NUR2392 / NUR 2392 Multidimensional Care II /
MDC 2 – Rasmussen Actual Exam – Complete
Questions and Answers with Detailed Rationales –
Pass Guaranteed – A+ Graded
Foundations: Fluid/Electrolytes & Acid-Base Balance
Q1: What is the normal physiological range for serum sodium in an adult patient?
A. 2.5 to 4.5 mEq/L
B. 8.5 to 10.5 mg/dL
C. 3.5 to 5.0 mEq/L
D. 136 to 145 mEq/L [CORRECT]
Correct Answer: D
Rationale: The best answer is D, because 136 to 145 mEq/L is the standard reference
range for serum sodium, while the other options represent potassium and calcium
levels.
Q2: A nurse is reviewing a patient's morning lab results and notes a potassium level of
2.8 mEq/L. Which assessment finding should the nurse immediately correlate with this
result?
A. Hyperactive deep tendon reflexes and tetany
B. Positive Chvostek's sign and muscle cramps
C. Muscle weakness, flat T waves, and lethargy [CORRECT]
D. Tall, peaked T waves and bradycardia
Correct Answer: C
Rationale: This is correct because hypokalemia classically presents with muscle
weakness, flattened T waves on the ECG, and lethargy, whereas tall peaked T waves
and hyperreflexia are signs of hyperkalemia and hypocalcemia respectively.
Q3: When evaluating a patient's fluid balance, the nurse understands that insensible
fluid loss primarily occurs through which mechanisms?
A. Urine output and diarrhea
B. Sweating and respiratory vapor [CORRECT]
C. Wound drainage and GI suctioning
D. Nausea and vomiting
Correct Answer: B
,Rationale: The best answer is B, because insensible fluid loss refers to the water the
body loses that you cannot easily measure, which happens continuously through the
skin as sweat and via the lungs during respiration.
Q4: A patient with fluid volume overload (hypervolemia) is admitted to the med-surg
unit. Which set of clinical findings should the nurse expect during the initial
assessment?
A. Decreased blood pressure, flat neck veins, and dry mucous membranes
B. Increased blood pressure, crackles in the lungs, and bounding pulses [CORRECT]
C. Bradycardia, poor skin turgor, and concentrated urine
D. Weak peripheral pulses, hypotension, and weight loss
Correct Answer: B
Rationale: This aligns with fluid volume overload, where you would expect increased
blood pressure and bounding pulses due to excess vascular volume, along with
crackles from fluid backing up into the pulmonary system.
Q5: The nurse is caring for a patient who has a serum calcium level of 7.2 mg/dL.
Which nursing intervention is the highest priority to prevent a life-threatening
complication?
A. Implement seizure precautions and maintain a safe environment [CORRECT]
B. Encourage high-phosphorus foods to balance the calcium
C. Administer intravenous normal saline boluses rapidly
D. Restrict fluid intake to prevent further dilution
Correct Answer: A
Rationale: The best answer is A, because severe hypocalcemia lowers the threshold for
neuronal excitation, putting the patient at high risk for tetany, laryngospasm, and
seizures, making safety the top priority.
Q6: A provider orders intravenous potassium replacement for a patient with a potassium
level of 3.0 mEq/L. Which nursing action is most critical before and during the infusion?
A. Assessing the patient for Chvostek's and Trousseau's signs
B. Monitoring the IV site for infiltration and ensuring the rate does not exceed 10 mEq/hr
[CORRECT]
C. Applying a warm compress to the IV site to reduce vein irritation
D. Checking the patient's most recent serum magnesium level only
Correct Answer: B
Rationale: This is correct because infusing potassium too rapidly can cause cardiac
arrest, so it must be given slowly (usually no faster than 10 mEq/hr via a peripheral line)
with frequent cardiac monitoring and IV site checks to prevent tissue necrosis from
extravasation.
, Q7: A patient is diagnosed with hypermagnesemia. Which assessment finding is most
consistent with this electrolyte imbalance?
