Miami Dade College
1 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 1
F LU I D & E L E CT R O LYT E S · O N CO LO G Y · E N D - O F - L I F E C A R E
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
TOTAL QUESTIONS 60 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers fluid and electrolyte imbalances, oncology, end-of-life care, and chemotherapy
toxicities.
▸ Electrolyte reference ranges are provided within 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 – 60
1. A patient in the burn unit is in the emergent phase with third-spacing. What signs and
symptoms does the nurse expect to find?
A. Hypervolemia with bounding pulse and jugular vein distention
B. Hypovolemia with decreased blood pressure, tachycardia, and weak pulse
C. Hypernatremia with flushed skin and excessive thirst
D. Hypercalcemia with muscle weakness and bone pain
CORRECT ANSWER B — Hypovolemia. Third-spacing causes massive fluid shift from
intravascular space into interstitial tissues.
RATIONALE During the emergent burn phase, capillary permeability increases dramatically,
causing fluid and proteins to leak from the intravascular space into the interstitial
compartment (third-spacing). This produces hypovolemia with decreased BP,
tachycardia, weak pulse, and decreased urine output. Aggressive isotonic fluid
resuscitation is the priority.
2. Which characteristics describe normal cellular biology?
A. Larger nuclear-to-cytoplasmic ratio, loose adherence, rapid continuous division
B. Loss of specific functions, infiltrative growth, and metastasis
C. Smaller nuclear-to-cytoplasmic ratio, tight adherence, and non-migratory behavior
D. Variable growth rate, abnormal chromosomes, and angiogenesis
CORRECT ANSWER C — Smaller nuclear-to-cytoplasmic ratio, tight adherence, and non-
migratory behavior.
RATIONALE Normal cells have a smaller nuclear-to-cytoplasmic ratio, tight adherence
(contact inhibition), and are non-migratory — remaining in their tissue of origin.
Cancer cells display the opposite: larger nuclear-to-cytoplasmic ratio, loose
adherence, and migratory behavior enabling invasion and metastasis.
,3. Which findings are characteristic of cancerous cell biology?
A. Tight adherence, non-migratory, small nuclear-to-cytoplasmic ratio
B. Specific functions maintained, slow growth, no tissue infiltration
C. Larger nuclear-to-cytoplasmic ratio, specific functions lost, loose adherence,
rapid/continuous division
D. Normal tissue resemblance, no metastasis, does not cause death
CORRECT ANSWER C — Larger nuclear-to-cytoplasmic ratio, specific functions lost, loose
adherence, rapid/continuous division.
RATIONALE Cancer cells exhibit a larger nuclear-to-cytoplasmic ratio, loss of differentiated
functions, loose adherence (loss of contact inhibition), and rapid continuous
division. These features enable malignant cells to invade tissues, access
blood/lymphatic vessels, and metastasize. Chemotherapy targets these rapidly
dividing cells.
4. Which characteristics describe benign tumor cells?
A. Little resemblance to normal cells, invade and infiltrate tissues, metastasize via blood and
lymphatics
B. Resemble normal tissue cells, no infiltration or damage of tissues, grow slow with no
metastasis, does not cause death unless it interferes with vital functions
C. Rapid growth, cause anemia and weakness, inflammation and weight loss, damage
tissues and cause death unless controlled
D. Loose adherence, larger nuclear-to-cytoplasmic ratio, loss of specific functions
CORRECT ANSWER B — Resemble normal tissue cells, no infiltration or damage of tissues, grow
slow with no metastasis, does not cause death unless it interferes with vital
functions.
RATIONALE Benign tumors resemble their tissue of origin, maintain some normal function,
grow slowly by expansion (not infiltration), do not metastasize, and are generally
not life-threatening unless their location interferes with vital functions (e.g., a
benign brain tumor compressing the brainstem). They are typically well-
encapsulated.
, 5. Which characteristics describe cancerous (malignant) tumor cells?
A. Encapsulated, resemble parent tissue, grow slowly, do not metastasize
B. Little resemblance to normal cells, invades and infiltrates, rate of growth varies, gains
access to blood and lymphatic channels to metastasize, causes effects (anemia,
weakness, inflammation, weight loss), damages tissues and causes death unless
controlled
C. Tight adherence, small nuclear-to-cytoplasmic ratio, specific functions maintained
D. Non-migratory, contact inhibition intact, normal chromosome structure
CORRECT ANSWER B — Little resemblance to normal cells, invades and infiltrates, variable
growth rate, metastasizes, causes systemic effects, damages tissues and
causes death unless controlled.
RATIONALE Malignant cells show anaplasia (little resemblance to parent tissue), invade and
infiltrate surrounding structures, have variable growth rates, metastasize via
blood and lymphatics, and produce systemic effects including anemia, weakness,
inflammation, and weight loss (cachexia). Without treatment, malignant disease
progressively damages tissues and causes death.
6. A patient with breast cancer who underwent mastectomy and chemotherapy 5 years ago
presents with shortness of breath. What is the next best action?
A. Order a chest X-ray and discharge home with albuterol inhaler
B. Contact a pulmonologist — possible chemotherapy toxicity
C. Prescribe antibiotics for suspected community-acquired pneumonia
D. Refer to psychiatry for anxiety-related dyspnea
CORRECT ANSWER B — Contact a pulmonologist — possible chemotherapy toxicity.
RATIONALE Late-onset pulmonary toxicity from chemotherapeutic agents (e.g., bleomycin,
cyclophosphamide, methotrexate) can present months to years after treatment as
pulmonary fibrosis, interstitial pneumonitis, or cardiopulmonary damage. A
patient with prior chemotherapy presenting with dyspnea requires specialist
evaluation by a pulmonologist to assess for drug-induced pulmonary toxicity
versus other causes such as metastatic disease.
