151Question
A 6-year-old whose seizures do not respond to medication has just started a ketogenic diet. Which breakfast choice by the parent shows understanding of the diet?
- Oatmeal with banana slices and honey
- Scrambled eggs cooked in butter with avocado slices
- Whole-grain toast with strawberry jam and orange juice
- Low-fat yogurt with granola and berries
Show the answer and explanation
Answer: B. Scrambled eggs cooked in butter with avocado slices
Topic: ketogenic diet for refractory seizures
The ketogenic diet is very high in fat, adequate in protein and very low in carbohydrate, so the body makes ketones for fuel. It is used for seizures that do not respond to drugs and is supervised by the health care team.
Why the others are wrong
- A – Oatmeal, banana and honey are high in carbohydrate.
- C – Toast, jam and juice supply a large amount of sugar and starch.
- D – Granola, fruit and flavored yogurt contain much more carbohydrate than the diet allows.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
152Question
A nurse is checking for dehydration in a 78-year-old client. Which assessment finding is the most reliable in this client?
- Skin that stays tented after being pinched on the forearm
- The client reports feeling very thirsty
- Dry oral mucous membranes with a furrowed tongue
- Pitting edema of both ankles
Show the answer and explanation
Answer: C. Dry oral mucous membranes with a furrowed tongue
Topic: assessing dehydration in older adults
In older adults, skin loses elasticity with age, so forearm tenting is unreliable, and the thirst sensation is blunted. Dry mucous membranes and a furrowed tongue are more dependable signs of fluid loss.
Why the others are wrong
- A – Reduced skin elasticity with aging makes forearm tenting a poor test.
- B – Older adults have a blunted thirst response, so this is not dependable.
- D – Edema points to fluid excess, not a fluid deficit.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
153Question
A client whose asthma flares after eating certain foods has a documented sensitivity to sulfites. Which snack should the nurse advise the client to avoid?
- Dried apricots
- Fresh peaches
- A plain baked potato
- Grilled chicken strips
Show the answer and explanation
Answer: A. Dried apricots
Topic: sulfite-triggered asthma
Sulfites are used as preservatives in dried fruit, wine and some bottled juices, and they can trigger bronchospasm in people with sulfite-sensitive asthma. Fresh and unprocessed foods generally contain no added sulfites.
Why the others are wrong
- B – Fresh fruit has no added sulfite preservative.
- C – A plain potato is unprocessed and sulfite-free.
- D – Plain cooked chicken does not contain sulfite preservatives.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
154Question
A client with COPD becomes short of breath and stops eating a few bites into each large meal. The client has lost weight over the past month. Which plan should the nurse suggest?
- Offer six small meals and snacks that are higher in calories and protein, with a rest before eating
- Serve three large meals so the client can rest longer between them
- Restrict protein to reduce carbon dioxide production
- Offer a low-calorie diet to lower oxygen demand
Show the answer and explanation
Answer: A. Offer six small meals and snacks that are higher in calories and protein, with a rest before eating
Topic: meal strategies in COPD
Large meals press the stomach against the diaphragm and increase the work of breathing. Small, frequent, energy- and protein-dense meals with a rest beforehand make eating easier and help reverse weight loss.
Why the others are wrong
- B – Large meals worsen dyspnea and the client is already unable to finish them.
- C – Protein restriction would speed muscle loss, and protein is needed for respiratory muscle strength.
- D – Weight loss calls for more calories, not fewer.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
155Question
A client with stage 3 chronic kidney disease, whose diet had been stable, develops dyspnea, bibasilar crackles and a 3-kg weight gain over four days. Which change in the diet plan should the nurse anticipate?
- More protein to replace what is lost in the urine
- Stricter limits on sodium and fluids
- Liberal fluids to flush the kidneys
- Added potassium-rich foods to support the heart
Show the answer and explanation
Answer: B. Stricter limits on sodium and fluids
Topic: diet change in CKD with fluid overload
Dyspnea, crackles and rapid weight gain indicate fluid overload and heart failure, so the plan needs tighter sodium and fluid limits. More protein, extra fluids and extra potassium would add workload or risk.