A. Muscle tremors and hyperreflexia
B. Respiratory depression and hypotension [CORRECT]
C. Positive Trousseau's sign and facial twitching
D. Tachycardia and increased deep tendon reflexes
Correct Answer: B
Rationale: The best answer is B, because high magnesium levels act as a central
nervous system depressant, leading to lethargy, decreased respiratory rate,
hypotension, and loss of deep tendon reflexes.
Q8: A patient with severe nausea and vomiting has the following arterial blood gas
(ABG) results: pH 7.52, PaCO2 48 mm Hg, HCO3- 32 mEq/L. How should the nurse
interpret these findings?
A. Uncompensated respiratory alkalosis
B. Partially compensated metabolic acidosis
C. Partially compensated metabolic alkalosis [CORRECT]
D. Fully compensated respiratory acidosis
Correct Answer: C
Rationale: This aligns with the RO-ME rule (Respiratory Opposite, Metabolic Equal); the
pH is high (alkalosis) and the HCO3- is high (metabolic), and since the PaCO2 is also
high but the pH is not normalized, it is partially compensated by the lungs retaining
CO2.
Q9: The nurse is evaluating a patient's lab results and notes an anion gap of 15 mEq/L.
The nurse knows this elevated anion gap is most commonly associated with which
clinical condition?
A. Chronic obstructive pulmonary disease (COPD) exacerbation
B. Diabetic ketoacidosis (DKA) [CORRECT]
C. Syndrome of inappropriate antidiuretic hormone (SIADH)
D. Metabolic alkalosis from prolonged nasogastric suctioning
Correct Answer: B
Rationale: The best answer is B, because DKA causes an accumulation of unmeasured
anions like ketone bodies, which widens the gap between measured cations (sodium)
and measured anions (chloride, bicarbonate).
Q10: A patient presents with a potassium level of 6.8 mEq/L and tall, peaked T waves
on the ECG. Which ordered medication should the nurse prepare to administer first?
A. Regular insulin and 50% dextrose IV push [CORRECT]
B. Oral sodium polystyrene sulfonate (Kayexalate)
C. Intravenous calcium gluconate
MDC 2 – Rasmussen Actual Exam – Complete
Questions and Answers with Detailed Rationales –
Pass Guaranteed – A+ Graded
Foundations: Fluid/Electrolytes & Acid-Base Balance
Q1: What is the normal physiological range for serum sodium in an adult patient?
A. 2.5 to 4.5 mEq/L
B. 8.5 to 10.5 mg/dL
C. 3.5 to 5.0 mEq/L
D. 136 to 145 mEq/L [CORRECT]
Correct Answer: D
Rationale: The best answer is D, because 136 to 145 mEq/L is the standard reference
range for serum sodium, while the other options represent potassium and calcium
levels.
Q2: A nurse is reviewing a patient's morning lab results and notes a potassium level of
2.8 mEq/L. Which assessment finding should the nurse immediately correlate with this
result?
A. Hyperactive deep tendon reflexes and tetany
B. Positive Chvostek's sign and muscle cramps
C. Muscle weakness, flat T waves, and lethargy [CORRECT]
D. Tall, peaked T waves and bradycardia
Correct Answer: C
Rationale: This is correct because hypokalemia classically presents with muscle
weakness, flattened T waves on the ECG, and lethargy, whereas tall peaked T waves
and hyperreflexia are signs of hyperkalemia and hypocalcemia respectively.
Q3: When evaluating a patient's fluid balance, the nurse understands that insensible
fluid loss primarily occurs through which mechanisms?
A. Urine output and diarrhea
B. Sweating and respiratory vapor [CORRECT]
C. Wound drainage and GI suctioning
D. Nausea and vomiting
Correct Answer: B
,Rationale: The best answer is B, because insensible fluid loss refers to the water the
body loses that you cannot easily measure, which happens continuously through the
skin as sweat and via the lungs during respiration.
Q4: A patient with fluid volume overload (hypervolemia) is admitted to the med-surg
unit. Which set of clinical findings should the nurse expect during the initial
assessment?
