EXAM 1 - NUR2392 / NUR 2392 (LATEST ) :
MULTIDIMENSIONAL CARE II / MDC 2 - RASMUSSEN
Total: 120 Questions | Multiple Choice (A-D) | Aligned with the NCLEX-RN Test Plan and QSEN Competencies | Answer
Key and Rationales Included
Section 1: Perioperative Nursing
Q1: The nurse is completing the preoperative assessment of a 47-year-old client scheduled for an elective
laparoscopic cholecystectomy this morning. Which finding requires immediate notification of the surgeon
before the client goes to the operating room?
A. Reports feeling anxious about the surgical outcome
B. Blood pressure of 138/88 mm Hg
C. Episodes of chest pain and shortness of breath two days ago *[CORRECT]*
D. States that the last solid meal was eaten 8 hours ago
Correct Answer: C
Rationale: Recent chest pain and dyspnea suggest an unresolved cardiac risk, and per NUR 2392 preoperative
standards and NCLEX-RN Reduction of Risk Potential content, any new cardiopulmonary symptom must be
reported so the surgeon can evaluate whether surgery should proceed or be postponed. Anxiety is an expected
emotional response addressed with support and preoperative teaching. A mildly elevated blood pressure is
monitored rather than canceling surgery. Compliance with NPO status for 8 hours is appropriate and requires no
action.
Q2: A client signs the consent form for an abdominal hysterectomy and then asks the nurse, 'What exactly will
they do during the surgery?' Which response by the nurse is most appropriate?
A. I will contact your surgeon so the procedure and its risks can be explained to you again *[CORRECT]*
B. It is the removal of your uterus through an incision in your lower abdomen
C. Most clients recover from this type of surgery within two weeks without any problems
D. You have already signed the consent form, so the procedure can proceed as scheduled
Correct Answer: A
Rationale: Under informed consent standards in the NUR 2392 curriculum and NCLEX-RN Management of
Care, it is the surgeon's responsibility to explain the procedure, risks, and alternatives; if the client demonstrates
lack of understanding, the nurse must withhold signature confirmation, notify the surgeon, and document.
Option B has the nurse explaining the procedure, which exceeds the nurse's legal role in obtaining consent.
Option C minimizes the client's concern with reassurance that does not answer the question. Option D dismisses
the client's right to be informed and violates the principles of consent.
NUR 2392 - Multidimensional Care II | Exam 1 | 2026/2027 Page 1
,EXAM 1 - NUR2392 (LATEST 2026/2027) : MULTIDIMENSIONAL CARE II / MDC 2 - RASMUSSEN
Q3: The nurse is teaching a preoperative client how to use an incentive spirometer to prevent postoperative
pulmonary complications. Which client statement indicates correct understanding of the technique?
A. I will blow into the device as forcefully as I can for 10 seconds
B. I will use the device once every 4 hours while I am awake
C. I will exhale into the device to make the indicator rise
D. I will inhale slowly and deeply through the mouthpiece and hold my breath for 3 to 5 seconds
*[CORRECT]*
Correct Answer: D
Rationale: Correct incentive spirometry requires a slow, sustained maximal inhalation, a 3 to 5 second breath
hold to promote alveolar expansion, and full exhalation, repeated about 10 times per hour while awake, per NUR
2392 postoperative pulmonary care standards. Blowing out forcefully describes peak flow technique, not
spirometry, and does not inflate alveoli. Once every 4 hours is far too infrequent to prevent atelectasis. Exhaling
into the device moves the indicator in the wrong direction and defeats the purpose of the device.
Q4: During the preoperative interview, the nurse asks a client scheduled for a total knee arthroplasty about the
use of over-the-counter products and supplements. Which finding is the priority to report to the surgeon and
anesthesia provider?
A. Walks 30 minutes three times each week
B. Uses ginkgo biloba daily for memory enhancement *[CORRECT]*
C. Drinks one cup of coffee every morning
D. Had chickenpox during childhood
Correct Answer: B
Rationale: Ginkgo biloba inhibits platelet aggregation and increases the risk of perioperative bleeding and
interaction with anesthetic agents, so per NUR 2392 medication reconciliation standards and evidence-based
perioperative guidelines it must be reported and typically held before surgery. Regular walking is a protective
factor that lowers surgical risk. One cup of coffee is a minor caffeine intake that is addressed with NPO
instructions only. Remote childhood chickenpox has no bearing on this procedure.
