‫‪M.

H‬‬

‫‪DECEMBER‬‬
‫‪01.12.2019‬‬

‫للملف تحديث يوميا‬

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‫الناس للناس ‪ ........‬ومازالت الدنيا بخير‬ ‫وهل جزاء االحسان اال االحسان‬
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1. Temperature 41 c is ……………Hyperpyrexia
2. When checking rectal temperature how depth thermometer should be inserted
A. 2cm
B. 3.5cm
C. 4cm
D. 4.5

3. Patients with cardiac disease, the nurse should avoided which of the following place when taking temperature
A. Rectal
B. Oral
C. Axillary
D. Tympanic

4. A 15-year-old girl is admitted to the hospital with diarrhea. She has been repeatedly vomiting for now weak and
lethargic. She is oriented to time to questions appropriately. The nurse prepares temperature using an electronic
thermometer. Which measurement would be most appropriate?
A. Oral
B. Rectal
C. Axillary
D. Tympanic
5. Fastest and most sanitary thermometer is :
A. Glass
B. Electronic
C. Chemical
D. Tympanic
Infection control
6. Which of the following is an example of epidemic point source?
A. Tuberculosis
B. Public health agency
C. Contaminated water source
D. Communicable disease pavilion
7. TB epidemic disease Corona virus measles Small pox chicken pox
Airborne Airborne Airborne Airborne Airborne

8. Meningitis Diphtheria Rubella influenza

Droplet Droplet Droplet Droplet
9. RSV.. ‫؟‬Respiratory syncytial virus (RSV) MRSA isolation ?! Ebola virus
Contact Contact contract

Tuberculosis
 TB epidemic disease
 TB. Wear N95 mask
 TB. Test Mantoux test / PPD TEST
 TB TEST WITHIN 48-72 Hours
 Isoniazid for TB side effect numbness , hepatitis symptoms , stomach upset ,rashes
 Tb accurate test sputum culture and to be done early morning

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Meningitis. ...
 Streptococcal pneumonia
 meningococcal vaccine. Hib
 Neck rigidity
 Droplet
 Cloudy CSF
 Lumber puncture
 Surgical mask. No N95 mask
10. A 32 years old man develops chronic productive cough. He has not been feeling hungry and has lost three
kilograms body weight in the past three weeks. On examination of his lung
fields, there was diminished breath sound and widespread crackles. An early
morning sputum culture was sent to the lab.
A. Droplet
B. Contact
C. Airborne
Rationale TB chest XRAY

11. year-old man is diagnosed with tuberculosis (TB) and negative pressure room. Which of the following should
wear a facemask?
A. Patient's health care providers
B. All people who enter the patient's room
C. Person has close contact with the patient
D. Family members who are at risk for infection

12. A nurse working in medical unit is preparing to with droplet precaution measures in place. The following
personal protective equipment; eyewear. What is the correct sequence foe putting the equipment on?
A. Face Mask, Gown, Eyewear, and Gloves
B. Gown, Face Mask, Eyewear, and Gloves
C. Eyewear, Cloves, Face Mask, and Gown
D. Gloves, Gown, Face Mask, and Eyewear

13. A nurse working in medical unit is going out (removing) with droplet precaution measures in place. The following
personal protective equipment; eyewear. What is the correct sequence foe putting the equipment on?
A. Face Mask, Gown, Eyewear, and Gloves
B. Gown, Face Mask, Eyewear, and Gloves
C. Eyewear, Cloves, Face Mask, and Gown
D. Gloves, Eyewear , Gown, , and Face Mask

14. Mr X attended in outpatient clinic with symptoms of shortness of breath, diarrhea and severe respiratory
distress Which of the following is the best diagnosis of Mrs. A case?
A. Corona virus
B. Swine Flue
C. Zika virus
D. Hepatitis

15. A nurse receives a telephone call from the admission office of the hospital and is told that a patient with
streptococcal meningitis will be admitted to the Medical Unit. The nurse is planning to apply infection control
measures for the patient.Which type of isolation precaution the nurse must observe?
A. Droplet precautions
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B. Contact precautions
C. Airborne precautions
D. Standard precautions

16. A 45-year-old patient admitted with pulmonary tuberculosis. The unit nurse placed the patient in an isolation
room with negative air pressure and prepared all the personal protective equipment at the entrance of the
room. What type of precaution measure has the nurse activated?
A. Contact
B. Droplet
C. Airborne
D. Standard

17. To reduce the risk of transmitting methicillin-resistant sta aurous (MRSA) from an infectious wound, which of the
following precautions should be implemented?
A. Airborne
B. Contact
C. Droplet
D. Reverse isolation

18. A 5-year-old child is seen in the primary care clinic with mild fever, headache, and malaise for about 2 days and
today he has a rash filled with fluids. which of the following is the best suggested diagnosis?
A. Chicken pox
B. German measles
C. Measles
D. Scarlet fever

19. three year-old boy present to the pediatric clinic with his mother who complains that the child has developed a
skin rash. There is a clear drainage from the nose and he appears tired. The rash first appeared on the face and
then spread over the trunk and is now beginning to appear over the hands. Some lesions show open ulcerations
and other have crusted over. There are scratch marks over the skin. Which finding would indicate the child is
ready to return to school
A. Normal body temperature
B. Dry and scabbed lesions
C. Nares of free of drainage
D. Absence of rash over trunk

20. patient with measles (rubella) is on airborne precautions. Which of the following precaution techniques would
be essential to implement for non-immune persons entering the room?
A. Gloves
B. Gowns
C. Masks
D. Face shields

21. A home health nurse has entered a home to complete an admission assessment on a patient who has a
methicillin-resistant Staphylococcus aureus (MRSA) urinary tract infection. The patient will receive intravenous
anti-infective via a peripherally inserted central catheter (PICC) for 3 weeks. Which of the following actions
should the nurse take FIRST?
A. Shake the patient’s hand
B. Place the nursing supply bagon a clean, dry surface.
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C. Obtain the patient’s written consent for home health care
D. Perform hand hygiene per the agency protocol

22. You have just admitted a patient with bacterial meningitis to the medical-surgical unit. The patient complains of
a severe headache with photophobia and has a temperature of 102.60 F orally. Which type of isolation should be
suitable for the patient?
A. Air borne
B. Contact
C. Droplet

23. Patient with a colostomy complains of itching of the peris tornal skin. On assessment, the skin is covered in a red
rash with white patches visible. What is the most likely cause of this condition?
A. Not changing the pouch regularly
B. Candidiasis
C. Consuming acid-producing foods
D. Dehydration
24. A 33-year-old woman has come to the outpatient clinic for treatment of a vaginal infection. Physical assessment
reveals yellowish excessive, thin offensive and frothy discharge. Which of the following is the most likely
diagnosis?
A. Candidiasis
B. Trichomoniasis
C. Bacterial vaginosis
D. Chlamydia

25. A 5-year-old child is seen in the primary care clinic with headache, malaise for about 2 days and today he has a
fluids for how long the child should be isolated after formation of?
A. 2 days
B. 6 days
C. 10 days
D. 15 days
Rationale chicken pox

26. A toddler is seen in the Emergency Room with a history of high temperature for 5 days. He had watery eyes and
a cough for the last 3days, and then he developed a rash all over the body which started in his face and spread
down to his body. The mother did not remember the vaccination schedule of her son. For how long the child
should be isolated?
A. 5 days
B. 10 days
C. 15 days
D. 20 days
Rationale Measles

27. The nurse is assessing a 65-year-old patient, who reports the fatigue, weight loss, night sweats, and a productive
cough with thrick sputum The nurse should immediately initiate isolation precautions for which of the following?
A. Influenza
B. Pertussis
C. Bacterial pneumonia
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D. Pulmonary tuberculosis
28. Which of the following diagnostic tests is definitive for TB?
A. Chest x-ray
B. Mantoux test
C. Sputum culture
D. Tuberculin test

29. patient presented with high fever, headache, vomiting and neck stiffness for the past 3 days, which of the
following is the first diagnostic intervention for this patient:
A. Urine and stool analysis
B. lumber puncture with CSF aspiration
C. Complete blood count
D. Chest and abdomen x-ray

Cleft palate and Cleft lip

Age for surgery repair
30. Cleft lip 3 – 6 month after surgery consideration elbow restrain after surgery the infant should not be allow
to cry and the infant not allow to breast feed by sucking . never to put the baby prone position after cleft lip
repair surgery
31. Cleft palate 12 – 18 month position after surgery prone position ,
32. Consideration after cleft lip and cleft palate is :
 Burping the child frequently every 15 minutes
 To prevent cleft lip and cleft palate the pregent woman u should advice:
 Folic acide 400 iu
 Increase green vegetables & Citrus intake
 Feeding up right setting position

Questions
33. A 2-month-old infant with cleft lip is seen in the primary health care to get the regular vaccine of 2 months. The
mother asked proper time for the corrective cleft lip surgery of her infant. Which of following is the best nurse
response?
A. No specific age for repair of cleft lip
B. It is too late, repair should be done immediate after delivery
C. The age of 2 months old is the time for repair
D. The proper time for repair after the age of one year,

34. The nurse have been teaching a new mother how to feed was born with a cleft lip and palate before surgical
repair of Which of the following action from the mother indicate teaching has been successful?
A. burping the baby frequently
B. Prevent the infant from crying
C. Placing the baby flat during feeding
D. Keep the infant prone following feedings

35. Mother came to the Outpatient Department with an infant having cleft and palate. The infant was underweight,
so the nurse has to consider ching the proper way of feeding the child in the treatment plan. Which of the
following is the proper way of feeding
A. Use a non-squeezable bottle during feeding

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B. Feed infant in an upright, sitting position
C. Enlarge nipple holes of bottle to allow more milk to pass through
D. Feed infant longer than 45 minutes to allow more food to be

36. A 40-year-old women is a gravida 2, para 2 and is current conceive. Her previous pregnancy resulted in the birth
of a cleft lip and palate. The patient is anxious and concerned pregnancies and the nurse provides genetic
counseling and Which foods would most effectively prevent recurrence a palate?
A. Green vegetables and citrus fruit
B. Eggs, milk and dairy products
C. Wheat, corn, rice, oats and rye
D. Beef, chicken and yellow vegetables

37. A nurse is caring for a newborn with cleft lip. At which age would the nurse expect the doctor to perform?
A. 3-6 months
B. 6-10 months
C. 11-14 months
D. more than 14 months

38. A 2-day-old newborn is admitted to the nursery. While the nurse is administrating oral feeding, the milk returns
through the child's nose and mouth and the infant become cyanotic. Which of the following condition the
newborn should have?
A. Anorectal malformation
B. Tracheoesophageal fistula
C. Cleft lip and palate
D. Cardiac condition

39. 26- Which of the following vitamin supplements can decrease the incidence of Neural tube defects such as
anencephaly and spina bifida new-borns ?
A. Vitamin A
B. Riboflavin
C. Folic Acid
D. Vitamin K

Thyroidectomy
40. A patient returned to the Surgical Unit from the thyroidectomy. The nurse observed that the arousable. Blood
pressure 90/60 mmHg Heart rate 108 /min What immediate action should the nurse take?
A. Recheck pulse and blood pressure
B. Administer intravenous fluids as ordered
C. Place client in modified Trendelenburg's
D. Assess the back of neck surgical dressing for bleeding

41. Complication of thyroidectomy

A. Distension
B. Bleeding
C. Vocal cord injury

42. progressive enlargement of a multi-nodular go tracheal compression including pain at the site of
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the ear and jaw, difficulty swallowing, change of pf breath by compressing the oesophagus. There is in otherwise the
patient is at risk. What is the preferred treatment?
A. Iodine treatment
B. Thyroid hormone treatment
C. Radioactive iodine treatment
D. Surgical resection of abnormal thyroid

43. A Post thyroidectomy patient transferred to ward and developed tetany the nurse suspected that patient has ?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia

44. A nurse Wayne is aware that a positive Chvostek’s sign indicate

A. Hypocalcemia
B. Hyponatremia
C. Hypokalemia
D. Hypermagnesemia

45. Trousseau’s sign A sign of hypocalcemia. Carpal spasm can be elicited by compressing the brachial artery with a
blood pressure cuff for 3 minutes.

46. Chvostek’s sign A sign of hypocalcemia. A spasm of the facial muscles elicited by tapping the facial nerve just
anterior to the ear

47. Patient is being admitted to the Recovery Room following a thyroidectomy. The back of the neck wound is
covered with dressing. During the first 15 minutes, the patient started working and having diarrhea . A general
assessment is performed with special attention given for the high risk for haemorrhage . Where would bleeding
most likely occur?
A. Stool
B. Vomitus
C. Dressing
D. Back of neck

48. A 29 year-old man is in the Surgical Ward on his first post-ope thyroidectomy. He appears drowsy but the he is
able to respiration by nodding head. He is developing mild dy restlessness. What is the initial recommended goal
of care?
A. Monitor vital signs of thyroid storm
B. Assess for bilateral vocal fold mobility
C. Monitor for swelling on the neck
D. Monitor for vocal cord paralysis

Tonsillectomy

49. 3-year-old child with an elevated body temperature is administered oral aspirin . The nurse records the body
temperature of the child two hours an The American Academy of pediatrics suggests that removal of the tonsils
under certain conditions. Which of the following meets these conditions?
A. times viral tonsillitis per year
B. Infrequent snoring and nasal quality
C. Three times bacterial tonsillitis per year

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‫ ومازالت الدنيا بخير‬........ ‫الناس للناس‬ ‫وهل جزاء االحسان اال االحسان‬
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D. Tonsillitis accompanied by adenoid inflammation

50. 5year-old child is postoperative after tonsillectomy. The nurse should ask the parents to give the child which of
food after discharge from the hospital?
A. Meat and rice
B. Hot dog and potato chips
C. Mashed potatoes and soup
D. Cucumbers and tomato salad

51. The nurse is receiving a child postoperative tonsillectomy. Which of the following nursing assessment is suitable
for the postop care?
A. Encourage the child to cough spontaneously
B. Observe for subtle signs of haemorrhage
C. Place the child in the prone position
D. Suction the mouth to clear the airway Because of violent behaviour

52. The nurse is receiving a child postoperative tonsillectomy. Which of the following nursing action is
suitable for the postoperative care?
A. Encourage the child to cough spontaneously
B. Observe for subtle signs of haemorrhage
C. Place the child in the prone position
D. Suction the mouth to clear the airway Because of violence

53. After tonsillectomy, a child begins to vomit bright red blood .the Initial nursing action is to?

A. Notify the physician

B. Turn the child to the side
C. Maintain an NPO status
D. Administer the prescribed antiemetic

54. The nurse cares for a client who has undergone a tonsillectomy. The nurse is most concerned about which post-
operative finding?
A. Lack of appetite
B. Throat pain
C. Frequent swallowing
D. Nausea

Appendicitis
55. 18-year-old man college student was rushed fainted at the school. He complained of severe quadrant. Upon
palpation, he jerks even with sample was obtained. What is the most likely diagnosis of this patient?
A. Appendicitis
B. Liver Cirrhosis
C. Kidney stones
D. Duodenal ulcer

56. - year-old child was admitted with suspected appendicitis. A nurse was evaluating the child’s condition and the
mother stated that the child did have his bowel movement for the past two days and requested for natives.
What is the risk of giving laxative to patient with appendicitis?
A. Pain

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‫ ومازالت الدنيا بخير‬........ ‫الناس للناس‬ ‫وهل جزاء االحسان اال االحسان‬
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B. Fever
C. Rupture
D. Diarrhea

57. A man is to be discharged from the General appendectomy. The precautionary measures, plans are discussed
with him. What is the most important desired outcome after discharge

A. Remain free of post-surgical complications

B. Report fever, redness or drainage from the wound site
C. Use pain management techniques approp
D. Resume gradual activities and avoid weight

58. A 17 year-old arrived to the Emergency Room complaining abdominal pain on right lower quadrant. Pain was
rated as 9 numeric scale with positive rebound tenderness over the pain
Blood pressure Heart rate Respiratory rate Temperature
120/70 mmHg 95 /min
20 /min 39.2
Which of the following interventions has the highest priority?
A. Keep NPO
B. Secure an IV access
C. Prepareforultrasound
D. Prepare for abdominal surgery

59. The nurse would increase the comfort of the patient with appendicitis by:
A. Having the patient lie prone
B. Flexing the patient's right knee
C. Sitting the patient upright in a chair
D. Turning the patient onto his or her left side

Medication
60. Treatment of nephritic syndrome is corticosteroids

61. Isoniazid for TB side effect numbness , hepatitis symptoms , stomach upset ,rashes

62. A nurse is preparing scheduled medications due at 6 pm. If a doctor orders paracetamol tab 1g QID, and it was
supplied from the pharmacy in 250 mg tablets. Which of the following is the most appropriate nursing actions?
A. Ask the pharmacy to provide 1g tablets
B. Call the doctor to recheck the dosage
C. Give the patient four 250 mg tablets
D. Hold the medication and document in nursing notes

63. 13-year-old patient is admitted for diarrhea and vomiting. He looks pale and lethargic. A nurse is preparing to
give IV hypotonic solution.
Blood pressure 110/70 mmHg
Heart rate 76 /min
Respiratory rate 18 /min
Temperature 36.1°C
Which IV solution is most appropriate?
A. 0.9% saline
B. Lactated ringers
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C. 10% dextrose in water
D. 0.45% sodium chloride

64. A nurse is assigned to care for a group of patient in the medi expected to review the medical records of these
patient. What patient is at risk for excess fluid volume?
A. Patient with ileostomy
B. Patient taking a loop diuretic
C. Patient with chronic renal failure
D. Patient hooked to gastrointestinal

65. physician orders an intravenous fluid of D5NS at 100cc/hr. This is an example of which of the solution?
A. hyper alimentation
B. hypertonic
C. hypotonic
D. isotonic
66. When a patient was first diagnosed with schizophrenia, one of his family members asked the nurse about the
possible causes. The nurse said that one reason is that he may have had an excess secretion of a
neurotransmitter. Which of the following neurotransmitters?
A. serotonin
B. dopamine
C. glutamate

67. The nurse administered a dose of morphine sulfate as prescribed to a patient who is in the post anesthesia care
unit (PACU). The patient appears to be resting comfortably, the respiratory rate is 8 and the O2saturation is 21
oxygen via cannula is 86%. The nurse should IMMEDIATELY administer:
A. Flumazenil(Romazicon)
B. Medazolum(versed)
C. Naloxone (Narcan)
D. Ondansetron (Zofran)

68. Digoxin not given to pàtient who has ?

A. tachycardià
B. hypertension
C. tachypnea
D. bradycardia

69. Atropine is indicated for increase

A. Heart rate
B. Respiratory rate

70. Morphine side effect ?

A. tachycardià
B. hypertension
C. tachypnea
D. bradypnea

71. patient with ongoing magnesium sulfate the nurse should be alert to ?
A. temperature
B. respiratory rate
C. heart rate
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72. Soldier was brought to triage area after being exposed to chemical weapons. Signs and symptoms of nerve gas
exposure were noticed. A nurse prepares for medical management. Which medication should the nurse prepare
for
the patient?
A. Atropine
B. Adrenaline
C. Sodium nitrate
D. Sodium thiosulphate

73. Nitroglycine administration route :

A. Intramuscular
B. Sublingual
C. Subcutaneous
D. Oral
74. A nurse checks the medication chart of a part, which has the following order; Nitroglycerin tab Buccal at stat.
Which of the following medication administration routes should the nurse use?
A. In the ear
B. Intravenous
C. Under the skin
D. Between cheek and gum

75. A nurse is caring for a patient who had Coronary Artery bypass Graft Surgery (CABG) four hours ago. The nurse
notices that the patient has increased confusion and is restless. The patient reports nausea, weakness and
paresthesia in the extremities (see lab results)
Normal Values
Result Test
134-146 mmol/L
145 Sodium
3.5-5.2 mmol/L 6.8 Potassium
2.15-2.62 mmol/L 2.50 Calcium
Which of the following is the best medication?
A. Naloxone (Narcan)
B. Hydralazine (Apresoline)
C. Potassium chloride (KCI)
D. Sodium polystyrene sulfonate (Kayexalate

76. Which of the following statement by the nurse about the clomid as an ovulation inducing drug?
A. Given for the first 15 days in each cycle
B. Maximum dose is 50 mg daily for a month
C. It increases the risk of birth defects
D. It increase the risk of multiple pregnancies

77. Clomiphene citrate (Clomid) is prescribed for a 32-year-old infertility treatment. The nurse should understand
that this medication is used fo following actions?
A. induce ovulation
B. Decrease prolactin level
C. Reduce endometriosis
D. Stimulate the release of Follicle-Stimulating Hormone

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78. A nurse is caring for a client with bipolar disorder, who is receiving Lithium carbonate. Before Administration of
the next dose, the client complains of nausea and vomiting and the nurse finds that the client’s lithium blood
level 1.5mEq/lL. Which of the following actions is considered Apriority?
A. call the client’s physician immediately
B. withhold the next dose.
C. Administer IV fluids
D. Repeat the blood lithium level testing

79. patient was on a regular dose of lithium carbonate. The nurse noticed he has hand tremor, polyuria, diarrhea
and vomiting. What immediate action should be taken by the nurse?
A. Diuretics
B. Withholding lithium
C. Calling the psychiatrist
D. Monitoring serum lithium level

80. A patient was on a course of lithium carbonate drug. During the nurse found that he complained from
nystagmus visual hallucination, and oliguria Which of the following drug related complications best symptoms?
A. Overdose
B. Mild toxicity
C. Severe toxicity
D. Moderate toxicity

81. 49-year-old women presented to the Emergency Department complaint of severe chest pain. The ECG showed
that the patient myocardial infarction. The doctor ordered the nurse to give the 800 mg of aspirin. What is the
primary indication of aspirin in this case?
A. Breaks down the thrombus
B. Decreases the formation of platelet plugs
C. Inhibits the conversion of prothrombine to
D. Interferes with vitamin k to maintain

82. which of the following condition is a Contraindication for a woman oral Contraceptives?
A. Dysmenorrhea
B. Menorrhagia
C. Thrombophlebitis
D. Toxic shock syndrom

83. A patient was on a course of lithium carbonate drug. During the nurse found that he complained from
nystagmus visual hallucination, and oliguria Which of the following drug related complications best symptoms?
A. Overdose
B. Mild toxicity
C. Severe toxicity
D. Moderate toxicity

84. A 45-year-old distressed and restless patient in the Psychiatric Ward was unable to sleep during the nights for
the last two days. He was ordered sleep medication which was to be administered at 10 pm. At the time
medicine administration, the patient was found asleep in bed Which of the following action should the nurse
take regarding the dication?
A. Discard medicine and cancel the order
B. Leave it at the bed side for the patient
C. Wake him up and administer
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D. Hold, record and report

85. 13- nurse is given health education to the parent how to reduce febrile avulsion in the child at home. Which of
the following medication in the safest intervention?
A. Analgesic
B. Antipyretic
C. Antibiotic
D. Antiemetic

86. DR order to give Ofloxacin Otic route the nurse understand that medication will be given :
A. Nasal
B. Eye
C. Ear
D. Sublingual.

87. A home care patient with chronic Obstructive reports an upset stomach. The patient is taking and triamcinolone
acetonide (azmacort). Which of the following counselling should be given
A. Theo-dur on an empty stomach
B. Theo-dur and azmacort at the same time
C. Theo-dur and azmacort 12 hours apart
D. Theo-dur with milk or crackers

88. Which of the following vitamins is necessary for wound healing process?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin K

89. Which of the following vitamin supplements can decrease the incidence of Neural tube defects such as
anencephaly and spina bifida new-borns ?
A. Vitamin A
B. Riboflavin
C. Folic Acid
D. Vitamin K

90. A 78-year-old woman who lives in a long-term care facility has been ving repeated episodes of urinary tract
infections. She is prescribed then amine mandelate one gram to be taken by mouth four times per before meals
and at bedtime. The nurse advises the patient that she need to remove milk from the diet while taking the
medication. What is the primary purpose for this dietary advice?
A. To prevent mal absorption of medication
B. Decrease risk of gastrointestinal upset
C. Reduces effectiveness of medication
D. To make the urine acidic

91. A nurse received the serum digoxin level result for the patient the day and notes that the result is 2.6
ng/mL (see lab result)

Test result normal value

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Digoxin (men) 2.6 0.8-2ng/mL Which of following
nursing actions is the most important?

A. Notify the physician

B. Check previous vital signs of patient
C. Record normal value on nursing note
D. Administer scheduled dose of medication

92. A patient is being admitted in medical unit and has orders for fluid restriction of 1400ml / 24 hours. He is
receiving IV medications in 50ml solutions QID. How much fluid should the caring nurse allocate for cra intake in
24 hours?
A. 400 ml
B. 800 ml
C. 1000 ml
D. 1200 ml

93. nurse is preparing an order of Amydramine 30 mg PO BD. The available check is 15 mg /5 ml. What is the correct
dosage of the medication to be administered?
A. 5 ML
B. 10 ML
C. 15 ML
D. 20 ML

94. A nurse is preparing a medication order of 100 mg IV stat. The available hydrocortisone is 200mg per 5 ml
distilled water for injection. Which of the following is the correct administered?
A. 4.5 ML
B. 3.5 ML
C. 2.5 ML
D. 1.5 ML
95. A nurse is preparing to administer an intravenous infusion of 2000 ml of Ringer's lactate over 12-hours.
The administration set has a chamber that delivers 15 drops per ml. How many drops per minute
should be administered?
A. 14
B. 24
C. 42
D. 56

96. Doctor order to give medication x 300mg and available is 900mg/6ml how many ml the nurse will give
A. 1.2
B. 2
C. 4
D. 6

97. A 56-year-old man was admitted with complaint working for three days. The nurse is preparing to administer
infusion of saline 1000 ml over six hours. What is the hourly infusion rate that the nurse needs to infusion
therapy in mL/hour?
A. 155
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B. 167
C. 190
D. 217

98. Doctor Order: Heparin 10000 units OD S/C Standard Solution 40000 units/ml How many ml would you
administer?
A. 0,25.ml

99. A Physician has ordered clindamycin phosphate 300 mg to be administered intravenously the available stock was
labelled . clindamycin phosphate 900mg mg in 6 ml what is the correct dose to be administered by the nurse ?
A. 2 ml
B. 4 ml
C. 6 ml
D. 8 ml

100. A nurse check the medication chart of a patient, which has the following order; Paracetamol 500mg P.O.
QID. How many times a day should the nurse administer the medication?
A. Once
B. Twice
C. Three times
D. Four times
101. The following syringe contains 2 gm of morphine sulphate, how many grams are there in 1 ml:
A. 0.5 gm
B. 1 gm
C. 2 gm
D. 4 gm

102. The following syringe contains morphine sulphate in a concentration of 2 mg/cc, how much total morphine
this syringe contains:
A. 0.5 mg
B. 1 mg
C. 2mg
D. 4 mg

Administration

103. . During Cardiopulmonary Resuscitation (CPR) for a 75-year-old man in the Emergency Department, the
doctor introduced himself as a leader for the CPR. What is the most appropriate leadership style for this
situation?
A. Autocratic
B. Democratic
C. Bureaucratic
D. Laissez-faire

104. A nurse manager is open minded, listens to the team, understands others, makes changes to improve unit
operations and procedures. What type of leadership style is this?
A. Situational
B. Democratic
C. Compassionate
D. Transformational

105. A nurse manager includes staff in decision-making process what unit structure is used?
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A. Divisional
B. Centralized
C. Functional
D. Decentralized

106. What is the main limitation of democratic style of leadership?

A. it ignores the incompetent personnel
B. cannot be used in emergency situations
C. decreases collaboration among the team
D. may end up in inappropriate decision making

107. A nurse manger is preparing and writing a plan for dealing disasters (code red). Which procedure is the top
priority for the nurse manager the plan?
A. Infection control
B. Staff orientation
C. Patient education
D. Patient relocation

108. nurse manager was not happy about low results of patient’s survey. Which of the following is the first step
for nurse manager?
A. Schedule meeting with staff
B. Start changes to improve
C. Review evaluation details
D. Report to director

109. A 14- nurse manager assigns tasks according to clinical competencies of the nurses.Which of the following is
the management function?
A. Delegating
B. Evaluating
C. Planning
D. Controlling

110. post-operative patient who underwent an abdominal procedure requests a pain medication from the nurse
and rates the pain at a level nine. There a standing order for narcotic administration. When the nurse opera the
narcotic box and performs a count, the number of pills remaining in the box is different than the number of pills
recorded on thesheet. What is the most appropriate initial nursing action?
A. Notify the nursing supervisor
B. Write the finding on the narcotic sheet
C. Administer the patient's requested medication
D. Identify the last nurse who used the narcotic box

111. An 81-year-old bed ridden patient in the Geriatric Ward was pyretic through his nasogastric tube. After an
hour, the patient deep sleep, his breathing pattern changed and he did not rep calling his name. Which of the
following should be the immediate nursing inte
A. Call the physician to examine the patient
B. Check for the correct dosage given
C. Check vitals and inform physician
D. Try to wake up the patient

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112. The nurses in the Male Medical Unit took a signature on the from a patient who needs an abdominal CT
with contrast. What is the best nursing practice?
A. Consent should be taken after the procedure
B. Verbal consent is acceptable for this procedure
C. Consent should be taken from the patient's relatives
D. Consent should be taken according to the organization's

113. In the hospital digital dashboard, what types of data displayed?

A. Staffing
B. Financial
C. Performance
D. Knowledge-based

114. nurse is showing stress and anxiety due to long duty hours. Which of the following should the nurse manager
do?
A. Give day off
B. Give light tasks
C. Offer vacation
D. Talk about coping

115. A newly nursing director assigned to a hospital. That is the first should he do?
A. Evaluates the staff
B. Change the head nurses
C. Change the roles
D. Nothing to do

116. surgeon instructs a nurse to serve as a witness to an elderly patient’s informed consent for surgery. During
the explanations to the patient, it becomes clear that the patient is confused and does not understand the
procedure, but reluctantly sign the consent form. The nurse should:
A. Sign the form as a witness, making a nation that the patient did not appear to understand
B. Not sign the form as a witness and notify the nurse supervisor
C. Not sign the form and answer the patient’s questions after the surgeon leaves he room

117. A community nurse assigned to work in a Makkah, one of the most multicultural cities in Saudi Arab has to
interact with multicultural population every day What is the most important step the nurse should do before
with the clients?
A. Asking the client about his/her cultural background
B. Conducting an appropriate culturological assessment
C. Ensuring that the client has his/her a privacy
D. Looking at the client's file to take history

118. The head nurse meets with staff nurses to discuss ways to improve communication among shifts Which of
the following statement best exemplifies the final stage of conflict management?
A. "We need to clearly define the nature of the conflict”
B. " I will evaluate the outcomes of the strategies used monthly
C. " Let us create a time line for the implementation of our strategies”
D. " I have to force you to follow the rules to resolve the issue”
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119. The head nurse of a Coronary Care Unit delegated the staff a senior nurse in that unit What initial step must
the head nurse implement before?
A. Check the hospital policies for delegating tasks
B. Explain the task to the senior nurse
C. Negotiate with the senior nurse
D. Take the signature of the senior nurse

120. What must be known on legal points of delegation when process to a new nurse?
A. Evaluation of performance of delegate by clients
B. Actual time it takes to complete the task by delegat
C. Institution definition of the job description of
D. Number of times that the delegate has previously task

121. The nursing director wants to evaluate the quality of nursing care at the in-patient areas. The management
team will evaluate on quarterly basis the documentation and the relationship between the patient's length of
stay and the quality of care which of the following is the most important data source to identify the quality of
care?
A. Patient's complaints and time taken to resolve them
B. Patient's satisfaction level at the time of discharge
C. Details of nursing notes for patient's progress

122. The nurse manager received complaints from some nursing to improper work distribution and
discrimination How should the nurse manager handle the situation?
A. Investigate the complaints
B. Individual counselling
C. Identify list of problems
D. Continue to observe

123. which of the following is the most appropriate action for a head nurse starting at a new hospital?
A. Make immediate change at the unit
B. Plan and coordinate new strategies
C. Assess unit activities for at least three months
D. Ask about the previous head nurse managerial style

124. After teaching the deep breathing and coughing who is undergoing a surgery, the nurse asked
Demonstration and then helped him in correcting what part of therapeutic communication is used
A. Evaluation
B. Intervention
C. Identification
D. Demonstration

125. the intensive care unit nurse manager plans to delegates a nurse. What is indicated for a successful
delegation?
A. Nurse Manager supervises nurse.
B. Nurse has authority to change task.
C. Nurse Manager checks task sometimes.
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D. Nurse Manager asks another nurse to check task.

