76Question
A 6-year-old child has internal bleeding after a road accident. The provider states that a blood transfusion will be needed within the next few hours to save the child's life. The parents, who are Jehovah's Witnesses, refuse consent for blood on religious grounds. Which action by the nurse is most appropriate?
- Respect the refusal, as would be done for a competent adult who declines blood, and document it.
- Begin the transfusion when it is prescribed and inform the parents afterwards.
- Notify the provider and the nursing supervisor so that the facility can seek legal authorization to treat, and continue to support the parents.
- Tell the parents that they will be reported for neglect and lose custody unless they sign the consent.
Show the answer and explanation
Answer: C. Notify the provider and the nursing supervisor so that the facility can seek legal authorization to treat, and continue to support the parents.
Topic: refusal of blood for a minor
A competent adult may refuse blood for himself or herself, and the nurse's role is then to confirm that the decision is informed, respect it, and document it. Parents, however, cannot refuse life-saving treatment on behalf of a minor: the state's duty to protect the child allows a court to authorize treatment. The nurse follows the chain of command so the legal process can begin, while treating the parents with respect and without threats.
Why the others are wrong
- A – The adult rule does not transfer to a child; accepting the refusal would allow a preventable death of a minor.
- B – Transfusing against the parents' refusal without legal authorization or an immediate emergency exception exposes the nurse and deceives the family.
- D – Threats are coercive and destroy trust; the legal step is taken by the facility through proper channels, not used to force a signature.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
77Question
A nurse is caring for a client with a terminal illness. Which statements by the client suggest spiritual distress?
Select all that apply.
- 'Why would God let this happen to me? I have always tried to live a good life.'
- 'When I look back, I cannot see that my life has meant anything.'
- 'I have been praying more lately, and it gives me a sense of peace.'
- 'I must be being punished for something I did.'
- 'I cannot pray any more. I feel completely abandoned.'
- 'I lie awake wondering how my wife will manage the bills when I am gone.'
Show the answers and explanation
Answers: A, B, D and E.
- A – 'Why would God let this happen to me? I have always tried to live a good life.'
- B – 'When I look back, I cannot see that my life has meant anything.'
- D – 'I must be being punished for something I did.'
- E – 'I cannot pray any more. I feel completely abandoned.'
Topic: cues of spiritual distress
Spiritual distress is a disturbance in the beliefs and values that give a person meaning, hope and connection. Its cues include anger at or questioning of God, a sense of meaninglessness, feeling punished or guilty, inability to pray or take part in usual practices, and feeling abandoned. Finding comfort in prayer shows spiritual wellbeing, and concern about money is a real psychosocial need of a different kind.
Why the others are wrong
- C – Finding peace in prayer indicates effective spiritual coping, not distress.
- F – Worry about finances is a practical end-of-life concern suited to social work support; it does not show a disturbance of belief or meaning.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
78Question
A new admission has an indwelling urinary catheter placed in the hospital for urinary leakage. There is no retention or other documented indication. What is the nurse's best action?
- Leave it in place to keep the skin dry
- Ask the prescriber whether the catheter can be removed and begin a toileting program
- Change the catheter weekly
- Clamp the catheter and release it every four hours
Show the answer and explanation
Answer: B. Ask the prescriber whether the catheter can be removed and begin a toileting program
Topic: Catheter avoidance and CAUTI prevention
Long-term care regulations and infection control guidance limit indwelling catheters to clinical indications; incontinence alone is not one. Unneeded catheters raise the risk of urinary tract infection. The nurse asks for removal and offers alternative continence care.
Why the others are wrong
- A – Skin is better protected with toileting and barrier products, not a catheter.
- C – Routine changes do not address the lack of an indication.
- D – Clamping and releasing is outdated and does not prevent infection.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
79Question
A resident with dementia has cloudy, strong-smelling urine. There is no fever, no pain on urinating, no new frequency and mental status is at baseline. The family asks for an antibiotic. What is the nurse's best response?