Q5: A client is admitted to the post-anesthesia care unit after a hernia repair performed under spinal anesthesia.
Which assessment finding requires immediate nursing intervention?
A. Blood pressure of 88/50 mm Hg *[CORRECT]*
B. Inability to move the lower extremities
C. Tingling in the feet as sensation begins to return
D. A dull headache that worsens when sitting upright
Correct Answer: A
Rationale: Hypotension is the most common and dangerous complication of spinal anesthesia because
sympathetic blockade causes vasodilation below the level of the block; per NUR 2392 intraoperative and
recovery standards it is treated promptly with IV fluids, vasopressors, and oxygen to protect perfusion. Motor
blockade and returning paresthesia are expected until the anesthetic wears off and require ongoing monitoring.
A post-dural puncture headache is reported and managed conservatively but is not the immediate hemodynamic
threat that hypotension represents.
NUR 2392 - Multidimensional Care II | Exam 1 | 2026/2027 Page 2
,EXAM 1 - NUR2392 (LATEST 2026/2027) : MULTIDIMENSIONAL CARE II / MDC 2 - RASMUSSEN
Q6: A postoperative client is transferred to the surgical unit from the post-anesthesia care unit. Which
assessment should the nurse perform first?
A. The surgical dressing for drainage and approximation
B. Respiratory rate, depth, and oxygen saturation *[CORRECT]*
C. Pain intensity using a numeric rating scale
D. Urinary output from the indwelling catheter
Correct Answer: B
Rationale: The ABC framework in the NCLEX-RN test plan and the NUR 2392 prioritization model place
airway and breathing above all other assessments, and depressed ventilation from residual anesthesia and opioids
is the leading early postoperative threat. Dressing assessment follows airway and circulation along with vital
signs. Pain and urinary output are important comfort and elimination assessments that come after life-sustaining
functions are confirmed.
Q7: During a general anesthetic, the anesthesia provider notes a sudden rise in end-tidal carbon dioxide,
tachycardia, masseter rigidity, and a body temperature climbing to 39.1 degrees C (102.4 degrees F). Which
intervention is the priority?
A. Apply a cooling blanket and begin iced saline lavage
B. Obtain a blood sample for arterial blood gas analysis
C. Discontinue the volatile inhalation anesthetic agent *[CORRECT]*
D. Insert an indwelling urinary catheter to monitor output
Correct Answer: C
Rationale: These findings signal malignant hyperthermia, and the first step per MHAUS consensus guidelines
and the NUR 2392 intraoperative emergency protocol is to stop the triggering volatile agent and call for help,
followed immediately by dantrolene administration and 100 percent oxygen at high flow. Cooling measures are
started after the triggering agent is discontinued and dantrolene is being prepared. Blood gases and monitoring
interventions support management but delaying cessation of the trigger allows the crisis to progress.
Q8: Four hours after an abdominal surgery, the nurse finds the client's dressing saturated with bright red
drainage. The heart rate is 118 beats/min and blood pressure has fallen from 122/76 to 92/58 mm Hg. Which
action should the nurse take first?
A. Reinforce the dressing, take vital signs every 10 to 15 minutes, and notify the surgeon *[CORRECT]*
B. Remove the dressing to fully expose the incision and apply direct pressure to the wound
C. Elevate the head of the bed to 45 degrees and increase the IV fluid rate
D. Document the findings and reassess at the next scheduled vital sign check
Correct Answer: A
Rationale: Tachycardia with falling blood pressure and saturated bright red drainage indicates hemorrhage and
hypovolemia; per NUR 2392 postoperative complication standards the nurse reinforces the dressing, obtains
frequent vital signs, notifies the surgeon, and prepares to support volume. Removing a surgical dressing disrupts
clot formation and is avoided initially. Raising the head of the bed worsens hypotension by decreasing venous
return. Waiting for the next scheduled check delays recognition of a life-threatening emergency.
