MOH RN exam تحديث-Copy (1).pdf

MOH RN EXAM By : Mr.Hazem Attia Miss.Shaimaa Reda Miss.Eman Ahmed September2022 ‫” بسم هللا الرحمن الرحيم “‬ ‫هذا الملف لبرومترك وزارة الصحة اإلماراتية ‪MOH‬‬ ‫ألخصائي تمريض ‪RN‬‬ ‫اإلمتحانات الموجودة في الملف من نماذج وزارة الصحة ووقاية المجتمع‬ ‫اإلمتحان ‪ 100‬سؤال والنجاح ‪60%‬‬ ‫زمن اإلمتحان ‪ 3‬ساعات‬ ‫ونتمني التوفيق للجميع وال تنسونا من صالح دعائكم‬ ‫لينك قناة ‪ Final Revision for RN MOH‬علي التيليجرام‬ ‫‪https://t.me/+N24x8Eewx_sxNDNk‬‬ ‫‪1|Page‬‬ EXAM 1 1_4. 40 year old male is admitted to the ED with lethargy and tachypnea. His skin is dry and flushed. And he has a fruity breath odor. An I.V line is started and blood was drawn for laboratory studies, His blood glucose level is 840 mg/dl, and his urine analysis reveals +3 glucose and +3 ketones. The physician diagnoses Diabetic keto acidosis(DKA): 1. The nurse would expect to note all of the following physiologic abnormalities during the assessment of this patient Except: a. jugular venous distention. b. Hyperkalemia. c. Hyperventilation. d. Poor skin turgor. 2. The nurse's first priority in caring for this patient would be to: a. Administer insulin I.V. b. Administer insulin S.C. c. Administer volume replacement fluids and insulin I.V. d. Establish an airway and monitor its patency. 3. Which I.V. solution would the nurse expect to use in the initial treatment of this patient? a. Isotonic saline solution. b. Hypotonic saline solution. C. Hypertonic saline solution. d. Hypotonic dextrose solution. 4. During therapy, evaluation of the patient's serum potassium level is likely to demonstrate which pattern? 2|Page a. An initially elevated level, followed by gradually decreasing levels. b. An initially decreased level, followed by gradually increasing levels. c. An increase level that remains generally elevated. d. A decreased level that remains generally low. 5. Vulnerable patients generally include all of the following groups of patients except: a. Young children. b. Patients in pain. c. Disorientated patients. d. Suicidal patients. 6. The patient's right radius is fractured and the arm is splinted and appears to be swollen discolored and deformed The patient complains that the pain is becoming more intense and he can no longer feel his fingers. The nurse notes that the fingers are pale and dusky and more swollen than before. The splint is loosened but there is no change in the hand. The nurse should suspect that the patient has developed: a. A blood clot that is occluding the blood flow to the hand. b. A fat embolism. c. Compartment syndrome. d. Venous thrombosis. 7. while reading a physician's order, the nurse has difficulty reading the exact dosage prescribed because the handwriting is illegible. In this situation the nurse should: 3|Page a. Ask the patient what dosage was given in the past. b. Ask another nurse to determine the correct dosage. c. Hold the dose until the Physician rewrites the order. d. Contact the physician and obtain the correct dosage verbally 8. Methylprednisolone acetate comes prepared in 5 ml of sterile aqueous suspension containing 20 mg per milliliter The patient is to receive 45 mg. How many milliliters will you administer? a. 0.25 ml. b. 2.25ml. c. 5 ml. d. 11.25 ml 9. The classic signs and symptoms of a tension pneumothorax include all of the following EXCEPT a. Cyanosis and diaphoresis. b. Tracheal deviation away from the affected side. c. Equal breath sounds bilaterally. d. Distended neck veins. 10. While you are on duty you find one of your patients lying on the floor, apparently having a seizure. What would you do? a. Turn patient on his side and ask someone to hold him down. b. Observe nature and duration of seizures. c. Leave the patient and fetch the E-Cart. d. Place a tongue depression in the patient's mouth. 4|Page 11. A patient has been prescribed a bronchodilator which is to be administered using a metered-dose inhaler. The nurse should instruct the patient to a. Hold the container upside down before using it. b. Inhale the medication rapidly through the nose. c. Exhale after inhaling the medication. d. Inhale the medication through the mouth and not the nose. 12. The nurse normally assesses a patient with acute pancreatitis for elevated levels of serum: a. Cholesterol. b. Amylase. c. Potassium. d. Calcium 13. The most common cause of airway obstruction in unconscious patients is: a. Flaccid tongue blocking the hypo pharynx. b. Crush injury to trachea. c. Foreign body obstruction. d. Edema of the vocal cords. 14. A patient arrives in the ER by the ambulance service following a fall from the seating area at a school football game , The patient is alert and orientated and able to answer questions, opens his eyes as you speak and moves his fingers and toes at your command. He is in full spinal immobilization on arrival. His initial Glasgow Coma Score is a. Eye opening 3, Verbal 5, Motor 6-14. b. Eye opening 2. Verbal 2, Motor 2-6. 5|Page c. Eye opening 1, Verbal 1, Motor 1-3. d. Eye opening 4, Verbal 3, Motor 4-11. 15. Which of the following sequences represents the order in which the nurse should perform an assessment of a patient's abdomen a. Inspection, auscultate, percuss, palpate. b. Auscultate, inspect, percuss, palpate. c. Palpate, percuss, auscultate, inspect. d. Percuss, palpate, auscultate, inspect. 16. A child is to receive amoxicillin 75 mg orally. The medication is supplied as an oral suspension containing 150 mg per 6 ml. How many milliliters will you administer? a. 1.5 ml. b. 2 ml. c. 3 ml. d. 3.5m. 17. A nurse is caring for a patient in pain following an automobile accident. The nurse understands that pain medication for the patient should be saved until the pain is severe to prevent addiction. a) True. b) False. 18. The Braden and Waterfowl risk assessment tools are concerned with a. Risk of falls. b. Risk of weight loss. c. Risk of tissue damage. 6|Page d. Risk of GI bleeding. 19. A 26-year-old man arrives at the Emergency Department in an ambulance after an automobile accident. The physician notes that the patient has no obvious fractures or injuries and diagnoses him as having a possible blunt abdominal trauma. Which internal organ is typically injured in a patient with a blunt abdominal trauma? a. Pancreas. b. Spleen. c. Small intestine. d. Gallbladder. 20_21.CASE: A 40-year-old man arrives at the ED with severe middle facial trauma. He had been sitting in the front passenger an automobile that crashed into a tree at 100 km/hour. (Questions 68-69) 68. Because of the severe facial trauma and the report of the vehicular accident the nurse's first priority work: a. Call the patient's family to come to the hospital. b. Notify the police about the incident. c. Perform a drug screening on the patient. d. Maintain alignment of the spine. 21. During the physical assessment, the nurse notes clear drainage from the patient's nose. The nurse: a. Report the finding on the assessment form. b. Test the nasal drainage for cerebrospinal fluid (CSF). c. Assume that the patient has a respiratory infection. 7|Page d. Suction the nose gently using a circular motion. 22. Respiratory failure is associated with vertebral fractures above: a. T-4. b. T-2. c. C-7. d. C-4. 23. The best indicator of pain severity is the: a. Patients level of activity tolerance. b. Patient's description. c. Nurse's observation. d. Decreased limb movement. 24. An adult patient tells the nurse that she has been experiencing a great amount of flatulence in recent weeks. The nurse should instruct the patient to avoid foods such as: a. Tomatoes. b. Oranges. c. Cabbage. d. peas. 25. Assessment of the patient in shock should include which of the following in the primary survey? a. Abdominal sounds. b. Level of consciousness. c. Areas of deformity. d. Complete neurological exam. 8|Page 26. Which of the following events is a valid reason to interrupt or discontinue cervical spine precautions? a. No evidence of cervical spine injury is evident on clinical examination. b. Cervical spine x-ray series reveals no evidence of fracture, subluxation or dislocation. c. The historical account of the accident is inconsistent with the mechanism of injury that would produce cervical spine injury. d. None of the above. 27. During the transfusion of a second unit of blood, a patient blood pressure is noted to have risen from 92/44 (before first unit) to 124/60. The nurse should therefore carryout the following: a. Carry on the transfusion without change. b. Stop the blood immediately as a reaction is suspected. c. Slow the rate of transfusion to lower blood pressure. d. Increase the transfusion rate. 28. You realize that a medication error has been made and a patient has received the wrong medication. What should be your first action when realizing an error has been made? a. Assess the patient's condition. b. Notify the physician of the error. c. Complete an incident report. d. Report the error to the unit manager. 29. You are to administer penicillin 750,000 units intramuscularly. The bottle of penicillin is labeled 300,000 units/cc. How many cc will you administer? a. 0.8 cc. 9|Page b. 1.5 cc. c. 2.5 cc. d. 3 cc. 30. The rhythm below is ? a. Torsades de pointes. b. Ventricular tachycardia. c. course ventricular fibrillation. d. idioventricular rhythm. 31. Which of the fluid and electrolyte disturbances that occur in acute renal failure is most life threatening? a. Hyperkalemia. b. b fluid excess. a. Hypoproteinemia. b. Anemia. 32.If upon inspection an open fracture is suspected: A.Monitor activity must be tested. B.The limb should be moved slowly. C.Care must be taken to prevent contamination of fracture. D.An air splint should be applied and inflated. 10 | P a g e 33.Apatient arrives in the ED with a knife protruding from his left lower abdominal quadrant, An appropriate nursing action would be to: A.Immediately remove the object and apply firm pressure to the wound. B. leave the object in place until the patient is taken to the operating room. C. Establish the large I.V lines, then remove the object. D. Obtain an abdominal X-ray, then remove the object. 34.The immediate treatment for a patient with a large scalp laceration should include: A. Apply compression to the scalp to prevent help further blood loss. B. obtain a swab of the wound for culture and sensitivity. C. Encourage the wound to bleed to help expel any potential foreign body. D. Cut any excess skin using a scalpel and apply a dry dressing. 35.The nurse should anticipate further assessment of a patient with a Basal skull fracture to possibly reveal: A. otorrhea. B. meningism. C. Facial paresis. D.Hemianopia. 36.Potential complication of endotracheal intubation include: A. Esophageal intubation. B. Hypoxemia from prolonged intubation attempts. C. Conversation of cervical injury without neurological deficits to a cervical spine injury with neurological deficits. D. All of the above. 37. At which of the following temperature range is it safe to store medications which are instructed to be stored in a fridge? a. 0-4°C. 11 | P a g e b. 2-8°C. c. 0-8 °C. d. 5-10 °C. 38. The triage nurse suspects that this patient is showing signs of a myocardial infarction because the chest pain a. Is severe and radiating. b. Had not occurred previously. c. is accompanied by PVC's. d. Has lasted for 2 hours and is unrelieved by rest. 39. Which statement best describes shock? a. It is the inability of the body to excrete metabolic waste products. b. it refers to the collapse of the respiratory system. c. It refers to the collapse of the sympathetic nervous system. d. it is a state of inadequate tissue perfusion. 40. The nurse finds a container with the patient's urine specimen sitting on a counter in the cubicle. The patient states that the specimen has been sitting in the bathroom for at least 1 hour, What would be the nurse's most appropriate action? a. Discard the urine and obtain a new specimen. b. Send the urine to the laboratory as quickly as possible. c. Add fresh urine to the collection specimen until it can be transported to the laboratory. d. Refrigerate the specimen until it can be transported to the laboratory. 