Why the others are wrong
- A – Protein is limited, not increased, in CKD, and it would not treat fluid overload.
- C – More fluid would worsen the overload.
- D – Potassium is usually restricted in CKD because of the risk of hyperkalemia.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
156Question
A client wants to replace sugary snacks with a snack rich in complex carbohydrates and fiber. Which snack choice shows that the client understood the teaching?
- A frosted fruit-filled toaster pastry
- Vanilla sandwich cookies
- Fruit-flavored gummy candies
- A small bowl of air-popped popcorn
Show the answer and explanation
Answer: D. A small bowl of air-popped popcorn
Topic: complex carbohydrate snacks
Complex carbohydrates are starches and fibers found in whole grains, legumes and vegetables. Air-popped popcorn is a whole grain with fiber, while pastries, cookies and candy are mostly refined sugar.
Why the others are wrong
- A – A frosted pastry is refined flour with added sugar.
- B – Sandwich cookies are refined flour and sugar with little fiber.
- C – Gummies are almost pure sugar.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
157Question
A client who receives hemodialysis three times a week has gained 3.8 kg between sessions and has ankle edema and a blood pressure of 168/94 mm Hg. Which nursing action is most appropriate?
- Encourage the client to drink more to increase urine output
- Tell the client to eat more protein to reduce the swelling
- Ask that the next dialysis session be held until the edema improves
- Review the client’s daily fluid and sodium intake and teach ways to control thirst
Show the answer and explanation
Answer: D. Review the client’s daily fluid and sodium intake and teach ways to control thirst
Topic: fluid control in hemodialysis
Large weight gains between sessions come from fluid and sodium intake that the kidneys cannot excrete. Teaching how to limit fluids and salt and to manage thirst treats the cause.
Why the others are wrong
- A – The client's remaining urine output is small, and more fluid will worsen overload.
- B – Protein does not treat edema from fluid excess.
- C – Dialysis is what removes the fluid, so delaying it increases risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
158Question
A client with stage 3 chronic kidney disease who is not on dialysis has been told to eat a smaller amount of protein from lean sources. Which dinner choice shows that the client understands?
- A palm-sized portion of baked skinless chicken with steamed green beans and white rice
- A 12-ounce sirloin steak cooked well-done with a large baked potato
- Battered deep-fried fish with a large serving of French fries
- A bacon cheeseburger with a side of potato chips
Show the answer and explanation
Answer: A. A palm-sized portion of baked skinless chicken with steamed green beans and white rice
Topic: protein choices in CKD
Before dialysis, a controlled protein intake from lean sources lowers the waste load the kidneys must clear. A small portion of baked skinless poultry fits, while large portions and fatty or fried choices do not.
Why the others are wrong
- B – A 12-ounce steak is far more protein than a controlled plan allows.
- C – Fried, battered fish adds fat, and a large serving brings more protein than intended.
- D – Bacon, cheese and chips raise protein, saturated fat and sodium all at once.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
159Question
A provider prescribes 0.6 g/kg/day of protein for a client with stage 4 chronic kidney disease who is not on dialysis and weighs 80 kg. What daily protein amount should the nurse plan for?
- 40 g
- 48 g
- 64 g
- 80 g
Show the answer and explanation
Answer: B. 48 g
Topic: protein calculation in CKD
At 0.6 g/kg/day, 80 kg x 0.6 = 48 g of protein per day. Controlled protein intake in non-dialysis chronic kidney disease reduces the nitrogen waste the kidneys must clear.
Why the others are wrong
- A – 40 g equals about 0.5 g/kg, below the amount prescribed.
- C – 64 g equals 0.8 g/kg, the usual allowance for a healthy adult, not the prescribed restriction.
