1Question
An Rh-negative client with a negative antibody screen gave birth 12 hours ago. The newborn's blood type is reported as Rh-positive. The client received Rho(D) immune globulin at 28 weeks of gestation. Which plan is correct?
- Give Rho(D) immune globulin to the newborn within 72 hours of birth.
- Give Rho(D) immune globulin to the client within 72 hours of birth.
- No further dose is needed because one was given at 28 weeks.
- Withhold the drug from the client until she plans another pregnancy.
Show the answer and explanation
Answer: B. Give Rho(D) immune globulin to the client within 72 hours of birth.
Topic: Rho(D) immune globulin after birth
At birth, Rh-positive fetal cells can enter the mother's circulation. A dose given to the mother within 72 hours destroys those cells before her immune system forms lasting antibodies, protecting future pregnancies. The antenatal dose does not cover this exposure.
Why the others are wrong
- A – The drug is for the Rh-negative mother; given to an Rh-positive newborn it would attack the newborn's own cells.
- C – The 28-week dose protects only for the rest of the pregnancy.
- D – Sensitization happens within days of exposure, so delay makes the drug useless.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
2Question
A client is discharged on warfarin after treatment for a deep vein thrombosis in the left leg. Which statement by the client shows correct understanding of the teaching?
- I will eat about the same amount of green leafy vegetables from week to week.
- If I forget a dose, I will take two tablets the next day.
- I will use ibuprofen instead of acetaminophen when I have aches.
- Once my blood test is in range, I will not need more blood tests.
Show the answer and explanation
Answer: A. I will eat about the same amount of green leafy vegetables from week to week.
Topic: warfarin teaching after DVT
Warfarin blocks vitamin K-dependent clotting factors, so a steady intake of vitamin K keeps the INR stable; the client does not need to avoid these foods, only to keep the amount consistent. Sudden changes in intake move the INR out of range.
Why the others are wrong
- B – Doubling a dose can push the INR too high and cause bleeding; a missed dose is handled as the anticoagulation clinic instructs, never doubled.
- C – NSAIDs increase bleeding risk with warfarin; acetaminophen in usual doses is the preferred pain reliever.
- D – The INR changes with diet, illness and other drugs, so it is checked regularly for as long as warfarin is taken.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
3Question
A client with persistent asthma is prescribed an inhaled budesonide controller and an albuterol reliever inhaler. Which statements by the client show that teaching has been effective?
Select all that apply.
- I will use the budesonide inhaler every day, even when I feel well.
- I will rinse my mouth and spit after using the budesonide inhaler.
- I will take the albuterol on a fixed schedule four times a day to stop attacks from starting.
- If I am reaching for the albuterol more often than usual, my asthma is not well controlled and I should call the clinic.
- I should give up exercise because it will make my asthma worse.
- I will keep the cat out of my bedroom and stay away from tobacco smoke.
Show the answers and explanation
Answers: A, B, D and F.
- A – I will use the budesonide inhaler every day, even when I feel well.
- B – I will rinse my mouth and spit after using the budesonide inhaler.
- D – If I am reaching for the albuterol more often than usual, my asthma is not well controlled and I should call the clinic.
- F – I will keep the cat out of my bedroom and stay away from tobacco smoke.
Topic: asthma controller versus reliever and triggers
An inhaled corticosteroid treats the underlying airway inflammation and works only with regular daily use; rinsing afterwards prevents oral candidiasis. Rising use of the reliever is a warning of poor control, and reducing exposure to known triggers such as animal dander and smoke is part of every asthma plan.
Why the others are wrong
- C – A short-acting bronchodilator is used as needed for symptoms; regular scheduled use does not treat inflammation and masks poor control.
- E – Regular exercise is encouraged in asthma; symptoms with exercise mean control should be improved, not that activity should stop.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
4Question
A client with Parkinson disease is admitted with pneumonia. At home the client takes carbidopa-levodopa at 0600, 1000, 1400 and 1800. The hospital's standard schedule has placed the doses at 0900, 1300, 1700 and 2100, and this morning the client was rigid, froze while walking to the bathroom and nearly fell. Which action by the nurse is best?
- Arrange for the doses to be scheduled at the client's home times and give them on time.
- Give each dose with a high-protein meal so that it is absorbed more completely.