126. The head nurse of a Coronary Care Unit delegated the staff a senior nurse in that unit What initial step must
the head nurse implement before?
A. Check the hospital policies for delegating tasks
B. Explain the task to the senior nurse
C. Negotiate with the senior nurse
D. Take the signature of the senior nurse

127. nurse accidently dropped a medication ampoule, informed the charge nurse, and completed an incident
report form. The charge nurse arranges medication replacement.
Which of the following is the immediate nursing action required?
A. Revise protocol for medication related incidences
B. Allocate senior nurses to medication assignments
C. Provide missed medication dosage to patient first
D. Incident reporting must be given the priority

128. The nursing assistant with 20 years of experience approaches a recently graduated nurse who recently passed
the licensing examination. The nursing assistant states “the only difference between you and me is the size of
our pay checks”. Which of the following is the most appropriate
response for the newly graduated nurse?
A. assert a hierarchical position
B. emphasize the additional education received
C. explain the legal difference in the scope of practice
D. focus on the need to work together for quality client care

129. Nurse manager first days in new hospital will..?

A. introduce plan and strategy to top manager in hospital
B. introduce himself to staff
C. observation for 3 month before begin work

130. patient fall down in hospital where is the nurse documentation?

A. incident report
B. care plan
C. kadex

131. After accessing patients' medical records, which behavior nurse shows that patients confidentiality has been
breached?
A. Reviews patients medical record
B. Read patients care plan
C. Disclosing patients information
Maternity and Child
132. A 12- year- old boy was brought to the Emergency respiratory arrest due to drowning. Cardiac resuscitation
what is the major complication that might happen if treated after drowning quickly?
A. Sepsis
B. Alkalosis
C. Acidosis
D. Hypothermia

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133. A nurse is leading an educational session on the correct use of oral contraceptives. One of the attendees ask
the nurse what to do if she missed taking an oral contraceptive for one day? Which of the
following should be the nurse advice to her?
A. Continue as usual with no back up contraception
B. Take an active pill immediately and take the next pill at the usual time
C. Take two pills as soon as possible and then one pill daily at the usual time
D. Use back up contraception such as a condom for the next 7 days
134. Which of the following represents secondary infertility?
A. Male infertility
B. A couple that does not conceive
C. Infertility that occurs after previous pregnancy
D. Infertility lasts for more than 3 years

135. 15. A pregnant client with organ dysfunction presents with visual changes. 3+ deep tendon reflexes and a
severe headache. At a subsequent follow-up visit the client reports that the symptoms have resolved. What is
the most likely reason for the improvement?
A. Sleeping in a lateral position
B. Consumption of 8 ounces of water per day
C. Exposure to bright lighting
D. Ambulation every 30 minutes

136. A women patient with a body mass index of 35 is admitted to ward. Which of the following nursing
diagnosis, related to Imbalance the most appropriate :
A. Activity intolerance
B. Less than body requirement
C. More than body requirement
D. Deficient knowledge on normal nutrition

137. A nurse is providing health education for a primigravida patient who has gestational diabetes mellitus. Which
of the following statements made by the patient indicates the need for additional education?
A. “I should not do exercises”
B. “I should follow the prescribed diet”
C. “I should monitor my blood glucose”
D. “I should report any sign of infection”

138. Gestational diabetes is high blood sugar (diabetes) that starts or is found during pregnancy. The best time for
glucose screening tests during pregnancy is:
A. 7 – 12 weeks
B. 17 – 18 weeks
C. 24 – 28 weeks
D. 20 – 35 weeks

139. laboring women desires to participate in her cesarean and have pain control. Which of the following
methods would satisfy the women's needs
A. Epidural block
B. Pudendal block
C. Meperidine injection
D. General anesthesia

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140. which of the following statement described the latent phase?
A. First 3 cm of cervical dilatation
B. From onset of labour to full dilatation
C. When the cervix is 100% effaced
D. Time of progress from 4 cm to 7 cm

141. A nurse is performing an assessment of a women who is delivery Which assessment finding would indicates
a need to physician?
A. Hemoglobin of 11.0 g/dl
B. White blood cell count of 12,000
C. Fetal heart rate of 180 beats per minute
D. Maternal pulse rate of 85 beats per minute

142. Amniotic fluid importance . surrounds ,cushion ,protect baby . allow the fetus to move freely ,
maintain body temperature to the fetus , and contain urine from the fetus cushion
143. A 34-weeks-pregnant mother experiences a sudden gush o from her vagina and mild uterine contractions. She
informs about her condition and requests if she could wait until the delivery. Which of the following is the best
desired response for report to the hospital?
A. Intravenous fluids and medicines need to be administer
B. Observation is necessary to identify premature labor
C. Pain and fluid flow both need to be controlled
D. Fetal heart sound monitoring is necessary

144. During A Vaginal Delivery of Woman 38 Years Old the Nurse Should Consider the Risk of Which of The
Following
A. Acute bleeding and coma
B. Low potassium
C. Brain Injury
D. Fetal heart rate

145. Pregnant woman 34 weeks has hypertension this problem is identified as?
A. Hypertension
B. pregnancy induced DM
C. PIH (Pregnancy induced hypertension)
D. placenta Previa

146. A nurse is explaining to the nursing students working on the antepartum unit how to assess edema. Which
edema assessment score indicates edema of the lower extremities, face, hands, and sacral area?
A. +1
B. +2
C. +3
D. +4

147. 38weeks-pregnant woman complains that she has been craving to eat non food substance What is the term
that describes this pregnant mother’s condition?
A. Pica
B. Bulimia
C. Anorexia
D. Binge eating

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148. pregnant client is making her first Antepartum visit. She has a two year old son born at 40 weeks. a 5 year
old daughter born at 38 weeks and 7 year old twin daughters born at 35 weeks. She had a spontaneous abortion
3 years ago at 10 weeks. Using the GTPAL format the nurse should identify that the client is:
A. G4 T3 P2 A1 L4
B. G5 T2 P2 A1 L4
C. G5 T2 P1 A1 L4
D. G4 T3 P1 A1 L4

149. multiparous woman is admitted to postpartum ward after vaginal delivery. Assessment showed, lochia:
steady trickle of bright red blood and ndus: firm.
Blood pressure 110/70 mmHg Heart rate 80
/min Respiratory rate 20 /min Temperature
37.5
Which of the following is the most likely diagnosis/.
A. Endometritis
B. Uterine atony
C. Vulvar hematoma
D. laceration of the genital tract

150. A 7-year-old insulin dependent diabetic mother has delivered normally in 38 gestational weeks. The nurse
was assessing the insulin requirement this mother after delivery. What is the insulin requirement for this
patient?
A. Higher than before pregnancy
B. No changes in insulin requirement
C. Lower than when she was pregnant
D. Slightly increased than before deliver

151. A term baby boy has diagnosed with Down syndrome. Physical examination revealed flattened nose, low set
ears, upward slanting eyes, single palmer crease. Which of the following is the most common congenital
anomaly associated with the this disease?
A. Developmental dysplasia of hip (DDH)
B. Congenital heart disease
C. Hypospadias
D. Pyloric stenosis

152. Mother of nine children, three of them with congenital anomalies and one down syndrome; she is a primary
school graduate, with low financial status. She is not using any method of family planning. Accordingly, the
primary health care nurse has referred her for counseling.
Which of the following is a barrier facing the team responsible for providing health services to handicapped
individuals?
A. Sensory limitations
B. Rigid rules
C. Developmental disabilities
D. Deafness & hearing limitations

153. Mother of nine children, three of them with congenital anomalies and one down syndrome; she is primary
school graduate, with low financial status. She is not using any method of family planning. So, the primary health

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care nurse has referred her for counseling. Which of the following is the best health education method that can
be used?
A. community organization
B. individual counseling
C. group discussion
D. health class

154. When assess newborn wight in scale the nurse must avoid
A. Radiation
B. Evaporation
C. Conduction
D. Convection

155. multiparous patient on day 1 postpartum is asking the nurse to send her baby to the nursery so she can
sleep. What is the most likely phase of psychological adaptation?
A. Taking-in
B. Letting-go
C. Taking-go
D. Letting-in

156. A 65-year-old women visited the gynecological outpatient history reveals that she had 3 pregnancies, one
abortion gestational age, had 2 normal deliveries. She smokes 20 Her complaint is that she wets herself when
she cough embarrassing for her? Which of the following can be considered as risk factors pelvic floor muscles?
A. Chronic coughing
B. Diabetes mellitus
C. Excessive spot
D. Sedentary life style

157. At is the recommended weight gain during pregnancy of a woman with MI of < 18.5?
A. 12.5 -18 Kg
B. 11.5 -16 Kg
C. 7 -11.5 Kg
D. 5- 9 Kg

158. A 25-year-old mother gravid 2 para q came for a routine check Antenatal Clinic. The nurse assessed fetal
heart rate for the 38 pregnant mother. What is the expected normal fetal heart rate per minute?
A. 90
B. 100
C. 140
D. 170

159. A woman has polycystic ovary syndrome which is 3cm in size what should the nurse do?
A. A repeat the ultrasound after menstruation
B. Remove it by laparoscopy.
C. Give the medication
D. None

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160. A 28-year-old pregnant woman at 9 weeks presents to the o with vaginal bleeding. During assessment, the
nurse found height is 12cm. Which of the following is the most likely diagnosis?
A. Placenta previa
B. Abruptio placenta
C. Ectopic pregnancy
D. Hydatidiform mole

161. Nancy, a primipara who is due to deliver next week, calls and tells the nurse she has been having contractions
every four minutes for an hour. Before asking any further questions, the nurse confirms that Nancy knows how
to correctly time contractions, which is
A. from the end of one contraction to the beginning of the next.
B. from the beginning of one contraction to the end of the next.
C. from the end of one contraction to the end of the next.
D. from the beginning of one contraction to the beginning of the next

162. A 22-year-old gravida 2 para 1 with gestational age 38 week admitted to the hospital. The chief complaint is
decreased the fetal non-stress test revealed decreased variability and fetal movement. The next morning as part
of the antenatal the nurse checks the fetal heart rate by Doppler Sonicaid decreased the fetal heart rate to less
than 100 /min. which of the following action the nurse should do first?
A. Reassure the mother that the FHR is Ok
B. Notify immediately the physician or midwife
C. Reposition the patient to left lateral position
D. Ask the mother about the pattern of fetal movement

163. Pregnant patient admission to triage with abdominal pain on assessment the FHR found 70 p/m. what is the
first action for the nurse?
A. Call the doctor
B. Report the finding
C. Put the patient in left lateral position

164. A new-born has a diagnosed Developmental Dysplasia of the Hip (DDH) and is using a Pavlik Harness as
treatment. Which of the following mechanical factors is associated with DDH?
A. Intrauterine breech position
B. Caesarean section
C. Small infant size
D. Single fetus

165. The relative of a 25-year-old post-partum patient stopped her from taking bath until the 40 days provided
with the food by the family that was of saturated fat and a liter of reduced full asking, she said the diet was good
for the milk Which of the following should be the prioritized patient's understanding about?

A. A healthy and balanced diet is beneficial

B. Breast feed is not affected by mother's diet
C. Maintaining personal hygiene is most
D. Rest and relaxation is necessary to regain

166. When the nurse assessed the fundus of a multiparous mother who delivered 2 hours ago, she found the
following Level: 2 cm above the umbilicus. Position: deviated to the right. Consistency: Not well contracted
what is the next nursing action after massaging the fundus until it becomes firm?
A. Assess vital signs
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B. Increase V fluids
C. Evacuate the bladder
D. Ask the mother to rest
Mastitis question
167. Mastitis caused by ...... E.colia Streptococcus, & V aureus

168. A nurse is providing instructions to a mother who has been diagnosed with mastitis. Which of the following
statements if made by the mother indicates a need for further teaching?
A. I need to take antibiotics. And I should begin to feel better in 24-48 hours.
B. I can use analgesics to assist in alleviating some of the discomfort.
C. I need to wear a supportive bra to relieve the discomfort.
D. “I need to stop breastfeeding until this condition resolves.”

169. A primiparous mother who has mastitis is asking the nurse Feeding Which of the following would be the
proper nursing responthe organism of mastitis?
A. It will not affect the newborn
B. It will be deactivated by salivation
C. It will not be expressed in breast milk
D. It will be killed by immunoglobulins in breast milk

170. 41- A nurse is giving health education for a mother who has mastitis.Which of the following if stated by the
mother about what she needs to do, indicate that additional education is needed?
A. Take antibiotics
B. Use analgesics
C. Wear a supportive bra
D. Stop breast-feeding

171. A 23-year-old vaginal delivery primigravida mother was discomfort due to breast engorgement on the
second post The mother complained of pain on the breast site and the able to suck the milk.
Which of the following will relief the mother's discomfort?
A. Breast binder
B. Well-fitting brassiere
C. Encourage breast feeding
D. Lactation suppressing medication

172. The nurse was planning care for a 25-year-old primigravida post-partum mother who had engorgement due
to poor feeding technique. the left breast appeared red and swollen and was diagnosed as Which of the
following is the best education for the mother
A. Avoid wearing brassiere
B. Begin suckling on the right breast
C. Stop pumping milk from the left breast
D. Take antibiotics till the soreness subside

173. After 3 days of breast feeding a post partial patient reports nipple soreness. To relieve her discomfort the
nurse should suggest that she:
A. lubricate her nipples with expressed milk before feeding.
B. dry her nipples with soft towel after feeding.
C. Apply warm compresses to her nipples just before feeding.
D. Apply soap directly to her nipples, and then rinse.

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174. The nurse is teaching a newly delivered mother about breast feeding which of the following statements
indicates that the mother need further teaching?
A. I will empty my breast and use an alternate breast at
B. I will take a daily shower and clean the nipples with
C. I will let my nipples dry after feeding to prevent nipple tenderness
D. I will always wear a supportive wireless bra

175. The nurse is teaching a 32-week pregnant women how to distinguish between pre-labor (false) contractions
and true labor contractions. Which statement about pre-labor contraction is accurate?
A. They are regular and increase gradually
B. They are felt in the abdomen
C. They start at the back and radiate to the abdomen
D. They become more intense during walking

176. Azithromycin is prescribed for an adolescent female who has pneumonia and recurrent chlamydia . What
information is most important for the nurse to provide the
A. Use two forms of contraception while taking this drug
B. Have partners screened for human immunodeficiency
C. Decrease intake of high-fat foods, caffeine, and alcohol
D. Report a sudden onset arthralgia to the healthcare provider

177. A mother, who is planned for the labour induction, is started on intravenous medication. She is in the first
stage of her labour and is having regular and increasingly stronger uterine contractions. Her cervix is 1 cm dilated
for the past few hours; both the mother and the baby are being monitored.
Which of the following signs should alert the midwife?
A. Baby's head not engaged
B. Decreasing heart rate of the baby
C. Mother's blood pressure 110/60 mmHg
D. Mother's perspiration and increased thirst

178. A nurse is teaching a 26-year-old primigravida who are 33 weeks pregnant on the how to use a kick chart.
Which of the following statements will indicate that she understand the nurse's teaching?
A. Fetal movements must be counted three times per day
B. Fetal movements are felt best when the women is on her right side
C. Fetal movements is a reassuring sign which indicates that the fetushealthy
D. The kick chart is used to record fetal movement for the first time during pregnancy

179. Which test should be performed to screen for cervical neoplasia during antenatal assessment?
A. Papanicolau (PAP)
B. Vaginal rectal culture
C. Rapid plasma regain test (PPR)
D. Venereal disease research laboratory test (VDRL)

180. While the nurse is performing postpartum assessment for a primiparous mother delivered 2 hours ago, she
found the following:
Fundus
level: Midway between symphysis pubis and umbilicus
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Position: At the mid line
Consistency: Contracted
Lochia: Constantly
Which of the following is the most likely diagnosis?
A. full bladder
B. Perineal hematoma
C. Birth canal laceration
D. Retained placental part

181. A multipara mother complained of small vulva with swelling following vaginal delivery of a baby weight 3.8
Kg What is the initial nursing action should the nurse advise the mother to perform?
A. Apply ice pack
B. Maintain bed rest
C. Administer analgesics
D. Encourage fluid intake

182. A primigravida mother is assisted out of the bed a few normal vaginal delivery. She is taken to the bathroom
cleaning herself and to pass urine. She has difficulty in commode seat and is having no urge to urinate. Which of
the following intervention is the most desired?
A. Teach kegel's exercises
B. Give warm sits bath first
C. Pour warm water over vulva
D. Identify possible perineal tears

183. A 20-year-old primigravida, who is pregnant at 40 weeks admitted to labor and delivery unit in active labor.
Vaginal revealed that, the fetal occiput is close to the maternal Which of the following ould the nurse expect to
be increase this fetal position?
A. Leg cramps
B. Back discomfort
C. Vaginal bleeding
D. Nausea and vomiting

184. A mother, who is planned for the labor induction, is started on intravenous medication. She is in the first
stage of her labor and is having regular and increasingly stronger uterine contractions Her cervix is1cm dilated
for the past few hours; both the mother and the baby are being monitored. Which of the following signs should
alert the midwife?
A. Baby's head not engaged
B. Decreasing heart rate of the baby
C. Mother's blood pressure 110/60 mmHg
D. Mother's perspiration and increased thirst

185. Molar pregnancy: is an abnormal form of pregnancy in which a non-viable fertilized egg implants in the
uterus and will fail to come to term.

186. Molar pregnancy sings ………. Rapid increase of uterine growth

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187. A women was discharged from gynecological ward after gestational trophoblastic disease (molar pregnancy)
Which of the following is the best advice to give her?
A. Never to fall pregnant again
B. To request the doctor to sterilize her
C. To consider having her uterus removed
D. to avoid falling pregnant for at least one year

188. postpartum mother is to be discharged on the second day of her forceps delivery. She had sutures on her
vaginal and perineum tears. She is breastfeeding her baby and eating thespecial food provided by her family.
what discharge teaching needs more emphasis?
A. Diet management and exercise plan
B. Newborn care and vaccination records
C. Hygiene practices and alert signs to report
D. Family planning and child growth monitoring

189. When performing a postpartum assessment on a women the presence of clots in the lochia. The nurse
examines the that they are larger than 1 cm, Which of the following nursing actions is most appropriate?
A. Document the findings
B. Notify the physician
C. Reassess the client in 2 hours
D. Encourage increased intake of fluids

190. Multiparous mother is attending at the outpatient clinic 2 weeks after er delivery for follow up. While the
nurse is assessing the mother, she would not palpate the fundus. Which of the following is the most appropriate
nursing action?
A. Document normal finding
B. Massage the fundus to be firm
C. Assess lochia amount and color
D. Admit the mother to the hospital

191. Lochia red fleshy odor mean :

A. Normal
B. Infection
C. Bleeding

192. A newborn is delivered by the midwife. The umbilical cord i cut safely by following necessary aseptic
techniques. Furth newborn is to be taken. Which of the following intervention is the most desired?
A. Assess sucking response
B. Increase mother child bonding
C. Assess and record APGAR score
D. Keep dry and maintain thermoregulation

193. The nurse was educating a postpartum woman during discharge about importance of breast feeding. Which
of the following if said by the women, indicates the need for further education?
A. Breast milk is nutritionally balanced
B. Breast milk reduces the risk of infection
C. Breast feeding promotes mother-child bonding
D. Breast feeding prevents pregnancy

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194. 4 weeks of gestation neonate is admitted to the Neonatal Intensive Unit immediately after delivery with
respirator distress syndrome de 1.
hart rate 140 /min
respiratory rate 77 /min
Temperature 36.5
Which of the following method of feeding is recommended to promote with of this premature?
A. Enteral feeding of breast milk
B. Enteral feeding of premature formula
C. Oral breast feeding
D. Oral premature formula

195. Multiparous mother is attending at the outpatient clinic 2 weeks after er delivery for follow up. While the
nurse is assessing the mother, she would not palpate the fundus. Which of the following is the most appropriate
nursing action?
A. Document normal finding
B. Massage the fundus to be firm
C. Assess lochia amount and color
D. Admit the mother to the hospital

196. A women breastfeed her infant one or two hours and her infant cries most of the time and she feels pain in
her breast. Which of the following instructions are appropriate for the nurse to give the mother:
A. Regulate breast feeding every 3 hours
B. That’s normal feeding problem
C. Shift to bottle feeding
D. Start weaning your baby

197. A 17-years-old mother presented to the primary health after delivery. She is suffering from fatigue, anemia,
fever vaginal discharge (see lab results)
81/50 mmHg Blood pressure
98 /min Heart rate
26 /min Respiratory rate
39.6C Temperature
Result Test
4.6 RBC 4.7-6.1 × 1012/L (Male) Normal Values 4.2-5.4 ×1012 /L (Female)
88 Hb 130-170 g/L (Male) 120-160 g/L (Female)
2.50 Calcium 2.15-2.62 mmol/L
Which of the following is considered as the main maternal postpartum haemorrhage complication ?
A. Death
B. Candidacies
C. Cervical cancer
D. Uterine prolapsed

198. A pregnant woman she come to gynocolical word she have vaginal bleeding and no FHS and cervex not
dialted they diagnosis invetable abortion the treatment for this ledy :
A. surgical treatment
B. induction of labor(syntocinon)
C. dialitation and curtage

199. A gravid 8 para 8 women has just delivered a 4.5Kg infant a pregnancy. Which of the following is a possible
complication?
A. Postpartum depression

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B. Maternal hypoglycemia
C. Postpartum hemorrhage
D. Pregnancy-induced hypertension

200. Puerperal sepsis symptoms is ?

A. Temperature of 38c or higher 2 – 10days postpartum

201. A 17-year-old mother presented to the primary health center ten after delivery. She is suffering from fatigue,
anemia, fever and vaginal discharge (see lab results)
Blood pressure 80/50 mmHg
Heart rate 112 /min
Respiratory rate 35 /min
Temperature 39.6 C
Test Result Normal Values
RBC 4 4.7-6.1 × 1012 /L (male) 4.2-5.4 × 1012 /L (female)
Hb 90 130-170 g/L 120-160 g/L (female)
HCT 0.29 0.42-0.52 (male) 0.37-0.48 (female)
WBC 12.8 4.5-10.5 × 109/L
Which of the following is the best diagnosis of health problem in this case?
A. Severe urinary track infiction
B. Vesico-vaginal fistula
C. Puerperal sepsis
D. Post-partum haemorrhage

202. A newborn born by elective caesarian section under general anesthesia ter 28 weeks of pregnancy. His
weight is 850 gm, and he is in (20) th percentile in intrauterine growth chart. He is admitted to Neonatal tensive
Care Unit. Which of the following is the classification of this newborn according to stational age and birth weight
using intrauterine growth chart?
A. He is appropriate for gestational age
B. He is extremely low birth weight
C. He is small for gestational age
D. He is very low birth weight.

203. 32- 5-year-old child was brought to the Emergency Room with a fractured ght forearm. He had several
bruises on his body but showed no signs of ain while palpating them. He seemed scared and did not answer any
questions asked. Why should the nurse discuss this case with the nurse manager?
A. Continuity of care
B. Rule out child abuse
C. Psychological support
D. Fracture management

204. Which of the following would be the proper interpretation by the nurse for a chromosomal analysis showing
46, XY?
A. Normal male
B. Abnormal male
C. Normal female
D. Abnormal female

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205. Which of the following would be the proper interpretation by the nurse for a chromosomal analysis showing
46, XX?
A. Normal male
B. Abnormal male
C. Normal female
D. Abnormal female

206. To measure fatal heat rate fetus daily activity through ?

A. Doppler sound
B. Weighting measures
C. Non-stress test
D. Daily fetus kicks

207. A30week gestational preterm admitted to NICU 2hours ago the neonate starts to have grunting ,nasal flaring
which of the following the nurse recognize regarding signs and symptoms?
A. Neonate has RDS
B. It is normally in the first 24 hours of birth
C. This is not significant unless become cyanosis
D. Neonate has hypoglycaemia

208. A nurse in the Neonatal Intensive Care Unit is caring for premature newborn, is diagnosed with Respiratory
Distress (RDS) and the doctor ordered administrating surfactant Surfactant should be given by which of the
following routes?
A. Intravenous
B. Subcutaneous
C. Intramuscular
D. Endtracheal

209. while a nurse is assessing an infant born 11 hours ago caesarean section, she auscultated moist lung sounds.
Which of the following is the most likely
interpretation?
A. Abnormal finding
B. Normal finding
C. Pneumothorax
D. Surfactant aspiration

210. Lanugo hair is fine hair in preterm baby less than 30weeks

211. Vernix caseosa, also known as vernix, is the waxy or cheese-like white
substance found coating the skin of newborn human babies. It is produced by
dedicated cells and is thought to have some protective roles during fetal
development and for a few hours after birth.

