101Question
A transgender man on long-term testosterone, who has had no gender-affirming surgery, attends a wellness visit. Which statement by the nurse about cancer screening is accurate?
- “You still need cervical cancer screening because you have a cervix.”
- “Testosterone shrinks the cervix, so Pap tests are no longer needed.”
- “Screening depends on your gender identity, so none is required.”
- “You should begin prostate screening at age 40, as other men do.”
Show the answer and explanation
Answer: A. “You still need cervical cancer screening because you have a cervix.”
Topic: cancer screening based on organs present
Screening recommendations follow the organs a person has. A transgender man who still has a cervix and breast tissue needs cervical and breast screening on the same schedule as other people with those organs.
Why the others are wrong
- B – Testosterone does not remove the need for screening, and atrophy can even make results harder to read.
- C – Screening depends on the organs present, not on gender identity.
- D – A transgender man who has not had surgery has no prostate gland.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
102Question
A client with migraine has taken an over-the-counter analgesic almost daily for 2 months. The headaches are now more frequent and are present on waking. Which explanation should the nurse give?
- The dose is too low and should be increased
- The headaches have turned into a harmless type that no longer needs any treatment at all
- The client is allergic to the analgesic and must stop all headache drugs
- Daily pain medicine can cause rebound headache; a preventive plan is needed
Show the answer and explanation
Answer: D. Daily pain medicine can cause rebound headache; a preventive plan is needed
Topic: medication-overuse headache
Using acute headache medicines too often can produce daily or near-daily headaches called medication-overuse headache. Management includes limiting acute medicine days and starting preventive therapy as directed by the provider.
Why the others are wrong
- A – Taking more would worsen the cycle of rebound headache.
- B – Headaches that worsen need evaluation and a plan.
- C – The pattern is rebound from overuse, not allergy, and acute treatment is still needed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
103Question
A client with type 1 diabetes is found unresponsive with a blood glucose of 38 mg/dL. No IV access is in place. Which prescribed intervention should the nurse give first?
- Orange juice by mouth
- Glucagon intramuscularly or subcutaneously
- Glucose gel between the cheek and gum
- Rapid-acting insulin by subcutaneous injection
Show the answer and explanation
Answer: B. Glucagon intramuscularly or subcutaneously
Topic: glucagon in severe hypoglycemia
Low blood glucose normally triggers glucagon release, a negative feedback signal that makes the liver release glucose. When a client cannot take food safely and has no IV, injected glucagon raises glucose within minutes; IV dextrose is used when access is available.
Why the others are wrong
- A – An unresponsive client cannot safely swallow, and oral fluid could be aspirated.
- C – Oral products are unsafe in a client who cannot protect the airway.
- D – Insulin lowers glucose even further and would worsen the emergency.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
104Question
A client with stable angina has worn a nitroglycerin patch around the clock for three weeks and now reports that chest tightness with exertion has returned. Which teaching by the nurse is most appropriate?
- Take the patch off for part of each day, usually overnight, then apply a new one in the morning
- Apply a second patch beside the first one so that the total dose rises while the symptoms persist
- Keep wearing the patch continuously, and cover it with an occlusive dressing so it works better
- Use the patch only when chest tightness starts, because it works faster than a sublingual tablet does
Show the answer and explanation
Answer: A. Take the patch off for part of each day, usually overnight, then apply a new one in the morning
Topic: nitrate tolerance with patch
Continuous nitrate exposure produces tolerance, so the effect fades. A daily nitrate-free interval of roughly ten to twelve hours, commonly overnight, restores the response. Short-acting sublingual nitroglycerin remains the drug for an acute attack.
Why the others are wrong
- B – Doubling up increases the risk of headache and hypotension and does not correct tolerance.
- C – Continuous exposure causes the loss of effect, and an occlusive cover would not restore it.
- D – The patch is a maintenance drug with a slow onset; it cannot relieve an acute attack.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
105Question
A client with knee osteoarthritis takes acetaminophen and has less pain but still has a warm, swollen joint. The client asks why the swelling has not gone down. Which explanation by the nurse is most accurate?
- “Swelling takes longer to improve, so the tablets need several more weeks before they reduce inflammation.”
- “Acetaminophen reduces swelling only when it is taken at bedtime rather than in the daytime.”
- “Your dose is likely too low; a larger dose of the same drug would also lower the inflammation.”
- “Acetaminophen relieves pain but has very little effect on inflammation, so swelling may need another type of drug.”
Show the answer and explanation
Answer: D. “Acetaminophen relieves pain but has very little effect on inflammation, so swelling may need another type of drug.”
