NUR 2502 / NUR2502 Final Exam: Multidimensional
Care III / MDC 3 – Rasmussen Actual Exam Complete
Questions & Rationales | Complex Care | Pass
Guaranteed - A+ Graded
[Complex Management of Chronic Illnesses]
Q1: A patient with systolic heart failure is scheduled for discharge. The nurse is
reinforcing teaching about the daily weight protocol. Which statement by the patient
indicates a need for further instruction?
A. "I will weigh myself every morning after I go to the bathroom but before I eat."
B. "I need to use the same scale every day, preferably in the same spot."
C. "I should call my doctor if I gain more than 2 pounds in a day or 5 pounds in a week."
D. "If I notice a sudden weight gain, I will drink some extra water to flush it out."
Correct Answer: D
Rationale: Drinking extra water is dangerous for a heart failure patient because it
increases fluid load, worsening the congestion. This indicates a misunderstanding of
fluid restriction principles.
Q2: A patient with End-Stage Renal Disease (ESRD) is receiving hemodialysis. The
nurse observes the patient has a new onset of fever, swelling, and redness at the AV
fistula site. What is the priority nursing action?
A. Apply a warm compress to the area
B. Instruct the patient to keep the arm elevated
C. Notify the nephrologist immediately
D. Check the patient's white blood cell count
Correct Answer: C
Rationale: These signs suggest infection of the access site, which is a major
complication for ESRD patients and can lead to sepsis rapidly. The provider needs to be
notified immediately for antibiotics and intervention.
Q3: When teaching a patient with chronic obstructive pulmonary disease (COPD) about
energy conservation, the nurse suggests pursed-lip breathing. What is the primary
physiological benefit of this technique?
A. It increases the oxygen concentration in the lungs.
B. It helps keep the airways open longer during exhalation.
C. It prevents the accumulation of mucus in the alveoli.
,D. It stimulates the diaphragm to contract more forcefully.
Correct Answer: B
Rationale: Pursed-lip breathing creates back-pressure in the airways (positive
end-expiratory pressure) which prevents the small airways from collapsing prematurely
during exhalation, allowing for more effective air exchange.
Q4: A patient with cirrhosis of the liver presents with asterixis and confusion. The nurse
recognizes these as early signs of hepatic encephalopathy. What dietary restriction is
most critical at this stage?
A. High protein
B. Low sodium
C. Low protein
D. High carbohydrate
Correct Answer: C
Rationale: The liver cannot detoxify protein byproducts (ammonia) effectively in
cirrhosis. Reducing protein intake decreases the production of ammonia, which is
causing the neurologic symptoms.
Q5: A patient with poorly controlled Type 2 diabetes has peripheral neuropathy. During
the foot assessment, the nurse notes a small, painless ulcer on the plantar surface of
the big toe. Why is the lack of pain significant in the context of multidimensional care?
A. It indicates that the infection has spread to the bone.
B. It means the patient likely has adequate circulation despite the ulcer.
C. It delays treatment because the patient is unaware of the injury.
D. It suggests the ulcer is actually a pressure injury, not a diabetic ulcer.
Correct Answer: C
Rationale: Neuropathy damages the sensory nerves, so the patient cannot feel the
trauma or pressure causing the ulcer. This "painless" nature often leads to delays in
seeking care, worsening the infection and increasing the risk of amputation.
Q6: A nurse is caring for a patient with chronic heart failure who is taking digoxin
(Lanoxin). Which finding requires immediate follow-up?
A. Heart rate of 58 bpm
B. Complaints of mild nausea and visual halos
C. Serum potassium level of 4.0 mEq/L
D. Slight swelling of ankles at the end of the day
Correct Answer: B
Rationale: Nausea (anorexia) and visual disturbances (halos) are classic early signs of
digoxin toxicity. While a HR of 58 requires monitoring, these specific symptoms indicate
a dangerous toxicity level that requires immediate intervention.
, Q7: A patient with COPD is prescribed home oxygen therapy at 2 L/min via nasal
cannula. The nurse teaches the patient about the risk of carbon dioxide retention. Why
is this a specific concern for this patient?
