26Question
During hip surgery under general anesthesia with sevoflurane and succinylcholine, a 19-year-old develops jaw and muscle rigidity, a heart rate of 142/min, a rapidly rising end-tidal carbon dioxide, and a temperature of 104.5 F (40.3 C). Which drug does the nurse prepare for immediate administration?
- Acetaminophen intravenously
- Dantrolene intravenously
- Neostigmine intravenously
- Naloxone intravenously
Show the answer and explanation
Answer: B. Dantrolene intravenously
Topic: dantrolene for malignant hyperthermia
These findings indicate malignant hyperthermia, a hypermetabolic crisis triggered by volatile anesthetics and succinylcholine. Dantrolene stops the abnormal release of calcium inside muscle cells, which halts the rigidity and heat production. Trigger agents are stopped, 100% oxygen is given, and the client is cooled.
Why the others are wrong
- A – Acetaminophen lowers fever through the hypothalamus and does nothing for the muscle metabolic crisis.
- C – Neostigmine reverses non-depolarizing neuromuscular blockade and would not stop malignant hyperthermia.
- D – Naloxone reverses opioids and has no role in this crisis.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
27Question
A client completes a 20-minute guided relaxation session before a medical test. Which set of findings best shows that the parasympathetic nervous system has become dominant?
- Heart rate 112/min, dilated pupils, a dry mouth, and quiet bowel sounds
- Rising blood pressure, pale cool skin, quiet bowel sounds, and a dry mouth
- Rapid shallow breathing, sweating, trembling hands, and widened pupils
- Heart rate 64/min, constricted pupils, and active bowel sounds
Show the answer and explanation
Answer: D. Heart rate 64/min, constricted pupils, and active bowel sounds
Topic: parasympathetic versus sympathetic effects
The parasympathetic division governs rest and digest functions. It slows the heart, constricts the pupils, increases salivation and stimulates digestive activity. The sympathetic division produces the opposite pattern: faster heart rate, dilated pupils, dry mouth, sweating and reduced gut motility.
Why the others are wrong
- A – Tachycardia, dilated pupils and a dry mouth are sympathetic effects.
- B – Rising pressure, pallor and slowed bowel sounds are sympathetic vasoconstriction and gut slowing.
- C – Rapid breathing, diaphoresis and tremor are signs of sympathetic arousal.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
28Question
A client newly diagnosed with celiac disease learns that biopsy showed flattened villi in the small intestine. The client asks what problem this is most likely to cause. Which response by the nurse is best?
- The surface for taking in nutrients is reduced, so shortages of iron, folate and fat-soluble vitamins can develop.
- The intestinal lining makes too much digestive enzyme, which causes hard stools and weight gain from overeating.
- Bile cannot enter the small intestine, so the stool turns dark brown and becomes very hard to pass.
- The small intestine absorbs too much water from food, so the stools become dry and infrequent.
Show the answer and explanation
Answer: A. The surface for taking in nutrients is reduced, so shortages of iron, folate and fat-soluble vitamins can develop.
Topic: villous damage and malabsorption
Villi greatly increase the surface of the small intestine, and most nutrient absorption occurs there. When they are flattened, absorption falls and clients develop malabsorption, with diarrhea, weight loss and deficiencies such as iron-deficiency anemia, folate deficiency and low fat-soluble vitamins. Treatment is a strict gluten-free diet.
Why the others are wrong
- B – Damaged villi lead to poor digestion and absorption, so weight loss rather than gain is expected.
- C – Villous damage does not block bile flow, and stools in malabsorption are loose and pale rather than hard and dark.
- D – Failure to absorb leads to diarrhea, not constipation from excess water absorption.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
29Question
A client assigned male at birth begins estradiol therapy as part of gender-affirming care and asks what changes to expect. Which statement by the client shows correct understanding?
- My voice will gradually rise to a higher pitch as the months go by.
- My facial hair will stop growing completely within a few weeks.
- My height will increase slightly as my long bones lengthen.
- My body fat will slowly shift toward my hips and thighs.
Show the answer and explanation
Answer: D. My body fat will slowly shift toward my hips and thighs.
Topic: feminizing hormone therapy effects
Estrogen therapy gradually produces breast development, redistribution of fat toward the hips and thighs, softer skin, reduced muscle mass and fewer spontaneous erections. Changes appear over months to years. Voice pitch does not change with hormones, and facial hair thins slowly rather than disappearing quickly.
