76Question
A client with vomiting and diarrhea for two days has dark amber urine and a dry mouth. Which laboratory finding supports a fluid volume deficit?
- Urine specific gravity of 1.004
- Urine specific gravity of 1.034
- Hematocrit of 31 percent with hemoglobin of 10 g/dL
- Blood urea nitrogen of 6 mg/dL
Show the answer and explanation
Answer: B. Urine specific gravity of 1.034
Topic: urine specific gravity in dehydration
Dehydration concentrates the urine and the blood. Specific gravity rises above the usual upper limit of about 1.030, and hematocrit and BUN also tend to rise.
Why the others are wrong
- A – Very dilute urine suggests overhydration or a concentrating problem.
- C – A low hematocrit would suggest anemia or fluid overload.
- D – A low BUN suggests overhydration or low protein intake.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
77Question
After a water main break, a community is told to boil water before drinking it. Which instruction is correct?
- Heat the water until it just begins to steam, then drink it.
- Let the water stand overnight so bacteria settle out.
- Run the cold tap for five minutes, which makes it safe.
- Bring the water to a full rolling boil for at least one minute, then let it cool.
Show the answer and explanation
Answer: D. Bring the water to a full rolling boil for at least one minute, then let it cool.
Topic: boil-water advisories
A rolling boil for at least one minute kills bacteria, viruses and parasites; the time is longer at high altitude. Boiling does not remove chemicals such as arsenic, for which an alternative water source is needed.
Why the others are wrong
- A – Steaming is not hot enough to kill microbes.
- B – Standing does not kill disease-causing organisms.
- C – Flushing does not disinfect the water.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
78Question
A meal contains 30 g of carbohydrate, 20 g of protein and 10 g of fat. Approximately how many calories does it provide?
- 60 kcal
- 240 kcal
- 290 kcal
- 390 kcal
Show the answer and explanation
Answer: C. 290 kcal
Topic: calculating calories from grams
Carbohydrate and protein each provide about 4 kcal per gram and fat about 9 kcal per gram. So 30 x 4 = 120, 20 x 4 = 80, and 10 x 9 = 90, for a total of 290 kcal.
Why the others are wrong
- A – Adds the grams instead of converting to calories.
- B – Counts fat as 4 kcal per gram instead of 9.
- D – Counts protein as 9 kcal per gram instead of 4.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
79Question
A client with hypertension is following the DASH eating plan. Which client statement shows the need for further teaching?
- “Canned soups and deli meats are fine if they are low in fat.”
- “I season my food with herbs, lemon and pepper instead of salt.”
- “I choose fat-free yogurt as a snack.”
- “I read labels to compare the sodium in packaged foods.”
Show the answer and explanation
Answer: A. “Canned soups and deli meats are fine if they are low in fat.”
Topic: DASH eating plan teaching
The DASH plan limits sodium and emphasizes fruits, vegetables, whole grains and low-fat dairy. Canned soups and deli meats are high in sodium whether or not they are low in fat.
Why the others are wrong
- B – Correct; this lowers sodium.
- C – Correct; low-fat dairy fits the plan.
- D – Correct; label reading helps limit sodium.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
80Question
A client with uncontrolled hyperthyroidism has lost 12 pounds in two months, has a heart rate of 110 and drinks five cups of coffee daily. Which diet plan should the nurse expect?
- Low in calories and protein to slow metabolism
- Clear liquids with extra caffeine for energy
- High in calories and protein, with frequent meals and no caffeinated drinks
- Fluid-restricted and high in sodium
Show the answer and explanation
Answer: C. High in calories and protein, with frequent meals and no caffeinated drinks
Topic: diet in hyperthyroidism
Excess thyroid hormone raises metabolism, so the client needs extra calories and protein, often as frequent meals and snacks. Caffeine is avoided because it worsens rapid heart rate and tremor.
Why the others are wrong
- A – Metabolism is already high; restricting nutrition worsens the weight loss.
