Gaith - Nursing sample for Prometric exam_compressed (1).pdf

‫أوليس يُجزى ُم ٌ‬ ‫حسن اال باحسان‬ ‫ك غيث‬ ‫نحيا‬ ‫فكلنا كالغيث للغير مازالت‬ ‫الدنيا بخير‬ ‫قلبي اطمان‬ ‫ملف تحديث شهريا الضافة الجديد‬ ‫وتصحيح اي اخطاء‬ ‫‪1‬‬ ...

‫أوليس يُجزى ُم ٌ‬ ‫حسن اال باحسان‬ ‫ك غيث‬ ‫نحيا‬ ‫فكلنا كالغيث للغير مازالت‬ ‫الدنيا بخير‬ ‫قلبي اطمان‬ ‫ملف تحديث شهريا الضافة الجديد‬ ‫وتصحيح اي اخطاء‬ ‫‪1‬‬  ‫أوليس يُجزى ُم ٌ‬ ‫حسن اال باحسان‬ ‫التعديالت‬ ‫‪1392 A‬‬ ‫‪1487 B‬‬ ‫‪2‬‬  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ Positioning 📍Craniotomy👉semi fowler 📍Hip surgery👉keep leg in abduction 📍Cast👉elevate extremity to prevent edema 📍Asthma👉sitting position 📍Icp👉elevate the head of the bed 📍Distended neck vein👉elevate 30 degree 📍Enema👉sims position 📍Post cardiac cath👉semi fowler 📍Spinal pefida👉prone position 📍Seizure👉side lying 📍Shock👉supine with elevated leg 📍Nasogastric tube👉high fowler 📍Nasogastric tube irrigation and tube feeding 👉 HOB evelvated 30-45 📍Central venous catheter👉trendelenburg position 📍Endoscopy👉left lateral position 📍Cleft palate👉supine upright position 📍Cleft palate👉 elbow restrain and avoid prone 📍Post tonsillectomy👉side lying/lateral/prone 📍Teratology of fallout 👉knee chest position 📍During liver biopsy👉position client supine with the right side of the upper abdomen exposed. 3  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 📍After liver biopsy 👉right lateral, side lying, position........💕‫️☺غيث‬. 📍After. hemorrhoidectomy👉lateral, side lying, position, Jackknife position 📍perineal or vaginal procedures👉lithotomy position 📍Central line CVP👉 trendelenburg position 📍The nurse would increase the comfort of the patient with appendicitis by👉Flexing the patient's right knee 📍Post thyroidectomy position 👉👉Place the client in the semi-Fowler’s to Fowler’s position to reduce swelling and edema in the neck area. 📍Mastectomy👉👉 with arm on affected side elevated to allow lymph drainage Cranial Nerves Nerve I Olfactory Nerve smell Bottle containing something that smell Nerve II Optic Nerve Vision Use visual acuity chart. ( Snellen chart Nerve III Oculomotor Nerve Eye function , pupil dilation. Have patient blink their eyes Nerve IV Oculomotor Nerve Eye movement Have patient look down Nerve V Trigeminal Nerve Sensory of the face, chewing pinprick & brushing teeth (Clench jaw. Test for feeling by lightly touching forehead, cheek and jaw. Nerve VI Abducens Nerve Eye movement Have patient look to each side Nerve VII facial Nerve Facial expression, wrinkle forehead, Cotton , hammer , sweats and salts taste anterior tongue Nerve VIII Vestibulocochlear Nerve Auditory acuity, balance and Rinne test (nap fingers beside postural responses patient ear, have them stand on one foot) Nerve IX Glossopharyngeal Nerve Taste and swallowing Tongue depressor and pen light Nerve X Vagus Nerve Gag reflex Tongue depressor Nerve XI Accessory Nerve Muscles of neck Nerve XII Hypoglossal Nerve Tongue movement. stick tongue out 4  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ Rule of the B’s.. If the pH & the bicarb are both in the same direction = metabolic If they are in different directions = respiratory RESPIRATORY OR METABOLIC ! PH ↑ HCO3 ↑ or PH ↓ HCO3 ↓ it is Metabolic PH ↑ HCO3 ↓ or PH ↓ HCO3 ↑ it is Respiratory Respiratory ‫………………… عكس االتجاه تكون‬.Metabolic ‫نفس االتجاه تكون‬ pH = 7.35-7.45 acidosis/alkalosis HCO3 (bicarb) = 22-26 (2+2+2 = 6) CO2 = 45-35 ACIDOSIS OR ALKALOSIS ! PH < 7.45 Alkalosis PH > 7.35 Acidosis Compensated or uncompensated ! Un compensated if PCO2 or HCO3 are Normal Partially compensated if Nothing is Normal Compensated if PH is Normal ---------------------------------------------------------------------------------------------------------------- ex: PH: 7.30 ↓ bicarb: 20 = ↓ = metabolic acidosis ex: pH: 7.58 =↑ bicarb: 32 = ↑ = metabolic alkalosis ex: pH: 7.22 =↓ bicarb: 30 =↑ = respiratory acidosis 5  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ Vomiting Metabolic Alkalosis Nasogastric tube suction Metabolic Alkalosis Diarrhoea Metabolic Acidosis Ileostomy Metabolic Acidosis Dehydration Metabolic Acidosis CPR Respiratory Acidosis Drowning Respiratory Acidosis Cushing syndrome Metabolic Alkalosis 1. A 12- year- old boy was brought to the Emergency respiratory arrest due to drowning. Cardiac resuscitation what is the major complication that might happen if treated after drowning quickly? A. Sepsis B. Alkalosis C. Acidosis D. Hypothermia 2. An ICU nurse reviews the chart of a 47-year-old man patient mechanical ventilator for a long time. Arterial blood gas result see lab results). Test Result Normal Values ABG HCO3 24 22-28 mmd/L ABG PCO3 10.66 4.7-6.0 KPa PH 7.16 7.36-7.45 ABG PO2 6.13 10.6-14.2 KPa SA O2 81 95-100 % What condition the patient is experiencing presently? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis 3. Gastric suction can cause : A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis. 4. ABG reading was low PH ,HIGH PCO2 , NORMAL Hco3 what the interpretation ? A. Compensated respiratory acidosis B. Uncompensated respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis 5. Patient with ABG PH 7.33 ‫ و‬HCO3 30 , PCO2 50 6  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ A. Compensate respiratory B. Compensate metabolic C. Uncompensated respiratory D. Uncompensated metabolic 6. The nurse assesses a client with an ileostomy for possible development of which of the following acid-base imbalances? A. Respiratory acidosis B. Metabolic acidosis C. Metabolic alkalosis D. Respiratory alkalosis 7. The nurse is assigned to care for the a patient with Cushing syndrome on adrenal corticoid hormones syndrome on adrenal corticoid hormones Ph 7.2 Which of the following condition should nurse expect to patient A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic alkalosis D. Metabolic acidosis 8. A nurse reviewed a chart of a 42 year-old man whose ABG analysis report is shown PH 7.20 PCO2 35 HCO3 20. Which of the following I the most likely interpretation of the findings in the report? A. Respiratory alkalosis B. Metabolic acidosis C. Respiratory acidosis D. Metabolic acidosis 9. A 20 year old woman, a case of panic attacks, comes to the emergency department. An arterial blood gas analysis is done PH 7.53 7.35-7.45 HCO3 22 22-26 PCO2 27 35-45 what is most likely? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis. 7  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ Intravenous solution 10. A client was admitted in the Emergency Room due to mild metabolic acidosis associated with dehydration and potassium the doctor administered Hartmann’s (lactated Ringer’s) intravenous fluid and electrolyte replacement. Which of the following elements of the lactated Ringer’s solution highest value? A. Calcium B. Sodium C. Potassium D. Magnesium 11. Ringer Lactate consider as which type of IV solution? A. Hypotonic B. Hypertonic C. Isotonic D. Hyper alimentation 12. physician orders an intravenous fluid of D5NS at 100cc/hr. This is an example of which of the solution? A. hyper alimentation B. hypertonic C. hypotonic D. isotonic 13. 13-year-old patient is admitted for diarrhoea and vomiting. He looks pale and lethargic. A nurse is preparing to give IV hypotonic solution. Blood pressure 110/70 mmHg Heart rate 76 /min Respiratory rate 18 /min Temperature 36.1°C Which IV solution is most appropriate? A. 0.9% saline B. Lactated ringers C. 10% dextrose in water D. 0.45% sodium chloride 8  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ CPR Questions 14. CPR DEPTH ONE THIRD OF CHEST = 1.5 INCH =4CM IN INFANTS , IN ADULT 2 INCH = 5CM 15. CPR site 16. CPR Technique IS : A. 30:2 120 B. 15:2 100 17. You are performing CPR on an infant when a second rescuer appears. What is the next step in management? A. Immediately transport the patient B. Wait until exhausted, then switch C. Have the second rescuer help with CPR, to minimize fatigue D. Have the second rescuer begin ventilations; ratio 30:2 18. What should be your first concern at the scene where a person has been seriously burned? A. Checking the scene for safety. B. Checking the victims breathing and pulse. C. Calling your local emergency phone number. D. Cooling the burned area. 19. While performing cardiopulmonary resuscitation (CPR) on a 5-year-old child, the nurse palpates for a pulse. Which of the following sites is best for checking the pulse during CPR in a 5-year-old child? A. Femoral artery B. Carotid artery. C. Radial artery D. Brachial artery 20. After activating the emergency call system, what should be the next immediate action? A. Initiate ventricular pacing B. Administer a bolus of lidocaine as prescribed C. Defibrillate the patient D. Open the patient's airway 21. A nursing instructor teaches a group of students about basic life support. The instructor asks a student to identify the most appropriate location to assess the pulse of an infant under 1 year of age. Which of the following if stated by the student, would indicate that the student understands the appropriate procedure: A. Carotid B. Popliteal C. Radial D. Brachial. 