51Question
A client who has multiple sclerosis asks, "Is there a special diet that will stop my disease?" Which response is best?
- “Cutting out all gluten and dairy will halt the loss of myelin.”
- “High-dose vitamin supplements can replace your disease-modifying medicine.”
- “No diet has been proven to stop it, but a balanced diet with plenty of fruits, vegetables and whole grains is recommended.”
- “Fasting two days a week will repair the damaged myelin.”
Show the answer and explanation
Answer: C. “No diet has been proven to stop it, but a balanced diet with plenty of fruits, vegetables and whole grains is recommended.”
Topic: diet claims in multiple sclerosis
No specific diet has been shown to prevent or stop multiple sclerosis progression. The nurse gives honest information, encourages a balanced diet, and refers to a dietitian for individual needs such as fatigue or vitamin D.
Why the others are wrong
- A – No evidence supports that claim, and restrictive diets can cause deficiencies.
- B – Supplements do not replace medication and high doses can be harmful.
- D – No evidence supports it, and fasting can worsen fatigue.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
52Question
A client says, "I bought several memory supplements online. Should I start taking them?" Which response by the nurse is best?
- “Let's review what you already eat and take, and check the products with your provider or pharmacist first.”
- “Supplements sold in stores are tested by the FDA for effectiveness before sale.”
- “Memory supplements are natural, so they are safe to start.”
- “Start two or three at a low dose and see which one helps.”
Show the answer and explanation
Answer: A. “Let's review what you already eat and take, and check the products with your provider or pharmacist first.”
Topic: supplement safety counseling
Supplements are not reviewed for effectiveness before they are sold, and they can interact with medications. The nurse first reviews diet and current medicines and involves the provider or pharmacist before any new product is started.
Why the others are wrong
- B – Dietary supplements are not approved for effectiveness before they are marketed.
- C – Natural does not mean safe; they can interact with medicines or cause harm.
- D – Starting several products at once makes it impossible to identify a problem and risks interactions.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
53Question
A client with coronary artery disease asks how often to eat fatty fish for heart health. Which recommendation should the nurse give?
- One serving each month, fried in batter
- At least two servings each week, baked or grilled
- Every day, in any form
- None, because fish is too high in fat to be heart healthy
Show the answer and explanation
Answer: B. At least two servings each week, baked or grilled
Topic: fish and heart health
The American Heart Association recommends at least two servings of fish a week, especially fatty fish, prepared by baking or grilling rather than frying.
Why the others are wrong
- A – Too infrequent, and frying adds fat.
- C – More than is needed; the preparation matters as much as the amount.
- D – The fat in oily fish is largely unsaturated omega-3 fat that benefits the heart.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
54Question
A pathology report on a client with Alzheimer disease describes extracellular plaques between neurons. Which protein makes up these plaques?
- Tau protein
- Beta-amyloid
- Alpha-synuclein
- Myelin basic protein
Show the answer and explanation
Answer: B. Beta-amyloid
Topic: plaques and tangles
Beta-amyloid fragments clump outside neurons to form plaques, while abnormal tau protein builds up inside neurons as tangles. Both are characteristic of Alzheimer disease.
Why the others are wrong
- A – Forms the neurofibrillary tangles inside neurons.
- C – Forms the Lewy bodies of Parkinson disease and Lewy body dementia.
- D – A structural protein of the myelin sheath, not the plaque component.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
55Question
A client with asthma reports wheezing and nasal congestion about 30 minutes after taking ibuprofen before jogging. The client still has knee pain. Which analgesic does the nurse expect to be safest?
- Acetaminophen
- Naproxen sodium, taken with food
- Aspirin
- Ketorolac
Show the answer and explanation
Answer: A. Acetaminophen
Topic: NSAID-induced bronchospasm
Some clients with asthma develop bronchospasm after taking aspirin or other nonsteroidal anti-inflammatory drugs. Acetaminophen does not block the same enzyme pathway and is usually the safer analgesic.
Why the others are wrong
- B – An NSAID that can cause the same bronchospasm.
- C – Aspirin commonly triggers bronchospasm in people with this sensitivity.
- D – A strong NSAID; it carries the same respiratory risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
56Question
A postoperative client with a wound infection has a serum albumin of 2.8 g/dL. Which finding gives the most reliable evidence that the client is malnourished?
