26Question
A teenager with chronic kidney disease and hypertension plans to pack lunches for school. The nurse has taught the family about limiting sodium. Which lunch indicates that further teaching is needed?
- Rice bowl with roasted vegetables and herbs
- Instant noodle cup with the full seasoning packet
- Turkey wrap made with fresh roasted turkey, lettuce, and cucumber
- Pasta salad with olive oil and fresh vegetables
Show the answer and explanation
Answer: B. Instant noodle cup with the full seasoning packet
Topic: low-sodium diet in chronic kidney disease
Instant noodle cups and their seasoning packets are extremely high in sodium. Sodium holds water, raises blood pressure, and adds work for damaged kidneys. Fresh foods seasoned with herbs and oil keep sodium low.
Why the others are wrong
- A – Rice and roasted vegetables seasoned with herbs are low in sodium.
- C – Freshly roasted turkey with vegetables is low in sodium, unlike processed deli meat.
- D – Pasta with olive oil and fresh vegetables contains very little sodium.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
27Question
A client who recently moved inland has hypothyroidism that the provider attributes to low dietary iodine. The client eats little seafood. Which food should the nurse suggest as a natural source of iodine?
- Roasted chicken breast
- Steamed brown rice
- Fresh apple slices
- Baked cod or haddock
Show the answer and explanation
Answer: D. Baked cod or haddock
Topic: dietary sources of iodine
Ocean fish such as cod and haddock are among the richest natural sources of iodine. Dairy products, eggs, and iodized salt also contribute. Chicken, rice, and apples contain little iodine.
Why the others are wrong
- A – Chicken breast supplies protein but little iodine.
- B – Brown rice supplies carbohydrate and fiber and has little iodine.
- C – Apples supply fiber and vitamin C, not iodine.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
28Question
A client with COPD who has had three exacerbations this year reviews a 24-hour diet recall with the nurse. The nurse explains that diets high in saturated fat are linked with more airway inflammation. Which item from the recall should the nurse suggest cutting down on first?
- Fried sausage and a full-fat cheese omelet at breakfast
- Oatmeal with sliced pears
- Baked fish with steamed vegetables
- Whole-grain toast with a small amount of olive oil
Show the answer and explanation
Answer: A. Fried sausage and a full-fat cheese omelet at breakfast
Topic: saturated fat and airway inflammation in COPD
Fried sausage and full-fat cheese are rich in saturated fat, which is associated with worse airway inflammation and lung function in COPD. The other meals are built around whole grains, fruit, fish, vegetables, and unsaturated fat, which fit a pattern that is better for the lungs.
Why the others are wrong
- B – Oatmeal and pears provide fiber and are low in saturated fat.
- C – Baked fish and vegetables are low in saturated fat and provide healthy fats.
- D – A small amount of olive oil is an unsaturated fat and a better choice than animal fats.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
29Question
A 2-year-old has had repeated respiratory infections and a scrape that is slow to heal. The parent says the child refuses meat, avoids dairy products because of stomach upset, and eats mostly pasta, white bread, and fruit. Which micronutrient deficiency should the nurse suspect?
- Vitamin C
- Vitamin K
- Iodine
- Zinc
Show the answer and explanation
Answer: D. Zinc
Topic: zinc deficiency in toddlers
Zinc supports immune function and wound healing, and its best sources are meat, shellfish, dairy, and legumes. A child who avoids meat and dairy and eats refined grains is at risk of deficiency, which shows as frequent infections and delayed healing. Fruit in the diet supplies vitamin C, making that deficiency less likely.
Why the others are wrong
- A – Vitamin C is found in fruit, which the child eats, so deficiency is less likely.
- B – Vitamin K deficiency causes bleeding problems, which are not described.
- C – Iodine deficiency affects the thyroid and growth, not infection and healing.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
30Question
A 58-year-old client at a clinic reports intermittent palpitations and light-headedness. Vital signs are stable and the client has no chest pain. Which test is the provider most likely to order first to look for a rhythm problem?
- Coronary angiography through a femoral artery catheter
- 12-lead electrocardiogram
- Transesophageal echocardiogram with sedation
- Cardiac magnetic resonance imaging of the chest
Show the answer and explanation
Answer: B. 12-lead electrocardiogram
Topic: first test for palpitations
A 12-lead tracing is quick, painless and noninvasive, and it records the heart's electrical activity, so it is the usual first test for palpitations and light-headedness. It can show arrhythmias, conduction delays and signs of old or evolving injury.
Why the others are wrong
- A – Invasive, and reserved for when noninvasive testing points to blocked coronary arteries.
