126Question
A low-income mother who is breastfeeding her 3-month-old needs help buying food, nutrition education, and breastfeeding support. Which program should the nurse recommend?
- SNAP
- WIC
- The National School Lunch Program
- Meals on Wheels
Show the answer and explanation
Answer: B. WIC
Topic: WIC referral
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental foods, nutrition education, breastfeeding support, and referrals to postpartum women, infants, and children under five with nutritional risk factors. SNAP is general food assistance without that tailored package.
Why the others are wrong
- A – SNAP gives general food benefits and no breastfeeding or infant-specific package.
- C – It serves school-age children.
- D – It delivers meals to older adults.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
127Question
A client asks the nurse about a popular diet. Which feature should make the nurse most doubtful about its safety and validity?
- It recommends a calorie range suited to the client’s age, sex, and activity level, aiming for steady, gradual weight loss.
- It asks the client to keep a daily record of food and beverage intake and weigh in each week.
- It promises a 10-lb loss in one week by eliminating a food group, using testimonials, and requiring a supplement line.
- It sets target amounts of protein, carbohydrate, and fat across meals with flexibility in food choice.
Show the answer and explanation
Answer: C. It promises a 10-lb loss in one week by eliminating a food group, using testimonials, and requiring a supplement line.
Topic: judging a fad diet
Red flags in a diet include rapid-loss promises, elimination of whole food groups, reliance on testimonials rather than research, and products the client must buy. Calorie targets, food records, and balanced macronutrient guidance are standard parts of sound plans.
Why the others are wrong
- A – A suitable calorie range is standard.
- B – Self-monitoring is evidence-based.
- D – Balanced macronutrient targets are reasonable.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
128Question
A nurse prepares to assess the abdomen of a client who reports bloating. In which order should the nurse perform the examination?
- Inspection, palpation, percussion, then auscultation of the abdomen
- Auscultation, inspection, palpation, then percussion
- Inspection, auscultation, percussion, then palpation
- Percussion, palpation, inspection, then auscultation
Show the answer and explanation
Answer: C. Inspection, auscultation, percussion, then palpation
Topic: sequence of abdominal assessment
For the abdomen the usual order is inspect, auscultate, percuss, and then palpate, because touching and tapping can change bowel sounds. Percussion over gas-filled bowel is tympanic, and deep palpation comes last to limit discomfort.
Why the others are wrong
- A – This order palpates before listening and may alter bowel sounds.
- B – Listening before looking is out of order, and palpation precedes percussion.
- D – Starting with percussion alters bowel sounds.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
129Question
A client has a new ileostomy. Which explanation of the risk for dehydration should the nurse include in teaching?
- Water and sodium that the colon would usually absorb are lost in loose, watery stool.
- The stomach can no longer make enough fluid to digest food.
- The small intestine absorbs almost no water, so the body relies mainly on the colon to keep fluid.
- The ileostomy increases the amount of urine the kidneys produce.
Show the answer and explanation
Answer: A. Water and sodium that the colon would usually absorb are lost in loose, watery stool.
Topic: dehydration risk with an ileostomy
Most water is absorbed in the small intestine, but the colon normally absorbs the remainder and firms the stool. With an ileostomy the colon is bypassed, so output is loose and can carry large losses of water, sodium, and potassium, especially early after surgery.
Why the others are wrong
- B – Gastric fluid production is not the issue.
- C – The small intestine absorbs most of the water.
- D – An ileostomy does not increase urine output.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
130Question
A client with an elevated LDL cholesterol asks which cooking fat to use in place of butter. Which choice should the nurse recommend?
- Coconut oil
- Lard
- Palm kernel oil shortening
- Olive oil
Show the answer and explanation
Answer: D. Olive oil
Topic: cooking fats and LDL cholesterol
Replacing saturated fat with unsaturated fat lowers LDL cholesterol. Olive oil is mostly monounsaturated. Coconut oil, lard, and palm kernel oil are high in saturated fat and raise LDL.
Why the others are wrong
- A – Coconut oil is very high in saturated fat, despite its healthy image.
- B – Lard is animal saturated fat.
- C – Palm kernel oil is high in saturated fat.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
131Question
A client with hypertension is learning the DASH eating plan. Which statement shows more teaching is needed?
- “Canned vegetables with added salt are fine; the plan only limits salt at the table.”
- “I will choose low-fat dairy products.”
- “I will read labels to compare sodium.”
- “I will eat more fruits and vegetables each day because they provide potassium, fiber, and magnesium.”
Show the answer and explanation
Answer: A. “Canned vegetables with added salt are fine; the plan only limits salt at the table.”