- B – Caffeine increases heart rate and tremor.
- D – Neither is indicated and sodium is not a treatment.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
81Question
A client who has followed a strict vegan diet for several years is being counseled. Besides protein, which nutrient will the nurse emphasize obtaining from a supplement or fortified foods?
- Vitamin C
- Vitamin K
- Vitamin B12
- Dietary fiber
Show the answer and explanation
Answer: C. Vitamin B12
Topic: nutrient gaps in a vegan diet
Vitamin B12 occurs naturally almost only in animal foods, so people who eat a strict vegan diet need a supplement or fortified foods to prevent deficiency, anemia and nerve damage.
Why the others are wrong
- A – Plentiful in fruits and vegetables.
- B – Plentiful in leafy green vegetables.
- D – Plentiful in plant foods.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
82Question
A client with osteoarthritis of both knees asks which foods might help calm joint inflammation. Which menu item should the nurse suggest?
- Sugar-sweetened cola served with each lunch and dinner meal
- Deep-fried chicken strips with a biscuit
- Spinach and kale salad dressed with olive oil
- Processed deli meat on white bread
Show the answer and explanation
Answer: C. Spinach and kale salad dressed with olive oil
Topic: foods that calm joint inflammation
Dark leafy greens and olive oil are part of an anti-inflammatory eating pattern rich in antioxidants and unsaturated fat. Highly processed meats, fried foods, and sugar-sweetened drinks promote inflammation and weight gain, which also stresses weight-bearing joints.
Why the others are wrong
- A – Sugar-sweetened drinks add calories and are linked to higher inflammation and weight gain.
- B – Frying adds saturated and trans fats that favor inflammation.
- D – Processed meats are high in sodium and additives and are linked to inflammatory markers.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
83Question
A client with dermatitis herpetiformis follows a strict gluten-free diet and is reviewing a shopping list with the nurse. Which item should the nurse tell the client to remove?
- Soy sauce brewed with wheat
- Corn tortillas labeled gluten-free
- Plain popcorn kernels
- Fresh pineapple chunks
Show the answer and explanation
Answer: A. Soy sauce brewed with wheat
Topic: hidden gluten in condiments
Traditional soy sauce is brewed with wheat and therefore contains gluten, which triggers the rash in dermatitis herpetiformis. Corn, popcorn, and fresh fruit are naturally gluten-free. Clients must read labels for hidden wheat, barley, and rye in sauces and seasonings.
Why the others are wrong
- B – Corn tortillas labeled gluten-free are safe.
- C – Plain popcorn has no wheat, barley, or rye.
- D – Fresh fruit is naturally gluten-free.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
84Question
A client with Parkinson disease takes carbidopa-levodopa three times daily and plans to try a 16-hour daily fast. The client asks the nurse what to expect. Which response is best?
- “Fasting has been proven to slow Parkinson disease, so you can safely begin the 16-hour plan tomorrow morning without any changes.”
- “Fasting can change when your medicine is absorbed and how well it works, so please talk with your provider before you start.”
- “Fasting will not matter as long as you keep drinking plenty of water throughout the day.”
- “Skip your morning dose on fasting days so that your stomach stays completely empty.”
Show the answer and explanation
Answer: B. “Fasting can change when your medicine is absorbed and how well it works, so please talk with your provider before you start.”
Topic: fasting and levodopa timing
Evidence for fasting in Parkinson disease is still limited, and levodopa timing is sensitive to meals and protein. Changing meal patterns can cause motor fluctuations, low blood pressure, or low blood glucose, so the plan must be reviewed with the prescriber first. Medicine doses are never skipped without an order.
Why the others are wrong
- A – The benefit is not established, so promising it is inaccurate.
- C – Water does not address the effect on drug absorption and symptom control.
- D – Skipping a dose can cause rigidity and a serious worsening of symptoms; only the prescriber changes doses.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
85Question
A client with asthma and a BMI of 36 kg/m2 asks why the nurse keeps discussing weight loss when the problem is wheezing. Which explanation is best?
