176Question
A client who had gestational diabetes gave birth two days ago and asks if she needs any more diabetes testing. What is the nurse's best response?
- “Your sugar levels returned to normal at delivery, so no more testing is needed.”
- “You need a glucose tolerance test 4 to 12 weeks after delivery.”
- “You only need testing if you become pregnant again.”
- “You need testing only if you develop thirst and frequent urination.”
Show the answer and explanation
Answer: B. “You need a glucose tolerance test 4 to 12 weeks after delivery.”
Topic: postpartum screening after gestational diabetes
Gestational diabetes raises the lifetime risk of type 2 diabetes. A glucose tolerance test 4 to 12 weeks after birth is recommended, followed by repeat screening at regular intervals for life.
Why the others are wrong
- A – Normal glucose after delivery does not remove the lifetime risk.
- C – The risk of type 2 diabetes continues even without another pregnancy.
- D – Diabetes is often silent, so waiting for symptoms delays diagnosis.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
177Question
A nurse teaches a client with prediabetes about lowering the risk of type 2 diabetes. Which client statement shows that more teaching is needed?
- “I will choose water instead of sweetened drinks.”
- “I will skip breakfast and lunch so I can have a bigger dinner.”
- “I will pick whole-grain bread over white bread.”
- “I will walk briskly for about 30 minutes on most days of every week.”
Show the answer and explanation
Answer: B. “I will skip breakfast and lunch so I can have a bigger dinner.”
Topic: diabetes prevention teaching
Skipping meals followed by a large dinner causes large glucose swings and is not part of a diabetes-prevention plan. Choosing water, whole grains and regular activity lowers risk.
Why the others are wrong
- A – Replacing sweetened drinks with water is a sound change.
- C – Whole grains have more fiber and a lower glucose effect than refined bread.
- D – Regular brisk walking improves insulin sensitivity.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
178Question
A nurse assesses a 6-year-old who eats almost no protein foods. Which finding would the nurse expect?
- Slowed growth with muscle wasting and thin, brittle hair
- Bowed legs and widened wrists
- Bleeding gums and tiny skin hemorrhages around the hair follicles
- Night blindness and dry eyes
Show the answer and explanation
Answer: A. Slowed growth with muscle wasting and thin, brittle hair
Topic: protein deficiency in childhood
Protein supplies the amino acids for building tissue, so inadequate intake in childhood slows growth and causes muscle loss and hair changes. The other findings point to deficiencies of vitamin D, vitamin C and vitamin A.
Why the others are wrong
- B – Bowed legs and widened wrists point to rickets from vitamin D deficiency.
- C – Bleeding gums and tiny skin hemorrhages point to scurvy from vitamin C deficiency.
- D – Night blindness and dry eyes point to vitamin A deficiency.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
179Question
An 84-year-old resident has lost 6 kg in three months and eats poorly. The family asks for an appetite-stimulating medication. What should the nurse do first?
- Request an order for megestrol acetate to start today
- Restrict the diet to low-fat, low-sodium foods to prevent heart disease
- Tell the family that weight loss is a normal part of aging and needs no action
- Look for treatable causes such as depression, dental pain or swallowing problems
Show the answer and explanation
Answer: D. Look for treatable causes such as depression, dental pain or swallowing problems
Topic: unintentional weight loss in older adults
Unintentional weight loss in an older adult usually has a reversible cause, so the cause is sought and treated before drugs. Appetite stimulants such as megestrol are on the AGS Beers list of drugs to avoid in older adults because of the risk of blood clots.
Why the others are wrong
- A – Megestrol is a Beers-list drug to avoid in older adults and does not address the cause.
- B – Restrictive diets make poor intake worse in a client already losing weight.
- C – Losing 6 kg in three months is not normal aging; it needs assessment for a cause.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
180Question
A mother of a 2-month-old who is breastfed on demand asks whether to give small bottles of water to help bowel movements, which have become less frequent. What is the nurse's best response?
