NUR 2356 MDC 1 Final Exam
(MDC 1) Final Exam Practice Test:
Part 3
Comprehensive 150-Question Practice Exam
with Integrated Answers and Detailed Rationales
Covering Advanced Fluid Management, Isolation Protocols, and Prioritized
Postoperative Care.
1. A nurse is reviewing the arterial blood gas (ABG) results of a client with an acute
exacerbation of chronic obstructive pulmonary disease (COPD): pH 7.31, PaCO₂ 55
mmHg, HCO₃⁻ 25 mEq/L. Which of the following acid-base imbalances is present?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratory acidosis
Answer: D) Respiratory acidosis
₂
₃⁻
2. A client is admitted with severe, intractable diarrhea for 4 days. Which acid-base
imbalance should the nurse anticipate monitoring this client for?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: A) Metabolic acidosis
3. A nurse is assessing a client who has a serum sodium level of 155 mEq/L. Which of the
following clinical findings should the nurse expect to observe?
A) Hyperactive bowel sounds
, B) Severe thirst and dry mucous membranes
C) Decreased deep tendon reflexes
D) Bradycardia
Answer: B) Severe thirst and dry mucous membranes
4. A nurse is caring for an older adult client who has a serum potassium level of 3.1
mEq/L. Which of the following medications should the nurse identify as a potential
cause of this electrolyte imbalance?
A) Spironolactone
B) Furosemide
C) Lisinopril
D) Metoprolol
Answer: B) Furosemide
5. A nurse is reviewing a client's electrocardiogram (ECG) and notes tall, peaked T waves
and a widened QRS complex. Which of the following laboratory values correlates with
these electrical cardiac changes?
A) Potassium 2.8 mEq/L
B) Potassium 6.1 mEq/L
C) Sodium 130 mEq/L
D) Calcium 10.8 mg/dL
Answer: B) Potassium 6.1 mEq/L
6. A client has an order for a continuous intravenous infusion of 0.45% Sodium Chloride
(Half Normal Saline). The nurse understands that this fluid belongs to which of the
following solution classifications?
A) Isotonic crystalloid
B) Hypertonic crystalloid
C) Hypotonic crystalloid
D) Colloid solution
Answer: C) Hypotonic crystalloid
7. A nurse is preparing to administer an intravenous fluid bolus of 3% Sodium Chloride to
a client with severe symptomatic hyponatremia. Which of the following assessments is
, the priority for the nurse to perform during the infusion?
A) Assessing bowel sounds in all four quadrants
B) Monitoring capillary blood glucose levels
C) Assessing breath sounds for crackles and monitoring neurological status
D) Checking the client's skin turgor over the sternum
Answer: C) Assessing breath sounds for crackles and monitoring neurological
status
8. A nurse is caring for a client who is diagnosed with fluid volume excess (hypervolemia).
Which of the following objective findings should the nurse expect to find during the
assessment?
A) Flattened neck veins when supine
B) Postural hypotension
C) Distended jugular veins and a bounding pulse
D) Elevated urine specific gravity of 1.035
Answer: C) Distended jugular veins and a bounding pulse
9. A nurse is assessing a client with chronic kidney disease who presents with a serum
calcium level of 7.0 mg/dL. Which of the following clinical signs should the nurse assess
for?
A) Negative Babinski reflex
B) Trousseau's sign and Chvostek's sign
C) Flaccid paralysis of the extremities
D) Hyperglycemia
Answer: B) Trousseau's sign and Chvostek's sign
10. A nurse is monitoring a client who has a serum magnesium level of 1.1 mEq/L. Which of
the following clinical findings should the nurse expect?
A) Hypoactive deep tendon reflexes
B) Prolonged bradycardia
C) Hyperactive deep tendon reflexes and muscle tremors
D) Complete muscle flaccidity
Answer: C) Hyperactive deep tendon reflexes and muscle tremors
, 11. A nurse is reviewing a preoperative client's medical record. Which of the following
actions is the nurse's legal responsibility regarding informed consent?
A) Informing the client about the alternative surgical choices available
B) Explaining the specific risks and benefits of the intended procedure
C) Verifying that the client understands the surgery and witnessing their signature
D) Determining the exact depth of anesthesia required for the operation
Answer: C) Verifying that the client understands the surgery and witnessing their
signature
12. A nurse is preparing a client for an elective surgery. Which of the following laboratory
findings should the nurse report to the surgeon immediately?
A) Hemoglobin 14.5 g/dL
B) Platelet count 65,000/mm³
C) Blood urea nitrogen (BUN) 18 mg/dL
D) White blood cell count 7,200/mm³
Answer: B) Platelet count 65,000/mm³
13. A client in the post-anesthesia care unit (PACU) has a respiratory rate of 7
breaths/minute and an oxygen saturation of 86% following general anesthesia. Which of
the following actions should the nurse perform first?
A) Administer a rapid IV bolus of naloxone
B) Stimulate the client physically and verbally encourage deep breathing
C) Insert an endotracheal tube immediately
D) Call the attending surgeon to report the values
Answer: B) Stimulate the client physically and verbally encourage deep breathing
14. During an intraoperative procedure, the circulating nurse notes that the client develops
generalized skeletal muscle rigidity, an elevated heart rate of 130 beats/minute, and a
rapidly rising body temperature. Which of the following medications should the nurse
prepare to administer?
