MDC 2 | Rasmussen
OBJECTIVE ASSESSMENT - EXAM
MDC 2
Exam 1
Rasmussen College | Complete Q&As
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Cardiovascular Disorders & Management Renal & Urinary Disorders
Respiratory Conditions & Care Perioperative Nursing Concepts
Fluid & Electrolyte Balance
COVER PAGE - 1
,SECTION 1 | Cardiovascular Disorders & Management | Q1-Q20
MDC 2 Exam 1 2026/2027
Q1 Question 1 of 75
A 68-year-old male with a history of hypertension and hyperlipidemia presents to the emergency
department with crushing substernal chest pain radiating to the left arm that began 45 minutes ago.
The 12-lead ECG shows ST-segment elevation in leads II, III, and aVF. What is the priority nursing
intervention?
A. Administer sublingual nitroglycerin and reassess pain in 5 minutes
B. Obtain a complete health history and medication list before treatment
C. Initiate the cardiac catheterization pathway for immediate reperfusion therapy
D. Place the patient on continuous telemetry and wait for cardiac biomarkers
Correct Answer: C
Rationale:
ST-elevation myocardial infarction (STEMI) requires immediate reperfusion, with a target door-to-balloon time
of 90 minutes. Initiating the cardiac catheterization pathway is the priority because timely reperfusion reduces
myocardial damage and mortality. Nitroglycerin is used for angina but is not sufficient for STEMI. Waiting for
biomarkers causes fatal delays in treatment.
Q2 Question 2 of 75
A 72-year-old female is admitted with acute decompensated heart failure. She has dyspnea at rest,
bilateral crackles throughout the lung fields, and an oxygen saturation of 88% on room air. Her
brain natriuretic peptide level is 1,200 pg/mL. What is the most appropriate initial pharmacologic
intervention?
A. Administer intravenous furosemide to reduce preload and relieve pulmonary congestion
B. Start a beta-blocker to reduce heart rate and myocardial oxygen demand
C. Give oral potassium supplementation to prevent hypokalemia from diuretic therapy
D. Initiate intravenous normal saline at 125 mL/hr to maintain intravascular volume
Correct Answer: A
Rationale:
IV furosemide is the first-line treatment for acute decompensated heart failure with pulmonary congestion
because it rapidly reduces preload through venodilation and diuresis, relieving pulmonary edema and improving
oxygenation. Beta-blockers are contraindicated in acute decompensated HF because they reduce contractility.
Potassium supplementation may be needed later but is not the initial priority. Normal saline would worsen fluid
overload.
MDC 2 Exam 1 - 2026/2027 | Passing Score: 80% | Page 2 of 40
,SECTION 1 | Cardiovascular Disorders & Management | Q1-Q20
MDC 2 Exam 1 2026/2027
Q3 Question 3 of 75
A 55-year-old male with a mechanical mitral valve replacement has an international normalized
ratio (INR) of 1.5 on his routine lab work. His target INR range is 2.5 to 3.5. The patient reports
missing several doses of warfarin over the past two weeks. What is the most appropriate action?
A. Instruct the patient to take three times the normal dose of warfarin tonight and recheck INR in the
morning
B. Administer vitamin K intravenously to reverse anticoagulation effects
C. Consult the provider about adjusting the warfarin dose and reinforcing adherence education
while monitoring for thromboembolic signs
D. Discontinue warfarin permanently and transition to aspirin therapy
Correct Answer: C
Rationale:
A subtherapeutic INR in a patient with a mechanical heart valve places the patient at significant risk for valve
thrombosis and embolic stroke. Consulting the provider for dose adjustment, reinforcing adherence education,
and monitoring for thromboembolic signs addresses both immediate safety and long-term management. Taking
a triple dose could cause dangerous overshooting. Vitamin K would further lower the INR, worsening the risk.
Q4 Question 4 of 75
A 60-year-old female with a history of atrial fibrillation is prescribed dabigatran. She now presents
with acute onset of severe headache, confusion, and a computed tomography scan showing an
intracerebral hemorrhage. What reversal agent should the nurse anticipate administering?
A. Protamine sulfate to reverse the anticoagulant effect
B. Vitamin K and prothrombin complex concentrate
C. Fresh frozen plasma to replace clotting factors
D. Idarucizumab as the specific reversal agent for dabigatran
Correct Answer: D
Rationale:
Idarucizumab is the specific FDA-approved reversal agent for dabigatran, a direct thrombin inhibitor, and
rapidly neutralizes its anticoagulant effect in life-threatening bleeding. Protamine sulfate reverses heparin, not
dabigatran. Fresh frozen plasma is nonspecific and less effective. Vitamin K and PCC are used for warfarin
reversal, not direct thrombin inhibitors.