Topic: anti-inflammatory vs analgesic only
Acetaminophen acts as an analgesic and antipyretic with minimal anti-inflammatory action. Nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen reduce inflammation and swelling, though they carry their own gastrointestinal, renal and cardiovascular risks.
Why the others are wrong
- A – Acetaminophen does not reduce inflammation with time; waiting would not change the swelling.
- B – Timing does not alter its lack of anti-inflammatory action.
- C – A higher dose raises liver risk and still does not add anti-inflammatory effect.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
106Question
A client with a traumatic brain injury received mannitol two hours ago. Which finding best indicates that the drug has been effective?
- Urine output increased to 300 mL/h and serum sodium is rising
- Blood pressure has risen to 170/100 mm Hg and the heart rate has slowed
- Intracranial pressure has fallen from 28 to 14 mm Hg and the client opens the eyes to voice
- The client reports thirst and has a dry mouth with a weight loss of 1 kg
Show the answer and explanation
Answer: C. Intracranial pressure has fallen from 28 to 14 mm Hg and the client opens the eyes to voice
Topic: mannitol effectiveness in head injury
Mannitol draws water out of swollen brain tissue into the blood, so its goal is lower intracranial pressure and improved neurologic status. Urine output shows that the drug is working on the kidneys but is not by itself a measure of benefit.
Why the others are wrong
- A – Diuresis shows that the drug was given, not that brain swelling improved; sodium rise can be an adverse effect.
- B – That pattern with slowing heart rate suggests rising intracranial pressure.
- D – Those findings reflect fluid loss, not benefit to the brain.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
107Question
A nurse teaches the mother of a child who has localized impetigo on the cheek and is prescribed mupirocin ointment. Which instruction is most appropriate?
- Gently soak and remove the crusts, then apply the ointment to the lesions, and wash hands before and after
- Cover the sores with an adhesive bandage and leave it on until the ointment runs out
- Apply a steroid cream first so that the redness clears before using mupirocin
- Let the child share towels and washcloths if they are washed every few days
Show the answer and explanation
Answer: A. Gently soak and remove the crusts, then apply the ointment to the lesions, and wash hands before and after
Topic: impetigo topical treatment and hygiene
Localized impetigo is treated with a topical antibiotic such as mupirocin after crusts are softened and removed, so that the drug reaches the skin. Hand hygiene and separate linens limit the spread to others and to other body sites.
Why the others are wrong
- B – Lesions need regular cleaning and drug contact; leaving a dressing unchanged traps crusts.
- C – A steroid is not indicated and may worsen a bacterial infection.
- D – Sharing linen spreads the infection; separate items should be used.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
108Question
A drug with a half-life of 3 hours is given as a single 480-mg dose. Assuming no further doses, about how much drug remains in the body 12 hours later?
- 15 mg
- 30 mg
- 60 mg
- 120 mg
Show the answer and explanation
Answer: B. 30 mg
Topic: half-life calculation
Twelve hours is four half-lives of three hours each. The amount halves each time: 480, 240, 120, 60, then 30 mg. About 30 mg remains.
Why the others are wrong
- A – That would be five half-lives, which is 15 hours.
- C – That is three half-lives, 9 hours, not 12.
- D – That is two half-lives, 6 hours, not 12.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
109Question
A client is newly diagnosed with stage 1 hypertension and asks what can be done besides taking medication. Which recommendation by the nurse is most consistent with current guidance?
- Take extra salt on days when exercising so that the blood pressure stays up
- Take naproxen daily for muscle soreness from exercise
- Limit physical activity to avoid any strain on the heart
- Follow a DASH-style eating pattern with reduced sodium and add regular aerobic activity
Show the answer and explanation
Answer: D. Follow a DASH-style eating pattern with reduced sodium and add regular aerobic activity
Topic: lifestyle measures for hypertension
Current guidance recommends the DASH pattern of fruits, vegetables, whole grains and low-fat dairy, reduced sodium, increased potassium intake as appropriate, weight loss when overweight, regular aerobic exercise and limited alcohol. NSAIDs can raise blood pressure.
Why the others are wrong
- A – Sodium should be reduced, not increased, in hypertension.
- B – NSAIDs can raise blood pressure and blunt antihypertensive drugs.
- C – Regular activity lowers blood pressure and is encouraged.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
110Question
A client with plaque psoriasis asks whether treatment will cure the condition. Which response by the nurse is most accurate?
- “Once the plaques clear with treatment, the disease is gone for good.”
- “Several weeks of an oral antibiotic will clear it and stop it from coming back.”
