Page 1 of 81
MDC II (NUR 2392) MULTIDIMENSIONAL CARE IIEXAM
WITH VERIFIED ANSWERS DETAILED RATIONALES
GRADED A+
MDC II (NUR 2392) Multidimensional Care II
Section 1: Perioperative Nursing & Pain Management (Questions 1–30)
1. A nurse is reviewing a patient's preoperative laboratory results and notes a potassium level
of 3.1 mEq/L. What is the nurse's priority action before proceeding with surgery?
A. Document the finding as a normal preoperative value
B. Notify the surgeon and anesthesia provider of the abnormal result
C. Encourage the patient to eat potassium-rich foods before surgery
D. Proceed with surgery as scheduled since the value is only slightly low
Rationale: B. A potassium level of 3.1 mEq/L is below the normal range of 3.5 to 5.0 mEq/L.
Hypokalemia can predispose the patient to cardiac dysrhythmias during anesthesia and
surgery. The nurse must notify the provider before proceeding.
2. A patient scheduled for surgery tells the nurse, "I don't want to be put to sleep. I'm afraid I
won't wake up." Which nursing response is most appropriate?
A. "Everyone feels that way before surgery. You'll be fine."
B. "Tell me more about your fears regarding anesthesia."
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C. "You shouldn't worry. The anesthesiologist is very experienced."
D. "You can refuse anesthesia, but the surgery will be cancelled."
Rationale: B. This response uses therapeutic communication by acknowledging the patient's
fear and inviting further discussion. The nurse should explore the patient's concerns before
providing education or reassurance.
3. A nurse is preparing a patient for surgery and verifies that the patient has signed the
informed consent form. Which statement by the patient indicates that the consent may not
be valid?
A. "My surgeon explained the procedure and the risks."
B. "I understand I might need a blood transfusion."
C. "I don't remember what the doctor said about the risks."
D. "I have asked all my questions and feel ready."
Rationale: C. For informed consent to be valid, the patient must understand the procedure, its
risks, benefits, and alternatives. If the patient does not remember the discussion about risks,
the consent may not be truly informed.
4. A postoperative patient is being transferred to the PACU. Which assessment finding
requires immediate intervention by the nurse?
A. Blood pressure of 118/72 mmHg
B. Heart rate of 88 beats per minute
C. Respiratory rate of 8 breaths per minute
D. Temperature of 37.2°C (99.0°F)
Rationale: C. A respiratory rate of 8 breaths per minute indicates respiratory depression,
which is a common complication of anesthesia and opioid medications. This requires
immediate intervention, including stimulation and possible reversal agents.
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5. A nurse is assessing a patient who had abdominal surgery 24 hours ago. The patient reports
pain at an 8 out of 10 and has not used the incentive spirometer. What is the nurse's priority
intervention?
A. Administer prescribed pain medication and encourage use of the incentive spirometer
B. Document the patient's refusal to use the incentive spirometer
C. Increase the frequency of vital sign monitoring
D. Notify the surgeon that the patient is not cooperating with care
Rationale: A. Pain is a barrier to deep breathing and mobilization, which increases the risk of
postoperative complications such as atelectasis and pneumonia. Effective pain management
should be provided first to enable the patient to participate in pulmonary hygiene.
6. A patient is scheduled for surgery and asks the nurse why they must be NPO after midnight.
What is the nurse's best response?
A. "It's hospital policy and we must follow it."
B. "An empty stomach reduces the risk of vomiting and aspiration during anesthesia."
C. "You won't feel hungry during the surgery anyway."
D. "It helps the surgeon see your organs more clearly."
Rationale: B. The primary purpose of NPO status before surgery is to reduce the volume and
acidity of gastric contents, decreasing the risk of aspiration during induction of anesthesia.
7. A nurse is caring for a patient who is 2 days postoperative following a hip replacement. The
patient suddenly reports shortness of breath and chest pain. What is the nurse's priority
action?
A. Administer prescribed pain medication
B. Encourage the patient to cough and deep breathe
C. Notify the provider immediately and prepare for emergency evaluation
D. Assist the patient to ambulate to relieve the discomfort
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Rationale: C. Sudden shortness of breath and chest pain in a postoperative patient is
concerning for pulmonary embolism, which is a life-threatening emergency. Immediate
notification and evaluation are required.
8. A nurse is teaching a patient about patient-controlled analgesia (PCA). Which statement by
the patient indicates correct understanding?
A. "I can push the button as often as I want for pain relief."
B. "My family can push the button for me if I am sleeping."
C. "The machine has a limit to prevent me from getting too much medication."
D. "I should wait until my pain is a 10 before using the PCA."
Rationale: C. PCA pumps have programmed limits (dose and lockout intervals) to prevent
overdose. The patient should be the only one to push the button, and the PCA is most
effective when used before pain becomes severe.
9. A nurse is assessing a surgical wound and notes that the edges are well approximated, with
slight redness and minimal serosanguineous drainage. How should the nurse document this
finding?
A. Wound infection
B. Normal wound healing
C. Wound dehiscence
D. Hematoma formation
Rationale: B. Well-approximated edges, slight redness, and minimal serosanguineous drainage
are normal findings in the early stages of wound healing.
10. A patient is recovering from surgery and has a Jackson-Pratt (JP) drain in place. The nurse
notes that the drain bulb is fully expanded. What action should the nurse take?