- Request a urine culture and antibiotic because the urine smells
- Assess for fever, dysuria, new urgency or frequency, flank or suprapubic pain and change in condition, and explain that treatment is not usually needed without symptoms
- Encourage cranberry juice as a substitute for antibiotics
- Insert a catheter to obtain a clean specimen
Show the answer and explanation
Answer: B. Assess for fever, dysuria, new urgency or frequency, flank or suprapubic pain and change in condition, and explain that treatment is not usually needed without symptoms
Topic: UTI versus asymptomatic bacteriuria
Bacteria in the urine without symptoms (asymptomatic bacteriuria) is common in older adults and treatment does not help but causes harm and resistance. Evidence-based criteria require symptoms. The nurse assesses for symptoms and teaches the family.
Why the others are wrong
- A – Odor and cloudiness alone do not justify culture or treatment.
- C – Cranberry juice is not an established treatment.
- D – Catheterization risks infection and is not indicated.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
80Question
Three residents on one unit develop watery diarrhea within two days, and one has a positive Clostridioides difficile test. What should the nurse do first?
- Place symptomatic residents on contact precautions with soap-and-water hand hygiene and notify infection prevention
- Rely on alcohol-based hand rub after each contact
- Give an antimotility drug to each resident
- Wait for all test results before changing practice
Show the answer and explanation
Answer: A. Place symptomatic residents on contact precautions with soap-and-water hand hygiene and notify infection prevention
Topic: Clostridioides difficile outbreak
C. difficile spores are not killed by alcohol-based rub. Contact precautions, hand washing with soap and water, dedicated equipment, sporicidal cleaning and prompt notification of infection prevention limit spread.
Why the others are wrong
- B – Alcohol rub does not kill spores.
- C – Antimotility drugs are generally avoided and need an order.
- D – Waiting for results allows spread.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
81Question
A 58-year-old client with a long history of acid reflux tells the nurse, 'My stomach has been burning since this morning, but it feels heavier than my usual heartburn and my jaw aches.' Which question should the nurse ask next?
- What foods or drinks did you have in the hours before the burning started?
- Does it feel unlike your usual reflux, or spread to your arm or neck?
- Have you already taken your usual antacid or reflux medicine today?
- Does anyone in your family have a history of stomach cancer or ulcers?
Show the answer and explanation
Answer: B. Does it feel unlike your usual reflux, or spread to your arm or neck?
Topic: atypical cardiac pain
Cardiac ischemia can present as epigastric burning or jaw discomfort, especially in clients who already attribute symptoms to reflux. A change from the usual pattern plus radiation is a red flag, so the nurse explores quality and radiation before anything else.
Why the others are wrong
- A – Diet is relevant to reflux, but the description suggests possible cardiac pain, which has to be explored first.
- C – Treatment history can wait; it does not clarify whether this could be a cardiac event.
- D – Family history of gastric cancer is not the urgent question when the pain quality has changed and the jaw hurts.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
82Question
A 74-year-old client who had abdominal surgery years ago comes to the emergency department with cramping abdominal pain, repeated vomiting since yesterday and a visibly swollen abdomen. Which question should the nurse ask first?
- Have you had any burning or pain when you pass urine?
- Does anyone in your family have colon cancer?
- When did you last pass gas or have a bowel movement?
- Do you have trouble swallowing solid food or pills?
Show the answer and explanation
Answer: C. When did you last pass gas or have a bowel movement?
Topic: bowel obstruction screening question
Cramping pain, vomiting and distension in a client with previous abdominal surgery suggest a bowel obstruction. The most revealing question is when the client last passed stool or flatus, because obstruction stops both.
Why the others are wrong
- A – Urinary symptoms are worth asking about later, but they do not explain vomiting and distension.
- B – Family history matters over time but does not guide the immediate assessment.
- D – Dysphagia does not match the cramping, distension and prior surgery.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
83Question
A client reports episodes of dizziness for the first time. Using the first element of a symptom analysis, which question should the nurse ask?
- Does anyone in your family have inner ear disease?
- Have you been around loud noise at work?
- When did the dizziness begin, and what were you doing at the time?
- What medicines and supplements do you take each day?
Show the answer and explanation
Answer: C. When did the dizziness begin, and what were you doing at the time?
Topic: symptom analysis opening question
A symptom analysis begins with onset and circumstances: when it started, how suddenly, and what the client was doing. These facts frame later questions about location, duration, character, aggravating factors, relieving factors and severity.
Why the others are wrong
- A – Family history comes later in the history.