- Unintended weight loss, reduced intake over weeks and visible loss of muscle and fat
- The serum albumin level alone
- The serum prealbumin level alone
- A blood urea nitrogen level that is below normal
Show the answer and explanation
Answer: A. Unintended weight loss, reduced intake over weeks and visible loss of muscle and fat
Topic: markers of malnutrition
Albumin and prealbumin are acute-phase proteins that fall during infection and surgery regardless of intake, so they are not recommended for diagnosing malnutrition. Diagnosis rests on weight loss, reduced intake and physical findings of muscle and fat loss.
Why the others are wrong
- B – Albumin falls with inflammation and fluid shifts, so it does not reliably reflect nutrition.
- C – Also drops during inflammation and is not a recommended malnutrition marker.
- D – Can reflect many things, including low protein intake, but it is not a diagnostic measure.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
57Question
A nurse explains why a client with a pulmonary embolism has low oxygen saturation despite normal breathing. Which process is directly impaired?
- Ventilation of the alveoli
- Diffusion across a thickened alveolar membrane
- Cellular use of oxygen in the tissues
- Perfusion of the ventilated alveoli
Show the answer and explanation
Answer: D. Perfusion of the ventilated alveoli
Topic: ventilation and perfusion
In a pulmonary embolism the clot blocks pulmonary blood flow, so alveoli are ventilated but not perfused. Oxygen cannot be picked up, and the ventilation-perfusion mismatch lowers oxygen saturation.
Why the others are wrong
- A – Air still moves in and out of the lungs; ventilation is mostly unchanged.
- B – The membrane is not thickened; blood simply is not reaching the alveoli.
- C – The problem is oxygen delivery to the blood in the lungs, not cell metabolism.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
58Question
A nurse teaches an older adult with osteoporosis and kyphosis about age-related respiratory changes. Which change does the nurse explain is made worse by the curved spine?
- Reduced chest wall expansion and a lower vital capacity
- Increased elastic recoil of the alveoli
- An increased number of functioning cilia
- A larger forced expiratory volume on each forceful breath
Show the answer and explanation
Answer: A. Reduced chest wall expansion and a lower vital capacity
Topic: age-related respiratory changes
Spinal curvature and vertebral compression stiffen and shorten the chest wall, limiting expansion and lowering vital capacity. Adequate calcium and vitamin D help slow the bone loss behind these changes.
Why the others are wrong
- B – Elastic recoil decreases with age.
- C – Ciliary function declines with age.
- D – Expiratory volume decreases with age and with a rigid chest.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
59Question
One day after chest tube insertion, a client has a crackling sensation under the skin around the insertion site that has spread toward the neck over the last hour. Which action should the nurse take first?
- Document it as an expected finding and recheck at the end of the shift
- Clamp the chest tube close to the chest wall
- Apply a warm compress over the crackling area
- Mark the edge of the area, assess breathing and notify the provider
Show the answer and explanation
Answer: D. Mark the edge of the area, assess breathing and notify the provider
Topic: subcutaneous emphysema with a chest tube
A crackling feeling under the skin is subcutaneous emphysema, caused by air escaping into the tissues. Spread toward the neck suggests a continuing leak or a blocked tube, so the nurse outlines the area, assesses airway and breathing, and notifies the provider.
Why the others are wrong
- A – Spreading subcutaneous air can signal an air leak and needs prompt reporting.
- B – Clamping can trap air and cause a tension pneumothorax.
- C – Heat does not treat trapped air and could delay recognition of a problem.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
60Question
A nurse teaches a client with stage 4 chronic kidney disease why bone health is monitored. Which laboratory pattern does the nurse expect?
- High calcium, low phosphorus and low parathyroid hormone
- Low calcium, low phosphorus and high parathyroid hormone
- Normal calcium, high phosphorus and low parathyroid hormone
- Low calcium, high phosphorus and high parathyroid hormone
Show the answer and explanation
Answer: D. Low calcium, high phosphorus and high parathyroid hormone
Topic: mineral and bone disorder in kidney disease
Failing kidneys cannot activate vitamin D or excrete phosphorus, so calcium falls and phosphorus rises. The parathyroid glands respond by releasing more hormone, and bone is broken down, producing mineral and bone disorder.
Why the others are wrong
- A – The opposite of the pattern in kidney failure.