Why the others are wrong
- A – Estrogen does not raise voice pitch; voice training or surgery may be used for that.
- B – Facial hair thins slowly over a long period and may need hair removal; it does not stop in weeks.
- C – Adult height does not change because growth plates have closed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
30Question
A client with myasthenia gravis who has drooping eyelids and trouble chewing is started on pyridostigmine. Which finding best shows that the dose is effective?
- Increased salivation with abdominal cramping after each dose
- Weakness that returns within a few minutes of every dose
- Eyelids stay lifted and the client finishes a meal without tiring
- Pupil constriction and a heart rate of 48/min
Show the answer and explanation
Answer: C. Eyelids stay lifted and the client finishes a meal without tiring
Topic: pyridostigmine effectiveness
Acetylcholinesterase inhibitors prolong acetylcholine at the neuromuscular junction and so improve muscle strength. Raised eyelids and sustained chewing show better muscle function. Salivation, cramping, bradycardia and miosis indicate too much cholinergic effect and possible cholinergic crisis.
Why the others are wrong
- A – Salivation and cramping are signs of excess cholinergic stimulation and suggest overdose.
- B – Rapid return of weakness suggests the dose is not effective.
- D – Miosis and bradycardia are muscarinic effects of too much drug, not signs of benefit.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
31Question
A 78-year-old with overactive bladder stopped oxybutynin because of dry mouth and constipation and is started on mirabegron. She asks how the new drug works. Which explanation is accurate?
- It blocks acetylcholine receptors so that the bladder muscle stops contracting.
- It tightens the muscle at the bladder outlet so urine is held back.
- It makes the kidneys produce less urine at night.
- It stimulates beta-3 receptors in the bladder wall so the muscle relaxes and holds more urine.
Show the answer and explanation
Answer: D. It stimulates beta-3 receptors in the bladder wall so the muscle relaxes and holds more urine.
Topic: mirabegron mechanism
Mirabegron is a beta-3 adrenergic agonist. It relaxes the detrusor muscle during bladder filling, which increases capacity and reduces urgency and frequency. Because it does not block muscarinic receptors, dry mouth and constipation are less common. Blood pressure should be monitored because it can rise.
Why the others are wrong
- A – Blocking acetylcholine receptors describes oxybutynin and other antimuscarinics, the drugs she stopped.
- B – Tightening the outlet would cause retention and is not how this drug works.
- C – Reducing nighttime urine output describes desmopressin, not mirabegron.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
32Question
A client who stopped lisinopril because of a persistent dry cough is switched to losartan. The client asks whether the cough will come back. Which response by the nurse is most accurate?
- Yes, losartan raises bradykinin in the same way lisinopril does, so the dry cough will return.
- Yes, but the cough should fade after the first week or two as the body adjusts to the new drug.
- No, because losartan stops the body from ever forming angiotensin II in the first place.
- A cough is much less likely, because losartan blocks angiotensin II at its receptor without raising bradykinin.
Show the answer and explanation
Answer: D. A cough is much less likely, because losartan blocks angiotensin II at its receptor without raising bradykinin.
Topic: ARB mechanism and cough
ACE inhibitors prevent the breakdown of bradykinin, which causes a dry cough in some clients. Angiotensin II receptor blockers such as losartan block angiotensin II at its receptor and do not affect bradykinin, so cough is uncommon. Rare angioedema can still occur, and ARBs are avoided in pregnancy.
Why the others are wrong
- A – Losartan does not raise bradykinin; only ACE inhibitors do.
- B – The cough is not an adjustment effect and is not expected with an ARB at all.
- C – Preventing angiotensin II formation describes ACE inhibitors; ARBs block its receptor instead.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
33Question
A client with heart failure who does not have diabetes starts dapagliflozin. The client is surprised to hear that glucose may appear in the urine. Which explanation by the nurse is best?
- The drug blocks a transporter in the kidney tubules, so less glucose and sodium return to the blood and more leave in the urine.
- The drug makes the pancreas release extra insulin, which pushes glucose into the urine.
- The drug breaks down glycogen in the liver, so too much glucose reaches the kidneys.
- The drug damages the kidney filters, which lets glucose leak through.