212. Mongolian spots are a type of birthmark caused by the pigment in the skin.

213. newborn has small, whitish, pinpoint spots over the nose, which the nurse
knows are caused by retained sebaceous secretions. When charting this
observation, the nurse identifies it as:
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A. Milia
B. Lanugo
C. Whiteheads
D. Mongolian spots

214. A 25 years old primipara is admitted for labor . the infant is delivered by forceps because of breech
presentation and full body assessment shows alrage blue macular marking over left
buttocks which o the following the most likely cause ?
A. Echymosis
B. Nervus flames
C. Telangiectasia nevi
D. Mongolian spots

215. A nurse is performing physical examination on the new born she notes that the
baby has cephalhetoma this baby is risk to develop which of the following?
A. Sudden death
B. Pathological jaundice
C. Infected umbilical cord
D. Increased intracranial pressure

216. A newborn with hyperbilirubinemia was started on phototherapy What will be the nurse's instruction
regarding feeding?
A. Feed glucose drinks
B. Breastfeed two hourly
C. Bottle feed till the bilirubin level reduce
D. Breastfeed alternatively with bottle feeds

217. Which action a nurse needs to include when caring for a newborn ceiving phototherapy?
A. Expose all surfaces
B. Prevent stimulation
C. Cover the eyes with shield
D. Change position every four hourly

218. A baby born at 35-week was admitted in neonatal intensive 27hours ago, physical examination
revealed yellow discoloration sclera and mucus membrane. The result of bilirubin level every 170mol.
The infant was diagnosed with neonatal jaundice physician order to start single phototherapy. Which
of following should the nurse consider as a priority during phototherapy of this newborn?
A. ensure proper fitting of eye covering (patches)
B. monitor bilirubin levels every 48 hours
C. feed the infant formula every 4 to 5 hours
D. avoid removing the infant from phototherapy

219. A nurse prepares to administer a vitamin K injection to a full term the mother wants to know the
importance of the injection Which of the following is the best nurse response to the mother
A. needed for blood clotting to prevent hemorrhage
B. accelerate the growth and development of infants
C. help in maintain healthy gut and passage of meconium
D. protect the infant from developing sever respiratory distress

220. The nurse determines that a client understands the purpose of a vitamin K injection for her newborn if the
client states that V K is administered for which purpose
A. New born lack vitamin
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B. New born have low blood levels
C. New born lack intestinal bacteria
D. New born cannot produce vitamin k in the liver

221. A nurse is administering a shot of vitamin K to 30 days old infant . which of the following target areaad is the
most appropriate
A. Gluteus maximus
B. Gluteus minimus
C. Vastus lateralis
D. Vastus medialis

222. Term baby boy is admitted to Neonatal Intensive Care Unit. Physical examination revealed flattened nose,
low set ears, upward slanting eyes, gle palmer crease. Which of the following is the possible diagnosis of the
newborn?
A. Cushing syndrome
B. Down syndrome
C. Intra-Uterine Growth Retardation
D. Congenital hypothyroidism

223. A nurse performing nursing care plan for a neonate after a birth, which intervention has the highest nursing
priority neonate?
A. obtained a dextrostix
B. give the initial bath
C. Give the vitamin k injection
D. cover the neonate head with a cap

224. When performing a newborn assessment, the nurse should measure the vital signs in the following
sequence:
A. Pulse, respirations, temperature
B. Temperature, pulse, respirations
C. Respirations, temperature, pulse
D. Respirations, pulse , temperature

225. A nurse is assessing a 2 days old full-term male neon circumcision. She observed that the circumcised area is
re a large amount of fresh blood.
Heart rate 110 /min
Respiratory rate 40 /min
Temperature 36.6 C
Which of the following action should the nurse take?
A. Apply antibiotic ointment on the affected area
B. Give the infant another injection of vitamin K
C. Clean the area with betadine to prevent infection
D. Apply gentle pressure with a sterile gauze

226. A newborn is diagnosed with hypospadias. When teaching the parents of this child, the nurse should tell them
to avoid which of the following before the hypospadias repair?
A. circumcision
B. drinking acidic juices
C. urinary catheterization
D. riding a bicycle
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227. What does the relationship of the site of the presenting part to the location on maternal pelvis refer to ?
A. Fetal lie
B. Fetal position
C. Fetal presentation
D. Fetal attitude

228. A 28 yea- old woman attended gynaecology clinic for conception counselling, the midwife assessed her pelvic
diameter . which type of pelvis is the most favourable for the normal delivery ?
A. Android
B. Gynaecoid
C. Anthropoid
D. Plathypelloid

229. A maternity nurse is performing a newborn assessment thirty minutes after delivery of a baby who did not
receive any prenatal care and has an unknown gestational age. The skin is extensively leathery, cracked and dry
and there is an absence of lanugo and vernix. How many weeks ’gestation is this neonate?
A. <30
B. 30-35
C. 36-40
D. >40

230. While a nurse is assessing the head of a newborn at the first hour after delivery , she observed a soft edema
over the vertex which crosses the suture line. Which of the following would be the proper nurses
interpretation?
A. Cephalohematoma
B. Hydrocephaly
C. Large head
D. Caput succedaneum

231. A mother asked the nurse that while she was changing the diapen for her female newborn, she noticed a brick
red stain on it. What is the best response by the nurse?
A. It is a sign of low iron excretion
B. It is expected in female newborn
C. It is due to medication given to the mother
D. it due to medication given to the newborn

232. woman who is 32 weeks gestation. Her weight was 66 kg last month and today it is 78 kg. Which of the
following is the best nursing action?
A. Assess the size of her fetus
B. Give health education good nutrition.
C. Advise her to exercise and lose some weight.
D. Check her blood pressure and test her urine for protein.

233. A nurse is caring is caring for a day 1 postpartum patient assessment revealed in addition to red lochia with
fleshy odor
Blood pressure 110/70 temperature 38 respiratory rate 20 heart rate 90
Which of the following would be the proper nursing interpretation of these findings ?
A. Normal
B. Infection
C. Dehydration
D. Hemorrhage

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234. A nurse is assessing a4-month-old formula fed infant .the parent reported that the infant was irritable, crying
excessively, not sleeping well, and vomiting, gastro esophageal reflux is expected. What nursing intervention
should the nurse expect to each parent ?
A. Place in an infant seat after eating
B. Give frequent feedings
C. Position the child in a swing
D. Thin formula with water
235. A woman was diagnosed with gestational trophoblastic disease. What is the lab investigation was done to
diagnose the disease condition?
A. cervical pap smear
B. serum HCG levels
C. serum estrogen levels
D. plasma thyroxine levels

236. A primigravid client who is at 14 weeks gestation has been diagnosed with hyperemesis gravidarum. The nurse
explains to the client that the condition is related to high levels of
A. Testosterone
B. Estrogen
C. Aldosterone
D. Progesterone

237. The normal systolic Bp for new Born:-

A. 40-60
B. 60-80
C. 80-100
D. 100-120

238. Neonatal mortality rate :

A. 1:100
B. 1:1000
C. 1:100000
D. 1:1000000

239. New born stomach capacity

A. 6ml
B. 12ml
C. 28ml

Hirschsprung’s Disease :

240. Definition :is a congenital anomaly also known as congenital aganglionosis or aganglionic megacolon. The
disease occurs as the result of an absence of ganglion cells in the rectum and other areas of the affected intestin

241. A nurse is assessing a 6-month-old infant that has retar reduced responsiveness and interaction with the
environment to smile or make eye contact. The nurse notices that the attempt to hold or comfort the crying
infant. What diagnosis should the nurse anticipate?
A. Celiac disease
B. Failure to thrive
C. Cystic fibrosis
D. Growth hormone deficiency

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242. A 3 days old newborn is diagnosed with Hirschsprung disease. The nurse is conducting a physical examination.
Which of the following findings will alert the nurse to suspect this disease in the newborn?

A. palpable sausage-shaped mass

B. cyanosis of fingers and toes
C. failure to pass meconium within 24-48 hours of life
D. weight less than expected for height and age

243. A 9 month old child is diagnosed Hischsprung disease scheduled for surgical operation which of the following
should the nurse understand the purpose for surgical intervention?
A. To remove the aganglion portion of the bowel to relieve obstruction
B. To maintain optimum nutritional status growth the intertinal
C. To stimulate intestinal adaptation with internal feeding
D. To minimize complication related to the disease

244. A 9 month old child is diagnosed with Hirschsprung disease he is scheduled for surgical operation whivh of the
following is thremost common complication expected during this age ?
A. Mechanical obstraction
B. Entro colitis
C. Pleural effusion
D. Esophageal Artesia

245. An 8-month-old infant is admitted with Hirschsprung disease. Which of the following would be a significant
finding in this infant?
A. Depressed anterior fontanel
B. Polyuria, hematuria
C. Weight gain, edema
D. Failure to thrive, constipation

246. The nurse is assessing a 2 -years-old child with Wilms surgery Which of the following should the nurse avoid?
A. Putting the child in lateral position
B. Palpating the child's abdomen
C. Putting the child in a private room
D. Provide mouth hygiene 30 minutes after meal

Intussusceptions

247. 5-month-old boy has been vomiting green colored vomit He has intermittent abdominal pain during which
he draws his chest, turns pale and cries forcefully. On observation, the in the stool which has a jelly-like
consistency. Abdominal pal a long. tube-like mass. There is no fever, rash nor diarrhea are hyperactive in all
quadrants which is the most likely form of initial treatment?
A. Manual manipulation
B. Surgical resection
C. Normal saline enema
D. Laparoscopy

248. A 7-month-old infant seen in the Emergency Department suffering from episodes of severe abdominal pain,
and the infant's stool became like red jelly. Abdominal examination revealed palpable sausage- shaped mass in
the right upper quadrant. Which of the following is the first line of therapeutic management for this infant?
A. Non-surgical hydrostatic reduction
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B. Surgical simple reduction
C. Pyloromyotomy
D. Endorectal pull-Through

249. 7month-old infant seen in the Emergency Department suffering from episodes of severe abdominal pain,
and the infant’s stool become like red jelly. Abdominal examinassions revealed palpable sausage-shaped mass in
the right upper quadrant which of the following is the best diagnosis?
A. Hirschsprung disease
B. Hypertrophic pyloric stenosis
C. Infant colic
D. Intussuception

250. Nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record
and expects to note which sign of this disorder documented?
A. watery diarrhea
B. rib bone-like stools
C. profuse projectile vomiting
D. Red jelly stool

251. 5year-old child was seen to the Emergency Department abdominal pain, palpable sauge-shaped mass, and
Intussusception is suspected Which of the following is the best diagnostic evaluation to?
A. X-ray
B. endoscopy
C. Rectal biopsy
D. Ultrasonograph
Pyloric stenosis
252. A 5-week-old newborn was admitted to pediatric Ward with pyloric stenosis, the newborn has weight loss,
and projectile vomiting during feeding . They scheduled surgical repair of pyloric stenosis Which of the following
postoperative intervention for this
A. IV fluid infant is retaining adequate amount by mouth
B. Administration of proper analgesia until infant discomfort resolve
C. Start feeding immediately after postoperative
D. Vomiting is uncommon in the first24-48 hrs

253. Surgery for pyloric stenosis movement?

A. Pylorotomy
B. Pylorectomy
C. Pylorostomy
D. Pyloromyotomy

254. PYLORIC stenosis peristalsis movement ?

A. From right to left
B. From left to right

255. 1 month-old infant is admitted to the surgical unit with hypertrophic pyloric stenosis and scheduled for the
surgery. Which of the following is the findings of abdominal examination?
A. palpable olive-like mass in the left side
B. palpable olive-like mass in the right side

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C. Palpable olive-like mass moved from left to right
D. Palpable olive-like mass moved from right to left

256. A 7-week-old infant boy is admitted with projectile vomiting decreased urine output, decreased bowel
movements and weight loss. He has poor turgor and appears hungry. The nurse observes left-to right peristaltic
waves after he vomits. The nurse would expect to find which of the following during the physical assessment?
A. Hepato-spleenomegaly
B. A palpable pyloric mass
C. Lymphadenopathy
D. Bulging fontanelles

257. The nurse is assessing a child (an infant ) with pyloric stenosis . which of the following is likely to note?
A. Diarrhea
B. Projectile vomiting
C. Swallowing difficulties
D. Currant jelly like stool

258. tetralogy of Fallot where is it located :

A. right heart side
B. left heart side

259. The Foley Family is caring for their youngest child, Justin, who is suffering from tetralogy of Fallot. Which of
the following positions is
used for congenital heart condition?
A. Semi fowler's position
B. knee chest position
C. prone position

260. A four-year old child is seen in the Emergency Department with a spiral fracture of the left arm . The x-ray
examination showed previously broken healed bones. What is your immediate action?
A. Call social services to immediately arrange foster care for the child
B. Ask the child about the previous accidents and management
C. Report the child abuse to the local authorities
D. Try to establish rapport and trust with the child’s family

261. A 62-year-old women admitted to the emergency department for the fourth time this year, each time the
patient comes with severe injuries and bruises in the body. What is your responsibility as a nurse to prevent
such incident to happen again?
A. Reports the assault to the local police and write a report
B. Provides information about safe shelter and support
C. Instructs the women to move away from her home
D. Discharge the patient to a safe shelter

262. 5-year-old child admitted to the pediatric ward with fracture arm. While assessing the child, the se notices a
bruises in the child's back. This is the third time in 1 month that the parent brings the child to hospital. ich time,
the child family provides vague explanations for various uries. Which of the following e pediatric nurse's priority
intervention?
A. Prevent the parents from visiting the child
B. Question the parents about the child's injury
C. Encourage the child to tell the truth about his injury
D. Report suspicion of abuse the proper hospital authorities
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263. Which of the following instruction should be given to the parents about colostomy care?
A. Use baby powder after stoma cleaning
B. Empty the pouch when it is completely full
C. Avoid tight diapers around the infant abdomen.
D. Use baby wipes to clean the skin around the stoma

264. A 1-year-old girl admitted to pediatric medical unit significant weight loss, diminished mid-arm
circumference diarrhea, and red hair. Which of the following type of malnutrition do the nurse suspect
A. Marasmus
B. Spitting up
C. Kwashiorkor
D. Rickets

265. 33 month-old infant is admitted to the Emergency Department (ED) with fractured arm. The mother
indicated that while the child was crawling fell down the stairs and broke his arm. Which of the following
observation would lead the nurse to suspect that this is a victim of abuse?
A. Age inappropriate injury
B. Pattern and shape of the injury
C. Child is appearing malnourished
D. Improper explanation of the cause of injury

266. A Community Nursing nurse is working with a family in their home The parents complain that their eight
year-old son is "wild" and that he never listens to them. They become upset at his antics to gain attention from
the nurse and send him out of the room. Which of the following responses from the nurse is the most
appropriate?
A. " That was the right thing, it teaches him who is in charge”
B. " Don't worry, he is a boy and with time, he will grow out of this”
C. " Let's talk about how we can teach your child the right behavior and your expectations of him”
D. " You are only reinforcing his behavior when you do that. Try putting him in time out instead”

267. 11- child is admitted to the pediatrics ward with acute lymphocytic LEUKEMIA , and has had joint pain for
several weeks. Physical findings ude widespread ecchymosis, generalized lymphadenopathy,
hepatosplenomegaly, and pallor. Lab work shows a low hemoglobin level, RBC count, low WBC count low
hematocrit , and low platelets. Which high risk is expected?
A. Infection
B. Fractures
C. Dehydration
D. Hepatitis

268. A nurse is teaching a group of new mothers in the post-natal ward on how to manage breast engorgement
after they are discharged to home. Which of the following statements by the mother will indicate to the nurse
that they understood how to prevent engorgement of the breasts?
A. breast feed every 4 hours
B. breast feeding during the day and bottle feeds at night
C. breast feed every 2-3 hours during the day and stop at night
D. breastfeed the baby every 2-3 hours during the day and night
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269. When would the nurse schedule a woman for a glucose tolerance test?
A. 6-10h week of pregnancy
B. 12th-16h week of pregnancy
C. 24th-28 week of pregnancy
D. 32h-36 week of pregnancy

270. Which of the following is the most common site to obtain a capillary blood sample from Neonates?
A. Heel
B. Earlobe
C. Fingertip

271. mother came to the clinic and afraid that her baby maybe will have meningitis as his brother already have
What should the nurse tell the mother?
A. The vaccine is reducing the risk for this decease

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Vaccination

272. How to storage vaccines in ICE

273. 9 month vaccine :

A. MCV4
B. Hepatitis A
C. Hib
D. MMR

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274. 1 year vaccine :
A. Opv
B. Hib
C. DTap
D. Hepatitis A and varicella

275. 18 month vaccine :

A. Rota
B. Hepatitis B
C. Hepatitis A

276. First dose of hepatitis B should be given when ?

A. At birth
B. At 2 month
C. At 6 month
D. At 1 year

277. Measles vaccine administration route

A. Intramuscular
B. Subcutaneous
C. Intradermal
D. Intravenous

278. DTap vaccine administration route

A. Intramuscular
B. Subcutaneous
C. Intradermal
D. Intravenous

279. What of the following disease are prevented by MMR vaccine?

A. Mumps-measles-Scarlet fever
B. Mumps-measles-rotavirus
C. Mumps-measles-rabies
D. Mumps-measles-germen- measles

280. mother brought her 6-month-old healthy infant to the well-baby clinic Which immunization should the nurse
anticipate to administer as per World Health Organization's recommendation?
A. Varicella (Chicken pox)
B. Rotavirus and hepatitis
C. Measles, Mumps, Rubella
D. Diphtheria, Tetanus and pertussis

281. 6month-old boy with hydrocephalus is admitted to the pediatric surgical Ward for ventriculoperitoneal Shunt
(VPS) insertion. Which of the following findings should be of the most concern when assessing the child
postoperative?
A. Sunken fontanelle and irritability
B. decreased head circumference
C. poor feeding and pupillary change
D. headache and excessive sleepiness

282. Dexamethasone ............ accelerates maturation of fetal lung .

283. Hirschsprung disease failure of neonate to pass stool )Meconium ) for 24 hours

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284. Apgar score done at 1 minute and 5 minutes at birth

285. most common cause of diarrhoea in paediatric ........................ virus rotavirus ,

286. Meconium is................. Dark green stool in newborn

287. Less than 24 hours after postpartum calls a nurse in the Mother/Infant Unit. She reports that she has very
heavy bright-red bleeding. being discharged, a mother who is newly What would be the best advice to give her?
A. "Don't worry about it; it is normal."
B. "Call your doctor and ask what to do."
C. "Lie down, massage lower abdomen. If it does not work then come to the hospital
immediately."
D. "Lie down for about an hour. Then check your bleeding, if it is still as heavy, call me back."

288. A 20 weeks pregnant , primary gravid woman visits the antenatal has sickle cell anemia trait and worried this
disease transmitted to her baby which of the following should be initial intervention
A. Plan for the fetal genetic screening
B. Educate mother that her disease is inactive
C. Discuss the chances of genetic disease in the fetus
D. Gather data about the other family members having the disease

289. A pregnant woman of 15 week gestation age and Rh –ve has an abortion admitted in the ward what should
the nurse do for this woman ?
A. Administer Rheum within 72hour
B. Do not give Rheum since it is not used with abortion
C. Do not give Rheum since the pregnancy is more than 12
D. Make certain she received Rheum on her first clinic visit

290. A4 days old baby diagnosed with physiological jaundice . his father is distressed and wants to know why he
have this condition . what the nurse should the nurse tell the about the most prominent physiological jaundice
A. Immature hepatic function
B. Decrease milk intake
C. Rh incompatibility
D. Red blood cell enzyme defects

Spina bifida
291. 26- Which of the following vitamin supplements can decrease the incidence of Neural tube defects such as
anencephaly and spina bifida new-borns ?
A. Vitamin A
B. Riboflavin
C. Folic Acid
D. Vitamin K

292. All of the following are types of spina bifida EXCEPT:

A. Myelomeningocele
B. Hemophilia
C. Meningocele
D. Spina Bifida Occulta

293. While caring for a neonate with a meningococcal, the nurse should avoid positioning the child on the:
A. Abdomen
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B. Left side
C. Right side
D. Back

294. infant is born with spinal bifida Which of the following complication is always found in these Infants?
A. Hydrocephalus
B. Craniosynostosis
C. Meningitis
D. Cerebral palsy

295. On the second day of hospitalization for ventriculoperitoneal shunt revision, a child with spina bifida
developed hives, itching and wheezing. The nurse should determine if the patient has been exposed to:
A. Peanuts
B. Strawberries
C. Eggs
D. Latex

296. Infant with spina bifida the nurse should monitor

A. Head circumference
B. Abdomen cicumfrance

297. Position for the baby with spina bifida is :

A. prone position
B. back
C. supine

298. In determining the one minute APGAR score of a male infant the nurse assesses a heart rate of 120 beats per
minute and respiratory rate of 44 per minute. He has flaccid muscle tone with slight flexion and resistance to
straightening. He has a loud cry with colour is acrocyanotic What is the APGAR score for the infant
A. 7
B. 8
C. 9
D. 10

299. Five minutes post-birth, a neonate has a heart rate of 98, irregular eathing, actively moves all extremities,
but has bluish hands and feet, as ll as a weak and timid cry. Which is the correct APGAR assessment score?
A. 9
B. 8
C. 7
D. 6

300. A nurse documented assessment on a newborn as listed (see

table) Points Indicator less than 98 /min Heart rate 28 /min irregular Respiratory rate Muscle tone
Minimal flexion of the
extremities Reflex irritability Grimace Body pink, extremities blue Colour
What is the total Apgar Sore?
A. 0
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B. 3
C. 5
TPN
301. A 16-year-old girl was found unconscious in her home by her mother. She brought to the hospital by
ambulance. The patient has no previously known medical history. On arrival, the nurse performs an assessment
for Level of consciousness and notes a Glasgow Coma Score of five. The nursenotes the patient's breathe smells
like acetone or fingernail paint remover. What is the priority therapeutic goal?
A. Increase blood glucose
B. Increase serum osmolarity
C. Increase circulatory volume
D. Decrease intracranial pressure

302. patient has a defect with the beta cells of the Islet of Langerhans. Which of the following should the nurse
most likely expect this patient to exhibit?
A. Anemia
B. Appendicitis
C. Cholelithiasis
D. Hyperglycemia

303. The nurse is planning care for several children who were admitted during the shift. Daily weights should be
the plan of care for the child who is receiving:
A. Total parenteral nutrition (TPN)
B. Supplement oxygen
C. Intravenous anti-ineffective
D. Chest physiotherapy

304. A nurse has just started total parenteral nutrition (TPN) as prescribed
for a patient with severe dysphagia low prealbumin levels. In one to two hours, the nurse should anticipate
assessing the patient’s:
A. Blood glucose level
B. Weight
C. Liver
D. Spo2

305. client with type 1 diabetes mellitus is admitted in which medication if found by the nurse in the should be
clarified with the physician?
A. Humalog (lispro) sliding scale before meals
B. Glargine (Lantus) 10 units subcutaneously
C. Metformin (Glucophage) 500 mg per orel
D. Dextrose 50% ampule intravenous push for 50 mg/dL

306. 28-year-old male is recovering from a moderate concussion following a motor vehicle accident 2 weeks ago,
when he suddenly develops an increased thirst, craving Coldwater. The patient urinates very large amount of
dilute, water like urine with specific gravity of 1.001 to 1.005 the patient is MOST likely developing
A. Diabetic mellitus
B. Diabetic insipidus

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C. Hypothyroidism
DIET
307. While planning for discharge education for a mother or rickets, the nurse knows to include the need for an
adequateWhich food should the mother choose for her child?
A. Potato and squash
B. Orange and tomatoes
C. Egg yolk and fish
D. Milk and yogurt

308. year-old woman with inflammatory bowel disease is scheduled to undergo a procedure in which a stoma will
be formed in the right lower quadrant, five centimeters below the waistline. The nurse advises the patient on
how to avoid potential post-operative intestinal obstruction. Which of the following types of food best
recommended post-operatively?
A. Broccoli and fish
B. Meats and cauliflower
C. Yogurt and parsley
D. Corn and seeds
309. A nurse is providing education to a patient who is being discharged after olecystectomy and has been placed
on a low fat diet. Which of the following foods should be avoided by the patient?
A. Canned beans
B. Whole milk
C. Rice
D. Fish

310. The nurse is caring for a patient who has abdominal pain constipation last three days. The nurse teaches the
patient about the most likely ative-producing foods. What are the foods that are mostly useful to relieve
constipation?
A. Cheese, pasta and eggs
B. Rice, eggs, and lean meat
C. Bran(Oats), figs, and prune
D. Cabbage, bananas and apple

311. Discharge teaching for a child with celiac disease would include instructions about avoiding which of the
following?
A. Rice
B. Milk
C. Wheat
D. Chicken

312. 5year-old child is postoperative after tonsillectomy. The nurse should ask the parents to give the child which
of food after discharge from the hospital?
A. Meat and rice
B. Hot dog and potato chips
C. Mashed potatoes and soup
D. Cucumbers and tomato salad

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313. A 40-year-old women is a gravida 2, para 2 and is current conceive. Her previous pregnancy resulted in the
birth of a cleft lip and palate. The patient is anxious and concerned pregnancies and the nurse provides genetic
counseling and Which foods would most effectively prevent recurrence a palate?
A. Green vegetables and citrus fruit
B. Eggs, milk and dairy products
C. Wheat, corn, rice, oats and rye
D. Beef, chicken and yellow vegetables

314. A nurse is caring for a patient diagnosed with abdominal x-ray reveals evidence of pancreatic sign of biliary
disease. What would the nurse most likely instruct the patient
A. Consume a high-protein diet
B. Gradually increase dietary fibre
C. Avoid ingestion of alcoholic beverages
D. Limit activities when the patient is fatigued
315. A 6 year old male is diagnosed with Nephrotic syndrome. When nursing care for the patient the plan of diet
should be?
A. high salt, High fat
B. high salt, High cholesterol
C. low salt, low fat
D. low protein, high

316. 5-year-old child was admitted with Nephrotic Syndrome. A nurse noticed that the child has slight facial
puffiness with mild pitting edema on his hands and feet. there was no distended abdomen Which type of diet
the nurse should order for the child?
A. High protein, high salt diet
B. Low protein, low fibre diet
C. Low protein, normal salt diet
D. Normal protein, low salt diet

317. An Indian patient, who is vegetarian, is being discharged from after an elective surgical procedure. The unit
nurse is teaching using visual aids and pictures about food combinations complete protein. Which of the
following food items should the nurse recommended dietary list of the patient?
A. Lentils
B. Potatoes
C. Macaroni
D. Green salad

318. An adolescent with a juvenile diabetes mellitus develops failure. Which of the following diets is suitable?
A. Low fat
B. Low mineral
C. Low protein
D. Low carbohydrate

319. A 60 years old patient was admitted with hepatic coma in the intensive care unit. The physician has ordered
protein restriction diet for the patient. Which of the following substances is most likely causes harmful
effects when the patient increases protein intake?
A. urea
B. creatinine
C. ammonia
D. amino acid

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320. A 40-year-old women patient with Parkinsonism Medical Ward. The patient stated that she has the past two
weeks. The nurse was planning to Which type of diet is most suitable for parkin?
A. Solid
B. Liquid
C. Semi solid
D. Clear liquid

321. A 68-year-old patient admitted to the Emergency Room with clinical nifestations of pulmonary embolism.
Arterial Blood Gas (ABC) and chest ay were ordered. Which of the following tests is used to diagnose this
condition?
A. Computed Tomography Scan (CT scan)
B. Magnetic Resonance Imaging (MRI)
C. Pulmonary angiography
D. Pulmonary function test

322. 39- A 23-year-old woman presents to the clinic with an intense headache that rates at a level 8 on the 1-10
scale. Additionally, she feels nauseous is sensitive when exposed to bright light. Cerebrospinal fluid samples
sent to the laboratory for analysis and complete blood count. Testing both kerning’s and Brzezinski’s sign are
positive. The patient is admitted the hospital and one hour later she has a seizure. In the period mediately
following the seizure, the nurse stays at the bedside to vide on-going care. Which of the following
assessments has priority at this time?
A. Blood pressure
B. Respiratory drive
C. Pupillary changes
D. Level of consciousness

323. During a night shift a medical doctor complains of back pain and asks the t nurse to give him morphine 5 mg
IM. Which of the following actions indicates professionalism in handing the ation by the nurse?
A. Call another doctor to manage
B. Refer him to Emergency Room
C. Administer morphine to doctor
D. Ask him to write a prescription first

324. d finds that it is still elevated. What is the most likely underlying physiology for the delayed response in
action of the aspirin?
A. High gastric pH
B. Thin epidermis
C. Low muscle tone
D. Short intestines

325. 65-year-old man is undergoing pre-operative preparation fond scope procedure in which the physician will
visualize the large and distal part of the small bowel with a camera attached to the flexible tube. Which of the
following positions is the most appropriate?
A. Left lateral Sim's
B. Right lateral recumbent
C. Trendelenbreg
D. Prone
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326. 60-year-old man is being discharged from the post-operative Care Unit following a transurethral resection of
the prostate. The nurse provides discharge information regarding the care of the bladder catheter. Which
method would be most effective in bladder retraining for this patient?
A. Scheduled urination every 2-3 hours
B. Limit fluid intake before sleeping time
C. Perform pelvic floor exercises daily
D. Increase fluid intake during the daytime

327. The unit nurse conducts initial assessment and observes the dressing is wet and requires change. The
patient looks drowsy with warm skin
(see lab results)
Blood pressure 110/70 mmHg Heart rate 99 /min
Respiratory rate 24 /min Temperature 38.8 C
Test Result Normal Values
RBC 5.5 4.7-6.1 × 1012 /L (male) 4.2-5.4 × 1012 /L (female)
Hb 133 130-170 g/L (male) 120-160 g/L (female)
WBC 25.5 4.5-10.5 × 109 /L
What is the most likely underlying diagnosis?
A. Sepsis
B. Gangrenous tissue
C. Acid base imbalance
D. Hyperthermia secondary to infection

328. nurse is completing the preoperative checklist for one of the patients who ring is wearing a ring. What is the
most appropriate action?
A. Give ring to security office
B. Lock ring with patient's valuables
C. Call patient's family to give them the ring
D. Respect patient's choice and leave ring on patient's finger

329. NA 17-year-old women went to the Emergency Department complaining of fever, sore throat, and
hoarseness of voice. Laboratory tests were done (see lab results).