- B – Phosphorus rises, not falls, as the kidneys fail to excrete it.
- C – Low calcium triggers a high, not low, parathyroid hormone level.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
61Question
A client with coronary artery disease is learning a Mediterranean-style eating pattern. Which fat should the nurse recommend for everyday cooking and salads?
- Butter, used in small amounts
- Coconut oil
- Extra-virgin olive oil
- Palm oil
Show the answer and explanation
Answer: C. Extra-virgin olive oil
Topic: fat choice in a Mediterranean pattern
Olive oil is the main fat in a Mediterranean pattern. It is rich in monounsaturated fat and replaces saturated fats, which supports heart health.
Why the others are wrong
- A – Butter is a saturated fat that does not align with the Mediterranean eating pattern's focus on replacing saturated fats with healthier unsaturated fats.
- B – Coconut oil is high in saturated fat and is not the primary fat source recommended for everyday cooking and salads in a Mediterranean eating pattern.
- D – Palm oil is high in saturated fat and is not the main fat used in a Mediterranean eating pattern, which emphasizes monounsaturated fats instead.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
62Question
A client with lactose intolerance avoids all dairy and is at risk for low calcium intake. Which choice provides calcium without lactose?
- Unfortified almond beverage with added vanilla
- Plain boiled potatoes
- Chicken broth with noodles
- Calcium-fortified soy beverage
Show the answer and explanation
Answer: D. Calcium-fortified soy beverage
Topic: calcium sources in lactose intolerance
Calcium-fortified plant beverages supply calcium without lactose. Lactose-free dairy products are also appropriate, and the label should be checked for added calcium.
Why the others are wrong
- A – Contains little calcium unless fortified.
- B – Plain boiled potatoes do not provide a significant amount of calcium to prevent deficiency risk in a client avoiding dairy.
- C – Chicken broth with noodles does not contain calcium and therefore cannot address the risk of low calcium intake.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
63Question
A marathon runner asks why runners "hit the wall" near mile 20. Which energy store does the nurse explain has been largely used up?
- Triglycerides stored in body fat
- Glycogen in muscle and liver
- Ketone bodies in the blood
- Skeletal muscle protein
Show the answer and explanation
Answer: B. Glycogen in muscle and liver
Topic: fuel sources in endurance exercise
Muscle and liver glycogen are the main carbohydrate stores and run low after about 90 to 120 minutes of hard endurance exercise. Runners then slow down sharply because fat cannot supply energy as fast as carbohydrate.
Why the others are wrong
- A – Fat stores are large and do not run out during a marathon.
- C – These are not the main fuel stores for a well-fed runner.
- D – Protein is a minor fuel source and is not the cause of 'hitting the wall'.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
64Question
A client who has a small bowel obstruction has colicky abdominal pain, abdominal distention and vomiting. Which new finding should the nurse report immediately?
- Vomiting of dark green fluid
- A rigid, board-like abdomen with rebound tenderness and fever
- High-pitched bowel sounds above the blockage
- Colicky pain that comes in waves
Show the answer and explanation
Answer: B. A rigid, board-like abdomen with rebound tenderness and fever
Topic: complications of bowel obstruction
A rigid abdomen with rebound tenderness and fever suggests strangulation or perforation with peritonitis, a surgical emergency. Vomiting, high-pitched sounds and waves of pain are expected with an obstruction.
Why the others are wrong
- A – Expected as contents back up behind the blockage.
- C – Expected as the bowel pushes against the obstruction.
- D – Expected with peristalsis against a blockage.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
65Question
A client with hypothyroidism and type 2 diabetes is taught about levothyroxine. Which statement shows understanding?
- “I take it with my calcium and iron tablets to save time.”
- “I take it first thing in the morning with water and wait before eating breakfast.”
- “I skip it on days when I feel energetic.”
- “I take it at bedtime after a heavy dinner.”
Show the answer and explanation
Answer: B. “I take it first thing in the morning with water and wait before eating breakfast.”
Topic: levothyroxine administration teaching
Levothyroxine absorbs best on an empty stomach, so it is taken with water 30 to 60 minutes before breakfast. Calcium, iron and antacids bind it and should be separated by about four hours.
Why the others are wrong
- A – Calcium and iron reduce absorption and should be taken several hours apart.
- C – It is a daily replacement and should not be skipped.
