NUR 2502 / NUR2502 Actual Exam 2026/2027 |
Multidimensional Care III / MDC 3 - Rasmussen | Verified
Questions and Answers | 100% Correct | Pass Guaranteed
- A+ Graded
Foundations of Multidimensional Care & Prioritization
Q1: The nurse receives report on four patients at the beginning of the shift. Which
patient should the nurse assess first based on the principles of prioritization?
A. A 48-year-old patient admitted with pneumonia who has a temperature of 100.4°F
and a productive cough.
B. A 62-year-old patient 2 days post-hip replacement who reports pain as a 6/10 and
requests medication.
C. A 55-year-old patient with chronic heart failure who reports sudden onset of
shortness of breath while resting.
D. A 30-year-old patient awaiting discharge instructions for cellulitis who is anxious
about going home.
Correct Answer: C
Rationale: Remember your ABCs: Airway, Breathing, and Circulation always come first.
Sudden shortness of breath in a heart failure patient could indicate pulmonary edema
and is an unstable physiological change, whereas pain, low-grade fever, and anxiety,
while important, are not immediately life-threatening.
Q2: The nurse is caring for a patient who is having difficulty breathing. Which action is
the most appropriate within the scope of nursing practice to address the patient's
immediate need?
A. Administer a dose of IV Lasix 40mg prescribed for kidney disease.
B. Raise the head of the bed to 45 to 90 degrees and apply supplemental oxygen.
C. Instruct the patient to cough forcefully to clear secretions.
D. Call the respiratory therapist to administer a nebulizer treatment stat.
Correct Answer: B
Rationale: Raising the head of the bed uses gravity to help lower the diaphragm and
expand the lungs, and oxygen treats hypoxia; these are independent nursing
interventions that should be implemented immediately while waiting for other team
members or medications.
,Q3: When reviewing morning lab values, the nurse identifies which result as a priority
concern requiring immediate notification of the provider?
A. Hemoglobin of 12.5 g/dL
B. White blood cell count of 11,000/mm³
C. Potassium level of 2.8 mEq/L
D. Platelet count of 180,000/mm³
Correct Answer: C
Rationale: A potassium level of 2.8 mEq/L indicates hypokalemia, which puts the patient
at high risk for life-threatening cardiac dysrhythmias, whereas the other values are
within or near normal limits and do not pose an immediate safety threat.
Q4: The charge nurse is making assignments for the oncoming shift. Which task is most
appropriate to delegate to a licensed practical nurse (LPN)?
A. Completing the initial admission assessment for a new patient with chest pain.
B. Administering a scheduled dose of IV Digoxin to a stable patient with heart failure.
C. Developing the nursing care plan for a patient recently diagnosed with diabetes.
D. Teaching a patient how to self-inject insulin for the first time.
Correct Answer: B
Rationale: LPNs can administer scheduled medications to stable patients as this falls
within their scope of practice under supervision, whereas initial assessments, care
planning, and patient education are complex responsibilities that require the RN's scope
of practice.
Q5: Using Maslow’s Hierarchy of Needs, which patient care situation should the nurse
address as the highest priority?
A. A patient expressing spiritual distress about their diagnosis.
B. A patient who has not voided for 8 hours and has bladder distention.
C. A patient who is lonely and requests a visit from the hospital chaplain.
D. A patient who is concerned about losing their job while hospitalized.
Correct Answer: B
Rationale: Maslow’s hierarchy places physiological needs at the base; bladder
distention is a physiological need that must be met before addressing higher-level
needs such as spiritual distress, love and belonging, or self-esteem.
Q6: The nurse is preparing to send a patient to the radiology department for a CT scan
with contrast. Which laboratory value must be checked prior to the procedure to prevent
injury?
A. Prothrombin time (PT)
B. Serum creatinine and BUN
C. Serum sodium
D. White blood cell count
, Correct Answer: B
Rationale: Contrast dye can be nephrotoxic, so checking kidney function (creatinine and
BUN) is essential to ensure the patient can excrete the dye and prevent further kidney
damage.
Q7: The nurse enters a room and finds the patient unresponsive with no pulse. What is
the first action the nurse should take?
A. Start chest compressions immediately.
B. Check the monitor for a heart rhythm.
C. Ventilate the patient with a bag-valve-mask.
D. Administer a shock with the AED.
Correct Answer: A
Rationale: The American Heart Association guidelines state that beginning high-quality
chest compressions as soon as a cardiac arrest is recognized is the priority to maintain
blood flow to vital organs.
Q8: A patient is prescribed heparin infusion. Which lab value does the nurse specifically
monitor to evaluate the therapeutic effect of this medication?
A. Prothrombin time (PT/INR)
B. Activated Partial Thromboplastin Time (aPTT)
C. Platelet count
D. Hematocrit
Correct Answer: B
Rationale: Heparin affects the intrinsic coagulation pathway, which is measured by the
aPTT to ensure the medication is working effectively without causing bleeding, unlike
INR which is used for warfarin.
Q9: The nurse is documenting patient care. Which entry is the most legally sound and
professional?
A. "Patient appears to be in a lot of pain, looks miserable."
B. "Incision is clean, dry, and intact. Patient reports pain 4/10."
C. "Wound care done, dressing changed."
D. "Doctor notified, patient seems stable."
Correct Answer: B
Rationale: Professional documentation should be objective, specific, and based on data;
"clean, dry, and intact" and a specific pain score are clear facts, whereas the other
options are subjective or lack necessary detail.
Q10: The nurse is managing care for a patient with a new tracheostomy. Which action is
essential to prevent airway obstruction?
