26Question
The nurse is teaching foot care to a client with type 2 diabetes mellitus and peripheral neuropathy. Which instructions should the nurse include?
Select all that apply.
- "Look at the tops and soles of your feet every day, using a mirror if needed."
- "Dry your feet well after washing, especially between the toes."
- "Soak your feet in warm water for 20 minutes every evening."
- "Rub moisturizing lotion between your toes to prevent cracking."
- "Go barefoot at home so that air can reach your feet."
- "Use a heating pad when your feet feel cold at night."
Show the answers and explanation
Answers: A and B.
- A – "Look at the tops and soles of your feet every day, using a mirror if needed."
- B – "Dry your feet well after washing, especially between the toes."
Topic: foot care in diabetes
With neuropathy the client cannot feel injuries, so daily inspection finds problems early. Keeping the skin clean and dry, particularly between the toes, prevents maceration and fungal infection that can open the way to ulcers.
Why the others are wrong
- C – Soaking macerates the skin and increases the risk of breakdown and infection.
- D – Lotion is used on dry skin of the feet but not between the toes, where moisture promotes fungal growth and maceration.
- E – Walking barefoot exposes insensate feet to unnoticed cuts and punctures; well-fitting shoes or slippers are worn at all times.
- F – A client with reduced sensation cannot feel a burn from a heating pad; socks are used for warmth.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
27Question
The nurse supervises unlicensed assistive personnel (UAP) who are giving perineal care to an uncircumcised older male client. Which action by the UAP requires the nurse to intervene?
- Gently retracting the foreskin before washing the glans
- Washing from the urinary meatus outward in a circular motion
- Rinsing and drying the area thoroughly after washing
- Leaving the foreskin retracted after the care is finished
Show the answer and explanation
Answer: D. Leaving the foreskin retracted after the care is finished
Topic: perineal care
The foreskin must be returned to its natural position after cleaning. Left retracted, it acts as a tight band behind the glans, causing swelling, pain and impaired circulation (paraphimosis), which is an emergency.
Why the others are wrong
- A – Gentle retraction is needed to clean the secretions that collect under the foreskin.
- B – Cleaning from the meatus outward moves from the cleanest area to the less clean and is correct.
- C – Rinsing and drying prevent irritation and skin breakdown and are correct.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
28Question
A client receiving chemotherapy has painful, reddened oral mucosa with several shallow ulcers. Which measures does the nurse include in the plan of care?
Select all that apply.
- Clean the teeth with a soft-bristle brush and rinse with a saline or baking soda solution after meals and at bedtime
- Rinse with a commercial alcohol-based mouthwash to lower the bacterial count
- Offer soft, bland, cool or room-temperature foods
- Moisten the mouth with lemon-glycerin swabs between meals
- Leave dentures out except at mealtimes
Show the answers and explanation
Answers: A, C and E.
- A – Clean the teeth with a soft-bristle brush and rinse with a saline or baking soda solution after meals and at bedtime
- C – Offer soft, bland, cool or room-temperature foods
- E – Leave dentures out except at mealtimes
Topic: chemotherapy mucositis care
Care of chemotherapy-induced mucositis keeps the mouth clean and moist without adding trauma: a soft brush, bland non-alcohol rinses, non-irritating foods and removal of dentures that rub the ulcerated tissue. Alcohol and lemon-glycerin dry and irritate the mucosa.
Why the others are wrong
- B – Alcohol dries and burns inflamed mucosa and worsens the pain and breakdown.
- D – Lemon-glycerin is acidic and drying; it irritates the ulcers and reduces saliva protection.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
29Question
A nurse finds a client sitting on the floor beside the bed at 0215. The nurse assesses the client, finds no injury, helps the client back to bed, notifies the provider and completes an event report. Which entry does the nurse write in the client's medical record?
- '0215: Found sitting on floor at right side of bed. States, "I slid down when I tried to stand." No injury found on examination; vital signs recorded. Provider notified.'
