NUR2755 / NUR 2755 Final Exam: Multidimensional
Care IV / MDC 4 – Rasmussen Actual Exam
Complete Questions & Rationales | Graded A+ |
Pass Guaranteed - A+ Graded
Coordinating Care Across the Interdisciplinary Team
Q1: You receive this SBAR handoff from the night nurse: "S: Mrs. Gable is a 62-year-old
post-op colectomy. B: She had a rough night with BP dropping to 88/50, HR 115, but
she warmed up with a 500 mL fluid bolus. Her wound drain looks a bit darker. A: I think
she might be developing an infection or internal bleeding. R: I need you to keep an eye
on her vitals and call the surgeon if she drops again." What is your priority follow-up
action as the day shift nurse?
A. Check the morning labs to see if her hemoglobin and WBC counts are trending down
B. Call the surgeon immediately to report the overnight hypotensive episode and
request a bedside evaluation
C. Perform a focused assessment on the surgical wound and drain output, then
re-check her current vital signs
D. Ask the charge nurse to assign a different patient because this one is too unstable
for the current nurse-to-patient ratio
Correct Answer: C
Rationale: What we’re really looking for here is your first nursing action, which is always
to validate the information you just received by assessing the patient yourself. The best
answer is checking the wound and current vitals so you have real-time, primary data
before calling the provider with an update.
Q2: During interdisciplinary rounds, the team is discussing a patient with a new
tracheostomy who is failing to wean off the mechanical ventilator. The patient is anxious
and pulling at the trach collar. Which team member's input is most critical to address the
immediate barrier to weaning?
A. The speech-language pathologist, to assess for silent aspiration
B. The respiratory therapist, to evaluate the trach collar fit and airflow
C. The physical therapist, to schedule mobility exercises for later in the afternoon
D. The clinical pharmacist, to review sedation holidays
Correct Answer: B
,Rationale: The best answer is the respiratory therapist because the patient is actively
pulling at the trach collar right now, indicating an immediate mechanical or airflow issue
that is halting the wean process. In multidimensional care, the priority is always
resolving the acute physical barrier before looking at long-term rehab or medication
adjustments.
Q3: A patient with complex chronic pain is being discharged home. The primary care
provider, physical therapy, and home health nursing have all made their plans. Which
action by the nurse best ensures safe care transition?
A. Providing the patient with a printed list of all the appointments they need to schedule
B. Calling the home health nurse to give a verbal report on the patient's pain regimen
C. Having the patient verbally teach back the plan for taking their new extended-release
pain medication
D. Making sure the discharge paperwork is placed in the chart before the patient leaves
the room
Correct Answer: C
Rationale: This choice is correct because true care coordination relies on the patient
understanding their own care plan, especially with high-risk medications like
extended-release opioids. Having the patient teach it back confirms they grasp the
safety considerations, which is much more protective than just handing them a piece of
paper.
Q4: The nursing student asks why the nurse is calling the provider about a patient's
potassium level of 5.2 mEq/L when the student learned that normal goes up to 5.0.
What is the best response by the nurse?
A. "We call for anything above 5.0 because the lab uses different reference ranges than
our textbook."
B. "In multidimensional care, the priority is always treating the number, so we need
orders to fix it right away."
C. "I'm calling because this patient just started on an ACE inhibitor and also has acute
kidney injury, so even a slight bump is a red flag."
D. "You're right that 5.2 isn't that high, but I like to practice defensive documentation so I
don't get blamed later."
Correct Answer: C
Rationale: This aligns with the principle of looking at the whole clinical picture rather
than treating an isolated lab value. The best answer is explaining that the context—new
ACE inhibitor plus AKI—makes a borderline number dangerous, which is exactly the
kind of clinical judgment we expect at the MDC 4 level.
Q5: You are caring for a patient who had a stroke and now has severe dysphagia. The
dietitian recommends a pureed diet with honey-thick liquids. At lunch, you observe the
, patient's spouse trying to feed the patient a regular cup of water. What is your most
appropriate action?
A. Quietly remove the water cup and bring in the thickened liquids without making a
scene
B. Stop the spouse, explain the aspiration risk immediately, and provide the correct
liquids
C. Document the incident in the chart and notify the charge nurse to speak with the
family
D. Let the spouse finish giving the water since it's only a small amount and then
reinforce the diet later
Correct Answer: B
Rationale: The best answer is stopping the spouse and explaining the risk right then
and there, because patient safety trumps any discomfort about correcting family
members. This aligns with the principle of immediate intervention to prevent aspiration,
which can be fatal, rather than passing the buck to the charge nurse.
Q6: During a care conference for a patient with end-stage liver disease, the social
worker mentions the patient's wife seems overwhelmed. The nurse adds, "She also
hasn't been complying with the low-sodium diet we taught her." What is the primary
issue with the nurse's communication style in this setting?
A. It breaches HIPAA because the wife's compliance is not the medical team's business
B. It uses judgmental language that shuts down collaborative problem-solving with the
team
C. It is inappropriate to discuss diet during a care conference focused on social work
needs
D. It demonstrates poor clinical judgment because liver patients don't actually need
sodium restrictions
Correct Answer: B
Rationale: What we’re really looking for here is professional communication. The best
answer highlights that labeling the spouse as "non-compliant" creates blame rather than
exploring why she is struggling, which goes against the collaborative, non-punitive spirit
of interdisciplinary rounds.
Q7: A patient is being transferred from the ICU to the step-down unit. The ICU nurse
gives a quick report in the hallway and says, "He's stable, just on a telemetry monitor,
pretty straightforward." When you get to the room, the patient tells you he feels very
short of breath. What is your next best action?
