Rasmussen University
LANIF · 2CDM
★ ★
R School of Nursing
EST. 1900
EMPOWERED LEARNING. INSPIRED FUTURES.
MDC2 — Final Examination
O N CO LO G Y · F LU I D & E L E CT R O LYT E S · AC I D - B A S E · D I A B E T E S · G I
INSTITUTION Rasmussen University COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC2 Final Examination — COURSE TITLE Multidimensional Care II
PowerPoint Review
TOTAL QUESTIONS 86 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers oncology, fluid and electrolytes, acid-base balance, diabetes mellitus, and GI disorders.
▸ Normal lab values and clinical parameters are integrated throughout rationales.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE FINAL EXAMINATION Questions 1 – 86
1. Malignant tumors spread to distant sites primarily through which pathways?
A. Direct extension and surgical seeding
B. Blood and lymphatic channels
C. Transperitoneal and transpleural routes
D. Cerebrospinal fluid pathways
CORRECT ANSWER B — Blood and lymphatic channels.
RATIONALE Metastasis — the spread of cancer cells from the primary site to distant organs —
occurs primarily through two pathways: (1) Hematogenous (blood) — cancer cells
invade blood vessels and travel through the circulatory system to distant sites
(liver, lungs, brain, bone). (2) Lymphatic — cancer cells enter lymphatic vessels
and spread to regional lymph nodes, then through the lymphatic system to
distant nodes and organs. The TNM staging system specifically assesses lymph
Node involvement (N) and distant Metastasis (M). This is why sentinel lymph node
biopsy is performed to determine if cancer has begun to spread.
2. Which level of prevention focuses on reducing risk factors before disease occurs?
A. Secondary prevention
B. Tertiary prevention
C. Primary prevention
D. Quaternary prevention
CORRECT ANSWER C — Primary prevention.
RATIONALE Primary prevention aims to prevent disease before it occurs by eliminating or
reducing risk factors. Examples: HPV vaccination (prevents cervical and other
HPV-related cancers), Hepatitis B vaccination (prevents liver cancer), smoking
cessation (prevents lung and many other cancers), sunscreen use (prevents skin
cancer), prophylactic surgery (mastectomy in BRCA carriers), and removal of
precancerous polyps. Secondary prevention = early detection through screening
(mammograms, Pap smears, colonoscopy). Tertiary prevention = treatment of
established disease to prevent complications and recurrence (chemotherapy,
radiation).
,3. Teaching patients to wear sunscreen is an example of which level of prevention?
A. Secondary prevention
B. Primary prevention
C. Tertiary prevention
D. Rehabilitative prevention
CORRECT ANSWER B — Primary prevention.
RATIONALE Sunscreen use is primary prevention — it prevents skin cancer (melanoma, basal
cell carcinoma, squamous cell carcinoma) from developing by blocking UV
radiation damage to skin cell DNA. This is an intervention applied BEFORE disease
occurs. Other primary prevention examples: HPV vaccine, smoking cessation,
healthy diet, exercise, and avoidance of known carcinogens. The nurse must
educate patients that even one blistering sunburn in childhood doubles the
lifetime risk of melanoma. Sunscreen with SPF 30+ should be applied 30 minutes
before sun exposure and reapplied every 2 hours.
4. Screening mammograms fall under which level of prevention?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Palliative prevention
CORRECT ANSWER B — Secondary prevention.
RATIONALE Screening mammograms are secondary prevention — they detect breast cancer
early, before symptoms develop, when treatment is most effective.
Mammography does NOT prevent cancer; it detects existing cancer at an early
stage. Other secondary prevention: Pap smears (cervical cancer), colonoscopy
(colorectal cancer — also provides primary prevention when polyps are removed),
PSA testing (prostate cancer), and skin examinations. The American Cancer
Society recommends annual mammograms starting at age 45 for average-risk
women, with the option to start at 40.
, 5. What is the only definitive method for diagnosing cancer?
A. Tumor marker blood tests
B. CT scan with contrast
C. Biopsy
D. PET scan
CORRECT ANSWER C — Biopsy.
RATIONALE Biopsy is the GOLD STANDARD and ONLY definitive method for diagnosing cancer.
Tissue is obtained (incisional, excisional, needle/core, or endoscopic biopsy) and
examined histologically under a microscope by a pathologist. Biopsy determines:
whether the lesion is benign or malignant, tumor type, grade (degree of
differentiation), and molecular markers that guide targeted therapy. Tumor
markers (CEA, CA-125, PSA) and imaging (CT, MRI, PET) are supportive but not
definitive — they suggest malignancy but cannot confirm it. The diagnosis of
cancer should always include a biopsy.
6. Which cancer treatment involves placement of radioactive material inside the body?
A. External beam radiation
B. Brachytherapy
C. Photodynamic therapy
D. Chemotherapy
CORRECT ANSWER B — Brachytherapy.
RATIONALE Brachytherapy (internal radiation) involves placing radioactive material (seeds,
pellets, ribbons, or capsules) directly into or near the tumor. This delivers a high
radiation dose to the tumor while minimizing exposure to surrounding healthy
tissue. Used for prostate, cervical, endometrial, and breast cancers. Safety
precautions: private room, radiation sign on door, dosimeter badge for staff, limit
visitor time (typically 30 min/day), pregnant women and children restricted,
maintain lead container and long-handled forceps at bedside (if implant
dislodges — NEVER touch with bare hands), and staff organize care to minimize
time at bedside (ALARA — As Low As Reasonably Achievable).
