NUR 2356 / NUR2356 Multidimensional Care I Exam 2 / MDC 1 Exam 2 Quiz Bank | Already Rated A | Latest 2026/2027 | Rasmussen College 2026/2027 | Page 1 | Passing Score: 80%
RASMUSSEN COLLEGE
NUR 2356 / NUR2356 Multidimensional Care I Exam 2
/ MDC 1 Exam 2 Quiz Bank | Already Rated A |
Latest 2026/2027 | Rasmussen College
2026/2027 Edition - Official Exam 2026/2027
75 80% N/A
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Fluid and Electrolyte Balance Q1-Q15
Section 2 Acid-Base Disorders Q16-Q30
Section 3 Pain Management Q31-Q45
Section 4 Perioperative Care Q46-Q60
Section 5 Oxygenation and Respiratory Function Q61-Q75
Instructions: Select the single best answer for each question. This exam is designed for NUR 2356 Multidimensional Care I
certification preparation. Passing score: 80% (60 questions correct).
NUR 2356 Multidimensional Care I Exam 2 -- 2026/2027 | Passing Score: 80% | Page 1 of 36
,SECTION 1 | Fluid and Electrolyte Balance | Q1-Q15 | NUR 2356 Multidimensional Care I Exam 2 2026/2027
Q1 Question 1 of 75
A 72-year-old male with heart failure is admitted with fatigue, muscle weakness, and deep tendon
hyporeflexia. His serum potassium is 2.9 mEq/L and his ECG shows flattened T waves and
prominent U waves. Which intervention should the nurse implement first?
A. Administer oral potassium supplement with meals
B. Encourage the patient to eat potassium-rich foods such as bananas and oranges
C. Initiate continuous cardiac monitoring and prepare for IV potassium replacement
D. Notify the provider and request a repeat potassium level in 4 hours
Correct Answer: C
Rationale:
The patient has severe hypokalemia (2.9 mEq/L) with ECG changes, which places him at risk for life-threatening
dysrhythmias. Continuous cardiac monitoring and IV potassium replacement are the priority because oral
supplementation is too slow for severe hypokalemia with ECG changes. Dietary changes are preventive, not
emergent, and waiting 4 hours to recheck is unsafe given the current ECG findings.
Q2 Question 2 of 75
A 58-year-old female receiving loop diuretic therapy for hypertension reports muscle cramps,
weakness, and polyuria. Her lab results show sodium 128 mEq/L, potassium 3.1 mEq/L, and
chloride 88 mEq/L. The nurse recognizes that these findings are most consistent with which
electrolyte imbalance?
A. Hyponatremia with hypokalemia and hypochloremia secondary to diuretic use
B. Hypernatremia with concurrent hypokalemia
C. Syndrome of inappropriate antidiuretic hormone with hypokalemia
D. Cushing syndrome presenting with electrolyte depletion
Correct Answer: A
Rationale:
Loop diuretics cause excessive urinary loss of sodium, potassium, and chloride, leading to hyponatremia,
hypokalemia, and hypochloremia as a combined pattern. The lab values of Na 128, K 3.1, and Cl 88 all fall below
normal ranges, and the symptoms of muscle cramps and weakness are classic for these deficits. SIADH would cause
dilutional hyponatremia but not typically hypokalemia and hypochloremia, and Cushing syndrome causes
hypernatremia and hypokalemia, not hyponatremia.
NUR 2356 Multidimensional Care I Exam 2 -- 2026/2027 | Passing Score: 80% | Page 2 of 36
,Q3 Question 3 of 75
A 45-year-old male with small cell lung cancer develops confusion, muscle twitching, and a serum
sodium of 118 mEq/L. Urine osmolality is 450 mOsm/kg and urine sodium is 65 mEq/L. The nurse
identifies that this clinical presentation is most consistent with which condition?
A. Diabetes insipidus causing hypernatremia
B. Syndrome of inappropriate antidiuretic hormone secretion
C. Addison disease with mineralocorticoid deficiency
D. Psychogenic polydipsia leading to dilutional hyponatremia
Correct Answer: B
Rationale:
Small cell lung cancer is a classic cause of SIADH, characterized by excessive ADH release leading to water
retention, dilutional hyponatremia, concentrated urine (elevated urine osmolality), and high urine sodium. Diabetes
insipidus causes hypernatremia, not hyponatremia. Addison disease causes hyponatremia with hyperkalemia and
hypotension, and psychogenic polydipsia would show dilute urine rather than concentrated urine.
Q4 Question 4 of 75
A 34-year-old female with severe vomiting for 3 days presents with a blood pressure of 90/58
mmHg, heart rate 112 bpm, poor skin turgor, and dry mucous membranes. Her serum sodium is 152
mEq/L. The nurse understands that the primary pathophysiology of her hypernatremia is which
mechanism?
