26Question
A nurse is given report on four clients at the start of the shift. Which client should the nurse assess first?
- A client 8 hours after total thyroidectomy who reports tightness in the neck and now has noisy, labored breathing
- A client 1 day after laparoscopic cholecystectomy who rates incisional pain 5 on a 0 to 10 scale and requests medication
- A client with type 2 diabetes whose fingerstick glucose before lunch is 210 mg/dL and who has no symptoms
- A client with pneumonia on the third day of antibiotics whose temperature is 100.4 F (38 C)
Show the answer and explanation
Answer: A. A client 8 hours after total thyroidectomy who reports tightness in the neck and now has noisy, labored breathing
Topic: post-thyroidectomy airway versus routine needs
Neck swelling or bleeding after thyroidectomy can compress the trachea, and noisy, labored breathing signals an airway threat. Airway problems come before pain, mild hyperglycemia or a low-grade fever, so this client is assessed first.
Why the others are wrong
- B – Moderate expected pain after surgery needs attention soon but is not a threat to life.
- C – A glucose of 210 mg/dL with no symptoms is not an emergency and can be handled after the airway.
- D – A temperature of 100.4 F (38 C) on antibiotics is a chronic-course finding and not immediately dangerous.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
27Question
A nurse in a primary care clinic is returning calls from the message list. Which callers should the nurse direct to call emergency medical services (911) immediately?
Select all that apply.
- An adult who describes sudden crushing chest pain spreading to the jaw that began 20 minutes ago
- A parent whose 2-year-old has a runny nose and a temperature of 100.2 F (37.9 C) but is playing
- An adult whose face suddenly drooped and who is slurring speech that began 30 minutes ago
- An adult with a sore throat for 2 days who is able to swallow fluids
- A parent whose toddler swallowed tablets from an unknown bottle and is now very hard to wake
- An adult with asthma who can speak only two or three words at a time and whose inhaler has not helped
Show the answers and explanation
Answers: A, C, E and F.
- A – An adult who describes sudden crushing chest pain spreading to the jaw that began 20 minutes ago
- C – An adult whose face suddenly drooped and who is slurring speech that began 30 minutes ago
- E – A parent whose toddler swallowed tablets from an unknown bottle and is now very hard to wake
- F – An adult with asthma who can speak only two or three words at a time and whose inhaler has not helped
Topic: telephone triage emergencies
Crushing chest pain, sudden facial droop with slurred speech, an unrousable child after an ingestion and severe breathing difficulty unrelieved by a rescue inhaler are time-critical threats to life or brain and cannot be managed by phone or a later visit. A mild cold in a playful toddler and a 2-day sore throat can be handled with advice or a routine appointment.
Why the others are wrong
- B – A playful toddler with a runny nose and a low-grade temperature is stable and can be managed with advice or an appointment.
- D – A sore throat for 2 days with intact swallowing can be seen at a routine visit.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
28Question
A nurse on an inpatient psychiatric unit receives report at the start of the shift. Which client should the nurse assess first?
- A client with major depression who told a staff member that he has saved up pills and plans to take them tonight
- A client with schizophrenia who is hearing voices commenting on her actions but is calm and sitting in the day room
- A client with bipolar disorder in a manic episode who is talking loudly and has eaten little for two days
- A client with an anxiety disorder who is pacing and requests a scheduled dose of lorazepam
Show the answer and explanation
Answer: A. A client with major depression who told a staff member that he has saved up pills and plans to take them tonight
Topic: psychiatric unit who to see first
A client with a plan and the means to attempt suicide is at immediate risk of death, and safety comes first on a psychiatric unit. The nurse assesses the risk, removes the means and arranges close observation before addressing the other needs.
Why the others are wrong
- B – A calm client with non-commanding voices is not in immediate danger.
- C – Poor intake in mania needs follow-up, but it is not as urgent as a stated suicide plan.
- D – Anxiety with a request for a scheduled medication can wait until the safety threat is handled.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
29Question
A nurse is delayed by an emergency and must decide which morning medications for a client can wait and which cannot. The client's breakfast tray has just arrived. Which medication is the most time-critical?