- “Give 2 ounces of water after every feeding to prevent constipation.”
- “Add a teaspoon of corn syrup to the water to soften the stools.”
- “Breast milk supplies all the fluid your baby needs, and less frequent soft stools can be normal.”
- “Switch to a high-calorie formula to make stools more regular.”
Show the answer and explanation
Answer: C. “Breast milk supplies all the fluid your baby needs, and less frequent soft stools can be normal.”
Topic: water for breastfed infants
Exclusively breastfed infants do not need water, and extra water can lower sodium and reduce milk intake. After the first weeks, breastfed infants may have fewer stools, which is normal if the stools are soft and the baby is feeding and growing well.
Why the others are wrong
- A – Water can displace milk and risks low sodium in a young infant.
- B – Corn syrup is not recommended for infants and does not treat normal variation.
- D – A formula change is not needed when the baby is feeding and gaining well.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
181Question
A nurse teaches parents about factors that can disrupt a newborn's developing gut microbiome. Which factor is most likely to disrupt it?
- Skin-to-skin contact after birth
- Exclusive breastfeeding during the first months of life
- Repeated courses of broad-spectrum antibiotics
- Vaginal birth
Show the answer and explanation
Answer: C. Repeated courses of broad-spectrum antibiotics
Topic: factors affecting infant gut microbiome
Broad-spectrum antibiotics reduce the diversity of gut bacteria. Vaginal birth, breastfeeding and skin-to-skin contact help the infant acquire a healthy microbiome.
Why the others are wrong
- A – Skin contact transfers helpful bacteria to the infant.
- B – Breast milk contains oligosaccharides that feed beneficial bacteria.
- D – Vaginal birth exposes the infant to the mother's beneficial bacteria.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
182Question
A preterm infant weighing 1.5 kg is ordered 120 kcal/kg/day of 24 kcal/oz formula in eight equal feedings. How many milliliters should the nurse give per feeding? (1 oz = 30 mL; round to the nearest whole number.)
- 14 mL
- 28 mL
- 36 mL
- 45 mL
Show the answer and explanation
Answer: B. 28 mL
Topic: preterm feeding volume calculation
1.5 kg × 120 kcal/kg = 180 kcal per day. The formula supplies 24 kcal per 30 mL, or 0.8 kcal/mL, so 180 ÷ 0.8 = 225 mL per day. 225 ÷ 8 feedings = about 28 mL per feeding.
Why the others are wrong
- A – 14 mL would result from dividing the daily volume into 16 feedings.
- C – 36 mL would result from dividing the daily volume into six feedings.
- D – 45 mL would result from dividing the daily volume into five feedings.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
183Question
A newborn is diagnosed with classic galactosemia after screening. The mother, who planned to breastfeed, asks what she should feed her baby. What is the nurse's best response?
- “Breast milk has lactose, which yields galactose, so your baby needs a special formula.”
- “Breast milk is fine if you pump it and warm it first.”
- “Your baby needs a regular lactose-containing formula with a digestive enzyme added to it.”
- “You can keep breastfeeding as long as you avoid dairy foods yourself.”
Show the answer and explanation
Answer: A. “Breast milk has lactose, which yields galactose, so your baby needs a special formula.”
Topic: galactosemia and infant feeding
People with galactosemia cannot break down galactose, which comes from the lactose in milk. Breast milk and regular formulas are contraindicated, and a lactose- and galactose-free formula is used to prevent liver damage, cataracts and sepsis.
Why the others are wrong
- B – Pumping and warming do not remove lactose from breast milk.
- C – An enzyme additive does not make a lactose-containing formula safe in galactosemia.
- D – The breast makes lactose whatever the mother eats, so cutting dairy from her diet does not make breast milk safe.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
184Question
The parent of a 14-year-old who is in a rapid growth spurt says, “He eats everything in sight. Is something wrong?” Which response by the nurse is best?