- Keep the client on bed rest each morning until the 0900 dose has taken effect.
- Hold the morning dose until physical therapy has evaluated the client's gait.
Show the answer and explanation
Answer: A. Arrange for the doses to be scheduled at the client's home times and give them on time.
Topic: carbidopa-levodopa timing and falls
Levodopa has a short duration of action, so symptom control depends on doses given at the client's established times; a delay of even a few hours brings back rigidity and freezing and raises the risk of falls and aspiration. The nurse has the schedule changed to the home regimen and gives each dose on time.
Why the others are wrong
- B – Dietary protein competes with levodopa for absorption and transport, so a high-protein meal with the dose reduces its effect.
- C – Bed rest leaves the cause untouched and adds the risks of immobility in a client who already has pneumonia.
- D – Holding the dose prolongs the off period and makes the gait and the fall risk worse.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
5Question
A nurse is to give regular insulin 6 units and NPH insulin 14 units in one syringe. Which sequence is correct?
- Inject air into the regular vial, then the NPH vial; withdraw the NPH first, then the regular insulin
- Inject air into the NPH vial, then the regular vial; withdraw the NPH first, then the regular insulin
- Inject air into the NPH vial only; withdraw the regular insulin first, then the NPH
- Inject air into the NPH vial, then the regular vial; withdraw regular first, then the NPH
Show the answer and explanation
Answer: D. Inject air into the NPH vial, then the regular vial; withdraw regular first, then the NPH
Topic: mixing regular and NPH insulin
Air is injected into the cloudy NPH vial first without touching the solution, then into the regular vial, and the clear regular insulin is withdrawn before the cloudy NPH. This keeps NPH from contaminating the regular vial, which must stay clear and fast-acting.
Why the others are wrong
- A – Withdrawing the NPH first then putting the needle into the regular vial contaminates the regular insulin with NPH.
- B – Pulling up the NPH first carries cloudy insulin into the regular vial on the next withdrawal.
- C – Air must go into the regular vial too, or a vacuum forms and the dose drawn is inaccurate.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
6Question
A nurse is preparing an intravenous loading dose of phenytoin for a client with status epilepticus. Which action is correct?
- Mix the dose in 5% dextrose in water and run it over 4 hours
- Slowly, under 50 mg/min, with ECG and blood pressure monitoring
- Push it rapidly over 1 minute to stop the seizure quickly
- Give it intramuscularly into the gluteus if the vein is hard to find
Show the answer and explanation
Answer: B. Slowly, under 50 mg/min, with ECG and blood pressure monitoring
Topic: IV phenytoin administration
Phenytoin is given in 0.9% sodium chloride, with the line flushed with saline before and after, at a rate no faster than 50 mg/min in adults, because rapid infusion can cause bradycardia, hypotension and cardiac arrest. It crystallizes in dextrose and is absorbed erratically when given intramuscularly.
Why the others are wrong
- A – Phenytoin precipitates in dextrose solutions, so saline is the carrier.
- C – A rapid push can cause severe hypotension and cardiac arrhythmias.
- D – Intramuscular phenytoin is absorbed slowly and unpredictably and damages tissue.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
7Question
A nurse withdraws morphine 4 mg from the automated dispensing cabinet, but the order is for 2 mg. Which actions does the nurse take?
Select all that apply.
- Have a second licensed nurse watch the unused 2 mg being wasted
- Record the dose given and the amount wasted, with the witness co-signing
- Keep the remaining 2 mg in a labeled syringe in the medication room for the next dose
- Ask unlicensed assistive personnel to witness the waste to save time
- Return the unused drug to the cabinet drawer
- Discard the unused 2 mg in the regular trash
Show the answers and explanation
Answers: A and B.
- A – Have a second licensed nurse watch the unused 2 mg being wasted
- B – Record the dose given and the amount wasted, with the witness co-signing
Topic: controlled substance waste
Controlled substances must be fully accounted for. A second licensed person witnesses the waste of the unused amount in the way the policy describes, and both the dose given and the amount wasted are documented with the witness signature. Saving, returning or discarding the drug in an unwitnessed way risks diversion and violates regulations.
Why the others are wrong
- C – Saving a controlled drug for later is unsafe and unaccounted for, and it is not allowed.
- D – The witness must be licensed according to policy, so an unlicensed assistant does not qualify.
