1Question
A nurse is reviewing the plan of care for an Rh-negative client. In which situations should the nurse expect Rho(D) immune globulin to be prescribed?
Select all that apply.
- At 28 weeks of gestation when the antibody screen is negative
- After an amniocentesis when the antibody screen is negative
- After the birth of an Rh-negative newborn
- Within 72 hours after the birth of an Rh-positive newborn
- When the antibody screen shows the client is already sensitized to the D antigen
Show the answers and explanation
Answers: A, B and D.
- A – At 28 weeks of gestation when the antibody screen is negative
- B – After an amniocentesis when the antibody screen is negative
- D – Within 72 hours after the birth of an Rh-positive newborn
Topic: Rho(D) immune globulin timing
Rho(D) immune globulin prevents an unsensitized Rh-negative client from forming antibodies after possible exposure to Rh-positive fetal blood. It is given routinely at 28 weeks, after events that can cause fetomaternal bleeding such as amniocentesis, and within 72 hours of the birth of an Rh-positive newborn.
Why the others are wrong
- C – An Rh-negative newborn has no D antigen, so there is nothing for the mother to react to.
- E – Once antibodies have formed the drug cannot reverse sensitization and is not given.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
2Question
A client at 31 weeks of gestation is admitted in preterm labor and is prescribed betamethasone by intramuscular injection. She asks what the injection is for. Which reply by the nurse is accurate?
- It relaxes the uterus so that the contractions stop.
- It prevents infection if your membranes rupture.
- It keeps your blood pressure from rising during labor.
- It helps your baby's lungs mature in case of an early birth.
Show the answer and explanation
Answer: D. It helps your baby's lungs mature in case of an early birth.
Topic: antenatal corticosteroids
Antenatal corticosteroids such as betamethasone speed the production of surfactant in the fetal lungs, lowering the risk and severity of respiratory distress syndrome when birth occurs preterm.
Why the others are wrong
- A – Stopping contractions is the work of tocolytic drugs, not of a corticosteroid.
- B – Antibiotics, not corticosteroids, are used against infection.
- C – Betamethasone has no role in controlling maternal blood pressure.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
3Question
The parents of a newborn ask about the vitamin K injection and the erythromycin eye ointment given after birth. Which statements by the nurse are accurate?
Select all that apply.
- Vitamin K is injected into the muscle of the thigh.
- Vitamin K lowers the chance that your baby will become jaundiced.
- Newborns cannot yet make enough vitamin K, so the injection prevents bleeding.
- The eye ointment protects against an eye infection picked up during birth.
- The eye ointment is rinsed out with saline one minute after it is applied.
Show the answers and explanation
Answers: A, C and D.
- A – Vitamin K is injected into the muscle of the thigh.
- C – Newborns cannot yet make enough vitamin K, so the injection prevents bleeding.
- D – The eye ointment protects against an eye infection picked up during birth.
Topic: newborn prophylaxis
A newborn's intestine has not yet been colonized by the bacteria that produce vitamin K, so a single intramuscular dose in the vastus lateralis prevents vitamin K deficiency bleeding. Erythromycin ointment in each eye prevents ophthalmia neonatorum caused by gonorrhea acquired in the birth canal.
Why the others are wrong
- B – Vitamin K acts on clotting factors and has no effect on bilirubin.
- E – The ointment is left in place; rinsing it out removes the protection.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
4Question
A client at 39 weeks of gestation is admitted in labor. Her vaginal-rectal culture for group B streptococcus at 36 weeks was positive. She asks why she was not simply given antibiotic tablets at that time. Which response by the nurse is best?
- "Tablets would have worked, but intravenous medicine is easier to give in the hospital."
- "You do not need treatment; your baby will receive the antibiotic after birth."
- "A positive culture means that a cesarean birth is the safest choice for your baby."
- "The bacteria often return after early treatment, so the antibiotic is given through your vein during labor, ideally at least 4 hours before birth."
Show the answer and explanation
Answer: D. "The bacteria often return after early treatment, so the antibiotic is given through your vein during labor, ideally at least 4 hours before birth."
Topic: group B streptococcus prophylaxis
Group B streptococcus normally lives in the bowel and vagina, and recolonization after antenatal treatment is common. Intravenous penicillin given during labor, ideally at least 4 hours before birth, lowers the bacterial load at the time the newborn is exposed and prevents early-onset newborn infection.
Why the others are wrong
- A – Antenatal oral treatment does not prevent newborn infection because recolonization is common; convenience is not the reason.