LANIF · 2CDM
★ ★
R School of Nursing
EST. 1900
EMPOWERED LEARNING. INSPIRED FUTURES.
MDC2 — Final Examination
O N CO LO G Y · F LU I D & E L E CT R O LYT E S · AC I D - B A S E · D I A B E T E S · G I
INSTITUTION Rasmussen University COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC2 Final Examination — COURSE TITLE Multidimensional Care II
PowerPoint Review
TOTAL QUESTIONS 86 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers oncology, fluid and electrolytes, acid-base balance, diabetes mellitus, and GI disorders.
▸ Normal lab values and clinical parameters are integrated throughout rationales.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE FINAL EXAMINATION Questions 1 – 86
1. Malignant tumors spread to distant sites primarily through which pathways?
A. Direct extension and surgical seeding
B. Blood and lymphatic channels
C. Transperitoneal and transpleural routes
D. Cerebrospinal fluid pathways
CORRECT ANSWER B — Blood and lymphatic channels.
RATIONALE Metastasis — the spread of cancer cells from the primary site to distant organs —
occurs primarily through two pathways: (1) Hematogenous (blood) — cancer cells
invade blood vessels and travel through the circulatory system to distant sites
(liver, lungs, brain, bone). (2) Lymphatic — cancer cells enter lymphatic vessels
and spread to regional lymph nodes, then through the lymphatic system to
distant nodes and organs. The TNM staging system specifically assesses lymph
Node involvement (N) and distant Metastasis (M). This is why sentinel lymph node
biopsy is performed to determine if cancer has begun to spread.
2. Which level of prevention focuses on reducing risk factors before disease occurs?
A. Secondary prevention
B. Tertiary prevention
C. Primary prevention
D. Quaternary prevention
CORRECT ANSWER C — Primary prevention.
RATIONALE Primary prevention aims to prevent disease before it occurs by eliminating or
reducing risk factors. Examples: HPV vaccination (prevents cervical and other
HPV-related cancers), Hepatitis B vaccination (prevents liver cancer), smoking
cessation (prevents lung and many other cancers), sunscreen use (prevents skin
cancer), prophylactic surgery (mastectomy in BRCA carriers), and removal of
precancerous polyps. Secondary prevention = early detection through screening
(mammograms, Pap smears, colonoscopy). Tertiary prevention = treatment of
established disease to prevent complications and recurrence (chemotherapy,
radiation).
,3. Teaching patients to wear sunscreen is an example of which level of prevention?
A. Secondary prevention
B. Primary prevention
C. Tertiary prevention
D. Rehabilitative prevention
CORRECT ANSWER B — Primary prevention.
RATIONALE Sunscreen use is primary prevention — it prevents skin cancer (melanoma, basal
cell carcinoma, squamous cell carcinoma) from developing by blocking UV
radiation damage to skin cell DNA. This is an intervention applied BEFORE disease
occurs. Other primary prevention examples: HPV vaccine, smoking cessation,
healthy diet, exercise, and avoidance of known carcinogens. The nurse must
educate patients that even one blistering sunburn in childhood doubles the
lifetime risk of melanoma. Sunscreen with SPF 30+ should be applied 30 minutes
before sun exposure and reapplied every 2 hours.
4. Screening mammograms fall under which level of prevention?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Palliative prevention
CORRECT ANSWER B — Secondary prevention.
RATIONALE Screening mammograms are secondary prevention — they detect breast cancer
early, before symptoms develop, when treatment is most effective.
Mammography does NOT prevent cancer; it detects existing cancer at an early
stage. Other secondary prevention: Pap smears (cervical cancer), colonoscopy
(colorectal cancer — also provides primary prevention when polyps are removed),
PSA testing (prostate cancer), and skin examinations. The American Cancer
Society recommends annual mammograms starting at age 45 for average-risk
women, with the option to start at 40.
, 5. What is the only definitive method for diagnosing cancer?
A. Tumor marker blood tests
B. CT scan with contrast
C. Biopsy
D. PET scan
CORRECT ANSWER C — Biopsy.
RATIONALE Biopsy is the GOLD STANDARD and ONLY definitive method for diagnosing cancer.
Tissue is obtained (incisional, excisional, needle/core, or endoscopic biopsy) and
examined histologically under a microscope by a pathologist. Biopsy determines:
whether the lesion is benign or malignant, tumor type, grade (degree of
differentiation), and molecular markers that guide targeted therapy. Tumor
markers (CEA, CA-125, PSA) and imaging (CT, MRI, PET) are supportive but not
definitive — they suggest malignancy but cannot confirm it. The diagnosis of
cancer should always include a biopsy.
6. Which cancer treatment involves placement of radioactive material inside the body?
A. External beam radiation
B. Brachytherapy
C. Photodynamic therapy
D. Chemotherapy
CORRECT ANSWER B — Brachytherapy.
RATIONALE Brachytherapy (internal radiation) involves placing radioactive material (seeds,
pellets, ribbons, or capsules) directly into or near the tumor. This delivers a high
radiation dose to the tumor while minimizing exposure to surrounding healthy
tissue. Used for prostate, cervical, endometrial, and breast cancers. Safety
precautions: private room, radiation sign on door, dosimeter badge for staff, limit
visitor time (typically 30 min/day), pregnant women and children restricted,
maintain lead container and long-handled forceps at bedside (if implant
dislodges — NEVER touch with bare hands), and staff organize care to minimize
time at bedside (ALARA — As Low As Reasonably Achievable).