- B – Exposure history is a narrower question that follows a general description.
- D – Medication history is important but is not the starting point of the symptom analysis.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
84Question
A client says quietly, "I just can't go on like this anymore." Which response should the nurse use?
- "Things will look better tomorrow."
- "You are not thinking of doing anything silly, are you?"
- "Let's talk about something more pleasant."
- "Are you having thoughts of killing yourself?"
Show the answer and explanation
Answer: D. "Are you having thoughts of killing yourself?"
Topic: asking about suicide
Asking directly and calmly about suicide does not plant the idea and opens the door for a risk assessment. Vague, leading or reassuring questions block disclosure.
Why the others are wrong
- A – Premature reassurance dismisses the feeling.
- B – A leading question invites a no.
- C – Changing the subject avoids the risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
85Question
The nurse helps a client with depression and recent suicidal thoughts write a safety plan before discharge. Which elements belong in the plan?
Select all that apply.
- Personal warning signs that a crisis is building
- Coping strategies the client can use alone
- A signed promise not to harm oneself
- Contacts for professionals and a crisis line
- Steps to limit access to lethal means at home
Show the answers and explanation
Answers: A, B, D and E.
- A – Personal warning signs that a crisis is building
- B – Coping strategies the client can use alone
- D – Contacts for professionals and a crisis line
- E – Steps to limit access to lethal means at home
Topic: safety planning
A safety plan is a written, collaborative list of warning signs, coping strategies, people and places for support, professional and crisis contacts, and steps to make the environment safer. A no-suicide contract is not evidence-based protection.
Why the others are wrong
- C – No-harm contracts do not prevent suicide and can give staff false reassurance.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
86Question
A 16-year-old is brought to the unit with fresh superficial cuts on the forearms and says, "Cutting makes the bad feelings go away." Which action is the priority?
- Remove privileges to discourage the behavior
- Treat the wounds, then calmly assess for suicidal thoughts without judgment
- Ask the teenager to sign a contract promising not to cut
- Tell the teenager that cutting is only attention seeking
Show the answer and explanation
Answer: B. Treat the wounds, then calmly assess for suicidal thoughts without judgment
Topic: adolescent non-suicidal self-injury
Non-suicidal self-injury is often used to regulate overwhelming emotion, but it also raises later suicide risk. The nurse attends to injuries, remains non-judgmental, and assesses suicidal intent and safety.
Why the others are wrong
- A – Punishment promotes secrecy and shame.
- C – Contracts do not provide safety.
- D – Labeling the behavior as attention seeking is inaccurate and harmful.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
87Question
A home health nurse visits an older client with moderate dementia who is cared for by a daughter. Which statements by the daughter indicate caregiver role strain that needs intervention?
Select all that apply.
- 'I have cancelled my own doctor's appointments twice, and I have not seen my friends in months.'
- 'I have been asking around about adult day programs for her.'
- 'I use a pill organizer and a wall calendar to keep track of her medications.'
- 'Sometimes I get so angry that I shout at her, and then I feel terrible about myself.'
- 'It makes me sad to see her change. My sister and I talk about it most weeks.'
Show the answers and explanation
Answers: A and D.
- A – 'I have cancelled my own doctor's appointments twice, and I have not seen my friends in months.'
- D – 'Sometimes I get so angry that I shout at her, and then I feel terrible about myself.'
Topic: caregiver role strain
Caregiver role strain shows as neglect of the caregiver's own health, social isolation, exhaustion, and anger or resentment followed by guilt. Seeking resources, using organizing aids, and sharing expected sadness with a supportive relative are signs of effective coping. Recognized strain calls for respite, support services and attention to the caregiver's own health, and it is also a risk factor for mistreatment of the care recipient.
Why the others are wrong
- B – Looking into day programs is active problem solving and help seeking, a sign of healthy coping.
- C – Using aids to organize medications shows the caregiver is managing the task effectively.
- E – Sadness at a parent's decline is expected, and talking regularly with a sister shows a support system in use.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
88Question
A newly licensed nurse privately tells a colleague that a senior nurse regularly belittles her in front of others and that she dreads each shift. What is the best initial response by the colleague?