- B – The mother is treated during labor; the newborn is observed and is not treated routinely in place of the mother.
- C – Colonization with group B streptococcus is not a reason for cesarean birth.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
5Question
A client's monitor shows a new irregularly irregular rhythm with no identifiable P waves and a ventricular rate of 82/min. The provider prescribes apixaban. The client says, 'My heart rate is fine now, so why do I need a blood thinner?' Which response by the nurse is best?
- The medication will change your heart back to a regular rhythm over the next few weeks.
- It keeps your heart rate from becoming too fast when you are active.
- Blood can pool and form clots in the upper chambers when they quiver, and a clot can travel to the brain.
- It dissolves any clots that are already in your heart so that they cannot cause harm.
Show the answer and explanation
Answer: C. Blood can pool and form clots in the upper chambers when they quiver, and a clot can travel to the brain.
Topic: atrial fibrillation and stroke prevention
The rhythm described is atrial fibrillation. Because the atria quiver instead of contracting, blood stagnates, especially in the left atrial appendage, and clots can form and embolize to the brain. Anticoagulation lowers stroke risk whether or not the ventricular rate is controlled.
Why the others are wrong
- A – Apixaban has no effect on rhythm; converting the rhythm requires antiarrhythmic drugs, cardioversion or ablation.
- B – Rate control is the job of beta blockers, certain calcium channel blockers or digoxin, not an anticoagulant.
- D – Anticoagulants prevent clots from forming or growing; they do not break down an existing clot.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
6Question
A client receives NPH insulin subcutaneously at 0700 each day and no other insulin. At which time does the nurse watch most closely for hypoglycemia?
- Within 30 minutes of the injection
- In the middle of the morning, about 2 hours after the injection
- In the middle to late afternoon, before the evening meal
- At no particular time, because this insulin has no peak
Show the answer and explanation
Answer: C. In the middle to late afternoon, before the evening meal
Topic: insulin peak and hypoglycemia timing
NPH is an intermediate-acting insulin that begins to work in 1 to 2 hours and peaks roughly 4 to 12 hours after injection. A morning dose therefore has its greatest effect in the afternoon, which is when hypoglycemia is most likely, especially if lunch or a snack is late or missed.
Why the others are wrong
- A – A risk this early belongs to rapid-acting insulin such as lispro or aspart.
- B – At 2 hours NPH has only begun to act; a peak this early belongs to short-acting regular insulin.
- D – A flat, peakless profile describes long-acting basal insulin such as glargine, not NPH.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
7Question
A client who takes dabigatran for atrial fibrillation arrives in the emergency department with a gastrointestinal hemorrhage and a falling blood pressure. Which agent does the nurse expect to be ordered to reverse the anticoagulant?
- Idarucizumab
- Protamine sulfate
- Phytonadione (vitamin K)
- Naloxone
Show the answer and explanation
Answer: A. Idarucizumab
Topic: dabigatran reversal
Idarucizumab is a monoclonal antibody fragment that binds dabigatran and reverses its effect. Protamine reverses heparin, vitamin K reverses warfarin, and naloxone reverses opioids; none of them neutralizes dabigatran.
Why the others are wrong
- B – Protamine binds heparin; it does not neutralize dabigatran.
- C – Vitamin K helps the liver make clotting factors, which reverses warfarin but not a direct thrombin inhibitor.
- D – Naloxone is an opioid antagonist with no effect on clotting.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
8Question
A client with type 1 diabetes is found unresponsive and diaphoretic with a capillary glucose of 38 mg/dL. The client has no intravenous access. Which action does the nurse take?
- Give orange juice by mouth with a straw
- Give glucagon IM or subcutaneously as ordered
- Wait for an IV line to be placed before treating
- Give a small dose of regular insulin to prevent a rebound
Show the answer and explanation
Answer: B. Give glucagon IM or subcutaneously as ordered
Topic: glucagon for severe hypoglycemia
A client who cannot swallow safely must not be given anything by mouth. Glucagon given by the intramuscular or subcutaneous route raises blood glucose quickly without an IV line; intravenous dextrose is used when access is available. Once the client is awake, a carbohydrate snack follows.
Why the others are wrong
- A – An unresponsive client cannot swallow safely, and oral fluid could be aspirated.
- C – Delay in treating severe hypoglycemia risks seizures and brain injury; glucagon works without IV access.
