NUR 2502 / NUR 2502
Multidimensional Care III (MDC 3)
Exam 1 - Comprehensive Nursing Examination
Rasmussen University
Latest Curriculum Standards
75 Multiple Choice Questions
7 Content Sections
Cognitive Levels: 25% Recall | 55% Application | 20% Analysis
Instructions: Read each question carefully. Select the best answer (A-D). Each question has one correct answer.
Rationales with clinical reasoning are provided following each question.
,NUR 2502 / MDC 3 Exam 1 | Rasmussen University 2026/2027 75 Questions
Section 1: Oncology Nursing (Q1-Q15)
Cancer Pathophysiology, Staging, Treatment Modalities, and Nursing Care
Q1. A nurse is educating a patient about the differences between benign and malignant tumors. Which of
the following characteristics is most consistent with a malignant tumor?
A. Encapsulated with well-differentiated cells
B. Rapid growth with invasion into surrounding tissues and potential for metastasis [CORRECT]
C. Slow growth pattern with distinct boundaries from surrounding tissue
D. Composed of well-differentiated cells that remain localized
Correct Answer: B
Rationale: Malignant tumors are characterized by rapid, uncontrolled cell growth, invasion into surrounding tissues, and
the ability to metastasize to distant sites. They are poorly differentiated, lack encapsulation, and do not respect tissue
boundaries. Benign tumors, in contrast, are encapsulated, well-differentiated, grow slowly, and remain localized without
metastatic potential. Understanding these distinctions is fundamental to MDC 3 oncology nursing practice at Rasmussen
University.
Q2. The oncology nurse is reviewing the TNM staging system with a patient newly diagnosed with colon
cancer. The patient's tumor is staged as T3, N1, M0. The nurse explains that this staging indicates:
A. A small tumor with no lymph node involvement and distant metastasis present
B. Tumor extension through the muscularis propria with regional lymph node involvement but no
distant metastasis [CORRECT]
C. A large tumor with extensive lymph node involvement and distant metastasis
D. Carcinoma in situ with no invasion of surrounding tissues
Correct Answer: B
Rationale: In the TNM staging system, T3 indicates tumor extension through the muscularis propria of the colon wall, N1
indicates regional lymph node involvement (1-3 positive nodes), and M0 indicates no distant metastasis. T staging ranges
from Tis (carcinoma in situ) to T4 (invasion of other organs/structures), N staging from N0 to N2, and M staging from
M0 (no distant metastasis) to M1 (distant metastasis present). Higher T, N, or M values indicate more advanced disease
and generally a poorer prognosis.
Q3. A patient receiving external beam radiation therapy for lung cancer reports fatigue, skin redness at the
treatment site, and difficulty swallowing. The nurse recognizes these findings as:
A. Signs of radiation pneumonitis requiring immediate intervention
B. Expected side effects of localized radiation therapy that should be documented and managed
[CORRECT]
C. Indications of an allergic reaction to the radiation contrast medium
D. Early manifestations of bone marrow suppression requiring transfusion
Correct Answer: B
Rationale: Fatigue, localized skin reactions (erythema, desquamation), and esophagitis (difficulty swallowing) are
common side effects of external beam radiation therapy, particularly when the treatment field involves the chest area.
These are expected adverse effects that require supportive care, including skin assessment, fatigue management, and
nutritional support. Radiation pneumonitis presents with cough, dyspnea, and fever (typically 2-3 months post-treatment),
and bone marrow suppression is more likely with large treatment fields. These findings do not suggest an allergic reaction
Page 2
, NUR 2502 / MDC 3 Exam 1 | Rasmussen University 2026/2027 75 Questions
to contrast medium.
Q4. A patient is receiving chemotherapy with doxorubicin (Adriamycin). The nurse should monitor for
which specific cardiotoxic effect associated with this medication?
A. Neurotoxicity presenting as peripheral neuropathy and paresthesia
B. Nephrotoxicity presenting as elevated serum creatinine and decreased urine output
C. Cardiotoxicity presenting as dilated cardiomyopathy, congestive heart failure, and reduced
ejection fraction [CORRECT]
D. Hemorrhagic cystitis presenting as hematuria and bladder irritation
Correct Answer: C
Rationale: Doxorubicin is well known for its cumulative dose-dependent cardiotoxicity, which can lead to dilated
cardiomyopathy and congestive heart failure. The lifetime maximum cumulative dose is typically capped at 450-550
mg/m2 to minimize irreversible cardiac damage. Nurses must monitor for signs of heart failure (dyspnea, edema, fatigue)
and coordinate with providers regarding baseline and serial echocardiograms or MUGA scans. Neurotoxicity is
associated with vincristine, nephrotoxicity with cisplatin, and hemorrhagic cystitis with cyclophosphamide.