- Body fat absorbs inhaled medication, so the drugs only start to work after substantial weight is lost.
- Weight loss will cure asthma once the client reaches a normal BMI, whatever the triggers or medicines used.
- Weight has no effect on breathing, and the question is part of a routine screening form.
- Extra body weight reduces lung volumes and adds work to breathing, and it is linked to poorer asthma control.
Show the answer and explanation
Answer: D. Extra body weight reduces lung volumes and adds work to breathing, and it is linked to poorer asthma control.
Topic: weight and asthma control
Excess weight reduces functional residual capacity and chest wall compliance and is associated with airway inflammation and worse symptom control. Weight reduction can improve control, but it does not eliminate the need for trigger avoidance and controller medicine.
Why the others are wrong
- A – Inhaled drugs act in the airways and are not trapped by body fat.
- B – Weight loss helps but does not cure asthma.
- C – Obesity does affect breathing and asthma control, so this denies a real link.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
86Question
A client with severe COPD has lost 6 lb in two months and says breathlessness makes it hard to finish meals. Which teaching is most appropriate?
- Rest before eating, take five or six small nutrient-dense meals, and add a high-calorie supplement.
- Eat three large meals each day and drink plenty of fluid with every one of them to stay hydrated.
- Choose mostly low-calorie foods so the stomach is never full while trying to breathe.
- Limit protein foods because digesting them makes breathing harder and increases the effort of each meal.
Show the answer and explanation
Answer: A. Rest before eating, take five or six small nutrient-dense meals, and add a high-calorie supplement.
Topic: eating with dyspnea in COPD
Breathing uses extra energy in COPD, and a full stomach pushes on the diaphragm. Small, frequent, calorie- and protein-dense meals after resting protect weight and muscle without worsening dyspnea. Large meals and drinking heavily with food cause early fullness.
Why the others are wrong
- B – Large meals and fluid with meals crowd the diaphragm and cause early fullness.
- C – Low-calorie foods worsen the energy deficit and weight loss.
- D – Protein is needed to preserve respiratory muscle; restricting it is not recommended.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
87Question
A client with stage 3 chronic kidney disease who is not on dialysis asks which protein foods are best. Which recommendation should the nurse make?
- Large portions of beef daily to prevent muscle loss
- Beans, lentils, and tofu more often than red meat
- Protein powders and shakes between all meals
- Processed deli meats because they are convenient
Show the answer and explanation
Answer: B. Beans, lentils, and tofu more often than red meat
Topic: protein sources in non-dialysis CKD
In non-dialysis CKD, protein is moderated, and plant proteins are encouraged because they lower the acid and phosphorus load compared with most animal foods. Protein powders and processed meats add excess protein, phosphorus additives, and sodium.
Why the others are wrong
- A – Large amounts of animal protein increase waste products and phosphorus load.
- C – Powders add more protein, often with added phosphates, and are not needed.
- D – Processed meats carry sodium and phosphate additives.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
88Question
A client with type 2 diabetes has not followed the meal plan written by the dietitian at two consecutive visits. Which nursing action is most likely to improve adherence?
- Reissue the same written plan with stricter calorie limits and a follow-up weight check.
- Ask a family member to monitor every meal and report each lapse to the care team.
- Ask what the client wants to change and build the plan together around the client’s goals and preferences.
- Describe the long-term complications of diabetes in detail until the client agrees to follow the plan as written.
Show the answer and explanation
Answer: C. Ask what the client wants to change and build the plan together around the client’s goals and preferences.
Topic: engaging the client in the meal plan
Adherence rises when the client takes part in setting goals and the plan fits the client’s preferences, culture, and resources. Stricter rules, surveillance, and fear-based teaching tend to reduce motivation and trust.
Why the others are wrong
- A – Repeating a plan that was not followed and adding stricter limits ignores barriers.
- B – Surveillance by family undermines autonomy and trust.