A. High oxygen levels will suppress the hypoxic drive to breathe.
B. The nasal cannula delivers oxygen too quickly for their damaged lungs.
C. Oxygen causes the airways to constrict, increasing resistance.
D. The patient will become addicted to the supplemental oxygen.
Correct Answer: A
Rationale: Chronic retainers of CO2 rely on low oxygen levels (hypoxic drive) to
stimulate breathing. Flooding them with too much oxygen can suppress this drive,
leading to respiratory failure and CO2 narcosis.
Q8: A patient with advanced cirrhosis has significant ascites causing shortness of
breath. The provider plans a paracentesis. Which post-procedure assessment is the
priority?
A. Monitoring for signs of infection
B. Assessing for leakage or bleeding at the puncture site
C. Measuring abdominal girth
D. Monitoring blood pressure for signs of hypovolemia
Correct Answer: D
Rationale: Removing large volumes of fluid can cause a sudden shift in fluid volume,
leading to hypotension and shock. While bleeding and leakage are important,
monitoring hemodynamic stability is the priority for safety.
Q9: Which medication class is considered a cornerstone of therapy for reducing
mortality and hospitalizations in patients with Heart Failure with Reduced Ejection
Fraction (HFrEF)?
A. Calcium channel blockers
B. Angiotensin-Converting Enzyme (ACE) inhibitors
C. Loop diuretics
D. Antiarrhythmics
Correct Answer: B
Rationale: ACE inhibitors (or ARBs/ARNIs) reduce afterload and remodeling of the
heart, which significantly decreases mortality and hospitalization rates over time.
Diuretics help symptoms but don't necessarily improve long-term survival as directly.
Q10: A patient with chronic kidney disease (CKD) asks why they need to take
phosphate binders with meals. What is the best explanation?
A. "They help your body absorb more calcium to strengthen your bones."
B. "They prevent the absorption of phosphorus from your food into your blood."
C. "They help your kidneys filter out the potassium better."
Care III / MDC 3 – Rasmussen Actual Exam Complete
Questions & Rationales | Complex Care | Pass
Guaranteed - A+ Graded
[Complex Management of Chronic Illnesses]
Q1: A patient with systolic heart failure is scheduled for discharge. The nurse is
reinforcing teaching about the daily weight protocol. Which statement by the patient
indicates a need for further instruction?
A. "I will weigh myself every morning after I go to the bathroom but before I eat."
B. "I need to use the same scale every day, preferably in the same spot."
C. "I should call my doctor if I gain more than 2 pounds in a day or 5 pounds in a week."
D. "If I notice a sudden weight gain, I will drink some extra water to flush it out."
Correct Answer: D
Rationale: Drinking extra water is dangerous for a heart failure patient because it
increases fluid load, worsening the congestion. This indicates a misunderstanding of
fluid restriction principles.
Q2: A patient with End-Stage Renal Disease (ESRD) is receiving hemodialysis. The
nurse observes the patient has a new onset of fever, swelling, and redness at the AV
fistula site. What is the priority nursing action?
A. Apply a warm compress to the area
B. Instruct the patient to keep the arm elevated
C. Notify the nephrologist immediately
D. Check the patient's white blood cell count
Correct Answer: C
Rationale: These signs suggest infection of the access site, which is a major
complication for ESRD patients and can lead to sepsis rapidly. The provider needs to be
notified immediately for antibiotics and intervention.
Q3: When teaching a patient with chronic obstructive pulmonary disease (COPD) about
energy conservation, the nurse suggests pursed-lip breathing. What is the primary
physiological benefit of this technique?
A. It increases the oxygen concentration in the lungs.
B. It helps keep the airways open longer during exhalation.
C. It prevents the accumulation of mucus in the alveoli.
,D. It stimulates the diaphragm to contract more forcefully.
Correct Answer: B
Rationale: Pursed-lip breathing creates back-pressure in the airways (positive
end-expiratory pressure) which prevents the small airways from collapsing prematurely
during exhalation, allowing for more effective air exchange.