41. When dealing with an aggressive patient, the first intervention the nurse should implement is 12 | P a g e a. Try to calm the patient through effective communication. b. Restrain the patient to ensure other patient safety is ensured. c. Sedate the patient with medication prescribed from the medical staff. d. Avoid talking to the patient until he/she calm down. 42. Which ECG finding is indicative of myocardial ischemia? a. ST segment depression. b. U wave appearance. c. T wave elevation. d. ST segment elevation 43. Which of the following terms refers to inflammation of the lining of the abdominal cavity? a. Appendicitis. b. Diverticulitis. c. Irritable bowel syndrome. d. Peritonitis. 44. A newly diagnosed diabetic patient should be instructed that signs and symptoms of Hyperglycemia include: a. Flushed skin. b. Bradycardia. c. Blurred Vision. d. nervousness. 45. In the Emergency Department a risk assessment for the development of a pressure ulcer is not required as the patients are very quickly discharged / transferred: 13 | P a g e a. True b. False 46. Which nursing action would the nurse expect to perform preoperatively for a patient with a penetrating wound? a. Establishment of two large-bore I.V. lines. b. Insertion of a nasogastric (NG) tube. c. Insertion of an indwelling urinary catheter. d. All of the above. 47. Which precaution below is NOT included in expanded precautions? a. Airborne precautions. b. Protective precautions. c. Droplet precautions. d. Contact precautions. 48. Which triage goal is considered the most important? a. Giving priority care to the most critically ill patients. b. Performing a comprehensive patient assessment for each patient. c. Performing an immediate patient interview. d. Placing the patients in appropriate treatment areas. 49. A nurse is assessing an adult patient for peripheral cyanosis. The nurse should assess the patient's a. Chest. b. Groin. c. Nail beds. d. Sclera. 14 | P a g e 50. A patient has a chest tube inserted because of a pneumothorax. The nurse should explain to the patient that the purpose of the chest tube is to a. Apply suction to the chest cavity. b. Provide adequate oxygenation. c. Allow the compressed lung to re-expand. d. Drain fluid from the pleural space. 51. A patient's chest tube accidentally disconnects from the drainage bottle when she turns onto her side. Which of following actions should you take? a. Notify the physician. b. Clamp the chest tube, then notify the physician. c. Reconnect the chest tube, then notify the physician. d. Raise the level of the drainage system. 52. To treat status epilepticus, the following drugs may be used: a. Felbamate (Febantel) IV, Lorazepam (Ativan) IV. b. Lorazepam (Ativan) IV, Phenobarbital (Luminal) IV. c. Propofol (Disproven) IV, Gabapentin (Neurontin) PO. d. Phenytoin (Dilantin) IV, Lamotrigine (Lamictal) IM 53. The Registered Nurse is helping a Nursing Assistant provide a bed bath to a comatose patient who is incontinent. The Nurse should intervene if which of the following actions is noted? a. The Nursing Assistant answers the phone while wearing gloves. b. The Nursing Assistant logrolls the patient to provide back care. c. The Nursing Assistant places an incontinent diaper under the patient. d. The Nursing Assistant positions the patient on the left side, head elevated 15 | P a g e 54. The Nurse prepares an adult patient for installation of eardrops. The Nurse should use which of the follow methods to administer the eardrops? a. Cool the solution for better absorption. Drop the medication directly into the auditory canal. b. Warm the solution. Flush the medication rapidly into the ear. c. Warm the solution. Drop the medication along the side of the ear canal. d. Warm the solution to 40°C. Drop the medication slowly into the ear canal. 55. A patient with status asthmaticus is in severe respiratory distress. The nurse should maintain the patient in position? a. Sitting upright. b. Side-lying. c. Supine. d. Prone. 56. A patient is scheduled to receive a blood transfusion. During the transfusion, the nurse should observe or symptoms of a transfusion reaction which includes: a. Dizziness. b. Chills. c. Hypothermia. d. Hyperreflexia. 57. Which of the following symptoms of hypertension is most common : A. Blurred vision. B. Epistaxis. C. Headache. D. Peripheral edema. 58. Which of the following measures best determines that a chest tube is no longer needed for a patient who had a pneumothorax? 16 | P a g e a. The drainage from the chest tube is minimal. b. Arterial blood gas levels are obtained to ensure proper oxygenation. c. It is removed and the patient is assessed to see if he is breathing adequately. d. Absence of fluctuation in the water seal chamber occurs when no suction is applied 59. A patient is to receive 5mg of morphine sulfate. The ampoule contains 10mg/ml. How much morphine the nurse should administer? a. 2.0 mL. b. 5.0 mL. c. 0.5 mL. d. 2.5 mL. 60. A nurse has just admitted an elderly patient following a fractured tibia. The patient appears malnourished. To assess the patient for protein deficiency, the nurse should assess which of the following laboratory findings? a. Serum albumin. b. White blood cells. c. Hematocrit. d. Liver enzymes. 61. An adult patient on the ward is hyperthermic. The nurse anticipates that the patient will exhibit a. Clot formations. b. Sluggish blood flow. c. An increased heart rate. d. A subnormal glucose level. 62. A balanced moist wound environment 17 | P a g e a. Prevents tissue dehydration and cell death. b. Causes peri-wound maceration. c. Interferes with growth factors. d. Keeps the wound surface cool. 63. A nurse is caring for a patient in severe pain following an automobile accident. The nurse understands the medication ordered for the patient should be saved until the pain is severe to prevent addiction. a.) True b) False 64. Which one below is the correct sequence for donning Personal Protective Equipment (PPE)? a. Gloves, goggles or face shield, gown, Mask or respirator, hand hygiene. b. Hand hygiene, gown, mask or respirator, goggles or face shield, gloves. c. Hand hygiene, gloves, goggles or face shield, mask or respirator, gown. d. Gown, mask or respirator, goggles or face shield, gloves, hand hygiene. 65. What type of precaution do you need to apply for patient with clostridium difficile? a. Standard and contact precautions. b. Standard precautions. c. Standard and airborne precautions. d. Droplet precautions. 66. At the start of your night shift you realize that one of your clients is progressively becoming confused. You suspect that this is happening as a 18 | P a g e reaction to her new medication regime. The best way to tackle this situation would be a. Call the doctor so that he authorizes restraining the patient so that she would not be of danger to herself and others. b. Try to calm down the patient and make her realize that she can hurt herself. c. Ask her relatives if they can stay in late and try and calm her down and to keep an eye on her. d. Confer with the doctor to investigate the source of the confusion and delegate one of your staff to monitor others the patient closely (constant supervision). 67. A patient is admitted to your ward suffering from right renal colic and will be shortly going down for his IVP (intravenous pyelography). Your nursing action would be to: a. Get a history of any allergies. b. Give a sedative. c. Administer a radio opaque dye orally. d. Restrict fluid intake. 68. A patient is admitted to your ward after sustaining a head injury. You are assessing your patient Glasgow Coma Scale. Which of the following would you not find in the scale framework: by using a a. Eye opening. b. Motor response. c. Respirations. d. Verbal response. 69. A total hip replacement is also known as total hip 19 | P a g e a. Arthroplasty. b. External fixation. c. Prosthetic replacement. d. Internal Fixation. 70. What advice would you give to your patient who is taking warfarin? a. Use an electric razor for shaving. b. Perform extensive exercises daily. c. Avoid sodium intake. d. Measure his bleeding time daily. 71. A patient is 6 hours post-op. She has a strong urge to void and voids 25 mL into the bedpan. Based on the you determine that the patient a. Is probably dehydrated and needs additional IV fluids. b. Is experiencing urinary retention and needs to be catheterized. c. Needs more time to void and tell the patient to try again in 1 hour. d. Has developed a urinary tract infection and needs antibiotics. 72. Your post-op patient is not able to take a deep breath as instructed, saying that he has severe incision intervention would be to: a. Provide pain medication at least 30 minutes before deep breathing exercises. b. Explain to the patient that it is very important to continue with deep breathing exercises and that discomfort is expected. c. Tell the patient to meditate while performing deep breathing to help him relax. d. Inform the physician about the patient's inability to perform deep breathing. 73. A patient in your ward has had an arteriogram performed to assess his lower limb circulation. W following would you suggest as post procedure advice: 20 | P a g e a. Elevate lower limbs to promote venous return. b. Maintain strict bed rest for the initial hours. c. Administer oxygen at 4 L/min for the 1st 2 hours. d. Stay nil orally (NPO) for the first 4 hours. 74. What is the most common symptom of an esophageal disorder? a. Epistaxis. b. Nasal obstruction. c. Dysphagia. d. Throat pain. 75. A 67-year-old woman is admitted for treatment of pulmonary edema. During the admission interview, she states that she has a six-year history of congestive heart failure (CHF) The Nurse performs an initial assessment When the Nurse auscultates the breath sounds, the Nurse should expect to hear a. Crackling. b. Wheezing. c. Whistling. d. Absent breath sounds. 76. A patient had abdominal surgery 2 days ago. Which observation indicates that peristaltic activity has returned? a. The patient has got hiccups. b. The patient is hungry. c. The patient is passing flatus. d. The patient is thirsty. 21 | P a g e 77. Your patient is receiving paracetamol oral solution through a nasogastric tube. The bottle of paracetamol reads 120mg/5ml. The order is for 600mg of paracetamol How much solution will you administer to this patient? a. 3mL. b. 25ml. c. 120ml. d. 10ml. 78. A patient that has been admitted to your ward and is scheduled to have abdominal paracentesis at 11am in preparation for the procedure, which of the following actions is NOT part of the patient preparation a. Weigh the patient before the procedure and document findings. b. Measure patient's abdominal girth before and after procedure and document findings. c. Ask the patient to void his bladder before the procedure. d. Ask the patient to stay in the modified Fowler's position during the procedure. 79. ketone testing is recommended for all people with type 1 diabetes when a. Blood sugars are greater than 14mmol /L. (252mg/dl). b. There is an acute illness. c. Nausea, vomiting or abdominal pain. d. All the above. 80. While caring for a patient receiving Total Parenteral Nutrition (TPN) through a central line, the nurse notices a small ooze of opaque fluid leaking from around the central line dressing It is MOST important for the nurse to take which of the following actions? a. Prepare to change the central line dressing. 22 | P a g e b. Verify that the patient is on antibiotics. c. Place the patient's head lower than his feet. d. Secure the Y-port where the lipids are. 81. The Nurse finds a visitor unconscious on the floor of a patient's room during visiting hours at the Hospital. Which of the following Nursing assessments is consistent with cardiopulmonary arrest? a. Absent pulse, fixed and dilated pupils. b. Absent respirations, fixed and dilated pupils. c. Absent pulse and respirations. d. Weak pulse and capillary changes. 