- D – Insulin lowers glucose further and would make the emergency worse.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
9Question
A client with osteosarcoma has received high-dose methotrexate, and the prescriber orders leucovorin 24 hours later. The nurse understands that leucovorin is given to do what?
- Rescue healthy cells from the toxic effects of methotrexate
- Increase the tumor-killing effect of methotrexate
- Prevent nausea and vomiting from chemotherapy
- Treat infection in a client who has a low white cell count
Show the answer and explanation
Answer: A. Rescue healthy cells from the toxic effects of methotrexate
Topic: leucovorin rescue
Methotrexate blocks the folate pathway in both cancer and normal cells. Leucovorin supplies a form of folate that bypasses the block, rescuing normal cells such as marrow and gut lining, and it is given on a strict schedule after the methotrexate.
Why the others are wrong
- B – Leucovorin protects normal cells; it does not strengthen the anticancer effect.
- C – Antiemetics such as ondansetron treat nausea; leucovorin does not.
- D – It does not treat infection, though marrow suppression is one of the toxicities it limits.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
10Question
A nurse is reviewing antidotes for the emergency department. Which pairings of antidote and drug are correct?
Select all that apply.
- Vitamin K for warfarin
- Protamine sulfate for warfarin
- Flumazenil for benzodiazepines
- Naloxone for benzodiazepines
- Deferoxamine for iron poisoning
- Acetylcysteine for digoxin toxicity
Show the answers and explanation
Answers: A, C and E.
- A – Vitamin K for warfarin
- C – Flumazenil for benzodiazepines
- E – Deferoxamine for iron poisoning
Topic: antidote and drug pairs
Vitamin K restores production of clotting factors that warfarin blocks, flumazenil competes with benzodiazepines at their receptor, and deferoxamine binds iron so that it can be excreted. Protamine reverses heparin, naloxone reverses opioids, and acetylcysteine is the antidote for acetaminophen.
Why the others are wrong
- B – Protamine neutralizes heparin, not warfarin.
- D – Naloxone blocks opioid receptors and has no effect on benzodiazepines.
- F – Acetylcysteine treats acetaminophen overdose; digoxin toxicity is treated with digoxin immune Fab.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
11Question
A client with stable angina has been prescribed sublingual nitroglycerin tablets. Which instruction about an episode of chest pain should the nurse include in the teaching?
- Call emergency services if the pain is not improved or is worse 5 minutes after taking one tablet
- Take up to three tablets 15 minutes apart before calling anyone, because the drug may work slowly
- Lie flat and wait 30 minutes, then take a second tablet only if the pain is still present
- Swallow the tablet with a full glass of water so that it is absorbed faster than under the tongue
Show the answer and explanation
Answer: A. Call emergency services if the pain is not improved or is worse 5 minutes after taking one tablet
Topic: sublingual nitroglycerin emergency plan
Chest pain that is not improved or is getting worse 5 minutes after one nitroglycerin tablet may be an acute coronary syndrome, and the client should call emergency services. The tablet is dissolved under the tongue while sitting, not swallowed. Waiting longer delays treatment of a possible myocardial infarction.
Why the others are wrong
- B – Waiting through three tablets spaced 15 minutes apart delays emergency care for a possible myocardial infarction.
- C – Lying flat and waiting 30 minutes is far too long; the client should sit and seek help early.
- D – The tablet must dissolve under the tongue; swallowing it exposes it to first-pass metabolism and slows relief.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
12Question
A client with heart failure receives furosemide 40 mg IV. Which findings indicate that the drug is having its expected effect?
Select all that apply.
- Serum potassium higher than baseline
- Increased urine output within the first hour
- Fewer crackles on lung auscultation
- Increased jugular vein distention
- A decrease in body weight
Show the answers and explanation
Answers: B, C and E.
- B – Increased urine output within the first hour
- C – Fewer crackles on lung auscultation
- E – A decrease in body weight
Topic: evaluating loop diuretic effect
Furosemide is a loop diuretic that removes sodium and water, so urine output rises, extra fluid leaves the body, weight falls, and lung crackles and edema lessen. It also removes potassium, so the potassium level falls rather than rises. More jugular vein distention would mean the fluid overload is worse.
Why the others are wrong
- A – Furosemide wastes potassium, so the level falls; a rise is not the expected effect.
- D – Increased distention means more fluid in the venous system, which is the opposite of the intended result.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
13Question
A client with cirrhosis and hepatic encephalopathy has started lactulose. Which finding best indicates that the drug is working?