A) Succinylcholine
B) Dantrolene sodium
C) Furosemide
D) Nitroprusside
Answer: B) Dantrolene sodium
(MDC 1) Final Exam Practice Test:
Part 3
Comprehensive 150-Question Practice Exam
with Integrated Answers and Detailed Rationales
Covering Advanced Fluid Management, Isolation Protocols, and Prioritized
Postoperative Care.
1. A nurse is reviewing the arterial blood gas (ABG) results of a client with an acute
exacerbation of chronic obstructive pulmonary disease (COPD): pH 7.31, PaCO₂ 55
mmHg, HCO₃⁻ 25 mEq/L. Which of the following acid-base imbalances is present?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratory acidosis
Answer: D) Respiratory acidosis
₂
₃⁻
2. A client is admitted with severe, intractable diarrhea for 4 days. Which acid-base
imbalance should the nurse anticipate monitoring this client for?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: A) Metabolic acidosis
3. A nurse is assessing a client who has a serum sodium level of 155 mEq/L. Which of the
following clinical findings should the nurse expect to observe?
A) Hyperactive bowel sounds
, B) Severe thirst and dry mucous membranes
C) Decreased deep tendon reflexes
D) Bradycardia
Answer: B) Severe thirst and dry mucous membranes
4. A nurse is caring for an older adult client who has a serum potassium level of 3.1
mEq/L. Which of the following medications should the nurse identify as a potential
cause of this electrolyte imbalance?
A) Spironolactone
B) Furosemide
C) Lisinopril
D) Metoprolol
Answer: B) Furosemide
5. A nurse is reviewing a client's electrocardiogram (ECG) and notes tall, peaked T waves
and a widened QRS complex. Which of the following laboratory values correlates with
these electrical cardiac changes?
A) Potassium 2.8 mEq/L
B) Potassium 6.1 mEq/L
C) Sodium 130 mEq/L
D) Calcium 10.8 mg/dL
Answer: B) Potassium 6.1 mEq/L
6. A client has an order for a continuous intravenous infusion of 0.45% Sodium Chloride
(Half Normal Saline). The nurse understands that this fluid belongs to which of the
following solution classifications?
A) Isotonic crystalloid
B) Hypertonic crystalloid
C) Hypotonic crystalloid
D) Colloid solution
Answer: C) Hypotonic crystalloid
7. A nurse is preparing to administer an intravenous fluid bolus of 3% Sodium Chloride to
a client with severe symptomatic hyponatremia. Which of the following assessments is
, the priority for the nurse to perform during the infusion?
A) Assessing bowel sounds in all four quadrants
B) Monitoring capillary blood glucose levels
C) Assessing breath sounds for crackles and monitoring neurological status
D) Checking the client's skin turgor over the sternum
Answer: C) Assessing breath sounds for crackles and monitoring neurological
status
8. A nurse is caring for a client who is diagnosed with fluid volume excess (hypervolemia).
Which of the following objective findings should the nurse expect to find during the
assessment?
A) Flattened neck veins when supine
B) Postural hypotension
C) Distended jugular veins and a bounding pulse
D) Elevated urine specific gravity of 1.035
Answer: C) Distended jugular veins and a bounding pulse
9. A nurse is assessing a client with chronic kidney disease who presents with a serum
calcium level of 7.0 mg/dL. Which of the following clinical signs should the nurse assess
for?
A) Negative Babinski reflex
B) Trousseau's sign and Chvostek's sign
C) Flaccid paralysis of the extremities
D) Hyperglycemia
Answer: B) Trousseau's sign and Chvostek's sign
10. A nurse is monitoring a client who has a serum magnesium level of 1.1 mEq/L. Which of
the following clinical findings should the nurse expect?
A) Hypoactive deep tendon reflexes
B) Prolonged bradycardia
C) Hyperactive deep tendon reflexes and muscle tremors
D) Complete muscle flaccidity
Answer: C) Hyperactive deep tendon reflexes and muscle tremors
, 11. A nurse is reviewing a preoperative client's medical record. Which of the following
actions is the nurse's legal responsibility regarding informed consent?
A) Informing the client about the alternative surgical choices available
B) Explaining the specific risks and benefits of the intended procedure
C) Verifying that the client understands the surgery and witnessing their signature
D) Determining the exact depth of anesthesia required for the operation
Answer: C) Verifying that the client understands the surgery and witnessing their
signature
12. A nurse is preparing a client for an elective surgery. Which of the following laboratory
findings should the nurse report to the surgeon immediately?
A) Hemoglobin 14.5 g/dL
B) Platelet count 65,000/mm³
C) Blood urea nitrogen (BUN) 18 mg/dL
D) White blood cell count 7,200/mm³
Answer: B) Platelet count 65,000/mm³
13. A client in the post-anesthesia care unit (PACU) has a respiratory rate of 7
breaths/minute and an oxygen saturation of 86% following general anesthesia. Which of
the following actions should the nurse perform first?
A) Administer a rapid IV bolus of naloxone
B) Stimulate the client physically and verbally encourage deep breathing
C) Insert an endotracheal tube immediately
D) Call the attending surgeon to report the values
Answer: B) Stimulate the client physically and verbally encourage deep breathing
14. During an intraoperative procedure, the circulating nurse notes that the client develops
generalized skeletal muscle rigidity, an elevated heart rate of 130 beats/minute, and a
rapidly rising body temperature. Which of the following medications should the nurse
prepare to administer?
A) Succinylcholine
B) Dantrolene sodium
C) Furosemide
D) Nitroprusside
Answer: B) Dantrolene sodium
