NUR2755 Final Exam – MDC IV Questions and Answers |
Fall 2025/2026 Update | 100% Correct | Rasmussen
University
QUESTION 1:
A patient is admitted with acute decompensated heart failure and pulmonary edema. Which
medication should the nurse anticipate administering first to reduce preload?
A. Lisinopril
B. Furosemide IV
C. Metoprolol
D. Digoxin
CORRECT ANSWER: B
RATIONALE: IV furosemide rapidly promotes diuresis and venodilation, reducing intravascular
volume and pulmonary congestion.
QUESTION 2:
A client with COPD is placed on 3 L/min via nasal cannula. What is the rationale for maintaining
a lower supplemental oxygen level?
A. To prevent oxygen saturation above 98%
B. To avoid suppression of the hypoxic drive to breathe
C. To prevent rebound hypoxemia
D. To decrease risk of pulmonary embolism
CORRECT ANSWER: B
RATIONALE: In clients with chronic CO₂ retention, hypoxia rather than hypercapnia stimulates
respiration. Excess oxygen may suppress their respiratory drive.
QUESTION 3:
A patient with a central venous catheter suddenly develops dyspnea, tachycardia, and chest
pain during tubing change. What is the nurse’s first action?
A. Call the provider immediately.
,B. Place the patient in the left lateral Trendelenburg position.
C. Remove the catheter.
D. Administer high-flow oxygen.
CORRECT ANSWER: B
RATIONALE: This presentation suggests an air embolism. Positioning the patient on the left side
with head down traps air in the right atrium and prevents it from entering pulmonary
circulation.
QUESTION 4:
Which ECG change indicates hyperkalemia?
A. Flattened T waves
B. ST depression
C. Peaked T waves
D. U waves
CORRECT ANSWER: C
RATIONALE: Tall, peaked T waves are the earliest and most characteristic ECG sign of elevated
serum potassium.
QUESTION 5:
A male client with cirrhosis demonstrates confusion and asterixis. Which intervention is most
effective in decreasing ammonia levels?
A. Administer lactulose as prescribed.
B. Restrict all fluids.
C. Encourage a high-protein diet.
D. Administer furosemide.
CORRECT ANSWER: A
RATIONALE: Lactulose lowers serum ammonia by promoting excretion through the stool, thereby
reducing hepatic encephalopathy.
QUESTION 6:
During a transfusion, a patient develops chills, fever, and flank pain 20 minutes after infusion
begins. What is the nurse’s first action?
,A. Continue infusion and notify provider.
B. Stop transfusion immediately.
C. Administer diphenhydramine.
D. Flush the line with normal saline.
CORRECT ANSWER: B
RATIONALE: An acute hemolytic reaction requires the transfusion to be stopped immediately and
blood returned to the lab for analysis.
QUESTION 7:
Which laboratory finding confirms the effectiveness of heparin for deep vein thrombosis
prophylaxis?
A. INR of 2–3
B. aPTT 1.5–2.5 times the control
C. Platelet count increase
D. PT 12 seconds
CORRECT ANSWER: B
RATIONALE: Therapeutic heparin therapy is reflected by an aPTT value approximately 1.5–2.5
times baseline.
QUESTION 8:
In a patient with diabetic ketoacidosis (DKA), which fluid should be administered initially?
A. 0.9% Normal saline
B. D5W
C. 0.45% Normal saline
D. 3% NaCl
CORRECT ANSWER: A
RATIONALE: Isotonic saline restores intravascular volume and perfusion before switching to
hypotonic or dextrose-containing fluids.
QUESTION 9:
A patient recovering from thyroidectomy complains of tingling around the mouth and fingertips.
Which electrolyte imbalance should the nurse suspect?
, A. Hypokalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypermagnesemia
CORRECT ANSWER: B
RATIONALE: Accidental removal of parathyroid tissue leads to low calcium and neuromuscular
irritability (positive Chvostek and Trousseau signs).
QUESTION 10:
Which medication is administered for a patient in supraventricular tachycardia (SVT)
unresponsive to vagal maneuvers?
A. Lidocaine
B. Adenosine
C. Atropine
D. Amiodarone
CORRECT ANSWER: B
RATIONALE: Adenosine transiently blocks AV nodal conduction and is drug of choice for acute
SVT termination.
QUESTION 11:
When preparing to administer potassium chloride (KCl) IV, what safety measure is most
essential?
A. Use a slow IV push over 5 minutes.
B. Dilute in IV fluid and administer via infusion pump.
C. Mix with dextrose-containing solution.
D. Administer without monitoring.
CORRECT ANSWER: B
RATIONALE: IV KCl must be diluted and administered using a controlled rate to avoid cardiac
arrest.