- '0215: Client fell out of bed because the bed alarm had not been switched on by the evening shift. Event report completed.'
- '0215: Client apparently fell while carelessly trying to get up without calling. Appears uninjured. Event report filed with risk management.'
- '0215: Unwitnessed fall. See event report for details.'
Show the answer and explanation
Answer: A. '0215: Found sitting on floor at right side of bed. States, "I slid down when I tried to stand." No injury found on examination; vital signs recorded. Provider notified.'
Topic: documenting a fall
The medical record holds the objective facts: what was seen, what the client said, the assessment, the care given and who was notified. The event report is a separate, confidential quality-improvement document; it is not part of the record and is not mentioned in it.
Why the others are wrong
- B – It assigns blame and a cause, and it mentions the event report in the record.
- C – 'Apparently' and 'carelessly' are assumption and judgement, and the entry refers to the event report.
- D – The record must contain the facts and assessment itself; it must not point to the event report.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
30Question
While scanning a pharmacy-prepared infusion bag before hanging it, a nurse notices that it holds ten times the ordered concentration of heparin. The nurse does not hang the bag and obtains the correct one from pharmacy. Which further action does the nurse take?
- No further action is needed because the medication did not reach the client
- Write in the client's medical record that a pharmacy error was caught before administration
- Tell the client that an overdose was narrowly avoided so the client can watch for future errors
- Report the near miss through the facility's event reporting system
Show the answer and explanation
Answer: D. Report the near miss through the facility's event reporting system
Topic: near miss reporting
An error that is caught before it reaches the client is a near miss, and it is reported in the same way as an error that causes harm. Near-miss reports let the organization find and fix the system weakness before the same failure harms someone.
Why the others are wrong
- A – Unreported near misses leave the hazard in place for the next client.
- B – Nothing happened to the client that belongs in the medical record; the event belongs in the reporting system.
- C – Disclosure is owed when an error reaches the client; here it would cause alarm without fixing the system, and safety is not the client's job to police.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
31Question
A nurse manager is reviewing last month's events on the unit. Which events are sentinel events that call for an immediate investigation with a root cause analysis?
Select all that apply.
- A surgical procedure was performed on the wrong knee
- A scheduled antibiotic was given 90 minutes late with no effect on the client
- A client died by suicide in a room on the unit
- A client slid to the floor during a transfer and had no injury
- A nurse noticed a wrong-dose syringe from pharmacy before giving it
Show the answers and explanation
Answers: A and C.
- A – A surgical procedure was performed on the wrong knee
- C – A client died by suicide in a room on the unit
Topic: sentinel events
A sentinel event is a patient safety event that reaches the client and results in death, permanent harm or severe temporary harm; wrong-site surgery and suicide of a client in a staffed care setting are named examples. Such events call for an immediate response and a thorough root cause analysis.
Why the others are wrong
- B – A late dose with no harm is a medication variance; it is reported but is not a sentinel event.
- D – A fall without injury is reported as an event but caused no death or serious harm.
- E – This is a near miss: it did not reach the client. It is reported, but it is not a sentinel event.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
32Question
Ten minutes after giving morning medications, a nurse realizes that a client received metoprolol 100 mg instead of the ordered 25 mg. Which action does the nurse take first?
- Notify the provider of the error
- Complete an event report while the details are fresh
- Check the client's heart rate and blood pressure
- Tell the client and the family that an error was made
Show the answer and explanation
Answer: C. Check the client's heart rate and blood pressure
Topic: medication error response and disclosure
After a medication error the client's safety comes first: the nurse assesses for the drug's effects, here bradycardia and hypotension, so that harm is found and treated early. The nurse then notifies the provider with those findings, carries out orders, discloses the error to the client according to policy, and completes the event report.
Why the others are wrong
- A – The provider is notified promptly, but with current assessment data; assessment comes first.
- B – The report is required but does nothing for the client's immediate safety.
