MDC III FINAL EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
Cardiovascular Disorders
Respiratory Disorders
Endocrine Disorders
Gastrointestinal Disorders
Neurological Disorders
Renal and Urinary Disorders
Hematological and Immunological Disorders
Perioperative and Emergency Nursing Care
Pharmacology and Fluid/Electrolyte Balance
Ethical, Legal, and Professional Standards
Introduction
This comprehensive assessment is designed to evaluate your mastery of key concepts in Medical-Surgical Nursing III,
focusing on the management of complex, multi-system disorders. The exam measures your ability to synthesize
foundational knowledge with clinical application, prioritize care in acute and critical situations, and make sound
professional judgments. You will encounter a variety of multiple-choice questions, including scenario-based items that
simulate real-world patient encounters. Success on this exam requires not only recalling facts but also demonstrating
critical thinking, clinical reasoning, and a deep understanding of the nursing process. Practical application and
professional decision-making are paramount in ensuring safe, effective, and compassionate patient care. This guide
provides verified answers and detailed rationales to reinforce learning and enhance test-taking confidence.
,Question 1
A patient with a history of heart failure is prescribed furosemide. Which laboratory value is most important for the
nurse to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum chloride
🟢 Correct Answer: B. Serum potassium
🔴 Explanation: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending loop
of Henle, leading to increased potassium excretion. Hypokalemia is a significant and potentially dangerous side
effect, making serum potassium the priority lab value to monitor.
Question 2
The nurse is caring for a patient who is 2 hours post-hip replacement surgery. Which assessment finding requires
immediate intervention?
A. Pain rated 5 on a 0-10 scale at the surgical site
B. Urine output of 60 mL over the last 2 hours
C. Oxygen saturation of 88% on room air
D. Mild edema in the lower extremity
🟢 Correct Answer: C. Oxygen saturation of 88% on room air
🔴 Explanation: An oxygen saturation of 88% indicates significant hypoxemia and could be a sign of a pulmonary
embolism or other serious complication such as atelectasis or pneumonia. This requires immediate intervention,
such as supplemental oxygen and further assessment. The other findings, while requiring attention, are less acutely
life-threatening.
Question 3
A patient with type 1 diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. The nurse anticipates
,which blood glucose level?
A. 70 mg/dL
B. 120 mg/dL
C. 180 mg/dL
D. 350 mg/dL
🟢 Correct Answer: D. 350 mg/dL
🔴 Explanation: The classic symptoms of polyuria, polydipsia, and polyphagia (the three P's) are indicative of
hyperglycemia. A blood glucose level of 350 mg/dL is significantly elevated and consistent with these symptoms.
Options A and B are within or near normal range, and 180 mg/dL, while elevated, is less likely to cause such
pronounced symptoms.
Question 4
The nurse is preparing to administer a blood transfusion to a patient. Which action is most important to prevent a
transfusion reaction?
A. Verify the patient's identity and blood product using a two-person check.
B. Pre-medicate the patient with diphenhydramine.
C. Infuse the blood rapidly over 15 minutes.
D. Assess the patient's vital signs every 30 minutes.
🟢 Correct Answer: A. Verify the patient's identity and blood product using a two-person check.
🔴 Explanation: The most critical step in preventing a transfusion reaction is the correct identification of the patient
and the blood product. This is typically done with a two-nurse verification process to ensure the right blood is given
to the right patient. Pre-medicating can reduce mild reactions but doesn't prevent major hemolytic reactions. Rapid
infusion and vital sign checks are important but secondary to proper verification.
Question 5
A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 3 L/min via nasal cannula. The
nurse is most concerned about which assessment finding?
, A. Respiratory rate of 16 breaths per minute
B. Oxygen saturation of 91%
C. The patient's report of a headache
D. The patient's respiratory rate decreasing to 10 breaths per minute
🟢 Correct Answer: D. The patient's respiratory rate decreasing to 10 breaths per minute
🔴 Explanation: Patients with COPD can have a hypoxic drive to breathe. Excessive oxygen can suppress this drive,
leading to hypoventilation, respiratory depression, and even respiratory arrest. A decreasing respiratory rate is a
critical sign of this complication.
Question 6
A patient is admitted with acute pancreatitis. Which laboratory finding is most consistent with this diagnosis?
A. Elevated serum amylase and lipase
B. Elevated serum bilirubin
C. Decreased serum calcium
D. Increased serum potassium
🟢 Correct Answer: A. Elevated serum amylase and lipase
🔴 Explanation: In acute pancreatitis, the inflamed pancreas releases digestive enzymes into the bloodstream,
leading to significantly elevated serum amylase and lipase levels. While bilirubin may be elevated in biliary
obstruction, and calcium may decrease, the hallmark diagnostic finding is the elevation of pancreatic enzymes.
Question 7
The nurse is assessing a patient who is at risk for developing deep vein thrombosis (DVT). Which intervention is most
effective for prevention?