Show the answer and explanation
Answer: A. The drug blocks a transporter in the kidney tubules, so less glucose and sodium return to the blood and more leave in the urine.
Topic: SGLT2 inhibitor action in heart failure
SGLT2 inhibitors block the sodium-glucose cotransporter in the proximal tubule, where most filtered glucose is reclaimed. Glucose and sodium, with water, are lost in the urine, which causes glucosuria and a mild diuresis that lowers fluid load in heart failure. Teaching includes hydration, genital hygiene and holding the drug during acute illness.
Why the others are wrong
- B – SGLT2 inhibitors act in the kidney and do not increase insulin secretion.
- C – They do not raise blood glucose by breaking down glycogen.
- D – The glucose in urine comes from blocked reabsorption, not from damaged filters.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
34Question
A 68-year-old with Parkinson disease has entacapone added to carbidopa/levodopa because each dose wears off before the next one is due. Two weeks later, which finding best indicates that the new drug is working?
- The urine has turned a brownish-orange color since the first week
- The resting tremor has disappeared completely in both hands
- Periods of stiffness and slowness between doses are shorter
- Involuntary writhing movements of the face and arms have begun
Show the answer and explanation
Answer: C. Periods of stiffness and slowness between doses are shorter
Topic: COMT inhibitor effectiveness
Entacapone inhibits COMT, which slows the breakdown of levodopa, so each dose lasts longer and end-of-dose wearing off is reduced. Evidence of benefit is more time with good mobility and fewer off periods. Harmless orange-brown urine and dyskinesia are effects of the drug, not measures of benefit; dyskinesia may require a lower levodopa dose.
Why the others are wrong
- A – Brownish-orange urine is a harmless side effect and tells nothing about benefit.
- B – Complete tremor loss is not an expected outcome; the aim is smoother control between doses.
- D – Dyskinesia is an adverse effect of increased levodopa action and should be reported.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
35Question
A woman with a urinary tract infection reports a sudden, strong need to void and leaks urine before she can reach the bathroom. Which type of incontinence does the nurse recognize?
- Stress incontinence
- Urge incontinence
- Overflow incontinence
- Functional incontinence
Show the answer and explanation
Answer: B. Urge incontinence
Topic: urge incontinence recognition
Urge incontinence is leakage preceded by a sudden, intense need to void, caused by involuntary bladder contractions. Bladder infection, age and outlet obstruction are among the risk factors. Stress incontinence follows coughing or lifting, overflow incontinence follows a bladder that never empties, and functional incontinence stems from being unable to reach or use the toilet.
Why the others are wrong
- A – Stress incontinence occurs with coughing, sneezing or lifting, not with a sudden urge.
- C – Overflow incontinence is dribbling from a bladder that does not empty fully.
- D – Functional incontinence occurs when the client cannot get to the toilet because of mobility or cognition.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
36Question
The daughter of a client with a left-hemisphere ischemic stroke asks why her father has right-arm weakness and slurred speech when his arm itself is not injured. Which explanation by the nurse is best?
- The nerves in his arm were damaged when blood flow to the arm itself stopped.
- The stroke injured the spinal cord, which carries the messages down to the arm.
- A blocked vessel injured part of the brain, which directs movement and speech.
- The autonomic nervous system has shut down the muscles of his arm and face.
Show the answer and explanation
Answer: C. A blocked vessel injured part of the brain, which directs movement and speech.
Topic: stroke and the central nervous system
An ischemic stroke is loss of blood flow to part of the brain. The brain and spinal cord form the central nervous system. Damage to motor and speech areas of one hemisphere causes weakness on the opposite side of the body and speech problems even though the arm and its nerves are intact.
Why the others are wrong
- A – The arm and its peripheral nerves are intact; the injury is in the brain.
- B – An ischemic stroke affects the brain, not the spinal cord.
- D – The autonomic system controls involuntary functions and does not account for limb weakness and slurred speech.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
37Question
A client with seasonal allergic rhinitis says diphenhydramine makes them too sleepy to work and asks why loratadine is called non-drowsy. Which explanation by the nurse is most accurate?
- Loratadine shrinks swollen nasal vessels, so it never acts on the central nervous system.
- Loratadine is a second-generation H1 blocker that enters the brain only slightly.
- Loratadine blocks H2 receptors in the stomach, which have nothing to do with alertness.
- Loratadine thins nasal mucus, so it does not need to reach the brain at all.