1 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 1
F LU I D & E L E CT R O LYT E S · O N CO LO G Y · E N D - O F - L I F E C A R E
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
TOTAL QUESTIONS 60 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers fluid and electrolyte imbalances, oncology, end-of-life care, and chemotherapy
toxicities.
▸ Electrolyte reference ranges are provided within 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 – 60
1. A patient in the burn unit is in the emergent phase with third-spacing. What signs and
symptoms does the nurse expect to find?
A. Hypervolemia with bounding pulse and jugular vein distention
B. Hypovolemia with decreased blood pressure, tachycardia, and weak pulse
C. Hypernatremia with flushed skin and excessive thirst
D. Hypercalcemia with muscle weakness and bone pain
CORRECT ANSWER B — Hypovolemia. Third-spacing causes massive fluid shift from
intravascular space into interstitial tissues.
RATIONALE During the emergent burn phase, capillary permeability increases dramatically,
causing fluid and proteins to leak from the intravascular space into the interstitial
compartment (third-spacing). This produces hypovolemia with decreased BP,
tachycardia, weak pulse, and decreased urine output. Aggressive isotonic fluid
resuscitation is the priority.
2. Which characteristics describe normal cellular biology?
A. Larger nuclear-to-cytoplasmic ratio, loose adherence, rapid continuous division
B. Loss of specific functions, infiltrative growth, and metastasis
C. Smaller nuclear-to-cytoplasmic ratio, tight adherence, and non-migratory behavior
D. Variable growth rate, abnormal chromosomes, and angiogenesis
CORRECT ANSWER C — Smaller nuclear-to-cytoplasmic ratio, tight adherence, and non-
migratory behavior.
RATIONALE Normal cells have a smaller nuclear-to-cytoplasmic ratio, tight adherence
(contact inhibition), and are non-migratory — remaining in their tissue of origin.
Cancer cells display the opposite: larger nuclear-to-cytoplasmic ratio, loose
adherence, and migratory behavior enabling invasion and metastasis.
,3. Which findings are characteristic of cancerous cell biology?
A. Tight adherence, non-migratory, small nuclear-to-cytoplasmic ratio
B. Specific functions maintained, slow growth, no tissue infiltration
C. Larger nuclear-to-cytoplasmic ratio, specific functions lost, loose adherence,
rapid/continuous division
D. Normal tissue resemblance, no metastasis, does not cause death
CORRECT ANSWER C — Larger nuclear-to-cytoplasmic ratio, specific functions lost, loose
adherence, rapid/continuous division.
RATIONALE Cancer cells exhibit a larger nuclear-to-cytoplasmic ratio, loss of differentiated
functions, loose adherence (loss of contact inhibition), and rapid continuous
division. These features enable malignant cells to invade tissues, access
blood/lymphatic vessels, and metastasize. Chemotherapy targets these rapidly
dividing cells.
4. Which characteristics describe benign tumor cells?
A. Little resemblance to normal cells, invade and infiltrate tissues, metastasize via blood and
lymphatics
B. Resemble normal tissue cells, no infiltration or damage of tissues, grow slow with no
metastasis, does not cause death unless it interferes with vital functions
C. Rapid growth, cause anemia and weakness, inflammation and weight loss, damage
tissues and cause death unless controlled
D. Loose adherence, larger nuclear-to-cytoplasmic ratio, loss of specific functions
CORRECT ANSWER B — Resemble normal tissue cells, no infiltration or damage of tissues, grow
slow with no metastasis, does not cause death unless it interferes with vital
functions.
RATIONALE Benign tumors resemble their tissue of origin, maintain some normal function,
grow slowly by expansion (not infiltration), do not metastasize, and are generally
not life-threatening unless their location interferes with vital functions (e.g., a
benign brain tumor compressing the brainstem). They are typically well-
encapsulated.
, 5. Which characteristics describe cancerous (malignant) tumor cells?
A. Encapsulated, resemble parent tissue, grow slowly, do not metastasize
B. Little resemblance to normal cells, invades and infiltrates, rate of growth varies, gains
access to blood and lymphatic channels to metastasize, causes effects (anemia,
weakness, inflammation, weight loss), damages tissues and causes death unless
controlled
C. Tight adherence, small nuclear-to-cytoplasmic ratio, specific functions maintained
D. Non-migratory, contact inhibition intact, normal chromosome structure
CORRECT ANSWER B — Little resemblance to normal cells, invades and infiltrates, variable
growth rate, metastasizes, causes systemic effects, damages tissues and
causes death unless controlled.
RATIONALE Malignant cells show anaplasia (little resemblance to parent tissue), invade and
infiltrate surrounding structures, have variable growth rates, metastasize via
blood and lymphatics, and produce systemic effects including anemia, weakness,
inflammation, and weight loss (cachexia). Without treatment, malignant disease
progressively damages tissues and causes death.
6. A patient with breast cancer who underwent mastectomy and chemotherapy 5 years ago
presents with shortness of breath. What is the next best action?
A. Order a chest X-ray and discharge home with albuterol inhaler
B. Contact a pulmonologist — possible chemotherapy toxicity
C. Prescribe antibiotics for suspected community-acquired pneumonia
D. Refer to psychiatry for anxiety-related dyspnea
CORRECT ANSWER B — Contact a pulmonologist — possible chemotherapy toxicity.
RATIONALE Late-onset pulmonary toxicity from chemotherapeutic agents (e.g., bleomycin,
cyclophosphamide, methotrexate) can present months to years after treatment as
pulmonary fibrosis, interstitial pneumonitis, or cardiopulmonary damage. A
patient with prior chemotherapy presenting with dyspnea requires specialist
evaluation by a pulmonologist to assess for drug-induced pulmonary toxicity
versus other causes such as metastatic disease.