- Listen without interrupting and acknowledge how upsetting this must be
- Advise her to ignore the behavior until it stops by itself
- Report the senior nurse to the nurse manager right away without telling the colleague first
- Suggest she confront the senior nurse in front of the team
Show the answer and explanation
Answer: A. Listen without interrupting and acknowledge how upsetting this must be
Topic: supporting a colleague who is bullied
The first step when a co-worker discloses mistreatment is to listen, believe and support the person, which respects her autonomy and builds trust. Options for reporting, documenting and using unit or organizational policy can then be explored together. Workplace bullying undermines a culture of safety and should not be ignored.
Why the others are wrong
- B – Ignoring bullying does not stop it and tells the colleague her concern is unimportant.
- C – Going to the manager without her knowledge takes the decision away from her and may break her trust; reporting is explored with her consent.
- D – A public confrontation can escalate the conflict and expose her to more harm.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
89Question
A client recovering from a mastectomy has many visitors but tells the nurse, 'No one understands how frightened I am.' Which nurse action best reflects what makes social support helpful?
- Encourage more visitors to widen the support network
- Explore the kind of support the client needs and connect her with a source that offers it, such as a trained peer survivor volunteer
- Tell her that a large number of visitors is the best predictor of good coping
- Limit visits to one person so she is not overwhelmed
Show the answer and explanation
Answer: B. Explore the kind of support the client needs and connect her with a source that offers it, such as a trained peer survivor volunteer
Topic: matching social support to need
Social support is protective when it fits the person's need and when the person can use it. A crowded room can still leave a person unsupported; emotional understanding from someone who has had a similar experience may match her need.
Why the others are wrong
- A – More visitors add quantity but not the understanding the client needs.
- C – Support quantity does not predict coping; fit does.
- D – Limiting visits does not address the unmet emotional need.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
90Question
A client admitted with three days of vomiting and diarrhea says they feel lightheaded each time they stand up. Which assessment best evaluates for fluid volume depletion?
- Apical pulse counted for a full minute with the client supine
- Orthostatic vital signs
- Temperature and respirations repeated every 15 minutes
- Blood pressure in both arms with the client seated
Show the answer and explanation
Answer: B. Orthostatic vital signs
Topic: orthostatic vital signs
Lightheadedness on standing with fluid loss points to orthostatic hypotension. Blood pressure and pulse are measured lying, then sitting, then standing, allowing time between positions; a drop in systolic pressure or a rise in pulse supports volume depletion.
Why the others are wrong
- A – A supine apical rate alone cannot show how the cardiovascular system responds to standing.
- C – Temperature and respirations do not measure the response to a change in position.
- D – A seated reading in both arms checks for arm differences, not for postural change.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
91Question
A nurse records the following findings for a 45-year-old client at a clinic visit. Which readings are within expected adult limits?
Select all that apply.
- Pulse 72 beats/min, regular
- Respirations 26 breaths/min
- Oral temperature 98.4 F (36.9 C)
- Blood pressure 152/96 mm Hg
- Oxygen saturation 97% on room air
Show the answers and explanation
Answers: A, C and E.
- A – Pulse 72 beats/min, regular
- C – Oral temperature 98.4 F (36.9 C)
- E – Oxygen saturation 97% on room air
Topic: interpreting adult vital signs
A resting adult pulse of 60 to 100 with a regular rhythm, a temperature near 98.6 F, and saturation of 95% or higher are expected. Respirations above 20 per minute are tachypnea in an adult, and 152/96 is a hypertensive reading that needs rechecking and follow-up.
Why the others are wrong
- B – 26 breaths/min is tachypnea; the usual adult range is 12 to 20.
- D – 152/96 mm Hg is elevated and should be rechecked and reported.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
92Question
A client pulled from cold water 20 minutes ago is shivering, alert, and speaking in full sentences with a respiratory rate of 16. A fingertip pulse oximeter reads 82% with a weak waveform, and the fingers are cold and pale. What should the nurse do first?
- Reapply the sensor to a well-perfused site such as the earlobe or forehead and continue warming
- Accept the reading and prepare the client for intubation
- Immerse the hands in hot water to restore the signal
- Wait until the core temperature is normal before checking oxygenation again
Show the answer and explanation
Answer: A. Reapply the sensor to a well-perfused site such as the earlobe or forehead and continue warming
Topic: pulse oximetry in hypothermia
Cold, poorly perfused fingers give an unreliable fingertip reading, and a weak waveform is a clue. The nurse verifies on a better-perfused site while continuing to warm the client gently. If the client shows distress or the corrected value is still low, the nurse treats hypoxemia without delay.