MDC 2 Exam 1 - 2026/2027 | Passing Score: 80% | Page 3 of 40
, SECTION 1 | Cardiovascular Disorders & Management | Q1-Q20
MDC 2 Exam 1 2026/2027
Q5 Question 5 of 75
A 48-year-old male with newly diagnosed hypertension has a blood pressure of 162/98 mmHg. He
has no history of diabetes or kidney disease. According to current guidelines, what is the target
blood pressure for this patient?
A. Less than 120/80 mmHg for all adults regardless of comorbidities
B. Less than 140/90 mmHg as the threshold for treatment in uncomplicated hypertension
C. Less than 130/80 mmHg as recommended by ACC/AHA guidelines
D. Less than 150/90 mmHg to minimize medication side effects
Correct Answer: C
Rationale:
The 2017 ACC/AHA guidelines recommend a blood pressure target of less than 130/80 mmHg for adults with
hypertension, including those without comorbidities, based on evidence that lower targets reduce
cardiovascular events. The older target of less than 140/90 mmHg is no longer recommended for most patients.
A target of less than 150/90 mmHg is inadequate for cardiovascular risk reduction.
Q6 Question 6 of 75
A 64-year-old male presents to the emergency department with sudden onset of severe tearing
chest pain radiating to his back. Blood pressure is 180/110 mmHg in the right arm and 98/60
mmHg in the left arm. A widened mediastinum is seen on chest X-ray. What is the priority nursing
action?
A. Administer thrombolytic therapy immediately for suspected myocardial infarction
B. Obtain a 12-lead ECG to rule out cardiac ischemia before further treatment
C. Administer intravenous beta-blocker therapy to reduce the rate of rise of aortic pressure and
lower blood pressure
D. Prepare for immediate surgical repair without medical stabilization
Correct Answer: C
Rationale:
Acute aortic dissection requires immediate blood pressure reduction with IV beta-blockers (esmolol or labetalol)
to reduce the force of left ventricular contraction and the rate of rise in aortic pressure, preventing further
tearing. Thrombolytics would be catastrophic in dissection by worsening bleeding. While an ECG is needed,
blood pressure control is the immediate life-saving priority.
MDC 2 Exam 1 - 2026/2027 | Passing Score: 80% | Page 4 of 40
OBJECTIVE ASSESSMENT - EXAM
MDC 2
Exam 1
Rasmussen College | Complete Q&As
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Cardiovascular Disorders & Management Renal & Urinary Disorders
Respiratory Conditions & Care Perioperative Nursing Concepts
Fluid & Electrolyte Balance
COVER PAGE - 1
,SECTION 1 | Cardiovascular Disorders & Management | Q1-Q20
MDC 2 Exam 1 2026/2027
Q1 Question 1 of 75
A 68-year-old male with a history of hypertension and hyperlipidemia presents to the emergency
department with crushing substernal chest pain radiating to the left arm that began 45 minutes ago.
The 12-lead ECG shows ST-segment elevation in leads II, III, and aVF. What is the priority nursing
intervention?
A. Administer sublingual nitroglycerin and reassess pain in 5 minutes
B. Obtain a complete health history and medication list before treatment
C. Initiate the cardiac catheterization pathway for immediate reperfusion therapy
D. Place the patient on continuous telemetry and wait for cardiac biomarkers
Correct Answer: C
Rationale:
ST-elevation myocardial infarction (STEMI) requires immediate reperfusion, with a target door-to-balloon time
of 90 minutes. Initiating the cardiac catheterization pathway is the priority because timely reperfusion reduces
myocardial damage and mortality. Nitroglycerin is used for angina but is not sufficient for STEMI. Waiting for
biomarkers causes fatal delays in treatment.
Q2 Question 2 of 75
A 72-year-old female is admitted with acute decompensated heart failure. She has dyspnea at rest,
bilateral crackles throughout the lung fields, and an oxygen saturation of 88% on room air. Her
brain natriuretic peptide level is 1,200 pg/mL. What is the most appropriate initial pharmacologic
intervention?
A. Administer intravenous furosemide to reduce preload and relieve pulmonary congestion
B. Start a beta-blocker to reduce heart rate and myocardial oxygen demand
C. Give oral potassium supplementation to prevent hypokalemia from diuretic therapy
D. Initiate intravenous normal saline at 125 mL/hr to maintain intravascular volume
Correct Answer: A
Rationale:
IV furosemide is the first-line treatment for acute decompensated heart failure with pulmonary congestion
because it rapidly reduces preload through venodilation and diuresis, relieving pulmonary edema and improving
oxygenation. Beta-blockers are contraindicated in acute decompensated HF because they reduce contractility.
Potassium supplementation may be needed later but is not the initial priority. Normal saline would worsen fluid
overload.
MDC 2 Exam 1 - 2026/2027 | Passing Score: 80% | Page 2 of 40
,SECTION 1 | Cardiovascular Disorders & Management | Q1-Q20
MDC 2 Exam 1 2026/2027
Q3 Question 3 of 75
A 55-year-old male with a mechanical mitral valve replacement has an international normalized
ratio (INR) of 1.5 on his routine lab work. His target INR range is 2.5 to 3.5. The patient reports
missing several doses of warfarin over the past two weeks. What is the most appropriate action?
A. Instruct the patient to take three times the normal dose of warfarin tonight and recheck INR in the
morning
B. Administer vitamin K intravenously to reverse anticoagulation effects
C. Consult the provider about adjusting the warfarin dose and reinforcing adherence education
while monitoring for thromboembolic signs
D. Discontinue warfarin permanently and transition to aspirin therapy
Correct Answer: C
Rationale:
A subtherapeutic INR in a patient with a mechanical heart valve places the patient at significant risk for valve
thrombosis and embolic stroke. Consulting the provider for dose adjustment, reinforcing adherence education,
and monitoring for thromboembolic signs addresses both immediate safety and long-term management. Taking
a triple dose could cause dangerous overshooting. Vitamin K would further lower the INR, worsening the risk.
Q4 Question 4 of 75
A 60-year-old female with a history of atrial fibrillation is prescribed dabigatran. She now presents
with acute onset of severe headache, confusion, and a computed tomography scan showing an
intracerebral hemorrhage. What reversal agent should the nurse anticipate administering?
A. Protamine sulfate to reverse the anticoagulant effect
B. Vitamin K and prothrombin complex concentrate
C. Fresh frozen plasma to replace clotting factors
D. Idarucizumab as the specific reversal agent for dabigatran
Correct Answer: D
Rationale:
Idarucizumab is the specific FDA-approved reversal agent for dabigatran, a direct thrombin inhibitor, and
rapidly neutralizes its anticoagulant effect in life-threatening bleeding. Protamine sulfate reverses heparin, not
dabigatran. Fresh frozen plasma is nonspecific and less effective. Vitamin K and PCC are used for warfarin
reversal, not direct thrombin inhibitors.
MDC 2 Exam 1 - 2026/2027 | Passing Score: 80% | Page 3 of 40
, SECTION 1 | Cardiovascular Disorders & Management | Q1-Q20
MDC 2 Exam 1 2026/2027
Q5 Question 5 of 75
A 48-year-old male with newly diagnosed hypertension has a blood pressure of 162/98 mmHg. He
has no history of diabetes or kidney disease. According to current guidelines, what is the target
blood pressure for this patient?
A. Less than 120/80 mmHg for all adults regardless of comorbidities
B. Less than 140/90 mmHg as the threshold for treatment in uncomplicated hypertension
C. Less than 130/80 mmHg as recommended by ACC/AHA guidelines
D. Less than 150/90 mmHg to minimize medication side effects
Correct Answer: C
Rationale:
The 2017 ACC/AHA guidelines recommend a blood pressure target of less than 130/80 mmHg for adults with
hypertension, including those without comorbidities, based on evidence that lower targets reduce
cardiovascular events. The older target of less than 140/90 mmHg is no longer recommended for most patients.
A target of less than 150/90 mmHg is inadequate for cardiovascular risk reduction.
Q6 Question 6 of 75
A 64-year-old male presents to the emergency department with sudden onset of severe tearing
chest pain radiating to his back. Blood pressure is 180/110 mmHg in the right arm and 98/60
mmHg in the left arm. A widened mediastinum is seen on chest X-ray. What is the priority nursing
action?
A. Administer thrombolytic therapy immediately for suspected myocardial infarction
B. Obtain a 12-lead ECG to rule out cardiac ischemia before further treatment
C. Administer intravenous beta-blocker therapy to reduce the rate of rise of aortic pressure and
lower blood pressure
D. Prepare for immediate surgical repair without medical stabilization
Correct Answer: C
Rationale:
Acute aortic dissection requires immediate blood pressure reduction with IV beta-blockers (esmolol or labetalol)
to reduce the force of left ventricular contraction and the rate of rise in aortic pressure, preventing further
tearing. Thrombolytics would be catastrophic in dissection by worsening bleeding. While an ECG is needed,
blood pressure control is the immediate life-saving priority.
MDC 2 Exam 1 - 2026/2027 | Passing Score: 80% | Page 4 of 40