- D – The client has a right to be told honestly, but disclosure follows assessment and notification of the provider.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
33Question
An 84-year-old client with mild Alzheimer's disease had a hip repaired two days ago. The daughter says, 'She knew me yesterday. Today she is not herself.' Which findings would support delirium rather than progression of the dementia?
Select all that apply.
- The change developed over about one day.
- The client is drowsy at noon and restless and agitated in the evening.
- The client's memory for recent events has slowly worsened over two years.
- The client cannot keep attention on a simple question long enough to answer it.
- The client is picking at the bed linen and seeing people who are not in the room.
- The client is alert and has had the same word-finding difficulty for months.
Show the answers and explanation
Answers: A, B, D and E.
- A – The change developed over about one day.
- B – The client is drowsy at noon and restless and agitated in the evening.
- D – The client cannot keep attention on a simple question long enough to answer it.
- E – The client is picking at the bed linen and seeing people who are not in the room.
Topic: delirium versus dementia
Delirium has an acute onset, a fluctuating course, inattention and a changed level of consciousness, often with visual misperceptions. It signals an underlying physical cause (infection, hypoxia, medications, pain, urinary retention) and is a medical emergency that is usually reversible.
Why the others are wrong
- C – Gradual decline over years is the pattern of dementia.
- F – A stable, alert state with long-standing language difficulty fits dementia.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
34Question
An 81-year-old client is admitted to the intensive care unit after emergency bowel surgery. The client is oriented and wears glasses and hearing aids at home. Which actions should the nurse include in the plan of care to reduce the risk of delirium?
Select all that apply.
- Make sure the client's glasses and hearing aids are in place during waking hours.
- Request a benzodiazepine at bedtime to ensure the client sleeps.
- Group nighttime care together, dim the lights and reduce noise so the client can sleep.
- Apply soft wrist restraints to protect the intravenous lines in case confusion develops.
- Help the client out of bed and walking as early as the condition allows.
- Leave the television on throughout the day and night to provide stimulation.
Show the answers and explanation
Answers: A, C and E.
- A – Make sure the client's glasses and hearing aids are in place during waking hours.
- C – Group nighttime care together, dim the lights and reduce noise so the client can sleep.
- E – Help the client out of bed and walking as early as the condition allows.
Topic: preventing delirium in intensive care
Delirium in critically ill older adults is reduced by non-drug measures used together: correcting sensory deficits, protecting the sleep-wake cycle, early mobilization, and frequent reorientation. Benzodiazepines and physical restraints are recognized contributors to delirium, and constant, meaningless stimulation adds to sensory overload and disrupts sleep.
Why the others are wrong
- B – Benzodiazepines increase the risk of delirium in older and critically ill clients; sleep is promoted by non-drug measures first.
- D – Restraints applied in advance are not justified by any behavior and themselves increase agitation and delirium.
- F – Continuous television is meaningless stimulation that disturbs sleep and adds to sensory overload.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
35Question
A resident with Alzheimer disease in a long-term care facility becomes restless, suspicious and tearful each day from about 4 p.m., and tries to leave 'to collect the children from school'. Which intervention should the nurse add to the plan of care?
- Dim the room lights in the late afternoon and encourage a long nap.
- Move bathing and physical therapy to the late afternoon so the resident is tired by evening.
- Turn on the lights and close the curtains before dusk, and offer a quiet, familiar activity with a snack at that time.
- Explain each afternoon that the children are adults now, and repeat this until the resident accepts it.
Show the answer and explanation
Answer: C. Turn on the lights and close the curtains before dusk, and offer a quiet, familiar activity with a snack at that time.
Topic: sundowning in dementia
Late-day worsening of confusion and agitation in dementia (sundowning) is linked to fatigue, fading light and shadows, and unmet needs such as hunger. Good lighting before dusk, a calm routine, a simple familiar activity and attention to physical needs reduce it. Demanding tasks late in the day and repeated confrontation with reality increase distress.