9  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ Chest Tube questions 22. A nurse is transferring a patient with chest tube the X-ray department for chest X-ray. Which location should the nurse place chest tube A. Directly on the stretcher in an upright B. On the side of stretcher next to patient C. Hanged on IV pole that is attached to the D. Attached to the stretcher and hanged 23. 69 year-old man is admitted to the intensive care unit following cardiac surgery. Two hours after admission, the nurse performs a routine assessment and notes the patient's chest tube drainage is 200 milliliters and a dark red color. He has had 60 milliliters output from the indwelling urinary catheter Blood pressure 138/68 mmhg Heart rate 76/min Respiratory rate 16/min Body temperature 37.0C oral Oxygen saturation 94% 6L/min nasal cannula Which finding should be reported to the doctor? A. Dark red chest tube drainage B. Urinary output C. Oxygen saturation D. Chest tube output volume 24. 40 year-old male patient has a chest tube and properly fixed following cardiac surgery. The chest tube is patent and functioning. When the nurse removes the dressing the tube falls out of the chest. Which is the most appropriate initial intervention the nurse should take? A. Reinsert the chest tube and notify the surgeon B. Apply an occlusive dressing to the insertion site C. Place the open end of the tube in 20 cm of water D. Administer O2 at 10L/min via non-rebreather mask 25. While attempting to get of the bed a patient accidentally disconnects the chest tube from the pleura evac drainage system which of the following actions should the nurse take first A. Insert the end of the chest tube in a container of sterile solution B. Raise the end chest tube above the level of insertion of the chest tube C. Clamp the chest tube near pleura evac drainage system D. Apply pressure dressing to chest tube insertion site 26. The nurse is caring for a client who has just had a chest tube attached to a water seal drainage system. To ensure that the system is functioning effectively the nurse should: A. Observe for intermittent bubbling in the water seal chamber B. Flush the chest tubes with 30-60 ml of NSS every 4-6 hours C. Maintain the client in an extreme lateral position D. Strip the chest tubes in the direction of the client 27. A client chest tube is connected to a chest tube drainage system with a water seal. The nurse noted that the water seal c is fluctuating with each breath that client takes. The fluctuation mwans that A. There is an obstruction in the chest tube B. The client is developing emphysema C. The chest tube system is functioning properly D. There is leak in the chest tube system 28. 20-Your patient has a chest tube. Your assessing the water seal chamber and you note ).11 that the water moves up as the patient inhales and then moves down when the patient ?exhales. What may be causing this to happen 10  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ A. This is normal and expected B. The chest tube has a leak C. The left chest tube is occluded D. The water seal suction should be increased 2-5 mmHg 29. 21-You are assisting a MD with the removal of a chest tube. What activity may the MD have ?the patient perform while the chest tube is being removed A. Valsalva maneuver. B. Leopold Maneuver C. Chest Physiotherapy D. Huff Cough Technique 30. A 67 year-old man is admitted to the Post-anesthesia Recovery unit following chest surgery. The patient has a right chest tube that is attached to low suction. Three hours after admission to the unit, the nurse observes the drainage output from the chest tube is 300 milliliters. What is the most appropriate initial intervention? A. Notify the doctor B. Reduce IV infusion rate C. Strip tube with roller device D. Re-position in left lateral decubitus 31. The nurse is caring for a client who has had a chest tube inserted and connected to water seal drainage. The nurse determines the drainage system is functioning correctly when which of the following is observed: A. Continuous bubbling in the water seal chamber B. Fluctuation in the water seal chamber C. Suction tubing attached to a wall unit D. Vesicular breath sounds throughout the lung fields 11  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 32. Which of the following is an example of epidemic point source? A. Tuberculosis B. Public health agency C. Contaminated water source D. Communicable disease pavilion Airborne Droplet Contact TB epidemic disease Streptococcus RSV Corona virus Meningitis MRSA measles Diphtheria Staphylococcus chicken pox Rubella Ebola virus Small pox influenza Tuberculosis  TB epidemic disease  TB. Wear N95 mask  TB. Test Mantoux test / PPD TEST  TB TEST WITHIN 48-72 Hours  Isoniazid for TB side effect numbness , hepatitis symptoms , stomach upset ,rashes  Tb accurate test sputum culture and to be done early morning Meningitis....  Streptococcal pneumonia  meningococcal vaccine. Hib  Neck rigidity  Droplet  Cloudy CSF  Lumber puncture  Surgical mask. No N95 mask 33. A 32 years old man develops chronic productive cough. He has not been feeling hungry and has lost three kilograms body weight in the past three weeks. On examination of his lung fields, there was diminished breath sound and widespread crackles. An early morning sputum culture was sent to the lab. A. Droplet B. Contact C. Airborne Rationale TB chest XRAY 34. 8 year-old man is diagnosed with tuberculosis (TB) and negative pressure room. Which of the following should wear a facemask? A. Patient's health care providers B. All people who enter the patient's room C. Person has close contact with the patient D. Family members who are at risk for infection 12  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 35. A nurse working in medical unit is preparing to with droplet precaution measures in place. The following personal protective equipment; eyewear. What is the correct sequence foe putting the equipment on? A. Face Mask, Gown, Eyewear, and Gloves B. Gown, Face Mask, Eyewear, and Gloves C. Eyewear, Cloves, Face Mask, and Gown D. Gloves, Gown, Face Mask, and Eyewear 36. A nurse working in medical unit is going out (removing) with droplet precaution measures in place. The following personal protective equipment; eyewear. What is the correct sequence foe putting the equipment off? A. Face Mask, Gown, Eyewear, and Gloves B. Gown, Face Mask, Eyewear, and Gloves C. Eyewear, Cloves, Face Mask, and Gown D. Gloves, Eyewear , Gown, , and Face Mask 37. Mr X attended in outpatient clinic with symptoms of shortness of breath, diarrhea and severe respiratory distress Which of the following is the best diagnosis of Mrs. A case? A. Corona virus B. Swine Flue C. Zika virus D. Hepatitis 38. A nurse receives a telephone call from the admission office of the hospital and is told that a patient with streptococcal meningitis will be admitted to the Medical Unit. The nurse is planning to apply infection control measures for the patient. Which type of isolation precaution the nurse must observe? A. Droplet precautions B. Contact precautions C. Airborne precautions D. Standard precautions 39. A 35 year old patient was admitted to a medical ward with confirmed agnosies f meningococcal infection. Which of the following infection control preventions the nurse should implement? A. Droplet precaution B. Contact precaution C. Airborne precaution D. Standard precaution 40. A 16 month old child is hospital in the intensive care unit with multi resistant sepsis. On the 3rd day. She had explosive diarrhea. A stool sample was sent to the laboratory for C. difficle investigation. Which of the following transmission based precaution is most appropriate? A. Combination airborne and droplet B. Contact C. Droplet D. Airborne 41. Which of the following is the most effective infection control precaution to prevent nosocomial infection? A. Hand washing before and after patient contact B. Wearing gloves and mask for direct patient care C. Isolation precaution D. Broad spectrum antibiotic 42. Mantoux test done for a patient result was 6.5cm it consider? 