- “Avoiding any stress or illness will guarantee that you never have another flare.”
- “Psoriasis is long-lasting with periods of flares and remission; treatment aims to control it.”
Show the answer and explanation
Answer: D. “Psoriasis is long-lasting with periods of flares and remission; treatment aims to control it.”
Topic: psoriasis as a chronic condition
Psoriasis is a chronic immune-mediated skin disease with cycles of remission and recurrence. Treatment, which may combine topical agents, phototherapy and systemic or biologic drugs, controls symptoms but does not cure. Triggers such as stress, infection and trauma to the skin can precipitate flares.
Why the others are wrong
- A – Psoriasis is chronic and plaques commonly return.
- B – Psoriasis is an immune-mediated disease, not a bacterial infection.
- C – Triggers can be reduced but not fully controlled, so a guarantee is not accurate.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
111Question
A nurse explains the first heart sound to a nursing student. Which description of the events at the start of ventricular systole is correct?
- The semilunar valves close, producing the first heart sound, and the ventricles fill
- The atrioventricular valves close, producing the first heart sound, and both ventricles begin to contract
- The atria contract strongly to push the last blood into the ventricles
- Only the left ventricle contracts while the right ventricle rests
Show the answer and explanation
Answer: B. The atrioventricular valves close, producing the first heart sound, and both ventricles begin to contract
Topic: events of ventricular systole
When ventricular pressure exceeds atrial pressure, the atrioventricular valves close, creating S1. Both ventricles then contract together, pressure rises until the semilunar valves open, and blood is ejected into the aorta and pulmonary artery while the atria refill.
Why the others are wrong
- A – Semilunar valve closure produces the second heart sound at the end of systole.
- C – Atrial contraction occurs before ventricular systole, not during it.
- D – Both ventricles contract at nearly the same time.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
112Question
A client with severe narrowing of one renal artery has high blood pressure. Which explanation of the mechanism is correct?
- Low blood flow to the kidney triggers renin release, which raises angiotensin II and aldosterone
- Low blood flow to the kidney triggers the release of a hormone that dilates the arteries
- The kidney releases extra erythropoietin that thickens the blood and so raises the pressure
- The narrowed artery stimulates the adrenal medulla to stop making aldosterone
Show the answer and explanation
Answer: A. Low blood flow to the kidney triggers renin release, which raises angiotensin II and aldosterone
Topic: renin release and blood pressure
When the juxtaglomerular cells sense reduced perfusion, they release renin. Renin leads to angiotensin II, which constricts vessels, and aldosterone, which retains sodium and water. This is the renin-angiotensin-aldosterone pathway, and it explains why ACE inhibitors lower blood pressure.
Why the others are wrong
- B – The response to low perfusion is vasoconstriction, not dilation.
- C – Erythropoietin is related to red cell production and is not the main mechanism here.
- D – Aldosterone production rises, not falls, in this setting.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
113Question
A client is admitted after an acute myocardial infarction and the cardiologist recommends high-intensity statin therapy. Which order should the nurse expect?
- Pravastatin 40 mg orally daily in the evening
- Simvastatin 20 mg orally daily
- Atorvastatin 80 mg orally daily
- Lovastatin 20 mg orally daily
Show the answer and explanation
Answer: C. Atorvastatin 80 mg orally daily
Topic: high-intensity statin
High-intensity statin therapy is defined as lowering LDL cholesterol by roughly 50% and includes atorvastatin 40 to 80 mg and rosuvastatin 20 to 40 mg. After an acute coronary event, guidelines recommend starting high-intensity therapy as soon as possible.
Why the others are wrong
- A – Pravastatin at this dose is a moderate-intensity statin.
- B – Simvastatin 20 mg is a moderate-intensity dose.
- D – Lovastatin 20 mg is a low-intensity dose.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
114Question
A client with coronary artery disease takes the highest tolerated statin dose, but the LDL cholesterol is still above goal. The prescriber adds ezetimibe. How should the nurse explain how this drug works?
- “It prevents your liver from making cholesterol, in the same way that your statin does.”
- “It binds bile in your gut and increases your triglyceride level.”
- “It breaks down fat deposits in your arteries and removes plaque quickly.”
- “It blocks the absorption of cholesterol from your small intestine, which lowers LDL further.”
Show the answer and explanation
Answer: D. “It blocks the absorption of cholesterol from your small intestine, which lowers LDL further.”
Topic: ezetimibe mechanism
Ezetimibe inhibits the NPC1L1 transporter in the small intestine and reduces dietary and biliary cholesterol absorption. Combined with a statin that lowers hepatic synthesis, it produces an additional reduction in LDL cholesterol.