82. The doctor has asked you to start a 24 hour urine collection to send to the lab for creatinine clearance. The collection is to be started at 6am the following morning when the client is woken up. Should the nurse who is starting the collection a. Advice the patient to save the first urine of the morning in a different specimen bottle. b. Collect the first specimen of the morning so as to add it up with the whole total at the end of the 24hours. c. Perform a dip-stick analysis of the first specimen and chart the findings in the patient's file. d. Discard the first urine and start the collection after that. 83. You are doing neurological assessment for a patient that had sustained a minor head injury. You check his pupil reaction a. As an indication of brain damage. b. To check if there is damage to the cornea. c. To assess if there is bleeding in the eyes. 23 | P a g e d. To assess the patient's level of consciousness. 84. in which of the following wounds would you NOT consider using a hydrogel? a. On a medium to heavy exudating wound. b. On a necrotic wound. c. On a sloughy wound. d. On a sloughy wound with necrotic patches. 85. One of the patients assigned to you is a 28 year old male that has just undergone a thyroidectomy. He is quite anxious and becomes quite worried as he is hoarse and has a week voice. What would be your action? a. Assess the wound for bleeding. b. Reassure the patient that this is normal for post op thyroidectomy and is only temporary. c. Tell another nurse to call the surgeon and monitor the patient closely. d. Advice the patient to stay nil orally (NPO)till he is reviewed by the surgeon. 86. Which drug should be given to reverse warfarin? a. Vitamin K. b. Enoxaparin. c. Protamine sulfate. d. Dipyridamole. 87. The patient underwent a transurethral resection of the prostate (TURP). Immediately after surgery, your main task is to a. Observe the patient's vital signs and monitor urinary drainage. b. Monitor the patient's bowel sounds. c. Explain to the patient what complications could develop. 24 | P a g e d. Assist the patient with ambulation as soon as possible to prevent complications related to prolonged bed rest. 88. A 50 year old male has been admitted to your ward after an episode of hematemesis. A cold gastric lavage has been ordered. The cold lavage, in this case, is primarily done to: a. Decrease peristalsis. b. Promote vasoconstriction. c. Decrease amount of hydrochloric acid. d. To relieve pain. 89. The Nurse is caring for a patient with a cast on the left leg. The nurse would be most concerned if which of the following were observed? a. Capillary refill time was less than 3 seconds. b. Patient complained of discomfort and itching. c. Patient complained of tightness and pain in his leg. d. Patient's foot is elevated on a pillow. 90. Cholecystitis is defined as: a. Stones in common bile duct. b. Presence of gallstones. c. Inflammation of gallbladder. d. Removal of gallbladder 91. The physician ordered Mantoux test on a patient suspected of having active tuberculosis. Which statement is correct about this test: a. The test must be "read" in 48-72 hours. b. More than 10 mm of induration is considered positive in patient with HIV. 25 | P a g e c. The test will be negative in patients who received the bacilli Calmette-Guerin (BCG) vaccine. d. The test should be done on three consecutive days. 92. A 60-year-old man is admitted to the hospital with a diagnosis of chronic bronchitis. He has a 10-year history of emphysema. The Nurse should place him in which of the following positions? a. Side-lying. b. Supine. c. High-Fowler. d. semi-fowler. 93. A patient returns from surgery. Which nursing diagnosis takes priority at this time? a. Ineffective breathing pattern. b. Deficient fluid volume. c. Imbalanced nutrition: Less than body requirements. d. Diarrhea. 94. A 74-year-old patient has vascular disease. Which nursing intervention would be most appropriate for this patient? a. Encourage him to avoid caffeine and nicotine. b. Advise him to wear knee-length stockings. c. Instruct him to soak both feet in cool water. d. Caution him not to exercise daily. 95. When caring for a patient with quadriplegia, which of the following nursing interventions takes priority? a. Forcing fluids to prevent renal calculi. 26 | P a g e b. Maintaining skin integrity. c. Obtaining adaptive devices for more independence. d. Preventing atelectasis. 96. A patient with chronic respiratory failure is admitted to the unit. How much oxygen could a Registered Nurse give him safely in the absence of any hospital protocol? a. 0.2 liters per minute via nasal prongs. b. 2 liters per minute via mask or nasal prongs. c. 8 liters per minute by any means. d. 12 liters per minute by nasal prongs. 97. Draining wound, abscess and areas of skin breakdown should not be cleaned with saline prior to specimen collection in order to yield more growth of microorganism in the result. a. True. b. False. 98. young client is brought to the emergency room by the local police. The client is told that physician will be in to see him in about 30 minutes. The client becomes very loud and offensive and want to be seen by the physician immediately. Which of the following is the appropriate nursing intervention? A. Attempt to talk to the client to de-escalate the behavior. B. Watch the escalate before intervening. C. Inform the client that he will be asked to leave behavior continues. D. Offer to take the client to an examination room until he can treated. 27 | P a g e 99. When the laboratory technician approaches a client who has been experiencing delusions to obtain a blood specimen, the client begins to shout, "you are all vampires. Let me out of here!" What would be the best statement by the nurse ? A. "Don't worry; the technician is only going to take blood from you" B. It is wrong to think the lab technician is a vampire?" C. "The technician will leave and come back later for your blood" D. "It must be fearful to feel that others want to hurt you " 100. The psychiatric client tells the nurse "All nurses trying to give me injections of poison". Which of the following does the client most likely have? A. Poor insight towards his own illness. B. A false fixed belief that cannot be corrected by reasoning. C. A false interpretation of a real external stimulus. D. A false sensory perception that does not exist reality. EXAM 2 1. Mr. Ali , 55year old client , is admitted to renal unit with the diagnosis of chronic kidney failure for hemodialysis. 1.The therapeutic diet given to chronic kidney disease patient is : A. Decreased fluid, carbohydrate and protein. B. Increased fluid, carbohydrate and protein. C. Decreased fluid and protein , increased carbohydrate. D. Decreased fluid and carbohydrate, increased protein. 2. Ali asks the nurse about the frequency of hemodialysis per week. The nurse’s response is based on an understanding that the typical schedule is as follows: A. 8 hours of dialysis 2 days per week. 28 | P a g e B. 2_3 hours of dialysis 5 days per week. C. 3_4 hours of dialysis 3 days per week. D. 2 hours of dialysis 6 days per week. 3. While undergoing hemodialysis, Ali becomes dizzy, starts to sweat, and tells the nurse that he has headache and nausea. Which of the following complication would the nurse suspect: A. Air embolism. B. Hypotension. C. Myocardial infarction. D. Peritonitis. 4. Which of the following abnormal blood test results would not improve by hemodialysis: A. Elevated serum creatinine. B. Hyperkalemia. C. Decreased hemoglobin. D. hypernatremia. 5.Mona developed bleeding while she undergoing a laparotomy. 5. Mona has an order to receive a unit of packed red blood cells. Which of the following I.V solutions should the nurse give before and after the infusion of blood products. A. 0.9% sodium chloride. B. 5% dextrose in 0.9% sodium chloride. C. 5% dextrose in 0.45% sodium chloride. D. Lactated ringer. 6. During blood transfusion, Mona develops chills and headache. The nurse “best action is to : 29 | P a g e A. Lightly cover the client. B. Notify the physician stat. C. Stop the transfusion immediately. D. Slow the blood flow to keep vein open. 7_8. Ahmed, 18 years old patient, is admitted to ICU as a case of spinal cord injury after sustaining a road traffic accident. 7. A priority nursing responsibility when caring for Ahmed is to : A. Prevent urinary tract infection. B. Prevent contractures and atrophy. C. Prepare Ahmed for vocational rehabilitation. D. Avoid flexion or hyperextension of the spine. 8. Two weeks later, Ahmed begins to vomit thick coffee ground material. Which of the following is a priority nursing intervention. A. Change Ahmed’s diet to bland. B. Prepare for insertion of a nasogastric tube. C. obtain a stool specimen for occult blood. D. Prepare to administer an antiemetic drug. Mr. John, 17 years old male, is admitted to the medical ward with a diagnosis of DKA. 9. Mr. John typically presents with all of the following manifestations Except : A. Tremors and slow respiration. B. Altered level of consciousness and Kussmaul"s respiration. C. Polyuria and poor skin turgor. D. Tachycardia and hypotension. 10. Which of the following intravenous fluid therapy should be administer to Mr. John : A. NSS 0.9 with KCL. B. DW 0.5 with KCL. 30 | P a g e C. NSS o.45 with calcium gluconate. D. Ringer lactate with KCL. (Questions 11- 15 refer to the following case) Saif is a patient who is recovering from a complicated case of pneumonia. His chest x-ray consolidation of the right lower lobe with pleural effusion. 11. The nurse should anticipate which of the following interventions for saif? a. IV corticosteroid administration and oxygen therapy. B. Endotracheal intubation and Ventolin nebulizer. C. Thoracentesis and antibiotic administration. D. Diuretic administration and postural drainage of the right lower lobe. 12. Which of the following is an expected outcome for Saif with a nursing diagnosis of ineffective airway clearance? A. Respiratory rate between 8 and 10 per minute. B. Presence of clear breath sounds. C. Spo2 between 85% - 90%. D. Chest expansion on the right side is more than left side. 13. The nurse is performing suctioning to Saif. The best way to determine the effectiveness of nasotracheal suctioning is by: A. Doing chest X-ray before and after suctioning. B. Asking the client if he can breath more easily after suctioning. C. Observing the rate and rhythm of respiration before and after suctioning. D. Auscultating the chest before and after suctioning. 14. While suctioning, when is the best time to occlude the vent on the catheter? A. When inserting the catheter. 31 | P a g e B. When inside the trachea C. When withdrawing the catheter. D. when patient cough. ( Questions 16 - 20 refer to the following case ) Mr. Raju, a 33 years old male, is admitted to the hospital with a diagnosis of alcohol liver cirrhosis complete by ascites. He states a 5 kg weight gain over the last 10 days. He has edema in the feet and ankles and his abdomen is distended and shiny with strike. 16. The nurse is developing a plan of care for Raju. Which nursing diagnosis is the most appropriate? A. Fluid volume excess. B. Impaired gas exchange. C. Activity intolerance. D. Imbalanced nutrition more than body requirement. 17. Which of the following nursing actions be avoided while caring for Raju? A. Encourage him to eat small frequent meals. B. Encourage him to turn frequently when in bed. C. Place his in supine position. D. Trim his finger nails. 18. The nurse is monitoring Raju signs of portal Hypertension. Which of the following complications are associated with the presence of portal hypertension? A. Hepatomegaly B. Hepatic encephalopathy C. Hepatocellular jaundice D. Esophageal varices 32 | P a g e 19. Liver biopsy was scheduled. Which of the following institutions should be given to Raju preparing him for procedure? A. Ambulate 2 hours after the procedure. B. stay on your right side immediately after the procedure. C. Take a deep breath when the needle is inserted. D. Drink a contrast media 6 hours before the procedure. 20. The nurse is reviewing the laboratory results for Raju and notes ammonia level is elevated. Which did the nurse anticipate to be prescribed for him: A. Low protein diet. B. High fat diet. C. Low carbohydrate diet. D. High fiber diet. ( Questions 21_ 23 refer to the following case) Mr. Fouad, a 58 years old client, is admitted to the hospital for cataract surgery. 