A. Pure water loss exceeding sodium loss from vomiting and inadequate fluid intake
B. Excess sodium intake from dietary sources
C. Hyperaldosteronism causing renal sodium retention
D. Cushing syndrome producing cortisol-mediated sodium retention
Correct Answer: A
Rationale:
Prolonged vomiting with inadequate fluid replacement leads to dehydration and hypernatremia through pure water
loss that exceeds sodium loss. The clinical signs of hypotension, tachycardia, poor skin turgor, and dry mucous
membranes all indicate significant volume depletion. Hyperaldosteronism and Cushing syndrome would cause
hypervolemic hypernatremia without signs of volume depletion, and dietary sodium excess is an uncommon cause of
hypernatremia.
NUR 2356 Multidimensional Care I Exam 2 -- 2026/2027 | Passing Score: 80% | Page 3 of 36
, Q5 Question 5 of 75
A 67-year-old male with chronic kidney disease stage 4 has a serum calcium of 11.8 mg/dL, serum
phosphate of 2.0 mg/dL, and reports generalized bone pain. The nurse recognizes that his
hypercalcemia is most likely caused by which mechanism?
A. Secondary hyperparathyroidism from chronic renal failure
B. Excessive dietary calcium supplementation
C. Primary hyperparathyroidism from a parathyroid adenoma
D. Malignancy-associated humoral hypercalcemia
Correct Answer: A
Rationale:
Chronic kidney disease leads to phosphate retention and reduced calcitriol production, triggering secondary
hyperparathyroidism with elevated PTH levels that increase bone resorption and calcium release. The low phosphate
combined with hypercalcemia and bone pain is consistent with PTH-mediated bone demineralization. Primary
hyperparathyroidism is less likely in CKD, malignancy-associated hypercalcemia typically shows normal or elevated
phosphate, and dietary calcium excess rarely causes hypercalcemia in renal failure.
Q6 Question 6 of 75
A 50-year-old woman who underwent a total thyroidectomy 2 days ago reports numbness and
tingling around her mouth and in her fingertips. On assessment, the nurse elicits a positive
Trousseau sign. Which electrolyte imbalance does this finding most strongly suggest?
A. Hypercalcemia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Correct Answer: D
Rationale:
Post-thyroidectomy hypocalcemia occurs due to accidental removal or damage to the parathyroid glands, leading to
reduced PTH and decreased serum calcium. Perioral numbness, tingling in the fingertips, and a positive Trousseau
sign (carpal spasm induced by blood pressure cuff inflation) are classic signs of hypocalcemia. Hypercalcemia
causes muscle weakness and lethargy rather than tetany, and hyperkalemia and hyponatremia do not produce these
neuromuscular findings.
NUR 2356 Multidimensional Care I Exam 2 -- 2026/2027 | Passing Score: 80% | Page 4 of 36
RASMUSSEN COLLEGE
NUR 2356 / NUR2356 Multidimensional Care I Exam 2
/ MDC 1 Exam 2 Quiz Bank | Already Rated A |
Latest 2026/2027 | Rasmussen College
2026/2027 Edition - Official Exam 2026/2027
75 80% N/A
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Fluid and Electrolyte Balance Q1-Q15
Section 2 Acid-Base Disorders Q16-Q30
Section 3 Pain Management Q31-Q45
Section 4 Perioperative Care Q46-Q60
Section 5 Oxygenation and Respiratory Function Q61-Q75
Instructions: Select the single best answer for each question. This exam is designed for NUR 2356 Multidimensional Care I
certification preparation. Passing score: 80% (60 questions correct).
NUR 2356 Multidimensional Care I Exam 2 -- 2026/2027 | Passing Score: 80% | Page 1 of 36
,SECTION 1 | Fluid and Electrolyte Balance | Q1-Q15 | NUR 2356 Multidimensional Care I Exam 2 2026/2027
Q1 Question 1 of 75
A 72-year-old male with heart failure is admitted with fatigue, muscle weakness, and deep tendon
hyporeflexia. His serum potassium is 2.9 mEq/L and his ECG shows flattened T waves and
prominent U waves. Which intervention should the nurse implement first?
A. Administer oral potassium supplement with meals
B. Encourage the patient to eat potassium-rich foods such as bananas and oranges
C. Initiate continuous cardiac monitoring and prepare for IV potassium replacement
D. Notify the provider and request a repeat potassium level in 4 hours
Correct Answer: C
Rationale:
The patient has severe hypokalemia (2.9 mEq/L) with ECG changes, which places him at risk for life-threatening
dysrhythmias. Continuous cardiac monitoring and IV potassium replacement are the priority because oral
supplementation is too slow for severe hypokalemia with ECG changes. Dietary changes are preventive, not
emergent, and waiting 4 hours to recheck is unsafe given the current ECG findings.
Q2 Question 2 of 75
A 58-year-old female receiving loop diuretic therapy for hypertension reports muscle cramps,
weakness, and polyuria. Her lab results show sodium 128 mEq/L, potassium 3.1 mEq/L, and
chloride 88 mEq/L. The nurse recognizes that these findings are most consistent with which
electrolyte imbalance?