Why the others are wrong
- A – That is the action of a statin, which is why a different mechanism is added.
- B – That describes a bile acid sequestrant, and increased triglycerides is not the aim.
- C – No lipid drug dissolves plaque quickly; this claim is inaccurate.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
115Question
A client with a fractured C4 vertebra is in a cervical collar. Which assessment is the nurse's highest priority?
- Respiratory rate, depth, and vital capacity
- Sensation in the lower extremities and feet
- Bowel sounds in all four quadrants
- Skin integrity over the sacrum
Show the answer and explanation
Answer: A. Respiratory rate, depth, and vital capacity
Topic: cervical spinal injury and respiratory priority
The phrenic nerve arises from spinal levels C3 to C5 and controls the diaphragm. A fracture at C4 can impair breathing, so respiratory rate, depth, vital capacity and oxygen saturation come first according to airway, breathing and circulation priorities.
Why the others are wrong
- B – It matters for the injury level but is not an immediate threat to life.
- C – Bowel function is assessed after respiratory and neurologic stability.
- D – Pressure injury prevention is important but is not the first priority.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
116Question
A client receiving an anticholinergic drug has a dry mouth, a heart rate of 112 beats/minute, and constipation. The nurse understands these effects occur because the drug alters function of which part of the nervous system?
- Sensory afferent pathways that carry pain and touch signals to the spinal cord
- Somatic motor pathways that control voluntary movement of skeletal muscle
- Autonomic pathways to glands, smooth muscle, and the heart
- Motor neurons in the cerebral cortex that start voluntary movement
Show the answer and explanation
Answer: C. Autonomic pathways to glands, smooth muscle, and the heart
Topic: autonomic nervous system and drug effects
The autonomic nervous system carries involuntary control to glands, smooth muscle, and cardiac muscle. Blocking muscarinic receptors in the parasympathetic division reduces secretions and gut motility and lets the heart rate rise, which produces this pattern. Somatic, sensory, and cortical pathways do not control these organs.
Why the others are wrong
- A – Sensory pathways carry information toward the central nervous system; they do not cause secretions or gut changes.
- B – Somatic motor pathways move skeletal muscle voluntarily and would not explain a dry mouth or constipation.
- D – Cortical motor neurons start voluntary movement; they do not regulate glands or smooth muscle.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
117Question
A client who has just been told a family member was in a serious accident has a pounding heart, dilated pupils, rapid breathing, and a dry mouth. Which set of autonomic changes explains these findings?
- Parasympathetic activation with a slowed heart rate, constricted pupils, and increased salivation
- Sympathetic activation with a faster heart rate, dilated pupils, and bronchodilation
- Somatic activation with voluntary contraction of skeletal muscle and a tense posture
- Parasympathetic withdrawal alone with increased gut motility and bladder emptying
Show the answer and explanation
Answer: B. Sympathetic activation with a faster heart rate, dilated pupils, and bronchodilation
Topic: sympathetic response
Perceived threat triggers the sympathetic 'fight or flight' response: heart rate rises, pupils dilate, airways widen, and digestive secretions fall, causing a dry mouth. The parasympathetic division produces the opposite pattern.
Why the others are wrong
- A – Parasympathetic activation slows the heart, constricts pupils, and increases saliva, the opposite of this client's findings.
- C – Somatic pathways control skeletal muscle only and cannot explain pupil size, heart rate, or dry mouth.
- D – Increased gut motility and bladder emptying are not present, and reduced parasympathetic tone alone does not account for the dilated pupils and bronchodilation.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
118Question
A client with hypothyroidism has taken a stable levothyroxine dose for 6 weeks and attends a follow-up visit. Which finding suggests the dose may now be too high?
- Constipation, dry skin, and intolerance of cold that began before therapy was started
- Resting heart rate of 112 beats/minute with fine tremors and trouble sleeping
- Persistent fatigue, thinning hair, and a 3-pound (1.4 kg) weight gain since the start of therapy
- Slowed speech, puffiness around the eyes, and a husky voice that has not improved
Show the answer and explanation
Answer: B. Resting heart rate of 112 beats/minute with fine tremors and trouble sleeping
Topic: levothyroxine dose evaluation
Too much levothyroxine produces signs of hyperthyroidism such as tachycardia, tremor, insomnia, and weight loss. The other findings are features of hypothyroidism and suggest the dose may be too low or not yet effective.
Why the others are wrong
- A – These are classic hypothyroid findings that suggest under-treatment, not excess.
- C – Fatigue, hair thinning, and weight gain point to continuing hypothyroidism.