- Two to three soft stools daily and improved alertness
- No stool for 2 days and a calmer abdomen
- Eight or more watery stools in 24 hours
- A rise in the serum ammonia level
Show the answer and explanation
Answer: A. Two to three soft stools daily and improved alertness
Topic: lactulose therapy goal
Lactulose acidifies the colon, which traps ammonia as ammonium, and its laxative effect carries the ammonia out in the stool. The target is about two to three soft stools a day with better mental status. Many watery stools mean the dose is too high and risk dehydration and electrolyte loss.
Why the others are wrong
- B – No stool means no ammonia is being cleared and the therapy is not working.
- C – Eight or more watery stools signals an excessive dose with the risk of dehydration and low potassium.
- D – A rising ammonia level shows the problem is worsening, not improving.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
14Question
A client rated incisional pain as 8 on a scale of 0 to 10 and received an intravenous opioid. Which finding at reassessment best shows that the medication has had the intended effect?
- The client rates the pain as 3, wakes easily, has respirations of 14/min, and is able to cough and deep breathe
- The client is asleep, is hard to wake, and has respirations of 9/min
- The client says the pain is still 8 but would rather not have more medication
- The client's blood pressure and heart rate are lower than before the dose
Show the answer and explanation
Answer: A. The client rates the pain as 3, wakes easily, has respirations of 14/min, and is able to cough and deep breathe
Topic: evaluating response to an analgesic
The goal of an analgesic is pain reduced to a level the client finds acceptable and that allows the activities needed for recovery, without unsafe sedation. A lower self-reported score, easy arousal, adequate respirations and the ability to cough and deep breathe together show this. Evaluation always includes both pain relief and sedation and respiratory status.
Why the others are wrong
- B – Difficulty waking with slow respirations is oversedation and needs action.
- C – An unchanged score means the pain is not controlled, whatever the client's wish about further doses.
- D – Vital signs are unreliable measures of pain and may fall for other reasons.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
15Question
A client in the early stage of Alzheimer disease is started on donepezil. The client's daughter asks how the medication is expected to help. Which explanation by the nurse is most accurate?
- It blocks excess glutamate from overstimulating and damaging nerve cells.
- It clears beta-amyloid plaques from the cortex over several months.
- It raises dopamine release so the client feels calmer and sleeps better.
- It slows the breakdown of acetylcholine so more is available at synapses.
Show the answer and explanation
Answer: D. It slows the breakdown of acetylcholine so more is available at synapses.
Topic: cholinesterase inhibitor in Alzheimer disease
Donepezil is a cholinesterase inhibitor. Alzheimer disease involves loss of cholinergic neurons, so slowing the enzyme that destroys acetylcholine raises the amount available in the synapse and may modestly stabilize memory and daily function. It does not cure or reverse the disease.
Why the others are wrong
- A – Blocking glutamate at NMDA receptors is the action of memantine, not donepezil.
- B – Plaque-clearing is the aim of amyloid-directed antibodies given by infusion; donepezil does not do this.
- C – Donepezil acts on the cholinergic system, not on dopamine release.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
16Question
A nurse is orienting a new graduate who is about to give an oral medication to an 84-year-old client. The nurse explains that an age-related change in the digestive tract can lengthen the time a drug stays in contact with the gut wall. Which change is the nurse describing?
- Slowed gastric emptying and intestinal movement
- A rise in gastric acid secretion that dissolves tablets faster
- A higher proportion of body fat that stores fat-soluble drugs
- Increased liver blood flow that speeds first-pass metabolism
Show the answer and explanation
Answer: A. Slowed gastric emptying and intestinal movement
Topic: age-related changes in drug absorption
With aging, gastric emptying and intestinal movement slow, so a drug spends longer in the gut and more of it may be absorbed. Together with reduced kidney and liver clearance, this raises the chance of drug accumulation and toxicity in older clients.
Why the others are wrong
- B – Gastric acid secretion tends to decrease with age, not increase.
- C – Body fat does rise with age, but this changes distribution of fat-soluble drugs rather than absorption in the gut.
- D – Liver blood flow decreases with age, which slows rather than speeds metabolism.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
17Question
A 46-year-old client is newly diagnosed with primary-progressive multiple sclerosis after two years of steadily worsening gait without distinct relapses. Which disease-modifying drug does the nurse anticipate the neurologist will prescribe?