13  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ A. Latent B. Suspected C. Active 43. When planning discharge teaching for a patient hospitalized for treatment of the 3rd burns over 30% of the body, a nurse knows it is most important to include instructions regarding the loss of large amounts of serum occurring with burns and the resulting loss of immune function. Which of the following instructions should be include? A. Wash hands frequently each day B. Wear supplemental oxygen at night C. Wear masks while in public spaces D. Take a multiple vitamin tablet night 44. An infection control nurse notices purulent exudates , redness and tenderness on the surgical wound site for few post –operative patients in a surgical unit , She discussed with the ward nurse and emphasized that wound infection after the surgery can be prevented. Which of the following is the best possible action to minimize the incidence of wound infection ? A. Perform assessment of pain on the wound site B. Wash hand before and after each patient activity C. Encourage adequate intake and early ambulation 45. A patient in surgical was transferred to isolation room after the wound swab confirmed to have methicillin Resistant staphylococcus Atreus MRSA. Which of the following measures should the nurse take to prevent infection in the ward? A. Clean the would three times a day B. Discard all soiled dressing into waste bag C. Instruct the patient to wash hands regularly D. Wear gloves and gown on every entry into the room 46. Medical asepsis requires which of the following hand washing techniques? A. Use hot water to ensure that pathogens are killed B. Use circular motion washing from clean to dirty areas C. Rinse soap off keeping hands and forearms lower than downs D. Hands shall be held higher than elbows and scrub 47. A 45-year-old patient admitted with pulmonary tuberculosis. The unit nurse placed the patient in an isolation room with negative air pressure and prepared all the personal protective equipment at the entrance of the room. What type of precaution measure has the nurse activated? A. Contact B. Droplet C. Airborne D. Standard 48. To reduce the risk of transmitting methicillin-resistant staphylococcus auras (MRSA) from an infectious wound, which of the following precautions should be implemented? A. Airborne B. Contact C. Droplet D. Reverse isolation 14  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 49. A 45 year old patient is admitted with pulmonary tuberculosis. The unit nurse placed the patient in isolation room with negative air pressure and prepared all PPE at the entrance of the room. Which of the following PPE is the most important for the nurse when caring for this patient? A. Hair cover B. Sterile gloves C. N95 respirator D. Protective goggle 50. 8 month-old child diagnosed with bronchiolitis due to respiratory ncytial virus (RSV) is admitted to the pediatric hospital. The nurse should initiate which of the following isolation precaution? A. Contact B. Airborne C. Standard D. Droplet 51. A 5-year-old child is seen in the primary care clinic with mild fever, headache, and malaise for about 2 days and today he has a rash filled with fluids. which of the following is the best suggested diagnosis? A. Chicken pox B. German measles C. Measles D. Scarlet fever 52. A eight year-old boy present to the pediatric clinic with his mother who complains that the child has developed a skin rash. There is a clear drainage from the nose and he appears tired. The rash first appeared on the face and then spread over the trunk and is now beginning to appear over the hands. Some lesions show open ulcerations and other have crusted over. There are scratch marks over the skin. Which finding would indicate the child is ready to return to school A. Normal body temperature B. Dry and scabbed lesions C. Nares of free of drainage D. Absence of rash over trunk 53. A patient with measles (rubella) is on airborne precautions. Which of the following precaution techniques would be essential to implement for non-immune persons entering the room? A. Gloves B. Gowns C. Masks D. Face shields 54. A home health nurse has entered a home to complete an admission assessment on a patient who has a methicillin-resistant Staphylococcus aureus (MRSA) urinary tract infection. The patient will receive intravenous anti-infective via a peripherally inserted central catheter (PICC) for 3 weeks. Which of the following actions should the nurse take FIRST? A. Shake the patient’s hand B. Place the nursing supply began a clean, dry surface. C. Obtain the patient’s written consent for home health care D. Perform hand hygiene per the agency protocol 55. You have just admitted a patient with bacterial meningitis to the medical-surgical unit. The patient complains of a severe headache with photophobia and has a temperature of 102.60 F orally. Which type of isolation should be suitable for the patient? 15  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ A. Air borne B. Contact C. Droplet 56. In order to reduce the risk of disease transmission from a patient with diphtheria, which of the following standard precautions would the nurse implement? A. Airborne B. Contact C. Droplet D. Ventilatory 57. Patient with a colostomy complains of itching of the peris tornal skin. On assessment, the skin is covered in a red rash with white patches visible. What is the most likely cause of this condition? A. Not changing the pouch regularly B. Candidiasis C. Consuming acid-producing foods D. Dehydration 58. A 33-year-old woman has come to the outpatient clinic for treatment of a vaginal infection. Physical assessment reveals yellowish excessive, thin offensive and frothy discharge. Which of the following is the most likely diagnosis? A. Candidiasis B. Trichomoniasis C. Bacterial vaginosis D. Chlamydia 59. The nurse is assessing a 65-year-old patient, who reports the fatigue, weight loss, night sweats, and a productive cough with thick sputum The nurse should immediately initiate isolation precautions for which of the following? A. Influenza B. Pertussis C. Bacterial pneumonia D. Pulmonary tuberculosis 60. Which of the following diagnostic tests is definitive for TB? A. Chest x-ray B. Mantoux test C. Sputum culture D. Tuberculin test 61. A patient presented with high fever, headache, vomiting and neck stiffness for the past 3 days, which of the following is the first diagnostic intervention for this patient: A. Urine and stool analysis B. lumber puncture with CSF aspiration C. Complete blood count D. Chest and abdomen x-ray 62. When a patient is admitted with acute influenza, what type of isolation is MOST appropriate? A. Reverse isolation B. Contact isolation C. strict isolation D. Respiratory isolation 16  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 63. What precautions are necessary when caring for a patient with Hepatitis A? A. Gowning before entering the room B. Wearing gloves for direct care C. Wearing a mask at all times D. Placing the patient in a private room 64. The nurse is assigned to care for the a patient with Ebola virus disease. Which of the following is the most common mode of transmission for Ebola virus? A. Vector B. Airborne C. Direct contact D. Common vehicle 65. A nurse is caring a patient diagnosed with pulmonary tuberculosis and she has to wear N95 mask when she enters to the parent room. Based on the cycle of infection, which of the following is the reason to use the mask? A. Break the transmission chain at the portal of entry. B. Break the transmission chain at the portal exit C. Kill the agent exits in the patients room. D. Eliminate the reservoir of the bacteria 66. After receiving the initial treatment of TB , a 27 years old woman in the chest disease ward was given discharge instruction on dietary management , medication, regimen, hygiene care and follow up visits. What is the instructions need to be emphasized the most? A. Increase protein diet to promote healing B. More rest and relaxation to restore therapy C. Maintain daily exercise schedule to improve health D. Dispose sputum as guided to avoid spread of disease 67. A patient is admitted to the emergency room with an unknown infection disorder. Which of the following is the most important measure a nurse implement to