific marker of cardiac necrosis
Correct Answer: C
Rationale: Troponin I is the most specific and sensitive biomarker of myocardial cell injury, and concurrent
elevation of CK-MB supports an acute infarction rather than noncardiac injury. Skeletal muscle strain elevates
myoglobin without a proportional troponin rise, pathologic Q waves rather than biomarkers identify remote
infarction, and myoglobin is the least cardiac-specific marker listed. Interpretation of cardiac markers is a core
NUR 2502 laboratory concept under the NCLEX-RN Physiological Adaptation area.
Q4: Which assessment findings should the nurse expect in a client with isolated right-sided
heart failure?
A. Orthopnea, moist cough with pink frothy sputum, and crackles
B. Dyspnea on exertion with resting hypoxemia and fine bibasilar crackles
C. Pulsus alternans with S3 gallop and progressive fatigue on exertion
D. Elevated jugular venous distention, dependent peripheral edema, and
hepatomegaly *[CORRECT]*
Correct Answer: D
Rationale: Right-sided failure causes venous congestion behind the failing right ventricle, producing jugular
venous distention, dependent edema, hepatomegaly, ascites, and abdominal discomfort. Orthopnea, crackles,
and frothy sputum are manifestations of left-sided failure with pulmonary congestion, not isolated right-sided
failure. Differentiating ventricular failure profiles is essential NUR 2502 content mapped to the NCLEX-RN
Physiological Adaptation blueprint.
Rasmussen College - NUR 2502 Multidimensional Care III 2
, NUR 2502 / NUR2502: Multidimensional Care III / MDC 3 - Exam 2 Review (Latest )
Q5: The nurse is teaching a client with newly diagnosed heart failure about self-management at
home. Which client statement indicates a correct understanding of daily weight monitoring?
A. I will weigh myself each morning after voiding, before breakfast, and call the
clinic if I gain 2 to 3 pounds in one day *[CORRECT]*
B. I will weigh myself each evening after dinner and report any weight that is 2 pounds
above my ideal body weight
C. I will weigh myself once a week on the same scale and call the clinic only if my shoes
no longer fit
D. I will weigh myself every morning and evening and average the two values to track my
fluid balance
Correct Answer: A
Rationale: Daily weights taken after voiding, before eating, at the same time each day detect fluid retention
earliest; a gain of 2 to 3 pounds in 24 hours or about 5 pounds in a week must be reported because it signals
worsening fluid overload before symptoms appear. Evening weights, weekly weights, or averaging values delay
detection and allow decompensation. This reflects the QSEN safety competency and NUR 2502 heart failure
self-management standards.
Q6: A client taking digoxin 0.25 mg daily and furosemide 40 mg daily reports nausea and
seeing yellow-green halos around lights. Which laboratory result should the nurse identify as
the most likely contributing factor?
A. Magnesium 2.0 mg/dL
B. Potassium 3.1 mEq/L *[CORRECT]*
C. Sodium 138 mEq/L
D. Calcium 9.4 mg/dL
Correct Answer: B
Rationale: Hypokalemia from loop diuretic therapy potentiates digoxin binding at the myocardium and
precipitates toxicity, which presents with gastrointestinal upset, visual disturbances, and dysrhythmias. Normal
magnesium, sodium, and calcium values do not explain the findings, and in fact hypercalcemia rather than
normal calcium can also sensitize the myocardium to digoxin. Recognizing electrolyte potentiation of drug
toxicity aligns with NUR 2502 pharmacology content and the NCLEX-RN Pharmacological Therapies area.
Rasmussen College - NUR 2502 Multidimensional Care III 3