Why the others are wrong
- A – Low light increases shadows and misperception, and a long late nap disrupts night sleep and worsens evening confusion.
- B – Demanding activities late in the day add fatigue and stimulation at the time the resident copes least; they belong in the morning.
- D – Repeated correction cannot be retained in dementia and causes fresh distress each time; validation and redirection work better.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
36Question
A client has been in a single isolation room for 12 days. The window blind stays closed, staff enter only for essential care, and there have been no visitors. The client now sleeps for much of the day, seems bored and apathetic, is unsure of the date, and reports 'patterns moving on the wall'. Vital signs and laboratory values are unchanged. Which action by the nurse is most appropriate?
- Open the blind, provide a clock, calendar and radio, and plan regular unhurried contact with staff and by telephone or video with family.
- Lower the lights, reduce noise and limit entry to the room further so the client can rest.
- Ask the provider to prescribe an antipsychotic for the visual disturbances.
- Tell the client that the patterns are not real and that being unsure of the date is normal in the hospital.
Show the answer and explanation
Answer: A. Open the blind, provide a clock, calendar and radio, and plan regular unhurried contact with staff and by telephone or video with family.
Topic: sensory deprivation versus overload
Prolonged isolation with little light, contact or meaningful input produces sensory deprivation: boredom, apathy, excessive sleep, disorientation and perceptual distortions. The treatment is to restore meaningful stimulation and orientation cues. Measures that reduce stimulation are for sensory overload and would make deprivation worse.
Why the others are wrong
- B – Reducing light, noise and contact is the remedy for sensory overload and deepens deprivation.
- C – The perceptual changes come from the environment; a drug treats the result while the cause continues.
- D – Reorientation alone, with a dismissive explanation, does nothing to change the lack of stimulation producing the symptoms.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
37Question
The nurse on a detoxification unit has four clients. Which one should the nurse see first?
- A client in opioid withdrawal with yawning, runny nose and abdominal cramps asking for medication
- A client intoxicated on cannabis who is anxious, hungry and has red eyes
- A client 72 hours after the last drink with temperature 38.9 C, heart rate 124/min, blood pressure 176/102 mm Hg, seeing spiders and disoriented
- A client two days after stopping methamphetamine who is sleeping long hours and feels low
Show the answer and explanation
Answer: C. A client 72 hours after the last drink with temperature 38.9 C, heart rate 124/min, blood pressure 176/102 mm Hg, seeing spiders and disoriented
Topic: delirium tremens priority
Fever, tachycardia, hypertension, hallucinations and disorientation three days after stopping alcohol indicate delirium tremens, which is life threatening and needs immediate treatment and safety measures.
Why the others are wrong
- A – Opioid withdrawal is uncomfortable but not usually life threatening.
- B – Cannabis intoxication with anxiety is stable and managed with a calm environment.
- D – A stimulant crash causes fatigue and low mood and is not an emergency.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
38Question
A client is brought in after using methamphetamine. Which findings should the nurse expect?
Select all that apply.
- Tachycardia
- Pupillary constriction
- Paranoid ideation
- Hypertension
- Dilated pupils
- Slow shallow breathing
Show the answers and explanation
Answers: A, C, D and E.
- A – Tachycardia
- C – Paranoid ideation
- D – Hypertension
- E – Dilated pupils
Topic: stimulant intoxication
Stimulants increase sympathetic activity: fast heart rate, high blood pressure, dilated pupils, agitation and paranoia. Pinpoint pupils and slow breathing point to opioids.
Why the others are wrong
- B – Constricted pupils suggest opioids.
- F – Slow shallow breathing suggests opioid or sedative effect.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
39Question
A client found unresponsive after heroin use is given naloxone and wakes up. Thirty minutes later the client is alert and wants to leave. What is the nurse's priority?
