MCD2 Final Exam Latest
1. A nurse is caring for a patient who is status post an upper endoscopic procedure. Which of the
following should be included as priority in the post procedure assessment?
a. Gag reflex
b. Level of consciousness
c. Blood pressure
d. Pain level
Answer: a
Justification: After upper endoscopy, the topical anesthetic suppresses the gag reflex. Assessing
its return is the priority to prevent aspiration before allowing oral intake.
2. A 40 year old female presents to the emergency room with upper abdominal pain radiating to
her right shoulder and nausea, upon assessment the patient’s temperature is 101.2 degrees F,
heart rate 110, and blood pressure 140/82. Based on the patient’s presentations, which of the
following do you anticipate to be the patient’s diagnosis?
a. Cholecystitis
b. Pancreatitis
c. Gastritis
d. Peptic ulcer disease
Answer: a
Justification: RUQ pain radiating to the right shoulder (referred from diaphragmatic irritation),
fever, and tachycardia are classic signs of acute cholecystitis.
3. A client asks the nurse when they can expect to feel improvement after starting a prescription
for thyroid hormone treatments of hypothyroid. How would the nurse respond?
,a. 2 weeks
b. 24 hours
c. 6 months
d. 1 year
Answer: a
Justification: Symptomatic improvement from levothyroxine typically begins within 1–2 weeks,
though full effect may take several weeks.
4. A client assessment reveals fatigue, poor memory, and stiff muscles with labs showing an
elevated TSH, and low T3 and T4. The nurse knows that these are manifestations of which
disorder?
a. Hypothyroidism
b. Hyperthyroidism
c. Cushing’s syndrome
d. Addison’s disease
Answer: a
Justification: Elevated TSH with low T3/T4 confirms primary hypothyroidism; fatigue, memory
issues, and muscle stiffness are common symptoms.
5. A client with diabetes has blood glucose of 640 mg/dL and reports always being thirsty and
having to void. The nurse knows that which terms describe this subjective finding?
a. Polydipsia and polyuria
b. Polyphagia and polydipsia
c. Polyuria and polyphagia
,d. Polydipsia and bradycardia
Answer: a
Justification: Excessive thirst = polydipsia; frequent urination = polyuria. These are classic
hyperglycemia symptoms.
6. A nurse assesses a patient who has a 15 year history of diabetes and notes decrease tactile
sensation in both feet. Which action would the nurse take?
a. Examine the patient’s feet for signs of injury
b. Request an order for an MRI of the spine
c. Apply heating pads to improve circulation
d. Notify the provider immediately
Answer: a
Justification: Loss of protective sensation increases risk for unnoticed foot injuries; immediate
inspection is priority to prevent ulcers/amputation.
7. A nurse cares for a patient with adrenal hyper function. The patient screams at her husband,
bursts into tears, and throws her water pitcher against the hall. She then tells the nurse, “I feel
like I am going crazy.” How would the nurse respond?
a. You feel this way because of your hormone level
b. You need to control your emotions better
c. I will call a psychiatrist to see you
d. Let’s talk about what is making you so angry
Answer: a
, Justification: Emotional lability is caused by excess cortisol; explaining this validates the
patient's experience and reduces fear of “going crazy.”
8. A nurse cares for a patient with chronic hypercortisolism. What action would the nurse take?
a. Wash hands when entering the room
b. Encourage a high-carbohydrate diet
c. Restrict fluid intake to 1 liter per day
d. Place the patient in a private room with negative pressure
Answer: a
Justification: Chronic hypercortisolism (Cushing’s) causes immunosuppression. Hand hygiene is
critical to prevent infection.
9. A nurse is caring for a 26 year old female that presented to the emergency department with
abdominal pain, bloating, constipation, and bolus of diarrhea. Which of the following is the
patient most likely exhibiting?
a. IBS (Irritable Bowel Syndrome)
b. Crohn’s disease
c. Ulcerative colitis
d. Celiac disease
Answer: a
Justification: Alternating constipation and diarrhea with bloating and abdominal pain in a young
adult, without red flags, is typical of IBS.