Topic: sodium in canned foods on DASH
Most dietary sodium comes from processed and packaged foods, not the shaker, so canned vegetables with added salt work against the plan. Clients should select no-salt-added or rinse canned items and compare labels.
Why the others are wrong
- B – Low-fat dairy is part of the plan.
- C – Label reading is recommended.
- D – Fruits and vegetables add potassium.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
132Question
A nurse averages two seated blood pressure readings taken at separate visits: 126/76 and 136/84 mm Hg. Using current adult guidelines, how should the nurse classify the average?
- Normal blood pressure
- Elevated blood pressure
- Stage 1 hypertension
- Stage 2 hypertension
Show the answer and explanation
Answer: C. Stage 1 hypertension
Topic: classifying averaged blood pressure
The average is 131/80 mm Hg. Under the American College of Cardiology/American Heart Association classification, stage 1 hypertension is a systolic of 130 to 139 or a diastolic of 80 to 89. Elevated is a systolic of 120 to 129 with a diastolic under 80, and stage 2 starts at 140 or 90.
Why the others are wrong
- A – Normal is below 120/80.
- B – Elevated requires a diastolic under 80 with a systolic of 120 to 129.
- D – Stage 2 requires 140 or higher, or 90 or higher.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
133Question
A client who began a heart-healthy eating plan three months ago to lower LDL cholesterol and blood pressure returns for follow-up. Which finding best supports that the plan is working?
- LDL cholesterol fell from 142 to 118 mg/dL and blood pressure from 148/92 to 132/84 mm Hg.
- The client says salads are eaten daily, although labs have not been repeated.
- LDL cholesterol moved from 142 to 140 mg/dL and blood pressure from 148/92 to 150/94 mm Hg.
- The client’s spouse reports that all nutrition classes were attended.
Show the answer and explanation
Answer: A. LDL cholesterol fell from 142 to 118 mg/dL and blood pressure from 148/92 to 132/84 mm Hg.
Topic: objective evidence of progress
Outcome evaluation relies on objective measures that match the goals. Lower LDL and blood pressure show the plan is effective, whereas self-report and attendance only describe behavior and the unchanged numbers show no improvement.
Why the others are wrong
- B – Self-report without repeat labs is not objective outcome data.
- C – Values essentially unchanged or worse show no improvement.
- D – Attendance reflects participation, not outcome.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
134Question
A client had a myocardial infarction six months ago and takes a high-intensity statin. Which lipid result best indicates that the treatment goal is being met?
- LDL cholesterol 118 mg/dL with HDL cholesterol 62 mg/dL
- LDL cholesterol 48 mg/dL
- Total cholesterol 210 mg/dL with triglycerides 140 mg/dL
- LDL cholesterol 96 mg/dL
Show the answer and explanation
Answer: B. LDL cholesterol 48 mg/dL
Topic: lipid goal after myocardial infarction
After a myocardial infarction the main target is a low LDL cholesterol. Current guidance treats an LDL below 70 mg/dL as the threshold for very-high-risk clients, with lower targets often preferred, so 48 mg/dL satisfies the goal. A high HDL or modest total cholesterol does not offset a high LDL.
Why the others are wrong
- A – An LDL of 118 is far above target despite a good HDL.
- C – Total cholesterol does not show LDL control.
- D – An LDL of 96 is above 70.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
135Question
A client with hypothyroidism takes levothyroxine and a daily calcium supplement. Which instruction is best?
- Take levothyroxine alone 30 to 60 minutes before breakfast, and take calcium at least 4 hours later.
- Take levothyroxine together with the calcium supplement each morning with breakfast to improve the absorption of both.
- Take levothyroxine with breakfast coffee so it is not forgotten.
- Take levothyroxine with the evening meal so food prevents nausea.
Show the answer and explanation
Answer: A. Take levothyroxine alone 30 to 60 minutes before breakfast, and take calcium at least 4 hours later.
Topic: levothyroxine timing
Levothyroxine is best absorbed on an empty stomach. Calcium, iron, antacids, soy, and coffee reduce its absorption, so it is taken alone with water and other products are separated by at least 4 hours.
Why the others are wrong
- B – Calcium binds levothyroxine and lowers absorption.
- C – Coffee reduces absorption.
- D – Food reduces absorption and dosing time should be consistent.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
136Question
A client with hypothyroidism and newly elevated blood pressure asks which single dietary change would reduce sodium the most. Which response is best?
- Stop adding salt at the table and while cooking, and change nothing else about the diet or the grocery shopping list.
- Cook with sea salt instead of table salt.