- D – Food in the stomach reduces absorption.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
66Question
A client has taken levothyroxine for six weeks. Which finding at the follow-up visit should the nurse report as a possible sign the dose is too high?
- Resting heart rate of 112 with tremor and weight loss
- Constipation, dry skin and a slowed resting heart rate
- Fatigue and feeling cold
- Weight gain and slowed speech
Show the answer and explanation
Answer: A. Resting heart rate of 112 with tremor and weight loss
Topic: signs of levothyroxine overdose
Too much levothyroxine produces signs of hyperthyroidism such as fast pulse, tremor and weight loss. Constipation, dry skin, fatigue, cold intolerance and weight gain suggest that the dose is still too low.
Why the others are wrong
- B – Constipation, dry skin and a slowed resting heart rate indicate hypothyroidism, suggesting the dose is too low rather than too high.
- C – Fatigue and feeling cold are signs of hypothyroidism, indicating the medication dose is insufficient instead of excessive.
- D – Weight gain and slowed speech are symptoms of hypothyroidism, meaning the dose is likely too low and not causing toxicity.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
67Question
A client with type 2 diabetes asks why the hemoglobin A1C is only rechecked every three months after a diet change. What should the nurse say?
- “It measures your blood sugar from this morning.”
- “It reflects only your blood sugar over the last day.”
- “It is unreliable, so it is done once a year.”
- “It reflects your average blood sugar over about the last three months.”
Show the answer and explanation
Answer: D. “It reflects your average blood sugar over about the last three months.”
Topic: meaning of the A1C test
Glucose attaches to hemoglobin for the life of a red blood cell, so the A1C reflects average glucose over about two to three months. That is why it is repeated after about three months, once a change in diet or medicine has had time to show an effect.
Why the others are wrong
- A – A fasting or point-of-care glucose measures that.
- B – The test reflects a much longer period.
- C – It is a dependable measure of long-term control and is repeated more often when therapy changes.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
68Question
A client who is starting warfarin asks whether salads and spinach are allowed. Which response by the nurse is best?
- “Avoid all green vegetables while you are on this medicine.”
- “Eat greens only on days when you skip your warfarin.”
- “Keep the amount of leafy greens about the same from week to week.”
- “Eat as many as you like; vitamin K has no effect on warfarin.”
Show the answer and explanation
Answer: C. “Keep the amount of leafy greens about the same from week to week.”
Topic: warfarin and vitamin K
Warfarin works by blocking vitamin K-dependent clotting factors, so sudden changes in vitamin K intake alter the INR. The goal is a consistent intake, not avoidance.
Why the others are wrong
- A – Unneeded restriction that harms nutrition.
- B – Skipping doses is unsafe and does not keep intake consistent.
- D – Vitamin K opposes warfarin's effect, so large swings change the INR.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
69Question
A client who lost 8 pounds returns after two months having gone back to the old eating habits. Which response by the nurse is best?
- “Since you didn't stay on the plan, continuing probably won't help.”
- “Slips are common when changing habits. Let's look at what triggered it and restart your plan.”
- “You need more willpower; try harder next time.”
- “Tell me exactly how many calories you ate each day.”
Show the answer and explanation
Answer: B. “Slips are common when changing habits. Let's look at what triggered it and restart your plan.”
Topic: relapse in behavior change
Behavior change is rarely a straight line, and lapses are an expected part of the process. A supportive response treats the lapse as information, explores the trigger and helps the client restart.
Why the others are wrong
- A – Discourages the client and ignores that lapses are part of change.
- C – Blames the client and gives no practical help.
- D – Focuses on detail rather than the lapse and may feel punishing.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
70Question
A client with iron-deficiency anemia takes oral ferrous sulfate. Which statement shows understanding of how long to continue treatment?
- “I can stop as soon as I feel less tired.”
- “I will stop when my stools turn dark.”
- “I will keep taking it for months after my blood count returns to normal.”
- “I will take it with my morning coffee to remember.”
Show the answer and explanation
Answer: C. “I will keep taking it for months after my blood count returns to normal.”
Topic: duration of oral iron therapy
Blood counts normalize before the body's iron stores are replenished, so therapy usually continues for several months after hemoglobin is normal. Dark stools are expected, and coffee or tea should be avoided near the dose.