21. Which symptom should the nurse find consistent with Mr. Fouad's diagnosis? A. Halos and rainbows around light. B. Eye pain and irritation that worsens at night. C. Blurred and hazy vision. D. Eye strain and headache when doing close work. 22. The nurse knows that her teaching regarding prevention of intraocular pressure after cataract surgery has been achieved if she observes Mr. Fouad: A. Cutting out of bed quality in the morning. B. Performing deep breathing and exercises. 33 | P a g e C. Tying his shoe laces. D. Asking someone to pick up mobile from the floor. 23. When teaching Mr. Fouad and his family about signs and symptoms of hemorrhage from the operative site, the nurse should tell them that this complication is manifested as: A. Mild pain and discomfort. B. Drainage of clear fluid. C. Sharp pain in the eye. D. Difficulty adjusting to new glasses. 24-27. Hossam, 45 years old male, admitted to the medical ward with blood pressure 185/110mmHg. He is diagnosed as a case of essential hypertension. 24. To get an accurate blood pressure measurement for Hossam, the nurse should : A. Insert the diaphragm of the stethoscope under the cuff. B. Position the sphygmomanometer above the level of the heart. C. Pump the cuff about 60mmHg above the point where the brachial pulse is lost. D. Ask Hossam to sit with the arm supported at heart level. 25. The doctor prescribes Atenolol (Tenormin) 50mg PO daily for Hossam. The nurse should teach Hossam to : A. Monitor his blood pressure every week. B. Avoid stopping the medication suddenly. C. Follow a high sodium diet. D. Stop the medication if his blood pressure is normal. 26. One of the major nursing interventions after administration of Frusemide (Lasix) for Hossam to monitor : A. Liver enzymes. 34 | P a g e B. Serum electrolytes. C. Peripheral pulse. D. Apical heart rate. 27. Upon discharge, the nurse should instruct Hossam to : A. have regular eye examination. B. monitor his blood pressure monthly. C. follow a regular diet. D. discontinue the medication if he develops severe headache. 28_30. Iman, 55 year old female admitted to the female ward with severe burning back pain. MRI of lumber spine revealed a herniated L4,L5 disc. 28. The nurse advises Iman to assume Which of the following positions in bed: A. prone with a low _level pillow. B. high fowler with the legs straight. C. supine with knees flexed. D. right lateral position. 29. Which of the following could be Iman’s pain : A. excess CSF in the area. B. pressure on the spinal nerve root. C. pressure on the spinal cord. D. decrease in intra spinal fluid pressure 30. Iman undergoing laminectomy surgery. What postoperative assessment should the nurse do to check for signs of nerve injury. A. measure vital signs. B. assess presence of dorsalis pedis pulse. C. assess any leakage of CSF in the dressing. D. assess Iman’s ability to void freely. 7. Voltaren injection 50 mg IM was prescribed for Ms. Iman. The ampoule is labeled 75 mg 3 ml. The dose should be administered in ml is: 35 | P a g e A. 0.5 ml B. 1 ml C. 2 ml. D. 3 ml 8. Ms. Iman underwent Laminectomy. On the first day post operatively, she asks to be turned to her side. The nurse should A. Ask Ms. Iman to help by using an overhead trapeze to turn herself. B. Turn the shoulders first followed by hips and legs. C. Inform Ms. Iman that she must be in supine position only. D. Get another nurse to help logroll Ms. Iman into position. 31_32. Soha, 40 years old, admitted to the ward as a case of renal colic: 31. Which of the following manifestations could Soha exhibit upon admission. A. suprapubic pain. B. hematuria. C. weight loss. D. polyuria. 32. Soha undergoes an intravenous pyelogram (IVP), which of the following interventions should the nurse do to prepare Soha for the procedure: A. administering diuretic as prescribed. B. explaining about flushing sensation felt upon injecting the contrast agent. C. encouraging adequate fluid intake. D. administering laxatives as prescribed. 33_40. Rashid, 68 years old, who experiences thrombotic cerebrovascular accident (CVA) is admitted to the hospital, He also has dysphasia and aphasia. 36 | P a g e 33. The brain CT scan of Rashid shows infarction over the left cerebral hemisphere. Which of the following clinical assessment findings matches the CT scan result. A. left sided hemiplegia. B. right sided hemiplegia. C. paraplegia. D. left sided paresthesia. 34. Which of the following is a priority assessment in the first 24 hours of admission for Rashid: A. Risk factors for vascular disease. B. pupil size and pupillary response. C. urinary elimination pattern. D. speech and language ability. 35. The nurse inserts nasogastric tube for Rashid, The most appropriate technique the nurse can use to determine whether the distal end of the tube is in the stomach is to : A. request a portable X-Ray of the chest. B. aspirate gastric fluid. C. install 100ml of tap water into the tube. D. feel for the air at the tube’s proximal tube. 36. The nurse is planning to administer the medications through the nasogastric tube for Rashid. Which action would ensure that the correct patient receives the medication: A. check the name of the vital signs sheet in the patient “room. B. learn to recognize Rashid’s face. 37 | P a g e C. check Rashid’s ID band. D. call Rashid by name. 37. Rashid’s nasogastric tube is removed. Which of the following measures would be ineffective in decreasing Rashid’s risk of aspiration while eating: A. maintaining an upright position while feeding him. B. restricting the diet to liquid until swallowing improves. C. introducing food on the unaffected side of the mouth. D. keeping distractions to a minimum. 38. While assisting Rashid to ambulate, The nurse should stand on Rashid’s : A. unaffected side and hold the unaffected hand. B. affected side and hold the affected hand. C. unaffected side and hold one arm around the cline’s waist. D. affected side and hold one arm around the cline’s waist 39. Rashid has a Foley catheter in situ. Which of the following measures should be taken by the nurse while caring for Rashid's urinary drainage system? A. Allow the tube to rest on the floor. B. Disconnect the tube to empty the bag. C. Hang the drainage bag below the level of the bladder. D. Clamp the drainage tube when changing Rashid's position. 40. Rashid with expressive aphids becomes frustrated and upset when attempting to communicate with the nurse. What should the nurse do to help alleviate this frustration? A. Limit the client contact with others to Limit the frustration. B. Anticipate needs so that the client does not have to ask for help. C. Face the client and speak loudly so that client can see and hear better. D. Allow plenty of time for the client to communicate. 38 | P a g e (Questions 40-45 refer to the following case ) Salem, a 26-year-old patient, sustained head injury after being involved in a Road Traffic Accident (RTA) Craniotomy and tracheostomy were performed to Salem.. 41. The doctor orders for Salem IV of D5 1\4 NS at 75 ml per hour. At 7:00 PM, a new bag of 1 L fluid is hung. If the IV infuses at the prescribed rate, how much fluid should be left in the bag at 7:00 AM? A. 100 ml. B. 500 Ml. C. 900 ml. D. Bag should be empty 42. Which drug would be prescribed for Salam to rapidly reduce cerebral edema? A. Acetazolamide ( Diamox ). B. Furosemide ( Lasix ). C. Mannitol ( Sonitrol). D. Spironolactone ( Aldactone). 43. Which of the following respiratory care modalities is* most* appropriate for Salem who developed increased developed increased intracranial pressure? A. Positioning the client in high F0wler. B. Intubation and controlling hyperventilation. C. Administration of high flow oxygen via venturi mask. D. Frequent suctioning with hyper oxygenation. 44. A physician writes orders for Salem who has increased intracranial pressure. The nurse should question the order that states: 39 | P a g e A. Keep the neck of the client flexed. B. Administer steroids as ordered. C. Administer osmotic diuretics as ordered. D. Place the client with head of the bed elevated 30 degrees. 45. Salem develops a seizure attack postoperatively. Which of the following actions should not be done during attack? A. Opening Salem's mouth and placing an airway. B. Putting the bed in a flat position. C. Moving away all hazardous items. D. Closing the surrounding curtains ( Questions 46-56 refer to the following case ) Naser, a 60 years old obese client, is admitted to the hospital with a diagnosis of peptic ulcer and is scheduled for subtotal gastronomy. 46. which of the following sings would alert the nurse that the ulcer has perforated? A. The client complaints of continuous pain for a week. B. Bowel movements are painful and stool is while. C. Extreme tender and rigid abdomen. D. Gastric pain after eating. 47. The nurse plans a health teaching session about leg exercises post operatively in order to prevent A. Pneumonia. B. Deep Vein thrombosis (DVT). C. Atelectasis. 40 | P a g e D. Congestive Heart Failure. 48. After giving the pre anesthesia medication to Naser, the nurse should tell him to: A. Sit on the edge of the bed for 10 minutes. B. Empty his bladder. C. Remain in bed with side rails up. D. Take a bath with antiseptic soap. After surgery. Nasser returns to the ward in stable condition. 49. During the immediate postoperative period the nurse should give the highest priority towards: A. Checking bowel sounds. B. Maintaining continuous IV infusion. C. Recording intake and output. D. Checking vital signs hourly. 50. The intravenous fluid order Nassar is 2 liters dextrose/ saline to run over 24 hours. the drop factor for the IV tubing uses is 20. the expected flow rate for the IV order be: A. 14 gtts/ minutes. B. 21 gtts/ minutes. C. 28 gtts/ minutes. D. 33 gtts/ minutes. 51. Nassar complaints of pain at the surgery site; the nurse must "first" act by: A. Diverting Nassar's attention through turning the music on B. Administering ordered analgesics 41 | P a g e C. Reporting to the surgeon on call. D. Assessing the characteristics of pain. 52. The nurse assessing Nassar post operatively would consider which of the following as a symptom of thrombophlebitis of the leg? A. Negative boman”s sign. B. weak or absent pedal pulses. C. cool temperature and mottled appearance of the foot. D. Calf pain with dorsiflexion of the foot. 53. Which intervention would be indicated for Nassar with thrombophlebitis of the leg? A. Keep the patient on the bed rest. B. Gently massage the affected leg. C. keep the leg positioned below the level of heart. D. Start antibiotic therapy. 54. Later. the physician ordered heparin therapy for Nassar. the rationale for starting heparin is to: A. Dissolve the clots. B. Increase blood flow to the leg. C. Prevent additional clots from forming. D. Constrict the vessels. 55. 25000 units of heparin in 250 ml. D5W is infused to Nasser at a rate of 10 mL\hour. How many units per hour are infusing? A. 10 units. B. 100 units. 42 | P a g e C. 1000 units. D. 2500 units. On the fifth postoperative day, Nasser would advise to have his first meal. 56. Thirty minutes after the meal, Nasser complains of fullness, palpitation and dizziness. The nurse interprets it as which of the following: A. Shock. B. paralytic ileus. c. Gastrointestinal obstruction. d. Dumping syndrome. ( Questions 57-59 refer to the following case ) Mohamed is admitted to the intensive care unit ICU following a road traffic accident. He sustained chest injury with hemo-pneumothorax. 57. Which of the following findings would indicate pneumothorax in Mohamed? A. Presence of rales. B. Inspiratory wheeze. C. absence of breath sounds. D. Dullness on percussion. 58. An Intercostal drainage tube is inserted for Mohamed; fluctuations in the tubing of the chest drainage bottle indicate which of the following? A. The apparatus is working well. B. The chest tube is blocked. C. The tube end is not under water seal. D. Air has leaked into the chest cavity. 