- C – Invasive, used to look for clots or valve problems after a rhythm or structural problem is already suspected.
- D – Shows detailed structure and scar, but it does not record a rhythm and is not a first-line test for palpitations.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
31Question
A client recently found to have atrial fibrillation tells the nurse about drinking four or five energy drinks every day to stay alert at work. Which instruction should the nurse give?
- Switch to the sugar-free versions, because the sugar is what triggers the fast rhythm.
- Keep drinking them as long as your pulse stays below 100 beats per minute afterward.
- Stop the energy drinks; stimulants can set off fast rhythm episodes.
- Drink them only on an empty stomach so the caffeine is absorbed and cleared more quickly.
Show the answer and explanation
Answer: C. Stop the energy drinks; stimulants can set off fast rhythm episodes.
Topic: triggers of atrial fibrillation
Caffeine and other stimulants in energy drinks can provoke or worsen episodes of rapid atrial rhythm, so a client with atrial fibrillation is taught to cut them out. Teaching should also cover other common triggers such as heavy alcohol use and stimulant decongestants.
Why the others are wrong
- A – Sugar-free versions usually still contain caffeine and other stimulants, which are the trigger.
- B – A normal pulse after the drink does not make stimulant intake safe; the trigger itself should be avoided.
- D – Absorption timing does not remove the stimulant effect on the atria.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
32Question
A client with chronic kidney disease who missed two dialysis sessions reports generalized weakness. The monitor shows tall, peaked T waves and a widening QRS. Which prescription should the nurse expect for immediate protection of the heart?
- Intravenous calcium gluconate
- Intravenous potassium phosphate
- Intravenous digoxin
- Oral potassium chloride with a meal
Show the answer and explanation
Answer: A. Intravenous calcium gluconate
Topic: ECG changes and potassium
Tall, peaked T waves with a widening QRS in a client who missed dialysis indicate hyperkalemia. Intravenous calcium gluconate stabilizes the cardiac cell membrane within minutes, buying time for treatments that lower the potassium level.
Why the others are wrong
- B – Would raise potassium and worsen the rhythm.
- C – Digoxin is risky in hyperkalemia and does nothing to protect the membrane.
- D – Potassium is already dangerously high; giving more could cause cardiac arrest.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
33Question
A client with an elevated LDL cholesterol level is learning to change eating habits. Which client statement shows understanding of the teaching?
- I'll fry my food in coconut oil, because it comes from a plant.
- I'll have grilled liver a few times a week because it is a lean meat.
- I'll choose full-fat cheese for protein now that I'm eating less meat.
- I'll add lentils and beans to my soups in place of bacon.
Show the answer and explanation
Answer: D. I'll add lentils and beans to my soups in place of bacon.
Topic: diet for high LDL
Lentils and beans supply soluble fiber and plant protein, and replacing a high-saturated-fat food such as bacon with them lowers LDL cholesterol. Plant oils that are high in saturated fat, organ meats and full-fat dairy work against that goal.
Why the others are wrong
- A – Coconut oil is high in saturated fat, which raises LDL cholesterol.
- B – Organ meats are high in dietary cholesterol and are not a heart-healthy daily choice.
- C – Full-fat cheese adds saturated fat and works against lowering LDL.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
34Question
An older client admitted with fatigue says clothes have become loose. The nurse is screening for nutrition problems. Which question should the nurse ask first?
- How has your weight changed over the last few months, and how well have you been eating?
- Who usually does the grocery shopping in your home?
- Do you take a daily multivitamin or other supplement?
- Do you enjoy cooking for yourself at home?
Show the answer and explanation
Answer: A. How has your weight changed over the last few months, and how well have you been eating?
Topic: nutrition screening interview
Unintended weight change and reduced intake are the most direct cues to a person's current nutritional status, so they come first in a screen. Details about shopping, cooking and supplements follow once a problem is confirmed.
Why the others are wrong
- B – Useful later for planning, but it does not show whether nutrition is already compromised.
- C – Helpful for the full history, but not the most direct indicator of current nutritional status.
- D – A preference question that does not measure intake or weight change.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
35Question
A client with Cushing syndrome has peripheral edema, a fasting glucose of 168 mg/dL and reduced bone density. Which meal plan should the nurse expect to be appropriate?
- Low in protein and high in sodium to replace what is being lost in the urine
- Low in potassium and high in simple sugars for quick energy
- High in protein and calcium, low in sodium and simple sugars
- High in fat with fluids restricted to treat the edema
Show the answer and explanation
Answer: C. High in protein and calcium, low in sodium and simple sugars
Topic: diet in Cushing syndrome
Excess cortisol causes sodium and fluid retention, hyperglycemia, protein breakdown and bone loss. The diet therefore limits sodium and simple sugars and provides generous protein, calcium and vitamin D, with potassium-rich foods as needed.