- D – Slowed speech, periorbital puffiness, and hoarseness also reflect inadequate replacement.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
119Question
A client with cystitis who has just started phenazopyridine asks, 'Now that the burning is better, do I still need the antibiotic?' What is the nurse's best response?
- Yes, phenazopyridine only eases the burning and pain, and the antibiotic is what treats the infection.
- No, phenazopyridine also kills the bacteria in the bladder, so the antibiotic can be stopped once you feel better.
- Yes, because the antibiotic is needed to stop the orange discoloration of the urine.
- No, phenazopyridine works best when it is taken alone, and a full week of treatment is recommended.
Show the answer and explanation
Answer: A. Yes, phenazopyridine only eases the burning and pain, and the antibiotic is what treats the infection.
Topic: urinary analgesic action
Phenazopyridine is a urinary analgesic that relieves pain, burning, and urgency but has no antibacterial action. The infection is treated only by the prescribed antibiotic, which should be taken as directed.
Why the others are wrong
- B – Phenazopyridine has no antibacterial effect, and stopping an antibiotic early risks relapse and resistance.
- C – The orange urine is a harmless dye effect and has nothing to do with the antibiotic.
- D – It is not an infection treatment, and use is limited to a short time, not a full week alone.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
120Question
A client asks the nurse, 'What is the difference between getting a vaccination and being immune?' Which response is most accurate?
- A vaccination is the act of giving the vaccine, while immunity is the protection the body develops afterward.
- A vaccination is the protection the body develops over time, while immunity is the act of giving the vaccine.
- The two words mean the same thing, and protection starts the moment the injection is given.
- A vaccination always causes a mild form of the disease, while immunity is caused only by illness.
Show the answer and explanation
Answer: A. A vaccination is the act of giving the vaccine, while immunity is the protection the body develops afterward.
Topic: vaccination versus immunity
Vaccination is the act of introducing a vaccine, usually by injection, and immunity is the protection that develops as the immune system responds. Protection generally takes days to weeks, and most vaccines do not cause the disease.
Why the others are wrong
- B – This reverses the terms; the vaccine is given, and the protection develops in the body.
- C – They are not identical, and protection takes time to develop after the dose.
- D – Vaccines are designed to build protection without causing the disease, and immunity can also come from vaccination.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
121Question
A newborn whose mother is hepatitis B surface antigen-positive receives hepatitis B vaccine and hepatitis B immune globulin (HBIG) in the delivery area. How should the nurse explain these two products to the parents?
- Both products make the baby's own immune system produce antibodies that will protect the baby for the rest of his or her life.
- The vaccine supplies ready-made antibodies for immediate protection, and the immune globulin trains the baby's immune system to make its own.
- The vaccine and the immune globulin each supply antibodies that protect the baby for a few weeks and then wear off completely.
- Immune globulin gives immediate, short-lived antibodies, and the vaccine starts the baby's own lasting protection.
Show the answer and explanation
Answer: D. Immune globulin gives immediate, short-lived antibodies, and the vaccine starts the baby's own lasting protection.
Topic: active versus passive immunity
HBIG supplies pre-formed antibodies, which is passive immunity that acts at once but fades. The vaccine stimulates the infant's own immune system to make antibodies and memory cells, which is active immunity that lasts. Giving both gives immediate and long-term protection.
Why the others are wrong
- A – Immune globulin does not make the baby's immune system produce antibodies.
- B – This reverses the roles of the two products.
- C – The vaccine builds lasting protection and does not simply wear off after weeks.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
122Question
A nurse is planning nutrition teaching for a client with a stage 3 pressure injury. Which food choices best supply a nutrient needed for collagen synthesis?
- Oranges, strawberries, and red bell peppers
- Almonds, sunflower seeds, and wheat germ added to meals each day
- Whole-grain bread, brown rice, and oatmeal served at most meals
- Skim milk, yogurt, and fortified cereal taken at breakfast and bedtime
Show the answer and explanation
Answer: A. Oranges, strawberries, and red bell peppers
Topic: vitamin C and wound healing
Ascorbic acid (vitamin C) dissolves in body water and is needed to build collagen, and citrus fruit, strawberries, and peppers are rich sources. The other choices supply vitamin E, B vitamins and fiber, or calcium and vitamin D, which do not play the same direct role in collagen formation.
Why the others are wrong
- B – These foods are mainly sources of vitamin E, not vitamin C.
- C – Whole grains supply B vitamins and fiber but little vitamin C.
- D – Dairy and fortified cereal supply calcium and vitamin D rather than vitamin C.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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