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NUR2502 Final Exam: Multidimensional
Care III (MDC 3) Questions With Verified
Solutions And Rationales
Section I: Cardiovascular System (Questions 1-20)
1. A client with left-sided heart failure develops increasing dyspnea, bilateral
crackles, and an oxygen saturation of 86%. Which action should the nurse take
first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position and administer prescribed oxygen
C. Obtain the client's daily weight
D. Restrict sodium intake
Correct Answer: B
Rationale: The client is experiencing impaired oxygenation associated with
pulmonary congestion. Positioning upright improves lung expansion, while
prescribed oxygen supports oxygenation. Daily weight and sodium restriction are
important for heart-failure management but are not the immediate priority .
2. Which assessment finding is most consistent with right-sided heart failure?
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A. Pulmonary crackles
B. Pink frothy sputum
C. Peripheral edema and jugular venous distention
D. Severe inspiratory wheezing
Correct Answer: C
Rationale: Right-sided heart failure causes systemic venous congestion, producing
peripheral edema, jugular venous distention, hepatomegaly, and weight gain.
Left-sided failure more commonly produces pulmonary congestion .
3. A client taking digoxin has an apical pulse of 52/min. What should the nurse
do?
A. Administer the medication as scheduled
B. Hold the medication and notify the provider according to protocol
C. Administer an additional dose
D. Encourage increased sodium intake
Correct Answer: B
Rationale: Digoxin can slow the heart rate. Bradycardia is a clinically significant
finding and warrants holding the dose and further evaluation. Digoxin toxicity
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may also produce nausea, vomiting, visual disturbances, confusion, and
dysrhythmias .
4. Which findings may indicate digoxin toxicity?
A. Hypertension and tachycardia
B. Nausea, vomiting, and visual disturbances
C. Polyuria and polydipsia
D. Weight gain and edema
Correct Answer: B
Rationale: Digoxin toxicity can affect gastrointestinal, neurologic, visual, and
cardiac systems. Examples include nausea/vomiting, anorexia, visual disturbances,
confusion, bradycardia, or dysrhythmias .
5. A client with acute pulmonary edema is severely dyspneic and coughing pink,
frothy sputum. Which position is most appropriate?
A. Supine
B. Trendelenburg
C. High-Fowler's
D. Prone
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Correct Answer: C
Rationale: High-Fowler's positioning promotes maximum lung expansion and
decreases venous return to the heart, which can reduce pulmonary congestion .
6. A client presents with chest pain. The 12-lead ECG shows ST-segment elevation
in leads II, III, and aVF. Which type of myocardial infarction is this?
A. Anterior wall MI
B. Inferior wall MI
C. Lateral wall MI
D. Posterior wall MI
Correct Answer: B
Rationale: ST-segment elevation on ECG is the hallmark finding of an ST-elevation
myocardial infarction (STEMI). Leads II, III, and aVF correspond to the inferior wall
of the left ventricle, indicating an inferior wall MI .
7. In the MONA protocol for acute coronary syndrome, which medication is
administered first?
A. Morphine
B. Oxygen
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NUR2502 Final Exam: Multidimensional
Care III (MDC 3) Questions With Verified
Solutions And Rationales
Section I: Cardiovascular System (Questions 1-20)
1. A client with left-sided heart failure develops increasing dyspnea, bilateral
crackles, and an oxygen saturation of 86%. Which action should the nurse take
first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position and administer prescribed oxygen
C. Obtain the client's daily weight
D. Restrict sodium intake
Correct Answer: B
Rationale: The client is experiencing impaired oxygenation associated with
pulmonary congestion. Positioning upright improves lung expansion, while
prescribed oxygen supports oxygenation. Daily weight and sodium restriction are
important for heart-failure management but are not the immediate priority .
2. Which assessment finding is most consistent with right-sided heart failure?
1|Page
,2|Page
A. Pulmonary crackles
B. Pink frothy sputum
C. Peripheral edema and jugular venous distention
D. Severe inspiratory wheezing
Correct Answer: C
Rationale: Right-sided heart failure causes systemic venous congestion, producing
peripheral edema, jugular venous distention, hepatomegaly, and weight gain.
Left-sided failure more commonly produces pulmonary congestion .
3. A client taking digoxin has an apical pulse of 52/min. What should the nurse
do?
A. Administer the medication as scheduled
B. Hold the medication and notify the provider according to protocol
C. Administer an additional dose
D. Encourage increased sodium intake
Correct Answer: B
Rationale: Digoxin can slow the heart rate. Bradycardia is a clinically significant
finding and warrants holding the dose and further evaluation. Digoxin toxicity
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,3|Page
may also produce nausea, vomiting, visual disturbances, confusion, and
dysrhythmias .
4. Which findings may indicate digoxin toxicity?
A. Hypertension and tachycardia
B. Nausea, vomiting, and visual disturbances
C. Polyuria and polydipsia
D. Weight gain and edema
Correct Answer: B
Rationale: Digoxin toxicity can affect gastrointestinal, neurologic, visual, and
cardiac systems. Examples include nausea/vomiting, anorexia, visual disturbances,
confusion, bradycardia, or dysrhythmias .
5. A client with acute pulmonary edema is severely dyspneic and coughing pink,
frothy sputum. Which position is most appropriate?
A. Supine
B. Trendelenburg
C. High-Fowler's
D. Prone
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, 4|Page
Correct Answer: C
Rationale: High-Fowler's positioning promotes maximum lung expansion and
decreases venous return to the heart, which can reduce pulmonary congestion .
6. A client presents with chest pain. The 12-lead ECG shows ST-segment elevation
in leads II, III, and aVF. Which type of myocardial infarction is this?
A. Anterior wall MI
B. Inferior wall MI
C. Lateral wall MI
D. Posterior wall MI
Correct Answer: B
Rationale: ST-segment elevation on ECG is the hallmark finding of an ST-elevation
myocardial infarction (STEMI). Leads II, III, and aVF correspond to the inferior wall
of the left ventricle, indicating an inferior wall MI .
7. In the MONA protocol for acute coronary syndrome, which medication is
administered first?
A. Morphine
B. Oxygen
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