Why the others are wrong
- A – Excess cortisol breaks down protein and causes sodium retention; sodium should be limited, not added.
- B – Cortisol excess lowers potassium and raises glucose, so this plan worsens both.
- D – A high-fat diet and fluid restriction do not address the glucose, bone or protein problems.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
36Question
A nurse teaches a client with vitamin D deficiency about diet and sun exposure. Which statement by the client shows the need for further teaching?
- Sitting by a closed sunny window every day will give me enough vitamin D.
- I'll eat canned salmon or mackerel a couple of times a week.
- Fortified milk and cereal can add to what I get from food.
- I'll ask my provider about the dose before starting a supplement.
Show the answer and explanation
Answer: A. Sitting by a closed sunny window every day will give me enough vitamin D.
Topic: vitamin D sources
Glass blocks the ultraviolet B rays that let skin make vitamin D, so sitting behind a closed window does not correct a deficiency. Fatty fish, fortified foods and a provider-guided supplement are all appropriate.
Why the others are wrong
- B – Correct; fatty fish are among the best food sources.
- C – Correct; fortified foods are a practical source.
- D – Correct; the dose is individualized to the level and cause.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
37Question
A client with Crohn disease and fat malabsorption reports trouble seeing in dim light and dry, irritated eyes. Which deficiency should the nurse suspect?
- Vitamin A
- Vitamin B12
- Vitamin K
- Thiamine
Show the answer and explanation
Answer: A. Vitamin A
Topic: vitamin A deficiency
Vitamin A is fat soluble and is needed for the retina and for moist eye surfaces. Fat malabsorption lowers its absorption, and the early signs are poor vision in dim light and dry eyes.
Why the others are wrong
- B – Causes numbness, a sore smooth tongue and anemia rather than night vision loss.
- C – Causes easy bruising and bleeding, not visual changes.
- D – Causes neuropathy, confusion or heart failure, not night blindness.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
38Question
A 16-year-old who follows a very restrictive diet has thinning hair, muscle wasting, slow healing of a scrape and pitting edema of both ankles. Which deficiency does the nurse suspect?
- Vitamin C
- Iron
- Vitamin A
- Protein
Show the answer and explanation
Answer: D. Protein
Topic: protein deficiency signs
Inadequate protein leads to muscle wasting, hair thinning and delayed wound healing. Low blood protein also lowers oncotic pressure, so fluid leaks into tissues and causes edema.
Why the others are wrong
- A – Typically shows as bleeding gums, easy bruising and corkscrew hairs.
- B – Typically shows as pallor, fatigue and spoon-shaped nails without muscle wasting and edema.
- C – Typically shows as night blindness and dry eyes.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
39Question
A nurse is performing an abdominal assessment on a client with nausea and abdominal pain. In which order should the nurse proceed?
- Inspect, palpate, percuss, and finally auscultate the abdomen
- Inspect, auscultate, percuss, then palpate
- Auscultate, inspect, palpate, then percuss
- Palpate, inspect, auscultate, then percuss
Show the answer and explanation
Answer: B. Inspect, auscultate, percuss, then palpate
Topic: abdominal assessment sequence
The abdomen is the exception to the usual inspect, palpate, percuss, auscultate sequence: the nurse auscultates before percussing and palpating because touching the abdomen can change bowel activity. Painful areas are examined last.
Why the others are wrong
- A – Palpating before listening can stimulate the bowel and change the bowel sounds.
- C – Inspection comes first; and palpation should be last.
- D – Palpation first can cause pain, guarding and altered sounds.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
40Question
A client with iron-deficiency anemia becomes short of breath and dizzy after walking to the bathroom. The nurse has already addressed gas exchange. Which additional nursing diagnosis is best supported by these cues?
- Risk for fluid volume excess related to sodium retention
- Impaired swallowing related to muscle weakness
- Activity intolerance related to reduced oxygen-carrying capacity
- Acute confusion related to an electrolyte imbalance and dehydration
Show the answer and explanation
Answer: C. Activity intolerance related to reduced oxygen-carrying capacity
Topic: nursing diagnosis in anemia
Fewer red cells carry less oxygen, so ordinary activity outstrips oxygen supply and causes breathlessness and dizziness. Activity intolerance is the diagnosis that reflects this supply-and-demand imbalance and guides pacing of activity and rest.
