MDC 3 Final Exam Review; MDC 3 Clinical Review Questions and Answers 2026 - Rasmussen.

MDC 3 Clinical Review Which of the following are diagnostic criteria for metabolic syndrome? (Select all that apply) a) Triglycerides 150 b) Waist circumference 40 inches c) HDL Cholesterol 60 d) Blood pressure 130/85 e) Elevated fasting glucose 100 A nurse is assessing a client 72 hours after admission who develops a fever, purulent sputum, and crackles in both lungs. What is the nurse's priority? a) Administer broad-spectrum antibiotics b) Obtain a sputum culture c) Increase intravenous fluid rate d) Perform a chest X-ray Which arterial blood gas (ABG) result is consistent with severe COPD, respiratory acidosis, and air trapping? a) pH: 7.30, PaCO2: 60, HCO3: 30 b) pH: 7.48, PaCO2: 30, HCO3: 22 c) pH: 7.35, PaCO2: 45, HCO3: 24 d) pH: 7.50, PaCO2: 50, HCO3: 35 A client using a decongestant nasal spray reports that their congestion is worsening after several days of use. What is the most likely cause? a) Development of a secondary bacterial infection b) An allergic reaction to the spray ingredients c) Rebound congestion from overuse d) Incorrect administration technique A client with facial trauma presents with dyspnea, stridor, and restlessness. What is the priority nursing action? a) Perform a focused neurological assessment b) Administer intravenous pain medication c) Prepare for emergent intubation d) Apply a cold compress to the face Which of the following conditions or symptoms are commonly associated with Obstructive Sleep Apnea (OSA)? (Select all that apply) a) Loud snoring and gasping b) Morning headaches c) Daytime sleepiness d) Bradycardia during apneic episodes e) Hypertension f) Weight loss and malnutrition A client with tuberculosis is prescribed isoniazid and rifampin. Which statement by the client indicates a need for further intervention? a) “I will take my medication at the same time every day.” b) “If I feel better, I can stop taking the medications.” c) “I should avoid drinking alcohol while on these drugs.” d) “My urine might turn an orange color.” A nurse is teaching a client with asthma how to use a peak flow meter. Which instruction is correct? a) Perform the test once a day before breakfast b) Use the meter only when feeling short of breath c) Perform the test three times and record the highest value d) Record the average of three consecutive tests A client with acute pulmonary edema is gasping for air with an O2 saturation of 78% and pink frothy sputum. What is the priority action? a) Start an intravenous line for diuretics b) Place the client in high Fowler’s and apply oxygen c) Obtain an immediate chest X-ray d) Auscultate the heart for murmurs A client with a history of COPD has the following ABG: pH: 7.36, PaCO2: 58, HCO3: 32. How should the nurse interpret these results? a) Uncompensated respiratory acidosis b) Fully compensated respiratory acidosis c) Partially compensated metabolic alkalosis d) Normal ABG for a COPD patient A postmenopausal client is prescribed estrogen replacement therapy. Which finding should the nurse report to the provider immediately? a) Mild nausea b) Breast tenderness c) Calf pain and swelling d) Occasional headaches A nurse is teaching testicular self-examination (TSE) to a 20-year-old male. Which statement indicates a correct understanding? a) “I should check my testicles once a year during my physical.” b) “I should check my testicles after a warm shower each month.” c) “If I feel a lump, I should wait a week to see if it goes away.” d) “The best time to check is right before going to bed.” A 55-year-old male asks the nurse why he needs a Digital Rectal Exam (DRE). What is the best explanation? a) To screen for colon cancer b) To check for prostate enlargement and cancer c) To evaluate for inguinal hernias d) To assess for hemorrhoids Which client is at the highest priority for early prostate cancer screening with DRE and PSA? a) 50-year-old Caucasian male with no family history b) 45-year-old African American male whose father was diagnosed with prostate cancer c) 60-year-old Asian male with hypertension d) 40-year-old Hispanic male with obesity Which symptom is most suggestive of Pelvic Inflammatory Disease (PID)? a) Clear vaginal discharge b) Suprapubic pain and fever c) Dysuria without fever d) Irregular menstrual cycles Which assessment finding is consistent with Bacterial Vaginosis? a) Thick, white, "cottage cheese" discharge b) Gray, fishy-smelling vaginal discharge c) Green, frothy discharge with itching d) Small, painful blisters in the genital area Which lipid panel results best reflect the success of ASCVD (Atherosclerotic Cardiovascular Disease) risk reduction treatment? a) High LDL, low HDL b) Low LDL, high HDL c) High triglycerides, high LDL d) Low HDL, low