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Questions that failed the audit

Every question bank claims its items are checked. None of them show you the ones that weren’t good enough. Here are 99 of the 358 items our clinical audit rejected, each with the objection that killed it — verbatim, not summarised.

Read them the way an examiner would. Most look completely reasonable, which is the point: these are the flaws that survive in banks that never publish their rejects.

Read this first

The questions on this page are flawed on purpose. The keyed answers and the reasoning behind them are wrong or unsafe in the way each objection describes. Do not memorise anything here as fact. The verified bank is on the practice pages.

By section

What one looks like

Rejected — do not study this as correctBasic sciences

A 65-year-old patient is admitted with a 3-day history of severe vomiting and diarrhea. The patient has been taking furosemide 40 mg daily for heart failure. On assessment, the nurse notes muscle weakness, hypoactive bowel sounds, and a weak, irregular pulse. Which electrolyte imbalance does the nurse suspect?

  1. AHyperkalemia
  2. BHypokalemiaKeyed by the writer
  3. CHyponatremia
  4. DHypercalcemia

What the audit caught

Rationale for Option B incorrectly categorizes a 'weak pulse' as a 'cardiac dysrhythmia.' A weak pulse indicates decreased stroke volume or contractility (or hypovolemia), whereas a dysrhythmia refers specifically to rhythm irregularity. While hypokalemia causes both decreased contractility and dysrhythmias, the rationale conflates distinct clinical assessment findings.

These came out of the same pipeline that produced the published bank — written to the blueprint, then handed to an independent audit told to refute them. How that works, or practise the questions that passed.