43 | P a g e 59. Mohamed is transferred to the ward from the intensive care unit with the intercostal drainage in place. Which of the following nursing interventions is appropriate upon receiving the client? A. Milking the tubing to prevent accumulation of fibrin and clots. B. Raising the bottle to bed height to accurately assess the fluid level. C. Attaching the chest tube to the bed linen to ensure patency of the tubing. D. Documenting the time and amount of drainage in the collection bottle. (Questions 60-61 refer to the following case) Karim, a 55-year-old client, presents to the hospital with left ventricular failure. He is started on Digoxin and Lasix 60. The major goal in the caring of Karim would be : A. Enhance comfort. B. Improve respiratory status. C. Increase cardiac output. D. Decrease peripheral edema. 61. Prior to giving digoxin, the nurse finding the apical pulse as 55 beats/min. Which one of the following is an appropriate nursing action? A. Check serum potassium level. B. Take an immediate ECG. C. Withhold the drug and inform the doctor. D. Give the tablet after one hour. ( Questions 62_64 refer to the following case ) Faisal, 18 years old male, a case of Beta_ thalassemia and AIDS comes to the word. 44 | P a g e 62. Which of the following features would cause Faisal to develop AIDS: A. frequent blood transfusion. B. deferral injections. C. suppressed immune system. D. drinking contaminated water. 63. Which of the following goals would be appropriate for Faisal. A. adhere to measures that prevent the spread of infection to others. B. adhere to low sodium, low protein diet. C. verbalize the importance of using sedatives to provide adequate rest. D. avoid social activities with friends after discharge from hospital. 64. Being thalassemia, which of the following complications would Faisal develop from frequent blood transfusion : A. Malignancy. B. Diabetes Mellitus. C. Iron overload. D. Heart Failure. ( Questions 65-68 refer to the following case ) Rami, a 59-year-old client, arrives to the emergency department complaining of sever chest pain radiating to the left shoulder and jaw. Rami is diagnosed with acute myocardial infarction : 65. What would the immediate nursing interventions include upon arrival to the hospital A. Complete Rami's registration information. B. Inquire about chest pain precipitating factor. 45 | P a g e C. Start sublingual nitroglycerin. D.Administer oxygen via nasal cannula. 66. The nurse is examining the tracing of Rami's 12-lead ECG. Which electrocortical infarction? A. Prolonged PR interval. B. Widening QRS complex. C. ST segment elevation. D. Tall, peaked T waves. 67. The physician orders continuous intravenous nitroglycerine ( Tidal ) infusion includes: A. Obtaining blood for arterial blood gas analysis (ABG). B. Monitoring blood pressure every 15 minutes. C. Monitoring urine output every hour. D. Obtaining serum potassium level daily. 68. Immediately after cardiac catheterization, which nursing intervention A. Allow to ambulate to bathroom with assistance only. B. Monitor pedal pulses frequently. C. Maintain the head of bed in a high-fowler's position. D. Restrict fluids. 70. Bactrim (Tri methprim) is ordered for a client suffering from urinary tract infection (UTI). Which of the following measures should be done before starting Bactrim therapy? A. Assessing urine odor and color. B. Checking blood count. 46 | P a g e C. Performing urine culture and sensitivity. D. Measuring intake and output. 71. Which of the following instructions should the nurse teach client with colostomy about the care for the stoma? A. Applying liberal amounts of Vaseline and leave it exposed B. Rinsing the area with hydrogen peroxide and then applying fresh gauze bandages. C. Washing the area with soap and water then applying a protective ointment. D. Pouring saline around the stoma and rubbing the area to remove hard feces. 72. When a client is having hypertensive crisis, the nurse's immediate concern is to prevent which of the following complications? A. End organ failure. B. Seizures. C. Left ventricular hypertrophy. D. Stroke. 73. A client undergoes a screening Mantoux test which yields an induration of 3 mm after 48 hrs. A correct interpretation of this finding is: A. He has active Tuberculosis. B. He has Tubercle bacilli but in a dormant state. C. He has been vaccinated with BCG vaccine. D. The result is not significant. 74. While walking in the hallway, a client grabs his chest and falls to the floor. The first assessment to determine A. Pupils' size. B. Responsiveness. 47 | P a g e C. Blood pressure. D. Presence of pulse. 75. After removing the indwelling catheter, the client became incontinent. To help the client ,The nurse should: A. Limit fluid intake to within 1000ml daily. B. Recommend intermittent catheterization. C. Set up a regular toileting schedule. D. Apply a large diaper. Questions 76 and 77 refer to the following case ) A two-year-old child is brought to the hospital by her parents. A diagnosis of viral meningitis. 76. To identify the possible signs of increased intracranial pressure, the nurse should monitor A. Restlessness, anorexia, rapid respirations. b. Vomiting, seizures, headache. C. Anorexia, irritability, hypothermia. D. Bulging fontanels, decreased blood pressure, hyperthermia. 77. The nurse reviews the results of the cerebrospinal fluid (CSF) analysis, which of the following diagnosis? A. Cloudy CSF, decreased protein, and decreased glucose. B. Cloudy CSF. elevated protein and decreased glucose 79. Which of the following would the nurse consider before drawing a blood sample for electrolyte congestive heart failure? A. Administer oxygen as prescribed. 48 | P a g e B. Place the child in a decorated room. C. Give the prescribed dose of Digoxin. D. Avail attractive musical mobile. 80. A priority nursing action before administering intravenous fluid with potassium chloride for dehydration is? A. Assessing the child's weight. B. Measuring the child's body temperature. C. Checking the amount of urinary output. D. Assessing the child's blood pressure. 81. A one and a half year old child is to receive Ampicillin 4 times a day. The child weight is 15 Kg the nurse give to this client at 10:00 am if the correct dosage is 75mg/kg/day? A. 11 mg B. 28 mg C. 281 mg D. 1125 mg 82. The mother of a toddler with nephrotic syndrome asks the nurse what can be done about Which of the following interventions would the nurse suggest? A. Apply cool compresses to the child's eyes. B. Elevate the head of the child's bed. C. Apply eye drops every 8 hours. D. Limit the child's television watching. 83. The first grader school student, with a known history of anemia, complains of dizziness. What the school nurse's best initial response would be to: 49 | P a g e A. Check the child's pulse and blood pressure. B. Have the child sit until the dizziness subsides C. Make the child smell ammonia to prevent fainting. D. Assist the child to the nurses' room. 84. During an acute attack of bronchial asthma in a 6-year-old child breathing A. Wheezing on expiration. B. Periods of apnea. C. Grunting on inspiration. D. Abdominal muscle retractions. 85. A 4-year-old child diagnosed with acute lymphocytic leukemia Which of the following tests would help the doctor to evaluate the child's A. Urine analysis B. CBC 86. In the first postpartum day at the postnatal word, the client tells the nurse that her perineum is edematous and painful from the episiotomy. The *best* nursing action is to: A. Apply an ice pack to her perineum. B. Assist her to take a warm bath. C. Encourage her to drink plenty of water. D. Apply a heat tamp directly to the area. a Samer, 38 years old patient, is admitted to the psychiatric unit as a case of paranoid schizophrenia. 87. Management of schizophrenia includes: A. Psychotherapy therapy, biofeedback and anxiolytics. B. Hydrotherapy, play, and at therapy. 50 | P a g e C. Occupational therapy, group therapy and antiparkinsonian drugs. D. Psychotherapy, major tranquilizers and electroconvulsive therapy. 88. Which of the following are characteristics of people with delusion ? A. Anorexia and hopelessness. B. Flight of ideas and hyperactivity. C. Panic and multiple physical complaints. D. Suspicious and resistance to the therapy. 89. Which of the following is an appropriate intervention to manage Mr. Samer delusions? A. Educate her about the long-term effect of her medication. b. Teach her to avoid sharing her unusual thought with others. C. involve her with recreational activities to distract her from delusional thoughts. D. begin group therapy as soon as possible to increase her social skills. 90. The appropriate nursing interventions for a client who is experiencing anxiety attack should include A. Turning on the lights and opening the windows. B. Leaving the client alone. C. Staying with the client and speaking in short sentences. D. Turning on music. 91. Which of the following functions are not performed by a psychiatric nurse in mental health care setting? A. Assessing and planning for client care. B. Health teaching and counseling. C. psychotherapy and prescribing medications. 51 | P a g e D. Counseling and establishment of nursing diagnosis. EXAM 3 1. After talking with the parents of a child with Down syndrome, which of the following would the nurse identify as an appropriate goal for the care of the child? A. Encourage self-care skills in the child. B. Teaching the child something new each day. C. Encourage more lenient behavior limits for the child. D. Achieving age-appropriate social skills. 2. A 2-year-old girl returns from surgery with a temporary colostomy after a bowel resection for Hirschsprung’s disease. Which of the following postoperative interventions should have a priority? A. Change the surgical dressing. B. Suction the nasopharynx frequently to remove secretions. C. Irrigate the colostomy with 100 ml of normal saline. D. Auscultate the patient's breath sounds. 3. A 2-year old girl has been successfully treated for a croup. Her parents ask, "What should we do if she gets croup again? What is the nurse's best response? A. You don't have to worry. She now has immunity to croup and will not get it again." B. "Come to the emergency department immediately when she is coughing. C. "Keep a cold mist humidifier running in her room, give lots of fluids and watch her breathing. D. You could put a crib in the bathroom and let her sleep with the hot shower running to make steam." 52 | P a g e 4. 4-year-old girl is admitted to the hospital with suspected leukemia. Which of the following would be the best room assignment? A. with a 4-year-old girl who has rheumatoid arthritis. B. Alone in a private room. C. With a 4-year-old who has leukemia. D. With a 5-year-old boy who is having a tonsillectomy. 5. A 5-month-old has recurrent middle ear infections since she was 3 months old. What is the most important to assess when she comes for a visit? A. How well she eats. B. Her weight gain since her last visit. C. Her compliance with taking the prescribed antibiotics for the last infection. D. Her body temperature. 6. A child has an order to receive 250 cc of Intravenous fluid every 4 hours. The nurse would set the infusion pump to run at which of the following flow rate? A. 10 ml/hr B. 25 ml/hr C. 42 ml/hr D. 63 ml\ hr 7. The nurse is reviewing the teaching plan for the parents of a child who has undergone cleft lip repair. Which instructions should the nurse give? A. Lay the infant on his back or side to sleep. B. Clean the suture line alter each feed by dabbing it with saline solution. C. Set the infant up for each feed. D. All of the above. 53 | P a g e 8. A child with leukemia is being discharged after receiving chemotherapy. Which of the following instructions should the nurse give to the parents? A. Provide a diet low in protein and high in carbohydrate. B. Avoid fresh vegetables that are not cooked or peeled. C. Notify the doctor if the child develops low grade temperature. D. increase the use of humidifier thorough the house. 9. One morning the nurse notes that the jaws of a 3-year-old male are clamped and is having seizure. The priority nursing responsibility at this time is to A. Start oxygen at 1 liter by mask. B. insert a padded tongue blade. C. Restrain the child to prevent injury to soft tissue. D. Protect the child from harm from the environment. 