Miami Dade College
3 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 3
D I A B E T E S · CO LO R E CTA L C A N C E R · I B D · L I V E R · E N D O C R I N E · T H Y R O I D
INSTITUTION Miami Dade College COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ADN ACADEMIC YEAR
EXAM TITLE MDC2 Examination 3 — COURSE TITLE Med-Surg Nursing II
Comprehensive
TOTAL QUESTIONS 77 Questions FORMAT Multiple Choice — Select the Single
Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question unless otherwise instructed.
▸ Content covers diabetes mellitus complications, colorectal cancer, IBD, liver disorders, endocrine disorders,
and thyroid conditions.
▸ Cancer screening frequency guidelines are included.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
, COMPREHENSIVE EXAMINATION Questions 1 – 77
1. What are the recommended blood pressure levels for patients with diabetes mellitus?
A. Below 160/100; below 150/90 in younger adults
B. Below 140/90; below 130/80 in younger adults
C. Below 120/80 for all adults
D. Below 150/95 for all adults regardless of age
CORRECT ANSWER B — Below 140/90; below 130/80 in younger adults.
RATIONALE Blood pressure control is critical in diabetes to reduce cardiovascular and renal
complications. The target is <140/90 for most adults with DM, with a more stringent goal
of <130/80 for younger adults who can tolerate tighter control. Hypertension in DM
accelerates microvascular (retinopathy, nephropathy) and macrovascular (MI, stroke)
complications. Regular monitoring and lifestyle modifications plus pharmacotherapy
are essential.
2. What are the recommended LDL cholesterol levels for patients with diabetes mellitus?
A. Without CVD: <130 mg/dL; With CVD: <100 mg/dL
B. Without CVD: <100 mg/dL; With CVD: <70 mg/dL
C. Without CVD: <160 mg/dL; With CVD: <130 mg/dL
D. Without CVD: <70 mg/dL; With CVD: <50 mg/dL
CORRECT ANSWER B — Without CVD: <100 mg/dL; With CVD: <70 mg/dL.
RATIONALE Diabetes is considered a coronary artery disease risk equivalent — lipid management is
aggressive. For DM patients without established CVD, LDL target is <100 mg/dL. For
those WITH known CVD (secondary prevention), the target is more stringent at <70
mg/dL. Statin therapy is first-line for LDL reduction. Lifestyle modifications complement
pharmacotherapy: reducing saturated/trans fats, increasing omega-3 fatty acids, fiber,
plant sterols, weight loss, and physical activity.
,3. Which lifestyle changes improve the lipid profile? Select all that apply.
A. Reducing saturated fat, trans fat, and cholesterol intake
B. Increasing intake of omega-3 fatty acids, fiber, and plant sterols
C. Weight loss and increased physical activity
D. All of the above
CORRECT ANSWER D — All of the above.
RATIONALE Comprehensive lipid management includes: reducing saturated and trans fats (decrease
LDL), increasing omega-3 fatty acids (anti-inflammatory, triglyceride-lowering),
increasing soluble fiber (binds cholesterol in the GI tract), plant sterols/stanols (compete
with cholesterol absorption), weight loss (reduces total cholesterol and LDL), and
increased physical activity (raises HDL, lowers triglycerides). These lifestyle
interventions are foundational before and alongside pharmacotherapy.
4. What interventions reduce modifiable risk factors for cardiovascular disease?
A. Only pharmacologic therapy — lifestyle changes are ineffective
B. Smoking cessation, diet modification, exercise, blood pressure control, maintaining prescribed
aspirin use, and maintaining prescribed lipid-lowering drug therapy
C. Genetic testing and family history assessment only
D. Stress reduction alone is sufficient
CORRECT ANSWER B — Smoking cessation, diet, exercise, BP control, maintaining prescribed aspirin
use, and maintaining prescribed lipid-lowering drug therapy.
RATIONALE Modifiable CVD risk factors are addressed through a comprehensive approach: smoking
cessation (single most effective intervention), heart-healthy diet (Mediterranean, DASH),
regular exercise (150 min/week moderate-intensity), BP control (<140/90), aspirin
therapy (for secondary prevention or high-risk primary prevention), and lipid-lowering
medications (statins). These interventions target the major modifiable risk factors:
hypertension, hyperlipidemia, smoking, obesity, and physical inactivity.
, 5. The risk for stroke is how much higher in adults with diabetes mellitus?
A. 1.5x higher
B. 2–4x higher
C. 5–7x higher
D. No increased risk
CORRECT ANSWER B — 2–4x higher.
RATIONALE Diabetes mellitus increases stroke risk 2–4 times compared to non-diabetic individuals.
The mechanisms include accelerated atherosclerosis from chronic hyperglycemia,
hypertension (common comorbidity), endothelial dysfunction, increased platelet
aggregation, and impaired fibrinolysis. This is why aggressive risk factor management
(BP control, lipid management, antiplatelet therapy, glucose control) is essential in the
diabetic population.
6. What defines legal blindness and how common is it in patients with DM?
A. Visual acuity of 20/100 or less; 10x more common in DM
B. Visual acuity of 20/200 or less; 25x more common in patients with DM
C. Visual acuity of 20/400 or less; 50x more common in DM
D. Complete absence of light perception; same prevalence as general population
CORRECT ANSWER B — Visual acuity of 20/200 or less; 25x more common in patients with DM.
RATIONALE Legal blindness is defined as best-corrected visual acuity of 20/200 or less in the better
eye, or visual field of 20 degrees or less. Diabetes is the leading cause of new blindness
in adults aged 20–74. Diabetic retinopathy makes blindness 25 times more common in
DM patients than the general population. Annual dilated eye exams are essential for
early detection and treatment to prevent vision loss.