- Multivitamin tablet by mouth once daily
- Docusate capsule by mouth once daily
- Rapid-acting insulin ordered to be given with the meal
- Levothyroxine tablet by mouth once daily before breakfast
Show the answer and explanation
Answer: C. Rapid-acting insulin ordered to be given with the meal
Topic: time-critical scheduled medications
Time-critical medications are those where an early or late dose can cause harm or lose effect, such as insulin tied to meals. Rapid-acting insulin must be matched to food intake to avoid hypoglycemia or hyperglycemia. Daily supplements, stool softeners and once-daily thyroid replacement tolerate a short delay.
Why the others are wrong
- A – A multivitamin can be given later in the shift without harm.
- B – A daily stool softener is not tied to a precise time.
- D – Levothyroxine has a long half-life, so a brief delay does not cause harm, although it is best given on an empty stomach.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
30Question
A nurse on a pediatric unit receives report on four children. Which child should the nurse see first?
- A 6-year-old on the first day after an appendectomy who rates abdominal pain 4 on a 0 to 10 scale and is asking for medication
- A 9-year-old with asthma who is wheezing after a nebulizer treatment but speaks in full sentences and is playing a video game
- A 2-year-old with cellulitis receiving intravenous antibiotics who is crying when the parent leaves the room
- A 3-year-old with a high fever who is drooling, sitting upright and leaning forward, and has a muffled voice
Show the answer and explanation
Answer: D. A 3-year-old with a high fever who is drooling, sitting upright and leaning forward, and has a muffled voice
Topic: pediatric airway emergency who first
Fever, drooling, a tripod-like upright posture and a muffled voice suggest acute epiglottitis, which can obstruct the airway suddenly. The nurse goes to this child first, keeps the child calm, does not examine the throat and has airway equipment and the provider summoned. The others are stable or have expected needs.
Why the others are wrong
- A – Mild to moderate postoperative pain is expected and can be treated shortly after the airway threat.
- B – A child who speaks in full sentences and is playing is breathing adequately despite mild wheezing.
- C – Crying on separation is expected behavior in a toddler and is not a physiologic emergency.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
31Question
A nurse receives report on four clients. Which client should the nurse assess first?
- A client 3 hours after cardiac catheterization through the femoral artery whose groin is swelling, whose heart rate has risen from 76 to 112 and whose blood pressure has fallen
- A client with chronic obstructive pulmonary disease whose oxygen saturation is 90% on 2 L/min, which is the client's usual level
- A client with heart failure who has 1+ pitting ankle edema and a weight 1 pound (0.5 kg) above yesterday's weight
- A client on the second day after bowel resection who has not yet passed flatus and rates pain 3 on a 0 to 10 scale
Show the answer and explanation
Answer: A. A client 3 hours after cardiac catheterization through the femoral artery whose groin is swelling, whose heart rate has risen from 76 to 112 and whose blood pressure has fallen
Topic: expanding groin hematoma after catheterization
An enlarging groin swelling with a rising heart rate and falling blood pressure after femoral artery access suggests active bleeding or hematoma with early shock, which is an unexpected and life-threatening change. The other findings are chronic, expected or minor for those conditions.
Why the others are wrong
- B – An oxygen saturation of 90% is this client's usual level and is expected in COPD.
- C – Mild edema and a pound of weight gain need follow-up, but they are not an immediate threat.
- D – Delayed return of bowel function on day 2 and mild pain are common after bowel surgery.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
32Question
A client with newly diagnosed type 1 diabetes will be discharged in two hours, and the nurse has limited teaching time. Which topics are survival skills that the nurse should teach first?
Select all that apply.
- How to draw up and inject insulin safely
- How to recognize and treat a low blood glucose
- The schedule for eye and foot examinations over the coming years
- How to adjust insulin doses for future travel across time zones
- How to check blood glucose with the meter and record the results
- How to count carbohydrates when eating at restaurants
Show the answers and explanation
Answers: A, B and E.
- A – How to draw up and inject insulin safely
- B – How to recognize and treat a low blood glucose
- E – How to check blood glucose with the meter and record the results
Topic: survival skills first in discharge teaching
When time is short, the nurse teaches what the client must know to stay safe at home: giving insulin correctly, recognizing and treating hypoglycemia, and checking glucose. Long-term screening schedules, travel adjustments and advanced diet skills are important but can wait for follow-up teaching.
