NUR 2502 Final Exam: Multidimensional Care III (MDC 3) Verified
and Updated Questions and Answers - Rasmussen
1. A patient is admitted with a suspected Pulmonary Embolism (PE). Which diagnostic test is
considered the gold standard for confirming this diagnosis?
A. CT Pulmonary Angiography (CTPA)
B. Chest X-ray
C. Arterial Blood Gas (ABG)
D. D-dimer assay
Answer: A
Explanation: While D-dimer is a good screening tool, CT Pulmonary Angiography (CTPA) is the preferred
gold standard for confirming the presence of a pulmonary embolism.
2. When assessing a patient in the compensatory stage of shock, which clinical manifestation
should the nurse expect?
A. Tachycardia and narrowed pulse pressure
B. Decreased urine output
C. Cold, clammy skin
D. Metabolic acidosis
Answer: A
Explanation: In the compensatory stage, the body attempts to maintain homeostasis through
sympathetic nervous system activation, leading to increased heart rate and vasoconstriction.
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize to protect the heart from dysrhythmias?
A. Calcium Gluconate
B. Sodium Polystyrene Sulfonate
C. Regular Insulin and D50
D. Furosemide
Answer: A
,Explanation: Calcium gluconate does not lower potassium but antagonizes the cardiotoxic effects of
hyperkalemia, stabilizing the myocardial cell membrane.
4. Which electrolyte imbalance is a hallmark sign of Reeding Syndrome in a severely
malnourished patient receiving TPN?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypophosphatemia
Answer: D
Explanation: Hypophosphatemia is the classic hallmark of refeeding syndrome as cells rapidly take up
phosphorus during the shift from catabolism to anabolism.
5. A nurse is caring for a patient with Acute Respiratory Distress Syndrome (ARDS). What is
the primary pathophysiological change in this condition?
A. Increased compliance of the lungs
B. Increased permeability of the alveolar-capillary membrane
C. Obstruction of the large airways
D. Decrease in pulmonary capillary pressure
Answer: B
Explanation: ARDS is characterized by damage to the alveolar-capillary membrane, leading to non-
cardiogenic pulmonary edema and severe hypoxemia.
6. A patient is experiencing Thyroid Storm. Which of the following is a priority nursing
intervention?
A. Administering IV fluids and maintaining a cool environment
B. Encouraging vigorous exercise to use up excess energy
C. Administering Levothyroxine immediately
D. Restricting fluid intake to prevent edema
Answer: A
Explanation: Thyroid storm is a hypermetabolic state; interventions focus on reducing body
temperature, providing hydration, and managing tachycardia.
, 7. Which clinical finding is most indicative of Cardiac Tamponade?
A. Muffled heart sounds, JVD, and hypotension
B. Hypertension and bradycardia
C. Flattened neck veins and tachycardia
D. Bounding peripheral pulses
Answer: A
Explanation: These three signs are known as Beck’s Triad, which indicates fluid accumulation in the
pericardial sac compressing the heart.
8. A patient with an acute burn injury is in the emergent phase. Using the Parkland Formula
(4mL x kg x %TBSA), how much fluid should be given in the first 8 hours for a 70kg patient
with 50% TBSA burns?
A. 14,000 mL
B. 7,000 mL
C. 3,500 mL
D. 10,500 mL
Answer: B
Explanation: Total fluid = 4 * 70 * 50 = 14,000 mL. Half is given in the first 8 hours, which is 7,000 mL.
9. In a patient with Acute Pancreatitis, which laboratory value is typically the most specific
for confirming the diagnosis?
A. Elevated Serum Lipase
B. Elevated Serum Amylase
C. Decreased WBC count
D. Elevated Serum Calcium
Answer: A
Explanation: While amylase rises quickly, lipase is more specific to the pancreas and stays elevated
longer during acute pancreatitis.
and Updated Questions and Answers - Rasmussen
1. A patient is admitted with a suspected Pulmonary Embolism (PE). Which diagnostic test is
considered the gold standard for confirming this diagnosis?
A. CT Pulmonary Angiography (CTPA)
B. Chest X-ray
C. Arterial Blood Gas (ABG)
D. D-dimer assay
Answer: A
Explanation: While D-dimer is a good screening tool, CT Pulmonary Angiography (CTPA) is the preferred
gold standard for confirming the presence of a pulmonary embolism.
2. When assessing a patient in the compensatory stage of shock, which clinical manifestation
should the nurse expect?
A. Tachycardia and narrowed pulse pressure
B. Decreased urine output
C. Cold, clammy skin
D. Metabolic acidosis
Answer: A
Explanation: In the compensatory stage, the body attempts to maintain homeostasis through
sympathetic nervous system activation, leading to increased heart rate and vasoconstriction.
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize to protect the heart from dysrhythmias?
A. Calcium Gluconate
B. Sodium Polystyrene Sulfonate
C. Regular Insulin and D50
D. Furosemide
Answer: A
,Explanation: Calcium gluconate does not lower potassium but antagonizes the cardiotoxic effects of
hyperkalemia, stabilizing the myocardial cell membrane.
4. Which electrolyte imbalance is a hallmark sign of Reeding Syndrome in a severely
malnourished patient receiving TPN?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypophosphatemia
Answer: D
Explanation: Hypophosphatemia is the classic hallmark of refeeding syndrome as cells rapidly take up
phosphorus during the shift from catabolism to anabolism.
5. A nurse is caring for a patient with Acute Respiratory Distress Syndrome (ARDS). What is
the primary pathophysiological change in this condition?
A. Increased compliance of the lungs
B. Increased permeability of the alveolar-capillary membrane
C. Obstruction of the large airways
D. Decrease in pulmonary capillary pressure
Answer: B
Explanation: ARDS is characterized by damage to the alveolar-capillary membrane, leading to non-
cardiogenic pulmonary edema and severe hypoxemia.
6. A patient is experiencing Thyroid Storm. Which of the following is a priority nursing
intervention?
A. Administering IV fluids and maintaining a cool environment
B. Encouraging vigorous exercise to use up excess energy
C. Administering Levothyroxine immediately
D. Restricting fluid intake to prevent edema
Answer: A
Explanation: Thyroid storm is a hypermetabolic state; interventions focus on reducing body
temperature, providing hydration, and managing tachycardia.
, 7. Which clinical finding is most indicative of Cardiac Tamponade?
A. Muffled heart sounds, JVD, and hypotension
B. Hypertension and bradycardia
C. Flattened neck veins and tachycardia
D. Bounding peripheral pulses
Answer: A
Explanation: These three signs are known as Beck’s Triad, which indicates fluid accumulation in the
pericardial sac compressing the heart.
8. A patient with an acute burn injury is in the emergent phase. Using the Parkland Formula
(4mL x kg x %TBSA), how much fluid should be given in the first 8 hours for a 70kg patient
with 50% TBSA burns?
A. 14,000 mL
B. 7,000 mL
C. 3,500 mL
D. 10,500 mL
Answer: B
Explanation: Total fluid = 4 * 70 * 50 = 14,000 mL. Half is given in the first 8 hours, which is 7,000 mL.
9. In a patient with Acute Pancreatitis, which laboratory value is typically the most specific
for confirming the diagnosis?
A. Elevated Serum Lipase
B. Elevated Serum Amylase
C. Decreased WBC count
D. Elevated Serum Calcium
Answer: A
Explanation: While amylase rises quickly, lipase is more specific to the pancreas and stays elevated
longer during acute pancreatitis.