- Choose lower-sodium versions of packaged foods, because most sodium comes from processed foods.
- Drink extra water after salty meals to flush out the sodium.
Show the answer and explanation
Answer: C. Choose lower-sodium versions of packaged foods, because most sodium comes from processed foods.
Topic: main source of dietary sodium
Most dietary sodium comes from processed, packaged, and restaurant foods, so label reading and choosing lower-sodium versions has the largest effect. Removing the shaker alone, switching to sea salt, or relying on water does not lower sodium intake.
Why the others are wrong
- A – The shaker is a minority of intake.
- B – Sea salt has similar sodium.
- D – Water does not offset sodium eaten.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
137Question
A client with type 2 diabetes wants a mid-afternoon snack. Which choice best helps keep blood glucose steady?
- An apple with a spoonful of peanut butter
- A small glass of fruit juice with two vanilla wafers
- Plain white crackers
- A glazed donut
Show the answer and explanation
Answer: A. An apple with a spoonful of peanut butter
Topic: steady-glucose snack
Pairing fiber-containing carbohydrate with protein or fat slows glucose absorption. Juice, refined crackers, and a donut are quickly absorbed and cause sharper glucose rises.
Why the others are wrong
- B – Juice is a fast carbohydrate with no fiber.
- C – Refined crackers digest quickly.
- D – A donut adds sugar and refined flour.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
138Question
A client taking glipizide is alert and reports sweating and shakiness. The glucose is 58 mg/dL. What should the nurse do first?
- Give a peanut butter sandwich and a glass of milk, then recheck the glucose in about an hour.
- Administer glucagon intramuscularly.
- Withhold food and recheck the glucose in 30 minutes.
- Give 15 g of fast-acting carbohydrate, such as 4 oz of juice, and recheck in 15 minutes.
Show the answer and explanation
Answer: D. Give 15 g of fast-acting carbohydrate, such as 4 oz of juice, and recheck in 15 minutes.
Topic: treating mild hypoglycemia
An alert client with hypoglycemia should receive about 15 g of fast-acting carbohydrate, with a recheck in 15 minutes and repeat treatment if the glucose remains low. Fat and protein slow absorption, glucagon is for clients who cannot safely swallow, and delay risks worsening.
Why the others are wrong
- A – Fat and protein slow glucose rise, and the recheck is too late.
- B – Glucagon is reserved for clients who cannot take oral carbohydrate.
- C – Waiting without treatment lets glucose drop further.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
139Question
A client with Addison disease takes hydrocortisone and fludrocortisone and asks about diet. Which instruction is correct?
- Limit sodium to 2,000 mg daily and avoid salty foods to prevent high blood pressure and swelling.
- Do not restrict sodium; increase salt and fluids during vomiting, diarrhea, or hot weather.
- Eat extra bananas, oranges, and potatoes to replace potassium.
- Restrict fluids to prevent swelling.
Show the answer and explanation
Answer: B. Do not restrict sodium; increase salt and fluids during vomiting, diarrhea, or hot weather.
Topic: sodium and potassium in Addison disease
Adrenal insufficiency causes loss of sodium and water and retention of potassium. Clients need adequate or liberal sodium and fluids, particularly during illness or heat, and should avoid excess potassium. Replacement steroids are also increased during illness as directed.
Why the others are wrong
- A – Sodium restriction worsens hypotension and shock risk.
- C – Potassium is already high, so extra could cause hyperkalemia.
- D – Fluid restriction worsens dehydration and hypotension.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
140Question
A client with iron-deficiency anemia has an allergy to red meat. Which meal provides both iron and protein?
- Whole milk and crackers
- Macaroni and cheese
- Lentil and tomato soup
- Cucumber and rice salad
Show the answer and explanation
Answer: C. Lentil and tomato soup
Topic: plant sources of iron and protein
Lentils supply protein and non-heme iron, and the vitamin C in tomatoes improves iron absorption. Milk, pasta with cheese, and a cucumber and rice salad are low in iron.
Why the others are wrong
- A – Milk and crackers are low in iron, and milk can reduce absorption.
- B – Dairy pasta has little iron.
- D – Cucumber and rice supply little protein or iron.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
141Question
A client with iron-deficiency anemia asks which breakfast best improves absorption of iron from food. Which choice should the nurse recommend?
- Fortified cereal with milk and a cup of coffee
- Oatmeal with black tea
- Toast with cheese and a glass of milk
- Fortified cereal topped with strawberries
Show the answer and explanation
Answer: D. Fortified cereal topped with strawberries
Topic: enhancers and inhibitors of iron absorption
Vitamin C enhances absorption of non-heme iron, while calcium in dairy and tannins in tea and coffee inhibit it. Fortified cereal with strawberries pairs iron with vitamin C.