- E – A drug that has left the cabinet cannot be returned to the drawer, since its integrity cannot be assured.
- F – Disposal into regular trash is not a permitted way to waste a controlled substance and is also unwitnessed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
8Question
A nurse is preparing adenosine for a client with supraventricular tachycardia who is on continuous cardiac monitoring with a peripheral IV in the antecubital fossa. Which method of administration is correct?
- Rapid IV push into the port closest to the vein, followed at once by a rapid saline flush
- Slow IV push over 5 minutes through the port farthest from the vein, with a saline flush after 10 minutes
- Mixed in 100 mL of saline and infused over 30 minutes by pump
- Deep intramuscular injection into the deltoid, repeated in 10 minutes if the rhythm persists
Show the answer and explanation
Answer: A. Rapid IV push into the port closest to the vein, followed at once by a rapid saline flush
Topic: adenosine rapid push and flush
Adenosine is cleared from the blood in seconds, so it is given as a rapid IV push into the port nearest the vein and flushed in immediately with saline to move it to the heart. The client is warned of brief chest pressure and flushing, and the monitor may show a short pause or asystole. Resuscitation equipment must be ready.
Why the others are wrong
- B – A slow push through a distant port lets the drug be metabolized before it reaches the heart, so it will not work.
- C – An infusion over 30 minutes is far too slow for a drug that lasts seconds.
- D – Adenosine is given IV only; an IM injection would not give the rapid effect needed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
9Question
A client who received a drug-eluting coronary stent 2 weeks ago is discharged on aspirin and clopidogrel. Which instructions should the nurse include?
Select all that apply.
- Do not stop either medicine, even for a dental procedure, unless the cardiologist says so
- Ibuprofen is the best choice for headaches while taking these medicines
- Report black, tarry stools or blood in the urine
- If you bruise easily, stop the clopidogrel until the bruises fade
- If you miss a dose, take two doses the next day
Show the answers and explanation
Answers: A and C.
- A – Do not stop either medicine, even for a dental procedure, unless the cardiologist says so
- C – Report black, tarry stools or blood in the urine
Topic: dual antiplatelet teaching after stent
Stopping antiplatelet therapy early after a stent can cause stent thrombosis and a heart attack, so any interruption must be decided by the cardiologist. Dual antiplatelet therapy raises the risk of bleeding, so signs such as black stools or blood in the urine are reported. NSAIDs add to bleeding risk, and doses are never doubled.
Why the others are wrong
- B – NSAIDs add to bleeding risk and can interfere with aspirin; acetaminophen is usually the safer choice.
- D – Easy bruising is common with these drugs; stopping clopidogrel on one's own risks stent clotting.
- E – Doubling doses raises the bleeding risk; a missed dose is handled as the prescriber or pharmacist directs.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
10Question
A client in the emergency department has fever, low blood pressure, and a suspected pneumonia that may be causing sepsis. The prescriber orders blood cultures and IV broad-spectrum antibiotics. Which sequence should the nurse follow?
- Start the first antibiotic dose, then collect the blood cultures once the infusion is finished
- Wait for the Gram stain result so that the most appropriate antibiotic can be chosen before starting
- Hold the antibiotic until the sputum culture grows an organism
- Collect blood cultures from two separate sites, then start the antibiotic without waiting for results
Show the answer and explanation
Answer: D. Collect blood cultures from two separate sites, then start the antibiotic without waiting for results
Topic: cultures before the first antibiotic dose
Blood cultures are collected before the first antibiotic dose because an antibiotic in the blood can make cultures falsely negative, but in suspected sepsis the antibiotic is not delayed to wait for results. Two sets from separate sites are collected quickly, then the antibiotic is started promptly. Therapy is adjusted later when culture results return.
Why the others are wrong
- A – Drawing cultures after the antibiotic can give false negatives and lose the chance to identify the organism.
- B – Waiting for a Gram stain delays treatment of a life-threatening infection.
- C – A sputum culture takes days; holding the antibiotic that long in sepsis risks death.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
11Question
A nurse is teaching an older client how to take alendronate for osteoporosis. Which instruction is correct?