- Allow discharge because the client is now alert
- Give a second naloxone dose now to prevent relapse
- Start buprenorphine immediately to prevent withdrawal
- Keep the client under close observation with respiratory monitoring because naloxone may wear off before the opioid does
Show the answer and explanation
Answer: D. Keep the client under close observation with respiratory monitoring because naloxone may wear off before the opioid does
Topic: naloxone duration and buprenorphine
Naloxone is a short-acting opioid antagonist, and many opioids last longer, so breathing may fail again as the reversal wears off. Buprenorphine is a partial agonist started for maintenance after withdrawal has begun, because it can precipitate withdrawal if given too early.
Why the others are wrong
- A – Discharging early risks re-sedation and respiratory arrest outside the hospital.
- B – A repeat dose is given for recurrent respiratory depression, not routinely to an alert client.
- C – Buprenorphine too soon can precipitate withdrawal and is not an overdose rescue drug.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
40Question
A client with alcohol use disorder says, "My wife says I drink too much. Honestly I like drinking, but my liver tests scare me." Which response reflects motivational interviewing?
- "You should stop drinking now. Your liver is at risk."
- "It sounds like part of you values drinking and part of you is worried about your health."
- "If you are scared, why have you not quit already?"
- "That is denial. Let me list every harm alcohol has caused you."
Show the answer and explanation
Answer: B. "It sounds like part of you values drinking and part of you is worried about your health."
Topic: motivational interviewing
Motivational interviewing explores ambivalence with empathy and reflective listening so the client voices reasons for change. Confrontation, advice-giving and labeling increase resistance.
Why the others are wrong
- A – Direct advice and orders increase resistance.
- C – A challenging why-question implies blame.
- D – Labeling denial and lecturing is confrontational.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
41Question
On an inpatient mental health unit, a client complains to the nurse that a roommate plays a radio late into the evening and that 'nobody here cares'. Which response by the nurse makes the best use of the therapeutic milieu?
- Take the radio from the roommate and keep it at the nurses' station.
- Offer to move the client to a different room that evening.
- Advise the client to use earplugs and try not to let it be upsetting.
- Encourage the client to raise the concern at the community meeting and offer support in doing so.
Show the answer and explanation
Answer: D. Encourage the client to raise the concern at the community meeting and offer support in doing so.
Topic: milieu therapy and community meetings
In milieu therapy the unit itself is the treatment: clients share responsibility for how the community runs and practice expressing needs and resolving conflict with peers in a safe setting. The community meeting is the place where problems of living together are raised and worked out, with staff supporting rather than solving.
Why the others are wrong
- A – The nurse solving the problem by removing property takes away both clients' chance to work it out and is punitive without a unit rule being discussed.
- B – A room change avoids the conflict and teaches nothing about resolving it.
- C – Telling the client to put up with it dismisses the concern and confirms the belief that nobody cares.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
42Question
A client who struck a staff member and could not be calmed by verbal intervention, a quiet room or offered medication has been placed in limb restraints. Which actions by the nurse are required while the client is restrained?
Select all that apply.
- Document the behavior that made restraint necessary and the less restrictive measures that were tried.
- Ask the provider for an as-needed restraint order to cover any further episodes during the stay.
- Check circulation and skin at the restraint sites and offer fluids and toileting at regular intervals.
- Release the client as soon as the stated criteria for safe behavior are met.
- Keep the restraints in place for the rest of the shift so the client learns that hitting has consequences.
Show the answers and explanation
Answers: A, C and D.
- A – Document the behavior that made restraint necessary and the less restrictive measures that were tried.
- C – Check circulation and skin at the restraint sites and offer fluids and toileting at regular intervals.
- D – Release the client as soon as the stated criteria for safe behavior are met.
Topic: restraint monitoring and release
Restraint is a last-resort safety measure used only when less restrictive measures have failed. Regulations require an order for each episode (never a standing or as-needed order), ongoing monitoring of the client's physical and psychological condition, attention to basic needs, documentation of the reason and the alternatives tried, and discontinuation at the earliest possible time. Restraint is never used as punishment or for staff convenience.