Why the others are wrong
- A – No cues suggest fluid overload.
- B – The client has no swallowing problem.
- D – The client is dizzy, not confused, and no electrolyte problem is described.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
41Question
A client has bleeding gums, tiny hemorrhages around hair follicles and slow wound healing. The diet history shows tea, toast and canned soup with almost no produce. Which addition should the nurse suggest first?
- Fresh strawberries and orange sections at breakfast
- Cheddar cheese slices and a glass of whole milk with the toast
- Whole milk with fortified cereal
- A roasted chicken thigh at dinner
Show the answer and explanation
Answer: A. Fresh strawberries and orange sections at breakfast
Topic: dietary sources of vitamin C
Bleeding gums, perifollicular hemorrhages and poor healing are classic signs of scurvy, a vitamin C deficiency. Fresh citrus fruit and berries are rich sources and are the most direct dietary correction.
Why the others are wrong
- B – Adds calcium and protein but almost no vitamin C.
- C – Provides calcium and some vitamins, but little vitamin C.
- D – Adds protein but little vitamin C.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
42Question
A nurse checks skin turgor to assess hydration in an 82-year-old client who has had vomiting for two days. Which site gives the most reliable result?
- The skin on the back of the hand or the top of the foot
- The skin on the forearm
- The skin over the sternum or forehead
- The skin over the abdomen
Show the answer and explanation
Answer: C. The skin over the sternum or forehead
Topic: skin turgor in older adults
Skin elasticity declines with age, so turgor on the hand or forearm is slow to recoil even in a well-hydrated older adult. The sternum and forehead keep their elasticity longer, so they give a more reliable picture of fluid status.
Why the others are wrong
- A – Elasticity there is lost with normal aging, so tenting can occur even when hydrated.
- B – Age-related loss of elasticity makes this site unreliable in older adults.
- D – Better suited to children; abdominal skin is affected by fat and stretch marks in adults.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
43Question
A client who takes warfarin for atrial fibrillation says, "I want to start a pineapple-enzyme supplement called bromelain for my swollen knee." Which response is best?
- “Natural supplements are safe to combine with any prescription medicine.”
- “Take the supplement 12 hours apart from your warfarin so they do not interact.”
- “Stop the warfarin on the days you take the supplement.”
- “Please check with your provider first; bromelain can add to the bleeding risk from warfarin.”
Show the answer and explanation
Answer: D. “Please check with your provider first; bromelain can add to the bleeding risk from warfarin.”
Topic: bromelain and anticoagulants
Bromelain can slow platelet function and may increase bleeding risk when taken with anticoagulants. The client should discuss any supplement with the provider or pharmacist before starting.
Why the others are wrong
- A – Natural products can interact with prescription drugs; this is false reassurance.
- B – Spacing the doses does not prevent the additive effect on bleeding.
- C – Stopping an anticoagulant without a provider's order puts the client at risk for stroke.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
44Question
A client with long-standing chronic obstructive pulmonary disease is admitted. Which nail finding does the nurse associate with chronic hypoxemia?
- Bulbous fingertips with a flattened angle at the nail base
- Concave, spoon-shaped nails
- Transverse grooves across the nail plate
- Pink nail beds with capillary refill under 2 seconds and a smooth surface
Show the answer and explanation
Answer: A. Bulbous fingertips with a flattened angle at the nail base
Topic: digital clubbing
In digital clubbing the nail base angle flattens to 180 degrees or more and the fingertip becomes bulbous. It develops with chronic hypoxemia and conditions such as lung cancer or cystic fibrosis.
Why the others are wrong
- B – Associated with iron-deficiency anemia.
- C – Beau lines follow a severe illness, chemotherapy or injury.
- D – A normal finding that does not suggest hypoxemia.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
45Question
A 74-year-old who takes metformin and eats mostly tea and toast reports six months of worsening forgetfulness. Before dementia is assumed, which laboratory tests does the nurse expect the provider to order?
- Serum amylase and lipase
- Prothrombin time and international normalized ratio
- Erythrocyte sedimentation rate and uric acid
- Vitamin B12 level and thyroid-stimulating hormone
Show the answer and explanation
Answer: D. Vitamin B12 level and thyroid-stimulating hormone
Topic: reversible causes of cognitive decline
Low vitamin B12 and thyroid disease are common reversible causes of cognitive decline. Metformin and a limited diet both raise the chance of B12 deficiency, so these tests come before a dementia label is applied.
Why the others are wrong
- A – Used for pancreatic problems, not for reversible causes of memory loss.
- B – Measure clotting and are not related to memory change.