- Glatiramer acetate
- Ocrelizumab
- Interferon beta-1a
- Natalizumab
Show the answer and explanation
Answer: B. Ocrelizumab
Topic: drug therapy for primary-progressive multiple sclerosis
Ocrelizumab is an anti-CD20 monoclonal antibody given by intravenous infusion and is approved for both relapsing forms and primary-progressive multiple sclerosis. The other drugs listed are approved only for relapsing forms. Premedication with a corticosteroid and an antihistamine reduces infusion reactions.
Why the others are wrong
- A – Glatiramer is used for relapsing forms and is not approved for primary-progressive disease.
- C – Interferon beta products are used for relapsing forms of the disease.
- D – Natalizumab is indicated for relapsing forms and carries a risk of progressive multifocal leukoencephalopathy.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
18Question
A client receiving chemotherapy has an absolute neutrophil count of 400/mm3 on the morning laboratory report. Which medication does the nurse anticipate the provider will order to stimulate neutrophil production?
- Epoetin alfa
- Ondansetron
- Filgrastim
- Romiplostim
Show the answer and explanation
Answer: C. Filgrastim
Topic: colony-stimulating factors for neutropenia
Filgrastim is a granulocyte colony-stimulating factor that signals the bone marrow to make more neutrophils, shortening the period of severe neutropenia. A count below 500/mm3 puts the client at high risk of serious infection.
Why the others are wrong
- A – Epoetin alfa stimulates red blood cell production for anemia.
- B – Ondansetron is an antiemetic and does not affect blood counts.
- D – Romiplostim stimulates platelet production, not neutrophils.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
19Question
A client comes to the clinic with months of vague abdominal discomfort and bloating. Which question is most useful in screening whether a digestive problem may be affecting the client's nutrition?
- Do you usually eat your meals alone or with other people?
- How many hours of sleep do you manage to get each night?
- What kinds of exercise do you do during a typical week?
- Have your clothes fit differently lately without any effort to change your weight?
Show the answer and explanation
Answer: D. Have your clothes fit differently lately without any effort to change your weight?
Topic: gastrointestinal health history
Weight change that was not planned is a key sign of a problem with appetite, digestion, or nutrient absorption and can point to illness. A weight history is therefore part of every gastrointestinal assessment. Questions about sleep, exercise, and meal company are useful in other contexts but do not screen for malabsorption.
Why the others are wrong
- A – Eating company can affect intake socially but does not screen for a digestive cause of weight change.
- B – Sleep habits are not a screen for nutrient absorption problems.
- C – Exercise history helps with general health but does not screen digestive function.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
20Question
A school nurse is teaching the parent of a 6-year-old who has repeated ear infections after colds. The nurse explains that a narrow channel joining the middle ear with the nasopharynx normally equalizes pressure and drains fluid. What is this structure called?
- Tympanic membrane
- Cochlea
- Eustachian tube
- Semicircular canal
Show the answer and explanation
Answer: C. Eustachian tube
Topic: anatomy of the middle ear
The eustachian tube links the middle ear with the nasopharynx, equalizes pressure, and drains secretions. In young children it is short and nearly horizontal, so it drains poorly and fluid can collect and become infected after a cold.
Why the others are wrong
- A – The tympanic membrane is the eardrum, a barrier between the outer and middle ear.
- B – The cochlea is part of the inner ear and converts sound into nerve signals.
- D – The semicircular canals are part of the inner ear and help with balance.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
21Question
A client admitted with a deep vein thrombosis has a continuous heparin infusion started per protocol. Which laboratory test will the nurse use to guide adjustment of the infusion rate?
- Activated partial thromboplastin time (aPTT)
- Prothrombin time with international normalized ratio (INR)
- Platelet count and hemoglobin
- Fibrinogen level and fibrin split products
Show the answer and explanation
Answer: A. Activated partial thromboplastin time (aPTT)
Topic: monitoring heparin therapy
The aPTT reflects the intrinsic clotting pathway and is the usual test for titrating unfractionated heparin; some facilities use an anti-factor Xa level instead. The PT/INR is used for warfarin. Platelet counts are also checked to detect heparin-induced thrombocytopenia but they do not set the dose.
Why the others are wrong
- B – PT with INR is the test used to monitor warfarin.
- C – Platelets and hemoglobin are monitored for complications but are not used to adjust the rate.
- D – Fibrinogen and fibrin split products assess clotting disorders such as DIC.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
22Question
A home health nurse visits a client with hypertension who has taken benazepril for 6 weeks. Which blood pressure finding best shows that the medication is working as intended, with no sign of an excessive effect?