QUESTION 12:
Fall 2025/2026 Update | 100% Correct | Rasmussen
University
QUESTION 1:
A patient is admitted with acute decompensated heart failure and pulmonary edema. Which
medication should the nurse anticipate administering first to reduce preload?
A. Lisinopril
B. Furosemide IV
C. Metoprolol
D. Digoxin
CORRECT ANSWER: B
RATIONALE: IV furosemide rapidly promotes diuresis and venodilation, reducing intravascular
volume and pulmonary congestion.
QUESTION 2:
A client with COPD is placed on 3 L/min via nasal cannula. What is the rationale for maintaining
a lower supplemental oxygen level?
A. To prevent oxygen saturation above 98%
B. To avoid suppression of the hypoxic drive to breathe
C. To prevent rebound hypoxemia
D. To decrease risk of pulmonary embolism
CORRECT ANSWER: B
RATIONALE: In clients with chronic CO₂ retention, hypoxia rather than hypercapnia stimulates
respiration. Excess oxygen may suppress their respiratory drive.
QUESTION 3:
A patient with a central venous catheter suddenly develops dyspnea, tachycardia, and chest
pain during tubing change. What is the nurse’s first action?
A. Call the provider immediately.
,B. Place the patient in the left lateral Trendelenburg position.
C. Remove the catheter.
D. Administer high-flow oxygen.
CORRECT ANSWER: B
RATIONALE: This presentation suggests an air embolism. Positioning the patient on the left side
with head down traps air in the right atrium and prevents it from entering pulmonary
circulation.
QUESTION 4:
Which ECG change indicates hyperkalemia?
A. Flattened T waves
B. ST depression
C. Peaked T waves
D. U waves
CORRECT ANSWER: C
RATIONALE: Tall, peaked T waves are the earliest and most characteristic ECG sign of elevated
serum potassium.
QUESTION 5:
A male client with cirrhosis demonstrates confusion and asterixis. Which intervention is most
effective in decreasing ammonia levels?
A. Administer lactulose as prescribed.
B. Restrict all fluids.
C. Encourage a high-protein diet.
D. Administer furosemide.
CORRECT ANSWER: A
RATIONALE: Lactulose lowers serum ammonia by promoting excretion through the stool, thereby
reducing hepatic encephalopathy.
QUESTION 6:
During a transfusion, a patient develops chills, fever, and flank pain 20 minutes after infusion
begins. What is the nurse’s first action?
,A. Continue infusion and notify provider.
B. Stop transfusion immediately.
C. Administer diphenhydramine.
D. Flush the line with normal saline.
CORRECT ANSWER: B
RATIONALE: An acute hemolytic reaction requires the transfusion to be stopped immediately and
blood returned to the lab for analysis.
QUESTION 7:
Which laboratory finding confirms the effectiveness of heparin for deep vein thrombosis
prophylaxis?
A. INR of 2–3
B. aPTT 1.5–2.5 times the control
C. Platelet count increase
D. PT 12 seconds
CORRECT ANSWER: B
RATIONALE: Therapeutic heparin therapy is reflected by an aPTT value approximately 1.5–2.5
times baseline.
QUESTION 8:
In a patient with diabetic ketoacidosis (DKA), which fluid should be administered initially?
A. 0.9% Normal saline
B. D5W
C. 0.45% Normal saline
D. 3% NaCl
CORRECT ANSWER: A
RATIONALE: Isotonic saline restores intravascular volume and perfusion before switching to
hypotonic or dextrose-containing fluids.
QUESTION 9:
A patient recovering from thyroidectomy complains of tingling around the mouth and fingertips.
Which electrolyte imbalance should the nurse suspect?
, A. Hypokalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypermagnesemia
CORRECT ANSWER: B
RATIONALE: Accidental removal of parathyroid tissue leads to low calcium and neuromuscular
irritability (positive Chvostek and Trousseau signs).
QUESTION 10:
Which medication is administered for a patient in supraventricular tachycardia (SVT)
unresponsive to vagal maneuvers?
A. Lidocaine
B. Adenosine
C. Atropine
D. Amiodarone
CORRECT ANSWER: B
RATIONALE: Adenosine transiently blocks AV nodal conduction and is drug of choice for acute
SVT termination.
QUESTION 11:
When preparing to administer potassium chloride (KCl) IV, what safety measure is most
essential?
A. Use a slow IV push over 5 minutes.
B. Dilute in IV fluid and administer via infusion pump.
C. Mix with dextrose-containing solution.
D. Administer without monitoring.
CORRECT ANSWER: B
RATIONALE: IV KCl must be diluted and administered using a controlled rate to avoid cardiac
arrest.
QUESTION 12:
