NUR2502: Multidimensional Care III MDC 3 Exam 2 Actual Exam 2026/2027 –
Complete Review with Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Cardiovascular Disorders (Q1-Q20)
Q1: A 68-year-old male presents with crushing substernal chest pain radiating to the left
arm, diaphoresis, and nausea. Vital signs: BP 88/56, HR 112, RR 24. ECG shows ST
elevation in leads V1-V4. Which priority intervention should the nurse implement first?
A. Administer morphine 2-4 mg IV for pain relief
B. Obtain a 12-lead ECG and activate the cardiac catheterization lab immediately
[CORRECT]
C. Start a heparin infusion at 18 units/kg/hr
D. Administer nitroglycerin 0.4 mg SL every 5 minutes
Correct Answer: B
Rationale: For STEMI, the priority is rapid reperfusion. The ECG confirms the diagnosis,
and immediate activation of the cardiac catheterization lab for primary PCI
(door-to-balloon time ≤90 minutes) is the standard of care. While MONA (morphine,
oxygen, nitroglycerin, aspirin) is important, reperfusion takes precedence. A is important
for pain relief but does not address the occluded coronary artery. C is part of medical
,management but does not achieve reperfusion. D is contraindicated if systolic BP <90
mmHg or right ventricular infarction is suspected. [100% VERIFIED – Rasmussen
NUR2502 MDC3]
Q2: A patient with acute coronary syndrome has troponin I levels that rise from 0.4
ng/mL at admission to 2.8 ng/mL at 6 hours. Which statement about cardiac
biomarkers is correct?
A. Troponin rises immediately and peaks within 1 hour of myocardial injury
B. Troponin rises within 3-6 hours, peaks at 12-24 hours, and remains elevated for 7-10
days, indicating myocardial necrosis [CORRECT]
C. CK-MB is more specific than troponin for myocardial injury
D. Myoglobin remains elevated for 2 weeks after MI
Correct Answer: B
Rationale: Troponin I and T are the most sensitive and specific biomarkers for
myocardial necrosis. They rise within 3-6 hours, peak at 12-24 hours, and remain
elevated for 7-10 days (troponin I) or 10-14 days (troponin T), making them useful for
late diagnosis but not for detecting reinfarction. A is incorrect because troponin does
not rise immediately. C is incorrect because troponin is more specific than CK-MB. D is
incorrect because myoglobin rises rapidly (1-2 hours) but returns to normal within 24
hours. [100% VERIFIED – Rasmussen NUR2502 MDC3]
,Q3: A patient with left-sided heart failure presents with dyspnea, orthopnea, paroxysmal
nocturnal dyspnea, and frothy pink sputum. Which pathophysiologic mechanism
explains these findings?
A. Right ventricular failure causing systemic venous congestion
B. Left ventricular failure causing pulmonary venous congestion and pulmonary edema
[CORRECT]
C. Pulmonary hypertension causing right heart strain
D. Cardiac tamponade causing impaired ventricular filling
Correct Answer: B
Rationale: Left-sided heart failure causes backward failure into the pulmonary
circulation, increasing pulmonary venous pressure and leading to pulmonary edema
(dyspnea, orthopnea, PND, pink frothy sputum from capillary rupture). A describes
right-sided heart failure (peripheral edema, JVD, hepatomegaly). C describes cor
pulmonale, not left heart failure. D describes tamponade physiology (Beck's triad).
[100% VERIFIED – Rasmussen NUR2502 MDC3]
Q4: A patient with heart failure is prescribed lisinopril 5 mg daily. Which mechanism of
action and patient teaching is correct?
A. Lisinopril is a beta-blocker that reduces heart rate; teach patient to check pulse
before taking
B. Lisinopril is an ACE inhibitor that reduces afterload and preload; monitor for cough,
hyperkalemia, and angioedema [CORRECT]
C. Lisinopril is a diuretic that reduces fluid volume; teach patient to take in the morning
, D. Lisinopril is a calcium channel blocker that causes vasodilation; monitor for
peripheral edema
Correct Answer: B
Rationale: ACE inhibitors (lisinopril, enalapril) inhibit angiotensin-converting enzyme,
reducing angiotensin II and aldosterone, thereby decreasing afterload and preload. Key
adverse effects include dry cough (10-15%), hyperkalemia, and angioedema (rare but
life-threatening). A is incorrect because lisinopril is not a beta-blocker. C is incorrect
because lisinopril is not a diuretic. D is incorrect because lisinopril is not a calcium
channel blocker. [100% VERIFIED – Rasmussen NUR2502 MDC3]
Q5: A patient with NYHA Class III heart failure reports shortness of breath with minimal
activity and is comfortable only at rest. Which statement about NYHA classification is
correct?
A. Class I: symptoms at rest; Class IV: no symptoms
B. Class III: marked limitation of physical activity; comfortable at rest but symptoms
with minimal activity [CORRECT]
C. Class II: unable to carry out any physical activity without symptoms
D. Class IV: slight limitation of physical activity
Correct Answer: B
Rationale: NYHA Class III is defined as marked limitation of physical activity; patients
are comfortable at rest but experience symptoms (fatigue, palpitation, dyspnea, angina)
Complete Review with Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Cardiovascular Disorders (Q1-Q20)
Q1: A 68-year-old male presents with crushing substernal chest pain radiating to the left
arm, diaphoresis, and nausea. Vital signs: BP 88/56, HR 112, RR 24. ECG shows ST
elevation in leads V1-V4. Which priority intervention should the nurse implement first?