- “Eating this much suggests binge eating, and he needs a mental health referral.”
- “Limit him to three meals a day with no snacks so he learns self-control.”
- “Switch him to low-calorie foods so he does not gain weight.”
- “Needs rise during a growth spurt, so a big appetite is expected.”
Show the answer and explanation
Answer: D. “Needs rise during a growth spurt, so a big appetite is expected.”
Topic: adolescent nutritional needs
Adolescents have the highest energy and nutrient needs of childhood during the growth spurt. A large appetite is usually normal, and nutrient-dense foods should be available.
Why the others are wrong
- A – A big appetite alone does not indicate binge eating during rapid growth.
- B – Withholding snacks cannot meet the extra needs of the growth spurt.
- C – Low-calorie foods fail to meet growth needs and can cause deficits.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
185Question
A client wants to support gut bacteria with foods that provide both probiotics and prebiotics. Which meal best meets this goal?
- Baked salmon with white rice and butter
- A fruit smoothie made with fruit juice and ice
- Grilled chicken breast with a plain dinner roll
- Plain yogurt with live cultures topped with sliced banana and oats
Show the answer and explanation
Answer: D. Plain yogurt with live cultures topped with sliced banana and oats
Topic: probiotics and prebiotics
Yogurt with live cultures provides probiotics, while bananas and oats supply fermentable fibers that act as prebiotics. The other meals contain little live culture or prebiotic fiber.
Why the others are wrong
- A – Fish, white rice and butter supply neither live cultures nor prebiotic fiber.
- B – Juice and ice supply sugar and no live cultures or fiber.
- C – Chicken and a plain roll have no live cultures and little fiber.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
186Question
An older adult with constipation is starting a daily psyllium fiber supplement. Which instruction is most important for the nurse to include?
- “Increase the fiber gradually, and drink a full glass of fluid with each dose.”
- “Limit fluids so the fiber does not make you bloated.”
- “Take the supplement together with all your other medications to simplify your routine.”
- “Stop the supplement if you notice gas on the first day.”
Show the answer and explanation
Answer: A. “Increase the fiber gradually, and drink a full glass of fluid with each dose.”
Topic: fiber supplement teaching
Bulk-forming fiber absorbs water, and without enough fluid it can cause hard stool or even obstruction. Increasing the dose gradually limits gas and bloating, and the supplement can bind other drugs, so it is taken apart from them.
Why the others are wrong
- B – Limiting fluids makes bulk-forming fiber dangerous and ineffective.
- C – Fiber can bind other drugs, so doses should be separated from them.
- D – Mild gas early on is common and settles with a gradual increase.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
187Question
A client who has followed a strict vegan diet for eight years reports tingling in both feet and an unsteady gait. The hemoglobin is low and the MCV is elevated. Which deficiency should the nurse suspect?
- Vitamin C
- Vitamin B12
- Iron
- Calcium
Show the answer and explanation
Answer: B. Vitamin B12
Topic: vitamin B12 deficiency in vegans
Vitamin B12 is found almost only in animal foods, so strict vegans need fortified foods or a supplement. Deficiency causes a macrocytic anemia and neurologic signs such as tingling and unsteady gait.
Why the others are wrong
- A – Vitamin C deficiency causes scurvy, not a macrocytic anemia with neuropathy.
- C – Iron deficiency causes small red cells and no nerve symptoms.
- D – Calcium deficiency affects bones and muscle cramps, not red cell size.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
188Question
A client at 12 weeks of pregnancy with a normal diet asks why her provider prescribed an iron supplement. What is the nurse's best response?
- “Iron prevents nausea and helps your baby’s bones form.”
- “Your body stops absorbing iron from food once you are pregnant, so you need a supplement.”
- “Your needs rise because your blood volume expands and your baby needs iron.”
- “Iron is only needed if your hemoglobin falls below 7 g/dL.”
Show the answer and explanation
Answer: C. “Your needs rise because your blood volume expands and your baby needs iron.”