NUR 2392 - Multidimensional Care II | Exam 1 | 2026/2027 Page 3
, EXAM 1 - NUR2392 (LATEST 2026/2027) : MULTIDIMENSIONAL CARE II / MDC 2 - RASMUSSEN
Q9: On the first postoperative day, a client has a temperature of 37.9 degrees C (100.2 degrees F), shallow
respirations, and decreased breath sounds at both lung bases. Which nursing intervention is the priority for this
client?
A. Request a prescription for an antipyretic medication
B. Encourage the client to increase intake of clear fluids
C. Provide a pillow to splint the incision during coughing
D. Coach the client to use the incentive spirometer 10 times per hour while awake *[CORRECT]*
Correct Answer: D
Rationale: A low-grade fever within 24 to 48 hours with shallow breathing and diminished basal breath points
to atelectasis, the most common early postoperative pulmonary complication; per NUR 2392 standards
aggressive incentive spirometry, deep breathing, and early ambulation reopen collapsed alveoli. Antipyretics
mask the fever without treating the underlying alveolar collapse. Oral fluids are appropriate once bowel function
returns but do not expand the lungs. Splinting supports a productive cough and complements but does not replace
lung expansion exercises.
Q10: On postoperative day 3, a client suddenly becomes dyspneic and reports sharp chest pain worse on
inspiration. The heart rate is 122 beats/min and the SpO2 is 86 percent on room air. Which action should the
nurse take first?
A. Begin chest physiotherapy and encourage vigorous coughing
B. Position the client upright and apply supplemental oxygen *[CORRECT]*
C. Obtain a 12-lead ECG and administer a PRN nitroglycerin tablet
D. Contact the surgeon to request additional IV fluid orders
Correct Answer: B
Rationale: Sudden dyspnea, pleuritic pain, tachycardia, and hypoxemia in a postoperative client are classic for
pulmonary embolism; per NCLEX-RN prioritization and NUR 2392 emergency standards the immediate actions
support oxygenation by positioning upright and applying oxygen, followed by rapid notification of the provider
for diagnostics. Chest physiotherapy is useless for embolic obstruction and may worsen distress. Nitroglycerin
treats ischemic cardiac pain, not embolic pleuritic pain. Additional fluids provide no benefit and could worsen
gas exchange if heart strain is present.
NUR 2392 - Multidimensional Care II | Exam 1 | 2026/2027 Page 4
MULTIDIMENSIONAL CARE II / MDC 2 - RASMUSSEN
Total: 120 Questions | Multiple Choice (A-D) | Aligned with the NCLEX-RN Test Plan and QSEN Competencies | Answer
Key and Rationales Included
Section 1: Perioperative Nursing
Q1: The nurse is completing the preoperative assessment of a 47-year-old client scheduled for an elective
laparoscopic cholecystectomy this morning. Which finding requires immediate notification of the surgeon
before the client goes to the operating room?
A. Reports feeling anxious about the surgical outcome
B. Blood pressure of 138/88 mm Hg
C. Episodes of chest pain and shortness of breath two days ago *[CORRECT]*
D. States that the last solid meal was eaten 8 hours ago
Correct Answer: C
Rationale: Recent chest pain and dyspnea suggest an unresolved cardiac risk, and per NUR 2392 preoperative
standards and NCLEX-RN Reduction of Risk Potential content, any new cardiopulmonary symptom must be
reported so the surgeon can evaluate whether surgery should proceed or be postponed. Anxiety is an expected
emotional response addressed with support and preoperative teaching. A mildly elevated blood pressure is
monitored rather than canceling surgery. Compliance with NPO status for 8 hours is appropriate and requires no
action.
Q2: A client signs the consent form for an abdominal hysterectomy and then asks the nurse, 'What exactly will
they do during the surgery?' Which response by the nurse is most appropriate?
A. I will contact your surgeon so the procedure and its risks can be explained to you again *[CORRECT]*
B. It is the removal of your uterus through an incision in your lower abdomen
C. Most clients recover from this type of surgery within two weeks without any problems
D. You have already signed the consent form, so the procedure can proceed as scheduled
Correct Answer: A
Rationale: Under informed consent standards in the NUR 2392 curriculum and NCLEX-RN Management of
Care, it is the surgeon's responsibility to explain the procedure, risks, and alternatives; if the client demonstrates
lack of understanding, the nurse must withhold signature confirmation, notify the surgeon, and document.
Option B has the nurse explaining the procedure, which exceeds the nurse's legal role in obtaining consent.