A. Hyponatremia with hypokalemia and hypochloremia secondary to diuretic use
B. Hypernatremia with concurrent hypokalemia
C. Syndrome of inappropriate antidiuretic hormone with hypokalemia
D. Cushing syndrome presenting with electrolyte depletion
Correct Answer: A
Rationale:
Loop diuretics cause excessive urinary loss of sodium, potassium, and chloride, leading to hyponatremia,
hypokalemia, and hypochloremia as a combined pattern. The lab values of Na 128, K 3.1, and Cl 88 all fall below
normal ranges, and the symptoms of muscle cramps and weakness are classic for these deficits. SIADH would cause
dilutional hyponatremia but not typically hypokalemia and hypochloremia, and Cushing syndrome causes
hypernatremia and hypokalemia, not hyponatremia.
NUR 2356 Multidimensional Care I Exam 2 -- 2026/2027 | Passing Score: 80% | Page 2 of 36
,Q3 Question 3 of 75
A 45-year-old male with small cell lung cancer develops confusion, muscle twitching, and a serum
sodium of 118 mEq/L. Urine osmolality is 450 mOsm/kg and urine sodium is 65 mEq/L. The nurse
identifies that this clinical presentation is most consistent with which condition?
A. Diabetes insipidus causing hypernatremia
B. Syndrome of inappropriate antidiuretic hormone secretion
C. Addison disease with mineralocorticoid deficiency
D. Psychogenic polydipsia leading to dilutional hyponatremia
Correct Answer: B
Rationale:
Small cell lung cancer is a classic cause of SIADH, characterized by excessive ADH release leading to water
retention, dilutional hyponatremia, concentrated urine (elevated urine osmolality), and high urine sodium. Diabetes
insipidus causes hypernatremia, not hyponatremia. Addison disease causes hyponatremia with hyperkalemia and
hypotension, and psychogenic polydipsia would show dilute urine rather than concentrated urine.
Q4 Question 4 of 75
A 34-year-old female with severe vomiting for 3 days presents with a blood pressure of 90/58
mmHg, heart rate 112 bpm, poor skin turgor, and dry mucous membranes. Her serum sodium is 152
mEq/L. The nurse understands that the primary pathophysiology of her hypernatremia is which
mechanism?
A. Pure water loss exceeding sodium loss from vomiting and inadequate fluid intake
B. Excess sodium intake from dietary sources
C. Hyperaldosteronism causing renal sodium retention
D. Cushing syndrome producing cortisol-mediated sodium retention
Correct Answer: A
Rationale:
Prolonged vomiting with inadequate fluid replacement leads to dehydration and hypernatremia through pure water
loss that exceeds sodium loss. The clinical signs of hypotension, tachycardia, poor skin turgor, and dry mucous
membranes all indicate significant volume depletion. Hyperaldosteronism and Cushing syndrome would cause
hypervolemic hypernatremia without signs of volume depletion, and dietary sodium excess is an uncommon cause of
hypernatremia.
NUR 2356 Multidimensional Care I Exam 2 -- 2026/2027 | Passing Score: 80% | Page 3 of 36
, Q5 Question 5 of 75
A 67-year-old male with chronic kidney disease stage 4 has a serum calcium of 11.8 mg/dL, serum
phosphate of 2.0 mg/dL, and reports generalized bone pain. The nurse recognizes that his
hypercalcemia is most likely caused by which mechanism?
A. Secondary hyperparathyroidism from chronic renal failure
B. Excessive dietary calcium supplementation
C. Primary hyperparathyroidism from a parathyroid adenoma
D. Malignancy-associated humoral hypercalcemia
Correct Answer: A
Rationale:
Chronic kidney disease leads to phosphate retention and reduced calcitriol production, triggering secondary
hyperparathyroidism with elevated PTH levels that increase bone resorption and calcium release. The low phosphate
combined with hypercalcemia and bone pain is consistent with PTH-mediated bone demineralization. Primary
hyperparathyroidism is less likely in CKD, malignancy-associated hypercalcemia typically shows normal or elevated
phosphate, and dietary calcium excess rarely causes hypercalcemia in renal failure.
Q6 Question 6 of 75
A 50-year-old woman who underwent a total thyroidectomy 2 days ago reports numbness and
tingling around her mouth and in her fingertips. On assessment, the nurse elicits a positive
Trousseau sign. Which electrolyte imbalance does this finding most strongly suggest?
A. Hypercalcemia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Correct Answer: D
Rationale:
Post-thyroidectomy hypocalcemia occurs due to accidental removal or damage to the parathyroid glands, leading to
reduced PTH and decreased serum calcium. Perioral numbness, tingling in the fingertips, and a positive Trousseau
sign (carpal spasm induced by blood pressure cuff inflation) are classic signs of hypocalcemia. Hypercalcemia
causes muscle weakness and lethargy rather than tetany, and hyperkalemia and hyponatremia do not produce these
neuromuscular findings.
NUR 2356 Multidimensional Care I Exam 2 -- 2026/2027 | Passing Score: 80% | Page 4 of 36