Why the others are wrong
- B – Intubation would not be justified by an unverified number in an alert client.
- C – Hot water burns cold, numb skin and rapid rewarming is unsafe.
- D – Oxygenation must be checked now; waiting for normal temperature could miss true hypoxemia.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
93Question
A client with a specific phobia of elevators begins graded exposure therapy. Which client statement shows the plan is understood?
- "I will avoid elevators until the fear goes away by itself."
- "I will take my antianxiety pill before every ride so I never feel scared."
- "First we will find the childhood event that caused this fear, then I can ride."
- "I will face elevators in small steps while using relaxation until the fear settles."
Show the answer and explanation
Answer: D. "I will face elevators in small steps while using relaxation until the fear settles."
Topic: phobia graded exposure evaluation
Graded exposure, a form of behavior therapy, pairs stepwise contact with the feared object with relaxation skills so anxiety decreases with repeated exposure. Avoidance keeps the phobia alive.
Why the others are wrong
- A – Avoidance reinforces the phobia.
- B – Relying on a drug before each exposure prevents learning that anxiety falls on its own.
- C – Behavior therapy does not require finding the origin first.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
94Question
A client with obsessive-compulsive disorder washes the hands for two hours each morning, has red cracked skin, and misses the morning group. Which approach is best?
- Allow time for the ritual at first, protect the skin, and follow the team plan to reduce ritual time gradually
- Remove the soap so the client cannot wash
- Reassure the client that the hands are already clean
- Insist the client leave the room for group in five minutes or lose privileges
Show the answer and explanation
Answer: A. Allow time for the ritual at first, protect the skin, and follow the team plan to reduce ritual time gradually
Topic: OCD ritual approach
Compulsions relieve intense anxiety. Abrupt prevention increases anxiety and worsens the behavior, so the nurse allows the ritual initially, provides skin care, and works toward gradual limits within the treatment plan.
Why the others are wrong
- B – Forbidding the ritual abruptly sharply raises anxiety and may lead to hidden ritual or aggression.
- C – Logical reassurance does not stop a compulsion and can become part of the ritual.
- D – Punishing the behavior does not address anxiety and damages trust.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
95Question
A client with multiple left rib fractures has a segment of chest wall that moves inward on inspiration and outward on expiration. SpO2 is 90% on room air. Which nursing action is the priority?
- Wrap the chest wall tightly with an elastic binder
- Give oxygen, provide prescribed pain control and monitor respiratory effort for fatigue
- Place the client flat to relieve pressure on the ribs
- Withhold analgesics to avoid respiratory depression
Show the answer and explanation
Answer: B. Give oxygen, provide prescribed pain control and monitor respiratory effort for fatigue
Topic: flail chest
A flail segment causes pain, poor ventilation and often underlying lung contusion. Oxygen and effective analgesia allow deep breathing, and the nurse watches for tiring that signals need for ventilatory support.
Why the others are wrong
- A – Tight binding restricts chest expansion and increases atelectasis and hypoxia.
- C – Lying flat reduces lung expansion; upright positioning is preferred if the spine is cleared.
- D – Untreated pain causes shallow breathing; analgesia is needed with monitoring.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
96Question
A client with a hemothorax has had a chest tube placed. Over the past hour the drainage has stayed bright red and high in volume, and the client is becoming pale with a falling blood pressure. What should the nurse do first?
- Clamp the chest tube to slow the loss
- Milk the tubing to prevent clots from blocking it
- Notify the provider immediately and prepare for blood replacement and possible surgery
- Lower the collection system to the floor and recheck in an hour
Show the answer and explanation
Answer: C. Notify the provider immediately and prepare for blood replacement and possible surgery
Topic: hemothorax
Continuing heavy bright red drainage with signs of shock suggests ongoing hemorrhage, which usually requires surgical control and blood replacement. The provider must be told at once.
Why the others are wrong
- A – Clamping can lead to tension pneumothorax and does not stop bleeding.