Test Result Normal values

Hb 120.5 120-158 g/L
HCT 0.39 0.36-0.47 g/L
RBC 4.0 3.8-5.1 × 1022/L
WBC 14.2 4-10.5 × 109/L
Throat culture positive Beta Haemolytic Non found
Streptococcus
Which of the following would be the possible complication for the patient condition?
A. Cellulitis
B. Bacterial cholangitis
C. Infective endocarditis
D. Rheumatic heart disease

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330. A postoperative patient has on order to discontinues the foley 11:30 AM, the nurse removes the Foley
intact. At 1:00 PM, the patient complains of feeling the need to urinate and voids 30 ce. The nurse should assess
the patient for signs of which of the following?
A. Urinary retention
B. Urinary tract infection
C. Cystitis
D. Haematuria
331. A 3-year-old child is admitted to the Medical Ward for vomiting, and dehydration. The nurse sat with the
parents to comply admission interview and wanted to get as much information as Which of the
following communication techniques should the nurse
A. Use of question containing the word "how"
B. Use of question with direct comments to clarify
C. Use of statements that indicate patient will be fine
D. Use of leading question and those involving yes or no

332. An ICU nurse reviews the chart of a 47-year-old man patient mechanical ventilator for a long time. Artorial
blood gas resul see lab results).
Test Result Normal Values
ABG HCO3 24 22-28 mmd/L
ABG PCO3 10.66 4.7-6.0 KPa
PH 7.16 7.36-7.45
ABG PO2 6.13 10.6-14.2 KPa
SA O2 81 95-100 %
What condition the patient is experiencing presently?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

333. To decrease the anxiety of a 10-year-old girl who is undergoing surgery.Which of the following should the
nurse do?
A. Use a heart model to show her how the surgery will go
B. Provide her with verbal explanation of the upcoming surgery
C. Give her a book to read about the surgery 2 weeks prior
D. Let her parents talk to her about the importance of having surgery

334. patient who is admitted denies any medication allergies medical records state, "No known drug allergies." A
medibeen sent to the pharmacy for gentamicin. The pharmacistrecord in the pharmacy of an allergy to the
medication. Which of the following is the best way for the nurse to pro
A. Administer the medication with Benadryl (Diphen
B. Notify the doctor of the allergy and request new orders
C. Investigate further then call the doctor for clar
D. Give the medication as ordered by the physician

335. An 81-year-old bed ridden patient in the Geriatric Ward was pyretic through his nasogastric tube. After an
hour, the patie deep sleep, his breathing pattern changed and he did not rep calling his name. Which of the
following should be the immediate nursing inte
A. Call the physician to examine the patient
B. Check for the correct dosage given
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C. Check vitals and inform physician
D. Try to wake up the patient

336. At the beginning of the afternoon shifts in the receiving handover from a morning shift nurse post coronary
angioplasty. The nurse waveform on the monitor, upon assessment the carotid pulse (see image). What should
be the most appropriate next action?
Give a DC shock
A. Refuse to receive patient
B. Check ventilators settings
C. Shout for help and start chest compression

337. After activating the emergency call system ,what should be the next immediate action ( seeimage ) ?
A. Initiate ventricular pacing
B. Administer a bolus of lidocaine as prescribed
C. Defibrillate the patient
D. Open the patient's airway

338. A nurse enters the room of a patient who is on the patient complains of not feeling well, the (see image).
What is the most likely interpretation?
A. Sinus tachycardia
B. Ventricular fibrillation
C. Normal sinus rhythm
D. Ventricular tachycardia

339. 48-year-old man was admitted to the extensive anterior MI. Duringthe night consciousness. The cardiac
monitor showed VF2 checked carotid and found no pulse. Which is the best emergency management?
A. Cardiac thumb twice
B. Cardioversion, 50 joules
C. Electrical shock, 200 joules
D. Chest compression for five minutes

340. A nurse is caring for a 58-year-old patient

(see lab result).
Test Result Normal Value
Magnesium 2.8 0.7-1.2mmoI/L
Which ECG change is the nurse expected to note?
A. Prolonged QRS
B. Multiple P waves
C. Prominent U waves
D. Depressed ST segment

341. During surgery requiring general anaesthesia, and a carotid pulse is not palpated. How many compressions
per minute should be
A. 50
B. 60
C. 80
D. 100

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342. which of the following indication for patient with MI:-
A. s t depression
B. st elevation
C. short st
D. none of the above

343. 40-year-old man is admitted to a Coronary pain. The ECG has normal sinus rhythm with
leads V1-V4.
Blood pressure 123/69 mmHg
What is the most likely nursing diagnosis?
A. Acute chest pain
B. Myocardial in fraction
C. Decreased cardiac output
D. Ineffective tissue perfusion

344. Which of the following is most appropriate to delegate assistance

A. Insertion of an oral airway
B. Changing postoperative dressing
C. Initial interview on a newly admitted patient
D. Repositioning a patient to side-lying position

345. Which of the following patients the nurse should see first?
A. Patient complaining of muscle aches and fever
B. Patient scheduled for electrocardiography
C. Patient newly diagnosed with hypertension
D. Patient with complaint of chest pain

346. The unit nurse conducts initial assessment and observes the dressing is wet and requires change. The patient
looks drowsy with warm skin
(see lab results)
Blood pressure 110/70 mmHg Heart rate 99 /min
Respiratory rate 24 /min Temperature 38.8 C
Test Result Normal Values
RBC 5.5 4.7-6.1 × 1012 /L (male) 4.2-5.4 × 1012 /L (female)
Hb 133 130-170 g/L (male) 120-160 g/L (female)
WBC 25.5 4.5-10.5 × 109 /L
What is the most likely underlying diagnosis?
A. Sepsis
B. Gangrenous tissue
C. Acid base imbalance
D. Hyperthermia secondary to infection
347. A nurse diagnosis a patient with readiness for the This diagnosis is classified within which of the Nursing
diagnoses?
A. Acute nursing diagnoses
B. Risk nursing diagnoses
C. Wellness nursing diagnoses
D. Possible nursing diagnoses

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348. A man was restless and observed to have an increased physical activity after a heated argument with
another person. After the assessment, the following data was gathered: agitated, diaphoretic, distorted What is
the patient's level of anxiety?
A. Mild
B. Panic
C. Severe
D. Moderate

349. A 70-year-old man underwent a colectomy two days prior. In the past 24 hours, his blood pressure has
decreased and heart rate risen. He now weight two kilograms more than he did prior to admission. Urine output
from the indwelling catheter is 30 ml per hour and he has pitting + bilaterally in the lower extremities. The
abdomen appears distended and is firm to the touch.
Blood pressure 112/62 mmHg
Heart rate 110 /min
Respiratory rate 20 /min
Which of the following is the best nursing intervention?
A. High flow oxygen by mask
B. Position in Trendelenburg
C. Hemoglobin and hematocrit

350. 9-year-old woman patient in the Medical Ward is in a semiconscious .Her pancreatic cancer is metastasized
to her liver and lungs and she admitted for supportive treatment. Her physicians discussed with the ily that she
will not be given the Cardiopulmonary Resuscitation to save life if she goes into the cardiac arrest. Her two sons
agreed but the daughter is indecisive. Which of the following is the critical thinking behind not providing
discounted pulmonary resuscitation?
A. Unilateral judgment of health professionals
B. Refusal of patient’s right to treatment
C. Ethical dilemma and indecisiveness
D. Mercy killing to ease suffering

351. 30-year-old construction worker was stung by roof structure. He then began to complain of feel
An ambulance was called and on arrival, they four the ground and having breathing difficulties. His
The radial pulse is weak and thread.
Blood pressure 92/52 mmHg
Heart rate 118 /min
Respiratory rate 26 /min
Which white blood cell is most likely be elevated?
A. Eosinophils
B. Basophils
C. Monocytes
D. Neutrophils

352. The nurse is preparing to transfer a 55-year-old patient on a the CT-scan unit. The patient is too heavy for the
nurse to transport, nurse went to get an assistive device to transfer the patient. Which of the following transfer
device is the most appropriate for the nurse to use?
A. Board
B. Handle
C. Trapeze
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D. Mechanical lift

353. A newly RN nurse is about to remove a nasogastric tube to a client with Guillan Barre Syndrome. To
determine the proper Time of removing the tube, the nurse should do it when
A. when the client feeling hungry
B. when the client want to remove it
C. when the client totally conscious
D. when the client exit flatulence or gases

354. which type of study design provides the strongest evidence?

A. Qualitative study
B. Randomized control trial
C. Systematic review of descriptive studies
D. Systematic review of correlational studies

355. 28-year-old women is accompanied by her mother to the ward. She is admitted for her affective disorders
with anger recent events and stammering spells. She has panic followed by apathy and listless Ness. How
should the nurse manage the patient?
A. Be supportive and use therapeutic communication
B. Improvise sign language to control forgetfulness
C. Maintain calm environment and avoid argument
D. Anger management and speech therapy

356. A nurse accidently dropped a medication ampoule, informed the charge nurse, and completed an incident
report form. The charge nurse arranges medication replacement. Which of the following is the immediate
nursing action required?
A. Revise protocol for medication related incidences
B. Allocate senior nurses to medication assignments
C. Provide missed medication dosage to patient first
D. Incident reporting must be given the priority

357. 42-year-old woman is brought to the Emergency severe chest pain radiating to the left neck physician
instructs nurses to start the Morphine Aspirin (MONA) protocol. What is the top priority of nursing care?
A. Administer oxygen according to the physician
B. Administer aspirin according to the physician
C. Administer morphine according to the physician
D. Administer nitro-glycerine according to the physician

358. Home Health Care Department is newly established ar a hospital. At launch, nurses asked the charge nurse
about work at this department Which of the following is the first step of home health care?
A. Referral
B. Planning
C. Home visit
D. Assessment

359. The nurse is assessing a child who has Tetralogy of Fallot observed that the child is having clubbing in his
fingernails Which of the flowing might be the reason for this clubbing?

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A. Prolonged tissue hypoxia
B. Delayed physical growth
C. Inactive bone marrow
D. Pulmonary fibrosis

360. A 59-year-old woman is admitted in the Medical ward for pyomyositis in her arms and legs. The muscular
strength Progressively decreased within one year. She has irregular breathing pattern and has difficulty in
swallowing. Which of the following nursing diagnosis requires?
A. Risk of choking due to disturbed swallowing
B. Weakness and fatigue due to lower muscle
C. Disturbed breathing due to chest muscle
D. Disturbed activities of daily living

361. A 9- her of nine children, three of them with congenital anomalies and one n syndrome; she is a primary
school graduate, with low financial us. She is not using any method of family planning. So the primary care nurse
has referred her for counselling. Which of the following must be focused on by the community health care se to
provide an effective health education?
A. Educate regardless realistic objectives
B. Use clear and concise language
C. Use scientific terms during explanation
D. Explain the negative consequences in the family

362. high school girl, who has fears of being obese thin, visited the primary healthcare center with her The
mother reports that her daughter refuses to with the family, and often pretends being a sleep Which of the
following disorders best describe girl?
A. Bulimia
B. Obesity
C. Substance Abuse
D. Anorexia Nervosa

363. An 12-year-old child has been diagnosed with Diabetes insipidus which of the following is disorder?
A. Posterior pituitary
B. Adrenal medulla
C. Anterior pituitary
D. Adrenal cortex

364. the summer months, a five year-old girl presents with a sore throat and a dry cough that has slowly become
worse over the past three weeks. Her body temperature is 38.0oC. On auscultation, there is wheezing and
shortness of breath. She lives in an overcrowded house with three brothers, parents and grandparents in a low-
income neighbourhood where she attends school. Which is the greatest risk factor?
A. Residing in a low-income neighborhood
B. Exposure to a pathogen in summer season
C. Attending school
D. Living in crowded conditions

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365. A patient returns to a clinic for a follow-up visit and is diagnosed as positive for Human Immunodeficiency
Virus (HIV). The patient expresses fear related to lack of finances, fear of social avoidance, and hopelessness.
Which of the following nursing action should
A. Referral to a physician infectious disease specialist
B. Referral to a community-based HIV clinic
C. Referral to the local public health department
D. Recommendation to disclose the diagnosis to family
366. While taking the history from a new patient, the nurse densified that he had hypomanic episode which was
alternating with a mirror depressive\episode for the last two years. what is the most likely diagnosis?
A. Bipolar I disorder
B. Bipolar II disorder
C. Dysthymic disorder
D. Cyclothymic disorder

367. A 62-year-old women admitted to the emergency department for the fourth time this year, each time the
patient comes with sever injuries and bruises in the body. What is your responsibility as a nurse to prevent such
incident to happen again?
A. Reports the assault to the local police and write a report
B. Provides information about safe shelter and support
C. Instructs the women to move away from her home
D. Discharge the patient to a safe shelter

368. Five years old patient was brought to emergency room with several bruises on his body but showed
fractured right forearm. He had no signs of pain while palpating them. He seemed scared and didn't answer any
questions asked. Why should the nurse discuss this manager with the nurse?
A. care continuity
B. abuse role out
C. support psychological
D. management fracture

369. A nurse calls together an interdisciplinary team with members from medicine, social service, the clergy, and
nutritional services to care for a patient with a terminal illness. Which of the following types of care would the
team most likely be providing?
A. Palliative
B. curative
C. respite
D. preventive

370. A nurse is assigned to care for a Muslim female emergency caesarean section. The patient asks the to wear
a head scarf during the surgery. Which of the following is the most appropriate?
A. Ask the patient to remove the scarf
B. Tell the patient that it is ok to wear the scarf
C. Ask the patient to wear a surgical cap
D. Tell the patient that a request will be during the surger

371. A nurse is trying to secure a peripheral V access in a traumatic patient who is deteriorating. The nurse has
two failed attempts What should the nurse do next?
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A. Activate code
B. Use Interosseous needle
C. Consider arterial line
D. Call another nurse who is more exprienced

372. A 70-year-old women with a history of hypertension companies of lack of appetite due to bloating and
constipation. The abdomen is distended and examination shows a positive fluid wave. palpation of the abdomen
confirms guarding and tenderness over the right upper quadrant lower eg edema 3+ and pitting bilaterally are
also present. She has kilograms since her last appointment three weeks before4.5 164/92 mmHg Blood pressure
90 /min Heart rate
26 /min Respiratory rate
37.1C Temperature
92% on room air
Oxygen saturation
What is the most likely underlying health problem?
A. Hepatic congestion
B. Pulmonary hypertension
C. Left-sided ventricle failure
D. Splenomegaly

373. A 70-year-old man presents to the clinic with difficulty sleeping at night. He has not had a good night's rest
for several months and feels exhausted. He needs to place three pillows behind his back in order to sleep.
Examination of the lungs reveals crackles and whee Auscultation of the heart confirms an S gallop. Which of the
following is the most likely underlying health problem?
A. Asthma
B. Pulmonary stenosis
C. Right-sided heart failure
D. Left-sided heart failure

374. During a CPR of an admitted patient in cardiac arrest, a family member tasks the unit nurse to be at the
bedside and say final words to their loved one. The nurse explains to the family member that the scene is very
disturbing and the medical team is doing its job. the family member still insists in witnessing the resuscitation
efforts What would be the most appropriate action by the unit nurse?
A. Allow family member to be at bedside
B. Wait and ask permission from team leader
C. Call security to escort family member out
D. Refuse because there is not enough space in the room

375. A 30-year-old women was admitted with ectopic pregnancy on the sixth gestational week. The patient was
scheduled for resection of the involved fallopian tube with end to end anastomosis Which is the initial nursing
diagnosis for this patient?
A. Grieving
B. Acute pain
C. Hyperthermia
D. Knowledge deficit

376. What is the most appropriate blood product for a patient with hemorrhage due to upper GI bleeding?
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A. Plasma
B. Whole blood
C. packed red cell
D. Serum albumin

377. A new community nurse in the rural clinics has to have good background about the health status of the
community in order to assess their needs What is the appropriate way to assess the health status of the
community?
A. Home visit
B. Community assembly
C. Mass information campaign
D. Community health assessments

378. A 75 year-old bedridden patient is hosp Medical ward for the treatment of her in Area. Her wound is
infected with multiple Longer than normal time to treat. She Crying spells and is talking about death Which of
the following nursing diagnosis must be
A. Health and wellness
B. Coping mechanism
C. Self-perception
D. Belief system

379. a nurse is caring for a child with traction of fractured bone. In the chart, a doctor has placed a reminder to
maintain even and constant traction What would be the most likely understanding of the nurse for this order?
A. Add or remove weights every other day
B. Allow weights to hang free continuously
C. Elevate head and foot of the bed alternatively when in pain
D. Allow weights to hang free every 12 hours to achieve good circulation

380. A patient complains of pain when standing upright hump on the upper back. In the past year slightly shorter.
The doctor has suggested tests to What is the best appropriate intervention?
A. Instruct the patient in the use of prescribed magnesium supplements
B. Have the patient sleep propped on two pain
C. Prepare the patient for a CT scan of both hip
D. Instruct the patient in the use of vitamins

381. A 56-year-old patient was diagnosed with instructions about administration of insulin Regular Insulin and
Neutral Protamine Hagedo subcutaneously every morning?Which of the following is right period for(in minutes)
after administration?
A. 10-15
B. 30-60
C. 60-90
D. 240-360

382. In a post-operative patient in the Surgical Unit most indicative of a developing complication? ,
A. Increasing alertness
B. Weak and rapid pulse
C. Negative Homans' sign
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D. Minimal bowel sounds in four quadrants

383. A mother in the postnatal Ward is being provided with the her family and she has been instructed to be on
the bed members believe that the diet with the specific home increase the milk production and will promote her
healing Which of the following intervention is the most desired?
A. Respect the cultural believes and encourage activities
B. Teach and monitor for correct breast feeding practices
C. Discuss dietary plan and monitor weight gain
D. Explain post-partum care and follow ups

384. A child was admitted to the hospital three hours ago with a injury. The child responds appropriately, but
sluggishly to drifts in and out of sleep Which of the following best describes this patient's level of?
A. Lethargic
B. Obtunded
C. Comatose
D. Semi-comatose

385. A nurse is planning to discharge a known HIV, a the Isolation Unit after the recovery from upper, Which of
the following nursing problem requires?
A. Risk of infection due to altered immune
B. Fluid volume deficit due to frequent diarrhoea
C. Anxiety due to disease, fear and social
D. Weight loss due to higher metabolism rate

386. An elderly patient who has an aortic aneurysm Intensive Care Unit to a Medical Surgical Unit on day. While
assessing the client, a nurse notes extremity and is unable to palpate the pedal pulse Which intervention should
the nurse implement?
A. Wrap the lower extremities with warm
B. Use a Doppler ultrasound to reassess the
C. Elevate the extremities above heart level
D. Place a bed cradle over the bed to levitate

387. A 60-year-old man client had a permanent complains of chest pain and dyspnea with rapid feels suffocated
and appears restless
100/70 mmHg Blood pressure
96 /min Heart rate
32 /min Respiratory rate
37.2C Temperature
What is the immediate nursing intervention?
A. Monitor and report findings of chest
B. Chest X-ray to identify dislocation of
C. Manage pain with medication as ordered
D. Administer oxygen as ordered

388. A 28-year-old man and his wife involved in which his wife was killed. The client is being Care Unit for
multiple rib fractures and a broken which room his wife is located. Which of the following is the most
appropriate?
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A. "Your wife is not in the hospital"
B. " I'm sorry, but your wife did not survive the
C. "I need to get your family so that you can wife”
D. " The doctor will be talking to you about located”

389. A nurse is preparing a sterile field prior the Which of the following procedures illustrates the nurse to the
principles of aseptic technique?
A. Touch the outer 2-inch border of the sterile gloves
B. Place the sterile linen-wrapped package on waist level
C. Hold the bottle lip 1-2 inches above sterile pouring the solution
D. Open sterile item while holding outside hand then throw object onto sterile field

390. Which of the following is the appropriate nursing advice to mother complaining of epigastric burning
sensation and do use of drugs?
A. Chewing gums
B. Increase fluids at bedtime
C. Drink orange juice on getting up
D. Eat small meals every 2 to 3 hours

391. A nurse is caring for a 72-year-old man patient , is unsteady. The patient requests the nurse to help nurse
asked the patient to wait few minutes device to transfer him. Which of the following transfer devices is the
nurse to use?
A. Belt
B. Board
C. Handle
D. Mechanical lift

392. 62 year-old female patient is admitted for her left eye cataract removal. She has cataract in both eyes with
no visibility in her left sys. She is scheduled for the surgery .What essential safety precautions must be assessed
preoperatively?
A. Assess and document visual acuity of both eyes
B. Knowledge to prevent eye injury after Surgery
C. Cleanliness of eye and removal of eyeglasses

393. A nurse is providing postpartum care for a GSP4 mother who had a rapid labor of an infant weighing 4000
gm. Assessment revealed a boggy uterus, heavy lochia and stable vital signs. After fundal massage and bladder
evacuation. the fundus remains soft. which of the following is the most appropriate next nursing action?
A. Inform the physician ..
B. Reassess the vital signs
C. Continue fundal massage
D. Take venous blood sample

394. A 46-year-old man is presented to Emergency Room with severe chest and unstable angina. The ECG of the
patient shows ST segment pression on his 12-lead. e rhythm strip example of specific ECG changes
(see image). Which of the following cases the nurse determines ST segment depression?
A. Injury
B. Necrosis
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C. Ischemia
D. Nothing significant

395. A 35 year-old man with pulmonary edema is admitted to the Intensive re unit. He is on a Mechanical
Ventilator(MV) without sedation. After the cient is placed on the MV, the nurse diagnosed the case as impaired
communication related to intubation and MV. What is the best method for the nurse to communicate with the
patient?
A. Use normal verbal communication
B. Communicate with the patient after MV removal
C. Use non-verbal communication, such as head-nodding and writing

396. The nurse observes the client csf ,Which of the following of csf color indication for patient with bacterial
meningitis?
A. Cloudy
B. Clear
C. Red
D. Brown

397. Elsa Santos is a 18 year old student admitted to the ward with a diagnosis of epilepsy. She tells the nurse
that she is experiencing a generalized tingling sensation and “smells roses”. The nurse understands that Esla is
probably experiencing:
A. An olfactory hallucination
B. An acute CVA
C. An aura
D. An acute alcohol withdrawal

398. child has a third- degree burns of the hand, chest, face, which nursing diagnosing takes priority?
A. Ineffective airway clearance
B. disturbed body image
C. impaired urinary eliminations
D. risk for infection

399. A woman has polycystic ovary syndrome which is 3cm in size what should the nurse do?
A. A repeat the ultrasound after menstruation
B. Remove it by laparoscopy.
C. Give the medication
D. None

400. A home health nurse has entered a home to complete an admission assessment on a patient who has a
methicillin-resistant Staphylococcus aureus (MRSA) urinary tract infection. The patient will receive intravenous
anti-infective via a peripherally inserted central catheter (PICC) for 3 weeks. Which of the following actions
should the nurse take FIRST?
A. Shake the patient’s hand
B. Place the nursing supply bagon a clean, dry surface.
C. Obtain the patient’s written consent for home health care
D. Perform hand hygiene per the agency protocol

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401. Which of the following patient is the most appropriate to delegate to a new nurse?
A. Patient on a strict bed rest
B. Patient for discharge teaching
C. Patient scheduled for an operation
D. Patient who is hooked to mechanical ventilation

402. An 8-year-old girl is seen in the Emergency Department because of a fracture in the right fibula and she has a
fiberglass cast on her leg instead of a plaster cast. Which of the following is an advantage to use a fiberglass
cast?
A. Cheaper
B. Dries rapidly
C. Smooth external
D. Shape closely to body parts

403. 62 year-old female patient is admitted for her left eye cataract removal. She has cataract in both eyes with
no visibility in her left sys. She is scheduled for the surgery .What essential safety precautions must be assessed
preoperatively?
A. Assess and document visual acuity of both eyes
B. Knowledge to prevent eye injury after Surgery
C. Cleanliness of eye and removal of eyeglasses

404. A newly graduated nurse is inserting an intravenous cannula into the mid-cephalic vein of a patient who is
being admitted to the unit. As she withdraws the needle, a nurse calls out for help from another patient’s room.
The new nurse rushes to help. She secured the intravenous catheter and threw the needle into the waste basket
instead of the sharp’s container. When asked who had thrown the needle into the bin, the new nurse admits
that she had made that mistake. Which professional act best describes the newly graduated nurse’s response?
A. Responsibility
B. Accountability
C. Assertiveness
D. Leadership

405. A 50-year-old man presents to the Emergency Department after having suffered a fall while practicing
mountain biking. He appears confused and disoriented. His friend reports that he had been thrown over the
handle bars and hit his head against a rock
Blood pressure 108/66 mmHg
Heart rate 102 /min
Respiratory rate 22 /min
Temperature 37.2 C
Oxygen saturation 99% room air
Which initial intervention is the most important?
A. Intravenous infusion
B. Oxygen administration
C. cervical immobilization
D. Trendelenburg position

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406. A 24-weeks-pregnant mother is in the Antenatal Clinic. She is upset and crying about having her third baby
girl as her family wants a boy. She is requesting an abortion immediately before her family finds out about the
sex of the baby. Which of the following is the most appropriate plan for the mother?
A. Calm her down and reassure for an appropriate solution
B. Provide moral support and book her for procedure
C. Repeat ultrasound and wait for a few more weeks
D. Family counselling and follow religious guidance

407. A post-operative nurse assesses the newly formed stoma and skin of a patient who is one day post-
operative following a proctocolectomy with the formation of a permanent ileostomy. Which of the following
clinical findings would necessities immediate care
A. Bright red and moist stoma
B. Dark red and purple skin
C. Bloody liquid in pouch
D. Ulcerations with a rash

408. A 45-year-old man is admitted to the Surgical Ward for stoma care. The stoma appears a dark red to purple
colour, is slightly swollen and leaks a scant amount blood. There is no presence of stool around or on the site.
Which observation requires immediate attention?
A. Colour
B. Edema
C. Absence of stool

409. A nurse is taking care of a patient who underwent abdominal surgery three days ago. The patient has not
been able to breathe deeply and uses to get out of bed since the surgery due to pain. Also, the patient nplains of
shortness of breath, and the lung sounds are diminished on auscultation.
Blood pressure 120/70 mmHg
Heart rate 75 /min
Respiratory rate 22 /min
Temperature 36.4 ℃
Oxygen saturation 89%
Which of the following conditions should the nurse suspect?
A. Sepsis
B. Atelectasis
C. Congestive heart failure
D. Emphysema

410. What do the standards of pain management dictate nurse do?

A. Avoid the use of the word "pain"
B. Screen for pain at each encounter
C. Discourage around-the-clock dosage of analgesics
D. Administer analgesics via injection whenever possible

411. A nurse is planning post-operative teaching for a patient undergone left partial mastectomy. On the third
post-operative day, the nurse teaches the patient to elevate the arm above the heart several times per day.
What does this exercise reduce?
A. Pain
B. Infection
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C. Hematoma
D. Lymphedema

412. 33-year-old patient in her 13th week of pregnancy has come for her routine gynaecological Appointment.
According to the ultrasound, her fetus is a female. She already has three daughters but her family wants the
male child, so she asked the nurse guidance to terminate her pregnancy. The Nurse explained that baby's
gender is determined by the father. She later involved her husband in the Discharge planning and finally helped
the father agree to continue the mother's pregnancy. What professional obligation is fulfilled through the
nursing implementation?
A. Influenced decision making
B. Incident prevention beforehand
C. Empathetic leadership approach
D. Sympathetic knowledge sharing

413. conscious victim of a motor vehicle accident arrives at the emergency department. The patient is Gasping for
air, is extremely anxious, and has a deviated trachea. What diagnosis should the nurse Anticipate?
A. pleural effusion.
B. tension pneumothorax
C. pneumothorax
D. cardiac tamponed

414. A nurse calls together an interdisciplinary team with members from medicine, social service, the clergy, and
nutritional services to care for a patient with a terminal illness. Which of the following types of care would the
team most likely be providing?
A. Palliative
B. curative
C. respite
D. preventive

415. A 46-year-old patient is admitted in the Female back pain which is graded 6 on the scale of10 with the slight
elevation in her blood pressure. The eat lunch which is a low sodium diet documented that patient is
uncooperative and lunch. What can be assessed by the nursing document patient?
A. Subjective judgement of patient's statement
B. Misunderstanding of patient's attitude
C. Understatement of communication
D. Unethical evaluation of reality

416. The nurse is assigned to care for several patients, who should be assessed first by the nurse?
A. A diabetic patient who will be discharged
B. A patient with rheumatoid arthritis who has
C. An asthmatic patient who is due for
D. A patient with surgical incision who require
417. While administering medications, the nurse gives an anti-hypertension medication to the wrong patient (see
table)
A Document the entire scenario
B Document vital signs
C Notify doctor
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D Notify doctor if blood pressure is below 90/50 mmH
E Induce vomiting
F Administer antidote
G Monitor the patient
What sequence should the nurse follow?
A. A, D, F, G
B. B, C, G, A
C. B, D, E, F
D. B, E, F, G

418. 9-year-old child is admitted to pediatric word diagnosed with Glomerulonephritis (AGN). The mother ask the
nurse why you the blood pressure frequently which of the following the nurse should be respond based on
knowledge.
A. Acute hypertension must be anticipated and identified
B. Hypotension leading to sudden shock
C. Blood pressure fluctuations are a common side effect of therapy
D. Blood pressure fluctuation are a sign that the condition has become chronic

419. Which of the following terms applis to the tiny. blanched. slightly raised end arterioles found on the face.
neck. arms. and chest during pregnancy?
A. Epulis
B. Linea nigra
C. Striae gravidarum
D. Telangiectasias

420. Nurse manager prepares unit clinical operational plan What is top priority in the plan?
A. Infection control
B. Staff orientation
C. Quality projects
D. Safe patient care

421. A client presents with Hypocalcemia, hyperphosphatemia, muscle cramps, and positive Trousseau's sign.
What diagnosis does this support?
A. Diabetes insipidus
B. Conn's syndrome
C. Hypoparathyroidism
D. Acromegaly

422. A patient teath brush &bathing shoud be write in:

A. daily care activity
B. medication chart
423. Doctor during new born assessment he toush the bed by the sterile gloves the nurse shoud:-
A. let him complet the cvl then take to him
B. stop him and tell him remove the gloves and give new gloves

424. During skin assessment of a patient the nurse observed a skin

described as round solid mass beneath the skin (see image).
Which of the following terms is best to describe the lesion?
A. Cyst
B. Papule
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C. Pastule
D. Blister

425. A patient who has pain localized in the chest, now down the left arm. What is this type of pain called?
A. Phantom
B. Regimented
C. Shooting
D. Radiating

426. The nurse is preparing a patient for an insertion of a central venous pressure line into a neck vein .The nurse
should place the patient into which position?
A. Side-lying position
B. Fowler's position
C. Trendelenburg position
D. Semi-Fowler's position

427. Neonate is admitted to the neonatal intensive care unit for observation with a diagnosis of probable
meconium aspiration syndrome (MAS) the neonate weight 4.650 grams and is at 40 weeks gestation which of
the following would be the priority problem
A. Impaired skin integrity
B. Hyperglycaemia
C. Risk for impaired parent infant child attachment
D. Impaired gas exchange

428. Which action a nurse needs to include when caring for a newborn ceiving phototherapy?
A. Expose all surfaces
B. Prevent stimulation
C. Cover the eyes with shield
D. Change position every four hourly

429. Patient with ongoing potassium infusion he has burning sensation ant the site of infusion what should the
nurse do first
A. Stop infusion
B. Document as normal finding
C. Slow rate and call the doctor
D. Inform the doctor

430. Treating pregnant women diagnosed with syphilis is considered

A. Primary level of prevention
B. Secondary level of prevention
C. Tertiary level of prevention
D. Primary and secondary

431. A women breastfeed her infant one or two hours and her infant cries most of the time and she feels pain in
her breast. Which of the following instructions are appropriate for the nurse to give the mother:
A. Regulate breast feeding every 3 hours
B. That’s normal feeding problem
C. Shift to bottle feeding
D. Start weaning your baby

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432. A 7-year-old child is admitted to the Emergency Department, injury The child is oriented to the place, person
and time spontaneously obeys commands. The nurse is doing aped Coma Scale (PGCS). Which of the following
score the nurse should record?
A. 3
B. 8
C. 12
D. 15

433. Brachial artery t check pulse in infants

434. Prolactin Hormone promote Milk production

435. TB test Mantoux / PPD test result within 48-72Hours accurate test is sputum culture

436. Umbilical Cord one big vein& Two small arteries

437. Pulse deficit is the different between apical beats and brachial pulse
438. Rligion that prohibits blood transfusion Jehovah

439. Spina pifida position Prone position

440. Sound lung in heart failure .crackes

441. Postion after hemorroidectomy ?...........................antriolatral postion

The left anterolateral position is an excellent alternative for hemorrhoidectomy under local anesthesia. The pain
over the pubis and the low backache, frequently encountered in the prone position, are totally eliminated. Exposure
of the operative fields is excellent.