- D – Fear-based teaching rarely sustains behavior change.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
89Question
A client with kidney failure is limited to 1,000 mL of fluid daily and reports constant thirst. Which strategy should the nurse teach?
- Drink the whole allowance in two large portions, so that thirst is fully satisfied at once each time.
- Choose salty snacks, which increase saliva and reduce thirst.
- Rinse the mouth and swallow cold water whenever it feels dry.
- Use a small cup, sip slowly, and spread the daily total across waking hours, counting ice as fluid.
Show the answer and explanation
Answer: D. Use a small cup, sip slowly, and spread the daily total across waking hours, counting ice as fluid.
Topic: managing thirst on a fluid restriction
Spreading a small allowance over the day in small cups, and counting ice and other liquid foods, makes the limit more tolerable. Salty foods increase thirst, and swallowing water uncounted risks exceeding the limit.
Why the others are wrong
- A – Large boluses leave long thirsty periods and can overload the circulation.
- B – Salt increases thirst.
- C – Swallowed water is part of the allowance and must be counted.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
90Question
A client with kidney failure has a high serum phosphorus level and takes a phosphate binder with meals. Which breakfast choice shows understanding of a low-phosphorus diet?
- Bran muffin with peanut butter and a glass of chocolate milk
- Scrambled egg whites, white toast, and fresh blueberries
- Sausage and cheese biscuit with a cola
- Instant cocoa-flavored cereal with milk and a cola
Show the answer and explanation
Answer: B. Scrambled egg whites, white toast, and fresh blueberries
Topic: low-phosphorus breakfast choices
Egg whites, refined bread, and fresh fruit are low in phosphorus. Dairy, whole grains, and bran, along with colas and processed foods that contain phosphate additives, are high in phosphorus and absorbed readily.
Why the others are wrong
- A – Bran and chocolate milk are both high in phosphorus.
- C – Processed sausage, cheese, and cola are major phosphorus sources.
- D – Cereal with milk and cola adds dairy phosphorus and cola additives.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
91Question
A client with hyperkalemia from stage 4 chronic kidney disease wants to cut sodium and asks what to use in place of salt. Which response by the nurse is best?
- “Season with herbs, lemon juice, or garlic powder, and avoid salt substitutes made with potassium chloride.”
- “Use a potassium-based salt substitute, since it contains no sodium.”
- “Use low-sodium soy sauce and bouillon freely, because they are low in salt.”
- “Use sea salt in cooking, which has less sodium than table salt.”
Show the answer and explanation
Answer: A. “Season with herbs, lemon juice, or garlic powder, and avoid salt substitutes made with potassium chloride.”
Topic: salt substitutes with hyperkalemia
Many salt substitutes replace sodium with potassium chloride, which is dangerous when the kidneys cannot excrete potassium. Herbs, spices without added salt, and citrus add flavor safely. Sea salt has about the same sodium as table salt.
Why the others are wrong
- B – Potassium chloride can cause life-threatening hyperkalemia.
- C – Reduced-sodium products often contain potassium chloride and should be limited.
- D – Sea salt has similar sodium content to table salt.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
92Question
A nurse in an oncology clinic reviews four clients for dietitian referral. Which client needs the most urgent referral?
- A client with stable obesity who would like to lose 20 lb during the next year
- A client who follows a vegetarian diet and wants help planning balanced weekly meals and shopping lists
- A client on chemotherapy who lost 8% of body weight in a month and eats little due to mouth sores
- A client in remission whose weight has stayed stable for two years and who feels well
Show the answer and explanation
Answer: C. A client on chemotherapy who lost 8% of body weight in a month and eats little due to mouth sores
Topic: urgent dietitian referral
Rapid unintentional weight loss with poor intake in a client on chemotherapy signals acute malnutrition risk and needs prompt, intensive nutrition support. The other clients have chronic or routine nutrition goals that can be scheduled.
Why the others are wrong
- A – Chronic and planned; weight loss goals are not urgent.