- 152/94 mm Hg with no symptoms
- 136/86 mm Hg with mild headache
- 98/54 mm Hg with light-headedness
- 124/76 mm Hg with no dizziness
Show the answer and explanation
Answer: D. 124/76 mm Hg with no dizziness
Topic: evaluating ACE inhibitor effect
Benazepril is an angiotensin-converting enzyme inhibitor used to lower blood pressure. The goal for most adults under current ACC/AHA guidance is below 130/80 mm Hg. A reading of 124/76 without dizziness meets the goal. A reading that is too low with light-headedness suggests an excessive effect.
Why the others are wrong
- A – 152/94 mm Hg remains well above the target, so the treatment goal is not met.
- B – 136/86 mm Hg is still above the goal.
- C – 98/54 mm Hg with light-headedness suggests too much lowering and a risk of falls.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
23Question
A client with persistent asthma takes sustained-release theophylline tablets every morning. During a sudden bout of wheezing, the client asks whether to swallow an extra tablet. Which response by the nurse is best?
- Take one extra tablet right away, because this drug opens narrowed airways within a few minutes during an attack.
- Use the quick-relief inhaler for the wheezing and keep taking theophylline on schedule to prevent symptoms.
- Take an extra tablet only if the wheezing continues for more than an hour, then call the provider afterward.
- Skip the scheduled tablet until the wheezing settles, then restart it at the next regular dose time.
Show the answer and explanation
Answer: B. Use the quick-relief inhaler for the wheezing and keep taking theophylline on schedule to prevent symptoms.
Topic: theophylline as an asthma controller
Theophylline is a xanthine bronchodilator taken on a fixed schedule as a controller that keeps airways stable between episodes. It is not a rescue drug, and its therapeutic range is narrow, so extra doses risk toxicity such as tachycardia, dysrhythmias and seizures. Sudden symptoms are treated with the prescribed quick-relief inhaler.
Why the others are wrong
- A – Oral sustained-release theophylline acts slowly; an extra tablet does not stop an attack and risks toxicity.
- C – Waiting an hour and then doubling up is both unsafe and ineffective; theophylline is never used as a rescue dose.
- D – Skipping the controller leaves airways unprotected and does not help the current episode.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
24Question
A client is leaving the hospital after treatment for a kidney stone, the third the client has formed. Which statement by the client shows that the discharge teaching was understood?
- I will drink less in the evening so that I am not up at night to urinate.
- I will limit my water when I have flank pain so that less urine has to pass.
- I will sip fluids through the whole day so my urine stays pale.
- I will drink fluids only with meals so my kidneys are not overworked.
Show the answer and explanation
Answer: C. I will sip fluids through the whole day so my urine stays pale.
Topic: fluid intake to prevent kidney stones
Generous fluid intake spread across the day dilutes the urine, so the minerals that form stones stay in solution and small crystals are flushed out. Pale urine is a practical sign that intake is enough. Restricting fluids concentrates urine and favors new stones.
Why the others are wrong
- A – Cutting back in the evening lets urine concentrate overnight, which promotes stone formation.
- B – Limiting water during pain concentrates the urine and slows passage of the stone.
- D – Drinking only at meals leaves long stretches with concentrated urine.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
25Question
A 70-year-old client with benign prostatic hyperplasia, whose main complaint is a weak urine stream, is started on daily tadalafil. He asks how a drug known for erectile dysfunction could help him urinate. Which explanation by the nurse is accurate?
- It shrinks the prostate gland over several weeks by lowering the level of male hormone.
- It loosens smooth muscle around the urethra, prostate and bladder outlet, which eases urine flow.
- It keeps the bladder from contracting, so the bladder fills with much more urine before emptying.
- It acts on the kidneys to make less urine, especially overnight.
Show the answer and explanation
Answer: B. It loosens smooth muscle around the urethra, prostate and bladder outlet, which eases urine flow.
Topic: tadalafil mechanism in BPH
Tadalafil is a phosphodiesterase-5 inhibitor. In lower urinary tract tissue it raises cyclic GMP, relaxing smooth muscle and improving urine flow. It does not shrink the prostate. It must never be combined with nitrates because severe hypotension can result.
Why the others are wrong
- A – Shrinking the prostate by lowering male hormone describes 5-alpha-reductase inhibitors such as finasteride.
- C – Preventing bladder contraction would worsen retention, and it is not how tadalafil works.
- D – Reducing urine production describes desmopressin, which is not used for BPH.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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