reduce the risks of transmitting these microorganisms other? A. Hand hygiene B. Wearing gloves C. Wearing a mask D. Wearing a gown 68. A nurse is assigned to care for a patient with small that needs to be placed on airborne precaution. Which of the following item should be used before entering the patient room? A. Gloves and gown B. Gloves and goggles C. Gloves and mask D. Gloves , gown N 95 69. Which of the following is the primary level of prevention? A. Detect and treat existing disease B. Prevent illness or injury occurring C. Reduce the extent and severity of health problem D. Minimize disability and restore to prevent function 70. A Nurse is surgical unit prepares for a wound dressing. While she is preparing. She sneeze over the dressing trolley without wearing a facemask. Which of the following is the most appropriate action should the nurse take? A. set up a new sterile field 17  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ B. put on a mask and continue working C. continue working the most sterile field D. Replace the equipment she thinks is contaminated 71. Which of the following is the most effective infection control precaution to prevent nosocomial infection? A. Hand washing before and after patient contact B. Wearing gloves and mask for direct patient care C. Isolation precaution D. Broad spectrum antibiotic 72. A 16 month old child is hospital in the intensive care unit with multi resistant sepsis. On the 3rd day. She had explosive diarrhea. A stool sample was sent to the laboratory for C. difficle investigation. Which of the following transmission based precaution is most appropriate? A. Combination airborne and droplet B. Contact C. Droplet D. Airborne 73. When planning discharge teaching for a patient hospitalized for treatment of the 3rd burns over 30% of the body, a nurse knows it is most important to include instructions regarding the loss of large amounts of serum occurring with burns and the resulting loss of immune function. Which of the following instructions should be include? A. Wash hands frequently each day B. Wear supplemental oxygen at night C. Wear masks while in public spaces D. Take a multiple vitamin tablet night 74. A 20 year old woman is hospitalized with a strong and uncontrollable cough and has difficulty breathing while coughing. A doctor writes an order for the patient to be transported from the medical surgical department to the radiology department for an xray examination. The nurse prepares to transfer the patient and considers standard precautions and additional transmission precautions. Who of the following would be required to wear a mask? A. Radiology staff B. Nurse and patient C. Patient D. Nurse Thyroidectomy 75. A patient returned to the Surgical Unit from the thyroidectomy. The nurse observed that the arousable. Blood pressure 90/60 mmHg Heart rate 108 /min What immediate action should the nurse take? A. Recheck pulse and blood pressure B. Administer intravenous fluids as ordered C. Place client in modified Trendelenburg's D. Assess the back of neck surgical dressing for bleeding 76. Complication of thyroidectomy A. Distension B. Bleeding C. Vocal cord injury 77. progressive enlargement of a multi-nodular go tracheal compression including pain at the site of 18  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ the ear and jaw, difficulty swallowing, change of pf breath by compressing the oesophagus. There is in otherwise the patient is at risk. What is the preferred treatment? A. Iodine treatment B. Thyroid hormone treatment C. Radioactive iodine treatment D. Surgical resection of abnormal thyroid 78. A Post thyroidectomy patient transferred to ward and developed tetany the nurse suspected that patient has ? A. Hypokalemia B. Hypocalcemia C. Hyponatremia 79. A nurse Wayne is aware that a positive Chvostek’s sign indicate A. Hypocalcemia B. Hyponatremia C. Hypokalemia D. Hypermagnesemia 80. Trousseau’s sign A sign of hypocalcemia. Carpal spasm can be elicited by compressing the brachial artery with a blood pressure cuff for 3 minutes. 81. Chvostek’s sign A sign of hypocalcemia. A spasm of the facial muscles elicited by tapping the facial nerve just anterior to the ear 82. Patient is being admitted to the Recovery Room following a thyroidectomy. The back of the neck wound is covered with dressing. During the first 15 minutes, the patient started working and having diarrhea. A general assessment is performed with special attention given for the high risk for haemorrhage. Where would bleeding most likely occur? A. Stool B. Vomitus C. Dressing D. Back of neck 83. A 29 year-old man is in the Surgical Ward on his first post-operative thyroidectomy. He appears drowsy but the he is able to respiration by nodding head. He is developing mild restlessness. What is the initial recommended goal of care? A. Monitor vital signs of thyroid storm B. Assess for bilateral vocal fold mobility C. Monitor for swelling on the neck D. Monitor for vocal cord paralysis 84. A nuclear plant experienced a leakage, and all involved workers were brought to the Emergency Department for treatment. the medical team prescribed potassium iodide for the workers to block radioactive iodine to be absorbed by an organ in the body. Which of the following organs is the most sensitive to radioactive iodine? A. Brain B. Lungs C. Kidney 19  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ D. Thyroid 85. The nurse care for a 60 year old woman who history hypertension, hypothyroidism and elevated cholesterol levels. She takes tablets daily for each of the health problem. The doctor orders a routine dual- x-ray absorptiometry test that shows decrease bone density. Which medication most likely contributed the test result? A. Statins B. Anti-hypertensive C. Synthetic thyroid hormones D. Cholesterol absorption inhibitors 86. A 36 years old man ha undergone a subtotal thyroidectomy ago. he Is suspected to develop tetany after the surgery. Which of the following symptoms best indicates tetanus? A. Tingling in the fingers B. Pain in hands and feet C. Tension on the suture lines D. Bleeding on the back of the dressing 87. The nurse is assessing 50 year old woman whose thyroid enlarged. A blood sample was collected and an analysis confirm diagnosis. TSH 0.12 normal 0.4-6.5 Free 210 normal 50-140. Thyroxin T4 normal 4.5-11.2 A. Thyroidectomy B. Incision and drainage C. polythyroidectomy D. adrenalectomy Tonsillectomy 88. 3-year-old child with an elevated body temperature is administered oral aspirin. The nurse records the body temperature of the child two hours an The American Academy of pediatrics suggests that removal of the tonsils under certain conditions. Which of the following meets these conditions? A. times viral tonsillitis per year B. Infrequent snoring and nasal quality C. Three times bacterial tonsillitis per year D. Tonsillitis accompanied by adenoid inflammation 89. 5year-old child is postoperative after tonsillectomy. The nurse should ask the parents to give the child which of food after discharge from the hospital? A. Meat and rice B. Hot dog and potato chips C. Mashed potatoes and soup D. Cucumbers and tomato salad 90. The nurse is receiving a child postoperative tonsillectomy. Which of the following nursing assessment is suitable for the postop care? A. Encourage the child to cough spontaneously B. Observe for subtle signs of haemorrhage C. Place the child in the prone position 20  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ D. Suction the mouth to clear the airway Because of violent behaviour 91. The nurse is receiving a child postoperative tonsillectomy. Which of the following nursing action is suitable for the postoperative care? A. Encourage the child to cough spontaneously B. Observe for subtle signs of hemorrhage C. Place the child in the prone position D. Suction the mouth to clear the airway Because of violence 92. After tonsillectomy, a child begins to vomit bright red blood.the Initial nursing action is to? A. Notify the physician B. Turn the child to the side C. Maintain an NPO status D. Administer the prescribed antiemetic 93. A client presents with Hypocalcemia, hyperphosphatemia, muscle cramps, and positive Trousseau's sign. What diagnosis does this support? A. Diabetes insipidus B. Conn's syndrome C. Hypoparathyroidism D. Acromegaly 94. The nurse cares for a client who has undergone a tonsillectomy. The nurse is most concerned about which post- operative finding? A. Lack of appetite B. Throat pain C. Frequent swallowing D. Nausea Appendicitis 95. 