NUR2392/NUR 2392 Exam 4 V2 |
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A patient with Chronic Kidney Disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize for immediate administration to stabilize the
cardiac membrane?
A. Sodium Polystyrene Sulfonate
B. Calcium Gluconate
C. Furosemide
D. Regular Insulin and Dextrose
Correct Answer: B
Rationale: Calcium gluconate is administered intravenously to stabilize the myocardial cell
membrane and prevent life-threatening arrhythmias in the setting of severe hyperkalemia.
While insulin and dextrose help shift potassium into the cells, they do not stabilize the
heart directly. Sodium polystyrene sulfonate is used for the actual removal of potassium
but takes much longer to work.
2. Which clinical manifestation is most characteristic of a patient experiencing Diabetes
Insipidus (DI)?
A. High urine specific gravity (>1.030)
,B. Excessive thirst and dilute urine output
C. Severe hypertension and bradycardia
D. Fluid volume overload and weight gain
Correct Answer: B
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the
inability of the kidneys to concentrate urine. This results in massive polyuria and extreme
polydipsia. The urine specific gravity is typically very low, often less than 1.005, reflecting
the dilute nature of the output.
3. The nurse is caring for a patient who just returned from a thyroidectomy. The nurse notes
the patient is experiencing muscle twitching and a positive Chvostek’s sign. What is the
priority intervention?
A. Administer intravenous Calcium Gluconate
B. Check the surgical site for bleeding
C. Notify the provider of potential laryngeal nerve damage
D. Place the patient in a High-Fowler’s position
Correct Answer: A
Rationale: A positive Chvostek’s sign indicates hypocalcemia, which can occur if the
parathyroid glands are accidentally damaged or removed during a thyroidectomy. Acute
hypocalcemia can lead to tetany and laryngospasm, making it a medical emergency.
, Intravenous calcium gluconate should be readily available for these patients to reverse the
electrolyte imbalance.
4. A patient is diagnosed with Prerenal Acute Kidney Injury (AKI). Which condition likely
contributed to this diagnosis?
A. Aminoglycoside toxicity
B. Severe dehydration or hypovolemia
C. Benign Prostatic Hyperplasia (BPH)
D. Acute Glomerulonephritis
Correct Answer: B
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, causing a
decrease in renal blood flow. Severe dehydration, hemorrhage, or heart failure are classic
examples of prerenal triggers. This differs from intrarenal causes, which involve direct
damage to kidney tissue, and postrenal causes, which involve obstruction of urine flow.
5. When assessing a newly created Arteriovenous (AV) Fistula, which finding should the nurse
report to the healthcare provider immediately?
A. Presence of a palpable thrill
B. A loud bruit heard on auscultation
C. Slight redness and swelling at the surgical site
D. Absence of a distal pulse in the extremity
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A patient with Chronic Kidney Disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize for immediate administration to stabilize the
cardiac membrane?
A. Sodium Polystyrene Sulfonate
B. Calcium Gluconate
C. Furosemide
D. Regular Insulin and Dextrose
Correct Answer: B
Rationale: Calcium gluconate is administered intravenously to stabilize the myocardial cell
membrane and prevent life-threatening arrhythmias in the setting of severe hyperkalemia.
While insulin and dextrose help shift potassium into the cells, they do not stabilize the
heart directly. Sodium polystyrene sulfonate is used for the actual removal of potassium
but takes much longer to work.
2. Which clinical manifestation is most characteristic of a patient experiencing Diabetes
Insipidus (DI)?
A. High urine specific gravity (>1.030)
,B. Excessive thirst and dilute urine output
C. Severe hypertension and bradycardia
D. Fluid volume overload and weight gain
Correct Answer: B
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the
inability of the kidneys to concentrate urine. This results in massive polyuria and extreme
polydipsia. The urine specific gravity is typically very low, often less than 1.005, reflecting
the dilute nature of the output.
3. The nurse is caring for a patient who just returned from a thyroidectomy. The nurse notes
the patient is experiencing muscle twitching and a positive Chvostek’s sign. What is the
priority intervention?
A. Administer intravenous Calcium Gluconate
B. Check the surgical site for bleeding
C. Notify the provider of potential laryngeal nerve damage
D. Place the patient in a High-Fowler’s position
Correct Answer: A
Rationale: A positive Chvostek’s sign indicates hypocalcemia, which can occur if the
parathyroid glands are accidentally damaged or removed during a thyroidectomy. Acute
hypocalcemia can lead to tetany and laryngospasm, making it a medical emergency.
, Intravenous calcium gluconate should be readily available for these patients to reverse the
electrolyte imbalance.
4. A patient is diagnosed with Prerenal Acute Kidney Injury (AKI). Which condition likely
contributed to this diagnosis?
A. Aminoglycoside toxicity
B. Severe dehydration or hypovolemia
C. Benign Prostatic Hyperplasia (BPH)
D. Acute Glomerulonephritis
Correct Answer: B
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, causing a
decrease in renal blood flow. Severe dehydration, hemorrhage, or heart failure are classic
examples of prerenal triggers. This differs from intrarenal causes, which involve direct
damage to kidney tissue, and postrenal causes, which involve obstruction of urine flow.
5. When assessing a newly created Arteriovenous (AV) Fistula, which finding should the nurse
report to the healthcare provider immediately?
A. Presence of a palpable thrill
B. A loud bruit heard on auscultation
C. Slight redness and swelling at the surgical site
D. Absence of a distal pulse in the extremity
