Miami Dade College
1 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 1
O N CO LO G Y · F LU I D & E L E CT R O LYT E S · E N D - O F - L I F E · C H E M OT H E RA PY · D O S AG E
C A LCU L AT I O N S
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
TOTAL QUESTIONS 48 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 electrolyte imbalances, end-of-life care, chemotherapy safety,
radiation therapy, and dosage calculations.
▸ Some questions include select-all-that-apply or calculation-based formats.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All pharmacological and clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE EXAMINATION Questions 1 – 48
1. What signs and symptoms should a nurse expect in a client exhibiting third spacing?
A. Hypervolemia with bounding pulse and hypertension
B. Hypovolemia with decreased blood pressure and tachycardia
C. Hypernatremia with flushed skin and edema
D. Hypokalemia with muscle weakness and constipation
CORRECT ANSWER B — Hypovolemia.
RATIONALE Third spacing occurs when fluid shifts from the intravascular space into the
interstitial "third space" where it is physiologically trapped. Despite total body
fluid excess, the intravascular compartment is depleted — producing
hypovolemia. Expected signs include decreased blood pressure, tachycardia,
weak pulse, decreased urine output, and hemoconcentration. Aggressive isotonic
fluid resuscitation is the priority intervention.
2. Which laboratory value is most important to report for a patient receiving
chemotherapy?
A. Hemoglobin 10.5 g/dL
B. White blood cell count (WBC) 1,000 cells/mm³
C. Platelet count 145,000/mm³
D. Creatinine 1.1 mg/dL
CORRECT ANSWER B — White blood cell count (WBC) 1,000 cells/mm³.
RATIONALE A WBC of 1,000 cells/mm³ (normal: 5,000–10,000) indicates severe
leukopenia/neutropenia, placing the patient at extreme risk for life-threatening
infection. This is the most critical value to report immediately. The patient
requires neutropenic precautions, close monitoring for signs of infection (fever
≥100.4°F is a medical emergency), and possible growth factor support. Hgb 10.5 is
mildly low; platelets 145,000 is borderline normal; creatinine 1.1 is normal.
, 3. What is the primary focus of hospice care?
A. To cure the terminal illness through aggressive treatment
B. To focus on quality of life and preparation for death without hastening death or
prolonging life
C. To extend life as long as possible using all available medical technology
D. To provide rehabilitation services so the patient can return home independently
CORRECT ANSWER B — To focus on quality of life and preparation for death without hastening
death or prolonging life.
RATIONALE Hospice care affirms life and regards dying as a natural process — it neither
hastens nor postpones death. The focus is comfort, dignity, symptom
management, and quality of remaining life. Hospice provides interdisciplinary
care for patients with a prognosis of 6 months or less who choose to forgo
curative treatment. The family is the unit of care, and bereavement support
continues after death.
4. What intervention should a nurse include to promote safety for a client with
chemotherapy-induced peripheral neuropathy?
A. Encourage the client to walk barefoot to desensitize the feet
B. Instruct the client to inspect the feet daily for injuries that may go unnoticed
C. Apply heating pads to the feet nightly to improve circulation
D. Recommend tight-fitting shoes to provide constant sensory input
CORRECT ANSWER B — Instruct the client to inspect the feet daily for injuries that may go
unnoticed.
RATIONALE Peripheral neuropathy causes decreased sensation in a stocking-glove
distribution. The client may not feel cuts, blisters, burns, or pressure injuries —
small wounds can progress to serious infections, especially in
immunocompromised chemotherapy patients. Daily foot inspection, well-fitting
protective footwear, avoiding extreme temperatures, and fall precautions are
essential safety interventions.
1 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 1
O N CO LO G Y · F LU I D & E L E CT R O LYT E S · E N D - O F - L I F E · C H E M OT H E RA PY · D O S AG E
C A LCU L AT I O N S
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
TOTAL QUESTIONS 48 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 electrolyte imbalances, end-of-life care, chemotherapy safety,
radiation therapy, and dosage calculations.
▸ Some questions include select-all-that-apply or calculation-based formats.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All pharmacological and clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE EXAMINATION Questions 1 – 48
1. What signs and symptoms should a nurse expect in a client exhibiting third spacing?
A. Hypervolemia with bounding pulse and hypertension
B. Hypovolemia with decreased blood pressure and tachycardia
C. Hypernatremia with flushed skin and edema
D. Hypokalemia with muscle weakness and constipation
CORRECT ANSWER B — Hypovolemia.
RATIONALE Third spacing occurs when fluid shifts from the intravascular space into the
interstitial "third space" where it is physiologically trapped. Despite total body
fluid excess, the intravascular compartment is depleted — producing
hypovolemia. Expected signs include decreased blood pressure, tachycardia,
weak pulse, decreased urine output, and hemoconcentration. Aggressive isotonic
fluid resuscitation is the priority intervention.
2. Which laboratory value is most important to report for a patient receiving
chemotherapy?
A. Hemoglobin 10.5 g/dL
B. White blood cell count (WBC) 1,000 cells/mm³
C. Platelet count 145,000/mm³
D. Creatinine 1.1 mg/dL
CORRECT ANSWER B — White blood cell count (WBC) 1,000 cells/mm³.
RATIONALE A WBC of 1,000 cells/mm³ (normal: 5,000–10,000) indicates severe
leukopenia/neutropenia, placing the patient at extreme risk for life-threatening
infection. This is the most critical value to report immediately. The patient
requires neutropenic precautions, close monitoring for signs of infection (fever
≥100.4°F is a medical emergency), and possible growth factor support. Hgb 10.5 is
mildly low; platelets 145,000 is borderline normal; creatinine 1.1 is normal.
, 3. What is the primary focus of hospice care?
A. To cure the terminal illness through aggressive treatment
B. To focus on quality of life and preparation for death without hastening death or
prolonging life
C. To extend life as long as possible using all available medical technology
D. To provide rehabilitation services so the patient can return home independently
CORRECT ANSWER B — To focus on quality of life and preparation for death without hastening
death or prolonging life.
RATIONALE Hospice care affirms life and regards dying as a natural process — it neither
hastens nor postpones death. The focus is comfort, dignity, symptom
management, and quality of remaining life. Hospice provides interdisciplinary
care for patients with a prognosis of 6 months or less who choose to forgo
curative treatment. The family is the unit of care, and bereavement support
continues after death.
4. What intervention should a nurse include to promote safety for a client with
chemotherapy-induced peripheral neuropathy?
A. Encourage the client to walk barefoot to desensitize the feet
B. Instruct the client to inspect the feet daily for injuries that may go unnoticed
C. Apply heating pads to the feet nightly to improve circulation
D. Recommend tight-fitting shoes to provide constant sensory input
CORRECT ANSWER B — Instruct the client to inspect the feet daily for injuries that may go
unnoticed.
RATIONALE Peripheral neuropathy causes decreased sensation in a stocking-glove
distribution. The client may not feel cuts, blisters, burns, or pressure injuries —
small wounds can progress to serious infections, especially in
immunocompromised chemotherapy patients. Daily foot inspection, well-fitting
protective footwear, avoiding extreme temperatures, and fall precautions are
essential safety interventions.