18-year-old man college student was rushed fainted at the school. He complained of severe quadrant. Upon palpation, he jerks even with sample was obtained. What is the most likely diagnosis of this patient? A. Appendicitis B. Liver Cirrhosis C. Kidney stones D. Duodenal ulcer 96. - year-old child was admitted with suspected appendicitis. A nurse was evaluating the child’s condition and the mother stated that the child did have his bowel movement for the past two days and requested for natives. What is the risk of giving laxative to patient with appendicitis? A. Pain B. Fever C. Rupture D. Diarrhea 97. A woman patient is admitted for abdominal pain. She complain generalized plan nausea vomiting and constipation rebound tenderness and abdominal rigidity the past hour her localized on right side BP 130/68 HR 92 RR 18 TEM 38.6 What should the nurse suspect A. Intestinal obstruction B. Influenza C. Appendicitis D. Pyloric stenosis 21  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 98. A man is to be discharged from the General appendectomy. The precautionary measures, plans are discussed with him. What is the most important desired outcome after discharge A. Remain free of post-surgical complications B. Report fever, redness or drainage from the wound site C. Use pain management techniques appropriate D. Resume gradual activities and avoid weight 99. A 17 year-old arrived to the Emergency Room complaining abdominal pain on right lower quadrant. Pain was rated as 9 numeric scale with positive rebound tenderness over the pain Blood pressure Heart rate Respiratory rate Température 120/70 mmHg 95 /min 20 /min 39.2 Which of the following interventions has the highest priority? A. Keep NPO B. Secure an IV access C. Prepare for ultrasound D. Prepare for abdominal surgery 100. The nurse would increase the comfort of the patient with appendicitis by: A. Having the patient lie prone B. Flexing the patient's right knee C. Sitting the patient upright in a chair D. Turning the patient onto his or her left side 101. A 10-year-old girl presents to the Emergency Room (ER) with pain. On assessment, you noticed that when you palpate the right lower quadrant of the child’s abdomen, the child feels pain in the rig quadrant. Which of the following is the name of this sign? A. Rebound tenderness B. McBurney sign C. Roving’s sign D. Obdurate sign 102. A 10-year-old girl presents to the Emergency Room (ER) with pain. On assessment, you noticed that when you palpate the left lower quadrant of the child’s abdomen, the child feels pain in the rig quadrant. Which of the following is the name of this sign? A. Rebound tenderness B. McBurney sign C. Roving’s sign D. Obdurate sign 22  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 103. Treatment of nephritic syndrome is corticosteroids 104. Isoniazid for TB side effect numbness , hepatitis symptoms , stomach upset ,rashes 105. A 66 year old woman with a history of unstable angina and hypertension present to the emergency department with a dull chess pain that she describes as similar to heartburn. The pain radiates down the left arm. She had taken sublingual nitro-glycerine tablets with any relief any electrocardiograph is perform and shows elevated S T segments. Which medication is most likely to given to dissolve the thrombus? A. Heparin B. Warfarin C. Streptokinase D. Aspirin 106. A 62 year man with a history of intracerebral bleeding three months ago, was referred primary health care following acute starch symptoms. Brain CT scan is normal and the patient is receiving oxygen by nasal cannula at 4LPM BP 185/105 HR 82 RR 18 TEM 36.6 SO2 93% Which of the following medication would be ordered first? A. RtPA B. Aspirin C. Dopamine D. Nicardipine Rational :Probable acute ischemic stroke; consider fibrinolytic therapy. If the CT scan shows no sign of hemorrhage, it is probable that the patient experienced an ischemic stroke and is a candidate for fibrinolytic therapy. Check for fibrinolytic exclusions such as significant head trauma or stroke in the previous 3 months, history of intracranial hemorrhage, elevated blood pressure, active internal bleeding, or a blood glucose concentration less than 50 milligrams per deciliter. Then repeat the neurologic exam.Consult neurologist or neurosurgeon. If the CT scan indicates hemorrhage, consult neurologists and neurosurgeons, and begin the stroke or hemorrhage pathway.Administer aspirin. If the patient is not a candidate for fibrinolytic therapy, administer aspirin and begin the stroke or hemorrhage pathwa 107. A nurse checks the medication chart of a patient, which has the following order, nitroglycerin Tab sublingual. Which of the following medication administration routes should the nurse use? A. In the nose B. In the eyelid C. Under the skin D. Under the tongue 108. A 28 year man admitted to orthopedic ward complaining of throbbing pain in casted leg. Which of the following nursing intervention should be taken first? A. Remove the cast B. Notify a doctor C. Assess pedal pulse D. Administer PRN medication 109. A 62 year old woman presents to the clinic with a primary compliant of fatigue. An assess shows a smooth and reddened tongue with a loss of papillae and pallid mucous membranes. She complaints of a sense of 23  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ constant fullness of the stomach, with a decreased appetite and two three loose bowel movement per day. A neurological assessment shows numbness in the feet and lower legs. The patient type of test would the most likely? A. Schilling B. Erythropoietin C. Folic acid levels D. Vitamin B12 levels 110. A mother of a patient who is on antipsychotic drug asked a doctor about some more detail about the drug. The doctor told the mother that her son is taking an atypical antipsychotic drug. Which of the following is an examples of this type of drug? A. Thioridazine B. Clozapine C. Chlorpromazine D. Haloperidol 111. A nurse is preparing scheduled medications due at 6 pm. If a doctor orders paracetamol tab 1g QID, and it was supplied from the pharmacy in 250 mg tablets. Which of the following is the most appropriate nursing actions? A. Ask the pharmacy to provide 1g tablets B. Call the doctor to recheck the dosage C. Give the patient four 250 mg tablets D. Hold the medication and document in nursing notes 112. A patient with a history of atrial fibrillation has an order for 25 milligrams of drug (X), the available supply/dose is 0.25 milligrams. Which of the following doses in correct? A. Dispense two tablets to the patient B. Administer one tablet twice daily C. Dispense one half tablet to the patient D. Return tablets to the pharmacy and re-order 113. A patient with a history of atrial fibrillation has an order for 0.25 milligrams of drug (X), the available supply/dose is 0.125 milligrams. Which of the following doses in correct? A. Dispense two tablets to the patient B. Administer one tablet twice daily C. Dispense one half tablet to the patient D. Return tablets to the pharmacy and re-order 114. 13-year-old patient is admitted for diarrhea and vomiting. He looks pale and lethargic. A nurse is preparing to give IV hypotonic solution. Blood pressure 110/70 mmHg Heart rate 76 /min Respiratory rate 18 /min Temperature 36.1°C Which IV solution is most appropriate? A. 0.9% saline B. Lactated ringers C. 10% dextrose in water D. 0.45% sodium chloride 24  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 115. A nurse is assigned to care for a group of patient in the medion expected to review the medical records of these patient. What patient is at risk for excess fluid volume? A. Patient with ileostomy B. Patient taking a loop diuretic C. Patient with chronic renal failure D. Patient hooked to gastrointestinal 116. physician orders an intravenous fluid of D5NS at 100cc/hr. This is an example of which of the solution? A. hyper alimentation B. hypertonic C. hypotonic D. isotonic 117. When a patient was first diagnosed with schizophrenia, one of his family members asked the nurse about the possible causes. The nurse said that one reason is that he may have had an excess secretion of a neurotransmitter. Which of the following neurotransmitters? A. serotonin B. dopamine C. glutamate 118. The nurse administered a dose of morphine sulfate as prescribed to a patient who is in the post anesthesia care unit (PACU). The patient appears to be resting comfortably, the respiratory rate is 8 and the O2saturation is 21 oxygen via cannula is 86%. The nurse should IMMEDIATELY administer: A. Flumazenil(Romazicon) B. Medazolum(versed) C. Naloxone (Narcan) D. Ondansetron (Zofran) 119. Digoxin not given to pàtient who has which of the following ? A. tachycardià B. hypertension C. tachypnea D. bradycardia 120. Atropine is indicated for increase A. Heart rate B. Respiratory rate 121. Morphine side effect ? A. tachycardià B. hypertension C. tachypnea D. bradypnea 122. patient with ongoing magnesium sulfate the nurse should be alert to ? A. temperature B. respiratory rate C. heart rate 123. Soldier was brought to triage area after being exposed to chemical weapons. Signs and symptoms of nerve gas exposure were noticed. A nurse prepares for medical management. Which medication should the nurse prepare for the patient? 