Why the others are wrong
- A – Milk's calcium and coffee's tannins reduce absorption.
- B – Black tea tannins reduce absorption.
- C – Calcium in cheese and milk reduces iron absorption.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
142Question
A client who follows a vegetarian diet has iron deficiency anemia and relies on lentils and spinach as the main iron sources. Which addition to the meal should the nurse recommend to improve absorption of this plant iron?
- A cup of black tea with the meal
- Fresh orange segments or another vitamin C–rich food
- A glass of low-fat milk with the meal
- A large bowl of high-bran cereal eaten on the side of the meal
Show the answer and explanation
Answer: B. Fresh orange segments or another vitamin C–rich food
Topic: enhancing nonheme iron absorption
Iron from plant foods (nonheme iron) is poorly absorbed, and vitamin C taken in the same meal makes it easier for the intestine to absorb. Tannins, calcium and phytates each bind or compete with iron and lower absorption.
Why the others are wrong
- A – Tea contains tannins that bind iron in the gut and reduce absorption.
- C – Calcium in milk competes with iron for absorption when taken at the same meal.
- D – Bran is high in phytates, which bind iron and lower how much is absorbed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
143Question
A client at 9 weeks of pregnancy has fatigue and a mean corpuscular volume (MCV) of 108 fL; her vitamin B12 level is normal. She eats mainly chicken and plain pasta with few vegetables or beans. Which foods should the nurse encourage to correct the likely deficiency?
- Cheddar cheese, whole milk, and plain yogurt each day
- Lean beef, pork, and eggs
- Bananas, apples, and pears
- Lentils, asparagus, and fortified cereal
Show the answer and explanation
Answer: D. Lentils, asparagus, and fortified cereal
Topic: folate-rich foods in pregnancy
Large red cells with a normal B12 point to folate deficiency, and folate needs rise in pregnancy. Legumes, dark green vegetables and fortified grain products are the richest practical sources.
Why the others are wrong
- A – Dairy foods supply calcium and some B12 but little folate.
- B – Meats supply iron and B12, which are not the problem here, and are not rich in folate.
- C – These fruits are low in folate compared with legumes and leafy vegetables.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
144Question
A 52-year-old client with a long history of heavy alcohol use is admitted with fatigue, pallor and an MCV of 114 fL. The diet history shows almost no fruits, vegetables or fortified grains. Which deficiency does the nurse suspect?
- Folate
- Iron
- Vitamin C
- Zinc
Show the answer and explanation
Answer: A. Folate
Topic: folate deficiency and alcohol use
Heavy alcohol use together with a diet poor in vegetables and fortified grains is the classic setting for folate deficiency, which produces a macrocytic (megaloblastic) anemia. Alcohol also interferes with folate absorption and storage.
Why the others are wrong
- B – Iron deficiency produces small, pale red cells, not large ones.
- C – Vitamin C deficiency causes scurvy, with bleeding gums and poor healing, not macrocytosis.
- D – Zinc deficiency affects taste and healing but does not cause a macrocytic anemia.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
145Question
A client prescribed oral ferrous sulfate reports nausea when the tablet is taken on an empty stomach. Which instruction should the nurse give?
- Stop the iron until the nausea has gone away completely
- Switch to taking it at bedtime with a large glass of milk to settle the stomach
- Take the tablet with a small amount of food, but not with milk, coffee or tea
- Take it together with a calcium-containing antacid to protect the stomach
Show the answer and explanation
Answer: C. Take the tablet with a small amount of food, but not with milk, coffee or tea
Topic: oral iron and GI upset
Iron is absorbed best on an empty stomach, but a small amount of food is an accepted compromise when it upsets the stomach, because a lower absorption is better than a client who stops the drug. Milk, antacids, coffee and tea bind iron and should be avoided.
Why the others are wrong
- A – Stopping the drug leaves the anemia untreated; the dosing can be adjusted instead.
- B – Milk contains calcium that blocks iron absorption, and a large volume at bedtime may add to the discomfort.
- D – Calcium-containing antacids bind iron and sharply reduce its absorption.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
146Question
An 80-year-old client admitted with nutritional anemia has a hemoglobin of 7.8 g/dL and says she feels light-headed when she stands. Which action by the nurse is the priority?