- Take it with breakfast and a glass of milk so that the calcium protects the stomach
- Take it at bedtime with a snack and lie down to help it work overnight
- Take it with orange juice and a vitamin tablet, then rest for an hour
- Take it on an empty stomach with a full glass of plain water and stay upright for 30 minutes
Show the answer and explanation
Answer: D. Take it on an empty stomach with a full glass of plain water and stay upright for 30 minutes
Topic: bisphosphonate administration
Alendronate is poorly absorbed and can injure the esophagus. It is taken first thing in the morning on an empty stomach with a full glass of plain water, and the client stays upright, sitting or standing, for at least 30 minutes and waits before eating or taking other medicines. Food, milk, juice, and calcium all block its absorption.
Why the others are wrong
- A – Food and calcium in milk block absorption, so the drug would be wasted.
- B – Lying down raises the risk that the tablet will irritate or injure the esophagus, and food blocks absorption.
- C – Juice and a vitamin tablet reduce absorption, and resting lying down raises the risk of esophageal injury.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
12Question
A client with rheumatoid arthritis is prescribed methotrexate 15 mg by mouth once weekly. Which statement by the client shows the correct understanding of the dosing?
- I will take the tablets every morning with breakfast so that I do not forget
- I will take it only when my joints hurt, the same way I use ibuprofen
- I will take the dose on the same day each week and mark it on my calendar
- I can take a double dose on the day my joints are very stiff
Show the answer and explanation
Answer: C. I will take the dose on the same day each week and mark it on my calendar
Topic: weekly methotrexate dosing safety
Methotrexate for rheumatoid arthritis is taken once a week, and accidental daily dosing has caused fatal toxicity of the bone marrow, liver, and mouth. Taking it on the same day each week with a reminder system prevents error. It is not taken as needed and the dose is never doubled.
Why the others are wrong
- A – Daily dosing of a weekly drug is a well-known fatal error.
- B – The drug controls the disease over time and is not taken for symptoms as needed.
- D – Doubling the dose raises the risk of severe bone marrow and liver toxicity.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
13Question
A nurse is teaching a client to use a metered-dose inhaler that contains an inhaled corticosteroid, with a spacer. Which instructions should the nurse include?
Select all that apply.
- Shake the inhaler well before each puff
- Press the canister several times into the spacer, then take one breath
- Breathe in slowly and hold your breath for about 10 seconds
- Breathe in as fast and as hard as you can
- Rinse your mouth with water and spit it out afterward
- Swallow the rinse water so that no medicine is wasted
Show the answers and explanation
Answers: A, C and E.
- A – Shake the inhaler well before each puff
- C – Breathe in slowly and hold your breath for about 10 seconds
- E – Rinse your mouth with water and spit it out afterward
Topic: metered-dose inhaler with spacer technique
The inhaler is shaken to mix the dose, one puff is sprayed into the spacer at a time and inhaled slowly, and the breath is held about 10 seconds so the drug settles in the airways. The mouth is rinsed and the water spat out after an inhaled corticosteroid to prevent thrush and hoarseness. Swallowing the water defeats that purpose.
Why the others are wrong
- B – Several puffs in the spacer at once make the dose uneven and much of it clings to the walls; one puff per breath is used.
- D – A fast, forceful breath carries the drug to the throat instead of the lungs.
- F – Swallowing the rinse water brings the steroid back into the mouth and throat and can lead to thrush.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
14Question
A client who has difficulty swallowing is to receive morning medications crushed in applesauce. Which medications should the nurse question?
Select all that apply.
- Oxycodone extended-release tablet
- Furosemide 40 mg immediate-release tablet
- Pantoprazole delayed-release tablet
- Lisinopril 10 mg tablet
- Metoprolol succinate extended-release tablet
- Acetaminophen 500 mg immediate-release tablet
Show the answers and explanation
Answers: A, C and E.
- A – Oxycodone extended-release tablet
- C – Pantoprazole delayed-release tablet
- E – Metoprolol succinate extended-release tablet
Topic: medications that must not be crushed
Extended-release and delayed-release (enteric-coated) products are built to release the drug slowly or past the stomach. Crushing them releases the whole dose at once, which can cause overdose, or destroys the acid protection. Immediate-release plain tablets can generally be crushed. The nurse questions the order and asks the prescriber or pharmacist for an alternative form.
Why the others are wrong
- B – An immediate-release furosemide tablet has no release system and can be crushed.
- D – Plain lisinopril tablets can be crushed.