A. Review the transfer summary to see what his baseline oxygen requirements were in
the ICU
B. Hook him up to the continuous pulse oximetry immediately to get an objective
number
Care IV / MDC 4 – Rasmussen Actual Exam
Complete Questions & Rationales | Graded A+ |
Pass Guaranteed - A+ Graded
Coordinating Care Across the Interdisciplinary Team
Q1: You receive this SBAR handoff from the night nurse: "S: Mrs. Gable is a 62-year-old
post-op colectomy. B: She had a rough night with BP dropping to 88/50, HR 115, but
she warmed up with a 500 mL fluid bolus. Her wound drain looks a bit darker. A: I think
she might be developing an infection or internal bleeding. R: I need you to keep an eye
on her vitals and call the surgeon if she drops again." What is your priority follow-up
action as the day shift nurse?
A. Check the morning labs to see if her hemoglobin and WBC counts are trending down
B. Call the surgeon immediately to report the overnight hypotensive episode and
request a bedside evaluation
C. Perform a focused assessment on the surgical wound and drain output, then
re-check her current vital signs
D. Ask the charge nurse to assign a different patient because this one is too unstable
for the current nurse-to-patient ratio
Correct Answer: C
Rationale: What we’re really looking for here is your first nursing action, which is always
to validate the information you just received by assessing the patient yourself. The best
answer is checking the wound and current vitals so you have real-time, primary data
before calling the provider with an update.
Q2: During interdisciplinary rounds, the team is discussing a patient with a new
tracheostomy who is failing to wean off the mechanical ventilator. The patient is anxious
and pulling at the trach collar. Which team member's input is most critical to address the
immediate barrier to weaning?
A. The speech-language pathologist, to assess for silent aspiration
B. The respiratory therapist, to evaluate the trach collar fit and airflow
C. The physical therapist, to schedule mobility exercises for later in the afternoon
D. The clinical pharmacist, to review sedation holidays
Correct Answer: B
,Rationale: The best answer is the respiratory therapist because the patient is actively
pulling at the trach collar right now, indicating an immediate mechanical or airflow issue
that is halting the wean process. In multidimensional care, the priority is always
resolving the acute physical barrier before looking at long-term rehab or medication
adjustments.
Q3: A patient with complex chronic pain is being discharged home. The primary care
provider, physical therapy, and home health nursing have all made their plans. Which
action by the nurse best ensures safe care transition?
A. Providing the patient with a printed list of all the appointments they need to schedule
B. Calling the home health nurse to give a verbal report on the patient's pain regimen
C. Having the patient verbally teach back the plan for taking their new extended-release
pain medication
D. Making sure the discharge paperwork is placed in the chart before the patient leaves
the room
Correct Answer: C
Rationale: This choice is correct because true care coordination relies on the patient
understanding their own care plan, especially with high-risk medications like
extended-release opioids. Having the patient teach it back confirms they grasp the
safety considerations, which is much more protective than just handing them a piece of
paper.
Q4: The nursing student asks why the nurse is calling the provider about a patient's
potassium level of 5.2 mEq/L when the student learned that normal goes up to 5.0.
What is the best response by the nurse?
A. "We call for anything above 5.0 because the lab uses different reference ranges than
our textbook."
B. "In multidimensional care, the priority is always treating the number, so we need
orders to fix it right away."
C. "I'm calling because this patient just started on an ACE inhibitor and also has acute
kidney injury, so even a slight bump is a red flag."
D. "You're right that 5.2 isn't that high, but I like to practice defensive documentation so I
don't get blamed later."
Correct Answer: C
Rationale: This aligns with the principle of looking at the whole clinical picture rather
than treating an isolated lab value. The best answer is explaining that the context—new
ACE inhibitor plus AKI—makes a borderline number dangerous, which is exactly the
kind of clinical judgment we expect at the MDC 4 level.
Q5: You are caring for a patient who had a stroke and now has severe dysphagia. The
dietitian recommends a pureed diet with honey-thick liquids. At lunch, you observe the
, patient's spouse trying to feed the patient a regular cup of water. What is your most
appropriate action?
A. Quietly remove the water cup and bring in the thickened liquids without making a
scene
B. Stop the spouse, explain the aspiration risk immediately, and provide the correct
liquids
C. Document the incident in the chart and notify the charge nurse to speak with the
family
D. Let the spouse finish giving the water since it's only a small amount and then
reinforce the diet later
Correct Answer: B
Rationale: The best answer is stopping the spouse and explaining the risk right then
and there, because patient safety trumps any discomfort about correcting family
members. This aligns with the principle of immediate intervention to prevent aspiration,
which can be fatal, rather than passing the buck to the charge nurse.
Q6: During a care conference for a patient with end-stage liver disease, the social
worker mentions the patient's wife seems overwhelmed. The nurse adds, "She also
hasn't been complying with the low-sodium diet we taught her." What is the primary
issue with the nurse's communication style in this setting?
A. It breaches HIPAA because the wife's compliance is not the medical team's business
B. It uses judgmental language that shuts down collaborative problem-solving with the
team
C. It is inappropriate to discuss diet during a care conference focused on social work
needs
D. It demonstrates poor clinical judgment because liver patients don't actually need
sodium restrictions
Correct Answer: B
Rationale: What we’re really looking for here is professional communication. The best
answer highlights that labeling the spouse as "non-compliant" creates blame rather than
exploring why she is struggling, which goes against the collaborative, non-punitive spirit
of interdisciplinary rounds.
Q7: A patient is being transferred from the ICU to the step-down unit. The ICU nurse
gives a quick report in the hallway and says, "He's stable, just on a telemetry monitor,
pretty straightforward." When you get to the room, the patient tells you he feels very
short of breath. What is your next best action?
A. Review the transfer summary to see what his baseline oxygen requirements were in
the ICU
B. Hook him up to the continuous pulse oximetry immediately to get an objective
number