- D – 80 g equals 1 g/kg, which ignores the protein restriction entirely.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
160Question
A nurse teaches a client about dietary supplements. Which client statement indicates the need for further teaching?
- “I should tell my pharmacist and my provider about every supplement I take, even herbal ones.”
- “The Supplement Facts panel lists how much of each ingredient is in one serving.”
- “If a supplement is sold in a store, the FDA has already proven it safe.”
- “A label saying it supports joint health does not mean it treats arthritis.”
Show the answer and explanation
Answer: C. “If a supplement is sold in a store, the FDA has already proven it safe.”
Topic: supplement labeling and regulation
In the United States, supplements are not approved by the FDA for safety or effectiveness before they are sold, and labels may not claim to treat or cure a disease. Clients should report all supplements because they can interact with drugs.
Why the others are wrong
- A – Reporting supplements is correct because they can interact with prescription drugs.
- B – The Supplement Facts panel does list amounts per serving, so this is correct.
- D – This is correct: structure-function claims do not mean the product treats a disease.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
161Question
A 28-year-old client who is not using contraception plans to try to conceive within the next few months. Which statement by the client shows understanding of the teaching about folic acid?
- “I will begin taking folic acid after I get a positive pregnancy test.”
- “I only need folic acid if my diet has no vegetables.”
- “I will start a daily 400-microgram folic acid supplement now.”
- “I should take 4 milligrams a day, since that is the standard dose for everyone who may conceive.”
Show the answer and explanation
Answer: C. “I will start a daily 400-microgram folic acid supplement now.”
Topic: folic acid before pregnancy
The neural tube closes in the first weeks of pregnancy, often before pregnancy is recognized, so folic acid should be started before conception. The standard recommendation is 400 micrograms daily. A 4-mg dose is reserved for clients with a prior pregnancy affected by a neural tube defect.
Why the others are wrong
- A – Waiting for a positive test misses the early weeks when the neural tube is forming.
- B – Diet alone is not enough; the supplement is advised for everyone who may become pregnant.
- D – 4 mg is for those with a previous neural tube defect pregnancy, not for the general client.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
162Question
A client wants to keep as much vitamin C as possible in the broccoli served at dinner. Which preparation method should the nurse recommend?
- Boil it in a large pot of water for 20 minutes and drain it
- Soak the cut florets in a bowl of water for several hours before cooking them
- Simmer it slowly with a pinch of baking soda to keep it green
- Steam or microwave it briefly with very little water until just tender
Show the answer and explanation
Answer: D. Steam or microwave it briefly with very little water until just tender
Topic: preserving water-soluble vitamins
Water-soluble vitamins such as vitamin C dissolve in cooking water and are destroyed by heat and long cooking. Short cooking with little water, by steaming or microwaving, keeps the most.
Why the others are wrong
- A – Long boiling in a large volume of water leaches and destroys the vitamin.
- B – Soaking leaches water-soluble vitamins out into the water.
- C – Baking soda raises the pH, which speeds destruction of vitamin C.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
163Question
A healthy 74-year-old who eats meat regularly asks why her provider recommended a vitamin B12 supplement or fortified foods. What is the nurse's best explanation?
- “Less stomach acid with age makes B12 harder to release from food.”
- “Older adults can no longer digest animal protein, so meat does not supply B12.”
- “Aging muscles burn up B12 during exercise and it must be replaced daily.”
- “Your kidneys remove B12 faster as you age, so it must be replaced every day.”
Show the answer and explanation
Answer: A. “Less stomach acid with age makes B12 harder to release from food.”
Topic: B12 absorption in older adults
Stomach acid frees B12 from food proteins, and acid production often falls with age. The crystalline B12 in supplements and fortified foods does not need acid to be absorbed, which is why adults over 50 are advised to use them.
Why the others are wrong
- B – Older adults can digest protein; the issue is releasing B12 from it.
- C – Exercise does not use up B12 faster in older adults.