A. Encouraging the patient to remain on bed rest
B. Applying sequential compression devices (SCDs)
C. Administering oral anticoagulants
D. Restricting oral fluid intake
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
Cardiovascular Disorders
Respiratory Disorders
Endocrine Disorders
Gastrointestinal Disorders
Neurological Disorders
Renal and Urinary Disorders
Hematological and Immunological Disorders
Perioperative and Emergency Nursing Care
Pharmacology and Fluid/Electrolyte Balance
Ethical, Legal, and Professional Standards
Introduction
This comprehensive assessment is designed to evaluate your mastery of key concepts in Medical-Surgical Nursing III,
focusing on the management of complex, multi-system disorders. The exam measures your ability to synthesize
foundational knowledge with clinical application, prioritize care in acute and critical situations, and make sound
professional judgments. You will encounter a variety of multiple-choice questions, including scenario-based items that
simulate real-world patient encounters. Success on this exam requires not only recalling facts but also demonstrating
critical thinking, clinical reasoning, and a deep understanding of the nursing process. Practical application and
professional decision-making are paramount in ensuring safe, effective, and compassionate patient care. This guide
provides verified answers and detailed rationales to reinforce learning and enhance test-taking confidence.
,Question 1
A patient with a history of heart failure is prescribed furosemide. Which laboratory value is most important for the
nurse to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum chloride
🟢 Correct Answer: B. Serum potassium
🔴 Explanation: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending loop
of Henle, leading to increased potassium excretion. Hypokalemia is a significant and potentially dangerous side
effect, making serum potassium the priority lab value to monitor.
Question 2
The nurse is caring for a patient who is 2 hours post-hip replacement surgery. Which assessment finding requires
immediate intervention?
A. Pain rated 5 on a 0-10 scale at the surgical site
B. Urine output of 60 mL over the last 2 hours
C. Oxygen saturation of 88% on room air
D. Mild edema in the lower extremity
🟢 Correct Answer: C. Oxygen saturation of 88% on room air
🔴 Explanation: An oxygen saturation of 88% indicates significant hypoxemia and could be a sign of a pulmonary
embolism or other serious complication such as atelectasis or pneumonia. This requires immediate intervention,
such as supplemental oxygen and further assessment. The other findings, while requiring attention, are less acutely
life-threatening.
Question 3
A patient with type 1 diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. The nurse anticipates
,which blood glucose level?
A. 70 mg/dL
B. 120 mg/dL
C. 180 mg/dL
D. 350 mg/dL
🟢 Correct Answer: D. 350 mg/dL
🔴 Explanation: The classic symptoms of polyuria, polydipsia, and polyphagia (the three P's) are indicative of
hyperglycemia. A blood glucose level of 350 mg/dL is significantly elevated and consistent with these symptoms.
Options A and B are within or near normal range, and 180 mg/dL, while elevated, is less likely to cause such
pronounced symptoms.
Question 4
The nurse is preparing to administer a blood transfusion to a patient. Which action is most important to prevent a
transfusion reaction?
A. Verify the patient's identity and blood product using a two-person check.
B. Pre-medicate the patient with diphenhydramine.
C. Infuse the blood rapidly over 15 minutes.
D. Assess the patient's vital signs every 30 minutes.
🟢 Correct Answer: A. Verify the patient's identity and blood product using a two-person check.
🔴 Explanation: The most critical step in preventing a transfusion reaction is the correct identification of the patient
and the blood product. This is typically done with a two-nurse verification process to ensure the right blood is given
to the right patient. Pre-medicating can reduce mild reactions but doesn't prevent major hemolytic reactions. Rapid
infusion and vital sign checks are important but secondary to proper verification.
Question 5
A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 3 L/min via nasal cannula. The
nurse is most concerned about which assessment finding?
, A. Respiratory rate of 16 breaths per minute
B. Oxygen saturation of 91%
C. The patient's report of a headache
D. The patient's respiratory rate decreasing to 10 breaths per minute
🟢 Correct Answer: D. The patient's respiratory rate decreasing to 10 breaths per minute
🔴 Explanation: Patients with COPD can have a hypoxic drive to breathe. Excessive oxygen can suppress this drive,
leading to hypoventilation, respiratory depression, and even respiratory arrest. A decreasing respiratory rate is a
critical sign of this complication.
Question 6
A patient is admitted with acute pancreatitis. Which laboratory finding is most consistent with this diagnosis?
A. Elevated serum amylase and lipase
B. Elevated serum bilirubin
C. Decreased serum calcium
D. Increased serum potassium
🟢 Correct Answer: A. Elevated serum amylase and lipase
🔴 Explanation: In acute pancreatitis, the inflamed pancreas releases digestive enzymes into the bloodstream,
leading to significantly elevated serum amylase and lipase levels. While bilirubin may be elevated in biliary
obstruction, and calcium may decrease, the hallmark diagnostic finding is the elevation of pancreatic enzymes.
Question 7
The nurse is assessing a patient who is at risk for developing deep vein thrombosis (DVT). Which intervention is most
effective for prevention?
A. Encouraging the patient to remain on bed rest
B. Applying sequential compression devices (SCDs)
C. Administering oral anticoagulants
D. Restricting oral fluid intake