Q4: A patient with cirrhosis of the liver presents with asterixis and confusion. The nurse
recognizes these as early signs of hepatic encephalopathy. What dietary restriction is
most critical at this stage?
A. High protein
B. Low sodium
C. Low protein
D. High carbohydrate
Correct Answer: C
Rationale: The liver cannot detoxify protein byproducts (ammonia) effectively in
cirrhosis. Reducing protein intake decreases the production of ammonia, which is
causing the neurologic symptoms.
Q5: A patient with poorly controlled Type 2 diabetes has peripheral neuropathy. During
the foot assessment, the nurse notes a small, painless ulcer on the plantar surface of
the big toe. Why is the lack of pain significant in the context of multidimensional care?
A. It indicates that the infection has spread to the bone.
B. It means the patient likely has adequate circulation despite the ulcer.
C. It delays treatment because the patient is unaware of the injury.
D. It suggests the ulcer is actually a pressure injury, not a diabetic ulcer.
Correct Answer: C
Rationale: Neuropathy damages the sensory nerves, so the patient cannot feel the
trauma or pressure causing the ulcer. This "painless" nature often leads to delays in
seeking care, worsening the infection and increasing the risk of amputation.
Q6: A nurse is caring for a patient with chronic heart failure who is taking digoxin
(Lanoxin). Which finding requires immediate follow-up?
A. Heart rate of 58 bpm
B. Complaints of mild nausea and visual halos
C. Serum potassium level of 4.0 mEq/L
D. Slight swelling of ankles at the end of the day
Correct Answer: B
Rationale: Nausea (anorexia) and visual disturbances (halos) are classic early signs of
digoxin toxicity. While a HR of 58 requires monitoring, these specific symptoms indicate
a dangerous toxicity level that requires immediate intervention.
, Q7: A patient with COPD is prescribed home oxygen therapy at 2 L/min via nasal
cannula. The nurse teaches the patient about the risk of carbon dioxide retention. Why
is this a specific concern for this patient?
A. High oxygen levels will suppress the hypoxic drive to breathe.
B. The nasal cannula delivers oxygen too quickly for their damaged lungs.
C. Oxygen causes the airways to constrict, increasing resistance.
D. The patient will become addicted to the supplemental oxygen.
Correct Answer: A
Rationale: Chronic retainers of CO2 rely on low oxygen levels (hypoxic drive) to
stimulate breathing. Flooding them with too much oxygen can suppress this drive,
leading to respiratory failure and CO2 narcosis.
Q8: A patient with advanced cirrhosis has significant ascites causing shortness of
breath. The provider plans a paracentesis. Which post-procedure assessment is the
priority?
A. Monitoring for signs of infection
B. Assessing for leakage or bleeding at the puncture site
C. Measuring abdominal girth
D. Monitoring blood pressure for signs of hypovolemia
Correct Answer: D
Rationale: Removing large volumes of fluid can cause a sudden shift in fluid volume,
leading to hypotension and shock. While bleeding and leakage are important,
monitoring hemodynamic stability is the priority for safety.
Q9: Which medication class is considered a cornerstone of therapy for reducing
mortality and hospitalizations in patients with Heart Failure with Reduced Ejection
Fraction (HFrEF)?
A. Calcium channel blockers
B. Angiotensin-Converting Enzyme (ACE) inhibitors
C. Loop diuretics
D. Antiarrhythmics
Correct Answer: B
Rationale: ACE inhibitors (or ARBs/ARNIs) reduce afterload and remodeling of the
heart, which significantly decreases mortality and hospitalization rates over time.
Diuretics help symptoms but don't necessarily improve long-term survival as directly.
Q10: A patient with chronic kidney disease (CKD) asks why they need to take
phosphate binders with meals. What is the best explanation?
A. "They help your body absorb more calcium to strengthen your bones."
B. "They prevent the absorption of phosphorus from your food into your blood."
C. "They help your kidneys filter out the potassium better."
