Rasmussen University
LANIF · 2CDM
★ ★
R School of Nursing
EST. 1900
EMPOWERED LEARNING. INSPIRED FUTURES.
MDC 2 — Final Examination
CO M P R E H E N S I V E : E N D O C R I N E · G I · O N CO LO G Y · A B G · F LU I D & E L E CT R O LYT E S
INSTITUTION Rasmussen University COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC 2 Final Examination COURSE TITLE Multidimensional Care II
TOTAL QUESTIONS 70 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question unless instructed otherwise.
▸ Content covers endocrine disorders, GI conditions, ABG interpretation, oncology, fluid/electrolyte
imbalances, and diabetes management.
▸ Select-all-that-apply questions are identified in the stem.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All data reflects current evidence-based nursing practice.
, FINAL COMPREHENSIVE EXAMINATION Questions 1 – 70
1. A nurse is caring for a client recently diagnosed with diabetes insipidus. Which of the
following medications would be appropriate for this disorder?
A. Levothyroxine
B. Desmopressin
C. Prednisone
D. Regular insulin
CORRECT ANSWER B — Desmopressin.
RATIONALE Desmopressin acetate (DDAVP) is a synthetic analog of vasopressin (ADH) and is
the preferred treatment for central diabetes insipidus. DI results from ADH
deficiency → inability to concentrate urine → massive polyuria, polydipsia, and
risk of severe dehydration. Desmopressin replaces the missing ADH, reducing
urine output. For permanent DI, therapy is lifelong. The nurse must monitor for
water intoxication if the patient drinks excessive fluids while on DDAVP.
2. A nurse assesses a client who is recovering from an ileostomy placement. Which clinical
manifestation would alert the nurse to contact the healthcare provider urgently?
A. A pink and moist stoma
B. A bluish stoma
C. Liquid stool output
D. Mild peristomal redness
CORRECT ANSWER B — A bluish stoma.
RATIONALE A healthy stoma should be pink/red and moist — indicating adequate perfusion. A
bluish, dusky, or black stoma indicates ischemia or necrosis from compromised
blood flow. This is a surgical emergency requiring IMMEDIATE provider
notification. The nurse must assess stoma color with every assessment. Other
unexpected findings: excessive bleeding, stenosis, prolapse, or parastomal
hernia. A pale stoma may indicate anemia. Early detection of vascular
compromise can salvage the stoma.
,3. The nurse is caring for a client diagnosed with cholelithiasis. Which of the following
nursing instructions should be included as part of the discharge teaching?
A. "You should increase your intake of high-fat meats and fried foods."
B. "You should limit high-fat meats and fried foods from your diet."
C. "There are no dietary restrictions after cholelithiasis treatment."
D. "You should increase your dairy intake to prevent stone formation."
CORRECT ANSWER B — "You should limit high-fat meats and fried foods from your diet."
RATIONALE Cholelithiasis (gallstones) is exacerbated by fatty foods — dietary fat stimulates
cholecystokinin release, which causes gallbladder contraction. If stones are
present, this contraction against an obstructed cystic duct causes severe biliary
colic pain. Patients should follow a low-fat diet, avoiding fried foods, fatty meats,
butter, cream, and excessive oils. Weight reduction is recommended if obese.
Rapid weight loss should be avoided as it can promote gallstone formation.
4. A 46-year-old female client undergoing chemotherapy for breast cancer presents with
dizziness, nausea, vomiting, and fatigue. Labs: Na 150 mEq/L, K 3.0 mEq/L, Ca 15 mg/dL.
Which imbalances are present?
A. Hyponatremia, hyperkalemia, hypocalcemia
B. Hypernatremia, hypokalemia, hypercalcemia
C. Hypernatremia, hyperkalemia, hypercalcemia
D. Hyponatremia, hypokalemia, hypocalcemia
CORRECT ANSWER B — Hypernatremia (Na 150 > 145), hypokalemia (K 3.0 < 3.5),
hypercalcemia (Ca 15 > 10.5).