Topic: iron needs in pregnancy
Pregnancy expands the blood volume and the fetus and placenta take iron, so requirements increase substantially. Many diets do not supply enough, so a supplement is commonly advised to prevent anemia.
Why the others are wrong
- A – Iron does not prevent nausea or form fetal bones; it supports hemoglobin.
- B – Absorption of iron actually increases in pregnancy.
- D – Iron is advised well before hemoglobin is that low.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
189Question
The mother of a 9-month-old plans to switch from iron-fortified formula to whole cow's milk because it costs less. What should the nurse explain?
- “Cow’s milk is low in iron and can cause gut blood loss; wait until 12 months.”
- “Whole cow’s milk is fine now that your baby is eating a good variety of solid foods.”
- “Switch to skim milk, which is easier on your baby’s heart.”
- “Mix cow’s milk half and half with water to make it gentler.”
Show the answer and explanation
Answer: A. “Cow’s milk is low in iron and can cause gut blood loss; wait until 12 months.”
Topic: iron deficiency prevention in infants
Cow's milk is low in iron, interferes with iron absorption and can cause small intestinal blood losses in infants, so it raises the risk of iron deficiency anemia. Breast milk or iron-fortified formula should continue until at least 12 months.
Why the others are wrong
- B – Starting solids does not change the recommendation to wait until 12 months.
- C – Skim milk is not recommended for infants and lacks needed fat.
- D – Diluting milk lowers calories and nutrients and does not fix the iron problem.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
190Question
A 72-year-old who lives alone, smokes and drinks wine daily has fatigue. Which findings would support folate deficiency?
- Small, pale red cells with spoon-shaped nails
- An MCV of 112 fL with a smooth, sore red tongue
- A high ferritin level with bronzed skin
- Low platelets with bleeding after brushing the teeth
Show the answer and explanation
Answer: B. An MCV of 112 fL with a smooth, sore red tongue
Topic: recognizing folate deficiency
Folate deficiency produces a megaloblastic anemia with large red cells and often glossitis, a smooth, sore red tongue. Alcohol misuse, smoking, living alone and a poor diet are risk factors.
Why the others are wrong
- A – Small, pale cells with spoon nails indicate iron deficiency.
- C – High ferritin and bronzed skin suggest iron overload, not folate deficiency.
- D – Low platelets and bleeding suggest a platelet or vitamin K problem.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
191Question
A pregnant client who is lactose intolerant avoids dairy and asks how to get enough calcium for her baby's bones and teeth. Which suggestion is best?
- Large servings of raw spinach in salads
- Extra red meat and eggs at every meal
- A calcium-fortified soy beverage and canned salmon eaten with the soft bones
- Whole-grain cereal and brown rice at each meal
Show the answer and explanation
Answer: C. A calcium-fortified soy beverage and canned salmon eaten with the soft bones
Topic: non-dairy calcium sources in pregnancy
Fortified soy beverages and canned fish with edible bones supply well-absorbed calcium without lactose. Spinach contains oxalate, which binds most of its calcium, and meats, eggs and grains are poor calcium sources.
Why the others are wrong
- A – The calcium in spinach is mostly bound by oxalate and poorly absorbed.
- B – Meats and eggs contain little calcium.
- D – Whole grains and rice contain little calcium.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
192Question
A 68-year-old woman has eaten little calcium and has had very little sun exposure for decades. Which finding would be of greatest concern to the nurse?
- Dry, itchy skin on the forearms
- Occasional mild headaches
- Numbness in the fingertips when they are cold
- A wrist fracture after a minor fall
Show the answer and explanation
Answer: D. A wrist fracture after a minor fall
Topic: calcium, vitamin D and bone health
Long-term low calcium and vitamin D intake leads to loss of bone density and osteoporosis, so fractures from low-impact falls are the key concern. The other findings are unrelated to bone health.
Why the others are wrong
- A – Dry skin is common with aging and is not tied to calcium or vitamin D.