Option C minimizes the client's concern with reassurance that does not answer the question. Option D dismisses
the client's right to be informed and violates the principles of consent.
NUR 2392 - Multidimensional Care II | Exam 1 | 2026/2027 Page 1
,EXAM 1 - NUR2392 (LATEST 2026/2027) : MULTIDIMENSIONAL CARE II / MDC 2 - RASMUSSEN
Q3: The nurse is teaching a preoperative client how to use an incentive spirometer to prevent postoperative
pulmonary complications. Which client statement indicates correct understanding of the technique?
A. I will blow into the device as forcefully as I can for 10 seconds
B. I will use the device once every 4 hours while I am awake
C. I will exhale into the device to make the indicator rise
D. I will inhale slowly and deeply through the mouthpiece and hold my breath for 3 to 5 seconds
*[CORRECT]*
Correct Answer: D
Rationale: Correct incentive spirometry requires a slow, sustained maximal inhalation, a 3 to 5 second breath
hold to promote alveolar expansion, and full exhalation, repeated about 10 times per hour while awake, per NUR
2392 postoperative pulmonary care standards. Blowing out forcefully describes peak flow technique, not
spirometry, and does not inflate alveoli. Once every 4 hours is far too infrequent to prevent atelectasis. Exhaling
into the device moves the indicator in the wrong direction and defeats the purpose of the device.
Q4: During the preoperative interview, the nurse asks a client scheduled for a total knee arthroplasty about the
use of over-the-counter products and supplements. Which finding is the priority to report to the surgeon and
anesthesia provider?
A. Walks 30 minutes three times each week
B. Uses ginkgo biloba daily for memory enhancement *[CORRECT]*
C. Drinks one cup of coffee every morning
D. Had chickenpox during childhood
Correct Answer: B
Rationale: Ginkgo biloba inhibits platelet aggregation and increases the risk of perioperative bleeding and
interaction with anesthetic agents, so per NUR 2392 medication reconciliation standards and evidence-based
perioperative guidelines it must be reported and typically held before surgery. Regular walking is a protective
factor that lowers surgical risk. One cup of coffee is a minor caffeine intake that is addressed with NPO
instructions only. Remote childhood chickenpox has no bearing on this procedure.
Q5: A client is admitted to the post-anesthesia care unit after a hernia repair performed under spinal anesthesia.
Which assessment finding requires immediate nursing intervention?
A. Blood pressure of 88/50 mm Hg *[CORRECT]*
B. Inability to move the lower extremities
C. Tingling in the feet as sensation begins to return
D. A dull headache that worsens when sitting upright
Correct Answer: A
Rationale: Hypotension is the most common and dangerous complication of spinal anesthesia because
sympathetic blockade causes vasodilation below the level of the block; per NUR 2392 intraoperative and
recovery standards it is treated promptly with IV fluids, vasopressors, and oxygen to protect perfusion. Motor
blockade and returning paresthesia are expected until the anesthetic wears off and require ongoing monitoring.
A post-dural puncture headache is reported and managed conservatively but is not the immediate hemodynamic
threat that hypotension represents.
NUR 2392 - Multidimensional Care II | Exam 1 | 2026/2027 Page 2
,EXAM 1 - NUR2392 (LATEST 2026/2027) : MULTIDIMENSIONAL CARE II / MDC 2 - RASMUSSEN
Q6: A postoperative client is transferred to the surgical unit from the post-anesthesia care unit. Which
assessment should the nurse perform first?
A. The surgical dressing for drainage and approximation
B. Respiratory rate, depth, and oxygen saturation *[CORRECT]*
C. Pain intensity using a numeric rating scale
D. Urinary output from the indwelling catheter
Correct Answer: B
Rationale: The ABC framework in the NCLEX-RN test plan and the NUR 2392 prioritization model place
airway and breathing above all other assessments, and depressed ventilation from residual anesthesia and opioids
is the leading early postoperative threat. Dressing assessment follows airway and circulation along with vital
signs. Pain and urinary output are important comfort and elimination assessments that come after life-sustaining
functions are confirmed.
Q7: During a general anesthetic, the anesthesia provider notes a sudden rise in end-tidal carbon dioxide,
tachycardia, masseter rigidity, and a body temperature climbing to 39.1 degrees C (102.4 degrees F). Which
intervention is the priority?