442. Post Vitrect-omy position …Prone

443. Ear Drops in infant down and back , in Adult up and back

444. Ear drops in adult up and back , in infant down and bak
445. Hyperpyrexia above 40C

446. Alzheimer deficiency in serotonin

447. Abdominal assessment. 1. Inspection 2. Auscultation 3. Percussion 4.palpation........ very important

448. During new born assessment the nurse found extra finger in the new born hand
Polydactyl

449. During new born assessment the nurse found two digits are fused together
Syndactyly

450. when we should stop magnesium sulphate ( Respiratory Depression, Hypotension , Bradycardia deep
tendon Reflex )
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451. Antidote of magnesium sulphate is ( calcium gluconate )

452. Morphine antidote is naloxone / narcan

453. Hydrocephalus signs ( Bulging anterior fontanel & increase head circumference )

454. Naloxone - Digioxin should not be given if heart rate less than 60 or bradycardia

455. OPV oral polio vaccine ..... mixed of live attenuated polovirus

456. Postpartum perineal assessment acronym is REEDA ( Redness-Edema-Ecchymosis-Discharge-Approximation

457. When taking a BP, select the appropriate cuff size; a cuff that is too small will yield a falsely high reading, and
a cuff that is too large will yield a falsely low one.

458. Complication of diabetic mother hypoglycaemic and macrocosmic

459. OPV vaccine is live attenuated virus (poliovirus) vacine

460. Patient with BP230/180 is consider Hypertensive Crisis

461. A newly assigned nurse to the home health care department was conducting pre-entry phase of home visit.
Which of the following activities should the nurse do
A. Call physician for a referral order
B. Collect information and schedule visit
C. Establish mutually acceptable goals for care
D. Conduct a health history and physical assessment

462. A mother brought her 6-month-old healthy infant to the well-baby clinic which immunization should the
nurse anticipate to administer as per WHO recommendation?
A. Varicella (chicken pox)
B. Rotavirus and hepatitis
C. Measles , Mumps , Rubella
D. Diphtheria , Tetanus , pertussis

463. The nurse is teaching a 32-week pregnant women how to distinguish between pre labor (false ) contraction
and true labor contractions. Which statement about pre labor contractions accurate ?
A. they are regular and increase gradually
B. they are felt in the abdomen
C. they start at the back and radiate to the abdomen
D. they become more intense during walking

464. A 62-year-old women admitted to the emergency department for the fourth time this year, each time the
patient comes with sever injuries and bruises in the body. What is your responsibility as a nurse to prevent such
incident to happen again?
A. Reports the assault to the local police and write a report
B. Provides information about safe shelter and support
C. Instructs the women to move away from her home
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D. Discharge the patient to a safe shelter

465. A 3 years old child is admitted to the hospital with seizures. He was alert, oriented and has a rash in his
extremities and is diagnosed with meningitis. While doing physical examination of him, he starts to develop
seizures.
Blood pressure 100/57 mmHg
Heart rate 110/min
Respiratory rate 30/min Temperature 39.5 C
Which of the following vaccine is used to prevent meningitis?
A. hib vaccine
B. varicella vaccine
C. BCG vaccine
D. Rubella vaccine

466. After receiving multiple mosquito bites and experiencing flu-like symptoms, a patient consults a nurse at a
clinic and asks whether an appointment to see a health-care provider is necessary. which of the following
statements should be the basis for the nurse'sresponse
A. antiviral medications can be prescribed to destroy virus
B. Clinical signs can be mild flu-like symptoms to fatal encephalitis
C. If patient has West Nile virus, symptoms will progressively worsen
D. If patient used insect repellent, virus would have been destroyed when mosquito made skin
contact

467. A male client has received a prescription for orlistat for weight and nutrition management. In addition to the
medication, client states plans to take a multivitamin. what teaching should a nurse provide?
A. Be sure to take the multivitamin and the medication at leasr two hours apart
B. As a nutritional supplement, orlistat contains all the recommended daily vitamins and
minerals
C. Multivitamins are contraindicated during treatment with weightcontrol medications such as
orlistat
D. Following a well-balanced diet is a much healthier approach to good nutrition than
depending on a multivitamin

468. Which of the following variables is considered as a major factor that affects community health?
A. Personal behavioral choices include socio-cultural factors
B. Number of health care providers in hospitals within the community
C. Quality of the public safety officers includes police officers, firefighters
D. The number of recreational services in the community

469. During meningitis outbreak in one of the hospitals, the nun-immune staff were given an immunoglobulin in
order to prevent them from the infection. What is the type of immunity that will be developed by these staff?
A. active
B. long-term
C. natural
D. passive

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470. The Surgical unit nursing staff were instructed to follow the hospital protocol by reporting cases of any
patient's illnesses that are developed during their hospitalization especially the post-surgical wound infectors
Why must the nurses implement this protocol?
A. Control unnecessary hospitalization
B. Assess hospital infection rate
C. Report nosocomial infection
D. Improve reporting system

471. Which of the following statements indicate that a nursing staff need an education session related to
confidentiality and information security?
A. giving the password to patient’s family member.
B. leaving the computer in the nursing station secured.
C. leaving the personal electronic password safe.
D. allowing nursing students to read medical record to their patients

472. Which of the following is the best action to effectively increase surgery capacity?
A. Adapt outpatient departments for inpatients
B. Bring the injured people into the green zone
C. Provide care for the injured people with the available staff
D. Use the available supplies as it is difficult to arrange for additional

473. A patient has been experiencing recurrence of this media antibiotic therapy and the patient was scheduled
for preparative teaching, the patient asked the nurse about the purpose of the procedure.
What is the best answer that the nurse should provide?
A. Stimulates motion of the ossicles
B. Detects permanent hearing loss
C. Allows drainage of purulent fluid from the middle ear
D. Enables medication administration directly to the affected ear

474. After accessing patients' medical records, which behaviour nurse shows that patients confidentiality has
been breached?
A. Reviews patients medical record
B. Read patients care plan
C. Disclosing patients information
D. Documents medication administered

475. A nurse is assessing a 2 days old full-term male neon circumcision. She observed that the circumcised area is
re a large amount of fresh blood.
Heart rate 110 /min
Respiratory rate 40 /min
Temperature 36.6 C
Which of the following action should the nurse take?
A. Apply antibiotic ointment on the affected area
B. Give the infant another injection of vitamin K
C. Clean the area with betadine to prevent infection
D. Apply gentle pressure with a sterile gauze

476. Nurse manager prepares unit clinical operational plan What is top priority in the plan?

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A. Infection control
B. Staff orientation
C. Quality projects
D. Safe patient care

477. nurse is caring for a child with a diagnosis of pneumonia. The plan of nre includes nebulizer treatments and
chest physiotherapy. When should the nurse perform chest physiotherapy?
A. Prior to the nebulizer treatment
B. After the nebulizer treatment
C. Intermittently during the nebulizer treatment
D. Continuously during the nebulizer treatment

478. While taking the history from a new patient, the nurse densified that he had hypomanic episode which was
alternating with a mirror depressive\episode for the last two years. what is the most likely diagnosis?
A. Bipolar I disorder
B. Bipolar II disorder
C. Dysthymic disorder
D. Cyclothymic disorder

479. A 65-year-old women visited the gynecological outpatient history reveals that she had 3 pregnancies, one
abortion gestational age, had 2 normal deliveries. She smokes 20 Her complaint is that she wets herself when
she cough embarrassing for her. Which of the following can be considered as risk factors pelvic floor muscles?
A. Chronic coughing
B. Diabetes mellitus
C. Excessive spot
D. Sedentary life style

480. A nurse is assigned to care for a Muslim female emergency caesarean section. The patient asks the to wear
a head scarf during the surgery. Which of the following is the most appropriate?
A. Ask the patient to remove the scarf
B. Tell the patient that it is ok to wear the scarf
C. Ask the patient to wear a surgical cap
D. Tell the patient that a request will be during the surger
481. A gravid 8 para 8 women has just delivered a 4.5Kg infant a pregnancy. Which of the following is a possible
complication?
A. Postpartum depression
B. Maternal hypoglycemia
C. Postpartum hemorrhage
D. Pregnancy-induced hypertension

482. 62 year-old male patient in the Cardiac Surgery Ward is admitted for the coronary artery bypass surgery. he
has unstable angina for thepast one year and is apprehensive about the open-heart surgery .What essential
assessment needs immediate attention ?
A. Fear and anxiety regarding procedure
B. Need for spirometer and breathing exercise.

483. A 10-year-old girl presents to the Emergency Room (ER) with pain. On assessment, you noticed that when
you palpate the right lower quadrant of the child’s abdomen, the child feels pain in the rig quadrant.
Which of the following is the name of this sign?
A. Rebound tenderness
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B. McBurney sign
C. Roving’s sign
D. Obdurate sign

484. A 10-year-old girl presents to the Emergency Room (ER) with pain. On assessment, you noticed that when
you palpate the left lower quadrant of the child’s abdomen, the child feels pain in the rig quadrant.
Which of the following is the name of this sign?
A. Rebound tenderness
B. McBurney sign
C. Roving’s sign
D. Obdurate sign

485. A patient was on a regular does of lithium carbonate. The nurse that he has hand tremor, polyuria, diarrhea
and vomiting. What immediate action should be taken by the nurse?
A. Diuretics
B. Withholding lithium
C. Calling the psychiatrist
D. Monitoring serum lithium level

486. which of the following condition is a Contraindication for a woman oral Contraceptives?
A. Dysmenorrhea
B. Menorrhagia
C. Thrombophlebitis
D. Toxic shock syndrome

487. A 55 year-old man takes cyclosporine mg by mouth twice per day. He had a heart transplant two months
ago. He complains of stomach cramping, diarrhea and muscle twitches. Which electrolyte is most likely
elevated?
A. Calcium
B. Sodium
C. Magnesium
D. Potassium

488. A conscious victim of a motor vehicle accident arrives at the emergency department. The patient is
Gasping for air, is extremely anxious, and has a deviated trachea. What diagnosis should the nurse
Anticipate?
A. pleural effusion.
B. tension pneumothorax
C. pneumothorax
D. cardiac tamponed

489. Normal systolic Bp for new born:-

A. 40-60
B. 60-80
C. 80-100
D. 100-120

490. The doctor toush the bed by the sterile gloves the nurse should:
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A. Ask him to change the gloves and to give him new one
B. Let him to complete the Central line procedure
491. MR ahmed admitted to ICU with congestive heart disease his vital signs BP 110/60 HR 120 . stroke volume
80 the nurse expected cardiac out put to be
A. 180
B. 1700
C. 2400
D. 9600 cardiac output = stroke volume x Heart rate

492. A nurse is leading an educational session on the correct use of oral contraceptives. One of the attendees ask
the nurse what to do if she missed taking an oral contraceptive for one day? Which of the following should be
the nurse advice to her?
A. Continue as usual with no back up contraception
B. Take an active pill immediately and take the next pill at the usual time
C. Take two pills as soon as possible and then one pill daily at the usual time
D. Use back up contraception such as a condom for the next 7 day

493. Mother came with her baby with thalassemia the nurse will monitor Iron level and chelation therapy with
deferasirox or deferoxamine to prevent organ damage

494. A woman is 5 weeks gestation diagnosed with hyperemesis gravidarum what is the most important nursing
action?
A. sychological support
B. Folic acid supplementationr
C. strict intake and output record
D. providing the woman with a high protein diet

495. A nurse is preparing to administer 25 mg iron dextran inject patient with iron deficiency anemia .the nurse
knows this d to subcutaneous tissue and wants to administer the drug safely which of the best administration
techniques ?
A. Z-track
B. deep im
C. c. use large gauge
D. insert needle at 45 angle
496. A surgical nurse is assigned to care for a woman who had undergone vaginal hysterectomy. The nurse
performed assessment. Which of the following potential problem that the nurse should observe?

A. Pain
B. Fever
C. Anxiety
D. Bladder dysfunction

497. A 45 year-old man who is hospitalized feels tge constant need to keep things in order , particularly whilst
eating m the nurse observe him arranging the food on his plate into symmetrical and equal bite sized pieces , he
constantly worries that the food served could be outdate and potentially causes illness
Which nursing diagnosis is most important
A. Ineffective verbal communication
B. Self-esteem disturbance
C. Impaired social interaction
D. Anxiety

498. What do the standards of pain management dictate nurse do?

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A. Avoid the use of the word "pain"
B. Screen for pain at each encounter
C. Discourage around-the-clock dosage of analgesics
D. Administer analgesics via injection whenever possible

499. Baby born at 35-week was admitted in neonatal intensive 27hours ago, physical examination revealed yellow
discoloration sclera and mucus membrane. The result of bilirubin level every 170mol. The infant was diagnosed
with neonatal jaundice physician order to start single phototherapy. Which of following should the nurse
consider as a priority during phototherapy of this newborn?
A. ensure proper fitting of eye covering (patches)
B. monitor bilirubin levels every 48 hours
C. feed the infant formula every 4 to 5 hours
D. avoid removing the infant from phototherapy

500. 50year-old male was diagnosed with subdural underwent burr hole craniotomy for subdural hernatoma days
ago. In order to detect the sign of meningitis as one of which of the following indicates the patient has
meningitis ?
A. Negative Kernig's signs
B. Positive Brudzinski's sign
C. Absence of nuchal rigidity
D. Glasgow comma scale of 14 points

501. 10 years old boy diagnosis appendicitis has serve pain, the tool of pain scale to be use is:
A. Face pain rating
B. Flacc rating scale

502. A patient diagnosed with septic shock had an upward-trending glucose level (180-225 mg/dL) requiring
control with insulin. the patient's spouse asks why is insulin needed as the patient does not have dia Which of
the following is the most appropriate nursing response to educate the patient's spouse?

A. "It is common for critically clients to develop type diabetes. We give insulin to keep
glucose level under control (less than140 mg/dL)"
B. " Patient had diabetes before, you just didn't know it. we give insulin to keep glucose level
in the normal range (70-110 mg/dL)
C. " Increase in glucose is a normal response to stress by the body. We give insulin to keep
the level 1t 140-180-mg/dL"
D. " Increase is common in critically ill clients and effects their ability to fight off infection.
We give insulin to keep the glucose level in the normal range (70-110 mg/dL)"

503. 33-year old man presents to the emergency department with high grade fever, tachycardia, and tachypnea.
What is an appropriate nursing intervention for the patient’s fever?
A. provide dry clothing
B. keep limbs close to the body
C. cover the patient’s scalp with a cap
D. measure the patient’s fluid intake and output

504. A 78-year-old alert and oriented patient is returning from the radiology Department and the nurse is
preparing to transfer the patient from the wheelchair back into the bed. The nurse places the belt on the
Patient and prepares to lift the patient from the chair Which body mechanics would be most appropriate?
A. Widen leg stance

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B. Bend over to lift
C. Rotate from the waist
D. Maintain base of gravity in the feet

505. A 62 year-old male patient , admitted in the surgical Ward is scheduled for the surgical removal of polyps
from his descending colon under general anaesthesia . he is experiencing fatigue , abdominal pain and blood
streaked stools for a couple of months . he is worried whether the bleeding in his stools is going to stop after
surgery .
What is most appropriate response by the nurse for the patient concern ?
A. Surgery often relieves the symptoms
B. Let us have a detail discussion with your physician
C. Your condition may or may not resolve , it depends
D. In fact surgery is the only treatment for the problem

506. A 70year-old male patient is brought to the emergency department on awheelchair he complain of
drowsiness , fatigue ,lack od appetite for the last 3days . with history taking , the patient stated that he did not
eliminate since 5 days and he is not ambulating a lot because he has arthritis in both knee . why constipation is
one of the common problem for immobilized Patients ?
A. Decreased peristalsis
B. Increased colon motility
C. An increased defecation reflex
D. Decreased tightening of the anal sphincter

507. A patient is admitted to surgical unit after the removal of foreign body from the trachea through the
bronchoscopy . he is exhausted and is monitored for stability .
What is the most desired outcome of nursing care?
A. Presence of cough reflex and expectorant
B. Relaxed pain free and easily inbreathing
C. Optimum oxygen saturation at room air
D. Increase energy and activity level

508. A patient has undergone pericardiocentesis as part of the management of cardiac temponed Which of the
following would be most indicative of cardiac tamponad recurring?
A. Facial flushing
B. Declining heart sounds
C. Muffled heart sounds
D. Increasing blood pressure

509. A 19-year-old girl was scheduled for the extraction under general anaesthesia. Her pre-operative was done
and the consent was signed by her, but her nail polish and trim her long nails, requirement.
What should be the nurse's action in response to?
A. Explain why nails need to be cleaned
B. Respect the patient's right to refuse
C. Record and inform physician
D. Remove as per protocol

510. A nurse is caring for a pregnant patient who is diagnosed with abruption placenta. Which of the following
findings of assessment would indicate a concealed hemorrhage?
A. Maternal tachycardia
B. Decrease in fundal height
C. Rigid, board like abdomen
D. Acceleration in fetal heart rate

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511. In placenta Previa marginalia, the placenta is found at the :

A. Internal cervical os partly covering the opening
B. External cervical os slightly covering the opening
C. Lower segment of the uterus with the edges near the internal cervical
D. Lower portion of the uterus completely covering the cervix

512. An infection control nurse notices purulent exudates , redness and tenderness on the surgical wound site for
few post –operative patients in a surgical unit , She discussed with the ward nurse and emphasized that wound
infection after the surgery can be prevented. Which of the following is the best possible action to minimize the
incidence of wound infection ?
A. Perform assessment of pain on the wound site
B. Wash hand before and after each patient activity
C. Encourage adequate intake and early ambulation

513. 62.receiving multiple mosquito bites and experiencing flu-like symptoms, patient consults a nurse at a clinic
and asks whether an appointment to a health-care provider is necessary. Which of the following statements
should be the basis for thenurse’s bonse?
A. Antiviral medications can be prescribed to destroy virus
B. Clinical signs can be mild flu-like symptoms to fatal encephalitis
C. If patient has West Nile virus, symptoms will progressively worsen
D. If patient used insect repellent, virus would have been destroyed when mosquito made
skin contact

514. TB chest x-ray

515. 54- community health nurse visited a postnatal primigravida mother who ent back to work. The nurse
instructed the woman the different positions breast-feeding in order to lessen the burden of the mother at
night. Which of the following position will the nurse recommend for the mother night?
A. Cradle hold
B. Football hold
C. Reclining position
D. Side lying position

516. 45- multiparous mother is attending at the outpatient clinic 2 weeks after er delivery for follow up. While the
nurse is assessing the mother, she would not palpate the fundus. Which of the following is the most appropriate
nursing action?
A. Document normal finding
B. Massage the fundus to be firm
C. Assess lochia amount and color
D. Admit the mother to the hospital

517. What is a characteristic of an outstanding hospital vision?

A. Specific in scope
B. Easily understood
C. Focused on the past

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D. Kept in a private place

518. A 7-week-old infant boy is admitted with projectile vomiting decreased urine output decreased bowel
movements and weight loss. He has poor turgor and appears hungry. The nurse observes left-to right
peristaltic waves after he vomits. The nurse would expect to find which of the following during the physical
assessment?
A. Hepato-spleenomegaly
B. A palpable pyloric mass
C. Lymphadenopathy
D. Bulging fontanelles

519. A woman is 5 weeks gestation diagnosed with hyperemesis gar what is the most important nursing
action?
A. sychological support
B. Folic acid supplementationr
C. strict intake and output record
D. providing the woman with a high protein diet

520. A 4-month old infant is admitted with diarrhea and vomiting.To prevent the recurrence of diarrhea the nurse
should instruct the mother to do which of the following?
A. Frequent hand washing
B. Increase milk intake
C. Increase water intake
D. Change diaper frequently

521. Before administering a dose of furosemide (Lasix) to a 2-year old with a congenital heart defect, the nurse
should confirm the child's identify by checking the hospital ID band and
A. Verifying the child's room number.
B. Verifying the identity with a second nurse.
C. Asking the parent the child's name.
D. Asking the child to tell you his name.

522. A patient diagnosed with obsessive-compulsive disorder (OCD) continually carries a toothbrush, and will brush
and floss up to fifty times each day. The healthcare provider understands that the patient's behavior is an
attempt to accomplish which of the following?
A. Experience pleasure
B. Relieve anxiety
C. Avoid social interaction
D. Promote oral health

523. When a patient is admitted with acute influenza, what type of isolation is MOST appropriate?
A. Reverse isolation
B. Contact isolation
C. strict isolation
D. Respiratory isolation

524. What precautions are necessary when caring for a patient with Hepatitis A?
A. Gowning before entering the room
B. Wearing gloves for direct care
C. Wearing a mask at all times
D. Placing the patient in a private room

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525. Lochia red sometimes happens during postpartum to bleed heavily with Foul smell for the first three to ten
postpartum days, the nurse should expect that may to
A. Lochia pink
B. Sign of abnormal hemoglobin
C. Infection
D. Bleeding

526. Which of the following uses for abdominal examination

A. Percussion Inspection. Auscultation. Palpation
B. Auscultation .Percussion .Palpation Inspection
C. Inspection. Auscultation. Percussion. Palpation
D. Inspection. Palpation auscultation .percussion.

527. Before sending a client for a CT with contrast dye, what the nurse's most important action?
A. Teach about the need for post-procedure hydration.
B. Verify that the informed consent is complete.
C. Place the side rails of the bed up before transport.
D. Check the client's health record for allergies

528. A head nurse of a Coronary Care Unit delegated the staff a senior nurse in that unit what initial step must the
head nurse implement before?
A. Check the hospital policies for delegating tasks .
B. Explain the task to the senior nurse
C. Negotiate with the senior nurse
D. Take the signature of the senior nurse

529. Patient with cataract was admitted in the ward for cataract surgery. On admission, the patient perceived that
surroundings are mer as if her glasses need cleaning .What is the most important nursing problem at the early
stage?
A. Eye pain
B. Diplopia
C. Blurred vision
D. Light scattering

530. nurse is about to perform venipuncture to initiate intravenous therapy with 0.9% normal saline solution.
Before venipuncture, the nurse collects the require supplies and plans to Perform certain action.
Which of the following actions is the most important?
A. Apply a tourniquet below the site of venipuncture
B. Place an arm board at the joint above the venipuncture
C. Apply cool compress over the vein to be used for venipuncture
D. Inspect 0.9% normal saline solution date of expiry

531. 133-patient is being weaned off from the mechanical ventilator is about to hook the endotracheal tube to
oxygen at FiO2 of 40 Which of the following oxygen administration device is the best the nurse in
this situation?
A. Ambo bag
B. Ventura mask
C. Tracheostomy collar
D. T-piece/ Briggs

532. A 4-month old infant is admitted with diarrhea and vomiting. To prevent the recurrence of diarrhea the nurse
should instruct the mother to do which of the following?
A. Frequent hand washing
B. Increase milk intake
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C. Increase water intake
D. Change diaper frequently

533. 11 month baby how many ml orally he can received ?

A. 200
B. 400
C. 800
D. 1200

534. A patient is transferred to the post-anesthesia care unit (PACU) after surgery with epidural anesthesia. After
taking the patient's vital signs, what should the nurse assess next?
A. Spinal headache
B. Postoperative pain
C. Bladder distention
D. Ability to move legs

535. A post- portative patient in surgical unit most indicative of a developing complication?
A. increasing alertness
B. weak and rapid pulse
C. negative homans' sign
D. minimal bowel sounds in four quadrants

536. A 22-year-old patient is admitted in the male diagnosis of tonsillar abscess. He has high fever along
with dysphagia, difficulty in talking and patient is planned for needle aspiration of the intravenous
antibiotic including penciling.What is nursing problem need attention first?
A. An imbalance nutrion due to inadequate
B. acut pain related to throat inflammation
C. impaired swallowing related to dysphagia
D. hyper thermia related to acute infection

537. A nurse received the serum digoxin level result for the patient the day and notes that the result is
2.6 ng/mL (see lab result)

Test result normal value

Digoxin (men) 2.6 0.8-2ng/mL Which of following

nursing actions is the most important?

A. Notify the physician

B. Check previous vital signs of patient
C. Record normal value on nursing note
D. Administer scheduled dose of medication

538. All of the following are types of spina bifida EXCEPT:

A. Myelomeningocele
B. Hemophilia
C. Meningocele
D. Spina Bifida Occulta

539. In the 12th week of gestation, a client completely expels the products of conception. Because the client
is Rh-negative, the nurse must:

A. Administer RhoGam within 72 hours

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B. Make certain she receives RhoGAM on her first clinic visit
C. Not give RhoGam since it is not the birth of a stillborn
D. Make certain the client does not receive RhoGAM since the gestation only lasted
12 weeks

540. Which of the following patient can be transferee from emergency unit to inpatient ward?
A. Patient with DKA has nausea and vomiting
B. Patient with respiratory distress
C. Patient has operation next day
D. Patient with hematoma on manitol

541. A client who is gravida 1, para 0 is admitted in labor. Her cervix is 100% effaced, and she is
dilated to 3 cm. Her fetus is at +1 station. The nurse is aware that the fetus’ head is:
A. Not yet engaged
B. Entering the pelvic inlet
C. Below the ischial spines
D. Visible at the vaginal opening

542. 30 years old women absent her menstruation for 5 months and her menstrual cycle come
every 28 days, she controlled her diet and do heavy exercise this women condition?
A. Pregnancy
B. Primary amenorrhea
C. Secondary amenorrhea

543. A nurse was newly appointed to work in the Surgical Ward. She was assigned to take care of an obese
patient who just had an open laparotomy. Her mentor told her to pay attention to the surgical risks associated
with obesity. Which of the following postoperative complications the nurse should consider as a high risk
complication?
A. Hunger
B. Gas pain
C. Hemorrhage
D. Impaired wound healing
544. A nurse noticed that the digit probe of the pulse oximeter that is attacked to the right forefinger of a patient
is not reading. Which of the following is the most appropriate action that the nurse must take at this time?
A. Change the location of the pulse oximeter
B. Get a new pulse oximeter sensor probe other than a digit probe
C. Maintain position and check it after two hours
D. Assume oxygen saturation is at normal level

545. patient with a history of atrial fibrillation has an order for 25 milligrams of drug (X), the available supply/dose
is 0.25 milligrams.
Which of the following doses in correct?
A. Dispense two tablets to the patient
B. Administer one tablet twice daily
C. Dispense one half tablet to the patient
D. Return tablets to the pharmacy and re-order

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546. A nurse has taught a patient with iron deficiency anemia about eating als that are high in iron. Which of the
following meal is low in iron?
A. Dried beans and brown rice
B. Eggs and whole wheat toast
C. Steak and a salad made with fresh spinach
D. Cheese pizza and pasta with tomato sauce

547. A 45-year-old woman patient was diagnosed with bronchial asthma and was admitted in the Medical Ward.
The nurse taught the patient to metered dose nebulizer. Which of the following action indicates that she
understands the instruction?
A. Inhale slowly and deeply puff
B. Does not shake the pre-packaged nebulizer
C. Administer the puffs rapidly between breath
D. Remove the aero chamber immediately after administering the puff

548. Which of the Following Is the First Step for Inhaler Technique ducation in Patients with Asthma
A. Breathe out gently.
B. Place mouthpiece between lips.
C. Shake the inhaler.
D. Wait a few seconds then repeat the above process

549. nurse is caring for a child with a diagnosis of pneumonia. The plan of nre includes nebulizer treatments and
chest physiotherapy. When should the nurse perform chest physiotherapy?
A. Prior to the nebulizer treatment
B. After the nebulizer treatment
C. Intermittently during the nebulizer treatment
D. Continuously during the nebulizer treatment

550. When assessing the funds level At 36 week it is at the Xiphoid process

551. Pregnant women with genital herpes …. Caesarean section

552. Caput succedaneum” refers to swelling, or edema,

553. Nephrotic syndrome urine color ……………….. Dark urine

554. Patient with sickle cell anaemia priority is pain management

555. Stages of grief after death The five stages, Denial, Anger, Bargaining, Depression and Acceptance ( DABDA)

556. Complication of MI is Dysrhythmias

557. Nursing supervisor have shortage of staff ........ call for help

558. Gestational diabetic mother can be treated with Diet management

559. Which of the following is the best describe of hospital Vision.

A. provide a quality of care we would want for ourselves,
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B. Treat every individual in a non-judgmental manner, ensuring privacy, fairness and confidentiality
C. Improve the responsiveness of our services for the benefit of our patients and their families
D. Helping local people live longer, healthier lives.

