NUR 2502 Exam 2026/2027 | Rasmussen University NUR 2502 Multidimensional Care
III (MDC 3) Study Guide & Exam Prep | NUR 2502 Exam 1, Exam 2, Exam 3 & Final Exam
Practice Questions | Medical-Surgical Nursing, Clinical Judgment, Patient
Assessment, Priority Nursing Interventions, Cardiovascular Disorders, Heart Failure,
Valvular Heart Disease, Pulmonary Disorders, Chronic Respiratory Conditions, Renal
& Urinary Disorders, Acute Kidney Injury, Diabetes & Endocrine Disorders,
Reproductive & Sexual Health, Infectious Diseases, Syphilis, Medication
Administration, Patient Safety, Nursing Interventions, Patient Education & Evidence-
Based Care | Practice Questions with Detailed Rationales
Question 1: A nurse is caring for a client with acute decompensated heart failure
who has gained 2 kg over the past 24 hours. Which assessment finding requires
immediate intervention?
A. Bibasilar crackles extending to mid-lung fields
B. Blood pressure of 108/68 mmHg
C. Heart rate of 92 beats per minute
D. Peripheral edema rated 1+ bilaterally
E. Respiratory rate of 20 breaths per minute
CORRECT ANSWER: A. Bibasilar crackles extending to mid-lung fields
Rationale: Crackles extending beyond the lung bases indicate worsening
pulmonary congestion and impending pulmonary edema, which is a life-
threatening complication of heart failure. The other findings, while relevant to
heart failure assessment, do not indicate immediate decompensation requiring
urgent intervention.
Question 2: A client with a newly created ileostomy is being taught about
dietary modifications. Which statement by the client indicates correct
understanding?
A. "I should avoid high-fiber foods to prevent blockage."
B. "I need to chew my food thoroughly and eat slowly."
C. "I should drink only small amounts of fluid with meals."
D. "I can eat whatever I want without restrictions."
E. "I should increase my intake of raw vegetables."
CORRECT ANSWER: B. "I need to chew my food thoroughly and eat slowly."
,Rationale: Clients with ileostomies must chew food thoroughly and eat slowly to
prevent obstruction, as the stoma lacks the large intestine's ability to absorb
water and process roughage. High-fiber foods are actually recommended in
moderation, and adequate fluid intake (8-10 glasses daily) is essential.
Question 3: A nurse is assessing a client with increased intracranial pressure.
Which set of vital signs is most concerning?
A. Blood pressure 160/60 mmHg, heart rate 52, respirations 12
B. Blood pressure 110/70 mmHg, heart rate 88, respirations 18
C. Blood pressure 130/80 mmHg, heart rate 72, respirations 16
D. Blood pressure 100/60 mmHg, heart rate 100, respirations 22
E. Blood pressure 140/90 mmHg, heart rate 78, respirations 14
CORRECT ANSWER: A. Blood pressure 160/60 mmHg, heart rate 52, respirations
12
Rationale: This presentation reflects Cushing's triad (hypertension with widened
pulse pressure, bradycardia, and bradypnea), which is a late sign of increased
intracranial pressure indicating brainstem compression and impending herniation.
Question 4: A client with chronic kidney disease has a serum potassium level of
6.8 mEq/L. Which intervention should the nurse anticipate as the priority?
A. Administer sodium polystyrene sulfonate orally
B. Prepare for emergency hemodialysis
C. Restrict dietary potassium intake
D. Administer regular insulin with dextrose IV
E. Obtain a repeat serum potassium level
CORRECT ANSWER: D. Administer regular insulin with dextrose IV
Rationale: Regular insulin with dextrose is the most rapid pharmacologic
intervention to shift potassium intracellularly in severe hyperkalemia. Calcium
gluconate should also be considered for cardiac protection. Dialysis is definitive
but requires more time to initiate.
Question 5: A nurse is caring for a client with diabetic ketoacidosis. Which
finding indicates the client is improving?
,A. Serum glucose decreasing from 480 to 420 mg/dL
B. pH increasing from 7.18 to 7.12
C. Potassium decreasing from 5.8 to 3.2 mEq/L
D. Respiratory rate increasing from 28 to 36
E. Urine ketones increasing from moderate to large
CORRECT ANSWER: A. Serum glucose decreasing from 480 to 420 mg/dL
Rationale: A gradual decrease in serum glucose indicates the insulin infusion is
effective and DKA is resolving. The other findings indicate worsening acidosis,
dangerous hypokalemia, worsening respiratory compensation, or persistent
ketosis.
Question 6: A client is admitted with an acute exacerbation of chronic
obstructive pulmonary disease. Which oxygen delivery method is most
appropriate initially?