- D – Kidney loss of B12 is not the reason for the recommendation.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
164Question
A client at 24 weeks of pregnancy with new high blood pressure is choosing a restaurant meal. Which choice is best for the client?
- Fried chicken tenders with French fries
- Well-cooked grilled salmon with steamed vegetables and brown rice
- Raw tuna sushi rolls with seaweed salad
- A cold deli turkey and ham sandwich with extra cheese and mayonnaise
Show the answer and explanation
Answer: B. Well-cooked grilled salmon with steamed vegetables and brown rice
Topic: food choices in pregnancy with hypertension
Grilled, well-cooked fish with vegetables is low in saturated fat and sodium and safe in pregnancy. Fried food is high in fat, raw fish carries a risk of infection, and unheated deli meats can carry Listeria.
Why the others are wrong
- A – Deep-fried food is high in fat and sodium, which does not suit hypertension.
- C – Raw fish carries a risk of parasites and bacteria that is avoided in pregnancy.
- D – Unheated deli meats and cheese carry a Listeria risk and are high in sodium.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
165Question
A nurse sees a client at 33 weeks of gestation for a prenatal visit. Which finding should the nurse report to the provider immediately?
- Mild ankle swelling that is worse at the end of a long day spent working on her feet
- Blood pressure 152/98 mm Hg with a new, persistent headache and blurred vision
- Irregular, painless tightening of the abdomen that stops when she rests
- A weight gain of 0.5 kg since the visit two weeks ago
Show the answer and explanation
Answer: B. Blood pressure 152/98 mm Hg with a new, persistent headache and blurred vision
Topic: preeclampsia warning signs
Elevated blood pressure with headache and visual changes signals preeclampsia with severe features, which can lead to seizures, abruption and preterm delivery. The other findings are common and expected in late pregnancy.
Why the others are wrong
- A – Dependent ankle edema that eases with rest is common.
- C – Painless, irregular Braxton Hicks contractions that stop with rest are common.
- D – A gain of 0.5 kg over two weeks is within the expected range.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
166Question
A 5-year-old boy is 40 inches tall and weighs 60 pounds. The nurse uses the formula weight (lb) × 703 ÷ height (in)². What is the child's BMI, and what should the nurse do next?
- 26.4 kg/m²; plot it on a BMI-for-age growth chart to find the percentile
- 26.4 kg/m²; call the child overweight because the adult cutoff is 25
- 12.0 kg/m²; plot it on a BMI-for-age growth chart to find the percentile rank
- 15.0 kg/m²; reassure the parent that the weight is healthy
Show the answer and explanation
Answer: A. 26.4 kg/m²; plot it on a BMI-for-age growth chart to find the percentile
Topic: pediatric BMI calculation
60 × 703 = 42,180, and 40² = 1,600, so BMI = 26.4. In children the number is interpreted by percentile for age and sex on a growth chart, not by adult cutoffs.
Why the others are wrong
- B – Adult BMI cutoffs do not apply to children.
- C – 12.0 results from mixing kilograms into the pound formula.
- D – 15.0 does not follow from the numbers given and would wrongly suggest a healthy weight.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
167Question
The parent of a 3-year-old says, “My son refuses broccoli, so I have stopped serving it.” Which response by the nurse is best?
- “Make him stay at the table until he has eaten all of the broccoli on his plate.”
- “Offer a dessert as a reward each time he eats it.”
- “Keep offering a small portion without pressure; it often takes many tries.”
- “Stop offering it, since a dislike like this lasts through childhood.”
Show the answer and explanation
Answer: C. “Keep offering a small portion without pressure; it often takes many tries.”
Topic: picky eating in toddlers
Young children often need repeated, pressure-free exposure to a food before they accept it. Forcing or bribing teaches the child to dislike the food and can lead to feeding conflict.
Why the others are wrong
- A – Forcing a child to finish a food leads to more refusal and mealtime conflict.