560. Basal skull fracture signs................... Racoon eyes

561. Signs Intracranial pressure in infant with hydrocephalus is bulging anterior fontanel

562. Less than 24 hours after postpartum calls a nurse in the Mother/Infant Unit. She reports that she has very
heavy bright-red bleeding. being discharged, a mother who is newly What would be the best advice to give her?
A. "Don't worry about it; it is normal."
B. "Call your doctor and ask what to do."
C. "Lie down, massage lower abdomen. If it does not work then come to the hospital immediately."
D. "Lie down for about an hour. Then check your bleeding, if it is still as heavy, call me back."

563. newborn has small, whitish, pinpoint spots over the nose, which the nurse knows are caused by retained
sebaceous secretions. When charting this observation, the nurse identifies it as:
A. Milia
B. Lanugo
C. Whiteheads
D. Mongolian spots

564. A30week gestational preterm admitted to NICU 2hours ago the neonate starts to have grunting ,nasal flaring
which of the following the nurse recognize regarding signs and symptoms?
A. Neonate has RDS
B. It is normally in the first 24 hours of birth
C. This is not significant unless become cyanosis
D. Neonate has hypoglycaemia

565. A 20 weeks pregnant , primary gravid woman visits the antenatal has sickle cell anemia trait and worried this
disease transmitted to her baby which of the following should be initial intervention
A. Plan for the fetal genetic screening
B. Educate mother that her disease is inactive
C. Discuss the chances of genetic disease in the fetus
D. Gather data about the other family members having the disease

566. A nurse is performing physical examination on the new born she notes that the baby has cephalhetoma this
baby is risk to develop which of the following?
A. Sudden death
B. Pathological jaundice
C. Infected umbilical cord
D. Increased intracranial pressure

567. A pregnant woman of 15 week gestation age and Rh –ve has an abortion admitted in the ward what should
the nurse do for this woman ?
A. Administer Rheum within 72hour
B. Do not give Rheum since it is not used with abortion
C. Do not give Rheum since the pregnancy is more than 12
D. Make certain she received Rheum on her first clinic visit

568. A4 days old baby diagnosed with physiological jaundice . his father is distressed and wants to know why he
have this condition . what the nurse should the nurse tell the about the most prominent physiological jaundice
A. Immature hepatic function
B. Decrease milk intake
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C. Rh incompatibility
D. Red blood cell enzyme defects

569. For physical assessment steps for the foot is

A. Inspection , palpitation
B. Palpation , auscultation
C. Percussion, palpation

570. A nurse is teaching cord care to a group of new mothers during a baby bath demonstration. One of the
mothers ask the nurse on how to prevent infection of the cord. Which of the following is the best nursing
response?
A. Apply antibiotic cream to the cord after every diaper
B. change Clean the cord with water when necessary and keep dry
C. Clean the cord with surgical spirits twice a day
D. Cover the cord with a bandage and change daily

571. A37 years-old man present man present to emergency department with chest pain . An ECG shows significant
elevation in the ST segm II , III and aVF ,indicating MI related to occlusion in the artery what is the location of MI
?
A. Posterior MI
B. Anterior MI
C. Inferior MI
D. Lateral MI

572. which of the following indication for patient with MI:-

A. ST depression
B. ST elevation
C. short ST
D. none of the above

573. Complication of MI ....... Dysrthysmias , heart failure , pulmonary edema , angina , pericarditis , Dressler
syndrome

574. Causes of MI ...................atherosclerosis , coronary artery disease , elevated cholesterol level , hypertension,
smoking , obesity , stress

575. Watery rice diarrhoea ....... cholera

576. 71-year-old male was diagnosed with subdural underwent burr hole craniotomy for subdural hernatoma days
ago. In order to detect the sign of meningitis as one of which of the following indicates the patient has
meninge?
A. Negative Kernig's signs
B. Positive Brudzinski's sign
C. Absence of nuchal rigidity
D. Glasgow comma scale of 14 points

577. A nurse evaluate dietary practices of a patient who had been as having acute glomerulonephritis . the patient
verbalized following the appropriate diet for acute glomerulonephritis . which of the following diet verbalized by
the patient is approved diagnosis ?
A. Restricted fluid intake
B. Restricted dietary protein
C. Increase intake of low fiber food
D. Increase intake of sodium-rich food

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578. which of the following best describes the role of a case management?
A. promotes healthy lifestyle.
B. provides coordination of care to ensure continuity.
C. possesses highly skilled communication methods.
D. promotes the comfort of the patient

579. A 3-year-old child is admitted to the hospital with seizures. He oriented and has a rash in his extremities and
is diagnosed meningitis. While doing physical examination of him, he starts to seizures. Blood pressure
100/57 mmHg Heart rate 110 /min Respiratory rate 30 /min
Temperature 39.5 Which of the following is the priority of care during the seizure?
A. Put the child on right side
B. Protect the child from injury
C. Call the physician immediately
D. Administer oxygen 100%

580. A 5 years old child admitted with bacterial meningitis and is having seizure. Which of the following
intervention the nurse should initiate ?
A. restrain the child’s limbs to prevent injury
B. slowly put the child on his side on the floor
C. clear the area of objects and administer oxygen
D. roll the child to prone position to protect the airway

581. In the summer months, a five year-old girl presents with a sore throat and a dry cough that has slowly become
worse over the past three weeks. Her body temperature is 38.0oC. On auscultation, there is wheezing and
shortness of breath. She lives in an overcrowded house with three brothers, parents and grandparents in a low-
income neighborhood where she attends school. Which is the greatest risk factor?
A. Residing in a low-income neighborhood
B. Exposure to a pathogen in summer season
C. Attending school
D. Living in crowded conditions

582. A female patient diagnosed with cancer she intended to spend a part of her money for the poor people in case
of her cure. this action by the patient is considered?
A. Denial
B. Acceptance
C. Bargaining
D. Anger

583. 70 years-old woman is admitted to the cardiac care unit wit atrial fibrillation and is receiving intravenous
diltiazem and heparin What is the most likely nursing diagnosis?
A. High risk for infection
B. High risk for impaired gas exchange
C. High risk for decreased cardiac output
D. High risk for disturbed sensory perception

584. A patient hospitalized with chest pain is diagnosed with angina Which of the following discharge instruction
takes priority?
A. recognize signs and symptoms that require immediate report
B. Maintain low cholesterol, low sodium, and low potassium
C. Carry heavy objects away from the chest area
D. Maintain physical exercise daily

585. The nurse is assigned to care for a patient with Paget’s dis complaining of bone pain. Which of the following
conditions is this patient high risk for?
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A. Hypomagnesaemia
B. Hypernatremia
C. Hypercalcemia
D. Hyperkalemia

586. A 25-year-old-primipare visited her primary health care clinic husband. He says that his wife delivered 5 days
ago. For the past days she is very irritable and crying for nothing, she is tired and sleep and he is very concerned
about her condition. Which of the following diagnosis by the attending physician will her symptoms?
A. Post-partum blues
B. Postpartum psychosis
C. Postpartum depression
D. Postpartum anxiety

587. A 44 year-old woman presented to the Emergency Department with eye pain and redness. She was
diagnosed with uveitis related to a viral infection. The doctor prescribe dexamethasone eye drops.Where is the
correct place to instill eye drops?
A. Above the eyelid
B. Directly into the cornea
C. Into the conjunctiva sac
D. Outside the conjunctiva sac

588. A 22-year-old man presents to the Emergency Department complaints of breathing difficulties. He appears
restless and reports that he has had a cough with thick green sputum for days. The nurse performs auscultation
over the lung fields.
Blood pressure 130/80
Heart rate 100
Respiratory rate 24
Temperature 39
Which clinical finding is most likely heard over the right lower?
A. Decreased vocal resonance
B. Decreased fremitus
C. Tympani
D. Bronchial

589. A hospitalized 72-years-old man who uses a walker is received medication and must use the bathroom
several times each night To promote the safety of the patient, which of the following appropriate nursing
action?
A. Keep the side rails up
B. Leave the bathroom light on
C. Provide a bedside commode
D. Withhold the patient’s diuretic medication

590. A man patient admitted to the Medical Unit was diagnosed with deep venous thrombosis complaining of
pain on both legs. Which of the following nursing diagnosis most likely describes problem?
A. Risk for injury
B. Fluid volume excess
C. Electrolyte imbalance
D. Impaired tissue perfusion

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591. A client was admitted in the Emergency Room due to mild metabolic acidosis associated with dehydration
and potassium the doctor administered Hartmann’s (lactated Ringer’s) intravenous fluid and electrolyte
replacement. Which of the following elements of the lactated Ringer’s solution highest value?
A. Calcium
B. Sodium
C. Potassium
D. Magnesium

592. A client with a blunt trauma underwent an exploratory lapartomy repair an intra-abdominal injury. A
nasogastric tube attached suction and two closed-wound Hemovac abdominal drains He is receiving an
intravenous infusion of Ringer’s lactate epidural with continuous morphine. Twenty-four hour post- develops
hypotension, tachycardia, oliguria and sever nausea Which of the following is the priority nursing diagnosis?
A. Nausea
B. Risk for infection
C. Deficient fluid volume
D. Impaired urinary elimination

593. The nurse is mentoring a newly graduated nurse who is right-handed 39 year-old woman who underwent a
left-sided and is now in the medical-surgical unit. The intravenous fluid to infiltrate into the infusion site and the
student nurses equipment to insert a new intravenous catheter. Which catheter insertion site would indicate
that the new nurse needs to be corrected?
A. A site that has soft and elastic skin
B. A site next to a joint
C. The right arm
D. A distal site

594. A client in the second stage of labor is unable to push and lacks to bear down. What is the most appropriate
next step?
A. Assess fetal descent
B. Infuse intravenous fluids
C. Empty the client’s bladder
D. Administer oxygen to the mother

595. patient with a spinal cord injury states, "I have no constitution; I can’t do anything for myself." Which of the
following best describes this patient condition?
A. Powerlessness
B. Delusions
C. Suicidal
D. Resignation

596. A discharge planner is reviewing the file of a patient in prepare move him from the acute care to home care.
What activity should the discharge planner to do ensure the co care?
A. Make referral to the appropriate department
B. visit patient’s house to make sure it is safe
C. Call pharmacy to prepare medications for patient
D. Organize transportation for patient to be moved to

597. A newly assigned nurse to the home health care department was conducting pre-entry phase of home visit.
Which of the following activities should the nurse do?
A. call physician for referral order
B. collect information and schedule a visit
C. establish mutually acceptable goals for care
D. conduct a health history and physical assessment

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598. A nurse was educating a group of woman on prevention of infection. The nurse asked each woman to state
one preventive of vaginal infection. Which woman needs more education?
A. First woman "keep vaginal area clean & dry"
B. Second woman "wear cotton under wear"
C. Third woman "wipe from front to back after urination or
D. Fourth woman "Do vaginal douche twice a day "

599. A nine-month-old child who has had four ear infection six months is being discharged.
Which statement by the parent indicates the need for teaching?
A. I should never put my baby to bed with a bottle
B. My child should not use a pacifier after age six o
C. My child should drink his bottle while lying flat
D. My child should not be around people who sm

600. A mother who is postpartum calls nurse in the mother/Infant unit. She reposts has very heavy bright-red
bleeding. What would be the best advice to give her?
A. "Don’t worry about it; it is normal"
B. "Call your doctor and ask what to do"
C. "Lie down, massage lower abdomen. If it does not work to the hospital immediately"
D. "Lie down for about an hour. Then check your bleeding, if as heavy, call me back

601. A 15-year-old girl is admitted after a Motor Vehicle Accident child has a fracture in her left leg and a wound
in her face. When dealing with this child the nurse should be aware that important task to achieve during this
age is which of the following?
A. Initiative versus guilt
B. Industry versus inferiority
C. Trust versus mistrust
D. Identity vs. Role confusion

602. A 9-month-old child who has a repair cleft palate the nurse explaining mother on how she will give feeds to
her child. Which of the following instruction can be expected to include feeling education?
A. Open cup
B. Tea spoon
C. Bottle feed
D. Special bottle feed

603. A nurse calls together an interdisciplinary team with members from medicine, social service, the clergy, and
nutritional services to care for a patient with a terminal illness. Which of the following types of care would the
team most likely be providing?
A. Palliative
B. curative
C. respite
D. preventive

604. A nurse I,s preparing to assess the uterine fundus of a client in the immediate postpartum period. When the
nurse locates the fundus she notes that the uterus feels soft and boggy. Which of the following nursing
interventions would be most appropriate initially?
A. Massage the fundus until it is firm
B. Elevate the mother’s legs
C. Push on the uterus to assisting expressing clots
D. Encourage the mother to void

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605. A 43 year-old man in the post-surgical area complains of abdominal pain radiating to the naval which is
increasing with examination his abdomen is guarded with marked tender lower quadrant. What is the
immediate goal of care to do?
A. Teach abdominal splinting during coughing
B. Administer pain medication as ordered
C. Assess pain and report immediately
D. Position on the left lateral side

606. 27 years old female brought to the Emergency Rooaccompanied by her husband. He described that she had
marked Weight loss with episodes of emesis in the past three months. She is diagnosed as having anorexia. She
reported feeling Febrile, but had not measured her temperature. Her White Blood Count was 11,000/mm3.
Which of the following most Likely describe her diagnostic criteria for her anorexia?
A. Restricting food intake
B. Fear of gaining weight
C. Problems with body image
D. Binge eating disorder

607. 66 old women presents to the emergency department triage unit with labored breathing. She appeared
anxious and is sweating profusely across the forehead. The symptoms had begun Suddenly one hour before. The
jugular veins appear distended and she has a productive cough. On Auscultation the respiration is wet and not
clear with coughing..
Blood pressure 148/88 mmHg
Heart rate 94/min
Respiratory rate 26/min
Temperature 37.0◦C
Which triage acuity rating is most appropriate?
A. Urgent
B. Emergent
C. Non-urgent
D. Resuscitation

608. A nurse is providing a health teaching to a client about the proper use of a cane during ambulation. The nurse
could include which of the following instructions about the correct use of cane?
A. Patient moves the stronger leg forward to the cane
B. Patient holds the cane on the strong side of the body
C. Patient leans on the cane to provide support to the weaker side
D. Patient moves the cane forward about 4 inches to the strong side

609. A child with Jaundice and treat with photography , how can you protect the child skin?
A. Avoid oily substance
B. Using Vaseline after skin cleaning
C. applying cream

610. A nurse is caring for a patient two hours after a pacemaker placement. The patient suddenly starts
complaining of chest pain. The nurse observes dyspnea, cyanosis and absent breath sounds on the right side. The
nurse should anticipate what complications?
A. Hemothorax
B. Perforation of the heart
C. Pneumothorax
D. Hemorrhage

611. Which of the following could adversely affect the function of a pacemaker?
A. Hair dryer
B. Electric razor
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C. Television
D. Electric mixer

612. The nurse provides discharge instructions to a client after implantation of a permanent pacemaker. The nurse
should tell the client to avoid exposure to which item?
A. Hair dryers
B. Electric blankets
C. Electric toothbrushes
D. Airport metal detectors

613. The nurse provides discharge instructions to a client after implantation of a permanent pacemaker. The nurse
should tell the client to avoid exposure to which item?
A. Hair dryers
B. Electric blankets
C. Electric toothbrushes
D. Electric Mixer

614. A 58 year-old man had a permanent pacemaker inserted. The device is in place and functioning well. The skin
at the incision site is intact and free of infection. The nurse gives him the discharge instruction. What is the most
important nursing care outcome?
A. Understand functioning and operating of pacemaker
B. Monitor pulse rate and identify need for reporting
C. Able to identify the signs of detached pacemaker
D. Modify life style and wear pacemaker alert sign

615. A 9-year-old girl is seen in the emergency department because of a fracture in the right fibula. Which of the
following is the expected response to parent question aboutbone healing period of the girl?

a. 4-6 weeks
b. 2-4 weeks
c. 6-8 weeks
d. 8-10 weeks

(child (child 1) (child 2) (child 3) (child 4)

1)Behaviour of The child The child The child The child
the child completes the forgets apart of perform well completely meal
project on time their uniform and gets 90% on time
marks
Responses on The teacher The teacher The teacher The Maker gives
the child's rewards for wants singly doesn't appears an ice cream to
behaviour discipline instructs not to the child the child
repeat AGAIN

616. A school nurse is monitoring the behaviour of different children. Which child should the nurse expect to
show an aversive type of reinforcing stimulus (see image)?
A. Child 1
B. Child 2
C. Child 3
D. Child 4

617. A 13-weeks-pregnant, multi gravida women is anxious and apprehensive she has five children and is not
willing to continue with this pregnancy She is requesting the midwife to abort the fetus. She is under weight
malnourished and is over worked.

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BMI 17 Kg/m2
What intervention is desired immediately?
A. Admission and intravenous line management for induction
B. Family planning and birth control measures
C. Dietary management and supplements
D. Support, reassurance and counseling

618. which of the following is the most appropriate action for a nurse Manager starting at a new hospital?
A. Observe staff while keeping presence and role unknown
B. Plan and coordinate new strategies with top level management
C. Introduce self and observe unit activities for at least three months
D. Meet with each staff member separately about needed unit charges
619. A nurse explains to a patient that an endoscopy tube will be inserted down the throat during a gastroscopy
which will cause gagging, but it must be swallowed. What type of communication the endoscopy nurse has used
here?
A. Assertive
B. Interactive
C. Formative
D. Informative

620. A nurse who works in the surgical unit at one of the hospitals was asked by the home health care nurse to
make a home visit to a patient with colostomy, who had been discharged the previous day in order to give him a
follow-up care and education which of the following nurses should do the assigned task?
A. Critical care nurse
B. Psychiatric nurse
C. Surgical nurse
D. Community nurse

621. When is the ideal time to administer analgesia to a women in labour?

A. A soon as she requests analgesia
B. When labour is well established
C. When the women enters into transition phase
D. when the women progress from latent to active phase

622. A 46-year-old patient is admitted in the female Medical Ward for seven back pain, which is graded 6 on the
scale of 10. Her vital signs are take with the slight elevation in her blood pressive. The patient has refused
eat lunch which is a low sodium diet. The attending nurse has documented that patient is uncooperative and has
refused to eat the lunch. What nursing intervention needs attention first?
A. Arrange for alternative diet
B. Teach importance of the low sait diet
C. Take appropriate measures to relieve pain
D. Inform the physician for elevated blood pressure

623. a 30-year-old man was brought to the hospital by ambulance sitter felling from a height of 10 meters. He
was mechanically ventilated onafter a Glasgow Coma Score showed a level of six. The nurse is
observe for any changes in perceptual, sensory or cognitive
Which of the following is an expected patient's response at this time?
A. Slowly obeys commands
B. Exhibits no motor response
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C. Reacts towards painful stimuli
D. Uses incomprehensible words

624. A 46-year-old women is admitted in the Medical Ward for systemic lupus erythematous, complaining of joint
pain with dull aching pain in the number region. She has butterfly rashes on her face. Which of the following
should be the first nursing intervention for this patient?
A. Skin care and cortisone ointment as ordered
B. Pain relieving measures and physiotherapy
C. Assess back pain and monitor urine output
D. Analgesics as ordered warm environment

625. In the Emergency Unit a nurse made an error that lead to an admission order for the client to be on a venous
thromboembolic protocol is not processed. Two days after, a nurse notices the omitted order for heparin
5000 units subcutaneous every eight hours. which of the following statement best describes the appropriate
follow-up?
A. " I will contact the supervisor immediately about this error"
B. " I need to contact a physician and complete a variance report"
C. " I am too busy to complete a variance report. I'll do it next week"
D. " I am so glad I didn't make that mistake, that other nurse is going to be in trouble"

626. A 75-year-old patient was bed ridden for the last one year, She was incontinent, restless, delirious and was
trying to pull her nasogastric tube out , but her arms were restrained; her forearms had bruises and her lips
were dry and cracked.
Blood pressure 100/64 mmHg
Heart rate 102 /min
Respiratory rate 28 /min
Temperature 39.2 C
Which of the following nursing intervention each Nasogastric feed?
A. Pull to check the tube is in place
B. Check the tube for patency
C. Aspirate the content
D. Insert water

627. A 45-year-old of man was admitted to the Surgical Ward after removed of pancreatic cyst. The registered
nurse checked the post-operative orders Ondansetron PRN was prescribed for the patient.
Which of the following complaints from the patient will require the registered nurse to serve the Ondansetron
after 12 hours of pos-operativeperiod?
A. Wound pain
B. Nausea and vomiting
C. Congestion of flame
D. difficulty in passing urine

628. A man nurse is caring for a women diagnosed with major depression. The client states " I never had a male
nurse before". which of the following is the most appropriate nursing response?
A. " Do you feel threatened"
B. "Most of the nurses here are males"
C. " How do you feel having a male nurse"
D. " Do you want me to find a female nurse"

629. Which of the following statements best describes for patients with myopia?
A. They must hold a paper at arm's length or greater to read it
B. They can see close-up objects clearly, but distant objects are out of focus
C. They can see distant objects clearly, but close-up objects are out of focus
D. They are unable to focus horizontal and vertical rays of light on the retina simultaneously
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630. Which of the following tests measures the total quantity of prothrombin in the blood and monitors the
effectiveness of warfarin sodium (Coumarin) herapy and prolonged deficiencies in the extrinsic factor?
A. Thrombin time
B. Prothrombin time
C. Partial prothrombin time
D. Activated partial prothrombin time

631. A 72-year-old patient presents to the medical clinic drooling with a blank, masklike facial expression and a
high pitched, monotone, weak wike When walking, the patient does not swing the arms normally, but holds hem
stiffly rigid. What is the most likely diagnosis?
A. Parkinson's disease
B. Substance abuse
C. Traumatic brain injury
D. Transient ischemic attack

632. A 69-year-old obese women with a pelvic fracture has been immobile for four days. The patient is now
anxious, dyspneic, and domaining of substernal pain. The patient's capillary refill is greater than seconds.
Heart rate 122 /min
Respiratory rate 26 /min
Temperature 38.2 C
Which of the following the nurse suspects for this patient?
A. Panic attack
B. Pulmonary embolism
C. Aspiration pneumonia
D. Pneumothorax

633. The nurse is planning for a discharge teaching plan for a family of a30-year-old man with AIDS in relation to
sanitation practices. Which of the following statements should the nurse include in her instructions?
A. Wash used dishes in hot soapy water
B. Boil the dishes the patient used for 30 minutes and them wash with soap
C. Have the patient use disposable eating tools so it can be discarded after
D. Soak the kitchen tools in hot water for 24 hours before washing with soap

634. A 21-year-old in oversized clothing presents to the hospital with of felling dizzy and faint. The hair and nail
appear thin and dry. The skin appears pale and she has sunken eye sockets and tenting skin. Her body mass
index is 16. She often induces vomiting after eating blood is collected for analysis (see lab results).
Blood pressure 90/52 mmHg
Heart rate 118 /min
Respiratory rate 26/min
Temperature 37.2 ͦ C
Oxygen saturation 97%
Test Result Normal value
ABG¹ HCO₃ ̵ 31 22 – 88mmol/L
ABG PCO₂ 10.3 4.7-6.0 kPa
PH 7.50 7.36-7.45
Which nursing problems stem is the most appropriate?

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A. Impaired nutrition
B. Decreased cardiac output
C. Infective airway clearance
D. Ineffective breathing pattern

635. Before preparing a client for the first surgical case of the day, a part-time scrub nurse asks the circulating
nurse if a three minute surgical hand scrub is adequate preparation for this client.
Which response should the circulating nurse provide?
A. Inform the nurse that hand scrubs should be three minutes between cases
B. Direct the nurse to continue the surgical hand scrub for five minute duration
C. Validate that the nurse is implementing the OR policy for a surgical hand scrub
D. Ask the experienced nurse to perform this scrub since it is the first one of the day

636. Which f the following statements describe the function of Immunoglobulin (IgG).
A. It does not cross the placenta and is present in colostrum and breast milk
B. It protects against gastrointestinal and respiratory system infections
C. It provides temporary immunity to bacteria and toxins to which the mother has developed
immunity
D. It protects against gram negative bacteria and can be found cord blood

637. An infection control nurse is responsible to conduct the surveillance on how the hospital staff take
precautionary measures against flu, based on her findings, she is responsible to conduct the awareness razing
for the doctors and nurses in the in-patient areas. Which of the following is the goal of the nursing practice here?
A. Infection control management
B. Research and survey
C. Primary prevention
D. Health education

638. A 57-year-old man is admitted to the Cardiac Unit with palpitation headache, and chest tightness. On
auscultation S3 gallop and
murmur can be heard (see image).

Blood pressure 97/60 mmHg

Heart rate 170 /min
Respiratory rate 25 /min
Temperature 37.3 C
What is the ECG rhythm of the patient?
A. Atrial fibrillation
B. Ventricular tachycardia
C. Ventricular fibrillation
D. Supra-ventricular tachycardia

639. Which of the following is the main disadvantages of home care visit
A. Time consuming for healthcare team
B. Inexpensive than hospital care
C. Easy access to equipment or consultation
D. Nurses have more control on mother's distraction

640. Patient has nausea, vomiting and muscle weakness comes to ER, after assessment the doctor consider that
sign and symptom due to:
A. Hypokalaemia
B. Hypernatremia

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C. Hyperkalaemia
D. Hypoglycaemia

641. Patient has heart failure and suddenly has edema. What is the lung sound will be hearing?
A. Rales
B. Rhonchi
C. Wheezing

642. Which of the Following Is the Most Commend Site to Obtain a Capillary blood sugar sample from neonate?
A. Earl ape
B. fingertip
C. Heel
D. abdomen

643. The physician has written an order for the nurse’s assignee have a 24-hour urine collection sent to the
laboratory for special. Which of the following should the nurse realize prior to urine?
A. Start the urine collection at either 12:01 a.m. or 12:01pm
B. Provide enough sterile receptacles for the urine collection
C. At the start of the collection period, have the patient discard this urine
D. Inform the patient that they must save all urine for 24 beginning at 12:01 a.m.