- F – An immediate-release acetaminophen tablet can be crushed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
15Question
A nurse is teaching the parents of an 18-month-old child with iron deficiency anemia who is to receive a liquid iron supplement. Which instructions should the nurse include?
Select all that apply.
- Give the iron between meals with a small amount of orange juice.
- Mix the dose into a bottle of milk to hide the taste.
- Place the dose toward the back of the mouth with a dropper or syringe and brush the teeth afterward.
- Expect the stools to turn dark green or black.
- Stop the supplement if the stools become dark.
- Limit the amount of cow's milk the child drinks each day.
Show the answers and explanation
Answers: A, C, D and F.
- A – Give the iron between meals with a small amount of orange juice.
- C – Place the dose toward the back of the mouth with a dropper or syringe and brush the teeth afterward.
- D – Expect the stools to turn dark green or black.
- F – Limit the amount of cow's milk the child drinks each day.
Topic: iron supplement teaching
Iron is absorbed best on an empty stomach and with vitamin C, and poorly with milk. Liquid iron stains teeth, so it is placed toward the back of the mouth and the teeth are cleaned. Dark stools show the iron is being taken, and too much cow's milk both displaces iron-rich food and reduces absorption.
Why the others are wrong
- B – Milk reduces iron absorption, and a child who does not finish the bottle does not receive the full dose.
- E – Dark green or black stools are an expected, harmless effect of oral iron and not a reason to stop.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
16Question
A nurse is teaching a parent how to give a liquid oral medication to a 6-month-old infant at home. Which instructions should the nurse include?
Select all that apply.
- Hold the infant in a semi-upright position while giving the medication
- Mix the dose into a full bottle of formula so that the taste is hidden
- Aim the syringe at the back of the throat so that the infant swallows quickly
- Place the tip of the syringe inside the cheek, beside the gum, and give small amounts, letting the infant swallow each one
- Gently pinch the infant's nose closed if the infant refuses to swallow
- Measure the dose with the oral syringe supplied, not with a kitchen spoon
Show the answers and explanation
Answers: A, D and F.
- A – Hold the infant in a semi-upright position while giving the medication
- D – Place the tip of the syringe inside the cheek, beside the gum, and give small amounts, letting the infant swallow each one
- F – Measure the dose with the oral syringe supplied, not with a kitchen spoon
Topic: oral medication for an infant
Liquid medication is given to an infant semi-upright, a little at a time, into the pocket between cheek and gum, so that it is swallowed and not aspirated or spat out. An oral syringe measures accurately. Medication is not put into a bottle of feed, because an unfinished bottle means an unknown dose and the infant may come to refuse feeds.
Why the others are wrong
- B – If the infant does not finish the bottle the dose taken is unknown, and the altered taste can lead to refusal of feeds.
- C – Liquid squirted at the back of the throat triggers gagging and can be aspirated.
- E – Closing the nose forces the infant to gasp through a mouth full of liquid, which invites aspiration.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
17Question
A nurse is preparing to give an intramuscular injection to a 5-month-old infant. Which site is preferred?
- Deltoid muscle of the upper arm
- Vastus lateralis muscle of the anterolateral thigh
- Dorsogluteal muscle of the buttock
- Subcutaneous tissue over the triceps
Show the answer and explanation
Answer: B. Vastus lateralis muscle of the anterolateral thigh
Topic: intramuscular site by age
The vastus lateralis is the largest, best-developed muscle in an infant and lies away from major nerves and blood vessels, so it is the preferred intramuscular site at this age. The gluteal muscles develop with walking, and the deltoid is too small in infancy.
Why the others are wrong
- A – The deltoid has too little muscle mass in an infant; it is used for small volumes in older children.
- C – The dorsogluteal muscle is poorly developed before the child has been walking, and an injection there risks injury to the sciatic nerve.
- D – This is a subcutaneous site; medication ordered intramuscularly would be given by the wrong route.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
18Question
The nurse has checked a tablet against the medication administration record and is about to give it. The client says, "That is not the blood pressure pill I take at home. Mine is small and white." Which action should the nurse take?
