LANIF · 1CDM
★ ★
MDC School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC 1 — Final Examination
CO M P R E H E N S I V E R E V I E W · I N T E G U M E N TA RY · S E N S O RY · I M M U N E ·
M US CU LO S K E L E TA L
INSTITUTION Miami Dade College COURSE CODE MDC 1
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC 1 Final — Comprehensive COURSE TITLE Fundamentals of Nursing
TOTAL QUESTIONS 100 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers integumentary, sensory (eye/ear), immune, musculoskeletal, and genitourinary
disorders.
▸ Normal lab values are integrated throughout rationales.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE FINAL EXAMINATION Questions 1 – 100
1. The butterfly rash is a classic finding associated with which autoimmune disease?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus (SLE)
C. Psoriasis
D. Atopic dermatitis
CORRECT ANSWER B — Systemic lupus erythematosus (SLE).
RATIONALE The butterfly (malar) rash is a hallmark skin manifestation of SLE — a chronic
autoimmune inflammatory disease affecting collagen in the skin, joints, and
internal organs. The rash appears across the cheeks and bridge of the nose in a
butterfly pattern. Photosensitivity can trigger skin rashes, itching, and burning —
patients must stay out of the sun. Other SLE manifestations: nephritis (kidneys are
most commonly affected — assess BUN, creatinine, urine output ≥30 mL/hr),
pericarditis, Raynaud's phenomenon, pleural effusions, joint inflammation, fever,
and fatigue. First-line treatment: hydroxychloroquine. NSAIDs for symptomatic
therapy. Corticosteroids and immunosuppressants for severe disease. SLE in
pregnancy: higher risk for flare, fetal loss, DVT especially if patient has
antiphospholipid antibodies (consider heparin). Baby can develop heart block or
rash, usually resolving when maternal antibodies clear at 6–8 months.
Hydroxychloroquine is safe; if refractory, steroids are OK.
,2. What are the different types of pain scales used in clinical practice?
A. Only the numeric 0–10 scale
B. Wong-Baker FACES, Numeric pain scale, Verbal pain intensity scale, Visual analogue scale,
and Categorical scale
C. Only the Wong-Baker FACES scale
D. Only the FLACC scale for all patients
CORRECT ANSWER B — Wong-Baker FACES, Numeric (0–10), Verbal pain intensity, Visual
analogue, and Categorical scales.
RATIONALE Multiple validated pain scales exist because pain is subjective and patients have
different communication abilities: (1) Numeric Rating Scale (0–10) — most
common; patient rates pain from 0 (no pain) to 10 (worst imaginable). (2) Wong-
Baker FACES — six cartoon faces from smiling to crying; used for children and
non-English speakers. (3) Verbal Pain Intensity Scale — descriptive words (none,
mild, moderate, severe). (4) Visual Analogue Scale — a 10-cm line where patient
marks their pain level. (5) Categorical Scale — pain described by categories. (6)
PAINAD — for non-verbal patients with advanced dementia; assesses breathing,
vocalization, facial expression, body language, and consolability. The nurse
selects the appropriate scale based on the patient's age, cognitive status, and
communication ability. Pain is the fifth vital sign.
, 3. What is PAINAD and what is its purpose?
A. A pain medication administration record
B. Pain Assessment in Advanced Dementia — recognizes nonverbal clues to assess pain in
patients who cannot self-report
C. A postoperative pain protocol for surgical patients
D. A pain scale used exclusively for infants under 1 year
CORRECT ANSWER B — Pain Assessment in Advanced Dementia; recognizes nonverbal clues to
assess pain.
RATIONALE The PAINAD scale is specifically designed for non-verbal patients with advanced
dementia who cannot self-report pain using traditional scales. It assesses five
behavioral indicators: (1) Breathing — normal, labored, hyperventilation. (2)
Negative vocalizations — none, moaning, crying. (3) Facial expression — smiling,
sad, grimacing. (4) Body language — relaxed, tense, rigid. (5) Consolability — not
needing, distractible, unable to console. Each item scores 0–2; total 0–10. The
purpose is to recognize and quantify pain through objective observation of
nonverbal behaviors, ensuring that vulnerable patients receive appropriate pain
management. This is essential because untreated pain has serious physiological
and psychological consequences.