RATIONALE Normal ranges: Na 135–145 mEq/L, K 3.5–5.0 mEq/L, Ca 8.5–10.5 mg/dL. Sodium
150 = hypernatremia (dehydration from vomiting). Potassium 3.0 = hypokalemia
(GI losses from vomiting, poor intake). Calcium 15 = hypercalcemia (likely related
to bone metastases from breast cancer — tumor releases calcium from bone).
Hypercalcemia of malignancy is an oncologic emergency. Treatment: aggressive
IV Normal Saline hydration, loop diuretics, bisphosphonates, and calcitonin.
, 5. A nurse cares for a dying client. Which manifestation of active dying would the nurse
treat first?
A. Anorexia
B. Pain
C. Fatigue
D. Nausea
CORRECT ANSWER B — Pain.
RATIONALE Pain is the priority among symptoms of distress in an actively dying client.
Uncontrolled pain causes suffering and can worsen other symptoms (anxiety,
dyspnea, agitation). The nurse must assess pain frequently and administer
medications as prescribed — morphine is the gold standard for end-of-life pain
and dyspnea. After pain is addressed, other distressing symptoms (dyspnea,
nausea, agitation, secretions) are managed. The goal is comfort and dignity in the
dying process.
6. A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement
would the nurse include in the client's plan of care to delay the onset of microvascular
and macrovascular complications?
A. "Focus on weight loss alone; glycemic control is secondary."
B. "Maintain tight glycemic control and prevent hyperglycemia."
C. "Check your blood glucose only when you feel symptoms."
D. "Microvascular complications cannot be prevented."
CORRECT ANSWER B — "Maintain tight glycemic control and prevent hyperglycemia."
RATIONALE Tight glycemic control (HbA1c < 7%) is the cornerstone of preventing diabetic
complications. Hyperglycemia causes: microvascular damage → retinopathy
(blindness), nephropathy (renal failure), and neuropathy (amputations).
Macrovascular damage → accelerated atherosclerosis → MI, stroke, peripheral
vascular disease. The DCCT (Type 1) and UKPDS (Type 2) trials demonstrated that
intensive glucose control significantly reduces complication risk. Patient
education: regular glucose monitoring, medication adherence, dietary
management, and exercise.
LANIF · 2CDM
★ ★
R School of Nursing
EST. 1900
EMPOWERED LEARNING. INSPIRED FUTURES.
MDC 2 — Final Examination
CO M P R E H E N S I V E : E N D O C R I N E · G I · O N CO LO G Y · A B G · F LU I D & E L E CT R O LYT E S
INSTITUTION Rasmussen University COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC 2 Final Examination COURSE TITLE Multidimensional Care II
TOTAL QUESTIONS 70 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question unless instructed otherwise.
▸ Content covers endocrine disorders, GI conditions, ABG interpretation, oncology, fluid/electrolyte
imbalances, and diabetes management.
▸ Select-all-that-apply questions are identified in the stem.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All data reflects current evidence-based nursing practice.
, FINAL COMPREHENSIVE EXAMINATION Questions 1 – 70
1. A nurse is caring for a client recently diagnosed with diabetes insipidus. Which of the
following medications would be appropriate for this disorder?
A. Levothyroxine
B. Desmopressin
C. Prednisone
D. Regular insulin
CORRECT ANSWER B — Desmopressin.
RATIONALE Desmopressin acetate (DDAVP) is a synthetic analog of vasopressin (ADH) and is
the preferred treatment for central diabetes insipidus. DI results from ADH
deficiency → inability to concentrate urine → massive polyuria, polydipsia, and
risk of severe dehydration. Desmopressin replaces the missing ADH, reducing
urine output. For permanent DI, therapy is lifelong. The nurse must monitor for
water intoxication if the patient drinks excessive fluids while on DDAVP.
2. A nurse assesses a client who is recovering from an ileostomy placement. Which clinical
manifestation would alert the nurse to contact the healthcare provider urgently?
A. A pink and moist stoma
B. A bluish stoma
C. Liquid stool output
D. Mild peristomal redness
CORRECT ANSWER B — A bluish stoma.