Why the others are wrong
- B – As-needed or standing restraint orders are prohibited; each episode needs its own assessment and order.
- E – Restraint for a set period as a consequence is punishment; it must end as soon as the client is no longer a danger.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
43Question
A client is admitted involuntarily to a psychiatric unit after being judged a danger to self. The client demands to know 'what rights I have left'. Which rights does the client retain?
Select all that apply.
- To speak with an attorney and to have the commitment reviewed at a hearing.
- To sign out of the facility against medical advice.
- To refuse non-emergency medication unless the refusal is overridden through the review process that state law requires.
- To have health information kept confidential.
- To keep any personal belongings in the room, whatever they are.
- To be treated in the least restrictive setting that is safe.
Show the answers and explanation
Answers: A, C, D and F.
- A – To speak with an attorney and to have the commitment reviewed at a hearing.
- C – To refuse non-emergency medication unless the refusal is overridden through the review process that state law requires.
- D – To have health information kept confidential.
- F – To be treated in the least restrictive setting that is safe.
Topic: rights retained after involuntary admission
Involuntary admission removes only the freedom to leave. The client is still presumed competent and keeps civil rights, including due process and legal counsel, confidentiality, treatment in the least restrictive setting, and the right to give or refuse consent to treatment; medication may be given over objection only in an emergency or after the review process (judicial or clinical, depending on the state) that the law requires. Items that could be used for harm may be restricted for safety.
Why the others are wrong
- B – The right to leave is the one right an involuntary admission suspends; discharge depends on the legal process or the treating team.
- E – The right to personal property is limited by safety; items that could be used for self-harm can be removed from a client at risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
44Question
The parents of a 7-year-old with oppositional behavior at home and at school are referred to a parent management training program. They ask the nurse what they will be doing. Which description is most accurate?
- They will watch their child's individual play therapy sessions without taking part
- They will be taught to let the child set the family rules to build independence
- They will learn to give praise, rewards and planned consequences consistently after behaviors
- They will be told to give medication whenever the child's behavior worsens
Show the answer and explanation
Answer: C. They will learn to give praise, rewards and planned consequences consistently after behaviors
Topic: parent management training
Parent management training teaches caregivers behavioral principles. Parents learn to reinforce desired behavior with praise or rewards and to apply predictable, planned consequences to unwanted behavior, consistently, so the child learns what to expect.
Why the others are wrong
- A – Watching therapy is passive; parent training gives parents active skills to use at home.
- B – Children with oppositional behavior need clear, consistent limits set by the parents.
- D – Parent training is not medication management, and medication as an as-needed reward or response is inappropriate.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
45Question
A nurse is reviewing the history of a 62-year-old client who has leg pain when walking. Which history findings raise the likelihood of an arterial circulation problem in the legs?
Select all that apply.
- Type 2 diabetes mellitus
- Smoking a pack of cigarettes a day
- Brisk walking for 30 minutes most days
- Elevated low-density lipoprotein cholesterol
- Regular use of sunscreen
Show the answers and explanation
Answers: A, B and D.
- A – Type 2 diabetes mellitus
- B – Smoking a pack of cigarettes a day
- D – Elevated low-density lipoprotein cholesterol
Topic: peripheral vascular disease risk factors
Peripheral vascular disease is driven by atherosclerosis. Diabetes, tobacco use, dyslipidemia, hypertension and age damage arterial walls and promote plaque. Regular walking is protective and sun protection is unrelated.
Why the others are wrong
- C – Regular aerobic activity improves circulation and lowers risk.
- E – Sunscreen protects the skin from ultraviolet damage and has no link to arterial disease.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
46Question
A nurse finds 2+ pitting edema in both ankles and feet of a client with heart failure who reports gaining 5 pounds in the past week. Which actions are appropriate?
Select all that apply.
- Elevate the legs when the client is sitting or in bed
- Massage the calves firmly to move fluid upward
- Weigh the client at the same time each morning and compare
- Assess lung sounds and jugular vein distention
- Apply heat to the swollen feet to improve circulation
Show the answers and explanation
Answers: A, C and D.