- Explain that hospitals often use a different manufacturer and give the tablet
- Withhold the tablet and verify the prescription, the drug and the dose before giving anything
- Give the tablet and tell the pharmacist about the client's comment later in the shift
- Record that the client refused the medication and move on
Show the answer and explanation
Answer: B. Withhold the tablet and verify the prescription, the drug and the dose before giving anything
Topic: rights of administration, client questions a drug
A client who questions a medication is a last safety check, and the concern is resolved before the drug is given. The nurse goes back to the prescription, the home medication list and, if needed, the pharmacist to confirm right drug and right dose. If the tablet is correct, the nurse explains the difference and then gives it.
Why the others are wrong
- A – This may be true, but it is an assumption; the nurse must verify before giving.
- C – Verification after the dose cannot prevent an error.
- D – The client has not refused; the client has raised a question that the nurse must answer.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
19Question
Facility policy requires an independent double check before a heparin infusion is started. Which approach by the two nurses meets this requirement?
- The first nurse reads the order and the pump settings aloud and the second nurse agrees
- The second nurse signs the record later in the shift when the unit is quieter
- The first nurse checks the infusion twice, a few minutes apart
- The second nurse separately checks the order, the client, the drug, the concentration, the dose calculation and the pump settings without being told what to expect, and the two then compare
Show the answer and explanation
Answer: D. The second nurse separately checks the order, the client, the drug, the concentration, the dose calculation and the pump settings without being told what to expect, and the two then compare
Topic: high-alert medications, independent double check
An independent double check works only when the second person reaches a result alone, without hearing the first person's answer, and the two results are then compared. This is how an error made by the first nurse is caught rather than repeated. It is done before the high-alert medication reaches the client.
Why the others are wrong
- A – Being told the values invites the second nurse to agree rather than to check.
- B – A signature after the infusion has started is not a check.
- C – One person checking twice tends to repeat the same error.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
20Question
The nurse reviews assessment data before giving 0900 medications. Which doses should the nurse withhold and discuss with the provider?
Select all that apply.
- Digoxin for a client whose apical pulse is 52/min
- Lisinopril for a client whose blood pressure is 132/80 mm Hg and potassium is 4.2 mEq/L
- Metoprolol for a client whose blood pressure is 86/50 mm Hg and heart rate is 54/min
- Oral potassium chloride for a client whose potassium is 5.6 mEq/L
- Levothyroxine for a client whose heart rate is 76/min
Show the answers and explanation
Answers: A, C and D.
- A – Digoxin for a client whose apical pulse is 52/min
- C – Metoprolol for a client whose blood pressure is 86/50 mm Hg and heart rate is 54/min
- D – Oral potassium chloride for a client whose potassium is 5.6 mEq/L
Topic: when to hold a dose
Digoxin is held for an adult apical pulse below 60/min, a beta blocker is held for hypotension and bradycardia, and potassium is not given to a client who is already hyperkalemic. In each case the next dose would deepen an existing problem. The other two clients have findings within the expected range for their drugs.
Why the others are wrong
- B – Blood pressure and potassium are both acceptable, so the ACE inhibitor can be given.
- E – A heart rate of 76/min shows no sign of excess thyroid hormone; the dose is given.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
21Question
A client with type 1 diabetes received NPH insulin before breakfast. In the middle of the afternoon the client is sweaty, shaky and irritable but awake and able to swallow. The capillary blood glucose is 54 mg/dL. Which action should the nurse take first?
- Give glucagon by intramuscular injection
- Call the provider for a change in the insulin dose
- Give about 15 g of a fast-acting carbohydrate such as fruit juice and recheck the glucose in 15 minutes
- Offer a meat sandwich and a glass of milk
Show the answer and explanation
Answer: C. Give about 15 g of a fast-acting carbohydrate such as fruit juice and recheck the glucose in 15 minutes
Topic: insulin peak and hypoglycemia
NPH is an intermediate-acting insulin that peaks several hours after injection, which is when hypoglycemia is most likely. A conscious client who can swallow is treated with about 15 g of rapidly absorbed carbohydrate, and the glucose is rechecked after 15 minutes and the treatment repeated if it is still low. A snack with protein follows once the glucose has recovered.
Why the others are wrong
- A – Glucagon is for a client who cannot safely swallow.
- B – The dose may need review, but the low glucose is treated first.