25  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ A. Atropine B. Adrenaline C. Sodium nitrate D. Sodium thiosulphate 124. Nitroglycine administration route : A. Intramuscular B. Sublingual C. Subcutaneous D. Oral 125. A nurse checks the medication chart of a part, which has the following order; Nitroglycerin tab Buccal at stat. Which of the following medication administration routes should the nurse use? A. In the ear B. Intravenous C. Under the skin D. Between cheek and gum 126. A nurse is caring for a patient who had Coronary Artery bypass Graft Surgery (CABG) four hours ago. The nurse notices that the patient has increased confusion and is restless. The patient reports nausea, weakness and paresthesia in the extremities (see lab results) Normal Values Result Test 134-146 mmol/L 145 Sodium 3.5-5.2 mmol/L 6.8 Potassium 2.15-2.62 mmol/L 2.50 Calcium Which of the following is the best medication? A. Naloxone (Narcan) B. Hydralazine (Apresoline) C. Potassium chloride (KCI) D. Sodium polystyrene sulfonate (Kayexalate 127. Which of the following statement by the nurse about the clomid as an ovulation inducing drug? A. Given for the first 15 days in each cycle B. Maximum dose is 50 mg daily for a month C. It increases the risk of birth defects D. It increase the risk of multiple pregnancies 128. Clomiphene citrate (Clomid) is prescribed for a 32-year-old infertility treatment. The nurse should understand that this medication is used for following actions? A. induce ovulation B. Decrease prolactin level C. Reduce endometriosis D. Stimulate the release of Follicle-Stimulating Hormone 129. A nurse is caring for a client with bipolar disorder, who is receiving Lithium carbonate. Before Administration of the next dose, the client complains of nausea and vomiting and the nurse finds that the client’s lithium blood level 1.5mEq/lL. Which of the following actions is considered Apriority? A. call the client’s physician immediately B. withhold the next dose. C. Administer IV fluids 26  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ D. Repeat the blood lithium level testing 130. A patient was on a regular dose of lithium carbonate. The nurse noticed he has hand tremor, polyuria, diarrhea and vomiting. What immediate action should be taken by the nurse? A. Diuretics B. Withholding lithium C. Calling the psychiatrist D. Monitoring serum lithium level 131. A patient was on a course of lithium carbonate drug. During the nurse found that he complained from nystagmus visual hallucination, and oliguria Which of the following drug related complications best symptoms? A. Overdose B. Mild toxicity C. Severe toxicity D. Moderate toxicity 132. 49-year-old women presented to the Emergency Department complaint of severe chest pain. The ECG showed that the patient myocardial infarction. The doctor ordered the nurse to give the 800 mg of aspirin. What is the primary indication of aspirin in this case? A. Breaks down the thrombus B. Decreases the formation of platelet plugs C. Inhibits the conversion of prothrombine to D. Interferes with vitamin k to maintain 133. which of the following condition is a Contraindication for a woman oral Contraceptives? A. Dysmenorrhea B. Menorrhagia C. Thrombophlebitis D. Toxic shock syndrome 134. A patient was on a course of lithium carbonate drug. During the nurse found that he complained from nystagmus visual hallucination, and oliguria Which of the following drug related complications best symptoms? A. Overdose B. Mild toxicity C. Severe toxicity D. Moderate toxicity 135. A 45-year-old distressed and restless patient in the Psychiatric Ward was unable to sleep during the nights for the last two days. He was ordered sleep medication which was to be administered at 10 pm. At the time medicine administration, the patient was found asleep in bed Which of the following action should the nurse take regarding the dictation? A. Discard medicine and cancel the order B. Leave it at the bed side for the patient C. Wake him up and administer D. Hold, record and report 136. 13- nurse is given health education to the parent how to reduce febrile avulsion in the child at home. Which of the following medication in the safest intervention? A. Analgesic B. Antipyretic C. Antibiotic D. Antiemetic 27  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 137. Doctor order to give Ofloxacin Otic route the nurse understand that medication will be given : A. Nasal B. Eye C. Ear D. Sublingual. 138. A home care patient with chronic Obstructive reports an upset stomach. The patient is taking and triamcinolone acetonide (azmacort). Which of the following counselling should be given A. Theo-dur on an empty stomach B. Theo-dur and azmacort at the same time C. Theo-dur and azmacort 12 hours apart D. Theo-dur with milk or crackers 139. Which of the following vitamins is necessary for wound healing process? A. Vitamin A B. Vitamin C C. Vitamin D D. Vitamin K 140. Which of the following vitamin supplements can decrease the incidence of Neural tube defects such as anencephaly and spina bifida new-borns ? A. Vitamin A B. Riboflavin C. Folic Acid D. Vitamin K 141. A 78-year-old woman who lives in a long-term care facility has been ving repeated episodes of urinary tract infections. She is prescribed then amine mandelate one gram to be taken by mouth four times per before meals and at bedtime. The nurse advises the patient that she need to remove milk from the diet while taking the medication. What is the primary purpose for this dietary advice? A. To prevent mal absorption of medication B. Decrease risk of gastrointestinal upset C. Reduces effectiveness of medication D. To make the urine acidic 142. A nurse received the serum digoxin level result for the patient the day and notes that the result is 2.6 ng/mL (see lab result) Test result normal value Digoxin (men) 2.6 0.8-2ng/mL Which of following nursing actions is the most important? A. Notify the physician B. Check previous vital signs of patient C. Record normal value on nursing note D. Administer scheduled dose of medication 28  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 143. A patient is being admitted in medical unit and has orders for fluid restriction of 1400ml / 24 hours. He is receiving IV medications in 50ml solutions QID. How much fluid should the caring nurse allocate for cra intake in 24 hours? A. 400 ml B. 800 ml C. 1000 ml D. 1200 ml 144. A nurse is preparing an order of Amydramine 30 mg PO BD. The available check is 15 mg /5 ml. What is the correct dosage of the medication to be administered? A. 5 ML B. 10 ML C. 15 ML D. 20 ML 145. A nurse is preparing a medication order of 100 mg IV stat. The available hydrocortisone is 200mg per 5 ml distilled water for injection. Which of the following is the correct administered? A. 4.5 ML B. 3.5 ML C. 2.5 ML D. 1.5 ML 146. A nurse is preparing to administer an intravenous infusion of 2000 ml of Ringer's lactate over 12- hours. The administration set has a chamber that delivers 15 drops per ml. How many drops per minute should be administered? A. 14 B. 24 C. 42 D. 56 147. Doctor order to give medication x 300mg and available is 900mg/6ml how many ml the nurse will give A. 1.2 B. 2 C. 4 D. 6 148. A 56-year-old man was admitted with complaint working for three days. The nurse is preparing to administer infusion of saline 1000 ml over six hours. What is the hourly infusion rate that the nurse needs to infusion therapy in mL/hour? A. 155 B. 167 C. 190 D. 217 149. Doctor Order: Heparin 10000 units OD S/C Standard Solution 40000 units/ml How many ml would you administer? A. 0,25.ml 29  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 