Why the others are wrong
- C – Screening schedules matter over the long term but do not affect safety in the first days at home.
- D – Travel adjustments are an advanced topic that can wait for follow-up.
- F – Restaurant carbohydrate counting is an advanced skill that can be taught after the basics are learned.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
33Question
A school nurse is in the health office when four students arrive at the same time. Which student should the nurse assess first?
- A 9-year-old with a small paper cut on a finger that is bleeding only slightly and wants a bandage
- A 14-year-old with menstrual cramps who asks for ibuprofen and has a normal color and breathing
- An 11-year-old with a headache and a temperature of 99.8 F (37.7 C) who wants to lie down
- A 7-year-old with a known peanut allergy who ate a cookie and now has hives, lip swelling and a hoarse voice
Show the answer and explanation
Answer: D. A 7-year-old with a known peanut allergy who ate a cookie and now has hives, lip swelling and a hoarse voice
Topic: school nurse who to see first
Hives, lip swelling and a hoarse voice after eating an allergen suggest anaphylaxis, a rapidly progressing threat to airway and circulation. The nurse gives intramuscular epinephrine per the student's emergency plan, calls emergency services and monitors the student. The other students have minor complaints.
Why the others are wrong
- A – A tiny cut that is barely bleeding needs a bandage and can wait.
- B – Menstrual cramps in a student with normal color and breathing are not an emergency.
- C – A headache with a low-grade temperature is not urgent and can be assessed afterward.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
34Question
A charge nurse in a long-term care facility receives a report on four residents. Which resident should the nurse see first?
- A resident taking warfarin who fell this morning and now has a severe new headache, vomiting and increasing drowsiness
- A resident with a urinary tract infection who is taking an antibiotic and asking for more water to drink
- A resident with Alzheimer disease who is pacing the hallway and is unable to say what he needs
- A resident who has not had a bowel movement for two days and has mild abdominal bloating
Show the answer and explanation
Answer: A. A resident taking warfarin who fell this morning and now has a severe new headache, vomiting and increasing drowsiness
Topic: long-term care who to see first
A resident on an anticoagulant who fell and now has a severe headache, vomiting and growing drowsiness may have an intracranial bleed, which is life-threatening and time-sensitive. The nurse assesses neurologic status and calls the provider or emergency services at once.
Why the others are wrong
- B – A resident being treated for a urinary tract infection is stable and wants fluids, which the nurse can arrange soon.
- C – Pacing is common in dementia and needs attention to unmet needs but is not immediately dangerous.
- D – Mild constipation with bloating needs follow-up but is not an emergency.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
35Question
A walk-in clinic client lists three concerns: knee pain for several months, an itchy rash on one arm, and shortness of breath that began this morning. Which action should the nurse take first?
- Look closely at the rash for spread, drainage or signs of infection and ask what has been applied to it
- Review the client's medication list and past surgeries to find possible causes of the long-standing knee pain
- Ask about the client's usual activity level and whether supports or braces have been tried for the knee
- Check respiratory rate and oxygen saturation and ask about the new difficulty breathing
Show the answer and explanation
Answer: D. Check respiratory rate and oxygen saturation and ask about the new difficulty breathing
Topic: prioritizing multiple complaints in a clinic
Several complaints are sorted by urgency. A sudden change in breathing threatens oxygenation and may be life-threatening, so it is assessed before chronic or minor problems. Rash and knee pain are important but can wait.
Why the others are wrong
- A – A localized rash is a lower priority than a new breathing problem.
- B – Knee pain that has lasted for months is chronic and can be addressed after the acute problem.
- C – Activity level and supports relate to the long-standing knee complaint, which is not urgent.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
36Question
A client in an urgent care clinic reports sharp pain in the right knee after landing awkwardly during a basketball game. The nurse notes the cue but lacks enough information to judge its significance. Which questions should the nurse ask to analyze this cue?
Select all that apply.
- What movement were you making when the pain started?
- What makes the pain better or worse?
- Does the pain travel to other areas, such as the thigh or calf?
- Did your parents have knee problems when they were older?
- How would you rate the pain now on a scale of 0 to 10?