- B – Milking tubing is not a response to bleeding and can increase pressure and damage tissue.
- D – Waiting an hour delays life-saving treatment.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
97Question
The nurse teaches the parents of a child newly prescribed a once-daily extended-release stimulant for ADHD. Which instructions are correct?
Select all that apply.
- Give the dose in the morning
- Track height, weight and appetite regularly
- Crush the capsule if swallowing is difficult
- Give an extra evening dose when homework is hard
- Report chest pain, palpitations or fainting
- Stop the drug suddenly whenever grades improve
Show the answers and explanation
Answers: A, B and E.
- A – Give the dose in the morning
- B – Track height, weight and appetite regularly
- E – Report chest pain, palpitations or fainting
Topic: ADHD stimulant teaching
Stimulants given in the morning limit insomnia; they can suppress appetite and growth, and rare cardiovascular effects need reporting. Extended-release products should not be crushed, extra doses are not self-directed, and changes are made with the prescriber.
Why the others are wrong
- C – Crushing releases the extended-release dose at once and risks overdose effects.
- D – A late dose causes insomnia, and extra doses are not parent-directed.
- F – Stopping because grades improve is the prescriber's decision, not the family's.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
98Question
A 9-year-old with autism spectrum disorder is admitted. After the room is changed and meal time moves, the child covers the ears and rocks, distressed. What is the best nursing approach?
- Provide a predictable routine, a visual schedule, advance notice of changes and a quiet low-stimulus space
- Make firm eye contact and speak loudly to gain attention
- Require group meals to improve social skills
- Remove the comfort object so the child focuses on staff
Show the answer and explanation
Answer: A. Provide a predictable routine, a visual schedule, advance notice of changes and a quiet low-stimulus space
Topic: autism spectrum approach
Children with autism spectrum disorder rely on predictability and may be overwhelmed by sensory input. Routines, visual supports, preparation for change and reduced stimulation lower distress.
Why the others are wrong
- B – Eye contact and loud speech can be overwhelming.
- C – Forcing group meals during distress adds stress; social goals come later.
- D – Comfort objects help self-regulation and should not be removed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
99Question
A nurse is palpating the abdomen of a client who was physically assaulted last week. The client suddenly tenses, pulls away and begins to breathe rapidly. Which response best reflects a trauma-informed approach?
- Pause, explain what is being done and why, and ask if the client wishes to continue
- Complete the remaining quadrants quickly so the discomfort ends sooner
- Continue to palpate lightly while reassuring the client that there is nothing to be afraid of
- Tell the client that the examination is needed for the plan of care and finish the remaining areas
Show the answer and explanation
Answer: A. Pause, explain what is being done and why, and ask if the client wishes to continue
Topic: trauma-informed palpation
Trauma-informed care rests on safety, trust, choice and collaboration. When a client reacts, the nurse stops, explains the purpose of touch in plain terms and returns control to the client by asking about continuing, rather than pushing ahead.
Why the others are wrong
- B – Speed does not restore control; it can feel like a repeat of being overpowered.
- C – Continuing after a withdrawal removes the client's control and dismisses the reaction.
- D – Stressing necessity pressures the client and ignores the need for choice and consent.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
100Question
A nurse is preparing a client for a pelvic examination. The client has disclosed a history of sexual abuse. Which actions reflect a trauma-informed approach?
Select all that apply.
- Offer the client the choice of having a support person present
- Agree on a signal the client can use to stop the examination
- Keep the client draped and expose only the area being examined
- Explain each step before it is done
- Ask the client to describe the details of the abuse before starting
- Begin promptly and avoid conversation so the client has less time to feel anxious
Show the answers and explanation
Answers: A, B, C and D.
- A – Offer the client the choice of having a support person present
- B – Agree on a signal the client can use to stop the examination
- C – Keep the client draped and expose only the area being examined
- D – Explain each step before it is done
Topic: trauma-informed pelvic examination
Trauma-informed care emphasizes safety, predictability, choice and control. Explaining steps, agreeing on a stop signal, offering a support person and limiting exposure all give the client control and reduce the risk of retraumatization.
Why the others are wrong
- E – Pressing for details can retraumatize the client and is not needed for the examination.
- F – Silence and speed take away predictability and choice.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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