NUR2392/NUR 2392 Exam 2 V2 |
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A nurse is caring for a client with a history of heart failure who presents with an ejection
fraction of 35%. Which clinical manifestation should the nurse prioritize?
A. Crackle sounds heard in the lung bases
B. Dependent edema in the lower extremities
C. Weight gain of 1 pound in 24 hours
D. Increased jugular venous distention
E. N/A
Correct Answer: A
Rationale: An ejection fraction of 35% indicates significant left-sided heart failure and
reduced cardiac output. Crackles in the lungs represent pulmonary edema, which is a life-
threatening complication that requires immediate nursing intervention. While edema and
JVD are important, they reflect right-sided failure and are typically less urgent than
respiratory compromise.
2. The nurse is interpreting arterial blood gas (ABG) results for a patient: pH 7.30, PaCO2 52
mmHg, and HCO3 25 mEq/L. How should the nurse categorize this?
A. Respiratory Acidosis
,B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Correct Answer: A
Rationale: The pH is below 7.35, which signifies acidosis. The PaCO2 is elevated above 45
mmHg, which points toward a respiratory cause. Since the bicarbonate level is within the
normal range, this is uncompensated respiratory acidosis.
3. A client is diagnosed with Tuberculosis (TB). Which type of isolation precaution should the
nurse implement?
A. Standard Precautions
B. Contact Precautions
C. Airborne Precautions
D. Droplet Precautions
Correct Answer: C
Rationale: Tuberculosis is caused by Mycobacterium tuberculosis and is transmitted via
small particles that stay suspended in the air. For this reason, the client must be placed in a
negative pressure room and staff must wear N95 respirators. Droplet precautions are
insufficient because TB particles are smaller than those found in standard droplets.
, 4. Which dietary instruction is most appropriate for a client with Chronic Obstructive
Pulmonary Disease (COPD) who is experiencing weight loss?
A. Eat six small, high-calorie, high-protein meals daily.
B. Drink a large glass of water before each meal.
C. Consume a high-carbohydrate, low-fat diet.
D. Limit protein intake to reduce the workload on the kidneys.
Correct Answer: A
Rationale: Clients with COPD often experience dyspnea while eating and use extra energy
for breathing. Small, frequent, nutrient-dense meals help prevent fatigue and gastric
distention that could press on the diaphragm. High protein is necessary for tissue repair
and high calories are needed to combat the metabolic demands of increased work of
breathing.
5. A client with Peripheral Artery Disease (PAD) complains of pain while walking that resolves
with rest. What term should the nurse use to document this?
A. Dependent rubor
B. Rest pain
C. Neuropathic pain
D. Intermittent claudication
Correct Answer: D
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A nurse is caring for a client with a history of heart failure who presents with an ejection
fraction of 35%. Which clinical manifestation should the nurse prioritize?
A. Crackle sounds heard in the lung bases
B. Dependent edema in the lower extremities
C. Weight gain of 1 pound in 24 hours
D. Increased jugular venous distention
E. N/A
Correct Answer: A
Rationale: An ejection fraction of 35% indicates significant left-sided heart failure and
reduced cardiac output. Crackles in the lungs represent pulmonary edema, which is a life-
threatening complication that requires immediate nursing intervention. While edema and
JVD are important, they reflect right-sided failure and are typically less urgent than
respiratory compromise.
2. The nurse is interpreting arterial blood gas (ABG) results for a patient: pH 7.30, PaCO2 52
mmHg, and HCO3 25 mEq/L. How should the nurse categorize this?
A. Respiratory Acidosis
,B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Correct Answer: A
Rationale: The pH is below 7.35, which signifies acidosis. The PaCO2 is elevated above 45
mmHg, which points toward a respiratory cause. Since the bicarbonate level is within the
normal range, this is uncompensated respiratory acidosis.
3. A client is diagnosed with Tuberculosis (TB). Which type of isolation precaution should the
nurse implement?
A. Standard Precautions
B. Contact Precautions
C. Airborne Precautions
D. Droplet Precautions
Correct Answer: C
Rationale: Tuberculosis is caused by Mycobacterium tuberculosis and is transmitted via
small particles that stay suspended in the air. For this reason, the client must be placed in a
negative pressure room and staff must wear N95 respirators. Droplet precautions are
insufficient because TB particles are smaller than those found in standard droplets.
, 4. Which dietary instruction is most appropriate for a client with Chronic Obstructive
Pulmonary Disease (COPD) who is experiencing weight loss?
A. Eat six small, high-calorie, high-protein meals daily.
B. Drink a large glass of water before each meal.
C. Consume a high-carbohydrate, low-fat diet.
D. Limit protein intake to reduce the workload on the kidneys.
Correct Answer: A
Rationale: Clients with COPD often experience dyspnea while eating and use extra energy
for breathing. Small, frequent, nutrient-dense meals help prevent fatigue and gastric
distention that could press on the diaphragm. High protein is necessary for tissue repair
and high calories are needed to combat the metabolic demands of increased work of
breathing.
5. A client with Peripheral Artery Disease (PAD) complains of pain while walking that resolves
with rest. What term should the nurse use to document this?
A. Dependent rubor
B. Rest pain
C. Neuropathic pain
D. Intermittent claudication
Correct Answer: D