Show the answer and explanation
Answer: B. Loratadine is a second-generation H1 blocker that enters the brain only slightly.
Topic: second-generation antihistamine
Loratadine is a second-generation H1 antihistamine. Its chemistry keeps most of the drug out of the central nervous system, so sedation is uncommon. First-generation agents such as diphenhydramine cross into the brain easily and cause drowsiness.
Why the others are wrong
- A – Vessel shrinkage is the action of a decongestant; loratadine works by blocking histamine at H1 receptors.
- C – H2 blockers such as famotidine reduce gastric acid; loratadine acts at H1 receptors.
- D – Thinning mucus is a mucolytic or expectorant action, not an antihistamine action.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
38Question
A school nurse finds live lice on the scalp of an 8-year-old. A neighbor has told the parent to buy lindane shampoo. Which product does the nurse recommend as the first treatment?
- Lindane shampoo left on the hair for 4 minutes before it is rinsed off
- A single oral dose of mebendazole taken with the evening meal
- Oral metronidazole taken three times a day for seven days
- Permethrin 1% lotion applied to damp hair and rinsed after 10 minutes
Show the answer and explanation
Answer: D. Permethrin 1% lotion applied to damp hair and rinsed after 10 minutes
Topic: head lice treatment
Permethrin 1% is the usual first-line over-the-counter product for head lice. Lindane carries a boxed warning for neurotoxicity and is a last-line agent. Anthelmintics and antiprotozoal drugs do not kill lice.
Why the others are wrong
- A – Lindane can cause seizures and other neurotoxicity, so it is kept for people who have failed safer products.
- B – Mebendazole treats intestinal worms such as pinworm, not infestation of the scalp.
- C – Metronidazole treats protozoal and anaerobic infections and has no effect on lice.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
39Question
A client known to have stable angina tells the nurse that the chest pain now occurs while resting, woke the client from sleep, and lasted about 25 minutes. Which action is most appropriate?
- Reassure the client that rest is the right way to relieve angina and ask the client to call back if the pain recurs.
- Treat as a possible acute coronary syndrome: obtain an ECG and notify the provider immediately.
- Advise the client to schedule a stress test within the month.
- Increase the number of sublingual nitroglycerin tablets taken each day.
Show the answer and explanation
Answer: B. Treat as a possible acute coronary syndrome: obtain an ECG and notify the provider immediately.
Topic: recognizing unstable angina
Stable angina occurs with exertion and settles with rest. Pain at rest, lasting longer than 20 minutes, or waking the client indicates unstable angina or possible infarction, which is an emergency.
Why the others are wrong
- A – Pain at rest is a change from the stable pattern and is not relieved by simple rest.
- C – A routine test next month is too late for a possible unstable pattern.
- D – Changing the dose without evaluation could mask a developing infarction.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
40Question
A nurse gives epinephrine intramuscularly to a client in anaphylaxis. A few minutes later the client says, 'My heart is pounding and I feel shaky and nervous.' What is the best response?
- This means you are allergic to epinephrine, so I will stop it.
- Your symptoms mean the reaction is getting worse, so I will stop the epinephrine and give only an antihistamine.
- These effects are expected with epinephrine, and I will keep checking your heart rate and breathing.
- Try to calm down, because anxiety is the only reason for this.
Show the answer and explanation
Answer: C. These effects are expected with epinephrine, and I will keep checking your heart rate and breathing.
Topic: epinephrine adverse effects in anaphylaxis
Epinephrine stimulates adrenergic receptors, so palpitations, tremor, anxiety, and pallor are common and expected. They do not call for stopping the drug during anaphylaxis, but the client's heart rate, blood pressure, and breathing are monitored.
Why the others are wrong
- A – Palpitations and tremor are expected effects, not an allergy to the drug.
- B – An antihistamine alone does not replace epinephrine in anaphylaxis.
- D – Dismissing the feeling as anxiety ignores a known drug effect and the need for monitoring.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
41Question
A nursing student asks how sertraline relieves depression. Which explanation is correct?
- It slows the return of serotonin into the sending neuron, so more stays at the receptor.
- It speeds up electrical impulses along the axons of every neuron in the brain.
- It destroys acetylcholinesterase in the synapse, so more acetylcholine reaches the muscle fibers.
- It binds the serotonin receptor permanently, so serotonin can never act.