A. Apply a cooling blanket and begin iced saline lavage
B. Obtain a blood sample for arterial blood gas analysis
C. Discontinue the volatile inhalation anesthetic agent *[CORRECT]*
D. Insert an indwelling urinary catheter to monitor output
Correct Answer: C
Rationale: These findings signal malignant hyperthermia, and the first step per MHAUS consensus guidelines
and the NUR 2392 intraoperative emergency protocol is to stop the triggering volatile agent and call for help,
followed immediately by dantrolene administration and 100 percent oxygen at high flow. Cooling measures are
started after the triggering agent is discontinued and dantrolene is being prepared. Blood gases and monitoring
interventions support management but delaying cessation of the trigger allows the crisis to progress.
Q8: Four hours after an abdominal surgery, the nurse finds the client's dressing saturated with bright red
drainage. The heart rate is 118 beats/min and blood pressure has fallen from 122/76 to 92/58 mm Hg. Which
action should the nurse take first?
A. Reinforce the dressing, take vital signs every 10 to 15 minutes, and notify the surgeon *[CORRECT]*
B. Remove the dressing to fully expose the incision and apply direct pressure to the wound
C. Elevate the head of the bed to 45 degrees and increase the IV fluid rate
D. Document the findings and reassess at the next scheduled vital sign check
Correct Answer: A
Rationale: Tachycardia with falling blood pressure and saturated bright red drainage indicates hemorrhage and
hypovolemia; per NUR 2392 postoperative complication standards the nurse reinforces the dressing, obtains
frequent vital signs, notifies the surgeon, and prepares to support volume. Removing a surgical dressing disrupts
clot formation and is avoided initially. Raising the head of the bed worsens hypotension by decreasing venous
return. Waiting for the next scheduled check delays recognition of a life-threatening emergency.
NUR 2392 - Multidimensional Care II | Exam 1 | 2026/2027 Page 3
, EXAM 1 - NUR2392 (LATEST 2026/2027) : MULTIDIMENSIONAL CARE II / MDC 2 - RASMUSSEN
Q9: On the first postoperative day, a client has a temperature of 37.9 degrees C (100.2 degrees F), shallow
respirations, and decreased breath sounds at both lung bases. Which nursing intervention is the priority for this
client?
A. Request a prescription for an antipyretic medication
B. Encourage the client to increase intake of clear fluids
C. Provide a pillow to splint the incision during coughing
D. Coach the client to use the incentive spirometer 10 times per hour while awake *[CORRECT]*
Correct Answer: D
Rationale: A low-grade fever within 24 to 48 hours with shallow breathing and diminished basal breath points
to atelectasis, the most common early postoperative pulmonary complication; per NUR 2392 standards
aggressive incentive spirometry, deep breathing, and early ambulation reopen collapsed alveoli. Antipyretics
mask the fever without treating the underlying alveolar collapse. Oral fluids are appropriate once bowel function
returns but do not expand the lungs. Splinting supports a productive cough and complements but does not replace
lung expansion exercises.
Q10: On postoperative day 3, a client suddenly becomes dyspneic and reports sharp chest pain worse on
inspiration. The heart rate is 122 beats/min and the SpO2 is 86 percent on room air. Which action should the
nurse take first?
A. Begin chest physiotherapy and encourage vigorous coughing
B. Position the client upright and apply supplemental oxygen *[CORRECT]*
C. Obtain a 12-lead ECG and administer a PRN nitroglycerin tablet
D. Contact the surgeon to request additional IV fluid orders
Correct Answer: B
Rationale: Sudden dyspnea, pleuritic pain, tachycardia, and hypoxemia in a postoperative client are classic for
pulmonary embolism; per NCLEX-RN prioritization and NUR 2392 emergency standards the immediate actions
support oxygenation by positioning upright and applying oxygen, followed by rapid notification of the provider
for diagnostics. Chest physiotherapy is useless for embolic obstruction and may worsen distress. Nitroglycerin
treats ischemic cardiac pain, not embolic pleuritic pain. Additional fluids provide no benefit and could worsen
gas exchange if heart strain is present.
NUR 2392 - Multidimensional Care II | Exam 1 | 2026/2027 Page 4