- B – Mild headaches are not a sign of bone loss.
- C – Cold-induced fingertip numbness suggests a circulation problem.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
193Question
The mother of an exclusively breastfed 3-month-old plans to skip vitamin D drops and give the baby 10 minutes of direct midday sun each day instead. What should the nurse say?
- “Sun exposure is a good plan if you put sunscreen on the baby’s whole body before going out.”
- “Under 6 months, babies should avoid direct sun, so a vitamin D supplement is advised.”
- “Your breast milk has plenty of vitamin D if you eat well.”
- “Wait until the baby is 12 months old to start vitamin D.”
Show the answer and explanation
Answer: B. “Under 6 months, babies should avoid direct sun, so a vitamin D supplement is advised.”
Topic: vitamin D supplementation in breastfed infants
Breast milk is low in vitamin D, and infants under 6 months should avoid direct sun because of their delicate skin. A daily 400 IU supplement is recommended for breastfed infants beginning in the first days of life.
Why the others are wrong
- A – Sunscreen is not recommended on infants under 6 months, and the aim is to avoid direct sun.
- C – Even a well-nourished mother's milk contains little vitamin D.
- D – Waiting until 12 months leaves the infant at risk of rickets for most of the first year.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
194Question
The mother of a 3-month-old who breastfeeds and also gives about 8 ounces of formula a day asks whether the baby still needs vitamin D drops. What is the nurse's best response?
- “Yes; with so little formula, a 400 IU vitamin D supplement is still advised.”
- “No; any amount of formula supplies enough vitamin D.”
- “No; your baby gets enough vitamin D through your milk if you take prenatal vitamins daily.”
- “Yes, but only if the formula you use is not iron-fortified.”
Show the answer and explanation
Answer: A. “Yes; with so little formula, a 400 IU vitamin D supplement is still advised.”
Topic: vitamin D in partly formula-fed infants
Infants who are breastfed in whole or part, and formula-fed infants who take less than about 1 liter of fortified formula a day, need 400 IU of vitamin D daily. A small amount of formula does not cover the need.
Why the others are wrong
- B – A small volume of formula does not provide the daily requirement.
- C – Maternal supplements raise breast milk vitamin D only slightly at usual doses and are not a standard replacement.
- D – Iron content of the formula has no bearing on the need for vitamin D.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
195Question
An 8-year-old with a BMI above the 95th percentile drinks several glasses of juice and soda each day. The family asks for help with the child's weight. Which first step should the nurse recommend?
- Place the child on a strict low-calorie diet
- Weigh the child every day at home and reward each loss
- Start a daily high-intensity exercise program right away
- Work with the family to replace sugar-sweetened beverages with water or milk as a first step
Show the answer and explanation
Answer: D. Work with the family to replace sugar-sweetened beverages with water or milk as a first step
Topic: first step in childhood obesity management
Pediatric obesity is treated with family-centered changes in health behavior. Replacing sugar-sweetened drinks with water or milk is a feasible first change that lowers calorie intake without restrictive dieting, and activity is then increased gradually.
Why the others are wrong
- A – Strict calorie restriction can impair growth and is not recommended for children.
- B – Daily weighing and rewards for loss focus on the number and can promote disordered eating.
- C – Starting with intense exercise is hard to sustain, risks injury and discourages the child.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
196Question
The parent of a 10-year-old asks which food best supports bone growth by providing both calcium and vitamin D. Which food should the nurse recommend?
- Cooked spinach
- Brown rice with beans
- Vitamin D–fortified low-fat milk
- Roasted chicken breast
Show the answer and explanation
Answer: C. Vitamin D–fortified low-fat milk
Topic: food sources for bone growth
Fortified milk supplies calcium and vitamin D together, and the calcium in milk is well absorbed. Spinach calcium is poorly absorbed, and rice, beans and chicken contain little of either nutrient.