- A – Elevate the legs when the client is sitting or in bed
- C – Weigh the client at the same time each morning and compare
- D – Assess lung sounds and jugular vein distention
Topic: edema in heart failure
Rapid weight gain with dependent edema suggests fluid retention from worsening heart failure. The nurse tracks daily weights, assesses for other signs of congestion such as crackles and jugular distention, and elevates the legs to aid venous return. Deep massage could dislodge a clot and heat can damage skin with poor sensation or perfusion.
Why the others are wrong
- B – Firm calf massage could dislodge a deep vein clot and does not treat fluid overload.
- E – Heat can burn skin in edematous, poorly perfused tissue and increases swelling.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
47Question
A nurse is counting the apical pulse of a 4-year-old child. Where should the stethoscope be placed?
- Fourth intercostal space, left midclavicular line
- Second intercostal space at the right sternal border
- Fifth intercostal space, left midclavicular line
- Second intercostal space at the left sternal border
Show the answer and explanation
Answer: A. Fourth intercostal space, left midclavicular line
Topic: pediatric apical pulse location
In children under about 7 years, the apex of the heart lies at the fourth intercostal space near the left midclavicular line. In older children and adults it moves down to the fifth intercostal space.
Why the others are wrong
- B – The second right space is the aortic area, at the base of the heart.
- C – The fifth space is the apex for adults and children over about 7 years.
- D – The second left space is the pulmonic area, at the base of the heart.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
48Question
A 7-year-old child with allergic rhinitis is prescribed loratadine 10 mg by mouth once daily. The pharmacy supplies a syrup labeled 5 mg per 5 mL. How many milliliters will the nurse measure for one dose?
- 1 mL
- 2.5 mL
- 5 mL
- 10 mL
Show the answer and explanation
Answer: D. 10 mL
Topic: oral liquid volume
A concentration of 5 mg per 5 mL equals 1 mg per mL. The ordered 10 mg therefore needs 10 mL, because 10 mg divided by 1 mg/mL is 10 mL.
Why the others are wrong
- A – That volume would deliver only 1 mg, one tenth of the ordered dose.
- B – That volume would deliver only 2.5 mg, a quarter of the ordered dose.
- C – That volume would deliver only 5 mg, half the ordered dose.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
49Question
A client with AF and a rapid ventricular rate weighs 154 lb. The provider orders diltiazem 0.25 mg/kg IV over 2 minutes. The vial contains 5 mg/mL. How many milliliters will the nurse draw up? Round to the nearest tenth.
- 1.8 mL
- 3.5 mL
- 7.7 mL
- 17.5 mL
Show the answer and explanation
Answer: B. 3.5 mL
Topic: weight-based IV push volume
154 lb divided by 2.2 equals 70 kg. At 0.25 mg/kg the dose is 17.5 mg. With 5 mg per mL, 17.5 mg divided by 5 mg/mL equals 3.5 mL.
Why the others are wrong
- A – This halves the correct volume and does not match the calculation.
- C – This uses the weight in pounds instead of kilograms.
- D – This reports the dose in milligrams and calls it milliliters.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
50Question
A provider orders metformin 1,000 mg by mouth twice daily with meals. The pharmacy supplies tablets of 500 mg each. What total number of tablets will the client take in 24 hours?
- 2 tablets (a single dose)
- 3 tablets
- 4 tablets
- 6 tablets
Show the answer and explanation
Answer: C. 4 tablets
Topic: oral tablet calculation over 24 hours
Each dose is 1,000 mg divided by 500 mg per tablet, which equals 2 tablets. Two doses a day gives 2 x 2, or 4 tablets in 24 hours.
Why the others are wrong
- A – That is the number for one dose, not for the whole day.
- B – That does not match either the dose or the number of times per day.
- D – That would apply to three doses a day, but the order is for two.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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