Miami Dade College
1 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 1
L A B VA LU E S · O N CO LO G Y · F LU I D & E L E CT R O LYT E S · C H E M OT H E RA PY
INSTITUTION Miami Dade College COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC2 Examination 1 — COURSE TITLE Med-Surg Nursing II
Comprehensive Review
TOTAL QUESTIONS 40 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers laboratory values, oncology emergencies, fluid and electrolyte imbalances,
chemotherapy, and end-of-life care.
▸ Normal lab reference ranges are integrated throughout the rationales for clinical decision-making.
▸ 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 – 40
1. What is the normal range for BUN (Blood Urea Nitrogen)?
A. 0.6–1.2 mg/dL
B. 7–20 mg/dL
C. 135–145 mEq/L
D. 3.5–5.0 mEq/L
CORRECT ANSWER B — 7–20 mg/dL.
RATIONALE Normal BUN is 7–20 mg/dL. BUN > 20 mg/dL may indicate dehydration or kidney
failure. A high BUN with normal creatinine indicates dehydration (pre-renal
azotemia) — the BUN-to-creatinine ratio will be > 20:1. A high BUN with high
creatinine indicates renal dysfunction — both values rise because the kidneys
cannot filter waste products effectively.
2. A patient has an elevated BUN and a normal creatinine level. What does this
combination most likely indicate?
A. Acute kidney injury
B. Dehydration
C. Chronic renal failure
D. Rhabdomyolysis
CORRECT ANSWER B — Dehydration.
RATIONALE When BUN is elevated but creatinine remains normal, the BUN-to-creatinine ratio
exceeds 20:1, indicating pre-renal azotemia — most commonly caused by
dehydration. Decreased renal perfusion increases urea reabsorption while
creatinine clearance is maintained. This is reversible with fluid resuscitation. If
BOTH BUN and creatinine are elevated, intrinsic renal dysfunction is present.
, 3. What is the normal range for serum creatinine, and what does it indicate?
A. 7–20 mg/dL; indicates liver function
B. 0.6–1.2 mg/dL; best indicator for kidney function
C. 135–145 mEq/L; indicates fluid balance
D. 3.5–5.0 mEq/L; indicates cardiac rhythm stability
CORRECT ANSWER B — 0.6–1.2 mg/dL; best indicator for kidney function.
RATIONALE Creatinine (0.6–1.2 mg/dL) is a waste product of muscle metabolism excreted
almost entirely by glomerular filtration. It is the best laboratory indicator of
kidney function because it is produced at a relatively constant rate and is not
significantly reabsorbed. Rising creatinine = declining GFR = worsening renal
function. The nurse must check BUN and creatinine before administering
nephrotoxic medications including IV potassium and many chemotherapy agents.
4. What is the normal range for serum sodium (Na+), and what is its primary role?
A. 3.5–5.0 mEq/L; cardiac rhythm
B. 1.3–2.1 mEq/L; muscle and nerve function
C. 135–145 mEq/L; controls fluid balance
D. 70–100 mg/dL; energy metabolism
CORRECT ANSWER C — 135–145 mEq/L; controls fluid balance.
RATIONALE Sodium is the primary extracellular cation. Normal range is 135–145 mEq/L.
Where sodium goes, water follows — sodium is the main determinant of plasma
osmolality and extracellular fluid volume. Hyponatremia (<135) causes cellular
swelling and cerebral edema; hypernatremia (>145) causes cellular dehydration
and neurological symptoms. Sodium is critical for nerve impulse transmission
and acid-base balance.
1 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 1
L A B VA LU E S · O N CO LO G Y · F LU I D & E L E CT R O LYT E S · C H E M OT H E RA PY
INSTITUTION Miami Dade College COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC2 Examination 1 — COURSE TITLE Med-Surg Nursing II
Comprehensive Review
TOTAL QUESTIONS 40 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers laboratory values, oncology emergencies, fluid and electrolyte imbalances,
chemotherapy, and end-of-life care.
▸ Normal lab reference ranges are integrated throughout the rationales for clinical decision-making.
▸ 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 – 40
1. What is the normal range for BUN (Blood Urea Nitrogen)?
A. 0.6–1.2 mg/dL
B. 7–20 mg/dL
C. 135–145 mEq/L
D. 3.5–5.0 mEq/L
CORRECT ANSWER B — 7–20 mg/dL.
RATIONALE Normal BUN is 7–20 mg/dL. BUN > 20 mg/dL may indicate dehydration or kidney
failure. A high BUN with normal creatinine indicates dehydration (pre-renal
azotemia) — the BUN-to-creatinine ratio will be > 20:1. A high BUN with high
creatinine indicates renal dysfunction — both values rise because the kidneys
cannot filter waste products effectively.
2. A patient has an elevated BUN and a normal creatinine level. What does this
combination most likely indicate?
A. Acute kidney injury
B. Dehydration
C. Chronic renal failure
D. Rhabdomyolysis
CORRECT ANSWER B — Dehydration.
RATIONALE When BUN is elevated but creatinine remains normal, the BUN-to-creatinine ratio
exceeds 20:1, indicating pre-renal azotemia — most commonly caused by
dehydration. Decreased renal perfusion increases urea reabsorption while
creatinine clearance is maintained. This is reversible with fluid resuscitation. If
BOTH BUN and creatinine are elevated, intrinsic renal dysfunction is present.
, 3. What is the normal range for serum creatinine, and what does it indicate?
A. 7–20 mg/dL; indicates liver function
B. 0.6–1.2 mg/dL; best indicator for kidney function
C. 135–145 mEq/L; indicates fluid balance
D. 3.5–5.0 mEq/L; indicates cardiac rhythm stability
CORRECT ANSWER B — 0.6–1.2 mg/dL; best indicator for kidney function.
RATIONALE Creatinine (0.6–1.2 mg/dL) is a waste product of muscle metabolism excreted
almost entirely by glomerular filtration. It is the best laboratory indicator of
kidney function because it is produced at a relatively constant rate and is not
significantly reabsorbed. Rising creatinine = declining GFR = worsening renal
function. The nurse must check BUN and creatinine before administering
nephrotoxic medications including IV potassium and many chemotherapy agents.
4. What is the normal range for serum sodium (Na+), and what is its primary role?
A. 3.5–5.0 mEq/L; cardiac rhythm
B. 1.3–2.1 mEq/L; muscle and nerve function
C. 135–145 mEq/L; controls fluid balance
D. 70–100 mg/dL; energy metabolism
CORRECT ANSWER C — 135–145 mEq/L; controls fluid balance.
RATIONALE Sodium is the primary extracellular cation. Normal range is 135–145 mEq/L.
Where sodium goes, water follows — sodium is the main determinant of plasma
osmolality and extracellular fluid volume. Hyponatremia (<135) causes cellular
swelling and cerebral edema; hypernatremia (>145) causes cellular dehydration
and neurological symptoms. Sodium is critical for nerve impulse transmission
and acid-base balance.
