NUR 2502 Exam 3: Multidimensional Care III
(MDC 3) Verified and Updated Questions and
Answers
1. A client is admitted with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3 of 24
mEq/L. Which acid-base imbalance is present?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg with a
normal bicarbonate indicates the cause is respiratory.
2. Which electrolyte imbalance is the most common cause of tall, peaked T
waves on an EKG?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypercalcemia
Answer: C
Explanation: Hyperkalemia (high potassium) typically manifests on an EKG as tall, peaked
T waves, followed by prolonged PR intervals and widening of the QRS complex.
,3. A patient with heart failure is prescribed Digoxin. Which assessment finding
would indicate potential toxicity?
A. Heart rate of 88 beats per minute
B. Increased urine output and weight loss
C. Anorexia and blurred vision with yellow halos
D. Tingling in the fingers and toes
Answer: C
Explanation: Signs of digoxin toxicity include gastrointestinal upset (anorexia, nausea,
vomiting) and visual changes, such as yellow or green halos.
4. What is the priority nursing intervention for a client experiencing Atrial
Fibrillation with rapid ventricular response?
A. Administering oral aspirin
B. Assessing for symptoms of decreased cardiac output
C. Encouraging deep breathing exercises
D. Assisting with a high-protein diet
Answer: B
Explanation: In rapid A-fib, the ventricles cannot fill properly, leading to decreased cardiac
output. Assessing blood pressure and perfusion is the priority.
5. A client is diagnosed with left-sided heart failure. Which clinical manifestation
is most characteristic of this condition?
A. Crackles in the lung bases
B. Dependent edema in the ankles
C. Jugular venous distention
D. Hepatomegaly
Answer: A
Explanation: Left-sided heart failure leads to pulmonary congestion, causing respiratory
symptoms like crackles, shortness of breath, and cough.
,6. Which instruction should the nurse include for a client prescribed Warfarin
for a heart valve replacement?
A. Maintain a consistent intake of Vitamin K-rich foods
B. Increase intake of spinach and kale to stabilize the drug
C. Stop taking the medication if your gums bleed
D. Use a hard-bristled toothbrush to prevent infection
Answer: A
Explanation: Warfarin acts as a Vitamin K antagonist. Clients should maintain a consistent
intake of Vitamin K to keep the PT/INR levels therapeutic.
7. A nurse is caring for a client with a chest tube. Which observation in the
water-seal chamber requires immediate intervention?
A. Continuous bubbling in the water-seal chamber
B. Fluctuation of the water level with respirations
C. Gentle bubbling in the suction control chamber
D. 200 mL of drainage in the collection chamber over 8 hours
Answer: A
Explanation: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or the patient’s pleural space.
8. Which medication is typically the first-line treatment for a client with a
hypertensive crisis?
A. Sodium Nitroprusside
B. Furosemide
C. Spironolactone
D. Metformin
Answer: A
Explanation: Sodium Nitroprusside is a potent vasodilator used in hypertensive
emergencies to rapidly lower blood pressure.
, 9. A nurse is teaching a client about a scheduled Exercise Stress Test. Which
statement by the client indicates understanding?
A. I will drink a cup of coffee right before the test for energy
B. I will wear comfortable walking shoes for the test
C. I will smoke a cigarette to relax my nerves before the test
D. I will eat a heavy meal so I don’t get hungry
Answer: B
Explanation: Clients should wear comfortable clothing and shoes. They must avoid
caffeine and smoking for several hours before the test.
10. Which rhythm is characterized by a ‘sawtooth’ pattern on the EKG?
A. Ventricular Tachycardia
B. Atrial Flutter
C. First-degree Heart Block
D. Sinus Bradycardia
Answer: B
Explanation: Atrial Flutter is classic for its sawtooth F-wave pattern on the EKG.
11. A client presents with sharp chest pain that improves when leaning forward.
This is most likely indicative of:
A. Pericarditis
B. Myocardial Infarction
C. Pneumothorax
D. Heart Failure
Answer: A
Explanation: Chest pain that is pleuritic and relieved by sitting up and leaning forward is a
classic sign of pericarditis.
