Rasmussen University
3 MAXE · 2CDM
★ ★
R School of Nursing
EST. 1900
EMPOWERED LEARNING. INSPIRED FUTURES.
MDC2 — Examination 3
G I D I S O R D E RS · E N D O C R I N E · T H Y R O I D · A D R E N A L · 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 MDC2 Examination 3 — COURSE TITLE Multidimensional Care II
Comprehensive
TOTAL QUESTIONS 42 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers GI disorders (IBS, peritonitis, malabsorption), endocrine disorders (thyroid, parathyroid,
adrenal, pituitary), and oncology markers.
▸ Normal lab values are integrated throughout rationales for clinical decision-making.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All data reflects current evidence-based nursing practice.
, COMPREHENSIVE EXAMINATION Questions 1 – 42
1. What is the therapeutic range for Carcinoembryonic Antigen (CEA), and what do
increased values indicate?
A. <10 ng/mL; indicates liver failure and hepatitis only
B. <5 ng/mL; increased values can indicate cancer of the colon, stomach, or pancreas,
ulcerative colitis, Crohn's disease, hepatitis, and cirrhosis
C. <37 U/mL; indicates pancreatic cancer only
D. <200 mg/dL; indicates biliary obstruction
CORRECT ANSWER B — CEA < 5 ng/mL; increased values indicate colorectal, stomach, or
pancreatic cancer, UC, Crohn's, hepatitis, and cirrhosis.
RATIONALE CEA is a tumor marker with normal value < 5 ng/mL. Elevated CEA is associated
with colorectal, stomach, and pancreatic cancers. It can also be elevated in non-
malignant conditions: ulcerative colitis, Crohn's disease, hepatitis, and cirrhosis.
CEA is most useful for monitoring treatment response and detecting recurrence,
not for initial screening (lacks sensitivity and specificity). Carbohydrate antigen
19-9 (< 37 U/mL) is another GI tumor marker for pancreatic, stomach, colon, and
gallbladder cancers.
, 2. The nurse is caring for a patient with stomatitis. What should the nurse be on alert for?
A. Signs of hyperglycemia and polyuria
B. Signs and symptoms of dysphagia (coughing or choking when swallowing)
C. Signs of hypertension and tachycardia
D. Signs of peripheral neuropathy
CORRECT ANSWER B — S/S of dysphagia (coughing or choking when swallowing).
RATIONALE Stomatitis (inflammation of the oral cavity) causes pain and ulceration that can
impair swallowing. The nurse must assess for dysphagia — coughing or choking
during swallowing indicates difficulty and aspiration risk. This is critical because
aspiration can lead to pneumonia, especially in immunocompromised or elderly
patients. Stomatitis management: soft-bristled toothbrush or foam swabs, avoid
sodium lauryl sulfate toothpaste, rinse with sodium bicarbonate or warm saline
every 2–3 hours, avoid alcohol-containing mouthwashes, and use antifungals
(Nystatin, Diflucan) or antivirals as indicated.
3. Which populations are at risk for developing severe complications associated with
GERD?
A. Young adults with high-fiber diets
B. Older adults with age-related physiological changes, medication side effects, and
increased prevalence of hiatal hernias
C. Adolescents with sports-related injuries
D. Pregnant women in their first trimester only
CORRECT ANSWER B — Older adults: age-related physiological changes, medication side
effects, and increased prevalence of hiatal hernias.
RATIONALE Older adults are at higher risk for severe GERD complications (Barrett's
esophagus, esophageal strictures, aspiration pneumonia) due to: age-related
physiological changes (decreased LES tone, slowed gastric emptying, decreased
salivary bicarbonate), medication side effects (NSAIDs, calcium channel blockers,
anticholinergics all decrease LES pressure), and increased prevalence of hiatal
hernias. Importantly, older adults may NOT experience typical heartburn — they
may present with atypical chest pain, ENT infections, or pulmonary problems
(aspiration pneumonia, sleep apnea, asthma exacerbation).