A. Changing the tracheostomy ties every 24 hours.
Multidimensional Care III / MDC 3 - Rasmussen | Verified
Questions and Answers | 100% Correct | Pass Guaranteed
- A+ Graded
Foundations of Multidimensional Care & Prioritization
Q1: The nurse receives report on four patients at the beginning of the shift. Which
patient should the nurse assess first based on the principles of prioritization?
A. A 48-year-old patient admitted with pneumonia who has a temperature of 100.4°F
and a productive cough.
B. A 62-year-old patient 2 days post-hip replacement who reports pain as a 6/10 and
requests medication.
C. A 55-year-old patient with chronic heart failure who reports sudden onset of
shortness of breath while resting.
D. A 30-year-old patient awaiting discharge instructions for cellulitis who is anxious
about going home.
Correct Answer: C
Rationale: Remember your ABCs: Airway, Breathing, and Circulation always come first.
Sudden shortness of breath in a heart failure patient could indicate pulmonary edema
and is an unstable physiological change, whereas pain, low-grade fever, and anxiety,
while important, are not immediately life-threatening.
Q2: The nurse is caring for a patient who is having difficulty breathing. Which action is
the most appropriate within the scope of nursing practice to address the patient's
immediate need?
A. Administer a dose of IV Lasix 40mg prescribed for kidney disease.
B. Raise the head of the bed to 45 to 90 degrees and apply supplemental oxygen.
C. Instruct the patient to cough forcefully to clear secretions.
D. Call the respiratory therapist to administer a nebulizer treatment stat.
Correct Answer: B
Rationale: Raising the head of the bed uses gravity to help lower the diaphragm and
expand the lungs, and oxygen treats hypoxia; these are independent nursing
interventions that should be implemented immediately while waiting for other team
members or medications.
,Q3: When reviewing morning lab values, the nurse identifies which result as a priority
concern requiring immediate notification of the provider?
A. Hemoglobin of 12.5 g/dL
B. White blood cell count of 11,000/mm³
C. Potassium level of 2.8 mEq/L
D. Platelet count of 180,000/mm³
Correct Answer: C
Rationale: A potassium level of 2.8 mEq/L indicates hypokalemia, which puts the patient
at high risk for life-threatening cardiac dysrhythmias, whereas the other values are
within or near normal limits and do not pose an immediate safety threat.
Q4: The charge nurse is making assignments for the oncoming shift. Which task is most
appropriate to delegate to a licensed practical nurse (LPN)?
A. Completing the initial admission assessment for a new patient with chest pain.
B. Administering a scheduled dose of IV Digoxin to a stable patient with heart failure.
C. Developing the nursing care plan for a patient recently diagnosed with diabetes.
D. Teaching a patient how to self-inject insulin for the first time.
Correct Answer: B
Rationale: LPNs can administer scheduled medications to stable patients as this falls
within their scope of practice under supervision, whereas initial assessments, care
planning, and patient education are complex responsibilities that require the RN's scope
of practice.
Q5: Using Maslow’s Hierarchy of Needs, which patient care situation should the nurse
address as the highest priority?
A. A patient expressing spiritual distress about their diagnosis.
B. A patient who has not voided for 8 hours and has bladder distention.
C. A patient who is lonely and requests a visit from the hospital chaplain.
D. A patient who is concerned about losing their job while hospitalized.
Correct Answer: B
Rationale: Maslow’s hierarchy places physiological needs at the base; bladder
distention is a physiological need that must be met before addressing higher-level
needs such as spiritual distress, love and belonging, or self-esteem.
Q6: The nurse is preparing to send a patient to the radiology department for a CT scan
with contrast. Which laboratory value must be checked prior to the procedure to prevent
injury?
A. Prothrombin time (PT)
B. Serum creatinine and BUN
C. Serum sodium
D. White blood cell count
, Correct Answer: B
Rationale: Contrast dye can be nephrotoxic, so checking kidney function (creatinine and
BUN) is essential to ensure the patient can excrete the dye and prevent further kidney
damage.
Q7: The nurse enters a room and finds the patient unresponsive with no pulse. What is
the first action the nurse should take?
A. Start chest compressions immediately.
B. Check the monitor for a heart rhythm.
C. Ventilate the patient with a bag-valve-mask.
D. Administer a shock with the AED.
Correct Answer: A
Rationale: The American Heart Association guidelines state that beginning high-quality
chest compressions as soon as a cardiac arrest is recognized is the priority to maintain
blood flow to vital organs.
Q8: A patient is prescribed heparin infusion. Which lab value does the nurse specifically
monitor to evaluate the therapeutic effect of this medication?
A. Prothrombin time (PT/INR)
B. Activated Partial Thromboplastin Time (aPTT)
C. Platelet count
D. Hematocrit
Correct Answer: B
Rationale: Heparin affects the intrinsic coagulation pathway, which is measured by the
aPTT to ensure the medication is working effectively without causing bleeding, unlike
INR which is used for warfarin.
Q9: The nurse is documenting patient care. Which entry is the most legally sound and
professional?
A. "Patient appears to be in a lot of pain, looks miserable."
B. "Incision is clean, dry, and intact. Patient reports pain 4/10."
C. "Wound care done, dressing changed."
D. "Doctor notified, patient seems stable."
Correct Answer: B
Rationale: Professional documentation should be objective, specific, and based on data;
"clean, dry, and intact" and a specific pain score are clear facts, whereas the other
options are subjective or lack necessary detail.
Q10: The nurse is managing care for a patient with a new tracheostomy. Which action is
essential to prevent airway obstruction?
A. Changing the tracheostomy ties every 24 hours.