Q5. A patient with ER-positive breast cancer is prescribed tamoxifen as part of her treatment plan. The
nurse explains that tamoxifen works by:
A. Inhibiting tyrosine kinase enzymes involved in cancer cell signaling pathways
B. Blocking monoclonal antibody receptors on the surface of cancer cells
C. Acting as a selective estrogen receptor modulator (SERM) that blocks estrogen binding in breast
tissue [CORRECT]
D. Stimulating immune checkpoint receptors to enhance the body's anti-tumor response
Correct Answer: C
Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) that competitively blocks estrogen binding to
estrogen receptors (ER) in breast tissue, thereby inhibiting the growth-promoting effects of estrogen on ER-positive breast
cancer cells. It also has partial agonist effects in other tissues (e.g., endometrium, bone). Patient teaching should include
the risk of endometrial hyperplasia/cancer, hot flashes, and the importance of regular gynecologic exams. Aromatase
inhibitors (anastrozole, letrozole) are alternatives for postmenopausal women. Tyrosine kinase inhibitors target specific
enzymes, not hormone receptors.
Q6. A patient with a large B-cell lymphoma is receiving rituximab as part of the R-CHOP regimen. The
nurse understands that rituximab belongs to which class of cancer therapy?
A. Immune checkpoint inhibitors that block PD-1/PD-L1 signaling
B. Monoclonal antibodies that target CD20 receptors on B lymphocytes [CORRECT]
C. Tyrosine kinase inhibitors that block the BCR-ABL fusion protein
D. Hormonal agents that inhibit estrogen synthesis in postmenopausal women
Correct Answer: B
Rationale: Rituximab is a monoclonal antibody that specifically targets the CD20 antigen found on the surface of B
lymphocytes. By binding to CD20, rituximab flags B cells for immune-mediated destruction via complement-dependent
cytotoxicity and antibody-dependent cellular cytotoxicity. It is a cornerstone of treatment for non-Hodgkin lymphoma and
is used in combination with other agents in the R-CHOP regimen. Immune checkpoint inhibitors include pembrolizumab
and nivolumab; imatinib targets BCR-ABL; and aromatase inhibitors target estrogen synthesis.
Page 3
Multidimensional Care III (MDC 3)
Exam 1 - Comprehensive Nursing Examination
Rasmussen University
Latest Curriculum Standards
75 Multiple Choice Questions
7 Content Sections
Cognitive Levels: 25% Recall | 55% Application | 20% Analysis
Instructions: Read each question carefully. Select the best answer (A-D). Each question has one correct answer.
Rationales with clinical reasoning are provided following each question.
,NUR 2502 / MDC 3 Exam 1 | Rasmussen University 2026/2027 75 Questions
Section 1: Oncology Nursing (Q1-Q15)
Cancer Pathophysiology, Staging, Treatment Modalities, and Nursing Care
Q1. A nurse is educating a patient about the differences between benign and malignant tumors. Which of
the following characteristics is most consistent with a malignant tumor?
A. Encapsulated with well-differentiated cells
B. Rapid growth with invasion into surrounding tissues and potential for metastasis [CORRECT]
C. Slow growth pattern with distinct boundaries from surrounding tissue
D. Composed of well-differentiated cells that remain localized
Correct Answer: B
Rationale: Malignant tumors are characterized by rapid, uncontrolled cell growth, invasion into surrounding tissues, and
the ability to metastasize to distant sites. They are poorly differentiated, lack encapsulation, and do not respect tissue
boundaries. Benign tumors, in contrast, are encapsulated, well-differentiated, grow slowly, and remain localized without
metastatic potential. Understanding these distinctions is fundamental to MDC 3 oncology nursing practice at Rasmussen
University.
Q2. The oncology nurse is reviewing the TNM staging system with a patient newly diagnosed with colon
cancer. The patient's tumor is staged as T3, N1, M0. The nurse explains that this staging indicates:
A. A small tumor with no lymph node involvement and distant metastasis present
B. Tumor extension through the muscularis propria with regional lymph node involvement but no
distant metastasis [CORRECT]
C. A large tumor with extensive lymph node involvement and distant metastasis
D. Carcinoma in situ with no invasion of surrounding tissues
Correct Answer: B
Rationale: In the TNM staging system, T3 indicates tumor extension through the muscularis propria of the colon wall, N1
indicates regional lymph node involvement (1-3 positive nodes), and M0 indicates no distant metastasis. T staging ranges
from Tis (carcinoma in situ) to T4 (invasion of other organs/structures), N staging from N0 to N2, and M staging from
M0 (no distant metastasis) to M1 (distant metastasis present). Higher T, N, or M values indicate more advanced disease
and generally a poorer prognosis.
