MDC IV (NUR2755) Rasmussen University
2026 Complete Final Exam Questions and
Verified Answers Study Guide
Introduction:
This document contains 200 comprehensive final exam questions and verified
answers for MDC IV (NUR2755). Covers shock, burns, neurological disorders,
emergency care, respiratory conditions, surgical nursing, triage, frostbite, seizures,
spinal cord injuries, critical care interventions, and more. Organized in Q&A
format for NCLEX-style revision and final exam readiness.
1. What is the Parkland formula for fluid resuscitation in burn patients?
--- correct precise answers----
TBSA % × weight (kg) × 4 mL = total fluid in first 24 hours. Give half
during first 8 hours (starting at time of injury), half during next 16
hours.
2. How do you calculate mean arterial pressure (MAP)?
--- correct precise answers----
(Diastolic × 2 + Systolic) ÷ 3
3. A patient presents with anaphylactic shock. What clinical manifestations do
you expect?
--- correct precise answers----
Tachycardia, hypotension, angioedema, difficulty breathing, hives,
wheezing, stridor, anxiety, GI cramps.
4. What is the priority nursing intervention for a patient in hypovolemic shock?
--- correct precise answers----
Establish two large-bore IV lines and administer isotonic fluids (normal
saline or lactated Ringer’s).
5. A patient with septic shock has a mean arterial pressure of 55 mmHg despite
fluid resuscitation. Which medication does the nurse anticipate?
--- correct precise answers----
Norepinephrine (vasopressor) to maintain MAP ≥65 mmHg.
,6. What is the most reliable indicator of adequate tissue perfusion in a shock
patient?
--- correct precise answers----
Urine output ≥0.5 mL/kg/hour (e.g., ≥30 mL/hour in an adult).
7. During the compensatory stage of shock, which finding would the nurse
expect?
--- correct precise answers----
Tachycardia, tachypnea, narrow pulse pressure, cool and clammy skin
(except in early septic shock).
8. A patient with cardiogenic shock has an intra-aortic balloon pump (IABP).
What is the desired effect?
--- correct precise answers----
Decrease afterload (by balloon deflation) and increase coronary
perfusion (by balloon inflation during diastole).
9. Which type of shock is associated with a cervical spinal cord injury above
T6?
--- correct precise answers----
Neurogenic shock (bradycardia, hypotension, warm/dry skin due to loss
of sympathetic tone).
10.A patient in septic shock has a central venous oxygen saturation (ScvO2) of
55%. What does this indicate?
--- correct precise answers----
Inadequate tissue oxygen extraction; goal is ≥70%.
11.What is the priority nursing action for a burn patient with suspected
inhalation injury?
--- correct precise answers----
Assess for stridor, hoarseness, carbonaceous sputum, and prepare for
early intubation.
12.Calculate the Parkland fluid for a 70-kg patient with 40% TBSA burns.
What is the first 8-hour volume?
--- correct precise answers----
Total = 40 × 70 × 4 = 11,200 mL in 24 hours. First 8 hours = 5,600 mL
(at time of injury, not arrival).
, 13.A patient with full-thickness (third-degree) burns on the chest develops
difficulty breathing. What complication is most likely?
--- correct precise answers----
Eschar restriction of chest wall movement; need for escharotomy.
14.Which electrolyte imbalance is most common in the first 48 hours after
major burns?
--- correct precise answers----
Hyperkalemia (from cell destruction).
15.A burn patient’s urine output is 20 mL/hour over 2 hours. What should the
nurse do?
--- correct precise answers----
Increase IV fluid rate; goal urine output is 0.5-1.0 mL/kg/hour in adults.
16.A patient with an electrical burn has dark, tea-colored urine. What condition
does the nurse suspect?
--- correct precise answers----
Rhabdomyolysis; monitor creatine kinase and myoglobin.
17.What is the most common cause of death in the late phase of burn injury?
--- correct precise answers----
Sepsis (due to loss of skin barrier and immunosuppression).
18.A nurse is caring for a patient with a new tracheostomy. Which finding
requires immediate intervention?
--- correct precise answers----
Tracheostomy tube dislodgement or inability to pass a suction catheter.
19.A patient with a cervical spine injury at C5 develops bradycardia (HR 40)
and hypotension (BP 80/50). What is the priority intervention?
--- correct precise answers----
Administer IV fluids and atropine; neurogenic shock requires
vasopressors if fluid refractory.
20.A patient with a spinal cord injury at T4 becomes hypertensive (200/110),
bradycardic (HR 48), and complains of a pounding headache. What is the
most likely cause?
--- correct precise answers----
Autonomic dysreflexia; trigger is often a distended bladder or bowel. Sit
patient up and remove trigger.
