Miami Dade College
1 MAXE · 1CDM
★ ★
MDC School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC 1 — Examination 1
F U N DA M E N TA LS · CO M M U N I C AT I O N · S A F E TY · CU LT U R E · A SS E SS M E N T
INSTITUTION Miami Dade College COURSE CODE MDC 1
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC 1 Examination 1 — COURSE TITLE Fundamentals of Nursing
Comprehensive Review
TOTAL QUESTIONS 65 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers Maslow's hierarchy, comfort/pain, elimination, fluid balance, gas exchange, mobility,
sensory perception, perfusion, immunity, sexual health, therapeutic communication, safety, culture,
and healthcare organizations.
▸ 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 – 65
1. What are the five levels of Maslow's Hierarchy of Needs in correct order from most basic
to highest?
A. Self-Actualization, Self-Esteem, Relationships, Safety, Physiological
B. Physiological Needs, Safety and Security, Relationships/Love and Affection, Self-Esteem,
Self-Actualization
C. Safety, Physiological, Love, Esteem, Actualization
D. Physiological, Love, Safety, Esteem, Actualization
CORRECT ANSWER B — Physiological Needs → Safety and Security → Relationships/Love and
Affection → Self-Esteem → Self-Actualization.
RATIONALE Maslow's Hierarchy progresses from the most fundamental survival needs to the
highest human potential: Level 1 (base): Physiological Needs — air, water, food,
elimination, temperature, rest. Level 2: Safety and Security — protection from
harm, shelter, freedom from fear. Level 3: Relationships, Love and Affection —
belonging, family, friendship, intimacy. Level 4: Self-Esteem — respect,
recognition, confidence, achievement. Level 5 (peak): Self-Actualization —
reaching one's full potential, creativity, morality. In nursing, this hierarchy
provides a prioritization framework — physiological needs must be addressed
before higher-level needs.
,2. How should the nurse assess a client's comfort level?
A. Assume the client is comfortable unless they complain
B. Ask the patient if they are comfortable; if physical discomfort is present, assess pain level
and plan intervention; if mental discomfort, have them describe the nature of the stress
C. Only assess comfort when giving pain medication
D. Observe the client's facial expression only
CORRECT ANSWER B — Ask if they are comfortable; assess physical pain and plan intervention;
explore mental/emotional stress.
RATIONALE Comfort assessment begins with simply asking the client — self-report is the gold
standard. Comfort includes physical, psychological, social, and environmental
dimensions. Physical discomfort: assess pain using a standardized scale (0–10
numeric, FACES, PAINAD), location, quality, duration, and aggravating/relieving
factors. Mental/emotional discomfort: have the client describe the nature of their
stress, anxiety, or distress. The nurse then plans interventions targeting the
specific source of discomfort. Pain is considered the "fifth vital sign" and must be
assessed routinely along with temperature, pulse, respiration, and blood
pressure.
, 3. What is the best approach to prevent impaired comfort in patients?
A. Wait until the patient complains of discomfort before intervening
B. Anticipate which patients may experience impaired comfort and provide preplanned
interventions
C. Administer pain medication to all post-operative patients routinely
D. Only address comfort during scheduled assessments
CORRECT ANSWER B — Anticipate which patients may experience discomfort and provide
preplanned interventions.
RATIONALE Proactive nursing care anticipates and prevents problems before they occur.
Identifying high-risk patients (post-operative, invasive procedures, chronic
conditions, anxiety disorders) and implementing preplanned comfort measures
prevents suffering. Examples: pre-medicating before painful procedures,
positioning for comfort, providing warm blankets, creating a calm environment,
and addressing anxiety early. This approach is more effective than waiting for the
patient to report discomfort — by that point, the patient has already experienced
unnecessary suffering. Anticipatory care is a hallmark of excellent nursing
practice.
4. Pain is considered which vital sign?
A. First vital sign
B. Fifth vital sign
C. Not a vital sign
D. Optional vital sign
CORRECT ANSWER B — Fifth vital sign.
RATIONALE Pain is recognized as the "fifth vital sign" — it should be assessed and
documented alongside temperature, pulse, respiration, and blood pressure at
every assessment. The Joint Commission mandates pain assessment for all
patients. Pain is subjective — "Pain is whatever the experiencing person says it is,
existing whenever the experiencing person says it does" (McCaffery). Unrelieved
pain has serious consequences: increased stress hormones, impaired immune
function, delayed wound healing, cardiovascular strain, and psychological
distress. The nurse must believe the client's report and intervene accordingly.