10. An infant is diagnosis as having communicating hydrocephalus. When helping the parents understand the physician explanation on the baby's problem, the nurse should state: A. Too much Cerebrospinal fluid is produced within the ventricles of the brain. B. The Cerebrospinal fluid prevented from proper absorption by blockage in the ventricles of the brain. C. The (shunt) of the brain surface that normally absorbs cerebrospinal fluid after its production is not functioning (equality). D. There is allow of cerebrospinal fluid between the brain cells and the ventricles, which do not empty properly into the spinal cord." 11. A six years old child has short arm cast on the right extremity. While assessing the fingers during the immediate period after casting a nurse would report which of the following findings? A. Mild edema. 54 | P a g e B. Pain on movement. C. Slight coolness on the cast when touched. D. Capillary refill greater than 3 seconds. 12. The infant who weights 5 kg is to receive 750mg of antibiotic in a 24 hr period. The liquid antibiotic comes in a concentration of 125mg/5ml. If the antibiotic is to be given three times a day how many ml would the nurse administer with each dose? A. 2 ml. B. 5 ml. C. 6.25 ml. D. 10 ml. 13. All of the following are included in the plan of care for an infant with bronchiolitis EXCEPT. A. A administer Antibiotic therapy. B. Humidify the air. C. Instill Saline drops to relieve nasal congestion. D. None of the above. 14. A 4 ½ years girl is to get Digoxin 0.04mg at 9 am. The nurse checks her apical pulse and notes that it is 82 beats per minute (bpm) and irregular. Which interpretation by the nurse would be the most correct? A. She just woke and the pulse is slower in the morning. B. She may be experiencing Digoxin toxicity. C. This perfectly normal for child of his age. 55 | P a g e D. she may be developing hypokalemia. 15. The doctor placed a patient on Dilantin, 5 mg per kg body weight per day divided in 2 doses. On admission the patient weighted 20 kg. The correct dose to give to the patient at each dose would be: A. 115 mg. B. 225 mg. C. 50 mg. D. 100 mg. 16. Which statement by a 8 year-old girl with diabetes mellitus indicates that she understands Glycosylated hemoglobin assessment? A. The test will be inaccurate if late candy a day before the test. B. The test assess type of anemia acquired by people with insulin dependent diabetes. C. The test replace home blood sugar monitoring. D. The test gives an average blood glucose level for the past three months. 17. A 2 month-old girl with congestive heart failure, secondary to tetralogy of Fallot has been admitted to the hospital. She has been digitalized and her condition is now stable. While making rounds, the nurse observe that she is crying, dyspnea, and lips are cyanotic. In addition to starting ordered oxygen, which action would be best for the nurse take? A. place the patient in supine, extended position. B. Provide a pacifier in her mouth. C. Place the patient in lateral, knee-chest position. D. place the patient in modified Trendelenburg position. 56 | P a g e 18. The diagnosis of hemophilia A is confirmed in an infant. Which of the following instructions would the nurse provide the parents as the infant becomes more mobile and start to crawl? A. Administer one half of a child's aspirin for a temperature higher than 101 F (38.3C). B. Pad the elbows and knees of the child' clothing. C. Check the color of the child's clothing. D. Expect the eruption of the primary teeth to produce moderate to bleeding. 19. A child is admitted to the pediatric unit with the diagnosis of severe gastroenteritis: Which of the following would be most appropriate for the nurse to do? A. Apply / follow standard precautions. B. Place the child in a semiprivate room. C. Use regular eating utensils. D. Place all used linen in single bag. 20. The nurse is observing the parents of a 4 year old child who has just been admitted to hospital Which action indicates that the parents understand how to minimize anxiety during the child's hospitalization ? A. The parents carefully explain procedures to the child. B. The parents punish and scold the child if he starts to cry. C. The parents bring along the child's favorite toy. D. The parents move out of the room if the child starts crying. 21. A nurse is admitting a 14 month old female with croup. Which of the following is NOT a characteristic that the nurse would expect the child to have if she is developing normally? 57 | P a g e A. Closed anterior fontanels. B. Tendency to hold one object whilst looking for another. C. Recognition of familiar voices. D. Weight is triple the birth weight. 22. Which of the following should the nurse do after noting that a child with Hirschsprung disease has fever and watery explosive diarrhea? A. Notify the physician immediately. B. Administer anti diarrhea medications. C. Monitor the child every 30 minutes. D. No action necessary as that is a normal symptom of the disease. 23. When assessing a child for suspected intussusception which of the following would be the least likely to provide valuable information: A. Stool inspection B. Pain pattern C. Family history D. Abdominal palpation 24. A physician's orders Ampicillin (Omnipen), 125 mg IV every 6 hours. The medication label reads: 1g and reconstitute with 7.4 ml of bacteriostatic water. A nurse prepares to draw up how many milliliters to administer one dose? A. 0.54 ml. B. 0.92 ml. c) 11 ml. D. 7.4 ml. 58 | P a g e 25. When teaching the mother of an infant who has undergone surgical repair of cleft lip, which of the following solutions would you advice the mother to use? A. Mouth wash B. Povidone-iodine (Betadine) solution C. Mild antiseptic solution D. Normal saline 26. The parent asks the nurse why peanuts are one of the worst things a child can aspirate. Which of the following would the nurse include in the explanation as the main reason for the problem associated with aspirating a peanuts? A. They swell when wet. B. They contain fixed oil. C. They decompose when wet. D. They contain sodium. 27. The physician orders intravenous fluid replacement with potassium chloride to be added for a child with severe gastroenteritis. Before adding the potassium chloride to the intravenous fluid; which of the following assessments would be most important? A. The ability to void. B. The ability to pass stool. C. Assess baseline electrocardiogram. D. Assess serum calcium level. 59 | P a g e 28. A nasogastric tube is ordered to be inserted for a child with sever head trauma. Diagnosis testing reveals that the child has basilar skull fracture, Which of the following would the nurse do first? A. Ask the order to be changed To oral gastric Tube. B. Attempt to place the tube into the duodenum. C. Test the gastric aspirate for blood. D. Use extra lubrication when inserting the nasogastric tube. 29. A 3-month-old infant was admitted for bronchopneumonia. The nurse should include in the prevention teaching plan the need to A. Remove all tiny objects from the floor. B. Cover electric outlets with safety plugs. C. Keep the side rails of the crib to the highest position. D. Remove poisonous substances from low areas. 30. The physician ordered a tap-water enema for a month-old child. The nurse would consider that star a tab water enema could A. Results in loss of necessary nutrients. B. Cause fluid and electrolyte imbalance. C. increase the child's fear all intrusive procedure. D. Result in the child being infected with contaminated tap water. 31. The nurse understands that enteral feeding is often indicated for weak infant following repair of congenital heart defect because A. vomiting prevented. B. The feed can be given quickly, so handling is minimized. C. The amount of food we can be accurately regulated. 60 | P a g e D. a conserves the infant strength and does not depend on swallowing 32. A 5 years old child is admitted to the hospital with a diagnosis of meningitis. Which of these goals should have priority the child’s care plan? The child will A. Experience no weight loss. B. Be able to express her fears. C. Remain seizure free. D. Experience no cognitive loss. 33. 10 years old child is admitted to the hospital with a diagnosis of acute lymphoblastic leukemia. He is to be treated with combination of chemotherapeutic agents. One of the nursing diagnoses that is appropriate for the child is risk for injury related to platelet count: An appropriate outcome for that diagnosis is: A. improved appetite. B. increased white blood cell count. C. Absence of bleeding. D. Increased specific gravity of urine. 34. Learning processes associated with particular stage of development often are referred to as developmental tasks. A characteristic of developmental tasks is that: A. Tasks occur with predictable rhythm. B. There is no uniform time in learning a task. C. Tasks are learned at the same time in children. D. Most developmental tasks are learned by school age. 61 | P a g e 35. A patient is admitted to your unit to rule out myocardial infarction ( MI ) The patient tells the nurse that he does not understand the difference between angina and pain from myocardial infarction. The best response from the nurse would be A. Angina pain usually lasts only from 3.5 minutes and may be relieved by rest. b.. Angina pain is more severe than myocardial infarction pain c) Angina pain radiates to the left arm while acute MI pain does not. d) Angina pain requires morphine for relief. 36. Which of the fluid and electrolyte disturbances that occur in acute renal failure is most life threatening? a) Hyperkalemia. b) Fluid excess. c) Hypoproteinemia. d) Anemia. 37.A patient has undergone a radical cystectomy and now has ureter ileostomy You are allocated to take care of the patient and to look for any complication. Which of the following would you consider as need immediate attention a) There is mucous draining out of the stoma. b) Suspicion of fecal matter in the drainage bag. C)the stoma seems to be red d) There is edema of the stoma. 38. in a highly exudating wound, the main goal for the clinician is to identify and treat the case as well as protect the surrounding skin. if measures to protect the surrounding skin are inadequate. The surrounding skin would become: 62 | P a g e a) Macerated. b) Spreading cellulites. C) Necrotic. d) Granulating. 39. Which of the following is the most reliable index of a patient's neurologic condition? a) level of consciousness. b) Papillary response. c) Vital signs. d) Motor function. 40.The nurse discovers a fire in a bathroom in a patient's hospital room. After evacuating the patient from the room, the nurse should: a) Pour water on the fire quickly. b) Activate the hospital's fire code system. c) Call the fire department. d) Place wet sheets under the closed door. 41. Before ambulating a patient who has been bed-ridden for several days, the nurse should assess the patient for: a) Decreased respiratory rate. b) increased pulse pressure. c) Orthostatic hypotension. d) Secondary hypertension. 42. At which of the following temperatures is it safe to store medications which are instructed to be stored in a fridge? 63 | P a g e a) -4C b) -7C c) 0C d) 5C 43.The nurse is aware that the signs of increased ICP include: a) Narrowing pulse pressure, rising systolic blood pressure and bradycardia. b) Narrowing pulse pressure, rising systolic blood pressure and tachycardia. c) Widening pulse pressure, rising diastolic blood pressure and bradycardia. d) Widening pulse pressure, rising systolic blood pressure and bradycardia. 44. A patient being hemodialyzed becomes suddenly short of breath and complains of chest pain. The patient is tachycardia, pale anxious. A nutse suspects air embolism. The nurse should: a) Continue dialysis at a slower rate after checking the lines for air. b) Discontinue dialysis and notify the physician. c) Monitor vital signs every 15 minutes for next hour. d) Administer a bolus of 500ml normal saline to break up the air embolus. 45. You are to administer a medication to a patient but he/she is in the X-ray dept. What do you do? A. leave the medication on the patient's locker. B. leave the medication with the attendant. C. Give the patient the medication when he returns from X-ray. D. Prepare and keep medication in the drug trolley to give to the patient later. 