1. A nurse is caring for a patient who is status post an upper endoscopic procedure. Which of the
following should be included as priority in the post procedure assessment?
a. Gag reflex
b. Level of consciousness
c. Blood pressure
d. Pain level
Answer: a
Justification: After upper endoscopy, the topical anesthetic suppresses the gag reflex. Assessing
its return is the priority to prevent aspiration before allowing oral intake.
2. A 40 year old female presents to the emergency room with upper abdominal pain radiating to
her right shoulder and nausea, upon assessment the patient’s temperature is 101.2 degrees F,
heart rate 110, and blood pressure 140/82. Based on the patient’s presentations, which of the
following do you anticipate to be the patient’s diagnosis?
a. Cholecystitis
b. Pancreatitis
c. Gastritis
d. Peptic ulcer disease
Answer: a
Justification: RUQ pain radiating to the right shoulder (referred from diaphragmatic irritation),
fever, and tachycardia are classic signs of acute cholecystitis.
3. A client asks the nurse when they can expect to feel improvement after starting a prescription
for thyroid hormone treatments of hypothyroid. How would the nurse respond?
,a. 2 weeks
b. 24 hours
c. 6 months
d. 1 year
Answer: a
Justification: Symptomatic improvement from levothyroxine typically begins within 1–2 weeks,
though full effect may take several weeks.
4. A client assessment reveals fatigue, poor memory, and stiff muscles with labs showing an
elevated TSH, and low T3 and T4. The nurse knows that these are manifestations of which
disorder?
a. Hypothyroidism
b. Hyperthyroidism
c. Cushing’s syndrome
d. Addison’s disease
Answer: a
Justification: Elevated TSH with low T3/T4 confirms primary hypothyroidism; fatigue, memory
issues, and muscle stiffness are common symptoms.
5. A client with diabetes has blood glucose of 640 mg/dL and reports always being thirsty and
having to void. The nurse knows that which terms describe this subjective finding?
a. Polydipsia and polyuria
b. Polyphagia and polydipsia
c. Polyuria and polyphagia
,d. Polydipsia and bradycardia
Answer: a
Justification: Excessive thirst = polydipsia; frequent urination = polyuria. These are classic
hyperglycemia symptoms.
6. A nurse assesses a patient who has a 15 year history of diabetes and notes decrease tactile
sensation in both feet. Which action would the nurse take?
a. Examine the patient’s feet for signs of injury
b. Request an order for an MRI of the spine
c. Apply heating pads to improve circulation
d. Notify the provider immediately
Answer: a
Justification: Loss of protective sensation increases risk for unnoticed foot injuries; immediate
inspection is priority to prevent ulcers/amputation.
7. A nurse cares for a patient with adrenal hyper function. The patient screams at her husband,
bursts into tears, and throws her water pitcher against the hall. She then tells the nurse, “I feel
like I am going crazy.” How would the nurse respond?
a. You feel this way because of your hormone level
b. You need to control your emotions better
c. I will call a psychiatrist to see you
d. Let’s talk about what is making you so angry
Answer: a
, Justification: Emotional lability is caused by excess cortisol; explaining this validates the
patient's experience and reduces fear of “going crazy.”
8. A nurse cares for a patient with chronic hypercortisolism. What action would the nurse take?
a. Wash hands when entering the room
b. Encourage a high-carbohydrate diet
c. Restrict fluid intake to 1 liter per day
d. Place the patient in a private room with negative pressure
Answer: a
Justification: Chronic hypercortisolism (Cushing’s) causes immunosuppression. Hand hygiene is
critical to prevent infection.
9. A nurse is caring for a 26 year old female that presented to the emergency department with
abdominal pain, bloating, constipation, and bolus of diarrhea. Which of the following is the
patient most likely exhibiting?
a. IBS (Irritable Bowel Syndrome)
b. Crohn’s disease
c. Ulcerative colitis
d. Celiac disease
Answer: a
Justification: Alternating constipation and diarrhea with bloating and abdominal pain in a young
adult, without red flags, is typical of IBS.