- C – Used for inflammation and gout, not for reversible cognitive decline.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
46Question
A 60-year-old man asks how much alpha-linolenic acid, the plant omega-3 fat, he needs each day. Which adequate intake does the nurse give for adult men?
- 0.16 g
- 1.6 g
- 6.0 g
- 16 g
Show the answer and explanation
Answer: B. 1.6 g
Topic: adequate intake of ALA
The adequate intake of alpha-linolenic acid is 1.6 g per day for adult men and 1.1 g per day for adult women. Common sources include flaxseed, walnuts and canola oil.
Why the others are wrong
- A – Ten times too low.
- C – Several times higher than the adequate intake.
- D – Ten times higher than the adequate intake.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
47Question
The wife of a client with Alzheimer disease asks the nurse what is happening in her husband's brain. Which response is best?
- “Clumps of abnormal protein and twisted fibers build up and damage nerve cells.”
- “Blood clots are blocking the vessels and starving the brain.”
- “A slow virus is destroying the brain tissue.”
- “This is normal aging and nothing is physically wrong.”
Show the answer and explanation
Answer: A. “Clumps of abnormal protein and twisted fibers build up and damage nerve cells.”
Topic: explaining Alzheimer pathology to family
Alzheimer disease features beta-amyloid plaques and twisted tau fibers (neurofibrillary tangles) that damage and kill neurons. A short, accurate, plain-language explanation supports the family.
Why the others are wrong
- B – Describes a vascular cause, not the changes of Alzheimer disease.
- C – Alzheimer disease is not caused by a virus.
- D – Alzheimer disease is a disease process, not normal aging; this dismisses the family's concern.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
48Question
A client with suspected Alzheimer disease is scheduled for a fluorodeoxyglucose positron emission tomography scan. Which instruction should the nurse give?
- Avoid food and sugary drinks for several hours before the scan; plain water is allowed.
- Eat a large carbohydrate breakfast so the tracer can reach the brain.
- Walk briskly for an hour before the scan to improve tracer uptake.
- Stop all fluids, including water, for 12 hours beforehand.
Show the answer and explanation
Answer: A. Avoid food and sugary drinks for several hours before the scan; plain water is allowed.
Topic: preparation for positron emission tomography
The tracer behaves like glucose, so food and sugary drinks in the hours before the scan would compete with it and reduce image quality. Water is allowed, and clients with diabetes need individual instruction about glucose control.
Why the others are wrong
- B – A high blood sugar competes with the glucose tracer and lowers image quality.
- C – Exercise changes muscle uptake and is avoided before the test.
- D – Water is allowed and encouraged; unnecessary fluid restriction risks dehydration.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
49Question
Two days after a stroke, a client coughs while swallowing sips of water during a bedside swallow screen. Which action should the nurse take next?
- Offer thickened liquids until the swallowing problem resolves.
- Feed a pureed diet slowly while the bed is kept flat.
- Keep the client from eating or drinking, including oral medications, and request a swallowing evaluation.
- Request total parenteral nutrition to begin today.
Show the answer and explanation
Answer: C. Keep the client from eating or drinking, including oral medications, and request a swallowing evaluation.
Topic: dysphagia after stroke
Coughing with swallowing signals aspiration risk. The client stays NPO, including oral medications, until a speech-language pathologist evaluates swallowing, and enteral feeding is considered if the problem lasts.
Why the others are wrong
- A – Diet changes are chosen after a formal evaluation, not before it.
- B – Feeding a client who failed the screen risks aspiration, and a flat position makes it worse.
- D – Enteral routes are preferred if the gut works, and nutrition support is planned after the evaluation.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
50Question
A client with early Alzheimer disease asks about an eating pattern linked to slower cognitive decline. Which pattern should the nurse suggest?
- A low-fat pattern built on refined grains and fat-free processed snacks
- A Mediterranean-style pattern with leafy greens, berries, nuts, olive oil and fish
- A pattern centered on red meat and processed meats
- A ketogenic pattern high in butter and cream
Show the answer and explanation
Answer: B. A Mediterranean-style pattern with leafy greens, berries, nuts, olive oil and fish
Topic: diet pattern in early Alzheimer disease
Mediterranean and MIND-style patterns emphasize vegetables, berries, nuts, whole grains, olive oil and fish, and are associated with slower cognitive decline. They also support heart health, which is tied to brain health.
Why the others are wrong
- A – Refined, processed foods lack the nutrients and healthy fats associated with brain health.
- C – High in saturated fat and linked to poorer heart and brain health.
- D – Very high in saturated fat; it is not an established dietary approach for slowing cognitive decline.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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