RASMUSSEN COLLEGE MDC 2 EXAM 1 2026/2027 |
Verified Questions & Answers | Multidimensional Care II |
Pass Guaranteed - A+ Graded
Section 1: Cardiovascular Disorders (Questions 1-20)
Question 1 A patient with HFrEF has a new prescription for sacubitril/valsartan
(Entresto). The nurse should instruct the patient to avoid which medication due to
risk of angioedema?
A. Aspirin
B. ACE inhibitors [CORRECT]
C. Statins
D. Digoxin
Rationale: Sacubitril/valsartan is an ARNI that must not be used within 36 hours of
ACE inhibitors due to increased angioedema risk. Aspirin (Option A), statins (Option
C), and digoxin (Option D) do not have this interaction. The nurse must ensure a 36-
hour washout period when transitioning from ACEi to ARNI. This is a critical safety
priority for HFrEF management.
Question 2 A patient with heart failure weighs themselves daily and notes a 4-pound
weight gain in 2 days. The nurse should instruct the patient to:
A. Continue current medications and monitor for another week.
B. Contact the healthcare provider as this indicates fluid retention requiring
intervention. [CORRECT]
,C. Restrict all fluids completely until weight returns to baseline.
D. Take an extra dose of furosemide without consulting the provider.
Rationale: Weight gain >2-3 lbs in 24 hours or >5 lbs in a week indicates fluid
retention and requires provider notification for possible diuretic adjustment. Option
A delays necessary intervention. Option C is unsafe and unnecessary. Option D is
outside patient scope and dangerous. Patient education on daily weights is essential
for HF self-management.
Question 3 A patient with HFrEF is prescribed carvedilol. The nurse knows that beta-
blockers in heart failure should be:
A. Started at the target dose immediately for maximum benefit.
B. Started at a low dose and titrated slowly with monitoring of HR and BP.
[CORRECT]
C. Avoided entirely in all patients with heart failure.
D. Used only during acute decompensation to improve cardiac output.
Rationale: Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) reduce
mortality in HFrEF but must be started low and titrated slowly to avoid acute
decompensation. Option A risks worsening HF. Option C is incorrect; they are
guideline-directed therapy. Option D is dangerous; beta-blockers are contraindicated
in acute decompensation.
Question 4 A patient with heart failure has a BNP of 850 pg/mL. This value suggests:
A. Normal cardiac function
B. Mild heart failure
C. Moderate to severe heart failure [CORRECT]
D. Acute myocardial infarction
,Rationale: BNP >100 pg/mL suggests HF; >500 suggests moderate HF; >900
suggests severe HF. Option A is incorrect. Option B understates the severity. Option
D is possible but BNP is not specific for MI; troponin diagnoses MI. BNP guides
severity assessment and treatment response.
Question 5 A patient with Stage 2 hypertension (BP 158/96 mmHg) and no
compelling indications is started on monotherapy. The preferred first-line agent is:
A. ACE inhibitor
B. Thiazide diuretic [CORRECT]
C. Beta-blocker
D. Alpha-blocker
Rationale: Thiazide diuretics (chlorthalidone, HCTZ) are preferred first-line for Stage
1-2 hypertension without compelling indications per ACC/AHA guidelines. ACEi
(Option A) is first-line for CKD, DM, or HF. Beta-blockers (Option C) are not first-line
for uncomplicated HTN. Alpha-blockers (Option D) are not preferred due to
cardiovascular risks.
Question 6 A patient with hypertensive emergency (BP 220/130 mmHg) has acute
kidney injury and pulmonary edema. The appropriate initial management is:
A. Oral metoprolol 50 mg
B. IV labetalol, nicardipine, or clevidipine with controlled reduction of MAP by 25% in
the first hour [CORRECT]
C. Sublingual nifedipine for rapid blood pressure reduction
D. Observation and recheck blood pressure in 24 hours
Rationale: Hypertensive emergency requires IV agents with controlled reduction (not
>25% MAP in first hour) to prevent cerebral, coronary, and renal ischemia. Oral
agents (Option A) are inappropriate. Sublingual nifedipine (Option C) causes
, precipitous drops and is contraindicated. Observation (Option D) risks end-organ
damage.
Question 7 A patient with CAD presents with chest pain relieved by rest and
sublingual nitroglycerin. This describes:
A. Unstable angina
B. Stable angina [CORRECT]
C. NSTEMI
D. STEMI
Rationale: Stable angina is predictable, exertional, and relieved by rest/nitroglycerin.
Unstable angina (Option A) is new, worsening, or at rest. NSTEMI (Option C) and
STEMI (Option D) involve myocardial necrosis with troponin elevation. Differentiating
angina types guides urgency of intervention.
Question 8 A patient with acute MI is receiving MONA therapy. The "A" in MONA
stands for:
A. Alteplase
B. Aspirin [CORRECT]
C. Atorvastatin
D. Anticoagulation
Rationale: MONA = Morphine, Oxygen (if SpO2 <90%), Nitroglycerin, Aspirin (324
mg chewable). Aspirin reduces mortality in acute MI. Alteplase (Option A) is for
fibrinolysis, not universal. Atorvastatin (Option C) is initiated but not part of MONA.