A. Nasal cannula at 6 L/min
B. Simple face mask at 8 L/min
C. Venturi mask at 28%
D. Non-rebreather mask at 10 L/min
E. Partial rebreather mask at 10 L/min
CORRECT ANSWER: C. Venturi mask at 28%
Rationale: Venturi masks deliver precise, controlled oxygen concentrations, which
is critical in COPD to avoid suppressing the hypoxic drive. Low-flow oxygen at
higher concentrations can lead to CO2 retention and respiratory failure.
Question 7: A client is receiving heparin IV infusion for venous
thromboembolism. Which laboratory value requires immediate action?
A. INR of 2.5
B. aPTT of 35 seconds
C. Platelet count of 185,000/mm³
D. Hemoglobin of 12 g/dL
E. Fibrinogen of 400 mg/dL
CORRECT ANSWER: B. aPTT of 35 seconds
, Rationale: The therapeutic aPTT range for heparin therapy is typically 1.5 to 2.5
times the control value (approximately 45-70 seconds). An aPTT of 35 seconds is
subtherapeutic, and the client remains at risk for clot extension.
Question 8: A client with cirrhosis develops ascites. Which intervention is the
priority?
A. Administer furosemide as ordered
B. Restrict fluid intake to 1,000 mL/day
C. Prepare for therapeutic paracentesis
D. Weigh the client daily
E. Position the client in high Fowler's
CORRECT ANSWER: D. Weigh the client daily
Rationale: Daily weights are the most accurate indicator of fluid status and guide
diuretic therapy in ascites management. While other interventions are relevant,
obtaining an accurate baseline weight is the initial priority for ongoing
assessment.
Question 9: A client with acute pancreatitis is experiencing severe abdominal
pain. Which position should the nurse encourage?
A. Supine with legs extended
B. Prone position
C. Side-lying with knees flexed to chest
D. High Fowler's position
E. Trendelenburg position
CORRECT ANSWER: C. Side-lying with knees flexed to chest
Rationale: The fetal position (side-lying with knees to chest) reduces tension on
the abdominal muscles and decreases pain in pancreatitis by minimizing
stretching of the inflamed pancreas.
Question 10: A nurse is assessing a client with a suspected stroke. Which finding
indicates the need for immediate CT scan before thrombolytic therapy?
A. Sudden onset of hemiparesis
B. Blood glucose of 180 mg/dL
III (MDC 3) Study Guide & Exam Prep | NUR 2502 Exam 1, Exam 2, Exam 3 & Final Exam
Practice Questions | Medical-Surgical Nursing, Clinical Judgment, Patient
Assessment, Priority Nursing Interventions, Cardiovascular Disorders, Heart Failure,
Valvular Heart Disease, Pulmonary Disorders, Chronic Respiratory Conditions, Renal
& Urinary Disorders, Acute Kidney Injury, Diabetes & Endocrine Disorders,
Reproductive & Sexual Health, Infectious Diseases, Syphilis, Medication
Administration, Patient Safety, Nursing Interventions, Patient Education & Evidence-
Based Care | Practice Questions with Detailed Rationales
Question 1: A nurse is caring for a client with acute decompensated heart failure
who has gained 2 kg over the past 24 hours. Which assessment finding requires
immediate intervention?
A. Bibasilar crackles extending to mid-lung fields
B. Blood pressure of 108/68 mmHg
C. Heart rate of 92 beats per minute
D. Peripheral edema rated 1+ bilaterally
E. Respiratory rate of 20 breaths per minute
CORRECT ANSWER: A. Bibasilar crackles extending to mid-lung fields
Rationale: Crackles extending beyond the lung bases indicate worsening
pulmonary congestion and impending pulmonary edema, which is a life-
threatening complication of heart failure. The other findings, while relevant to
heart failure assessment, do not indicate immediate decompensation requiring
urgent intervention.
Question 2: A client with a newly created ileostomy is being taught about
dietary modifications. Which statement by the client indicates correct
understanding?
A. "I should avoid high-fiber foods to prevent blockage."
B. "I need to chew my food thoroughly and eat slowly."
C. "I should drink only small amounts of fluid with meals."
D. "I can eat whatever I want without restrictions."
E. "I should increase my intake of raw vegetables."
CORRECT ANSWER: B. "I need to chew my food thoroughly and eat slowly."
,Rationale: Clients with ileostomies must chew food thoroughly and eat slowly to
prevent obstruction, as the stoma lacks the large intestine's ability to absorb
water and process roughage. High-fiber foods are actually recommended in
moderation, and adequate fluid intake (8-10 glasses daily) is essential.
Question 3: A nurse is assessing a client with increased intracranial pressure.
