NUR2392/NUR 2392 Exam 3 V1 |
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A client with cirrhosis is admitted with an elevated ammonia level and is presenting with
confusion. Which medication should the nurse anticipate administering to promote the
excretion of ammonia?
A. Spironolactone
B. Propranolol
C. Lactulose
D. Furosemide
Correct Answer: C
Rationale: Lactulose is the primary medication used to lower serum ammonia levels by
trapping it in the gut and promoting its excretion through bowel movements. The nurse
should monitor for 2 to 3 soft stools per day to ensure the medication is effective. High
ammonia levels are the primary cause of hepatic encephalopathy in patients with liver
failure.
2. When caring for a client with acute pancreatitis, which laboratory result is the most specific
indicator of pancreatic cell injury?
A. Elevated serum lipase
,B. Decreased serum calcium
C. Elevated serum amylase
D. Increased white blood cell count
Correct Answer: A
Rationale: While both amylase and lipase rise in acute pancreatitis, serum lipase is more
specific to the pancreas and remains elevated for a longer period. Serum amylase can rise
due to other factors such as mumps or intestinal obstructions. The nurse must monitor
these values closely to evaluate the progression or resolution of the inflammation.
3. The nurse is assessing a client following a Transurethral Resection of the Prostate (TURP).
The client has a continuous bladder irrigation (CBI) system in place. The nurse notes that the
drainage is bright red with numerous large clots. Which action should the nurse take first?
A. Increase the rate of the irrigation fluid
B. Notify the healthcare provider immediately
C. Empty the drainage bag and record the volume
D. Administer prescribed analgesic for bladder spasms
Correct Answer: A
Rationale: The nurse should first increase the rate of the CBI to flush out clots and prevent
a blockage of the urinary catheter. Bright red drainage with large clots indicates active
arterial bleeding, and maintaining catheter patency is a priority. If the drainage does not
, clear or the catheter becomes obstructed despite increasing the rate, the surgeon must be
notified.
4. A nurse is providing discharge education to a client with Chronic Kidney Disease (CKD).
Which dietary instruction is the most important to include to prevent hyperkalemia?
A. Increase intake of leafy green vegetables
B. Substitute red meat with poultry
C. Drink at least 3 liters of fluid daily
D. Avoid salt substitutes containing potassium
Correct Answer: D
Rationale: Many salt substitutes replace sodium with potassium chloride, which can lead
to life-threatening hyperkalemia in CKD patients. The nurse must teach the client to read
labels carefully and avoid these products. Managing potassium intake is critical because the
kidneys can no longer effectively excrete excess electrolytes.
5. A client is diagnosed with acute cholecystitis and is scheduled for a laparoscopic
cholecystectomy. Which clinical manifestation is most characteristic of this condition?
A. Pain in the left lower quadrant radiating to the back
B. Burning epigastric pain relieved by eating food
C. Right upper quadrant pain that radiates to the right shoulder
D. Severe periumbilical pain that migrates to McBurney’s point
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A client with cirrhosis is admitted with an elevated ammonia level and is presenting with
confusion. Which medication should the nurse anticipate administering to promote the
excretion of ammonia?
A. Spironolactone
B. Propranolol
C. Lactulose
D. Furosemide
Correct Answer: C
Rationale: Lactulose is the primary medication used to lower serum ammonia levels by
trapping it in the gut and promoting its excretion through bowel movements. The nurse
should monitor for 2 to 3 soft stools per day to ensure the medication is effective. High
ammonia levels are the primary cause of hepatic encephalopathy in patients with liver
failure.
2. When caring for a client with acute pancreatitis, which laboratory result is the most specific
indicator of pancreatic cell injury?
A. Elevated serum lipase
,B. Decreased serum calcium
C. Elevated serum amylase
D. Increased white blood cell count
Correct Answer: A
Rationale: While both amylase and lipase rise in acute pancreatitis, serum lipase is more
specific to the pancreas and remains elevated for a longer period. Serum amylase can rise
due to other factors such as mumps or intestinal obstructions. The nurse must monitor
these values closely to evaluate the progression or resolution of the inflammation.
3. The nurse is assessing a client following a Transurethral Resection of the Prostate (TURP).
The client has a continuous bladder irrigation (CBI) system in place. The nurse notes that the
drainage is bright red with numerous large clots. Which action should the nurse take first?
A. Increase the rate of the irrigation fluid
B. Notify the healthcare provider immediately
C. Empty the drainage bag and record the volume
D. Administer prescribed analgesic for bladder spasms
Correct Answer: A
Rationale: The nurse should first increase the rate of the CBI to flush out clots and prevent
a blockage of the urinary catheter. Bright red drainage with large clots indicates active
arterial bleeding, and maintaining catheter patency is a priority. If the drainage does not
, clear or the catheter becomes obstructed despite increasing the rate, the surgeon must be
notified.
4. A nurse is providing discharge education to a client with Chronic Kidney Disease (CKD).
Which dietary instruction is the most important to include to prevent hyperkalemia?
A. Increase intake of leafy green vegetables
B. Substitute red meat with poultry
C. Drink at least 3 liters of fluid daily
D. Avoid salt substitutes containing potassium
Correct Answer: D
Rationale: Many salt substitutes replace sodium with potassium chloride, which can lead
to life-threatening hyperkalemia in CKD patients. The nurse must teach the client to read
labels carefully and avoid these products. Managing potassium intake is critical because the
kidneys can no longer effectively excrete excess electrolytes.
5. A client is diagnosed with acute cholecystitis and is scheduled for a laparoscopic
cholecystectomy. Which clinical manifestation is most characteristic of this condition?
A. Pain in the left lower quadrant radiating to the back
B. Burning epigastric pain relieved by eating food
C. Right upper quadrant pain that radiates to the right shoulder
D. Severe periumbilical pain that migrates to McBurney’s point