RATIONALE A healthy stoma should be pink/red and moist — indicating adequate perfusion. A
bluish, dusky, or black stoma indicates ischemia or necrosis from compromised
blood flow. This is a surgical emergency requiring IMMEDIATE provider
notification. The nurse must assess stoma color with every assessment. Other
unexpected findings: excessive bleeding, stenosis, prolapse, or parastomal
hernia. A pale stoma may indicate anemia. Early detection of vascular
compromise can salvage the stoma.
,3. The nurse is caring for a client diagnosed with cholelithiasis. Which of the following
nursing instructions should be included as part of the discharge teaching?
A. "You should increase your intake of high-fat meats and fried foods."
B. "You should limit high-fat meats and fried foods from your diet."
C. "There are no dietary restrictions after cholelithiasis treatment."
D. "You should increase your dairy intake to prevent stone formation."
CORRECT ANSWER B — "You should limit high-fat meats and fried foods from your diet."
RATIONALE Cholelithiasis (gallstones) is exacerbated by fatty foods — dietary fat stimulates
cholecystokinin release, which causes gallbladder contraction. If stones are
present, this contraction against an obstructed cystic duct causes severe biliary
colic pain. Patients should follow a low-fat diet, avoiding fried foods, fatty meats,
butter, cream, and excessive oils. Weight reduction is recommended if obese.
Rapid weight loss should be avoided as it can promote gallstone formation.
4. A 46-year-old female client undergoing chemotherapy for breast cancer presents with
dizziness, nausea, vomiting, and fatigue. Labs: Na 150 mEq/L, K 3.0 mEq/L, Ca 15 mg/dL.
Which imbalances are present?
A. Hyponatremia, hyperkalemia, hypocalcemia
B. Hypernatremia, hypokalemia, hypercalcemia
C. Hypernatremia, hyperkalemia, hypercalcemia
D. Hyponatremia, hypokalemia, hypocalcemia
CORRECT ANSWER B — Hypernatremia (Na 150 > 145), hypokalemia (K 3.0 < 3.5),
hypercalcemia (Ca 15 > 10.5).
RATIONALE Normal ranges: Na 135–145 mEq/L, K 3.5–5.0 mEq/L, Ca 8.5–10.5 mg/dL. Sodium
150 = hypernatremia (dehydration from vomiting). Potassium 3.0 = hypokalemia
(GI losses from vomiting, poor intake). Calcium 15 = hypercalcemia (likely related
to bone metastases from breast cancer — tumor releases calcium from bone).
Hypercalcemia of malignancy is an oncologic emergency. Treatment: aggressive
IV Normal Saline hydration, loop diuretics, bisphosphonates, and calcitonin.
, 5. A nurse cares for a dying client. Which manifestation of active dying would the nurse
treat first?
A. Anorexia
B. Pain
C. Fatigue
D. Nausea
CORRECT ANSWER B — Pain.
RATIONALE Pain is the priority among symptoms of distress in an actively dying client.
Uncontrolled pain causes suffering and can worsen other symptoms (anxiety,
dyspnea, agitation). The nurse must assess pain frequently and administer
medications as prescribed — morphine is the gold standard for end-of-life pain
and dyspnea. After pain is addressed, other distressing symptoms (dyspnea,
nausea, agitation, secretions) are managed. The goal is comfort and dignity in the
dying process.
6. A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement
would the nurse include in the client's plan of care to delay the onset of microvascular
and macrovascular complications?
A. "Focus on weight loss alone; glycemic control is secondary."
B. "Maintain tight glycemic control and prevent hyperglycemia."
C. "Check your blood glucose only when you feel symptoms."
D. "Microvascular complications cannot be prevented."
CORRECT ANSWER B — "Maintain tight glycemic control and prevent hyperglycemia."
RATIONALE Tight glycemic control (HbA1c < 7%) is the cornerstone of preventing diabetic
complications. Hyperglycemia causes: microvascular damage → retinopathy
(blindness), nephropathy (renal failure), and neuropathy (amputations).
Macrovascular damage → accelerated atherosclerosis → MI, stroke, peripheral
vascular disease. The DCCT (Type 1) and UKPDS (Type 2) trials demonstrated that
intensive glucose control significantly reduces complication risk. Patient
education: regular glucose monitoring, medication adherence, dietary
management, and exercise.