Q3. A patient receiving external beam radiation therapy for lung cancer reports fatigue, skin redness at the
treatment site, and difficulty swallowing. The nurse recognizes these findings as:
A. Signs of radiation pneumonitis requiring immediate intervention
B. Expected side effects of localized radiation therapy that should be documented and managed
[CORRECT]
C. Indications of an allergic reaction to the radiation contrast medium
D. Early manifestations of bone marrow suppression requiring transfusion
Correct Answer: B
Rationale: Fatigue, localized skin reactions (erythema, desquamation), and esophagitis (difficulty swallowing) are
common side effects of external beam radiation therapy, particularly when the treatment field involves the chest area.
These are expected adverse effects that require supportive care, including skin assessment, fatigue management, and
nutritional support. Radiation pneumonitis presents with cough, dyspnea, and fever (typically 2-3 months post-treatment),
and bone marrow suppression is more likely with large treatment fields. These findings do not suggest an allergic reaction
Page 2
, NUR 2502 / MDC 3 Exam 1 | Rasmussen University 2026/2027 75 Questions
to contrast medium.
Q4. A patient is receiving chemotherapy with doxorubicin (Adriamycin). The nurse should monitor for
which specific cardiotoxic effect associated with this medication?
A. Neurotoxicity presenting as peripheral neuropathy and paresthesia
B. Nephrotoxicity presenting as elevated serum creatinine and decreased urine output
C. Cardiotoxicity presenting as dilated cardiomyopathy, congestive heart failure, and reduced
ejection fraction [CORRECT]
D. Hemorrhagic cystitis presenting as hematuria and bladder irritation
Correct Answer: C
Rationale: Doxorubicin is well known for its cumulative dose-dependent cardiotoxicity, which can lead to dilated
cardiomyopathy and congestive heart failure. The lifetime maximum cumulative dose is typically capped at 450-550
mg/m2 to minimize irreversible cardiac damage. Nurses must monitor for signs of heart failure (dyspnea, edema, fatigue)
and coordinate with providers regarding baseline and serial echocardiograms or MUGA scans. Neurotoxicity is
associated with vincristine, nephrotoxicity with cisplatin, and hemorrhagic cystitis with cyclophosphamide.
Q5. A patient with ER-positive breast cancer is prescribed tamoxifen as part of her treatment plan. The
nurse explains that tamoxifen works by:
A. Inhibiting tyrosine kinase enzymes involved in cancer cell signaling pathways
B. Blocking monoclonal antibody receptors on the surface of cancer cells
C. Acting as a selective estrogen receptor modulator (SERM) that blocks estrogen binding in breast
tissue [CORRECT]
D. Stimulating immune checkpoint receptors to enhance the body's anti-tumor response
Correct Answer: C
Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) that competitively blocks estrogen binding to
estrogen receptors (ER) in breast tissue, thereby inhibiting the growth-promoting effects of estrogen on ER-positive breast
cancer cells. It also has partial agonist effects in other tissues (e.g., endometrium, bone). Patient teaching should include
the risk of endometrial hyperplasia/cancer, hot flashes, and the importance of regular gynecologic exams. Aromatase
inhibitors (anastrozole, letrozole) are alternatives for postmenopausal women. Tyrosine kinase inhibitors target specific
enzymes, not hormone receptors.
Q6. A patient with a large B-cell lymphoma is receiving rituximab as part of the R-CHOP regimen. The
nurse understands that rituximab belongs to which class of cancer therapy?
A. Immune checkpoint inhibitors that block PD-1/PD-L1 signaling
B. Monoclonal antibodies that target CD20 receptors on B lymphocytes [CORRECT]
C. Tyrosine kinase inhibitors that block the BCR-ABL fusion protein
D. Hormonal agents that inhibit estrogen synthesis in postmenopausal women
Correct Answer: B
Rationale: Rituximab is a monoclonal antibody that specifically targets the CD20 antigen found on the surface of B
lymphocytes. By binding to CD20, rituximab flags B cells for immune-mediated destruction via complement-dependent
cytotoxicity and antibody-dependent cellular cytotoxicity. It is a cornerstone of treatment for non-Hodgkin lymphoma and
is used in combination with other agents in the R-CHOP regimen. Immune checkpoint inhibitors include pembrolizumab
and nivolumab; imatinib targets BCR-ABL; and aromatase inhibitors target estrogen synthesis.
Page 3