Why the others are wrong
- A – Symptoms improve before the iron stores are rebuilt.
- B – Dark stools are an expected effect of iron and are not a reason to stop.
- D – Coffee and tea reduce iron absorption; taking it with a source of vitamin C helps.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
71Question
A client with a body mass index of 38 and breathlessness on exertion is starting a weight-loss plan. Which goal is most appropriate?
- Lose 20 pounds in the next two weeks
- Cut intake to 600 calories a day using meal-replacement shakes
- Skip breakfast and lunch each day
- Lose 1 to 2 pounds each week through diet and activity
Show the answer and explanation
Answer: D. Lose 1 to 2 pounds each week through diet and activity
Topic: realistic weight-loss goals
A safe, sustainable loss is about 1 to 2 pounds per week, reached through a modest calorie reduction and more activity. Even a 5 to 10 percent loss often improves breathing and other health measures.
Why the others are wrong
- A – Unsafe and unrealistic.
- B – Too restrictive and not sustainable.
- C – Skipping meals promotes overeating later and is not a recommended approach.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
72Question
A client is overwhelmed by conflicting nutrition posts online. Which guidance on judging a source should the nurse give?
- Trust pages with the most customer testimonials.
- Choose sources written by credentialed experts that cite research and do not sell the products they discuss.
- Follow the account with the most followers.
- Prefer sources that say doctors are hiding a miracle cure.
Show the answer and explanation
Answer: B. Choose sources written by credentialed experts that cite research and do not sell the products they discuss.
Topic: evaluating online nutrition information
Reliable nutrition information comes from qualified authors, cites research, and has no financial interest in the products. Testimonials, popularity and secret-cure claims are red flags.
Why the others are wrong
- A – Testimonials are anecdotes, not evidence.
- C – Popularity does not indicate accuracy.
- D – Such claims are a warning sign of misinformation.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
73Question
A client who does not eat fish wants a plant source of omega-3 fat. Which food should the nurse suggest?
- Corn oil used for frying and salad dressing
- Ground flaxseed stirred into oatmeal
- Plain white rice
- Cream cheese on a bagel
Show the answer and explanation
Answer: B. Ground flaxseed stirred into oatmeal
Topic: plant sources of omega-3
Flaxseed, walnuts, chia seeds and canola oil are plant sources of alpha-linolenic acid. Ground flaxseed is absorbed better than whole seeds.
Why the others are wrong
- A – Mostly omega-6 fat.
- C – Contains almost no omega-3 fat.
- D – Mostly saturated fat.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
74Question
A vegan client asks which pairing of plant foods supplies all the essential amino acids over the course of a day. Which pairing should the nurse suggest?
- Wheat pasta with corn
- Brown rice with black beans
- Cucumber and tomato salad with lettuce
- White bread with oatmeal
Show the answer and explanation
Answer: B. Brown rice with black beans
Topic: complementary plant proteins
Grains are low in lysine and legumes are low in methionine, so eating both over the day supplies all essential amino acids. The foods do not have to be eaten in the same meal.
Why the others are wrong
- A – Wheat pasta with corn pairs two grains that are both low in lysine, so this combination does not supply all essential amino acids.
- C – Vegetables contribute little protein.
- D – White bread with oatmeal pairs two grains that are both low in lysine, so this combination does not supply all essential amino acids.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
75Question
One week after a cholecystectomy, a client asks why greasy meals cause loose stools. Which explanation is best?
- “Your liver can no longer make bile, so fat passes through undigested.”
- “Bile now drips steadily into the intestine instead of being stored, so large fatty meals are not well digested.”
- “The surgery damaged your pancreas, so it cannot make lipase.”
- “Loose stools mean you have an infection that needs antibiotics.”
Show the answer and explanation
Answer: B. “Bile now drips steadily into the intestine instead of being stored, so large fatty meals are not well digested.”
Topic: digestion after cholecystectomy
Without the gallbladder, bile flows continuously into the intestine in small amounts rather than being concentrated and released with a meal. Large or fatty meals are then poorly emulsified. Smaller, lower-fat meals reintroduced gradually are usually tolerated.
Why the others are wrong
- A – The liver still makes bile; only the storage organ is removed.
- C – The pancreas is not affected by gallbladder removal.
- D – Fat intolerance is a common, expected change and not a sign of infection.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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