Anticoagulation (Option D) is given but not the "A."
Verified Questions & Answers | Multidimensional Care II |
Pass Guaranteed - A+ Graded
Section 1: Cardiovascular Disorders (Questions 1-20)
Question 1 A patient with HFrEF has a new prescription for sacubitril/valsartan
(Entresto). The nurse should instruct the patient to avoid which medication due to
risk of angioedema?
A. Aspirin
B. ACE inhibitors [CORRECT]
C. Statins
D. Digoxin
Rationale: Sacubitril/valsartan is an ARNI that must not be used within 36 hours of
ACE inhibitors due to increased angioedema risk. Aspirin (Option A), statins (Option
C), and digoxin (Option D) do not have this interaction. The nurse must ensure a 36-
hour washout period when transitioning from ACEi to ARNI. This is a critical safety
priority for HFrEF management.
Question 2 A patient with heart failure weighs themselves daily and notes a 4-pound
weight gain in 2 days. The nurse should instruct the patient to:
A. Continue current medications and monitor for another week.
B. Contact the healthcare provider as this indicates fluid retention requiring
intervention. [CORRECT]
,C. Restrict all fluids completely until weight returns to baseline.
D. Take an extra dose of furosemide without consulting the provider.
Rationale: Weight gain >2-3 lbs in 24 hours or >5 lbs in a week indicates fluid
retention and requires provider notification for possible diuretic adjustment. Option
A delays necessary intervention. Option C is unsafe and unnecessary. Option D is
outside patient scope and dangerous. Patient education on daily weights is essential
for HF self-management.
Question 3 A patient with HFrEF is prescribed carvedilol. The nurse knows that beta-
blockers in heart failure should be:
A. Started at the target dose immediately for maximum benefit.
B. Started at a low dose and titrated slowly with monitoring of HR and BP.
[CORRECT]
C. Avoided entirely in all patients with heart failure.
D. Used only during acute decompensation to improve cardiac output.
Rationale: Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) reduce
mortality in HFrEF but must be started low and titrated slowly to avoid acute
decompensation. Option A risks worsening HF. Option C is incorrect; they are
guideline-directed therapy. Option D is dangerous; beta-blockers are contraindicated
in acute decompensation.
Question 4 A patient with heart failure has a BNP of 850 pg/mL. This value suggests:
A. Normal cardiac function
B. Mild heart failure
C. Moderate to severe heart failure [CORRECT]
D. Acute myocardial infarction
,Rationale: BNP >100 pg/mL suggests HF; >500 suggests moderate HF; >900
suggests severe HF. Option A is incorrect. Option B understates the severity. Option
D is possible but BNP is not specific for MI; troponin diagnoses MI. BNP guides
severity assessment and treatment response.
Question 5 A patient with Stage 2 hypertension (BP 158/96 mmHg) and no
compelling indications is started on monotherapy. The preferred first-line agent is:
A. ACE inhibitor
B. Thiazide diuretic [CORRECT]
C. Beta-blocker
D. Alpha-blocker
Rationale: Thiazide diuretics (chlorthalidone, HCTZ) are preferred first-line for Stage
1-2 hypertension without compelling indications per ACC/AHA guidelines. ACEi
(Option A) is first-line for CKD, DM, or HF. Beta-blockers (Option C) are not first-line
for uncomplicated HTN. Alpha-blockers (Option D) are not preferred due to
cardiovascular risks.
Question 6 A patient with hypertensive emergency (BP 220/130 mmHg) has acute
kidney injury and pulmonary edema. The appropriate initial management is:
A. Oral metoprolol 50 mg
B. IV labetalol, nicardipine, or clevidipine with controlled reduction of MAP by 25% in
the first hour [CORRECT]
C. Sublingual nifedipine for rapid blood pressure reduction
D. Observation and recheck blood pressure in 24 hours
Rationale: Hypertensive emergency requires IV agents with controlled reduction (not
>25% MAP in first hour) to prevent cerebral, coronary, and renal ischemia. Oral
agents (Option A) are inappropriate. Sublingual nifedipine (Option C) causes
, precipitous drops and is contraindicated. Observation (Option D) risks end-organ
damage.
Question 7 A patient with CAD presents with chest pain relieved by rest and
sublingual nitroglycerin. This describes:
A. Unstable angina
B. Stable angina [CORRECT]
C. NSTEMI
D. STEMI
Rationale: Stable angina is predictable, exertional, and relieved by rest/nitroglycerin.
Unstable angina (Option A) is new, worsening, or at rest. NSTEMI (Option C) and
STEMI (Option D) involve myocardial necrosis with troponin elevation. Differentiating
angina types guides urgency of intervention.
Question 8 A patient with acute MI is receiving MONA therapy. The "A" in MONA
stands for:
A. Alteplase
B. Aspirin [CORRECT]
C. Atorvastatin
D. Anticoagulation
Rationale: MONA = Morphine, Oxygen (if SpO2 <90%), Nitroglycerin, Aspirin (324
mg chewable). Aspirin reduces mortality in acute MI. Alteplase (Option A) is for
fibrinolysis, not universal. Atorvastatin (Option C) is initiated but not part of MONA.
Anticoagulation (Option D) is given but not the "A."