- Arrange a dietitian consultation to plan iron-rich meals the client will accept
- Teach the client which foods are high in vitamin B12
- Help the client change position slowly and walk only with assistance
- Weigh the client each day at the same time
Show the answer and explanation
Answer: C. Help the client change position slowly and walk only with assistance
Topic: fall risk in older adults with anemia
Low hemoglobin reduces oxygen delivery to the brain, so dizziness on standing puts an older adult at immediate risk of a fall and injury. Safety comes before long-term nutrition teaching.
Why the others are wrong
- A – Dietary planning is needed, but it does not prevent a fall today.
- B – Teaching can wait until the client is safe, and the cause of the anemia is not yet known to be B12.
- D – Daily weights do not address the dizziness or the fall risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
147Question
A client newly diagnosed with iron deficiency anemia nods during diet teaching but cannot say which foods to eat or how to take the iron tablets. The client reads at a low literacy level. What is the nurse's best next step?
- Use plain language, give a few short steps, and ask the client to teach back the plan
- Give the client a detailed printed pamphlet to read at home
- Repeat the full explanation using medical terms and check understanding again at discharge
- Ask a neighbor to supervise every meal the client eats
Show the answer and explanation
Answer: A. Use plain language, give a few short steps, and ask the client to teach back the plan
Topic: low health literacy and diet teaching
Health literacy is a modifiable barrier. Plain language, a small number of key points and the teach-back method confirm that the client can use the information.
Why the others are wrong
- B – A long pamphlet does not help a client who has difficulty reading.
- C – Repeating the same medical wording does not change the barrier.
- D – Involving a neighbor removes the client's own role and is not something the client asked for.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
148Question
A client recovering from a partial hamstring tear asks which lunch would best support muscle repair. Which choice should the nurse recommend?
- Plain pasta with butter and cheese, and a large sweetened iced tea
- A fruit cup, gelatin dessert and ginger ale
- Rice cakes with jam and a small apple
- Grilled chicken breast with lentil soup and a side salad
Show the answer and explanation
Answer: D. Grilled chicken breast with lentil soup and a side salad
Topic: protein for muscle repair
Protein supplies the amino acids needed to rebuild injured muscle, and a meal that pairs animal and plant protein with vegetables also provides the energy and micronutrients for repair.
Why the others are wrong
- A – This meal is mostly refined carbohydrate and sugar with little protein.
- B – These choices are almost all sugar and water with almost no protein.
- C – Rice cakes, jam and fruit supply carbohydrate but little protein.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
149Question
A client with a slowly healing abdominal incision says, “I hardly drink anything because I do not want to keep running to the bathroom.” Which response by the nurse is best?
- “Healing depends only on how much protein you eat, so how much you drink does not matter much.”
- “Fluids help carry oxygen and nutrients to your wound; let’s plan a drinking schedule.”
- “You should save your fluids and drink them all at once in the evening instead.”
- “Limit your fluids until the incision has closed completely so you move less.”
Show the answer and explanation
Answer: B. “Fluids help carry oxygen and nutrients to your wound; let’s plan a drinking schedule.”
Topic: hydration and wound healing
Adequate fluid keeps blood volume and tissue perfusion up, so oxygen and nutrients reach the wound. A practical schedule respects the client's concern while correcting the misunderstanding.
Why the others are wrong
- A – Hydration matters for perfusion; protein is not the only factor.
- C – Drinking it all at once is hard to tolerate and leaves the client dry for most of the day.
- D – Restricting fluids reduces perfusion and delays healing, and no order restricts fluids.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
150Question
A client with SIADH after a head injury has a serum sodium of 124 mEq/L and an ordered fluid restriction. The client complains of constant thirst. Which strategy should the nurse use?
- Give extra fluids when thirst is intense to prevent dehydration
- Offer salty broth in place of water to relieve the thirst
- Give ice chips as often as wanted because they do not count as fluid
- Offer sugar-free hard candy and frequent mouth care, and space the allowed fluids across the day
Show the answer and explanation
Answer: D. Offer sugar-free hard candy and frequent mouth care, and space the allowed fluids across the day
Topic: SIADH fluid restriction
In SIADH the body holds water, which dilutes the sodium. Fluid is restricted, and comfort measures such as sugar-free candy, oral care and spacing the allowed fluids help with thirst without adding volume.
Why the others are wrong
- A – Extra fluid would worsen the dilution and could lower sodium further.
- B – Broth is still fluid, and extra sodium is not the treatment for a dilutional problem.
- C – Ice chips melt into water and must be counted in the fluid allowance.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
NCLEX-RN is a registered trademark of the National Council of State Boards of Nursing, Inc. (NCSBN). This site is not affiliated with, sponsored by or endorsed by the owner of that mark.
Nursing