3 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 3
D I A B E T E S · CO LO R E CTA L C A N C E R · I B D · L I V E R · E N D O C R I N E · T H Y R O I D
INSTITUTION Miami Dade College COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ADN ACADEMIC YEAR
EXAM TITLE MDC2 Examination 3 — COURSE TITLE Med-Surg Nursing II
Comprehensive
TOTAL QUESTIONS 77 Questions FORMAT Multiple Choice — Select the Single
Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question unless otherwise instructed.
▸ Content covers diabetes mellitus complications, colorectal cancer, IBD, liver disorders, endocrine disorders,
and thyroid conditions.
▸ Cancer screening frequency guidelines are included.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
, COMPREHENSIVE EXAMINATION Questions 1 – 77
1. What are the recommended blood pressure levels for patients with diabetes mellitus?
A. Below 160/100; below 150/90 in younger adults
B. Below 140/90; below 130/80 in younger adults
C. Below 120/80 for all adults
D. Below 150/95 for all adults regardless of age
CORRECT ANSWER B — Below 140/90; below 130/80 in younger adults.
RATIONALE Blood pressure control is critical in diabetes to reduce cardiovascular and renal
complications. The target is <140/90 for most adults with DM, with a more stringent goal
of <130/80 for younger adults who can tolerate tighter control. Hypertension in DM
accelerates microvascular (retinopathy, nephropathy) and macrovascular (MI, stroke)
complications. Regular monitoring and lifestyle modifications plus pharmacotherapy
are essential.
2. What are the recommended LDL cholesterol levels for patients with diabetes mellitus?
A. Without CVD: <130 mg/dL; With CVD: <100 mg/dL
B. Without CVD: <100 mg/dL; With CVD: <70 mg/dL
C. Without CVD: <160 mg/dL; With CVD: <130 mg/dL
D. Without CVD: <70 mg/dL; With CVD: <50 mg/dL
CORRECT ANSWER B — Without CVD: <100 mg/dL; With CVD: <70 mg/dL.
RATIONALE Diabetes is considered a coronary artery disease risk equivalent — lipid management is
aggressive. For DM patients without established CVD, LDL target is <100 mg/dL. For
those WITH known CVD (secondary prevention), the target is more stringent at <70
mg/dL. Statin therapy is first-line for LDL reduction. Lifestyle modifications complement
pharmacotherapy: reducing saturated/trans fats, increasing omega-3 fatty acids, fiber,
plant sterols, weight loss, and physical activity.
,3. Which lifestyle changes improve the lipid profile? Select all that apply.
A. Reducing saturated fat, trans fat, and cholesterol intake
B. Increasing intake of omega-3 fatty acids, fiber, and plant sterols
C. Weight loss and increased physical activity
D. All of the above
CORRECT ANSWER D — All of the above.
RATIONALE Comprehensive lipid management includes: reducing saturated and trans fats (decrease
LDL), increasing omega-3 fatty acids (anti-inflammatory, triglyceride-lowering),
increasing soluble fiber (binds cholesterol in the GI tract), plant sterols/stanols (compete
with cholesterol absorption), weight loss (reduces total cholesterol and LDL), and
increased physical activity (raises HDL, lowers triglycerides). These lifestyle
interventions are foundational before and alongside pharmacotherapy.
4. What interventions reduce modifiable risk factors for cardiovascular disease?
A. Only pharmacologic therapy — lifestyle changes are ineffective
B. Smoking cessation, diet modification, exercise, blood pressure control, maintaining prescribed
aspirin use, and maintaining prescribed lipid-lowering drug therapy
C. Genetic testing and family history assessment only
D. Stress reduction alone is sufficient
CORRECT ANSWER B — Smoking cessation, diet, exercise, BP control, maintaining prescribed aspirin
use, and maintaining prescribed lipid-lowering drug therapy.
RATIONALE Modifiable CVD risk factors are addressed through a comprehensive approach: smoking
cessation (single most effective intervention), heart-healthy diet (Mediterranean, DASH),
regular exercise (150 min/week moderate-intensity), BP control (<140/90), aspirin
therapy (for secondary prevention or high-risk primary prevention), and lipid-lowering
medications (statins). These interventions target the major modifiable risk factors:
hypertension, hyperlipidemia, smoking, obesity, and physical inactivity.
, 5. The risk for stroke is how much higher in adults with diabetes mellitus?
A. 1.5x higher
B. 2–4x higher
C. 5–7x higher
D. No increased risk
CORRECT ANSWER B — 2–4x higher.
RATIONALE Diabetes mellitus increases stroke risk 2–4 times compared to non-diabetic individuals.
The mechanisms include accelerated atherosclerosis from chronic hyperglycemia,
hypertension (common comorbidity), endothelial dysfunction, increased platelet
aggregation, and impaired fibrinolysis. This is why aggressive risk factor management
(BP control, lipid management, antiplatelet therapy, glucose control) is essential in the
diabetic population.
6. What defines legal blindness and how common is it in patients with DM?
A. Visual acuity of 20/100 or less; 10x more common in DM
B. Visual acuity of 20/200 or less; 25x more common in patients with DM
C. Visual acuity of 20/400 or less; 50x more common in DM
D. Complete absence of light perception; same prevalence as general population
CORRECT ANSWER B — Visual acuity of 20/200 or less; 25x more common in patients with DM.
RATIONALE Legal blindness is defined as best-corrected visual acuity of 20/200 or less in the better
eye, or visual field of 20 degrees or less. Diabetes is the leading cause of new blindness
in adults aged 20–74. Diabetic retinopathy makes blindness 25 times more common in
DM patients than the general population. Annual dilated eye exams are essential for
early detection and treatment to prevent vision loss.