- What do you plan to do after you leave the clinic today?
Show the answers and explanation
Answers: A, B, C and E.
- A – What movement were you making when the pain started?
- B – What makes the pain better or worse?
- C – Does the pain travel to other areas, such as the thigh or calf?
- E – How would you rate the pain now on a scale of 0 to 10?
Topic: analyzing cues with subjective questions
To analyze a pain cue the nurse needs the onset and mechanism, the factors that relieve or aggravate it, its radiation and its severity. These details show how serious the problem may be and guide what to do next.
Why the others are wrong
- D – Family history of knee problems does not help explain pain that began with a specific injury.
- F – The client's plans after the visit do not help analyze the pain.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
37Question
A clinic nurse sees a 44-year-old client who fell from a ladder at home an hour ago. Which findings are relevant cues that need follow-up?
Select all that apply.
- The client skipped lunch today
- The left wrist is visibly deformed and swollen
- The client reports numbness and tingling in the fingers of the left hand
- The client rates pain as 8 out of 10, worse with movement
- A neighbor drove the client to the clinic
Show the answers and explanation
Answers: B, C and D.
- B – The left wrist is visibly deformed and swollen
- C – The client reports numbness and tingling in the fingers of the left hand
- D – The client rates pain as 8 out of 10, worse with movement
Topic: recognizing relevant cues
Relevant cues are the findings that bear on the injury and its complications. Deformity with swelling suggests a possible fracture, numbness suggests nerve or circulatory compromise, and severe, movement-related pain supports a musculoskeletal injury. Meals and transport are background details.
Why the others are wrong
- A – A missed meal has no direct link to the injury being assessed.
- E – Who provided transport does not describe the client's condition.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
38Question
A nurse answers the clinic telephone. The caller says her husband has crushing chest pressure with sweating and shortness of breath that started 20 minutes ago. What should the nurse do first?
- Instruct the caller to hang up and call 911 now, and keep the caller on the line until help is confirmed if policy allows
- Ask the caller to drive her husband to the clinic for an electrocardiogram
- Schedule an urgent visit for the first appointment available tomorrow morning so the provider can examine her husband in the clinic
- Advise the husband to rest and call back if the pain has not eased in an hour
Show the answer and explanation
Answer: A. Instruct the caller to hang up and call 911 now, and keep the caller on the line until help is confirmed if policy allows
Topic: telephone triage
Telephone triage sorts callers by urgency and directs them to the right level of care. Symptoms suggesting a myocardial infarction require activation of emergency medical services without delay.
Why the others are wrong
- B – Driving delays advanced care and risks collapse en route; emergency medical services should be summoned.
- C – Possible myocardial infarction needs immediate emergency care.
- D – Waiting an hour delays treatment of a possible life-threatening event.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
39Question
A hospital reopens after flooding closed two floors. The incident commander must decide which services to restore first. Which approach best supports a successful recovery?
- Let each department restore its own services in its own order without a shared plan
- Wait until every repair is finished before reopening any service
- Use current data on beds, supplies, staffing and damage to sequence reopening
- Reopen services in the order that department managers happen to ask
Show the answer and explanation
Answer: C. Use current data on beds, supplies, staffing and damage to sequence reopening
Topic: post-disaster recovery decision-making
Recovery works best when decisions rest on accurate, current information about capacity, supplies, staff and damage, shared by one coordinated team. This lets leaders restore the most important services first and safely.
Why the others are wrong
- A – Uncoordinated recovery competes for scarce resources and can leave critical services without support.
- B – Delaying all services until everything is repaired leaves the community without care that could safely resume.
- D – Reopening by who asks first ignores clinical need and available resources.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
40Question
At a bus-crash scene, an angry client with a closed ankle fracture asks a nurse why he is waiting while others who arrived later are being treated. Which explanation of disaster triage is best?
- Clients are treated strictly in the order in which they arrived so that care is fair to everyone
- Clients who can walk are treated first because they will recover faster
- Clients with the most family members present are treated first
- Injured people are sorted by urgency so life-threatening injuries are treated first
Show the answer and explanation
Answer: D. Injured people are sorted by urgency so life-threatening injuries are treated first
Topic: purpose of disaster triage
Disaster triage sorts casualties by the urgency of their injuries and the likelihood that treatment will help, so scarce resources go first to those with immediate life-threatening problems.
