NUR2392 Multidimensional Care II
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. Case Study:
A 65-year-old male with a history of myocardial infarction and chronic
kidney disease is admitted with acute decompensated heart failure. He
presents with electrolyte imbalances, acid-base disturbances, and
depressive symptoms. Which integrative multidimensional care plan
properly addresses this patient's complex needs?
a) Focus solely on aggressive diuretic therapy and fluid restriction.
b) Initiate an interprofessional plan including a cardiology consult,
renal/electrolyte management, and psychological support.
c) Prioritize oxygen supplementation and bed rest, waiting for lab
stabilization.
d) Adjust medications based on daily labs without further consultation.
- Correct ANS: b)
- Rationale: This option demonstrates a multidimensional approach by
addressing not only the physical and biochemical needs (cardiac and
renal management) but also the psychological aspects—ensuring holistic,
coordinated care.
2. Case Study:
A patient with metastatic lung cancer reports severe pain, anxiety, and
feelings of social isolation. Which advanced intervention best exemplifies
a multidimensional strategy for this patient?
a) Prescribe high-dose opioids for pain control only.
b) Schedule regular palliative care consultations and integrate social
work and spiritual care services.
c) Focus on adjusting chemotherapy regimens and postpone
supportive care.
d) Refer to physical therapy for activity enhancement only.
- Correct ANS: b)
- Rationale: Multidimensional care in advanced cancer must
incorporate physical symptom management along with emotional, social,
and spiritual support, ensuring quality of life.
©2025
,3. Case Study:
An elderly patient with advanced COPD exhibits severe dyspnea, anxiety
about air hunger, and lacks family support. Which strategy best aligns
with the principles of advanced multidimensional care?
a) Administer bronchodilators and corticosteroids exclusively.
b) Develop a care plan that combines respiratory therapy, cognitive-
behavioral techniques for anxiety, and referral to community support
services.
c) Increase oxygen flow and admit for observation without further
planning.
d) Schedule immediate ICU admission for invasive ventilation.
- Correct ANS: b)
- Rationale: This approach addresses physical symptoms, manages
psychological distress, and bridges social support—all key components of
a holistic, multidimensional care plan.
4. Case Study:
A patient with severe gastrointestinal bleeding presents with altered
acid-base status. Which diagnostic evaluation is most critical to guide the
multidimensional care plan?
a) Electrocardiogram alone.
b) Upper GI endoscopy combined with arterial blood gas (ABG)
analysis.
c) Complete blood count (CBC) only.
d) CT scan of the abdomen with no additional studies.
- Correct ANS: b)
- Rationale: Endoscopy identifies the bleeding source while ABG
analysis evaluates the acid-base disturbance. Together, they provide a
comprehensive picture essential for advanced intervention planning.
5. Case Study:
A patient recovering from major abdominal surgery presents with
fluctuating pain, impaired wound healing, and signs of depression. Which
intervention best aligns with an advanced multidimensional care
©2025
, approach?
a) Increasing opioid analgesics for pain only.
b) Implementing a multimodal pain management plan that
incorporates pharmacological strategies, nutritional support, and
psychological therapy.
c) Focusing solely on wound care with dressing changes.
d) Prescribing antidepressants without reassessing pain management.
- Correct ANS: b)
- Rationale: A multidimensional approach addresses the physical pain,
nutritional needs for healing, and the psychological impact of surgery—
ensuring integrated and effective care.
6. Case Study:
A newly diagnosed diabetic patient is overwhelmed by disease
management because of socioeconomic constraints and low health
literacy. Which care plan best incorporates advanced multidimensional
concepts?
a) Provide standard written diabetic education materials.
b) Initiate a comprehensive plan that tailors education to the patient’s
literacy level, involves social service referrals for financial support, and
includes regular follow-up.
c) Emphasize medication adherence without additional support.
d) Refer solely to a diabetic educator without addressing
socioeconomic factors.
- Correct ANS: b)
- Rationale: Addressing educational, economic, and social factors
together exemplifies a multidimensional approach, ensuring improved
self-management in chronic conditions.