3 MAXE · 2CDM
★ ★
R School of Nursing
EST. 1900
EMPOWERED LEARNING. INSPIRED FUTURES.
MDC2 — Examination 3
G I D I S O R D E RS · E N D O C R I N E · T H Y R O I D · A D R E N A L · 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 MDC2 Examination 3 — COURSE TITLE Multidimensional Care II
Comprehensive
TOTAL QUESTIONS 42 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers GI disorders (IBS, peritonitis, malabsorption), endocrine disorders (thyroid, parathyroid,
adrenal, pituitary), and oncology markers.
▸ Normal lab values are integrated throughout rationales for clinical decision-making.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All data reflects current evidence-based nursing practice.
, COMPREHENSIVE EXAMINATION Questions 1 – 42
1. What is the therapeutic range for Carcinoembryonic Antigen (CEA), and what do
increased values indicate?
A. <10 ng/mL; indicates liver failure and hepatitis only
B. <5 ng/mL; increased values can indicate cancer of the colon, stomach, or pancreas,
ulcerative colitis, Crohn's disease, hepatitis, and cirrhosis
C. <37 U/mL; indicates pancreatic cancer only
D. <200 mg/dL; indicates biliary obstruction
CORRECT ANSWER B — CEA < 5 ng/mL; increased values indicate colorectal, stomach, or
pancreatic cancer, UC, Crohn's, hepatitis, and cirrhosis.
RATIONALE CEA is a tumor marker with normal value < 5 ng/mL. Elevated CEA is associated
with colorectal, stomach, and pancreatic cancers. It can also be elevated in non-
malignant conditions: ulcerative colitis, Crohn's disease, hepatitis, and cirrhosis.
CEA is most useful for monitoring treatment response and detecting recurrence,
not for initial screening (lacks sensitivity and specificity). Carbohydrate antigen
19-9 (< 37 U/mL) is another GI tumor marker for pancreatic, stomach, colon, and
gallbladder cancers.
, 2. The nurse is caring for a patient with stomatitis. What should the nurse be on alert for?
A. Signs of hyperglycemia and polyuria
B. Signs and symptoms of dysphagia (coughing or choking when swallowing)
C. Signs of hypertension and tachycardia
D. Signs of peripheral neuropathy
CORRECT ANSWER B — S/S of dysphagia (coughing or choking when swallowing).
RATIONALE Stomatitis (inflammation of the oral cavity) causes pain and ulceration that can
impair swallowing. The nurse must assess for dysphagia — coughing or choking
during swallowing indicates difficulty and aspiration risk. This is critical because
aspiration can lead to pneumonia, especially in immunocompromised or elderly
patients. Stomatitis management: soft-bristled toothbrush or foam swabs, avoid
sodium lauryl sulfate toothpaste, rinse with sodium bicarbonate or warm saline
every 2–3 hours, avoid alcohol-containing mouthwashes, and use antifungals
(Nystatin, Diflucan) or antivirals as indicated.
3. Which populations are at risk for developing severe complications associated with
GERD?
A. Young adults with high-fiber diets
B. Older adults with age-related physiological changes, medication side effects, and
increased prevalence of hiatal hernias
C. Adolescents with sports-related injuries
D. Pregnant women in their first trimester only
CORRECT ANSWER B — Older adults: age-related physiological changes, medication side
effects, and increased prevalence of hiatal hernias.
RATIONALE Older adults are at higher risk for severe GERD complications (Barrett's
esophagus, esophageal strictures, aspiration pneumonia) due to: age-related
physiological changes (decreased LES tone, slowed gastric emptying, decreased
salivary bicarbonate), medication side effects (NSAIDs, calcium channel blockers,
anticholinergics all decrease LES pressure), and increased prevalence of hiatal
hernias. Importantly, older adults may NOT experience typical heartburn — they
may present with atypical chest pain, ENT infections, or pulmonary problems
(aspiration pneumonia, sleep apnea, asthma exacerbation).