Why the others are wrong
- A – Arrival order ignores severity; in a disaster, urgency determines the sequence.
- B – Walking clients are generally the lowest priority in standard disaster triage.
- C – Family presence plays no role in triage decisions.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
41Question
At a mass-casualty site, a rescuer applying the START adult method finds a victim who cannot walk. The victim breathes 20 times a minute, has capillary refill under 2 seconds, and obeys simple commands. Which tag is assigned?
- Red (immediate)
- Green (minor)
- Black (expectant)
- Yellow (delayed)
Show the answer and explanation
Answer: D. Yellow (delayed)
Topic: START adult triage
In START triage, victims who can walk are green. Of those who cannot, a respiratory rate above 30, capillary refill over 2 seconds or failure to obey commands makes the tag red. A victim who passes all three checks is yellow, or delayed.
Why the others are wrong
- A – Red is for respirations above 30, delayed capillary refill, or inability to follow commands; none apply here.
- B – Green is for victims who can walk; this victim cannot.
- C – Black is for victims who are not breathing even after the airway is opened; this victim is breathing normally.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
42Question
A new staff nurse asks why the hospital has one emergency operations plan for floods, pandemics and chemical spills rather than a separate plan for each. Which explanation is best?
- It uses an all-hazards framework, with hazard-specific procedures added
- It is cheaper because a single plan never needs to be updated
- It includes only the hazards that have already struck this hospital
- Regulators forbid hazard-specific procedures in a hospital
Show the answer and explanation
Answer: A. It uses an all-hazards framework, with hazard-specific procedures added
Topic: emergency operations plan
An emergency operations plan sets out how a facility responds to and recovers from emergencies using an all-hazards approach, with common roles and structure supplemented by hazard-specific annexes.
Why the others are wrong
- B – Plans must be reviewed and updated regularly.
- C – Planning is meant to cover likely hazards, including ones that have not yet occurred.
- D – Regulators expect hazard-specific planning in addition to a common framework.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
43Question
A client with type 1 diabetes tells the nurse that he stopped his insulin two days ago and now takes a cinnamon supplement instead. He reports being thirsty and urinating often. Which action should the nurse take first?
- Explain that there is no evidence that cinnamon can replace insulin
- Document the client's decision to stop prescribed insulin
- Check the client's blood glucose and assess for signs of diabetic ketoacidosis
- Ask the provider to arrange a consultation with a registered dietitian about the client's diet
Show the answer and explanation
Answer: C. Check the client's blood glucose and assess for signs of diabetic ketoacidosis
Topic: priority assessment when insulin is stopped
A client with type 1 diabetes who has stopped insulin is at risk for diabetic ketoacidosis, and the symptoms of thirst and polyuria suggest hyperglycemia. Physiologic assessment takes priority over teaching, documentation or referral.
Why the others are wrong
- A – Education is needed but not before the client's physical status is checked.
- B – Documentation follows the assessment and the report to the provider.
- D – A dietitian does not address the immediate risk of ketoacidosis.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
44Question
A home health nurse visits a client with moderate Alzheimer's disease who recently left the stove burners on and walked out of the house at night. Which intervention best addresses safety?
- Give the spouse the number of a local dementia support group and a list of respite programs
- Teach the spouse ways to prevent caregiver burnout, including how to ask other relatives for help
- Encourage the client to keep handling his daily routine on his own for as long as possible
- Install door alarms and an automatic stove shut-off, and have the client wear an identification bracelet
Show the answer and explanation
Answer: D. Install door alarms and an automatic stove shut-off, and have the client wear an identification bracelet
Topic: home safety for dementia
For a client with dementia who has shown unsafe behaviors, the first step is to modify the environment to prevent harm, for example with alarms, automatic shut-offs and identification. Caregiver support and independence matter but do not remove the immediate hazards.
Why the others are wrong
- A – Community support helps the family but does not remove the immediate hazards.
- B – Preventing caregiver burnout is important but is not the immediate safety intervention.
- C – Encouraging full independence increases the risk of fire and wandering.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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