644. After Bee sting which of the white blood cell is the most likely elevated
A. Eosinophils
B. Basophils
C. Monocytes
D. Neutrophils

645. A 4 years old girl, was playing outside, she came to her mom crying and holding her right upper arm, she went
to the hospital with swelling over the upper arm, pain and itching, the appropriate management is:
A. Maintain patent airway
B. Administer s/c Epinephrine
C. Prepare for intubation

646. An older adult client with renal failure comes to the emergency department with a report of nausea and
vomiting. The client's heart rate is 45 beats/min. The nurse is most concerned about which medication that the
client takes
A. Nitroglycerin
B. Digoxin
C. Doxorubicin
D. Furosemide

647. A nurse was educating a group of woman on prevention of infection. The nurse asked each woman to state
one preventive of vaginal infection. Which woman needs more education?
A. First woman "keep vaginal area clean & dry"
B. Second woman "wear cotton under wear"
C. Third woman "wipe from front to back after urination or
D. Fourth woman "Do vaginal douche twice a day "

648. Disadvantage of democratic leader ................ cannot be in Emergency situation

649. Post operative breathing exercise importance
A. Prevent atelectasis
B. Move secretion

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650. The quality nurse manager teaches a new nurse graduate about the comparison between total quality
assurance (QA) and quality improvement (QI). What is the most appropriate statement regarding the common
aspect between QA and QI?
A. Aim to improve quality
B. focus on preventing errors
C. focus on staff development
D. view nursing activities as major tasks

651. A patient comes to the emergency unit with cough and severe dyspnea. The patient’s medical history
revealed a diagnosis of chronic heart failure and chronic obstructive pulmonary disease.
Blood pressure 110/70 mmhg
Heart rate 87/min
Respiratory rate 23/min
Temperature 37.3 C
Which of the following diagnostic tests will be most beneficial to a nurse to figure out if there is an
exacerbation of heart failure?
A. B-type natriuretic peptide (BNP)
B. arterial blood gas (ABG)
C. cardiac enzymes (CK-MB)
D. chest x-ray

652. client has atrial fibrillation the nurse should monitor the client for
A. cardiac arrests
B. cerebrovascular accident
C. heart block
D. ventricular fibrillation

653. Azithromycin is prescribed for an adolescent female who has pneumonia and recurrent chlamydia
What information is most important for the nurse to provide the
A. Use two forms of contraception while taking this drug
B. Have partners screened for human immunodeficiency
C. Decrease intake of high-fat foods, caffeine, and alcohol
D. Report a sudden onset arthralgia to the healthcare pro

654. Postpartum or puerperal infection is any clinical infection of the genital canal that occurs within 28 days
after miscarriage, induced abortion, or childbirth. The definition used in the United States continues to be the
presence of a fever of 38° C (100.4° F) or higher on 2 successive days of the first 10 postpartum days, starting 24
hours after birth.
655. Isoniazid for TB side effect numbness , hepatitis symptoms , stomach upset ,rashes

656. Neck rigidity .... nerve stiffness sings of meningitis

657. Alhj vaccine is Hib vaccine meningitis vaccine

658. Nerve cause tooth pain ..... V

659. Hypoglossal nerve 12th cranial nerve ............ innervates tongue muscle
660. MI ... ST elevation , Ischemia ..............ST depression
661. Pulse deficit : is the different between apical beats and brachial pulse

662. Common cause of death in school age is ................ accidents

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663. Serotonin Alzheimer ... dopamine schizophrenia

664. When a patient was first diagnosed with schizophrenia, one of his family members asked the nurse about the
possible causes. The nurse said that one reason is that he may have had an excess secretion of a
neurotransmitter. Which of the following neurotransmitters?
A. serotonin
B. dopamine
C. glutamate
D. endorphins

665. A newborn is diagnosed with hypospadias. When teaching the parents of this child, the nurse should tell them
to avoid which of the following before the hypospadias repair?
A. circumcision
B. drinking acidic juices
C. urinary catheterization
D. riding a bicycle

666. 452. 11 month baby weight 8 kg has vomiting 7 times how many ml orally he can received ?
A. 200
B. 600
C. 800
D. 1200
Weight x 75
667. Patient has low platelet low hemoglobin low WBCs
A. Prevent bleed
B. Check vital
C. Reverse isolation

668. A child has diarrhea 7 times and he is irritable and loss his skin turgor what is the degree of dehydration?
A. Mild
B. moderate
C. sever
D. extensive

669. According to information provider in the accompanying graphic, a transverse colostomy would be expected
to produce which of the following (see image)?
A. Fluid faces
B. Mushy feces
C. Semi-fluid feces
D. Solid feces

670. Baby boy birth weight is 3 kg what the expected

weight ate age of 1 year ?
A. 7
B. 9
C. 11
D. 13

671. Gastric suction can cause :

A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis

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D. Respiratory alkalosis.

672. CPR DEPTH ONE THIRD OF CHEST = 1.5 INCH =4CM IN INFANTS , IN ADULT 2 INCH = 5CM

673. CPR Technique IS :

A. 30:2 120
B. 15:2 100

674. Basilic vein A

675. Oral iron supplements are prescribed for child with iron deficiency anemia the nurse instruct the mother to
administer the iron with which food
A. Orange juice
B. Apple juice
C. Milk
D. Water

676. A 27-year-old woman patient's umbilical hernia is repaired under local anaesthesia. Her gold amulet which she
kept under her pillow was missing at first but now is given to her after it is found from the bag of the
housekeeping staff. The nurse in charge is to write an incident report which includes the patient's name, hospital
identification number, date, time and place of incident and the details of the item stolen. What short term action
is required by the in charge nurse?
A. Explain patient her belongings are her responsibility
B. Personal counseling of the house keeping staff
C. Report incident to the security department
D. Dismiss the involved personnel

677. patient is scheduled for a total hip arthroplasty. The nurse reviews the chart and notes the following: serum
potassium 2.8 mEq/L, AB positive blood type, and elevated ST segment electrocardiogram. Which of the
following would be the most appropriate action to do next?
A. Report abnormal diagnostic results to the surgeon
B. Review the patient consent for the surgical procedure
C. Educated the patient on the risk factors and side effects surgery
D. Ensure that the patient has a post-surgery physical therapy

678. Cardiac Care unit nurse decide to gather relevant data of myocardia infraction patient who has breathing
difficulty, bradycardia. What is the best kind of databases relevant to his situation for the nurse?
A. Focused database
B. Complete database
C. Emergency database
D. Follow-up database

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679. A nurse cares for a client with an epidural catheter for labor pain management and requests additional
medication. A student registered nurse anesthetist (SRNA) responds and administers medication via the
epidural catheter. Which action performed by the SRNA requires the nurse to stop administration of
medication?
A. Aspirating bloody fluid into a syringe
B. Obtaining a negative aspiration into a syringe
C. Cleansing the the port with alcohol for 15 seconds
D. Assessing the client’s blood pressure

680. Patient with Osteoporosis what the best exercise he should practice
A. Walking
B. Bowling

681. Patient feeling hand numbness which medication should receive

A. Vitamin C
B. Vitamin K
C. B12
D. Folic acid

682. Post limb amputation pain :

A. Phantom
B. Radiating
C. Shooting

683. Mother of nine children, three of them with congenital anomalies Down syndrome; she is a primary school
graduate, with low status. She is not using any method of family planning. According primary health care
nurse referred her for counseling Which of the following types of home
visits that the community her nurse should conduct for this client?
A. Systematic routine
B. Selective
C. Follow up
D. Field trip
684. A co-worker informs that the nurse about experiencing increased level of stress associated with daily
responsibilities to help cope with professional stress, the nurse should encourage the co-worker to;
A. Make a list of unfinished tasks
B. Complete complex mental task before physical tasks
C. Acknowledge daily accomplishments
D. Spend time with colleague away from work

685. Beneficence refers to actions that promote the well-being of others. The nurse who is exemplifying
beneficence takes positive actions to help clients

686. After testicle removal the client should avoid heavy lifting
687. Weber test :how is the Weber test done…… By placing a 512 vibrating tuning fork on the patient forehead
(midline), where you can hear a buzzing noise.
688. According to Ramsey sedation scale pt in icu on sedation on assessment patient deep sleep and not response
to light what is score
A. 2
B. 3
C. 4
D. 6
689. A 62-year-old women admitted to the emergency department for thefourth time this year, each time the
patient comes with severe injuries and bruises in the body. What is your responsibility as a nurse to
prevent such incident to happen again?
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A. Reports the assault to the local police and write a report
B. Provides information about safe shelter and support
C. Instructs the women to move away from her home
D. Discharge the patient to a safe shelter

690. After rectal surgery what bath type …………….. Sitz bath

691. Mother came to ER with child diagnosised with rheumatic fever the nurse should ask the mother if there is
family members has
A. Congenital heart disease
B. Recently have tonsillitis

692. A 45 years old with severe upper GI bleeding is admitted to the medical ward . The doctor orders the nurse
to give the patient blood transfusion. Which peripheral IV catheter gauge is best for this procedure ?
A. 14 gauge
B. 16 gauge
C. 20 gauge
D. 24 gauge

693. Which of the following religion is prohibited the blood transfusion?

A. Christian
B. Muslims
C. Jewish
D. Jehovah

694. A nurse is caring for a client who is having an allergic reaction febrile , flushed what the first nursing action
A. Stop blood transfusion immediately
B. Replace the blood with saline.
C. Administer an antihistamine.
D. Place the client flat with the feet elevated.
695. The nurse is monitoring a client receiving a blood transfusion after 30 minutes when the client develops a
cough with shortness of breath. The client also complains of a headache and a racing heart. What should the
nurse do first?
A. Stop transfusion immediately
B. Replace the blood with saline.
C. Administer an antihistamine.
D. Slow the infusion rate

Important Notes : if reaction happened within the first 15 minutes ……. Stop blood transfusion immediately .
if reaction happened after 15 minutes……… slow infusion rate first cause of overload then inform
the physician
696. During a patient's blood transfusion, which of the following are associated with an allergic reaction? the nurse
should recognize that
A. Diarrhea and rapid onset of chills
B. Itching and asthmatic wheezing
C. Low back pain and acute renal failure
D. Distended neck veins and a rise in venous pressure

697. Anurse is assigned to care for a 32-year-old glomerulonephritis. The nurse is transcribing patient file.
Which of the following orders should the nurse clarify?
A. Bed rest
B. Daily weights

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C. Strict intake and output check
D. Frequent blood pressure check

698. When is the best time to collect urine specimen for routine urinalysis and culture and sensitivity?
A. Early morning
B. Later afternoon
C. Midnight
D. Before breakfast

699. Which of the following circumstances is most likely to cause uterine atony and lead to postpartum
hemorrhage?
A. endometriosis
B. urine retention
C. cervical and vaginal tears
D. hypertension

700. The nurse is assigned to care for a patient with Paget's disease complaining of bone pain. Which of the
following conditions is this patient high risk for?
A. Hypomagnesaemia
B. Hypernatremia
C. Hypercalcemia
D. Hyperkalemia

701. Mother came to ER with rheumatic fever baby the nurse should ask the mother about?
A. if there is any member family has Congenital heart disease
B. If he recently had tonsillitis

702. Young patient arrived to ER with burn in his left arm and his weight 48Kg how to calculate fluid requirement
for the patient according to parkland formula ?
A. 1572ml
B. 1220ml
C. 1728ml
D. 2000ml
4 x WT x burned are ......................... 4 x 48 x 9= 1728ml

703. A75 year-old man is scheduled to undergo phacoemulsification surgery. The nurse meets with the family for a
pre-operative. The patient has a diagnosis of Alzheimer’s disease with memory decline. The family says that he
has become increasingly for and that his emotions are unstable. Which of the following actions the patient is
expected to do operation?
A. Lay supine for 20 minutes
B. Sit without moving under laser
C. Consistently speak clearly
D. Tolerate general anesthesia

704. A nurse admits a client sent from the health care provider’s office. The nurse calls the provider to obtain
prescriptions. Which action does the nurse take?
A. Hold treatments until the provider signs the prescriptions received.
B. Read each prescription back to the provider prior to ending the call.
C. Have the provider provide the prescriptions to another nurse as well.
D. Verify the prescriptions with the charge nurse before beginning treatment.
705. ABG reading was low PH ,HIGH PCO2 , NORMAL Hco3 what the interpretation ?
A. Compensated respiratory acidosis
B. Uncompensated respiratory acidosis
C. Metabolic acidosis
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D. Metabolic alkalosis

706. A 47 years old newly been diagnosed as having gastroesophageal reflux disease (GERD) comes to the clinic for
follow up appointment. The nurse prepares health education on the cause and care of GERD. Which of the
following stomach area is associated with the diagnosis? (See image)

A- 1
B- 2
C- 3 1111111
D- 4

707. three years old has returned to the clinic after 4 days of being
diagnosed with gastroenteritis and dehydration. A parent reports that the vomiting has stopped, and the child is
tolerating liquids, rice, applesauce, and bananas. The diarrhea persists, but seem to be decreasing in volume.
When evaluating for signs of dehydration, the nurse will assess the patient’s skin turgor by:
A. grasping the skin over the abdomen with two fingers and raising the skin with two fingers
B. grasping the skin over the forehead with two fingers and raising the skin with two fingers
C. holding the patient’s mouth open and assessing the tongue for deep creases or furrows
D. drawing two tubes of blood and running blood urea nitrogen (BUN) and creatinine (Cr)

708. To decrease the anxiety of a 10-year-old girl who is undergoing surgery. Which of the following should the
nurse do?
A. Use a heart model to show her how the surgery will go
B. Provide her with verbal explanation of the upcoming surgery
C. Give her a book to read about the surgery 2 weeks prior
D. Let her parents talk to her about the importance of having surger

709. An infection control nurse notices purulent exudate, redness and tenderness on the surgical wound site for a
few postoperative patients in a surgical unit. She discussed with the ward nurses and emphasized that wound
infection after surgery can be prevented. Which of the following is the best possible action to minimize the
incidence of wound infection?
A. perform assessment of pain on the wound site
B. wash hands before and after each patient activity
C. encourage adequate intake and early ambulation
D. support incision appropriately and avoidance of straining

710. A nurse is giving health education regarding the management of premenstrual syndrome symptoms to a group
of first year nursing students. Which of the following information regarding diet will the nurse include in the
presentation?
A. take three healthy meals a day to prevent hypoglycemia and increase feeling of well-being
B. include simple sugars in the diet to prevent low blood glucose levels which cause mood swings
C. drink 2000ml of fluid (water, coffee, tea) per day to flush the kidneys and improve fluid retention
D. decrease intake of caffeine such as coffee and chocolate to minimize irritability, insomnia and
anxiety

711. Hepatitis C complication include ; liver cirrhosis , Liver cancer, Liver failure

712. A diabetic mellitus patient had left low-knee amputation. The nurse in the surgical unit has been doing wound
care for three days. The nurse evaluated the wound's condition to review the care plan. Which sign shows poor
glucose control in wound healing?
A. Swelling of the stump
B. Bleeding of the stump
C. Mild redness of the wound site
D. Separation of the wound edges
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713. When examining the tympanic membrane of adult by otoscope, the nurse should move the ADULT pinna in
which direction?
A. Down and forward
B. Up and back
C. Up and forward
D. Down and back

714. When examining the tympanic membrane of infant by otoscope, the nurse should move the Infant pinna in
which direction?
A. Down and forward
B. Up and back
C. Up and forward
D. Down and back

715. client has just returned to a nursing unit after an above-knee amputation of the right leg. The nurse should
place the client i which position?
A. Prone
B. Reverse Trendelenburg's
C. Supine, with the amputated limb flat on the bed
D. Supine, with the amputated limp supported with pillows

716. patient with ongoing blood transfusion and the nurse observe that patient has difficulty to breathing and
shivering what the nursing priority
A. stop infusion
B. call physician
C. slow rate of infusion
D. give Intravenous fluid

717. A 70 years old man is brought to the emergency department on a wheelchair. He complains of drowsiness,
fatigue and lack of appetite for the past three days. With history taking, the patient stated that he did not
eliminate since five days and he is not ambulating a lot because he has arthritis in both knees. Why is
constipation one of the common problems for immobilized patients?
A. decreased peristalsis
B. increased colon motility
C. an increased defecation reflex
D. decreased tightening of the anal sphincter

718. Tympanocentesis is a minor surgical procedure that refers to puncture of the

tympanic membrane with a small gauge needle in order to aspirate fluid from the
middle ear

719. Otitis media surgery is myringotomy

720. Suspect patient with H1N1 what is the highest priority nursing action ?
A. Isolate the patient in private negative pressure room
B. Take nasopharyngeal swab

721. MAP (mean arterial pressure) definition : average pressure in a patient's arteries during one cardiac cycle

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722. A home health nurse visits a patient who is newly diagnosed with diabetes. The patient is compliant with
taking the prescribed hypoglycemic medications and eats three meals a day followed by desserts sweetened
with granulated sugar. The patient also exercises 30 minutes a day, three times a week. (See lab results)
Test Glucose HgbA1c Result Range from 6.6-8.36.9%Normal 3.9-5.5mmol/L 4.7-5.6% Which of the following
educational intervention takes priority?
A. glucoses Monitoring
B. dietary requirements
C. exercise regimen
D. medication

A Knowledge deficit related to diabetes mellitus

B Anxiety related to new diagnosis of diabetes mellitus
C Altered nutrition more than body requirement
D Altered health maintenance related to elevated blood glucose
E Altered in fluid and electrolyte balance to ketoacidosis
F Risk for infection related to chronic disease
723. An insulin dependent diabetic patient is admitted to the hospital in ketoacidosis. Of the nursing diagnoses
shown in the table which is the two with the HIGHEST priority?
A. A, C
B. E, F
C. D, E
D. D-B,E

724. A30 years old married man presents to the clinic with complaints of feeling sad for the past three months. He
is unable to maintain regular sleep routine; he lost his appetite and has difficulty concentrating. He is prescribed
a medication which prevent the reuptake of specific neurotransmitters that could contribute to his mental
health problem. Which side effects would be most important for the nurse to advise the patient of?
A. polyuria
B. photophobia
C. fluid retention
D. sexual dysfunction

725. A surgical unit nurse assessed a 35 years old post appendectomy observe abdominal distention with absent
bowel sounds. Which of the following interventions is most appropriate?
A. Encourage ambulation
B. Provide liquid diet as tolerated
C. Ensure patency of nasogastric tube
D. Check surgical site for signs of infection

726. The nurse assesses a client with an ileostomy for possible development of which of the following acid-base
imbalances?

A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis

727. Postpartum perineal assessment acronym is REEDA in which letter A mean ?

A. Approximation ( how well edges come together )

728. Which food consider low potassium diet ?

A. Bananas
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B. Avocado
C. Berriers
D. Strawberry

729. Which one of the following signs and symptoms is associated with increased intracranial pressure?
A. restlessness and confusion
B. bradycardia and hypertension
C. tachycardia and hypotension
D. respiratory depression and headache

730. The nurse anticipates which of the following responses in a client who develops metabolic acidosis.
A. Heart rate of 105 bpm
B. Urinary output of 15 ml
C. Respiratory rate of 30 cpm
D. Temperature of 39 degree Celsius

731. The Code of Professional Conduct is produced and published by:

A. The Nursing and Midwifery Council
B. The Royal College of Physicians
C. The Royal College of Nursing
D. The Department of Health

732. During a prenatal examination. The nurse draws blood from a young Rh negative client and explain that an
indirect Coombs test will be performed to predict whether the fetus is at risk for:
A. acute hemolytic disease
B. respiratory distress syndrome
C. Protein metabolic deficiency.
D. pathologic hyperbilirubinemia

733. Excess iodine affects with organ first?

A. Brain
B. Heart
C. Liver
D. thyroid

734. 46-year-old patient is in the male Urology Ward after the surgical removal of the stone from his left kidney
through percutaneous nephrolithotomy under general anesthesia. He has nurse and dull acting pain in left
lumbar region. His nephrostomy bag ia attached through atube in his left kidney for a few days ( see image)
What findings should alert the nurse to report to the physician
immediately?
A. Abdominal discomfort and conniption
B. Severe pain and discomfort at surgical site
C. Presence of blood and stone gravels in urine
D. Urine output less than the identified amount

735. A 6-year-old child was admitted to pediatric medical ward with acute
glomerulonephritis. Which of the following is an indication of acute
glomerulonephritis?
A. Pain in urination
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B. Frequent urination
C. Difficulty in urination
D. Pharyngitis 15 days ago

736. while school nurse was teaching a group of 14 years old children one of them remark 'you are too young yo be
our teacher! you are not much older than we are how should the nurse respond?
A. How do you think I am
B. We need to stay focused on the topic
C. Do you think you can teach it any better
D. I think I am qualified to teach this group

737. A 9 A cardiac monitor for a patient in a Coronary Care unit shows abnormal ECG rhythm with heart rate of 159
beats, QRS complex (0.18 second), and absent P wave.What could be the type of possible dysrhythmia?
A. Sinus tachycardia
B. Ventricular tachycardia
C. Ventricular fibrillation
D. Supraventricular tachycardia

738. 9year-old child has a fractured femur and full leg cast has been Which of the following is a physiologic effect of
immobilization?
A. A Venous stasis
B. B Increase metabolic rate
C. Positive nitrogen balance
D. D Increased need for oxygen

739. A community health nurse screens a group of high-risk adults for tuberculosis Which gauge needle should the
nurse use for an intradermal injection on the volar surface of the forearm?
A. 16 gauge needle
B. 20 gauge needle
C. 22 gauge needle
D. 26 gauge needle

740. The maximum time for suctioning in adults is:

A. 5 second
B. 8 seconds
C. 10 second
D. 15 second

741. A nurse is transferring a patient with chest tube the X-ray department for chest X-ray.
Which location should the nurse place chest tube
A. Directly on the stretcher in an upright
B. On the side of stretcher next to patient
C. Hanged on IV pole that is attached to the
D. Attached to the stretcher and hanged

742. A registered nurse in the Intensive care Unit performed Glasgow scale assessment on a 50-year-old man who
sustained head 24 hours ago. The recorded Glasgow Coma score was 10.
which one of the following actions should be taken immediately nurse?
A. Inform the registered nurse in charge of the nursing
B. Protect the patient by raising the two side rails
C. Inform operation theatre for emergency surgery
D. Perform neurologic assessment every 15 minutes

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743. 3-week-old newborn is diagnosed with Hirschsprung disease Which of the following preoperative care should
included in the plan of care?
A. Restricting oral intake to clear fluids
B. Administering a tap water enema
C. Inserting a gastrostomy tube
D. Using povidone-iodine to prepare the perineum

744. A 10 year old child has very limited vocabulary and interaction skills . she has an IQ of 45 , she is diagnosed to
have mental disease retardation of this classification ?
A. Profound
B. Mild
C. Moderate
D. Sever

745. 8-year-old child was admitted to the pediatric ward diagnosed with B-thalassemia. The nurse is planning to
give health education to the mother. Which of the following educational needs is recommended for the mother?
A. compliance to hydroxyurea
B. compliance to hemosiderosis
C. compliance to disferal
D. compliance to Iron supplement

746. A patient who is admitted denies any medication allergies. medical records state, "No known drug allergies." A
medic been sent to the pharmacy for gentamicin. The pharmacist record in the pharmacy of an allergy to the
medication. Which of the following is the best way for the nurse to pro
A. Administer the medication with Benadryl (Diphen
B. Notify the doctor of the allergy and request new orders
C. Investigate further then call the doctor for clar
D. Give the medication as ordered by the physician

747. Which of the following is the best nursing action to ensure safe medication administration the nurse feels the
dosage is unsafe for the patient ?
A. Call pharmacy
B. Call the head nurse
C. Contact the prescribing doctor
D. Administer half of the dosage

748. Which of the following consider contraindication of tonsillectomy ?

A. Child with adenoid infection more than 4 times per year
B. Child with tonsillitis more than 4 times per year
C. Child age less than three years old
D. Child with hypertrophied adenoids

749. A 50 year-old woman post myocardial infraction was admitted in the medical ward . A nurse was assigned to
care for the patient.
Blood pressure 140/80 Heart rate 120 Respiratory rate 22 Temperature 37.5 O2 sat 95%
A. Arrhythmias
B. Endocarditis
C. Cardiac failure
D. Cardiogenic shock

750. A child has been seizure free for 2 years . A mother asks the nurse how much longer that the child will need to
take the ant seizure medications
A. Medication can be discontinued at this time
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B. The medication dosage can be reduced gradually
C. New medication can be order after one year
D. Medications can be discontinued after 5 years

751. A teenage male patient with bipolar disorder is in the psychiatric ward for a week. he is speech is incoherent
and is complaining vision and hearing problems
Which of the following essential assessment need monitoring and reporting?
A. Visual and auditory hallucinations
B. Frequency and span of mood swings
C. Level of agitation and speech difficulty
D. Medication regimen and expected side effects

752. Child with cerebral palsy was brought to the out patient department for a monthly follow up visit. One of the
strategies to maximize the growth and development of the child during feeding is to maintain a pleasant and
distraction and distraction free environment , which of the following instruction should be recommended to th
mother ?
A. Serve food that will no stick to the spoon
B. Place the child in a sitting position during eating
C. Encourage child to eat with other children
D. Encourage finger foods that child can handle alone

753. A nurse is preparing to transfer a patient from the operating table to the postoperative bed. The patient had a
right total hip arthroplasty . the nurse must maintain the patient hips of the following position ?
A. Flexion
B. Abduction
C. Extension
D. Adduction

754. Which of the following statements describe puerperal infection ?

A. presence of fever of 38 or higher from 2 days to 10 days
B. presence of fever of 40

755. When would the nurse schedule a woman for a glucose tolerance test?
A. 6th -10th week of pregnancy
B. 12th -16th week of pregnancy
C. 24th -28th week of pregnancy
D. 32th -36th week of pregnancy

756. A 62 year old diabetes type II patient is admitted to hospital for amputation of the right foot due to gangrene
and ischemia. Preoperative , the patient rates the pain as 9 using the 1 – 10 pain sacle ) how can this patient
phantom pain best be controlled?
A. Post operative elevation of limb
B. Apply pressure bandage to stump
C. Control pain pre operatively
D. Apply ice to site for twenty minutes

757. A diabetic patient on subcutaneous insulin needs to rotate the site of injection to prevent which of the
following?
A. Insulin intolerance
B. Insensitivity to insulin
C. Increased rate of absorption
D. Hard painful lumps development

758. A patient height is 183 cm and weight is 63.5 kg BMI 19. What is the patient weight classified is ?
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A. Underweight
B. Normal
C. Overweight
D. Obese

759. A nurse is making an assessment for the manifestation of cyanosis in a dark-skinned client . which of the
following sites is the best for the nurse to check for presence of cyanosis
A. Lips
B. Palms
C. Nail bed
D. Conjunctiva

760. A nurse was assessing a newborn undergone circumcision . What is the immediate risk for newborn the nurse
to observe ?
A. Hypospedias

761. What the rationale of the initial postpartum assessment of the mother?
A. Determine of the uterus is well contracted
B. Monitor amount and color of the lochia
C. Obtain vital signs and determine pain level
D. Determine whether she is physically stable

762. Position after head trauma ?

A. Prone
B. Elevate head of bed 30degree to decrease intracranial pressure

763. A 30 years old woman , gravid 3 para 2 in her20 weeks pregnancy was complaining of increase leucorrheoa
during past weeks the nurse reassured the mother and explained the reason of this secretions ?
A. Vaginal infection
B. Expansion of uterus
C. Stimulation of cervix
D. Production of estrogen

764. When a patient tell his nurse “ I need to maintain medication compliance to avoid relapse “and nurse replies
“this correct” which of the following therapeutic communication techniques being used ?
A. Focusing
B. Exploring
C. Accepting
D. Reflecting

765. Incentive spirometry is ?

A. Use to prevent atelectasis after surgery

766. A nurse is inserting a nasogastric tube for a 65-year-old patient with paralytic ileus Immediately after insertion
200 ml of milky appearing drainage was noted in the bag. The nurse is not sure if the distal end of the tube is in
the stomach. What is the most appropriate technique confirm positioning?
A. X-ray of stomach
B. Check pH of drainage
C. Aspirate more fluid and check if color change
D. Flush with 100 ml saline and auscultate over stomach

767. patient who had aortic valve replacement with a mechanical heart valve has just completed discharge
teaching provided by a nurse on duty. Which statement by the patient indicates the effectiveness of the nurses
teaching?
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A. "I am glad that I can continue taking my Gingko Biloba"
B. "I will increase my intake of green and yellow vegetables"
C. . "I will start applying vitamin E to my chest inaision after showing"
D. "I will shave using an electric razor from now on"

768. Height of enema is ?

A. 50 cm
B. 150 cm
C. Blow red edge

769. A 67-year-old patient was brought to the Emergency Room with history of diabetes mellitus, hypertension and
heart failure complaining of acute shortness of breath and productive cough. The sputum was pink and frothy.
During the assessment, the nurse noticed crackles and wheezes. Blood pressure 80/45 mmHg Heart rate
124/min 36/min Respiratory rate 36.5°C Temperature Which of the following disorders should the nurse
suspect?
A. Pneumothorax
B. Uns0table angina
C. Pulmonary edema
D. Pulmonary embolus

770. A physically handicapped young woman uses a wheelchair to adapt with her problem. She had a neighbor who
repeatedly tell her that she might did a fault and for that she has been punished from God. Which model of
disability does this attitude belongs to?
A. moral
B. medical
C. disability
D. rehabilitation

771. disability patient already on the wheel chair has visited by her nephew, her nephew response to the patient
that she has done something wrong and that god punished her and become in this condition
Which of the following describing her nephew behaviour?
A. Moral
B. Anger
C. Abuse

772. A 62 year-old diabetes type II patient is in the post-operative care unit following amputation of the right foot.
Post-operatively, the patient tells the nursE of tingling, coldness and cramping in the right foot. Which of the
following describes best the type of pain?
A. Visceral
B. Somatic
C. Ischemic
D. Neuropathic

773. A 16-year-old man is in the Emergency Department with S Ose bleeding as a result of falling down while
climbing up the wall. On assessment, his nose appears slightly deviated and 2 swollen. He is breathing from his
mouth What sign helps evaluate that his nose is still bleeding
A. Complain of sharp pain in the nasal bone
B. Experiencee more difficulty in breathing
C. patientt is swallowing frequently
D. Increased swelling of the nose

774. 25-year-old woman has a family history of breast cancer. The nurse reviews the procedure for breast self-
examination (BSE) and tells her that the best time for a woman to perform a breast self-examination is:
A. a few days before her period.
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B. during her menstrual period.
C. on the last day of menstrual flow.
D. 3- 7days after the beginning of her period

775. Mass media disadvantage ?

A. One way communication
B. Two way communication
C. Large number of people

776. A nursing is given education to a patient with blood pressure 170/95 to avoid eating of which of the flowing ?
A. Canned food
B. Protein
C. Vegetables and fruits

777. A nurse is giving health education to 32 years old female to prevent uterine prolapsed ?
A. Kegel exercise

778. A client who is breastfeeding her newborn requests assistance from the lactation nurse. Which reflex does the
nurse explain in order to assist with latching on?
A. Extrusion reflex
B. Rooting reflex
C. Swallowing reflex
D. Tonic neck reflex