(MDC 3) Verified and Updated Questions and
Answers
1. A client is admitted with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3 of 24
mEq/L. Which acid-base imbalance is present?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg with a
normal bicarbonate indicates the cause is respiratory.
2. Which electrolyte imbalance is the most common cause of tall, peaked T
waves on an EKG?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypercalcemia
Answer: C
Explanation: Hyperkalemia (high potassium) typically manifests on an EKG as tall, peaked
T waves, followed by prolonged PR intervals and widening of the QRS complex.
,3. A patient with heart failure is prescribed Digoxin. Which assessment finding
would indicate potential toxicity?
A. Heart rate of 88 beats per minute
B. Increased urine output and weight loss
C. Anorexia and blurred vision with yellow halos
D. Tingling in the fingers and toes
Answer: C
Explanation: Signs of digoxin toxicity include gastrointestinal upset (anorexia, nausea,
vomiting) and visual changes, such as yellow or green halos.
4. What is the priority nursing intervention for a client experiencing Atrial
Fibrillation with rapid ventricular response?
A. Administering oral aspirin
B. Assessing for symptoms of decreased cardiac output
C. Encouraging deep breathing exercises
D. Assisting with a high-protein diet
Answer: B
Explanation: In rapid A-fib, the ventricles cannot fill properly, leading to decreased cardiac
output. Assessing blood pressure and perfusion is the priority.
5. A client is diagnosed with left-sided heart failure. Which clinical manifestation
is most characteristic of this condition?
A. Crackles in the lung bases
B. Dependent edema in the ankles
C. Jugular venous distention
D. Hepatomegaly
Answer: A
Explanation: Left-sided heart failure leads to pulmonary congestion, causing respiratory
symptoms like crackles, shortness of breath, and cough.
,6. Which instruction should the nurse include for a client prescribed Warfarin
for a heart valve replacement?
A. Maintain a consistent intake of Vitamin K-rich foods
B. Increase intake of spinach and kale to stabilize the drug
C. Stop taking the medication if your gums bleed
D. Use a hard-bristled toothbrush to prevent infection
Answer: A
Explanation: Warfarin acts as a Vitamin K antagonist. Clients should maintain a consistent
intake of Vitamin K to keep the PT/INR levels therapeutic.
7. A nurse is caring for a client with a chest tube. Which observation in the
water-seal chamber requires immediate intervention?
A. Continuous bubbling in the water-seal chamber
B. Fluctuation of the water level with respirations
C. Gentle bubbling in the suction control chamber
D. 200 mL of drainage in the collection chamber over 8 hours
Answer: A
Explanation: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or the patient’s pleural space.
8. Which medication is typically the first-line treatment for a client with a
hypertensive crisis?
A. Sodium Nitroprusside
B. Furosemide
C. Spironolactone
D. Metformin
Answer: A
Explanation: Sodium Nitroprusside is a potent vasodilator used in hypertensive
emergencies to rapidly lower blood pressure.
, 9. A nurse is teaching a client about a scheduled Exercise Stress Test. Which
statement by the client indicates understanding?
A. I will drink a cup of coffee right before the test for energy
B. I will wear comfortable walking shoes for the test
C. I will smoke a cigarette to relax my nerves before the test
D. I will eat a heavy meal so I don’t get hungry
Answer: B
Explanation: Clients should wear comfortable clothing and shoes. They must avoid
caffeine and smoking for several hours before the test.
10. Which rhythm is characterized by a ‘sawtooth’ pattern on the EKG?
A. Ventricular Tachycardia
B. Atrial Flutter
C. First-degree Heart Block
D. Sinus Bradycardia
Answer: B
Explanation: Atrial Flutter is classic for its sawtooth F-wave pattern on the EKG.
11. A client presents with sharp chest pain that improves when leaning forward.
This is most likely indicative of:
A. Pericarditis
B. Myocardial Infarction
C. Pneumothorax
D. Heart Failure
Answer: A
Explanation: Chest pain that is pleuritic and relieved by sitting up and leaning forward is a
classic sign of pericarditis.