150. A Physician has ordered clindamycin phosphate 300 mg to be administered intravenously the available stock was labelled. clindamycin phosphate 900mg mg in 6 ml what is the correct dose to be administered by the nurse ? A. 2 ml B. 4 ml C. 6 ml D. 8 ml 151. A nurse check the medication chart of a patient, which has the following order; Paracetamol 500mg P.O. QID. How many times a day should the nurse administer the medication? A. Once B. Twice C. Three times D. Four times 152. The following syringe contains 2 gm of morphine sulphate, how many grams are there in 1 ml: A. 0.5 gm B. 1 gm C. 2 gm D. 4 gm 153. The following syringe contains morphine sulphate in a concentration of 2 mg/cc, how much total morphine this syringe contains: A. 0.5 mg B. 1 mg C. 2mg D. 4 mg 154. A nurse is assigned to care for a patient in medical ward who has a physician order of 1500ml of normal saline 0.9% to be administered over 12 hour period. Which of the following is the infusion rate? A. 75 ml/hr B. 100ml/hr C. 125ml/hr D. 150ml/hr 155. Doctor order to give 75ml per hour over 12hours of normal saline how many ml total should be given? A. 450ml B. 600ml C. 900 ml D. 1000 ml 156. A 37year old female prevented to the Emergency room with complain of symptomatic bradycardia appropriate nursing intervention include establish intervention access what is the possible drug to be given in the IV solution ? A. Digoxin B. Atropine C. Anticoagulant D. Calcium channel blocker 157. A 25 year old woman present to the emergency room with decrease reflexes, hypoventilation, hypotension, and fuced pupils, a family member who is accompanying the patient has bottle of diazepam which the label 30  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ states was recently the family member also indicates that the patient has a depression. What intervention should the nurse expect to administer? A. Naloxone B. Active charcoal C. Tap water enema D. Magnesium sulfate to reduce the risk seizure 158. Nurse gives health education to patient In outpatient department regarding a medication. she told him "avoid working outdoors in a hot weather, excessive sweating ad during l water daily Which of the following is most likely medication? A. Diazepam B. Haloperidol C. Lithium carbonate D. Monoamine oxidase inhibitor 159. During CPR of an admitted patient following the cardiac arrest. Two Dc shocks and one dose of epinephrine was given. A third dose was delivered followed by anti arrhythmic medication. what medication is the most likely to be given next? A. Adenosine B. Lidocaine 2 mg C. Epinephrine 1 mg D. Sodium bicarbonate 160. A nurse is giving discharge planning instructions to the parents of a one year old child acute otitis media which of the following discharge instruction takes priority? A. Administrate antibiotics as prescribed B. Administer influenza vaccination C. Breast feeding as long as possible D. Continue using of pacifier 161. A 4 years old girl, was playing outside, she came to her mom crying and holding her right upper arm, she went to the hospital with swelling over the upper arm, pain and itching, the appropriate management is: A. Maintain patent airway B. Administer s/c Epinephrine C. Prepare for intubation 162. An older adult client with renal failure comes to the emergency department with a report of nausea and vomiting. The client's heart rate is 45 beats/min. The nurse is most concerned about which medication that the client takes A. Nitroglycerin B. Digoxin C. Doxorubicin D. Furosemide 163. The nurse is caring for a 60-year-old in the Medical-Surgical Unit. On entering the room the nurse finds the patient alert, oriented and. The skin color appears healthy and pink. The nurse observes electrocardiogram and notices absent P-waves. Which initial action is the most important? A. Defibrillate B. Cardio version C. Pacemaker preparation D. Intravenous amiodarone 31  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 164. During health education for a patient on Monooamine oxidase inhibitor (MAOI) the nurse instruct him to avoid certain foods that can interact with the MAOI. Food containing with of the following contents should be avoided? A. Alcohol B. Caffeine C. Tyra mine D. Folic acid 165. After teaching a 54 year old patient with angina on how to take nitroglycerin sublingual PRN. Which of the following statements reflect the patient understanding? A. I have to take this medication once i need it only B. It is ok to take one tablet daily to prevent the heart attack C. I can take two tablets together at once if the attack is D. This medication will regulate my heart beats and I will be 166. A 45 year old client who diagnosed with brain was schedule for craniotomy. It is important to preventing the developing of cerebral edema after surgery. What medication would the nurse expect to prescribed the client? A. Steroids B. Diuretics C. Ant convulsions D. Antihypertensive 167. A 71 year-old woman who resides in a long-term nursing home fell while walking down stairs. The attending nurse arrives to find the patient sitting motionless on the stairs. She is alert and oriented but wishes to rest. While she rests, the nurse reviews the chart and notes that her medication regimen includes metformin, loratadine, warfarin and diclofenac. Which medication is most likely to increase the patient's risk of injury? A. Metformin B. Loratadine C. Warfarin D. Diclofenac 168. ECG showed S-T elevation to confirm diagnosis of MI the nurse expect to do? A. Troponin level B. Cardiac catheterization C. ECO 32  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 169. On orientation day, a nurse educator said to a new nurse" our hospital provides the highest level of specialized healthcare in an integrated educational and research setting" which of the following aspects of the hospital's strategic plan is indicated by this statement? A. Vision B. Policy C. Values D. Mission 170. A head nurse of an intensive care unit wrote a report about the needs of her department and gave it to the nursing supervisor. Which of the following types of communication is this? A. Upward B. Horizontal C. Diagonal D. Downward 171. A 45 year old patient has a colostomy bag attached as a result of benign mass removal, while conducting the discharge teaching session, the nurse assessed the patient's wife understanding of the teaching. Which of the following steps of nursing process is exercised here? A. Implementation B. Planning C. Assessment D. Evaluation 172. Which of the following is correct nursing process order? A. Diagnosis, assess, plan, evaluate, implement B. Assess, diagnosis, plan, implement, evaluate C. Evaluate, assess, plan, implement, diagnosis. D. Plan, assess, diagnosis, evaluate, implement 173. A nurse calls a physician regarding a change in a patient's condition. A physician gives orders over the telephone for stat arterial blood gases. Which of the following is the best intervention to be implemented? A. Give order stat to health unit coordinator to input in computer B. Write down order and read it back to physician C. Write down order for ABGs immediately D. Call respiratory therapist stat to draw the ABGs 33  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 174. During Cardiopulmonary Resuscitation (CPR) for a 75-year-old man in the Emergency Department, the doctor introduced himself as a leader for the CPR. What is the most appropriate leadership style for this situation? A. Autocratic B. Democratic C. Bureaucratic D. Laissez-faire 175. A nurse manager is open minded, listens to the team, understands others, makes changes to improve unit operations and procedures. What type of leadership style is this? A. Situational B. Democratic C. Compassionate D. Transformational 176. Leadership using theories which type of leadership? A. Autocratic B. Democratic C. Transnormal 177. Nurse supervising on assistant nurse and delegate assignment to him and say"diving up patient's assignment" what type of leadership A. Autocratic B. Laissez-faire C. situational D. transformational 178. A nurse manager includes staff in decision-making process what unit structure is used? A. Divisional B. Centralized C. Functional D. Decentralized 179. What is the main limitation of democratic style of leadership? A. it ignores the incompetent personnel B. cannot be used in emergency situations C. decreases collaboration among the team D. may end up in inappropriate decision making 180. A nurse manger is preparing and writing a