- D – Protein and fat delay absorption of glucose; this snack is given after the glucose has come up.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
22Question
A client with hypertension is prescribed hydralazine. The automated dispensing cabinet also stocks hydroxyzine. Which actions by the nurse reduce the risk of giving the wrong drug?
Select all that apply.
- Pick the tablet by the colour and shape remembered from the previous shift
- Compare the label with the medication record and confirm that the drug fits the client's diagnosis
- Override a barcode mismatch alert because the two names are almost the same
- Remove both drugs at once so that a second trip to the cabinet is not needed
- Scan the client's identification band and the medication barcode before giving it
Show the answers and explanation
Answers: B and E.
- B – Compare the label with the medication record and confirm that the drug fits the client's diagnosis
- E – Scan the client's identification band and the medication barcode before giving it
Topic: look-alike, sound-alike drugs
Look-alike, sound-alike names are separated by reading the full label against the record, by checking that the drug's purpose matches the client's condition, and by barcode scanning at the bedside. These steps catch a wrong selection before it reaches the client.
Why the others are wrong
- A – Appearance changes with the manufacturer and is not a way to identify a drug.
- C – A mismatch alert is exactly the signal that the wrong product may have been picked; it is investigated, not overridden.
- D – Having both drugs in hand makes a mix-up more likely.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
23Question
The nurse is giving enoxaparin from a prefilled syringe to an adult after hip surgery. Which technique is correct?
- Inject into the deltoid muscle at a 90-degree angle
- Expel the air bubble from the syringe, then aspirate before injecting
- Inject into the subcutaneous tissue of the abdomen away from the umbilicus and do not rub the site
- Massage the site firmly after the injection to help the drug absorb
Show the answer and explanation
Answer: C. Inject into the subcutaneous tissue of the abdomen away from the umbilicus and do not rub the site
Topic: subcutaneous anticoagulant technique
Enoxaparin is given subcutaneously, usually into the abdominal wall well away from the umbilicus, with sites rotated. The air bubble in the prefilled syringe is left in place, the nurse does not aspirate, and the site is not rubbed, because each of these increases bruising or loss of drug.
Why the others are wrong
- A – An intramuscular injection of an anticoagulant can cause a hematoma in the muscle.
- B – The bubble is not expelled, and aspirating damages tissue and causes bruising.
- D – Massage causes bruising and bleeding at the site.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
24Question
A client who has arthritis of the hip and gets up slowly at night is prescribed hydrochlorothiazide once daily for hypertension. Which plan for taking the medication shows the best understanding?
- I will take it at bedtime so any dizziness happens while I sleep.
- I will take it in the evening with dinner so it works overnight.
- I will take it in the morning with my other daily medicines.
- I will take it only on days when my ankles are swollen.
Show the answer and explanation
Answer: C. I will take it in the morning with my other daily medicines.
Topic: timing of thiazide diuretics
A thiazide diuretic increases urine output for several hours after a dose. Taking it in the morning keeps the diuresis in daytime hours, protects sleep, and lowers the risk of nighttime falls. The drug must be taken every day to control blood pressure, not only when symptoms appear.
Why the others are wrong
- A – Taking it at bedtime would cause urination through the night and raise the risk of falling.
- B – An evening dose would still cause diuresis during the night.
- D – Hypertension has no symptoms; the drug must be taken daily and not by swelling.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
25Question
A nurse is teaching a client's sister how to use intranasal naloxone. A few minutes after the sister gives a dose, the client wakes up and begins breathing normally. What should the nurse tell the sister to do next?
- Stay with the client and call emergency services, since the opioid may outlast the naloxone.
- Let the client sleep it off, lying flat on the back, and check again in the morning.
- Give a second dose right away to make sure the opioid is fully reversed.
- No more help is needed as long as the client keeps breathing normally.
Show the answer and explanation
Answer: A. Stay with the client and call emergency services, since the opioid may outlast the naloxone.
Topic: naloxone and renarcotization
Naloxone works for a shorter time than many opioids, so respiratory depression can return after the antidote wears off. Emergency services should always be called, and the person should be watched closely until help arrives. A second dose is given only if the person does not respond.
Why the others are wrong
- B – Leaving the client alone and flat risks unnoticed re-sedation and airway loss.
- C – A second dose is for lack of response after a few minutes, not for a client who is already awake and breathing.
- D – Normal breathing right now does not protect against return of sedation when naloxone wears off.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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