Why the others are wrong
- A – Spinach contains oxalate, which binds calcium, and it has no vitamin D.
- B – Rice and beans are low in calcium and contain no vitamin D.
- D – Chicken breast is low in both calcium and vitamin D.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
197Question
A client with rheumatoid arthritis will take prednisone every day for at least six months. Which teaching about bone health should the nurse include?
- “Get enough calcium and vitamin D, do weight-bearing exercise, and report new back pain.”
- “Avoid all walking and weight-bearing to protect your bones.”
- “Take extra aspirin to prevent bone loss.”
- “Bone loss only happens with injected steroids, not with tablets.”
Show the answer and explanation
Answer: A. “Get enough calcium and vitamin D, do weight-bearing exercise, and report new back pain.”
Topic: glucocorticoid-induced bone loss
Long-term corticosteroids reduce bone formation and increase bone loss, raising fracture risk. Adequate calcium and vitamin D, weight-bearing activity and prompt reporting of new back pain, which may signal a vertebral fracture, are standard teaching.
Why the others are wrong
- B – Weight-bearing activity strengthens bone, and avoiding it increases bone loss.
- C – Aspirin does not prevent bone loss.
- D – Oral corticosteroids cause bone loss as well as injected ones.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
198Question
The parent of an 18-month-old asks how much fluoride toothpaste to use when brushing. Which instruction should the nurse give?
- Use a pea-sized amount, twice a day
- Use a smear about the size of a grain of rice, twice a day
- Wait until age 3 to start fluoride toothpaste
- Use a full strip of toothpaste on the brush for each brushing
Show the answer and explanation
Answer: B. Use a smear about the size of a grain of rice, twice a day
Topic: fluoride toothpaste dosing
For children under 3, a smear of fluoride toothpaste about the size of a grain of rice is recommended twice daily, and a pea-sized amount from ages 3 to 6. This protects against caries while limiting the amount swallowed.
Why the others are wrong
- A – A pea-sized amount is for ages 3 to 6, and a younger child swallows more of it.
- C – Delaying fluoride leaves the teeth without protection from caries.
- D – A full strip delivers too much fluoride to a toddler who will swallow much of it.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
199Question
A client at 37 weeks of pregnancy, expecting her first child, has intense itching with red, raised patches over her abdominal stretch marks that spare the skin around the navel. Which teaching is most appropriate?
- “The rash means you have an infection that needs antibiotics.”
- “Your baby must be delivered immediately because the rash harms the placenta.”
- “Take hot showers several times a day to relieve the itching.”
- “The rash is harmless to your baby and usually clears after birth.”
Show the answer and explanation
Answer: D. “The rash is harmless to your baby and usually clears after birth.”
Topic: PUPPP teaching
This pattern fits PUPPP, a benign itchy rash of late pregnancy that does not harm the fetus and resolves after birth. Treatment is symptomatic with topical corticosteroids, antihistamines, cool compresses and loose clothing.
Why the others are wrong
- A – PUPPP is not an infection, so antibiotics are not indicated.
- B – PUPPP does not affect the placenta or require early delivery.
- C – Heat worsens itching, so cool measures are used.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
200Question
A 16-year-old swimmer finishes a three-hour practice and says she feels tired and sore. Which post-practice snack should the nurse suggest?
- An energy drink with caffeine
- A candy bar with a cola
- Low-fat chocolate milk with a banana
- Plain water with nothing else until dinner
Show the answer and explanation
Answer: C. Low-fat chocolate milk with a banana
Topic: sports nutrition for adolescents
After long exercise, a snack combining carbohydrate and protein replaces glycogen and supports muscle repair. Low-fat chocolate milk with fruit provides both and also fluid. Energy drinks are not recommended for adolescents.
Why the others are wrong
- A – Caffeinated energy drinks are discouraged in adolescents and supply no protein.
- B – Candy and cola give sugar without protein or other nutrients.
- D – Water alone does not replace glycogen or supply protein for repair.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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