7. Case Study:
A patient with end-stage renal disease (ESRD) undergoing dialysis is
experiencing spiritual distress and anxiety. Which combination of
interventions embodies advanced multidimensional care?
a) Increase dialysis frequency.
b) Incorporate mindfulness training, assign spiritual
©2025
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. Case Study:
A 65-year-old male with a history of myocardial infarction and chronic
kidney disease is admitted with acute decompensated heart failure. He
presents with electrolyte imbalances, acid-base disturbances, and
depressive symptoms. Which integrative multidimensional care plan
properly addresses this patient's complex needs?
a) Focus solely on aggressive diuretic therapy and fluid restriction.
b) Initiate an interprofessional plan including a cardiology consult,
renal/electrolyte management, and psychological support.
c) Prioritize oxygen supplementation and bed rest, waiting for lab
stabilization.
d) Adjust medications based on daily labs without further consultation.
- Correct ANS: b)
- Rationale: This option demonstrates a multidimensional approach by
addressing not only the physical and biochemical needs (cardiac and
renal management) but also the psychological aspects—ensuring holistic,
coordinated care.
2. Case Study:
A patient with metastatic lung cancer reports severe pain, anxiety, and
feelings of social isolation. Which advanced intervention best exemplifies
a multidimensional strategy for this patient?
a) Prescribe high-dose opioids for pain control only.
b) Schedule regular palliative care consultations and integrate social
work and spiritual care services.
c) Focus on adjusting chemotherapy regimens and postpone
supportive care.
d) Refer to physical therapy for activity enhancement only.
- Correct ANS: b)
- Rationale: Multidimensional care in advanced cancer must
incorporate physical symptom management along with emotional, social,
and spiritual support, ensuring quality of life.
©2025
,3. Case Study:
An elderly patient with advanced COPD exhibits severe dyspnea, anxiety
about air hunger, and lacks family support. Which strategy best aligns
with the principles of advanced multidimensional care?
a) Administer bronchodilators and corticosteroids exclusively.
b) Develop a care plan that combines respiratory therapy, cognitive-
behavioral techniques for anxiety, and referral to community support
services.
c) Increase oxygen flow and admit for observation without further
planning.
d) Schedule immediate ICU admission for invasive ventilation.
- Correct ANS: b)
- Rationale: This approach addresses physical symptoms, manages
psychological distress, and bridges social support—all key components of
a holistic, multidimensional care plan.
4. Case Study:
A patient with severe gastrointestinal bleeding presents with altered
acid-base status. Which diagnostic evaluation is most critical to guide the
multidimensional care plan?
a) Electrocardiogram alone.
b) Upper GI endoscopy combined with arterial blood gas (ABG)
analysis.
c) Complete blood count (CBC) only.
d) CT scan of the abdomen with no additional studies.
- Correct ANS: b)
- Rationale: Endoscopy identifies the bleeding source while ABG
analysis evaluates the acid-base disturbance. Together, they provide a
comprehensive picture essential for advanced intervention planning.
5. Case Study:
A patient recovering from major abdominal surgery presents with
fluctuating pain, impaired wound healing, and signs of depression. Which
intervention best aligns with an advanced multidimensional care
©2025
, approach?
a) Increasing opioid analgesics for pain only.
b) Implementing a multimodal pain management plan that
incorporates pharmacological strategies, nutritional support, and
psychological therapy.
c) Focusing solely on wound care with dressing changes.
d) Prescribing antidepressants without reassessing pain management.
- Correct ANS: b)
- Rationale: A multidimensional approach addresses the physical pain,
nutritional needs for healing, and the psychological impact of surgery—
ensuring integrated and effective care.
6. Case Study:
A newly diagnosed diabetic patient is overwhelmed by disease
management because of socioeconomic constraints and low health
literacy. Which care plan best incorporates advanced multidimensional
concepts?
a) Provide standard written diabetic education materials.
b) Initiate a comprehensive plan that tailors education to the patient’s
literacy level, involves social service referrals for financial support, and
includes regular follow-up.
c) Emphasize medication adherence without additional support.
d) Refer solely to a diabetic educator without addressing
socioeconomic factors.
- Correct ANS: b)
- Rationale: Addressing educational, economic, and social factors
together exemplifies a multidimensional approach, ensuring improved
self-management in chronic conditions.
7. Case Study:
A patient with end-stage renal disease (ESRD) undergoing dialysis is
experiencing spiritual distress and anxiety. Which combination of
interventions embodies advanced multidimensional care?
a) Increase dialysis frequency.
b) Incorporate mindfulness training, assign spiritual
©2025