Show the answer and explanation
Answer: A. It slows the return of serotonin into the sending neuron, so more stays at the receptor.
Topic: mechanism of SSRIs at the synapse
Neurotransmission converts an electrical signal into a chemical message that crosses the synapse. Sertraline blocks the reuptake of serotonin, so more of the transmitter remains available to stimulate postsynaptic receptors.
Why the others are wrong
- B – Drugs of this class act at the synapse on chemical messengers, not on the speed of axonal impulses.
- C – Destroying acetylcholinesterase describes a different drug class and a different transmitter.
- D – Sertraline does not bind receptors permanently; it blocks reuptake of the transmitter.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
42Question
A client is given atropine before a procedure. Which findings does the nurse expect, based on blockade of muscarinic receptors?
- Dry mouth and a faster heart rate
- Increased salivation and a slower heart rate
- Constricted pupils and loose stools
- Bronchoconstriction and increased sweating
Show the answer and explanation
Answer: A. Dry mouth and a faster heart rate
Topic: anticholinergic effects of atropine
Acetylcholine is the main transmitter of the parasympathetic system, and atropine blocks its muscarinic receptors. The result is dry mouth, tachycardia, urinary retention, pupil dilation, and decreased sweating.
Why the others are wrong
- B – These are cholinergic effects, the opposite of atropine.
- C – Pupil constriction and diarrhea occur with parasympathetic stimulation.
- D – Atropine dilates bronchi and reduces sweating.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
43Question
A client in acute decompensated heart failure is started on dobutamine, which acts mainly on beta1 receptors. Which effect does the nurse expect?
- Relaxation of the smooth muscle in the bronchi, which widens the airways
- Constriction of blood vessels in the skin and gut
- Stronger heart contractions with improved cardiac output
- Slowing of conduction through the AV node
Show the answer and explanation
Answer: C. Stronger heart contractions with improved cardiac output
Topic: beta1 receptor stimulation
Beta1 receptors are found chiefly in the heart. Stimulating them increases the force of contraction, heart rate, and conduction speed, which raises cardiac output. Blocking them does the opposite.
Why the others are wrong
- A – Bronchodilation is a beta2 effect.
- B – Vasoconstriction is mainly an alpha1 effect.
- D – Beta1 stimulation speeds conduction rather than slowing it.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
44Question
The charge nurse is making assignments on an oncology unit. Which nurse should be reassigned away from preparing and giving chemotherapy?
- An RN who has completed chemotherapy competency training
- An RN who has worked in oncology for 15 years
- An RN who has seasonal allergies and mild sneezing
- An RN who is 10 weeks pregnant
Show the answer and explanation
Answer: D. An RN who is 10 weeks pregnant
Topic: hazardous drug handling in pregnancy
Many chemotherapy drugs are teratogenic and can harm a fetus through occupational exposure. Safe practice guidance advises that nurses who are pregnant or trying to conceive be offered alternative assignments.
Why the others are wrong
- A – Training is required for the task and is not a reason to remove the nurse.
- B – Experience supports safe handling.
- C – Mild allergy symptoms do not raise the risk of exposure to hazardous drugs.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
45Question
A client has a 5 cm breast tumor. The oncologist plans chemotherapy first to shrink the tumor before surgery. What is this approach called?
- Adjuvant therapy, given after the main treatment to prevent recurrence
- Neoadjuvant therapy, given before the main treatment to shrink the tumor
- Palliative therapy, given only to relieve symptoms of advanced disease and not to treat the tumor
- Salvage therapy, given after other treatments have failed
Show the answer and explanation
Answer: B. Neoadjuvant therapy, given before the main treatment to shrink the tumor
Topic: neoadjuvant therapy
Treatment given before the main therapy to make the tumor smaller or easier to remove is neoadjuvant therapy. Adjuvant therapy is given afterward to destroy remaining cells.
Why the others are wrong
- A – Adjuvant therapy follows surgery or radiation.
- C – The goal here is to improve surgical results, not only to relieve symptoms.
- D – Salvage therapy is used after earlier treatment has not worked.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
46Question
A client who cannot tolerate high-dose statins is prescribed ezetimibe and asks how the drug works. What does the nurse say?
- It blocks absorption of cholesterol from food and bile in the small intestine.
- It stops the liver from making new cholesterol each night while the client sleeps.