2026 Complete Final Exam Questions and
Verified Answers Study Guide
Introduction:
This document contains 200 comprehensive final exam questions and verified
answers for MDC IV (NUR2755). Covers shock, burns, neurological disorders,
emergency care, respiratory conditions, surgical nursing, triage, frostbite, seizures,
spinal cord injuries, critical care interventions, and more. Organized in Q&A
format for NCLEX-style revision and final exam readiness.
1. What is the Parkland formula for fluid resuscitation in burn patients?
--- correct precise answers----
TBSA % × weight (kg) × 4 mL = total fluid in first 24 hours. Give half
during first 8 hours (starting at time of injury), half during next 16
hours.
2. How do you calculate mean arterial pressure (MAP)?
--- correct precise answers----
(Diastolic × 2 + Systolic) ÷ 3
3. A patient presents with anaphylactic shock. What clinical manifestations do
you expect?
--- correct precise answers----
Tachycardia, hypotension, angioedema, difficulty breathing, hives,
wheezing, stridor, anxiety, GI cramps.
4. What is the priority nursing intervention for a patient in hypovolemic shock?
--- correct precise answers----
Establish two large-bore IV lines and administer isotonic fluids (normal
saline or lactated Ringer’s).
5. A patient with septic shock has a mean arterial pressure of 55 mmHg despite
fluid resuscitation. Which medication does the nurse anticipate?
--- correct precise answers----
Norepinephrine (vasopressor) to maintain MAP ≥65 mmHg.
,6. What is the most reliable indicator of adequate tissue perfusion in a shock
patient?
--- correct precise answers----
Urine output ≥0.5 mL/kg/hour (e.g., ≥30 mL/hour in an adult).
7. During the compensatory stage of shock, which finding would the nurse
expect?
--- correct precise answers----
Tachycardia, tachypnea, narrow pulse pressure, cool and clammy skin
(except in early septic shock).
8. A patient with cardiogenic shock has an intra-aortic balloon pump (IABP).
What is the desired effect?
--- correct precise answers----
Decrease afterload (by balloon deflation) and increase coronary
perfusion (by balloon inflation during diastole).
9. Which type of shock is associated with a cervical spinal cord injury above
T6?
--- correct precise answers----
Neurogenic shock (bradycardia, hypotension, warm/dry skin due to loss
of sympathetic tone).
10.A patient in septic shock has a central venous oxygen saturation (ScvO2) of
55%. What does this indicate?
--- correct precise answers----
Inadequate tissue oxygen extraction; goal is ≥70%.
11.What is the priority nursing action for a burn patient with suspected
inhalation injury?
--- correct precise answers----
Assess for stridor, hoarseness, carbonaceous sputum, and prepare for
early intubation.
12.Calculate the Parkland fluid for a 70-kg patient with 40% TBSA burns.
What is the first 8-hour volume?
--- correct precise answers----
Total = 40 × 70 × 4 = 11,200 mL in 24 hours. First 8 hours = 5,600 mL
(at time of injury, not arrival).
, 13.A patient with full-thickness (third-degree) burns on the chest develops
difficulty breathing. What complication is most likely?
--- correct precise answers----
Eschar restriction of chest wall movement; need for escharotomy.
14.Which electrolyte imbalance is most common in the first 48 hours after
major burns?
--- correct precise answers----
Hyperkalemia (from cell destruction).
15.A burn patient’s urine output is 20 mL/hour over 2 hours. What should the
nurse do?
--- correct precise answers----
Increase IV fluid rate; goal urine output is 0.5-1.0 mL/kg/hour in adults.
16.A patient with an electrical burn has dark, tea-colored urine. What condition
does the nurse suspect?
--- correct precise answers----
Rhabdomyolysis; monitor creatine kinase and myoglobin.
17.What is the most common cause of death in the late phase of burn injury?
--- correct precise answers----
Sepsis (due to loss of skin barrier and immunosuppression).
18.A nurse is caring for a patient with a new tracheostomy. Which finding
requires immediate intervention?
--- correct precise answers----
Tracheostomy tube dislodgement or inability to pass a suction catheter.
19.A patient with a cervical spine injury at C5 develops bradycardia (HR 40)
and hypotension (BP 80/50). What is the priority intervention?
--- correct precise answers----
Administer IV fluids and atropine; neurogenic shock requires
vasopressors if fluid refractory.
20.A patient with a spinal cord injury at T4 becomes hypertensive (200/110),
bradycardic (HR 48), and complains of a pounding headache. What is the
most likely cause?
--- correct precise answers----
Autonomic dysreflexia; trigger is often a distended bladder or bowel. Sit
patient up and remove trigger.