Which set of vital signs is most concerning?
A. Blood pressure 160/60 mmHg, heart rate 52, respirations 12
B. Blood pressure 110/70 mmHg, heart rate 88, respirations 18
C. Blood pressure 130/80 mmHg, heart rate 72, respirations 16
D. Blood pressure 100/60 mmHg, heart rate 100, respirations 22
E. Blood pressure 140/90 mmHg, heart rate 78, respirations 14
CORRECT ANSWER: A. Blood pressure 160/60 mmHg, heart rate 52, respirations
12
Rationale: This presentation reflects Cushing's triad (hypertension with widened
pulse pressure, bradycardia, and bradypnea), which is a late sign of increased
intracranial pressure indicating brainstem compression and impending herniation.
Question 4: A client with chronic kidney disease has a serum potassium level of
6.8 mEq/L. Which intervention should the nurse anticipate as the priority?
A. Administer sodium polystyrene sulfonate orally
B. Prepare for emergency hemodialysis
C. Restrict dietary potassium intake
D. Administer regular insulin with dextrose IV
E. Obtain a repeat serum potassium level
CORRECT ANSWER: D. Administer regular insulin with dextrose IV
Rationale: Regular insulin with dextrose is the most rapid pharmacologic
intervention to shift potassium intracellularly in severe hyperkalemia. Calcium
gluconate should also be considered for cardiac protection. Dialysis is definitive
but requires more time to initiate.
Question 5: A nurse is caring for a client with diabetic ketoacidosis. Which
finding indicates the client is improving?
,A. Serum glucose decreasing from 480 to 420 mg/dL
B. pH increasing from 7.18 to 7.12
C. Potassium decreasing from 5.8 to 3.2 mEq/L
D. Respiratory rate increasing from 28 to 36
E. Urine ketones increasing from moderate to large
CORRECT ANSWER: A. Serum glucose decreasing from 480 to 420 mg/dL
Rationale: A gradual decrease in serum glucose indicates the insulin infusion is
effective and DKA is resolving. The other findings indicate worsening acidosis,
dangerous hypokalemia, worsening respiratory compensation, or persistent
ketosis.
Question 6: A client is admitted with an acute exacerbation of chronic
obstructive pulmonary disease. Which oxygen delivery method is most
appropriate initially?
A. Nasal cannula at 6 L/min
B. Simple face mask at 8 L/min
C. Venturi mask at 28%
D. Non-rebreather mask at 10 L/min
E. Partial rebreather mask at 10 L/min
CORRECT ANSWER: C. Venturi mask at 28%
Rationale: Venturi masks deliver precise, controlled oxygen concentrations, which
is critical in COPD to avoid suppressing the hypoxic drive. Low-flow oxygen at
higher concentrations can lead to CO2 retention and respiratory failure.
Question 7: A client is receiving heparin IV infusion for venous
thromboembolism. Which laboratory value requires immediate action?
A. INR of 2.5
B. aPTT of 35 seconds
C. Platelet count of 185,000/mm³
D. Hemoglobin of 12 g/dL
E. Fibrinogen of 400 mg/dL
CORRECT ANSWER: B. aPTT of 35 seconds
, Rationale: The therapeutic aPTT range for heparin therapy is typically 1.5 to 2.5
times the control value (approximately 45-70 seconds). An aPTT of 35 seconds is
subtherapeutic, and the client remains at risk for clot extension.
Question 8: A client with cirrhosis develops ascites. Which intervention is the
priority?
A. Administer furosemide as ordered
B. Restrict fluid intake to 1,000 mL/day
C. Prepare for therapeutic paracentesis
D. Weigh the client daily
E. Position the client in high Fowler's
CORRECT ANSWER: D. Weigh the client daily
Rationale: Daily weights are the most accurate indicator of fluid status and guide
diuretic therapy in ascites management. While other interventions are relevant,
obtaining an accurate baseline weight is the initial priority for ongoing
assessment.
Question 9: A client with acute pancreatitis is experiencing severe abdominal
pain. Which position should the nurse encourage?
A. Supine with legs extended
B. Prone position
C. Side-lying with knees flexed to chest
D. High Fowler's position
E. Trendelenburg position
CORRECT ANSWER: C. Side-lying with knees flexed to chest
Rationale: The fetal position (side-lying with knees to chest) reduces tension on
the abdominal muscles and decreases pain in pancreatitis by minimizing
stretching of the inflamed pancreas.
Question 10: A nurse is assessing a client with a suspected stroke. Which finding
indicates the need for immediate CT scan before thrombolytic therapy?
A. Sudden onset of hemiparesis
B. Blood glucose of 180 mg/dL