A. Decreased blood pressure, flat neck veins, and dry mucous membranes
B. Increased blood pressure, crackles in the lungs, and bounding pulses [CORRECT]
C. Bradycardia, poor skin turgor, and concentrated urine
D. Weak peripheral pulses, hypotension, and weight loss
Correct Answer: B
Rationale: This aligns with fluid volume overload, where you would expect increased
blood pressure and bounding pulses due to excess vascular volume, along with
crackles from fluid backing up into the pulmonary system.
Q5: The nurse is caring for a patient who has a serum calcium level of 7.2 mg/dL.
Which nursing intervention is the highest priority to prevent a life-threatening
complication?
A. Implement seizure precautions and maintain a safe environment [CORRECT]
B. Encourage high-phosphorus foods to balance the calcium
C. Administer intravenous normal saline boluses rapidly
D. Restrict fluid intake to prevent further dilution
Correct Answer: A
Rationale: The best answer is A, because severe hypocalcemia lowers the threshold for
neuronal excitation, putting the patient at high risk for tetany, laryngospasm, and
seizures, making safety the top priority.
Q6: A provider orders intravenous potassium replacement for a patient with a potassium
level of 3.0 mEq/L. Which nursing action is most critical before and during the infusion?
A. Assessing the patient for Chvostek's and Trousseau's signs
B. Monitoring the IV site for infiltration and ensuring the rate does not exceed 10 mEq/hr
[CORRECT]
C. Applying a warm compress to the IV site to reduce vein irritation
D. Checking the patient's most recent serum magnesium level only
Correct Answer: B
Rationale: This is correct because infusing potassium too rapidly can cause cardiac
arrest, so it must be given slowly (usually no faster than 10 mEq/hr via a peripheral line)
with frequent cardiac monitoring and IV site checks to prevent tissue necrosis from
extravasation.
, Q7: A patient is diagnosed with hypermagnesemia. Which assessment finding is most
consistent with this electrolyte imbalance?
A. Muscle tremors and hyperreflexia
B. Respiratory depression and hypotension [CORRECT]
C. Positive Trousseau's sign and facial twitching
D. Tachycardia and increased deep tendon reflexes
Correct Answer: B
Rationale: The best answer is B, because high magnesium levels act as a central
nervous system depressant, leading to lethargy, decreased respiratory rate,
hypotension, and loss of deep tendon reflexes.
Q8: A patient with severe nausea and vomiting has the following arterial blood gas
(ABG) results: pH 7.52, PaCO2 48 mm Hg, HCO3- 32 mEq/L. How should the nurse
interpret these findings?
A. Uncompensated respiratory alkalosis
B. Partially compensated metabolic acidosis
C. Partially compensated metabolic alkalosis [CORRECT]
D. Fully compensated respiratory acidosis
Correct Answer: C
Rationale: This aligns with the RO-ME rule (Respiratory Opposite, Metabolic Equal); the
pH is high (alkalosis) and the HCO3- is high (metabolic), and since the PaCO2 is also
high but the pH is not normalized, it is partially compensated by the lungs retaining
CO2.
Q9: The nurse is evaluating a patient's lab results and notes an anion gap of 15 mEq/L.
The nurse knows this elevated anion gap is most commonly associated with which
clinical condition?
A. Chronic obstructive pulmonary disease (COPD) exacerbation
B. Diabetic ketoacidosis (DKA) [CORRECT]
C. Syndrome of inappropriate antidiuretic hormone (SIADH)
D. Metabolic alkalosis from prolonged nasogastric suctioning
Correct Answer: B
Rationale: The best answer is B, because DKA causes an accumulation of unmeasured
anions like ketone bodies, which widens the gap between measured cations (sodium)
and measured anions (chloride, bicarbonate).
Q10: A patient presents with a potassium level of 6.8 mEq/L and tall, peaked T waves
on the ECG. Which ordered medication should the nurse prepare to administer first?
A. Regular insulin and 50% dextrose IV push [CORRECT]
B. Oral sodium polystyrene sulfonate (Kayexalate)
C. Intravenous calcium gluconate