- B – Dessert as a reward makes the dessert more valued and the vegetable less so.
- D – Food dislikes in toddlers often change with repeated exposure.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
168Question
A client in the third trimester has been advised to limit sodium and saturated fat. Which snack should the nurse suggest?
- Whole-wheat crackers topped with processed cheese spread and bacon bits
- Teriyaki beef jerky strips
- Salted pretzel twists with mustard dip
- A sliced pear with a small handful of unsalted almonds
Show the answer and explanation
Answer: D. A sliced pear with a small handful of unsalted almonds
Topic: low-sodium snacks in pregnancy
Fresh fruit with unsalted nuts is low in sodium and provides fiber and unsaturated fat. Processed cheese, jerky and salted pretzels are high in sodium, and processed cheese adds saturated fat.
Why the others are wrong
- A – Processed cheese is high in sodium and saturated fat.
- B – Jerky is cured and seasoned with large amounts of sodium.
- C – Salted pretzels and prepared mustard add a lot of sodium.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
169Question
A client with an LDL cholesterol of 168 mg/dL wants to try diet changes before starting a statin. Which breakfast best supports lowering LDL?
- Two eggs fried in butter with sausage links and buttered toast
- A bakery pastry with a sweetened latte
- White toast with cream cheese and bacon
- Oatmeal topped with chopped walnuts and sliced apple
Show the answer and explanation
Answer: D. Oatmeal topped with chopped walnuts and sliced apple
Topic: soluble fiber and LDL
Oats and apples provide soluble fiber, which binds bile acids and lowers LDL, and walnuts supply unsaturated fat. The other choices are high in saturated fat or refined sugar.
Why the others are wrong
- A – Butter and sausage supply saturated fat and little fiber.
- B – A pastry and sweetened coffee give refined sugar and fat without fiber.
- C – Cream cheese and bacon are high in saturated fat and sodium, and white toast has little fiber.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
170Question
A client with a normal prepregnancy BMI asks how much weight she should gain during her singleton pregnancy. What is the nurse's best response?
- “Gain as much as your appetite asks for, because the baby takes what it needs.”
- “About 25 to 35 pounds is recommended, gained gradually and mostly after the first trimester.”
- “Gain no more than 10 pounds so the baby stays small and delivery is easier.”
- “Aim for about 40 to 50 pounds, since you are eating for two.”
Show the answer and explanation
Answer: B. “About 25 to 35 pounds is recommended, gained gradually and mostly after the first trimester.”
Topic: gestational weight gain
For a normal prepregnancy BMI, the recommended total gain is 25 to 35 pounds. Gaining too little risks poor fetal growth, and gaining too much raises the risk of gestational diabetes, hypertension and cesarean birth.
Why the others are wrong
- A – Unlimited gain increases the risks of diabetes, hypertension and cesarean birth.
- C – Too little gain risks growth restriction and preterm birth.
- D – A gain of 40 to 50 pounds is above the recommended range for a normal BMI.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
171Question
The parent of a 9-month-old plans to give 100% fruit juice in a bottle every day. Which teaching by the nurse is most appropriate?
- “Juice is not recommended in the first year; offer pureed whole fruit instead.”
- “Juice is fine if you dilute it with an equal amount of water and offer it in a cup.”
- “Juice at 9 months is recommended to add vitamin C to the diet.”
- “Juice is acceptable if it is only given in a bottle at bedtime.”
Show the answer and explanation
Answer: A. “Juice is not recommended in the first year; offer pureed whole fruit instead.”
Topic: juice in infancy
The AAP advises against juice in the first year of life because it adds sugar and calories without the fiber of whole fruit and can contribute to tooth decay. Whole pureed fruit is better, and small amounts of water are allowed once solids start.
Why the others are wrong
- B – Dilution still gives sugar and does not make juice recommended in the first year.
- C – Infants get vitamin C from breast milk or formula and from whole fruit.