- B – A routine request for planning with no deficit described.
- D – Stable weight and wellness indicate no acute need.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
93Question
A client’s care plan goal is to lose 1 to 2 lb per week through diet changes. At the four-week visit, which nursing action is part of evaluating the plan?
- Collecting a 24-hour diet recall and a list of food preferences to identify the client’s usual daily intake
- Writing a new goal with a target date for the next month
- Teaching the client how to read the nutrition facts label
- Comparing current weight and the food record with the goal, then deciding whether to revise the plan
Show the answer and explanation
Answer: D. Comparing current weight and the food record with the goal, then deciding whether to revise the plan
Topic: evaluating a nutrition goal
Evaluation measures progress against the stated outcome using objective data, then decides whether to continue, change, or end the plan. Collecting a recall is assessment, writing goals is planning, and teaching is implementation.
Why the others are wrong
- A – Gathering baseline intake is assessment.
- B – Setting a goal is planning.
- C – Teaching is implementation.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
94Question
A client with type 2 diabetes asks whether taking a chromium supplement will improve blood glucose control. Which response by the nurse is best?
- “Yes, most people with diabetes lack chromium, so a supplement is needed.”
- “Studies have not shown a reliable benefit, so continue your meal plan and medicines, and ask your provider first.”
- “It works very well in most people, so you can lower your prescribed medicine on your own once you have taken it for a few weeks.”
- “Supplements of any kind are never allowed for people with diabetes.”
Show the answer and explanation
Answer: B. “Studies have not shown a reliable benefit, so continue your meal plan and medicines, and ask your provider first.”
Topic: chromium supplements and glucose control
Current diabetes standards do not recommend chromium supplements, because trials have not shown consistent benefit and deficiency is rare. The nurse should affirm proven care, avoid overstating risks, and ask the client to discuss supplements with the provider, since changing medicines on a supplement’s promise is unsafe.
Why the others are wrong
- A – Chromium deficiency is rare, and supplementing is not recommended.
- C – Lowering medicine on the basis of a supplement can cause hyperglycemia.
- D – An absolute ban is inaccurate; the issue is evidence and interactions.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
95Question
The parent of a 4-year-old who refuses milk and has no food allergies asks how to meet the child’s calcium needs. Which suggestion is best?
- Give extra servings of meat and eggs each day
- Serve more fruit juice in place of milk
- Offer yogurt, cheese, and a calcium-fortified soy beverage.
- Use unfortified almond beverage as an equal substitute for milk
Show the answer and explanation
Answer: C. Offer yogurt, cheese, and a calcium-fortified soy beverage.
Topic: calcium sources for a milk-refusing preschooler
Children’s bones and teeth need calcium and phosphorus from dairy foods or fortified alternatives. Yogurt, cheese, and fortified soy beverage supply both. Meat, eggs, juice, and unfortified plant beverages do not supply comparable calcium.
Why the others are wrong
- A – Meat and eggs are low in calcium.
- B – Juice adds sugar and little calcium unless fortified.
- D – Unfortified almond beverage has little calcium and protein.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
96Question
A client has taken phenytoin for epilepsy for eight years. Which nutrition-related teaching should the nurse include?
- Ask the provider about vitamin D, calcium, and folate, because the drug can lower them and weaken bone.
- Take extra iron every day, since phenytoin mainly causes iron-deficiency anemia and fatigue in most clients.
- Limit all fluids, because phenytoin commonly causes fluid retention.
- Avoid sunlight completely, because the drug makes vitamin D toxic.
Show the answer and explanation
Answer: A. Ask the provider about vitamin D, calcium, and folate, because the drug can lower them and weaken bone.
Topic: phenytoin and bone health
Phenytoin speeds the liver’s breakdown of vitamin D and can lower folate, increasing the risk of osteomalacia, fractures, and megaloblastic anemia. The client should discuss monitoring and supplementation with the provider and keep adequate calcium intake.