LDL What is a classic sign of Peripheral Artery Disease (PAD) in the lower extremities? a) Warm, ruddy skin with edema b) Cool hairless skin, dependent rubor, and thick opaque nailbeds c) Brown pigmentation around the ankles d) Soft, palpable pulses with moist ulcers Which of the following instructions should be included in teaching to reduce ischemic risk in PAD? (Select all that apply) a) Smoking cessation b) Walk to the point of pain, rest, then resume c) Keep legs elevated above the heart d) Inspect feet daily e) Avoid tight shoes Which presentation is most typical of venous insufficiency? a) Pale, cool extremities with no pulse b) Ulcers at the medial malleolus with brown staining c) Sharp pain that increases with leg elevation d) Gangrene of the toes A nurse is assessing a client with left-sided heart failure. Which finding requires immediate follow-up? a) Jugular venous distention (JVD) b) Dependent edema in the ankles c) Crackles in the lungs d) Ascites A client with right-sided heart failure has gained 3 lbs in 2 days. Which action should the nurse take first? a) Notify the healthcare provider b) Assess for shortness of breath and lung sounds c) Review the client's sodium intake d) Administer an extra dose of prescribed diuretic A client with atrial fibrillation is receiving warfarin. Which lab result is most concerning to the nurse? a) INR 2.5 b) INR 6.2 with no active bleeding c) PT of 18 seconds d) PTT of 35 seconds A nurse assesses a client with PAD who reports calf pain after walking one block that resolves with rest. What is the priority nursing action? a) Complete bed rest to avoid pain b) Teach graded walking to the point of pain, then rest c) Apply heating pads to the calves twice daily d) Limit fluid intake to 1 liter per day A client with a dual-chamber pacemaker reports dizziness. The telemetry monitor shows pacemaker spikes that are not followed by QRS complexes. What is the priority action? a) Increase the pacemaker rate b) Assess lead position and obtain electrolytes c) Administer atropine intravenously d) Prepare for immediate cardioversion A client in torsades de pointes is pulseless. What is the priority intervention? a) IV Amiodarone and synchronized cardioversion b) Magnesium sulfate IV and defibrillation c) Epinephrine IV and chest compressions d) Lidocaine bolus and temporary pacing A nurse observes sawtooth flutter waves at a ventricular rate of 150 on the monitor. The client is stable. Which initial treatment is most appropriate? a) Immediate defibrillation b) Rate control with diltiazem or a beta-blocker c) Administration of epinephrine d) Insertion of a permanent pacemaker A nurse suspects cardiac tamponade in a post-operative cardiac client. Which assessment findings support this diagnosis? a) Hypertension and bradycardia b) Pulsus paradoxus and muffled heart sounds c) Widened pulse pressure and tachycardia d) Flattened neck veins and clear lung sounds Which finding is most consistent with chronic aortic regurgitation (AR)? a) Systolic click at the apex b) Diastolic blowing murmur at the left sternal border with bounding pulses c) Narrow pulse pressure and weak peripheral pulses d) Holosystolic murmur radiating to the axilla A client with chronic stable angina wearing a daily nitroglycerin patch reports 10/10 crushing chest pain. What should the nurse do first? a) Administer sublingual nitroglycerin b) Increase the dose of the patch c) Obtain a 12-lead ECG d) Apply a second patch to a different site Which instructions should the nurse include when teaching a client about a nitroglycerin (NTG) patch? (Select all that apply) a) Apply to a clean, dry, hairless area on the upper body b) Remove the old patch before applying a new one c) Rotate sites with each application d) Wear gloves when handling the patch e) Leave the patch on for 24 hours without removal A client suddenly loses consciousness and the monitor shows ventricular fibrillation. What is the immediate priority? a) Administer IV epinephrine b) Start chest compressions and charge the defibrillator c) Intubate the client d) Synchronize the monitor for cardioversion A client is in stable atrial fibrillation with a heart rate of 130 and blood pressure of 124/76. What is the first action? a) Synchronized cardioversion b) Rate control with diltiazem or a beta-blocker c) Administration of adenosine d) Immediate defibrillation A patient presents in stable V-tach with a blood pressure of 118/70. What is the best initial drug to administer? a) Atropine b) Amiodarone c) Digoxin d) Epinephrine Identify the rhythm described: Rapid rate, narrow QRS complexes, and P-waves that are often hidden. a) Atrial flutter b) SVT (Supraventricular Tachycardia) c) Sinus tachycardia d) Ventricular tachycardia Identify the rhythm described: Chaotic, wavy