1 MAXE · 1CDM
★ ★
MDC School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC 1 — Examination 1
F U N DA M E N TA LS · CO M M U N I C AT I O N · S A F E TY · CU LT U R E · A SS E SS M E N T
INSTITUTION Miami Dade College COURSE CODE MDC 1
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC 1 Examination 1 — COURSE TITLE Fundamentals of Nursing
Comprehensive Review
TOTAL QUESTIONS 65 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers Maslow's hierarchy, comfort/pain, elimination, fluid balance, gas exchange, mobility,
sensory perception, perfusion, immunity, sexual health, therapeutic communication, safety, culture,
and healthcare organizations.
▸ 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 – 65
1. What are the five levels of Maslow's Hierarchy of Needs in correct order from most basic
to highest?
A. Self-Actualization, Self-Esteem, Relationships, Safety, Physiological
B. Physiological Needs, Safety and Security, Relationships/Love and Affection, Self-Esteem,
Self-Actualization
C. Safety, Physiological, Love, Esteem, Actualization
D. Physiological, Love, Safety, Esteem, Actualization
CORRECT ANSWER B — Physiological Needs → Safety and Security → Relationships/Love and
Affection → Self-Esteem → Self-Actualization.
RATIONALE Maslow's Hierarchy progresses from the most fundamental survival needs to the
highest human potential: Level 1 (base): Physiological Needs — air, water, food,
elimination, temperature, rest. Level 2: Safety and Security — protection from
harm, shelter, freedom from fear. Level 3: Relationships, Love and Affection —
belonging, family, friendship, intimacy. Level 4: Self-Esteem — respect,
recognition, confidence, achievement. Level 5 (peak): Self-Actualization —
reaching one's full potential, creativity, morality. In nursing, this hierarchy
provides a prioritization framework — physiological needs must be addressed
before higher-level needs.
,2. How should the nurse assess a client's comfort level?
A. Assume the client is comfortable unless they complain
B. Ask the patient if they are comfortable; if physical discomfort is present, assess pain level
and plan intervention; if mental discomfort, have them describe the nature of the stress
C. Only assess comfort when giving pain medication
D. Observe the client's facial expression only
CORRECT ANSWER B — Ask if they are comfortable; assess physical pain and plan intervention;
explore mental/emotional stress.
RATIONALE Comfort assessment begins with simply asking the client — self-report is the gold
standard. Comfort includes physical, psychological, social, and environmental
dimensions. Physical discomfort: assess pain using a standardized scale (0–10
numeric, FACES, PAINAD), location, quality, duration, and aggravating/relieving
factors. Mental/emotional discomfort: have the client describe the nature of their
stress, anxiety, or distress. The nurse then plans interventions targeting the
specific source of discomfort. Pain is considered the "fifth vital sign" and must be
assessed routinely along with temperature, pulse, respiration, and blood
pressure.
, 3. What is the best approach to prevent impaired comfort in patients?
A. Wait until the patient complains of discomfort before intervening
B. Anticipate which patients may experience impaired comfort and provide preplanned
interventions
C. Administer pain medication to all post-operative patients routinely
D. Only address comfort during scheduled assessments
CORRECT ANSWER B — Anticipate which patients may experience discomfort and provide
preplanned interventions.
RATIONALE Proactive nursing care anticipates and prevents problems before they occur.
Identifying high-risk patients (post-operative, invasive procedures, chronic
conditions, anxiety disorders) and implementing preplanned comfort measures
prevents suffering. Examples: pre-medicating before painful procedures,
positioning for comfort, providing warm blankets, creating a calm environment,
and addressing anxiety early. This approach is more effective than waiting for the
patient to report discomfort — by that point, the patient has already experienced
unnecessary suffering. Anticipatory care is a hallmark of excellent nursing
practice.
4. Pain is considered which vital sign?
A. First vital sign
B. Fifth vital sign
C. Not a vital sign
D. Optional vital sign
CORRECT ANSWER B — Fifth vital sign.
RATIONALE Pain is recognized as the "fifth vital sign" — it should be assessed and
documented alongside temperature, pulse, respiration, and blood pressure at
every assessment. The Joint Commission mandates pain assessment for all
patients. Pain is subjective — "Pain is whatever the experiencing person says it is,
existing whenever the experiencing person says it does" (McCaffery). Unrelieved
pain has serious consequences: increased stress hormones, impaired immune
function, delayed wound healing, cardiovascular strain, and psychological
distress. The nurse must believe the client's report and intervene accordingly.