Why the others are wrong
- B – Phenytoin is not mainly linked to iron deficiency.
- C – Fluid restriction is not a standard effect or treatment.
- D – The drug lowers rather than raises vitamin D; sun avoidance is not advised.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
97Question
A 54-year-old client with a BMI of 33 kg/m2 reports months of gradual fatigue and thirst. Urine ketones are negative. The hemoglobin A1C is 7.1% on two separate tests. How does the nurse interpret these findings?
- Prediabetes
- Type 2 diabetes
- Type 1 diabetes
- Normal glucose regulation
Show the answer and explanation
Answer: B. Type 2 diabetes
Topic: interpreting hemoglobin A1C
An A1C of 6.5% or higher on two tests confirms diabetes. Older age, obesity, gradual onset, and no ketosis fit type 2 rather than type 1. Prediabetes is 5.7% to 6.4%.
Why the others are wrong
- A – Prediabetes is lower than 6.5%.
- C – Type 1 usually has abrupt onset, younger age, and ketosis risk.
- D – A normal A1C is below 5.7%.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
98Question
A client newly diagnosed with type 2 diabetes asks how to arrange meals. Which guidance should the nurse reinforce?
- Fill half the plate with starchy foods since they supply the energy needed for daily activity and exercise.
- Remove all carbohydrate and base meals on protein and fat.
- Fill half the plate with non-starchy vegetables, a quarter with lean protein, and a quarter with whole grains.
- Eat one very large meal daily to limit the number of glucose rises.
Show the answer and explanation
Answer: C. Fill half the plate with non-starchy vegetables, a quarter with lean protein, and a quarter with whole grains.
Topic: plate method for new type 2 diabetes
The plate method is a simple, evidence-based way to control portions and carbohydrate: vegetables for volume and fiber, lean protein for satiety, and limited carbohydrate from fiber-rich sources. Eliminating carbohydrate or eating a single large meal is neither required nor safe, especially with glucose-lowering drugs.
Why the others are wrong
- A – Starch should be a limited portion, not half the plate.
- B – Complete carbohydrate elimination is unnecessary and can cause hypoglycemia with some drugs.
- D – One large meal causes bigger glucose swings.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
99Question
A client with ulcerative colitis whose flare has resolved asks how to eat now that symptoms are controlled. Which teaching is best?
- Stay on a strict low-fiber diet permanently to prevent another flare from ever happening again.
- Add fiber back slowly, starting with cooked vegetables and peeled fruit, and track tolerance.
- Add large raw salads and whole nuts all at once to catch up on fiber.
- Restrict all fluids to reduce the number of stools.
Show the answer and explanation
Answer: B. Add fiber back slowly, starting with cooked vegetables and peeled fruit, and track tolerance.
Topic: reintroducing fiber after a colitis flare
During a flare, low-residue foods may ease symptoms, but in remission a varied diet with fiber is encouraged. Fiber should be reintroduced slowly, with cooked and peeled forms first, while a food diary identifies personal triggers. Fluids must stay adequate.
Why the others are wrong
- A – Permanent restriction reduces diet quality and is not needed in remission.
- C – Sudden large fiber loads can provoke symptoms.
- D – Fluid restriction risks dehydration.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
100Question
A client with lactose intolerance misses milk and asks about a dairy food that is often better tolerated. Which food should the nurse suggest?
- Premium vanilla ice cream, one scoop
- Chocolate milk
- Plain kefir with live cultures
- Evaporated milk
Show the answer and explanation
Answer: C. Plain kefir with live cultures
Topic: lactose intolerance and fermented dairy
Fermented dairy such as kefir and yogurt contains bacteria that digest part of the lactose, so many people with lactose intolerance tolerate it better. Ice cream, chocolate milk, and evaporated milk are high in lactose.
Why the others are wrong
- A – Ice cream contains substantial lactose.
- B – Chocolate milk has the same lactose as milk.
- D – Evaporated milk is concentrated and high in lactose.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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