NUR 2755 MULTIDIMENSIONAL CARE IV
(MDC 4) FINAL EXAM – RASMUSSEN
UNIVERSITY (2026/2027) | COMPLETE STUDY
REVIEW WITH PRACTICE QUESTIONS &
VERIFIED ANSWERS
• This 200-question practice exam mirrors the Rasmussen University NUR 2755
MDC 4 Final Exam format, covering all high-yield nursing topics tested in the course.
• Each question features five answer choices (A–E), a clearly marked correct answer
in bold, and a EXPERT RATIONALE — use it to study by attempting each question
first, then checking your answer and understanding the "why."
NUR 2755 MULTIDIMENSIONAL CARE IV (MDC 4) FINAL EXAM RASMUSSEN
UNIVERSITY (2026/2027) COMPLETE STUDY REVIEW WITH PRACTICE QUESTIONS
& VERIFIED ANSWERS
QUESTION 1
A nurse is caring for a client with chronic kidney disease (CKD) who has a
serum potassium level of 6.8 mEq/L. Which intervention should the nurse
prioritize?
A. Administer oral potassium supplement
B. Encourage increased dietary potassium intake
C. Place the client in Trendelenburg position
D. Prepare for peritoneal dialysis in 48 hours
E. Place the client on continuous cardiac monitoring
Correct Answer: E. Place the client on continuous cardiac monitoring
EXPERT RATIONALE: A potassium level of 6.8 mEq/L is critically high
(hyperkalemia). The most immediate life-threatening complication is fatal cardiac
dysrhythmia. Continuous cardiac monitoring is the priority intervention. Potassium
supplements and dietary increases would worsen the condition.
,QUESTION 2
A client with end-stage renal disease (ESRD) is receiving hemodialysis. The
nurse notes the client's blood pressure is 210/118 mmHg before dialysis. What
is the nurse's priority action?
A. Delay dialysis until the physician is notified and blood pressure stabilizes
B. Begin dialysis immediately to remove excess fluid
C. Administer a fluid bolus of 500 mL normal saline
D. Place the client in a supine position and recheck in 30 minutes
E. Notify the physician and administer prescribed antihypertensive
medication
Correct Answer: E. Notify the physician and administer prescribed
antihypertensive medication
EXPERT RATIONALE: A blood pressure of 210/118 mmHg represents a
hypertensive crisis. The nurse must notify the physician and administer
antihypertensives as prescribed before or during dialysis to prevent stroke or
cardiac event. A fluid bolus would dangerously worsen hypertension.
QUESTION 3
A nurse is teaching a client newly diagnosed with type 2 diabetes about foot
care. Which statement by the client indicates a need for further teaching?
A. "I will inspect my feet every day for sores or redness."
B. "I will wear well-fitting shoes and avoid going barefoot."
C. "I will keep my feet moisturized including between my toes."
D. "I will cut my toenails straight across."
E. "I will soak my feet in hot water daily to improve circulation."
, Correct Answer: E. "I will soak my feet in hot water daily to improve
circulation."
EXPERT RATIONALE: Soaking feet in hot water is contraindicated in diabetic clients
due to the risk of burns from decreased peripheral sensation. Moisture between
toes also promotes fungal infection. All other statements reflect correct foot care
practices.
QUESTION 4
A nurse is assessing a client with Addison's disease. Which clinical finding
requires the most immediate nursing intervention?
A. Hyperpigmentation of the skin
B. Fatigue and muscle weakness
C. Weight loss and anorexia
D. Blood pressure 78/50 mmHg and heart rate 122 bpm
E. Craving for salty foods
Correct Answer: D. Blood pressure 78/50 mmHg and heart rate 122 bpm
EXPERT RATIONALE: These findings indicate Addisonian crisis (acute adrenal
insufficiency), a life-threatening emergency characterized by severe hypotension
and tachycardia. Immediate IV fluid resuscitation and corticosteroid replacement
are required. Other findings are chronic manifestations of Addison's disease.
QUESTION 5
A client is admitted with diabetic ketoacidosis (DKA). Which laboratory finding
is most consistent with this diagnosis?
A. pH 7.48, bicarbonate 28 mEq/L, glucose 90 mg/dL
B. pH 7.38, bicarbonate 24 mEq/L, glucose 110 mg/dL
C. pH 7.50, bicarbonate 30 mEq/L, glucose 60 mg/dL
, D. pH 7.22, bicarbonate 10 mEq/L, glucose 520 mg/dL
E. pH 7.35, bicarbonate 22 mEq/L, glucose 200 mg/dL
Correct Answer: D. pH 7.22, bicarbonate 10 mEq/L, glucose 520 mg/dL
EXPERT RATIONALE: DKA is characterized by metabolic acidosis (low pH), low
bicarbonate due to buffering of ketoacids, and hyperglycemia typically above 300
mg/dL. The presence of ketones in the blood drives down the pH and bicarbonate.
QUESTION 6
A nurse is caring for a client receiving peritoneal dialysis. The nurse notes the
dialysate drainage is cloudy. What is the priority nursing action?
A. Document the finding and continue monitoring
B. Slow the dialysate infusion rate
C. Reposition the client to the left side
D. Notify the physician immediately and obtain a specimen for culture
E. Warm the dialysate before the next exchange
Correct Answer: D. Notify the physician immediately and obtain a specimen
for culture
EXPERT RATIONALE: Cloudy dialysate effluent is a hallmark sign of peritonitis, a
serious infection complication of peritoneal dialysis. The physician must be notified
immediately and a culture of the effluent obtained to guide antibiotic therapy.
QUESTION 7
A nurse is caring for a postoperative client following a thyroidectomy. The
client reports tingling around the mouth and in the fingertips. Which action
should the nurse take first?