A. Document the finding as normal
B. Compress the bulb to re-establish suction
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MDC II (NUR 2392) MULTIDIMENSIONAL CARE IIEXAM
WITH VERIFIED ANSWERS DETAILED RATIONALES
GRADED A+
MDC II (NUR 2392) Multidimensional Care II
Section 1: Perioperative Nursing & Pain Management (Questions 1–30)
1. A nurse is reviewing a patient's preoperative laboratory results and notes a potassium level
of 3.1 mEq/L. What is the nurse's priority action before proceeding with surgery?
A. Document the finding as a normal preoperative value
B. Notify the surgeon and anesthesia provider of the abnormal result
C. Encourage the patient to eat potassium-rich foods before surgery
D. Proceed with surgery as scheduled since the value is only slightly low
Rationale: B. A potassium level of 3.1 mEq/L is below the normal range of 3.5 to 5.0 mEq/L.
Hypokalemia can predispose the patient to cardiac dysrhythmias during anesthesia and
surgery. The nurse must notify the provider before proceeding.
2. A patient scheduled for surgery tells the nurse, "I don't want to be put to sleep. I'm afraid I
won't wake up." Which nursing response is most appropriate?
A. "Everyone feels that way before surgery. You'll be fine."
B. "Tell me more about your fears regarding anesthesia."
1|Page
,Page 2 of 81
C. "You shouldn't worry. The anesthesiologist is very experienced."
D. "You can refuse anesthesia, but the surgery will be cancelled."
Rationale: B. This response uses therapeutic communication by acknowledging the patient's
fear and inviting further discussion. The nurse should explore the patient's concerns before
providing education or reassurance.
3. A nurse is preparing a patient for surgery and verifies that the patient has signed the
informed consent form. Which statement by the patient indicates that the consent may not
be valid?
A. "My surgeon explained the procedure and the risks."
B. "I understand I might need a blood transfusion."
C. "I don't remember what the doctor said about the risks."
D. "I have asked all my questions and feel ready."
Rationale: C. For informed consent to be valid, the patient must understand the procedure, its
risks, benefits, and alternatives. If the patient does not remember the discussion about risks,
the consent may not be truly informed.
4. A postoperative patient is being transferred to the PACU. Which assessment finding
requires immediate intervention by the nurse?
A. Blood pressure of 118/72 mmHg
B. Heart rate of 88 beats per minute
C. Respiratory rate of 8 breaths per minute
D. Temperature of 37.2°C (99.0°F)
Rationale: C. A respiratory rate of 8 breaths per minute indicates respiratory depression,
which is a common complication of anesthesia and opioid medications. This requires
immediate intervention, including stimulation and possible reversal agents.
2|Page
,Page 3 of 81
5. A nurse is assessing a patient who had abdominal surgery 24 hours ago. The patient reports
pain at an 8 out of 10 and has not used the incentive spirometer. What is the nurse's priority
intervention?
A. Administer prescribed pain medication and encourage use of the incentive spirometer
B. Document the patient's refusal to use the incentive spirometer
C. Increase the frequency of vital sign monitoring
D. Notify the surgeon that the patient is not cooperating with care
Rationale: A. Pain is a barrier to deep breathing and mobilization, which increases the risk of
postoperative complications such as atelectasis and pneumonia. Effective pain management
should be provided first to enable the patient to participate in pulmonary hygiene.
6. A patient is scheduled for surgery and asks the nurse why they must be NPO after midnight.
What is the nurse's best response?
A. "It's hospital policy and we must follow it."
B. "An empty stomach reduces the risk of vomiting and aspiration during anesthesia."
C. "You won't feel hungry during the surgery anyway."
D. "It helps the surgeon see your organs more clearly."
Rationale: B. The primary purpose of NPO status before surgery is to reduce the volume and
acidity of gastric contents, decreasing the risk of aspiration during induction of anesthesia.
7. A nurse is caring for a patient who is 2 days postoperative following a hip replacement. The
patient suddenly reports shortness of breath and chest pain. What is the nurse's priority
action?
A. Administer prescribed pain medication
B. Encourage the patient to cough and deep breathe
C. Notify the provider immediately and prepare for emergency evaluation
D. Assist the patient to ambulate to relieve the discomfort
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, Page 4 of 81
Rationale: C. Sudden shortness of breath and chest pain in a postoperative patient is
concerning for pulmonary embolism, which is a life-threatening emergency. Immediate
notification and evaluation are required.
8. A nurse is teaching a patient about patient-controlled analgesia (PCA). Which statement by
the patient indicates correct understanding?
A. "I can push the button as often as I want for pain relief."
B. "My family can push the button for me if I am sleeping."
C. "The machine has a limit to prevent me from getting too much medication."
D. "I should wait until my pain is a 10 before using the PCA."
Rationale: C. PCA pumps have programmed limits (dose and lockout intervals) to prevent
overdose. The patient should be the only one to push the button, and the PCA is most
effective when used before pain becomes severe.
9. A nurse is assessing a surgical wound and notes that the edges are well approximated, with
slight redness and minimal serosanguineous drainage. How should the nurse document this
finding?
A. Wound infection
B. Normal wound healing
C. Wound dehiscence
D. Hematoma formation
Rationale: B. Well-approximated edges, slight redness, and minimal serosanguineous drainage
are normal findings in the early stages of wound healing.
10. A patient is recovering from surgery and has a Jackson-Pratt (JP) drain in place. The nurse
notes that the drain bulb is fully expanded. What action should the nurse take?
A. Document the finding as normal
B. Compress the bulb to re-establish suction
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