plan for dealing disasters (code red). Which procedure is the top priority for the nurse manager the plan? A. Infection control B. Staff orientation C. Patient education D. Patient relocation 181. nurse manager was not happy about low results of patient’s survey. Which of the following is the first step for nurse manager? A. Schedule meeting with staff B. Start changes to improve C. Review evaluation details D. Report to director 34  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 182. post-operative patient who underwent an abdominal procedure requests a pain medication from the nurse and rates the pain at a level nine. There a standing order for narcotic administration. When the nurse opera the narcotic box and performs a count, the number of pills remaining in the box is different than the number of pills recorded on the sheet. What is the most appropriate initial nursing action? A. Notify the nursing supervisor B. Write the finding on the narcotic sheet C. Administer the patient's requested medication D. Identify the last nurse who used the narcotic box 183. An 81-year-old bed ridden patient in the Geriatric Ward was pyretic through his nasogastric tube. After an hour, the patient deep sleep, his breathing pattern changed and he did not rep calling his name. Which of the following should be the immediate nursing intervention? A. Call the physician to examine the patient B. Check for the correct dosage given C. Check vitals and inform physician D. Try to wake up the patient 184. The nurses in the Male Medical Unit took a signature on the from a patient who needs an abdominal CT with contrast. What is the best nursing practice? A. Consent should be taken after the procedure B. Verbal consent is acceptable for this procedure C. Consent should be taken from the patient's relatives D. Consent should be taken according to the organization's 185. In the hospital digital dashboard, what types of data displayed? A. Staffing B. Financial C. Performance D. Knowledge-based 186. A newly nursing director assigned to a hospital. That is the first should he do? A. Evaluates the staff B. Change the head nurses C. Change the roles D. Nothing to do 187. surgeon instructs a nurse to serve as a witness to an elderly patient’s informed consent for surgery. During the explanations to the patient, it becomes clear that the patient is confused and does not understand the procedure, but reluctantly sign the consent form. The nurse should: A. Sign the form as a witness, making a nation that the patient did not appear to understand B. Not sign the form as a witness and notify the nurse supervisor C. Not sign the form and answer the patient’s questions after the surgeon leaves he room 188. A community nurse assigned to work in a Makkah, one of the most multicultural cities in Saudi Arab has to interact with multicultural population every day What is the most important step the nurse should do before with the clients? A. Asking the client about his/her cultural background B. Conducting an appropriate culturological assessment C. Ensuring that the client has his/her a privacy D. Looking at the client's file to take history 35  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 189. The head nurse meets with staff nurses to discuss ways to improve communication among shifts Which of the following statement best exemplifies the final stage of conflict management? A. "We need to clearly define the nature of the conflict” B. " I will evaluate the outcomes of the strategies used monthly C. " Let us create a time line for the implementation of our strategies” D. " I have to force you to follow the rules to resolve the issue” 190. The nursing director wants to evaluate the quality of nursing care at the in-patient areas. The management team will evaluate on quarterly basis the documentation and the relationship between the patient's length of stay and the quality of care which of the following is the most important data source to identify the quality of care? A. Patient's complaints and time taken to resolve them B. Patient's satisfaction level at the time of discharge C. Details of nursing notes for patient's progress 191. The nurse manager received complaints from some nursing to improper work distribution and discrimination How should the nurse manager handle the situation? A. Investigate the complaints B. Individual counselling C. Identify list of problems D. Continue to observe 192. which of the following is the most appropriate action for a head nurse starting at a new hospital? A. Make immediate change at the unit B. Plan and coordinate new strategies C. Assess unit activities for at least three months D. Ask about the previous head nurse managerial style 193. After teaching the deep breathing and coughing who is undergoing a surgery, the nurse asked Demonstration and then helped him in correcting what part of therapeutic communication is used A. Evaluation B. Intervention C. Identification D. Demonstration 194. the intensive care unit nurse manager plans to delegates a nurse. What is indicated for a successful delegation? A. Nurse Manager supervises nurse. B. Nurse has authority to change task. C. Nurse Manager checks task sometimes. D. Nurse Manager asks another nurse to check task. 195. nurse accidently dropped a medication ampoule, informed the charge nurse, and completed an incident report form. The charge nurse arranges medication replacement. Which of the following is the immediate nursing action required? A. Revise protocol for medication related incidences B. Allocate senior nurses to medication assignments C. Provide missed medication dosage to patient first D. Incident reporting must be given the priority 36  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 196. Nurse manager first days in new hospital will..? A. introduce plan and strategy to top manager in hospital B. introduce himself to staff C. observation for 3 month before begin work 197. After accessing patients' medical records, which behavior nurse shows that patients confidentiality has been breached? A. Reviews patients medical record B. Read patients care plan C. Disclosing patients information 198. During the assessment phase of a preoperative interview, the patient reports feeling nervous. The patient conveys to the nurse that a parent died in surgery due to malignant hyperthermia.to whom would this information be most important ? A. PACU NURSE B. SCRUB NURSE C. ANAESTHESIA TEAM D. CHARGE NURSE 199. a charge nurse in the nurse was noted poor staffing schedule in one of the shift. The schedule caused problems among staff members in the unit. The women the charge nurse should bring the problem to? A. Supervisor B. Chief nurse C. Follow charge nurse D. Grievance committee 200. nurse responsible for narcotic medication loses on ampule morphine. She reports the problem to nurse manager. Which of the following is the first thing she should say according to the SBAR approach? A. I have lost one ampule of morphine B. We should ask the nurse about the morphine C. I think I left the lid of narcotics box open D. We should open an investigation into problem 201. A nurse intervention a patient recently admitted to long term care facility to obtain information on the patient health perception. The nurse encourage the patient to elaborate this change. Which of the following type of question would be the most effective in this situation? A. Analytical B. Focused C. Closed D. Open ended 202. A nurse enters the room of a patient named Ahmed Saeed to administered medication but the patient not wear his identification bracelet. Which of the following is the most appropriate nursing action? A. Ask the patient are you Ahmed Saeed? B. Ask the patient what is your name C. Ask the patient hat mediation do you take 203. Research data to be collected from children on nursing unit. What type of consent is the most appropriate ? A. Informed written consent B. Consent signed by parents C. Consent from physician D. Hospital administration consent 37  ٌ ‫أوليس يُجزى ُم‬ ‫حسن اال باحسان‬ 204. Nurse manager prepares unit clinical operational plan What is top priority in the plan? A. Infection control B. Staff orientation C. Quality projects D. Safe patient care 205..What is a characteristic of democratic leadership style? A. More changes B. Structured work C. Staff participation D. No leader decisions 206. Which of the following vaccines in highly recommended to be taken by pilgrims before Haji season? A. Meningococca