A. Administer morphine 2-4 mg IV for pain relief
B. Obtain a 12-lead ECG and activate the cardiac catheterization lab immediately
[CORRECT]
C. Start a heparin infusion at 18 units/kg/hr
D. Administer nitroglycerin 0.4 mg SL every 5 minutes
Correct Answer: B
Rationale: For STEMI, the priority is rapid reperfusion. The ECG confirms the diagnosis,
and immediate activation of the cardiac catheterization lab for primary PCI
(door-to-balloon time ≤90 minutes) is the standard of care. While MONA (morphine,
oxygen, nitroglycerin, aspirin) is important, reperfusion takes precedence. A is important
for pain relief but does not address the occluded coronary artery. C is part of medical
,management but does not achieve reperfusion. D is contraindicated if systolic BP <90
mmHg or right ventricular infarction is suspected. [100% VERIFIED – Rasmussen
NUR2502 MDC3]
Q2: A patient with acute coronary syndrome has troponin I levels that rise from 0.4
ng/mL at admission to 2.8 ng/mL at 6 hours. Which statement about cardiac
biomarkers is correct?
A. Troponin rises immediately and peaks within 1 hour of myocardial injury
B. Troponin rises within 3-6 hours, peaks at 12-24 hours, and remains elevated for 7-10
days, indicating myocardial necrosis [CORRECT]
C. CK-MB is more specific than troponin for myocardial injury
D. Myoglobin remains elevated for 2 weeks after MI
Correct Answer: B
Rationale: Troponin I and T are the most sensitive and specific biomarkers for
myocardial necrosis. They rise within 3-6 hours, peak at 12-24 hours, and remain
elevated for 7-10 days (troponin I) or 10-14 days (troponin T), making them useful for
late diagnosis but not for detecting reinfarction. A is incorrect because troponin does
not rise immediately. C is incorrect because troponin is more specific than CK-MB. D is
incorrect because myoglobin rises rapidly (1-2 hours) but returns to normal within 24
hours. [100% VERIFIED – Rasmussen NUR2502 MDC3]
,Q3: A patient with left-sided heart failure presents with dyspnea, orthopnea, paroxysmal
nocturnal dyspnea, and frothy pink sputum. Which pathophysiologic mechanism
explains these findings?
A. Right ventricular failure causing systemic venous congestion
B. Left ventricular failure causing pulmonary venous congestion and pulmonary edema
[CORRECT]
C. Pulmonary hypertension causing right heart strain
D. Cardiac tamponade causing impaired ventricular filling
Correct Answer: B
Rationale: Left-sided heart failure causes backward failure into the pulmonary
circulation, increasing pulmonary venous pressure and leading to pulmonary edema
(dyspnea, orthopnea, PND, pink frothy sputum from capillary rupture). A describes
right-sided heart failure (peripheral edema, JVD, hepatomegaly). C describes cor
pulmonale, not left heart failure. D describes tamponade physiology (Beck's triad).
[100% VERIFIED – Rasmussen NUR2502 MDC3]
Q4: A patient with heart failure is prescribed lisinopril 5 mg daily. Which mechanism of
action and patient teaching is correct?
A. Lisinopril is a beta-blocker that reduces heart rate; teach patient to check pulse
before taking
B. Lisinopril is an ACE inhibitor that reduces afterload and preload; monitor for cough,
hyperkalemia, and angioedema [CORRECT]
C. Lisinopril is a diuretic that reduces fluid volume; teach patient to take in the morning
, D. Lisinopril is a calcium channel blocker that causes vasodilation; monitor for
peripheral edema
Correct Answer: B
Rationale: ACE inhibitors (lisinopril, enalapril) inhibit angiotensin-converting enzyme,
reducing angiotensin II and aldosterone, thereby decreasing afterload and preload. Key
adverse effects include dry cough (10-15%), hyperkalemia, and angioedema (rare but
life-threatening). A is incorrect because lisinopril is not a beta-blocker. C is incorrect
because lisinopril is not a diuretic. D is incorrect because lisinopril is not a calcium
channel blocker. [100% VERIFIED – Rasmussen NUR2502 MDC3]
Q5: A patient with NYHA Class III heart failure reports shortness of breath with minimal
activity and is comfortable only at rest. Which statement about NYHA classification is
correct?
A. Class I: symptoms at rest; Class IV: no symptoms
B. Class III: marked limitation of physical activity; comfortable at rest but symptoms
with minimal activity [CORRECT]
C. Class II: unable to carry out any physical activity without symptoms
D. Class IV: slight limitation of physical activity
Correct Answer: B
Rationale: NYHA Class III is defined as marked limitation of physical activity; patients
are comfortable at rest but experience symptoms (fatigue, palpitation, dyspnea, angina)