- It binds bile acids in the intestine so they leave in the stool.
- It breaks down triglycerides in the blood vessels.
Show the answer and explanation
Answer: A. It blocks absorption of cholesterol from food and bile in the small intestine.
Topic: ezetimibe mechanism
Ezetimibe inhibits the intestinal transporter that absorbs dietary and biliary cholesterol, which lowers LDL cholesterol. It acts differently from statins, bile acid sequestrants, and fibrates.
Why the others are wrong
- B – That describes the statin class.
- C – That describes a bile acid sequestrant such as cholestyramine.
- D – That describes fibrates, which activate lipoprotein lipase.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
47Question
A client with a potassium level of 2.8 mEq/L has flattened T waves and a U wave on the monitor. What does the T wave represent?
- Repolarization of the ventricles
- Depolarization of the atria as the SA node fires
- Depolarization of the ventricles as they contract
- Conduction delay through the AV node
Show the answer and explanation
Answer: A. Repolarization of the ventricles
Topic: T wave and repolarization
The P wave is atrial depolarization, the PR interval reflects AV node delay, the QRS is ventricular depolarization, and the T wave is ventricular repolarization. Hypokalemia flattens the T wave and may produce a U wave.
Why the others are wrong
- B – Atrial depolarization is the P wave.
- C – Ventricular depolarization is the QRS complex.
- D – Delay at the AV node is shown by the PR interval.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
48Question
A client with persistent asthma has used inhaled beclomethasone twice daily for one week. He tells the nurse, "This inhaler does nothing when I get short of breath, so it isn't working." Which response is most accurate?
- "It calms airway inflammation over time, so use it daily; your rescue inhaler treats sudden symptoms."
- "Take extra puffs of it whenever you feel short of breath, until the tightness goes away completely."
- "It should relax the airway muscles within minutes, so your inhaler technique is probably wrong."
- "Stop it for now, because a drug that gives no quick relief is not suited to your asthma at all."
Show the answer and explanation
Answer: A. "It calms airway inflammation over time, so use it daily; your rescue inhaler treats sudden symptoms."
Topic: inhaled corticosteroid controller versus rescue
Inhaled corticosteroids are controller drugs that reduce airway inflammation gradually, so they are used on a schedule and do not relieve acute bronchospasm. A short-acting bronchodilator is used for sudden symptoms.
Why the others are wrong
- B – Extra puffs of a steroid do not relieve acute symptoms and raise the dose of the steroid without benefit.
- C – Bronchodilators relax airway muscle quickly; corticosteroids do not, so technique is not the explanation.
- D – Stopping the controller removes the protection against future flare-ups.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
49Question
A client with heart failure has gained 3 kg in two days. The nurse finds 3+ pitting edema in both legs, bibasilar crackles, and dyspnea at rest. Which medication does the nurse expect the prescriber to order for the fluid overload?
- Intravenous furosemide
- Oral digoxin
- Oral valsartan
- Oral metoprolol succinate
Show the answer and explanation
Answer: A. Intravenous furosemide
Topic: loop diuretic for fluid overload
A loop diuretic such as furosemide acts quickly and powerfully to remove excess sodium and water, relieving pulmonary congestion and edema. The intravenous route gives the fastest effect when the client is symptomatic at rest.
Why the others are wrong
- B – Digoxin improves contractility and controls rate, but it does not remove fluid.
- C – Valsartan lowers afterload for long-term management; it is not a rapid decongestant.
- D – Beta blockers are started when the client is stable and may worsen decompensated failure.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
50Question
A client with the target disease is invited to join a trial. The consent form states that about 100 volunteers with the disease will receive the investigational drug so researchers can learn whether it works and refine the dose, while monitoring safety. Which phase is described?
- Phase I
- Phase II
- Phase III
- Phase IV
Show the answer and explanation
Answer: B. Phase II
Topic: phases of drug development
Phase II studies enroll a small to moderate number of volunteers who have the target condition to look for effectiveness and the best dose range while safety continues to be monitored. Phase I uses a few healthy volunteers, Phase III uses large groups, and Phase IV happens after marketing.
Why the others are wrong
- A – Phase I mainly tests safety and dosing in a small group, often healthy volunteers.
- C – Phase III compares the drug against standard care in large groups to confirm benefit.
- D – Phase IV is postmarketing surveillance after approval.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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