46.What is the best time to order a patient to take diuretic medication? a). Before bedtime. 64 | P a g e 4). Before meals. c) in the morning. d). Morning and evening. 47. A patient requires 2000 units of heparin, if stock contains 5000 units in 1ml. how much should you draw up? a). 0.3 ml b). 0.4 ml c) 3.0 ml d). 4.0 ml 48.Which substance produced by the kidney is essential for anemia management? a) iron b) Calcium. c) Anti-diuretic Hormone d). Erythropoietin. 49. A patient has an arteriovenous (AV) fistula in the right upper arm for Hemodialysis, When planning care for this client, which of the following measures should the nurse implement to promote client safety? a) The blood pressures only on the right arm to ensure accuracy. b) Monitor access flow and recirculation monthly and when required. c) Ensure use of torniquet white cannulating AVF utilizing area puncture technique. d) the retrograde technique in venous site cannulation. 50. patient with acute kidney failure is to undergo a renal biopsy. What is the most important information to tell the physician? 65 | P a g e a) the patient has signed the consent form. b) The patient is taking aspirin for chronic pain. c) The patient is still passing a urine. d) The patient is familiar with the procedure. 51. patient has just received a kidney transplant and is taking high dose immunosuppressive therapy, What is the major complication of this therapy? a) Pulmonary edema. b) Infection. c) Peptic ulcer. d) Hemorrhage 52. A patient with CKA is to have an A/V fistula. What will the surgeon advice the patient before surgery? a) Refrain from physical exercise for one month. b) Shave all hair on the non-dominant arm. c) Avoid taking excess salt in his diet. d) Avoid all Injections in the non-dominant arm. 53. A deficiency in potassium (hypokalemia) can be manifested by: a) weakness, fatigue, confusion, heart irregularities, and sometimes problems in muscular coordination. b) leg cramps, low blood pressure, sweating and sometimes confusion. c) anemia, back pain, fever and chills, and sometimes hypoglycemia. d) urticaria, dysphagia, nausea and vomiting and sometimes insomnia. 54. In general, patients with chronic kidney disease( CKD) need to restrict the intake of which of these a) Bread, asparagus, cucumber, green peas 66 | P a g e b) Baked potato, beans, spinach, yogurt. c) Noodle, corn, celery, apple. d) Ham, cheese, olives, bread. 55. The following are small molecular weight solutes except ? a) Urea. b) Calcium. c) Sodium. d) B, Microglobulin. 56. the bladder is a hollow sac for urine which we it expands normally holds? a) 300ml. b) 500ml. c) 1.000 ml. d) 1.200 ml. 57. Following creation of the A/V fistula what advice will you provide the patient? a) Ensure to start dialysis without UF for 2 hour. b) Avoid having his B/P taken on the fistula arm. c) Reduce fluid intake to regulate blood pressure. d) Stop taking anti-hypertensive medications. 58. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated as the ER. Which finding would to note as confirming this diagnosis? a) Elevated blood glucose level and high ketone level in urine. b) decreased urine output. c) increase respirations and increase in ph. 67 | P a g e d) comatose state. 59. To prevent spread of hepatitis B virus in a dialysis unit, nurses should? a) Advise patients to with their hands and dry them thoroughly. b) Use standard precautions. c) test all patients for hepatitis B and C monthly. d) keep visitors to the dialysis clinic to a minimum. 60. The most effective way to break the chain of infection is to (Choose one of the following) a) Identify microorganisms rapidly & accurately. b) Recognize the high-risk patients. c) Practice good hand hygiene und standard precautions at all times. d) Maintain a high level of environment sanitation. 61. How will you identify and check a patient who does not understand your language? a) use two patient Identifiers when verifying Identity eg: ID Band and verbal confirmation by the patient or family the sticker or documentation. b) Use hand signs. c) Assume that somebody explained to the patient. d) Contact his embassy. 62. Hand washing should be done? a) Before patient contact b) After patient contact c) Before and after patient contact. 68 | P a g e 63. A patient is prescribed intravenous solution of 500 ml sodium chloride 0.9% over 4 hours. What would be the rate ml/hour? a) 21 ml/hr b) 200 ml/hr c) 125 ml/hr d) 120 ml/hr 64. What are the important things to consider when collecting specimens? a) Identification of the specimen by patient and type. b) The medium in which the specimen will be placed in. c) The place where the specimen will be sent to. d) All of the above. 65. Which of the below is a measure taken pre-operatively to prevent Surgical Site Infection? a) Shaving the operative site using a razor. b) Administer Prophylaxis Antibiotics a day before the surgery. c) Wearing OR clothes that are washed at home. d) Shaving the operative site using a clipper. 66. What is the most important factor in Infection Control? a) Hand Hygiene. b) Hair removal. c) Cleaning surfaces. d) Using Personal Protective Equipment PPE. 67. What is the most appropriate short-term goal for the nursing diagnosis of "Risk for Violence toward Others’’ for Suzan? 69 | P a g e a) The client will not verbalize anger or hit anyone. b) The client will not harm anyone during hospitalization. c) The client will be able to recognize anger in self and take responsibility before losing contro. d) The client will be restrained if he becomes verbally or physically abusive. 68. Psychological debriefing provides opportunities to: a) Discuss how effectively the incident was managed. b) Identify attempts made to prevent the incident. c) Vent-out feelings, normalize reactions, assess and refer seriously impaired staff. d) Discuss the warning signs which were noticed regarding the patient. 69. When the client has a chronic medical illness that results in severe disability, it will be most important for the nurse to assess for which of the following? a) Suicidal ideation b) Depression. c) Anxiety. d) Helplessness. 70. The nurse is aware that a client's pain has both physiological and psychological components. The nurse bases pain management strategies on knowledge that the psychological component of pain comes from the need to do which of the following? a) Express feelings. b) Protect oneself from harm. c) Feel sorry for self. d) Keep feelings inside. 70 | P a g e 71. A patient with type 1 diabetes mellitus is admitted to the hospital with a diagnosis of ketoacidosis Which patient behavior is most likely to contribute to the development of ketoacidosis? 1) Increasing the length of daily walk. b) Neglecting to take insulin regularly. c) Falling to adhere to the prescribed diet. d) Working 8 hours per day. 72. After touching environmental surface contaminated with clostridium difficile, you should : A. Wash hands with water and dry with a paper towel. B. Perform surgical scrub. C. Wash hands with antimicrobial soap , and dry hands with a paper towel. D. Disinfect hands with alcohol based hand rub. EXAM 4 1. Doctor ordered to administer 4 L of O2 via face mask to Khalid to prevent dry in respiratory secretions when O2 is administered. The nurse should: A. Provide frequent back rub. B. Remove the oxygen mask periodically. C. Ensure that fluid intake is limited. D. Ensure that oxygen is humidified. 71 | P a g e 2. Arterial blood gases (ABGs ) results for Khalid show: PH 7.37, HCO3 26 mmHg, PaO2 94 mmHg. What should the nurse do? A. Elevate the head of the bed. B. Document the result as normal. C. Instruct the client to cough and deep breath. D. Increase the rate of oxygen flow the client is receiving. 3. while caring for Khalid the nurse understands that O2 toxicity can be prevented by? A. Humidified O2. B. O2 via face mask. C. Low fraction O2 for short period of time. D. O2 via non-rebreathing mask. 4. The nurse perform chest percussion and vibrations to Khalid. The purpose of that procedure to: A. Mobilize the mucus adhering to the bronchioles. B. Assess the presence of tactile fremitus. C. Remove respiratory secretions by gravity. D. Reduce pleuritic chest pain. 5. Which of the following factor would the nurse consider as possible cause of HIV: A. Is addicted alcohol. B. Share a flat with an HIV infected friend. 72 | P a g e C. Received unscreened blood transfusion in early adulthood. D. Was In prison for one year. Samera, a 35-year-old obese housewife, is admitted to the hospital as a case of appendicitis scheduled for appendectomy. 6. Which of the following statements should the nurse include in teaching Samera about prevent pulmonary embolism in the postoperative period? A. I will massage your calves frequently. B. You will have to start ambulation as early as possible. C. Although they could be painful, coughing and deep breathing exercise. D. You will have to wear Samera, when she is out of bed. Mr. Rasheed 48-year-old male, is admitted complaining of fever and persistent cough. Diagnostic tests confirmed the diagnosis of Pulmonary Tuberculosis (TB). 9. When collecting sputum for Acid Fast Bacilli from Mr. Rasheed, the nurse should. A. Select a clean disposable container B. Ask the patient to gargle with antiseptic mouthwash. C. Collect the specimen in the early morning D. Discard the first two specimens of sputum and collect the third one. 73 | P a g e 10. Which of the following is an essential criteria before discontinuing airborne isolation for Mr. Rasheed? A. The tuberculin test is negative. B. There are no more pulmonary lesions on chest X-ray. C. Sputum test for acid fast bacilli is negative. D. Mr. Rasheed's temperature has returned to normal. 11. Which of the following techniques should be followed by the nurse when doing Mantoux test (PPD) for Mr. Rasheed? A. Hold the needle and the syringe almost parallel to the client's skin. B. Pinch the skin when inserting the medication. C. Aspirate before injecting the medication. D. Massage the site after injecting the medication. 12. When interpreting the results of Mantoux test, the nurse explains to Mr. Rasheed that the presence of ………. at the test site might indicate a positive reaction. A. Bruises. B. induration C. Redness. D. Edema. 13. Mr. Rasheed was put on isolation. which of the following is inconsistent with tuberculosis isolation Principles? A. Keep the doors closed all the times except for entering or exiting. B. Nurses must wear sterile glove and gown whenever dealing with Mr. Rasheed. 74 | P a g e C. Limit visitors to Mr. Rasheed. D. Limit transport of Mr. Rasheed unless necessary. 14. Mrs. Marlyn, a 47-year-old mother, present to the clinic for routine check- up. The nurses teaching Mrs. Marlyn about Breast Self-Examination (BSE). The nurse will instruct her to A. Do the examination directly before menstruation. B. Examine the breast using up to down lung firm strokes. C. Perform BSE in a sitting position. D. Palpate the breast with the pads of the fingers using small circular motions. 15. The patient is prescribed ‘’Dormicum’’ for insomnia. When you enter the patient room, to get medication dose at night, you found him/her asleep. what should you do A. Do not give the dose and document the patient is sleep. B. leave the medication at the bedside of the patient he/ she wakes up to take it. C. Wake the patient up to take the medication because it is strategies order to must be give. D. None of the above 16. A client is diagnosed with generalized anxiety disorder is placed on buspirone (BuSpar) and clonazepam (Rivotril ) Which client statement indicates teaching has been effective? a) The client verbalizes that the clonazepam is to be used for long term therapy In conjunction with buspirone. b) The client verbalizes that buspirone can cause sedation and should be taken at night. c) could result with the long term use of buspirone. 75 | P a g e d) The client verbalizes that tolerance could result with the long term use of buspirone. 