A. Administer prescribed pain medication
(MDC 4) FINAL EXAM – RASMUSSEN
UNIVERSITY (2026/2027) | COMPLETE STUDY
REVIEW WITH PRACTICE QUESTIONS &
VERIFIED ANSWERS
• This 200-question practice exam mirrors the Rasmussen University NUR 2755
MDC 4 Final Exam format, covering all high-yield nursing topics tested in the course.
• Each question features five answer choices (A–E), a clearly marked correct answer
in bold, and a EXPERT RATIONALE — use it to study by attempting each question
first, then checking your answer and understanding the "why."
NUR 2755 MULTIDIMENSIONAL CARE IV (MDC 4) FINAL EXAM RASMUSSEN
UNIVERSITY (2026/2027) COMPLETE STUDY REVIEW WITH PRACTICE QUESTIONS
& VERIFIED ANSWERS
QUESTION 1
A nurse is caring for a client with chronic kidney disease (CKD) who has a
serum potassium level of 6.8 mEq/L. Which intervention should the nurse
prioritize?
A. Administer oral potassium supplement
B. Encourage increased dietary potassium intake
C. Place the client in Trendelenburg position
D. Prepare for peritoneal dialysis in 48 hours
E. Place the client on continuous cardiac monitoring
Correct Answer: E. Place the client on continuous cardiac monitoring
EXPERT RATIONALE: A potassium level of 6.8 mEq/L is critically high
(hyperkalemia). The most immediate life-threatening complication is fatal cardiac
dysrhythmia. Continuous cardiac monitoring is the priority intervention. Potassium
supplements and dietary increases would worsen the condition.
,QUESTION 2
A client with end-stage renal disease (ESRD) is receiving hemodialysis. The
nurse notes the client's blood pressure is 210/118 mmHg before dialysis. What
is the nurse's priority action?
A. Delay dialysis until the physician is notified and blood pressure stabilizes
B. Begin dialysis immediately to remove excess fluid
C. Administer a fluid bolus of 500 mL normal saline
D. Place the client in a supine position and recheck in 30 minutes
E. Notify the physician and administer prescribed antihypertensive
medication
Correct Answer: E. Notify the physician and administer prescribed
antihypertensive medication
EXPERT RATIONALE: A blood pressure of 210/118 mmHg represents a
hypertensive crisis. The nurse must notify the physician and administer
antihypertensives as prescribed before or during dialysis to prevent stroke or
cardiac event. A fluid bolus would dangerously worsen hypertension.
QUESTION 3
A nurse is teaching a client newly diagnosed with type 2 diabetes about foot
care. Which statement by the client indicates a need for further teaching?
A. "I will inspect my feet every day for sores or redness."
B. "I will wear well-fitting shoes and avoid going barefoot."
C. "I will keep my feet moisturized including between my toes."
D. "I will cut my toenails straight across."
E. "I will soak my feet in hot water daily to improve circulation."
, Correct Answer: E. "I will soak my feet in hot water daily to improve
circulation."
EXPERT RATIONALE: Soaking feet in hot water is contraindicated in diabetic clients
due to the risk of burns from decreased peripheral sensation. Moisture between
toes also promotes fungal infection. All other statements reflect correct foot care
practices.
QUESTION 4
A nurse is assessing a client with Addison's disease. Which clinical finding
requires the most immediate nursing intervention?
A. Hyperpigmentation of the skin
B. Fatigue and muscle weakness
C. Weight loss and anorexia
D. Blood pressure 78/50 mmHg and heart rate 122 bpm
E. Craving for salty foods
Correct Answer: D. Blood pressure 78/50 mmHg and heart rate 122 bpm
EXPERT RATIONALE: These findings indicate Addisonian crisis (acute adrenal
insufficiency), a life-threatening emergency characterized by severe hypotension
and tachycardia. Immediate IV fluid resuscitation and corticosteroid replacement
are required. Other findings are chronic manifestations of Addison's disease.
QUESTION 5
A client is admitted with diabetic ketoacidosis (DKA). Which laboratory finding
is most consistent with this diagnosis?
A. pH 7.48, bicarbonate 28 mEq/L, glucose 90 mg/dL
B. pH 7.38, bicarbonate 24 mEq/L, glucose 110 mg/dL
C. pH 7.50, bicarbonate 30 mEq/L, glucose 60 mg/dL
, D. pH 7.22, bicarbonate 10 mEq/L, glucose 520 mg/dL
E. pH 7.35, bicarbonate 22 mEq/L, glucose 200 mg/dL
Correct Answer: D. pH 7.22, bicarbonate 10 mEq/L, glucose 520 mg/dL
EXPERT RATIONALE: DKA is characterized by metabolic acidosis (low pH), low
bicarbonate due to buffering of ketoacids, and hyperglycemia typically above 300
mg/dL. The presence of ketones in the blood drives down the pH and bicarbonate.
QUESTION 6
A nurse is caring for a client receiving peritoneal dialysis. The nurse notes the
dialysate drainage is cloudy. What is the priority nursing action?
A. Document the finding and continue monitoring
B. Slow the dialysate infusion rate
C. Reposition the client to the left side
D. Notify the physician immediately and obtain a specimen for culture
E. Warm the dialysate before the next exchange
Correct Answer: D. Notify the physician immediately and obtain a specimen
for culture
EXPERT RATIONALE: Cloudy dialysate effluent is a hallmark sign of peritonitis, a
serious infection complication of peritoneal dialysis. The physician must be notified
immediately and a culture of the effluent obtained to guide antibiotic therapy.
QUESTION 7
A nurse is caring for a postoperative client following a thyroidectomy. The
client reports tingling around the mouth and in the fingertips. Which action
should the nurse take first?
A. Administer prescribed pain medication