- D – A bedtime juice bottle is a major cause of early childhood tooth decay.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
172Question
A 15-year-old eats fast food daily with friends after school. Which approach by the nurse is most likely to lead to change?
- Explain in detail the long-term risks of heart disease, diabetes and obesity to the teen
- Ask the parent to forbid all fast food and set a strict meal plan
- Choose realistic healthier options where the teen already eats with friends
- Hand the teen a printed list of foods to avoid and move on
Show the answer and explanation
Answer: C. Choose realistic healthier options where the teen already eats with friends
Topic: adolescent nutrition counseling
Adolescents are driven by autonomy and peers. Plans that build on their own choices and settings are more likely to work than lectures about future risks or rules imposed from outside.
Why the others are wrong
- A – Long-term risk talk has little power with teens who focus on the present.
- B – Strict bans take away autonomy and often cause resistance.
- D – A list of forbidden foods without discussion does not build a plan the teen owns.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
173Question
A client whose cholesterol panel shows a total of 245 mg/dL and an LDL of 170 mg/dL asks which change in the kinds of fat she eats would help most. What should the nurse recommend?
- Replace butter with olive oil and eat fish twice a week in place of some red meat
- Replace butter with a stick margarine made with partially hydrogenated vegetable oil
- Cook with coconut oil because it comes from a plant
- Cut all fat from the diet, including fish and nuts
Show the answer and explanation
Answer: A. Replace butter with olive oil and eat fish twice a week in place of some red meat
Topic: dietary fat quality and LDL
Replacing saturated fat with unsaturated fat, such as olive oil and fish, lowers LDL. Trans fats raise LDL, coconut oil is high in saturated fat, and completely fat-free eating is neither needed nor healthy.
Why the others are wrong
- B – Partially hydrogenated margarine contains trans fat, which raises LDL.
- C – Coconut oil is high in saturated fat and can raise LDL.
- D – Fish and nuts supply helpful unsaturated fats, so removing all fat is unnecessary.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
174Question
A client with gestational diabetes has fasting and after-meal glucose readings above target and asks how to eat. Which plan should the nurse reinforce?
- Eliminate all carbohydrate foods until delivery
- Eat one large meal in the evening and skip snacks
- Replace meals with fruit juice to keep glucose steady
- Spread moderate, consistent amounts of carbohydrate across three meals and two or three snacks
Show the answer and explanation
Answer: D. Spread moderate, consistent amounts of carbohydrate across three meals and two or three snacks
Topic: carbohydrate distribution in gestational diabetes
Distributing moderate amounts of carbohydrate across meals and snacks limits glucose peaks while supplying energy and nutrients to the fetus. Complete carbohydrate restriction, skipped meals and juice all cause problems.
Why the others are wrong
- A – Pregnancy needs carbohydrate for the fetus, and total restriction can cause ketosis.
- B – One large meal produces a high glucose peak and long fasting periods.
- C – Juice causes rapid glucose spikes and does not supply balanced nutrition.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
175Question
A client with prediabetes and insulin resistance usually eats a double cheeseburger and fries for lunch. Which lunch should the nurse suggest instead?
- A fried fish sandwich with tartar sauce and fries
- A large flour tortilla wrap filled with sausage, cheese and creamy sauce
- A grilled chicken salad with chickpeas, olive oil and vinegar dressing
- Sweetened fruit-flavored yogurt with a granola bar
Show the answer and explanation
Answer: C. A grilled chicken salad with chickpeas, olive oil and vinegar dressing
Topic: diet for insulin resistance
Lean protein with fiber-rich legumes, vegetables and unsaturated fat slows glucose absorption and avoids the saturated fat that worsens insulin resistance. The other meals are high in refined starch, sugar or saturated fat.
Why the others are wrong
- A – Fried food adds saturated fat and refined starch.
- B – Sausage and cheese add saturated fat, and a large flour tortilla adds refined starch.
- D – Sweetened yogurt and a granola bar are high in added sugar.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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