17. What are the 6 High Risk Medications? a) Narcotics and opiates, Concentrated electrolytes, Chemotherapy, Antithrombotic agent, Antidepressants and Neuromuscular blocking agents. b) Narcotics and opiates, concentrated electrolytes, Antipsychotics, Antithrombotic agent, Insulin and Muscular blocking agents. C) Narcotics and opiates, Concentrated electrolytes, Chemotherapy, Antithrombotic agent, Insulin and Muscular blocking agents. d) Narcotics and opiates, Concentrated electrolytes, Chemotherapy, , Antithrombotic agent, anti-psychotic ,and Muscular blocking agents. 18. A staff dispensing the prescribed medication to his patient deliberately DECIDED NOT to give full dose as prescribed. Patient was not injured. What it the most appropriate action if you observed the situation? a) Report the situation as Medication Error. b) Discuss the reason with the staff and advise him not to do so again. c) Informal staff manager and leave it for him to decide the course of action. d) Ignore the case as it didn't cause any physical harm to the patient. 19. The client who has acquired Immunodeficiency syndrome (AIDS) has a nursing diagnosis of disturbance self esteem. When caring for this client, which approach will be the most appropriate for the nurse to use? a) Avoid looking directly at the client. b) Maintain a formal relationship with the client. c) Keep contact with the client at a minimum. d) Listen attentively. 76 | P a g e 20. The client has been diagnosed with a life-changing medical illness. When planning care for this client should give priority to assessing for which of the following? a) Anger. b) Anorexia. c) Apathy. d) Euphoria. 21. A child is being sent home after tonsillectomy. Which foods are indicated for the child to eat? a. Meatloaf and uncooked carrots. b. Potato crisps. c. ice cream. d. Chocolates 22. Which of the following would best ensure proper insulin administration by a 9-year-old boy? a. He observes his parents as they administer his injection. b. He learns how to draw up his insulin but does not inject it. c. He learns how to administer his insulin with supervision. d. He manages his insulin administration independently. 23. A3-year-old boy has been returned to his room following surgery to correct hypospadias in order to prevent separation of incision, which action would be best for the nurse to take? a. Position him in semi-fowler's position. 77 | P a g e b. Elevate the scrotal sac on folded sheepskin. c. Use restraints as needed to keep him from touching the area. d. Clean the area every 2 hours with diluted hydrogen peroxide 24. A 3-year-old boy has Nephrotic syndrome. Which would be the best nursing goal for him? a. Provide analgesia, maintain fluid restriction and promote adequate rest. b. Provide rest, maintain skin integrity, and promote adequate nutritional intake. c. Provide vigorous diverse activities and promote adequate nutritional intake. d. Promote bed rest, maintain fluid restrictions, and provide analgesia. 25. The urinalysis of a toddler diagnosed with Nephrotic syndrome reveals 14 for protein. The nurse interprets this result as indicating which of the following? a. Decrease secretions of aldosterone b. Increased capillary permeability of albumin c. Inhibited tubular re absorption of sodium and water d. Presence of red cells in the urine 26. The stool culture of a child with profuse diarrhea reveals Salmonella enteritis, which of the following statements by the mother indicates effective teaching? a. "Some people become carriers and stay infectious for a long time." b. "After the acute stage passes, the organism is usually not present in the stool c. "Although the organism may be alive indefinitely, in time it will be of no danger to anyone." d. "If my child continuous to have the microorganism in the stool, an antitoxin can help destroy the organism. 78 | P a g e 27. The parents of a four month old infant who has not been circumcised express concern that the infant's penitent foreskin does not retract. The pediatric nurse advises the parents that: a. Circumcision is indicated. b. The foreskin is frequently not retractable until the age of three. c. This condition is potentially unhealthy. d. This condition will interfere with urination. 28. A 13 month old boy is admitted with gastroenteritis with episodes of vomiting and diarrhea for the past 3 days , What intervention should the nurse do to correct dehydration? a. Withhold all fluids and solids by mouth until symptoms subside. b. Allow mother to try and give oral fluids that the child likes. c. Give clear fluids by mouth if tolerated to supplement the IV. d. Allow milk in small but frequent amounts. 29. Dr. Ahmed, 43 years old physician is admitted to male acute ward. He is restless, loud and aggressive. Dr. Ahmed insisted that the staff must introduce him as Dr. Ahmad, the nurse's response should be: a. "I can't do that, it's better if patients don't know you are a doctor." b. "All the patients here are called by their first names." c. "That's fine, Dr. Ahmed, that's how I'll call you." d. "Why do you insist on being called doctor? 30. A 20 month old acutely ill toddler is admitted with sickle cell critics. The child is crying and restless and appear uncomfortable when toughed. Vital signs 79 | P a g e reveal elevated heart rate and temperature of 38°C. Which nursing diagnosis would a nurse expect to see included in the care plan? A. Ineffective airway clearance. B. Acute pain. C. Unbalanced nutrition. D. Risk for impaired parent- child attachment. 31. Which of the following diet plans would be appropriate for the nurse to discuss with family of the child with acute renal failure? A. High carbohydrate and protein. B. High fat and carbohydrate. C. Low fat and protein. D. Low carbohydrate and fat. 32. A 4-year-old with hydrocephalus is scheduled to have a ventriculo- peritoneal shunt in the right side of the head when developing the child's postoperative plan of care, the nurse would expect to place the patient in which the following positions immediately after surgery? a) On the right side with the foot of the bed elevated. b) On the left side with the head of the bed elevated. c) Prone, with the head of the bed elevated. d) Supine with head of the bed flat. 33. Which action best explains the main role of surfactant in the neonate? A. Assists with ciliary maturation in the upper airways. B. Helps maintain a rhythmic breathing pattern. 80 | P a g e C. Promotes clearing mucus from the respiratory track. D. Helps the lung remain expanded after the initial breath. 34. Abdominal palpitation is performed to determine? A. Presentation, engagement, dilation. B. Effacement, engagement, dilation. C. Position, engagement, Presentation. D. Viability, descent, Position. 35. Which of the following topics would be given Priority in the teaching Pain a woman who is attending Childbirth education Classes at 10 weeks of Pregnancy? a. Breastfeeding techniques. b. Relaxation method for labor. c. Management of pregnancy discomforts. d. Routine infant Care measures. 36. The nurse is caring for an Rh negative mother who has delivered an Rh positive child. The doctor told the mother about Rho Gam/Anti D but she stated that she is still confused. Which of the following responses by the nurse is most appropriate? A. Rho Gam/Anti D is given to your child to prevent the development of antibodies. B. Rho Gam/ Anti D is given to your child to the supply the necessary antibodies. C. Rho Gam/ Anti D is given to you to prevent the formation of antibodies. D. Rho Gam/ anti D b given to you to encourage the production of antibodies. 37. A central venous pressure reading directly reflects pressure in the: 81 | P a g e A. Left atrium ( LA ). B. Right atrium ( RA ). C. Left ventricle ( LV ). D. Pulmonary artery( PA ). 38. The nurse advise the client taking lithium carbonate to do. Which of the following to prevent toxic effects of lithium? A. Maintain adequate sodium and water intake. B. Establish a schedule for regular sleep. C. Avoid foods high in thiamine. D. Monitor for increased temperature. 39. Which of the following is the highest priority intervention for the nurse who is working with child : A. Have the child face his or her fear. B. Decrease fear and anxiety. C. Protect the child from fear. D. Allow the child to express fears. 40. What is the midwives priority when assessing a newborn at one hour of age? a. Perfusion of hands and feet. b. Passage of meconium. c. effective thermoregulation. d. Skin integrity. 41. Which one of the below condition correlate with the following information: 82 | P a g e High pH, High HCO3, High BE and neutral PCO2 : A. Respiratory alkalosis. B. Respiratory acidosis. C. Metabolic acidosis. D. Metabolic alkalosis. 42. When ventricular fibrillation occurs on your patient in the telemetry unit, you realize that the treatment would help your patient most is: A. Administration of oxygen. B. Defibrillation as soon as possible. C. Administration of sodium bicarbonate intravenously. D. Lie down in bed on his right side as the pressure would relieve pain. 43. The nurse assess that a client in a state of self- harm. The nurse priority on including which of the following is the plan of care? A. A room that is observable the nurses station. B. Contact that supervision of the client. C. Administration of all medications intra muscularly rather than orally. D. A quiet non-stimulating private room for the client. 44. When working with a client who has dementia, the primary intervention by the nurse is to ensure following: A. Client is offering directly choices to stimulate appetite. B. Client remains in safe and secure environment to prevent injuries. C. Client meet other clients with dementia to prevent social isolation. D. Client discuss feeling of fear and loss to prevent low self esteem and anxiety. 83 | P a g e 45. A colleague notifies you that she has administered an overdose of medication. What is your immediate response : A. Tell her no need to escalate if the patient’s condition is stable. B. Activate emergency code. C. Ensure the patient has come to no harm, asks the midwife to notify a doctor and complete an incidental report. D. Ask her to document clearly the events in the patient notes do not mention the incident to the patient and cause under distress. 46. Your patient progressed well in labor ( Vaginal birth after CS ) and she is now in second stage of labor. she has suddenly stopped contracting and you can’t locate the fetal heart easily, What could have happened: A. Uterine rupture. B. Placental abruption. C. Exhausted uterus, oxytocin needed. D. Change of fetal position with progress of second stage. 47. A laboring woman’s husband assists her during the transitional phase of labor. Which of the following behaviors if exhibited by the husband would require intervention by a nurse : A. Assists the woman to the bathroom when she says she needs to have a bowel movement. B. Gives ice chips to the woman when she says her mouth is dry. C. tells the woman to take deep breaths and tries to comfort the woman when she complains of intense abdominal pain. D. Encourage the woman to fix her gaze on him when she experiences a contraction. 48. A patient receiving lithium is scheduled to have blood levels drawn. At which of the following times would the nurse expect to have the specimen drawn? 84 | P a g e A. Immediately upon waking up. B. 4 hours after dose for the day. C. 12 hours after the last dose of medication. D. 1 hour before the next regularly scheduled dose. 49. If your work involves visiting a client at home ( community case management), you should be do the following EXCEPT: A. Inform your colleagues where and when you are going. B. Have a communication device such as a mobile phone. C. Evaluate client’s home for an escape rate on arrival. D. Go for the visit a lone to provide for privacy and maintain rapport. 50. The patient's last menstrual period began on September 8 and lasted for 6 days , the nurse calculates that her expected date of delivery (EDD) is : A. May 13 B. June 15 C. June 21 D. July 8 51. You have received a term baby after vacuum assisted stimulation due to fatal distress. Bab

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