line with no identifiable P-waves or QRS complexes. a) Ventricular tachycardia b) Ventricular fibrillation c) Asystole d) Atrial fibrillation Identify the rhythm described: The PR interval progressively lengthens until a QRS complex is dropped. a) First-degree AV block b) Second-degree AV Block (Type 1) c) Third-degree AV block d) Bundle branch block Identify the rhythm described: Wide, bizarre QRS complexes occurring at a rapid rate without P-waves. a) SVT b) Ventricular Tachycardia (Vtach) c) Atrial fibrillation d) Ventricular fibrillation Which pharmacological interventions are most appropriate for a client in Atrial Fibrillation (AFIB)? a) Anticoagulants, amiodarone, beta-blocker, calcium channel blocker b) Atropine, epinephrine, pacemaker c) Magnesium sulfate, defibrillation d) Adenosine, carotid massage Which of the following is the most common valvular disorder? a) Mitral valve prolapse b) Aortic stenosis c) Tricuspid regurgitation d) Pulmonic stenosis A client with left-sided heart failure reports increased dyspnea and the need to use three pillows to sleep. Which finding requires immediate follow-up? a) Pulse oximetry of 94% on room air b) Fine crackles at lung bases and an S3 heart sound c) Trace pedal edema d) Heart rate of 98 bpm A client taking lisinopril reports a persistent dry cough. What is the nurse's best response? a) "This is a sign of a worsening respiratory infection." b) "This is a common side effect; switching to an ARB may be appropriate." c) "You should stop the medication immediately and go to the ER." d) "The cough will likely resolve within 48 hours of starting the drug." A client scheduled for a Ventricular Assist Device (VAD) asks what it does. What is the most accurate response? a) It is a temporary external balloon that helps the heart pump. b) It is a mechanical circulatory support pump that assists failing ventricles in end-stage heart failure. c) It is a type of permanent pacemaker used for arrhythmias. d) It is a surgical procedure to replace damaged heart valves. Which findings are common in acute leukemia at presentation? (Select all that apply) a) Frequent infections b) Easy bruising/bleeding gums c) Bone pain d) Night sweats and weight loss e) Increased energy levels Which electrolyte patterns suggest Tumor Lysis Syndrome (TLS) in a client with AML? a) Low potassium, low phosphate, high calcium b) High potassium, high phosphate, low calcium c) Low potassium, high phosphate, high calcium d) High potassium, low phosphate, low calcium What is the most appropriate action for suspected Heparin-Induced Thrombocytopenia (HIT)? a) Increase the heparin dose b) Stop heparin and switch to protamine c) Administer a platelet transfusion d) Switch to warfarin immediately Which of the following are standard heparin safety checks? (Select all that apply) a) Dose verification with a second RN b) Monitoring aPTT levels c) Avoiding IM injections d) Sending the patient home on both heparin and warfarin together What is the most important initial step in treating Disseminated Intravascular Coagulation (DIC)? a) Administering fresh frozen plasma b) Treating the underlying cause c) Giving high-dose heparin d) Providing a platelet transfusion Which of the following should be included in home teaching for a client with hemophilia? (Select all that apply) a) Wear a medical alert bracelet b) Avoid IM injections c) Use acetaminophen for pain d) Desmopressin use for mild hemophilia A e) Use aspirin for joint pain What is included in the teaching for Polycythemia Vera? (Select all that apply) a) Periodic phlebotomy to keep HCT in target range b) Maintain hydration c) Use low-dose aspirin if ordered d) Avoid smoking and tight clothes e) Limit fluid intake to 1 liter per day A client with sickle cell disease presents with severe back pain and an O2 saturation of 88%. What is the priority management? a) Administer oxygen, IV fluids, and opioids b) Apply cold compresses to the painful areas c) Restrict fluid intake d) Prepare for immediate blood transfusion Which symptoms would signal the nurse to check a client's platelet count? (Select all that apply) a) Petechiae b) Ecchymosis c) Hypertension d) Polyuria Which intervention is best for mouth ulcers caused by chemotherapy? a) Use an alcohol-based mouthwash b) Eat spicy foods to stimulate taste buds c) Consume soft meals d) Use a firm-bristled toothbrush Which of the following are interventions for bleeding precautions? (Select all that apply) a) Use electric razors for shaving b) Implement fall precautions c) Use SubQ injections instead of IM when possible d) Vigorous flossing daily Which symptom is most consistent with an Abdominal Aortic Aneurysm (AAA)? a) Sharp, stabbing chest pain b) Palpable abdominal mass c) Hyperactive bowel sounds d) Left-sided weakness