779. A patient has depression and on antidepressants medication .while the nurse caring him he asked ( how long
the medication takes to reach the effectiveness )The proper nurse response is?
A. 3-4 days
B. 10-4 days
C. 14-18 days
D. a month

780. A 25 years client is admitted to the emergency department with sudden onset of right lower abdomen pain.
Which of the following physician orders should the nurse question at this time?
A. Apply heating pads to Abdomen
B. Obtain abdomen x ray
C. Start intravenous dextrose 5%
D. Nothing by mouth

781. In anticipate of further emergency treatment for a client with salicylate overdose, which of the following
medications should the nurse have available?
A. Vitamin K
B. Atropine sulfate
C. Dextrose 50%
D. Sodium thioslfate

782. Contraindication immunization for a patient who is receiving which medication ?

A. Steroids
B. Insulin
C. Midazolam

783. Radon cancer mostly affected ?

A. Lung
B. Cervical
C. Prostate
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784. Post MI medication ?

A. Heparin
B. Aspirin
C. Warfarin

785. A nurse researcher wrote in her explanatory statement: "The researcher will - 35 Use a questionnaire to
measure nursing job satisfaction," which ethics principle is the researcher addressing here?
A. Justice
B. Beneficence
C. Confidentiality
D. Non - maleficencge

786. A 3-year-old child is admitted to the Medical Ward for vomiting, and dehydration. The nurse sat with the
parents to comply admission interview and wanted to get as much information as Which of the following
communication techniques should the nurse
A. Use of question containing the word "how"
B. Use of question with direct comments to clarify
C. Use of statements that indicate patient will be fine

787. A 68-year-old diabetic women undergoes a below knee amputation to vascular insufficiency and infection. On
admission to care unit, the nurse makes the priority diagnosis: Risk for ineffective peripheral tissue perfusion.
Which intervention is most appropriate?
A. Ensure adequate pain relief
B. Elevate residual limb on a pillow
C. Administer oxygen by facemask
D. Apply ice to the stump

788. A nurse plans to teach a group of 20to25-year-old women about oral contraceptives. The nurse should instruct
that oral contraceptives may:
A. Increase the risk of pelvic inflammatory disease
B. Cause acne to worsen
C. Decrease the risk of breast and cervical cancer
D. Decrease the risk of endometriosis

789. A nurse is working in a medical unit and has been assigned to care for 65-year-old man with cerebrovascular
accident, which caused right-sided hemiparesis. The contractures due to immobility. is worried about the patient
developing muscle contracture nurse most important to be Which of the following nursing actions
implemented? is
A. Provide diet rich in protein
B. Turning the patient every 2 hours
C. Provide range of motion exercises
D. Apply moisturizing cream on the affected side

790. A patient is scheduled for a magnetic resonance imaging (MRI) scan for suspected lung cancer. Which of the
following is a contraindication to the study for this patient?
A. The patient is allergic to shellfish
B. The patient has a pacemaker
C. The patient suffers claustrophobia

791. Which of the following would the nurse included in her discharge education for a postpartum patient
regarding signs and symptoms that should be reported immediately?
A. Lochia rubra persists
B. Nipples become red
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C. Lochia decreases in amount
D. After pains increase with breast feeding

792. Every how many minutes to check fetal pulse with second stage of labor Every ?
A. 5min
B. 10min
C. 15min
D. 20min

793. A 45 year-old patient is admitted in the Intensive Care Unit and has been on a mechanical ventilator for five
days. Which weaning parameter indicates the patient has enough muscle strength to breathe?
A. Normal electrolytes
B. Positive fluid balance
C. Negative inspiratory force
D. Increased minute ventilation

794. A 9-month-old child who has a repair cleft palate the nurse explaining mother on how she will give feeds to
her child. Which of the following instruction can be expected to include feeling education?
A. Open cup
B. Tea spoon
C. Bottle feed
D. Special bottle feed

795. A nurse is inserting a nasogastric tube for a 65-year-old patient with paralytic ileus Immediately after insertion
200 ml of milky appearing drainage was noted in the bag. The nurse is not sure if the distal end of the tube is in
the stomach. What is the most appropriate technique confirm positioning?
A. X-ray of stomach
B. Check pH of drainage
C. Aspirate more fluid and check if color change
D. Flush with 100 ml saline and auscultate over stomach

796. Which of the following patient education is the most important in case of eye infection?
A. Cover eye for protection
B. Apply warm pads
C. Wash face two times a day
D. Take more fluids and eat balanced diet

797. A client is receiving mechanical ventilation when the alarm sounds and displays an alert showing low tidal
volumes. All connections and the ET tube are checked and secured but the alarm persists while O2 saturation
continues to drop. Which of the following is the most appropriate initial action?
A. Increase oxygen delivery to 100%
B. Manually ventilate through the endotracheal tube
C. Call the respiratory therapist to assess the patient
D. Elevate the head of the bed and apply a non-rebreather mask

798. A nurse provides care for a client who is 5 days post gastrectomy. The provider prescribes total parenteral
nutrition (TPN). Which statement by the nurse to an orienting nurse explains the client's need for TPN?
A. TPN is used for clients who are at increased risk for aspiration due to swallowing inability.
B. TPN is for clients who are unable to receive nutrients by mouth for an extended period of time.
C. TPN is the usual method of providing nutrition to clients after major abdominal surgery.
D. TPN is a temporary solution and can be used for the first 24 hours after surgery

799. Vitamin A deficiency cause ?

A. Night Blindness
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800. The mother with hypothyroidism high risk for ?

A. Preterm labor
B. Hemorrhage
C. Congenital anomalies

801. Doctor order to give 75ml per hour over 12hours of normal saline how many ml total should be given?
A. 450ml
B. 600ml
C. 900 ml
D. 1000 ml

802. In an education session with pregnant mothers, the midwife explains the purpose of amniotic fluid sac or the
water bag. After the completion, the midwife is revising the concepts by asking questions. Which of the
following statement made by the mothers is most appropriate regarding the fluid bag.
A. It provides the baby with immunity against diseases
B. It provides important nutrition and fluid to the baby
C. It protects and maintains baby's temperature
D. It protects the baby from harmful chemicals in mother's blood

803. When is the ideal time to administer analgesia to a women in labour?

A. A soon as she requests analgesia
B. When labour is well established
C. When the women enters into transition phase
D. when the women progress from latent to active phase

804. post-operative patient who underwent an abdominal procedure request pain medication from the nurse
and rates the pain at a level nine. There a standing order for narcotic administration. When the nurse opera the
narcotic box and performs a count, the number of pills remaining in the box is different than the number of pills
recorded on the sheet. What is the most appropriate initial nursing action?
A. Notify the nursing supervisor
B. Write the finding on the narcotic sheet
C. Administer the patient's requested medication
D. Identify the last nurse who used the narcotic

805. A 32 years old multigravida woman presents to the outpatient clinic complaining of dysmenorrhea and
menorrhagia. She had been diagnosed with uterine fibroids and blood studies has been ordered for her. Which
of the following results should the nurse report?
A. hematocrit, 37%
B. hemoglobin, 9 g/dl
C. white blood cell count, 10,000 cells/mm3
D. platelets count, 300,000 platelets/ microliter

806. A child is diagnosed with sickle cell diseases is admitted with severe pain in upper and lower extremities. What
type of crisis is that the child experiences?
A. Sequestration
B. Aplastic
C. Vasoocclusive
D. Hyper hemolytic

807. A newborn is diagnosed with Ventricular Septal Defect (VSD) Which of the following information should the
nurse give to the newborn's mother?
A. Cyanosis will occur most of the time during sleeping
B. Breast feeding is not recommended for your child
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C. The defect might close spontaneously after 6 months
D. Blood pressure is different on the child's arm and the leg

808. A 58 years old man had a permanent night pacemaker inserted. The device is in place and functioning well.
The skin at the incision site is intact and free of infection. What is the most important nursing care outcome?
A. understand functioning and operating of a pacemaker
B. monitor pulse rate and identify need for reporting
C. able to identify the signs of detached pacemaker
D. modify lifestyle and wear pacemaker alert sign

809. A primigravida woman who is pregnant at 30 weeks gestation told the nurse that she is worried that anything
happens to her baby. Which of the following should be the proper nurse's response?
A. Ask the woman not to worry
B. Ask the woman to express her concerns
C. Attract the woman's attention to other issue
D. Reassure the woman about the baby condition

810. 10 years old child had and appendectomy yesterday which pain scale should the nurse use to assess the child
pain ?
A. Numeric
B. Faces
C. Flacc
D. Cries

811. A nurse was assessing a newborn undergone circumcision what is the immediate risk for this newborn the
nurse need to observe ?
A. Bleeding
B. Fever
C. Infection
D. Pain

812. An infection control nurse is responsible to conduct the surveillance on how the hospital staff take
precautionary measure against flu, based on her findings, she is responsible to conduct the awareness rating
sessions for doctors and nurses in the patient areas.
which of the following is the goal of nursing practice here?
A. infection control management
B. research and survey
C. primary prevention
D. health education

813. A 28 weeks pregnant mother is in the antenatal clinic with the complaint of vaginal irritation itching and thick
white secretion . she is diagnosed as having vaginal candidiasis she had been having the same infection before
the pregnancy for which she was prescribed the vaginal cream she is using the same cream for the past few days
but her symptoms are not relieved what need to be emphasized to mother
A. change clothes daily use sanitary napkins
B. Avoid self treatment and seek doctor advise
C. Use medicated bubble baths and reduce activates
D. Was with warm water every two hours

A nurse is giving discharge planning instructions to the parents of a one year old child acute otitis media which of
the following discharge instruction takes priority?
A. Administrate antibiotics as prescribed
B. Administer influenza vaccination
C. Breast feeding as long as possible
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D. Continue using of pacifier

814. Which of the following obstacles up to the implementation of the primary health care strategy
A. Increase the number of health care workers
B. Misinterpretation of PHC concept
C. Decentralization management
D. Few political supervision

815. A 32year old woman has just been told that she is pregnant she states ‘ As mush as I love my children , I had
had hoped we would not have any more “ this statement reflect of which of the following related to pregnancy
A. Anger
B. Denial
C. Guilt
D. Ambivalence

816. After nurse assessed a newborn she reported that the baby has syndactyly the student nurse ask the nurse in
charge what is the syndactyly ?
Which of the following is the best nursing response
A. Fistula.
B. Abnormal big head
C. Extra finger or toes
D. Finger or toes wholly of partly united

817. A couple asked the nurse which of the first investigation they should do for infertility?
Which of the following should be the proper a nurse answer?
A. Hysterosalpingogram
B. Serum progesterone
C. Semen analysis
D. Endometrial biopsy

818. A nurse is assessing a 5 month old infant who has admitted to the pediatric ward with coarcotation of aorta
Which of the following is the most common assessment findings ?
A. Cyanosis and clubbing hands
B. Bounding pulse and hypotonicity
C. Cyanosis occur frequently during and after feeding
D. Blood pressure is different on the arm the leg

819. A nurse was observing the stool color for a newborn on the first day after delivery. What is the expected color
of stool for this newborn?
A. Brown
B. Light green
C. Light brown
D. Brownish green

820. The nurse listens to patient complains and discussed how each of the complaints can be managed which of the
following is the best description the nurse action ?
A. Promoting patient autonomy
B. Demonstrating sympathy
C. Ensure patient support
D. showing concerns

821. a nurse on unite to conduct a research project what is the most important step to be identified ?
A. research problem
B. research setting
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C. analysis plan
D. sample size

822. An 11 years old child has been diagnosed with type 1 diabetes mellitus . which of the following education
should the nurse explain about the exercise?
A. Extra insulin is require during exercise
B. Extra snacks are needed before exercise
C. Exercise will increase blood glucose
D. Exercise should be restricted

823. A 9 month old child is diagnosed Hischsprung disease scheduled for surgical operation which of the following
should the nurse understand the purpose for surgical intervention?
A. To remove the aganglion portion of the bowel to relieve obstruction
B. To maintain optimum nutritional status growth the intertinal
C. To stimulate intestinal adaptation with internal feeding
D. To minimize complication related to the disease

824. Which of organism can cause neonate to develop septicemia including respiratory distress apnea and
hypotension within 12 hours of birth
A. Escherichia coli
B. Cytomegalovirus
C. variclla zoster virus
D. Group B staphococcuss

825. A 16 years old girl admitted to inpatient unit accompanied by her mother who supports her to walk . she
looked very weak and held her head up with her hands . she diagnosed with anorexia nervosa . what is the
primary nursing diagnosis?
A. Risk for injury related to low potassium
B. Body image disturbance related to obesity
C. Imbalance nutrition relate to compulsive overeating
D. Imbalance nutrition related to restricting caloric intake

826. A nurse is caring for child who is pot tonsillectomy and adenoidectomy the nurse should plan to assess which
of the following complication?
A. Pulmonary hypertension
B. Hemorrhage
C. Hearing loss
D. Orthopnea

827. A nurse is conducting a fire safety class and she was explaining that elderly are twice was likely to die at home
from fire accidents compared to younger people therefore the nurse has suggested some safety measures
What should the nurse suggest to prevent fire accidents at home?
A. Have a smoke detectors installed in the houses
B. Invite a family member to sleep with the elderly at nigh
C. Encourage practicing evacuation I case of emergency

828. What the purpose of a late vaginal_rectal culture during ante natal screening ?
A. To screen for group B streptococci
B. To detect a Chlamydia infection
C. To screen for gonorrhea
D. To screen for syphilis

829. A woman at 240weeks gestational age has fever body ache and has coughing last 5 days she is sent to hospital
with admission prescriptions for H1N1influenza . which prescription has the highest priority ?
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A. Assign private room
B. Vital signs every 4 hours
C. Obtain specimens for culture
D. Ringer lactate IV

830. A woman was diagnosed gestational trophoblastics disease what is the lab investigation was done to diagnose
condition ?
A. Cervical pap smear
B. Serum HCG levels
C. Serum estrogen level
D. Plasma thyroxin level

831. A23-year-old gravid 1 ,para 0 mother is presented to the Antenatal clinic. The health educator educates group
of mothers in the waiting area. Which information regarding fetal circulation the educator should stress on?
A. One umbilical artery and one umbilical vein
B. One umbilical artery and two umbilical veins
C. Two umbilical arteries and one umbilical vein
D. Two umbilical arteries and two umbilical veins

832. What is the major task of the staff nurse during a code blue? )
A. Direct the code
B. Intubate the patient
C. Make treatment decision
D. Coordinate use of the crash cart

833. During a vaginal delivery of woman 38 years old the nurse should consider the risk of which of the following?
A. Acute bleeding and coma
B. Low potassium
C. Brain Injury
D. fetal heart rate

834. Pregnant woman signs and symptoms of hypoglycemia

A. Blurred vision
B. Dry mouth
C. Poly urea
D. Flushing

835. Contraindication immunization for the patient who is received which medication ?
A. Steroids
B. midazolam
C. insulin

836. colonized infection is …germs are on the body but do not make you sick

837. Isoniazid side effect ?

A. Hepatitis symptoms
B. Blindness

838. A 30-year-oldarimigravida postnatal mother come to the clinic on the She complained of feeling shivering,
redness, swelling and pain in her right Blood pressure 90/62 mmHg Hea 84/min Respiratory rate Temperature
38.8 °C Which is the most common organism that causes mastitis?
A. Pseudomonas
B. Escherichia coli
C. Group B streptococcus
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D. Staphylococcus aurous

839. A43-year-old woman fell and hit her head. She was admitted to the hospital and put on observation for a
possible closed head injury. The patient's orders include hourly checks for increasing intracranial pressure and
nursing interventions to reduce intracranial pressure.during the assessment, the nurse notes the intracranial
pressure is 16 mmhg . Which is the most appropriate nursing Intervention?
A. Provide an intravenous fluid bolus
B. Position patient in semi-fowler's
C. Prepare for hypothermia induction
D. Hyperventilate with positive pressure

840. A 46-year-old man diabetic patient is admitted to the surgical department because he has gangrened leg due
to uncontrolled blood sugar and contamination of leg ulcer. The admission plan is to do under knee amputation
of the left leg. The nurse is explaining to the patient that this will cause a permanent disability.
Which of the following statements is the best description for permanent disability?
A. Problems in body function and loss
B. Difficulties to experience life situations
C. Difficulties in executing activities
D. Loss of interaction with community

841. A 35-year-old woman presents to the clinic with complaints of itching and pain in the eyes. there are large
amounts of watery discharge and mucous from both eyes. The whites of the eyes are pink-colored and irritated.
the doctor orders a prescription for eye drops that contain prednisolone. The nurse educates the patient on
correct administration. Which advice is most important?
A. Irrigate the eye with saline before administration
B. B.Continue taking medication until the bottle is empty
C. Prior to administration block tear ducts with fingers
D. Apply to the inner aspect of conjunctival sac

842. - A 30-year-old pregnant lady in her 33 weeks pregnancy. When the nurse assesses the health condition of the
lady, she provides nursing care and health teaching. Which of the following types of home visiting is the best to
be conducted?
A. Selective
B. Follow up
C. Fieled trip
D. systemtic

843. Diet for patient with cancer ……………… fresh fruits and vegetables

sickle cell anemia

844. Diagnostic test for sickle cell anemia before birth is Amniotic fluid aspiration sample

845. Both parent have sickle anemia disease ?

A. 100%.
B. 50%.
C. 75%.
D. 25%

846. Both parent have sickle anemia trait the percentage for the child to have the disease ?
A. 100%.
B. 50%.
C. 75%.

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D. 25%

847. 25 weeks-pregnant, primary gravid woman is on her first antenatal visit, completing physical examination and
history, the midwife found out her husband has sickle cell anemia minor.
What should be the most appropriate plan of care?
A. Genetic counselling
B. Identify severity of disease
C. Discuss the chances of transferring
D. Amniocentesis to identify genetic abnormality

848. A6-year-old child is diagnosed with sickle. cell disease is admitted with severe pain in upper and lower
extremities. What type of crisis that the child experiences?
A. Sequestration
B. Aplastic Lae.
C. Vasoocclusive
D. Hyperhemolytic

849. Mother of a sickle cell anemia child is asking why her child can't go hiking with his friends.Which of the
following complications hiking can leads to ?
A. Enhance iron absorption
B. Decrease oxygen consumption
C. Inhibit hemoglobin production
D. Precipitate vaso-oclusive crisis

850. The nurse admits a client who is in sickle cell crisis. The nurse should prepare for which intervention as a
priority in the management of the client?
A. Pain management with an opioid
B. Intravenous fluid therapy
C. Oxygen administration
D. Blood transfusion

851. A nurse is assigned to care for a patient with a diagnosis of thrombotic stroke. The nurse knows that this type
of stroke is MOST LIKELY caused by:
A. Blockage of large vessels as a result of atherosclerosis
B. Emboli produced from valvular heart disease
C. Decreased cerebral blood flow due to circulatory failure
D. A temporary disruption in oxygenation of the brain
Sickle Cell Crisis types :

1.Vaso-Occlusive Crisis Caused by stasis of blood with clumping of cells in the microcirculation, ischemia, and
infarction Manifestations: Fever; painful swelling of hands, feet, and joints; and abdominal pain
2.Splenic Sequestration Caused by pooling and clumping of blood in the spleen (hypersplenism) Manifestations:
Profound anemia, hypovolemia, and shock

3.Hyperhemolytic Crisis An accelerated rate of red blood cell destruction Manifestations: Anemia, jaundice, and
reticulocytosis

4.Aplastic Crisis Caused by diminished production and increased destruction of red blood cells, triggered by viral
infection or depletion of folic acid Manifestations: Profound anemia and pallo

IV fluids
Hypotonic:
 D5W (in the body)
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 0.25% NaCl
 0.45% NaCl (half normal saline)
 2.5% Dextrose
Hypertonic:
 D5 NaCl
 D5 in Lactated ringers
 D5 0.45% NaCl
Isotonic:
 0.9% NaCl (Normal Saline)
 Lactated Ringers
 D5W (In the bag)


 BID. Twice a day. ‫باليوم مرتين‬

 TID three time per day. ‫باليوم مرات ثالث‬
 QIF four times per day. ‫اليوم ف مرات اربع‬
 Stat. ‫وحاال واحده مره‬
 PO = oral

N O V E M B E R
852. Toddler is admitted to the pediatric room with several episodes of diarrhea 3 days . the child is diagnosed with
gastroenteritis. Which organism is responsible about the most diarrhea episodes in children?
A. Rota
B. Bacillus magissterium
C. Shigella
D. Staphylococcus

853. During hospital admission of a homeless patient with mental illness , the nurse tells him that he needs an
immediate shower because he is smelly and looks horrible which o the following explains the nurse action?
A. Judgmental
B. Responsible
C. Professional
D. Empathically

854. A community Nursing nurse is planning to conduct prenatal teaching and community assembly for pregnant
adolescents. Which teaching strategy would be most effective?
A. Offering open sessions for pregnant adolescents and anyone else who wants to attend
B. Designing posters that girls can view individually in community Nursing centre
C. Preparing group class sessions for teaching pregnant adolescents together
D. Conducting one to one teaching sessions for both mothers and daughters

855. A 24 hours after delivery , the nurses noted that the newborn failed to pass meconium. This indicates which
of the following condition?
A. GERD
B. Pyloric stenosis
C. Failure to thrive
D. Hirsch sprung disease

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856. A 4month old infant returned immediately from operating room from cleft lip repair. Which of the following
nursing intervention should considered?
A. Apply elbow restrains
B. Apply suction when needed
C. Measure oral temperature
D. Put the infant in prone position

857. Immediately following the birth of a full-term newborn, which of the following is the priority nursing
diagnosis for this newborn?
A. airway clearance related to nasal & oral secretions
B. ineffective thermoregulation related to environmental factors
C. risk for imbalance fluid volume related t weak sucking reflex
D. risk for injury related to immature defense mechanisms

858. A multiparous 28 year old delivered a full term infant weight 3500 grams fetal heart monitoring during the
active phase of the first stage of labor showed variable decelerations. The midwife is inspecting the placenta
immediately following expulsion which type of placenta is most likely ?
A. Normal
B. Circumvallate
C. Succenturiate
D. Velamentous

859. Which of the following is independent function of primary health care nurse?
A. Complete history and nursing assessment
B. Referral for diagnostic evolution
C. Medical examination
D. Psychotherapy referral

860. A full term newborn is admitted to NICU with a diagnosis of meningocele. Which of the following admission
assessment is needed?
A. Specific gravity of urine
B. Head circumference
C. Weight and length
D. Palpation of the abdomen

861. A nurse is caring a patient diagnosed with pulmonary tuberculosis and she has to wear N95 mask when she
enters to the parent room. Based on the cycle of infection, which of the of the following is the reason to use the
mask?
A. Break the transmission chain at the portal of entry.
B. Break the transmission chain at the portal exit
C. Kill the agent exits in the patients room.
D. Eliminate the reservoir of the bacteria

862. A child with a diagnosis of Tetralogy of Fallot is scheduled to be discharge from the hospital. the nurse who is
planning discharge education should instruct the caregivers that during a hyper cyanotic spell, which position is
most likely to benefit the child?
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A. Supine
B. Prone.
C. side-lying
D. Knee-chest

863. Mother of nine children, three of them with congenital anomalies and one down syndrome, she is a primary
school graduate, with low financial status, she is not using any method of family planning . according, the
primary health are nurse has referred her for counseling.
Which of the following is a model concerned with disability as from of social injustice due to stigma, or
discrimination
A. Health belief
B. Biomedical
C. Sociopolitical
D. Economic

864. A nurse is assigned to care for a child after a cleft palate repair which of the following types of restraints is
very effective for child?
A. Mummy restraint
B. Elbow restraint
C. Wrist restraint
D. Mitt restraint

865. Which of the following interventions is appropriate for the diagnosis of risk for injury of a patient that has a
pacemaker?
A. Offer back rubs to promote relaxation
B. Instruct patient in dorsiflexion exercise of ankles
C. Have patient avoid exposure to magnetic resonance imaging
D. Observe incision site for redness purulent drainage warm soreness

866. Which of the following statement by the nurse describes the effect of clomid an ovulation inducing drug?
A. Given for the first 15 days in each cycle
B. Maximum dose is 50mg daily for a month
C. Increase the risk of birth defects
D. It increases the risk of multiple pregnancy

867. A nurse is caring for a newborn in Well Born Nursery she warps the baby with blanket and ensures the
nursey temperature is suitable for the babies. What type of heat loss is the nurse preventing?
A. Radiation
B. Conduction
C. Convention
D. Evaporation

868. Identification and quantification of health problem in a community as a whole in term of mortality and
morbidity. Which of the following explains this phrase?
A. Diagnosis
B. Assessment
C. Participation
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D. Involvement

869. A 3 year is brought by the mother to the emergency Department with fever diarrhea and vomiting. She
passed four loose motions and three vomiting the last 24 hours , she is anorexic, irritable , has dry lips and
moderate skin turgor. She is given ORS to drink, but she refused it after the first stip.
O2 sat 96 HR 36 TEM 38.8
What is the immediate nursing intervention is required to encourage the baby to drink the ORS?
A. Give In a cup once cold a day
B. Help her to drink with a syringe
C. Give in a small amount frequently
D. Engage in playing and help to her drink it

870. A 50 year old woman is attending the outpatient clinic for annual check up. Which of following should be
reported if inspected during breast examination?
A. Everted nipples
B. Symmetrical visible
C. Dimple in the left breast
D. Right breast is slightly larger than left breast

871. A pregnant woman is 36 weeks pregnant was admitted to antenatal ward for observation after being
involved in a car accident the refuses when the nurse tried to touch her abdomen to perform examination
saying it is painful. She also present mild vaginal bleeding . Which of the following is the most appropriate
diagnosis
A. Placenta previa
B. Tubal pregnancy
C. Abruptio placenta
D. Inevitable abortion

872. A patient fell in the bathroom and his left leg was fractured, in order to communicate information about the
patient to the next shift. Which of the following documentation should be used by the nurse at the nurse at the
end of the shift?
A. Kardex record
B. Assignment record
C. Shift report
D. Incident report

873. A 43 year old man is 30 hours post-operative following placement of a partial thickness skin auto graft for a
burn injury on the lower anterior leg. During routine assessment, the nurse notices the wound is bleeding
continuously. Which of the following is the nursing action?
A. Use a pen to outline and monitor area
B. Perform a wound swab for laboratory analysis
C. Incise and drain fluids from the wound bed
D. Apply firm and direct pressure for 10 minutes

874. The charge nurse is evaluating the skills of a newly registered nurse who is providing care to a client with
shock. Which action taken by the new nurse would most likely indicate the need for further instruction?

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A. Administers furosemide to a client in cardiogenic shock with a pulmonary artery wedge pressure
of 24 mmHge
B. Increase norepinphrine infusion rate to maintain arterial pressure greater than 65mmHge in a
client with anaphylactic shock
C. Moves pulse oximeter sensor from the finger to the forehead of a client with septic shock
D. Place the head of the bed in high fowler position for a client with hypovolemic shock

875. A 28 year old man is recovering from a moderate concussion following a motor vehicle accident two week
ago, when he suddenly develops an increased thirst, craving cold water, the patient urinated very large amounts
of dilute, water like urine with a specific gravity of 1.001 to 1.005.
Which of the following is the patient most likely developing ?
A. Diabetes mellitus
B. Diabetes insipidus
C. Hypothyroidism
D. Thyroid storm

876. A25 years old patient telephone the nurse in the day surgery unit and complains of intense pain in the
frontal lobe. Two days previously, she had undergone an elective surgical procedure that had required a spinal
anesthetic block. Which of the following remedies is the most alleviate the patient symptoms?
A. 1000ml fluid intake per day
B. Decrease exposure to light
C. Lie own in a flat position
D. Acetaminophen 200 mg by month

877. A 32 year old man is admitted to the isolation unit with acquired immune deficiency syndrome. He is
married and has one child. His wife is a depressed because of his diagnosis.
Which of the following nursing problems requires immediate planning?
A. Risk of infection due to autoimmune cell destruction
B. Nutrition deficit due to due body cell mass wastage
C. Risk of ineffective ineffective psychosocial and family support
D. Knowledge deficit about prognosis and treatment

878. A 56- year old man with history of COPD is complaining of chest, shortness of breath , lethargy, fever and
productive cough. Upon examination, crackles could be heard in the lower lobes
BP 11./70 HR 111 RR 18 TEM 37.4 Oxygen Sat 90%
A. Prone
B. Supine
C. High fowler
D. Trendelenburg

879. A 55 year patient stats states that he has difficulty in sleeping in the hospital because of the noise. The nurse
kept trying reassuring the patient but still cannot sleep.
To assist an adult patient to sleep better the nurse recommends which of the following?
A. Eating a large meal one hour before bedtime
B. Consuming a small glass of warm milk at bedtime
C. Performing mild exercise 30 minutes before going to bed
D. Administer a sedative, as ordered by physician
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880. A 47 year patient received spinal anesthesia five hours ago in the operation theatre and was transferred to
the surgical unit. Few hours later the patient complains of incisional pain. The surgical site is dry and intact but
the patient looks pale irritated.
BP 175/90 HR 112 RR 27 TEM 37.6
What is the most appropriate nursing intervention ?
A. Take a 12 lead ECG
B. Administer pain medication
C. Notify treating physician
D. Strat IV infusion and place patient in supine

881. A nuclear plant experienced a leakage, and all involved workers were brought to the Emergency Department
for treatment . the medical team prescribed potassium iodide for the workers to block radioactive iodine to be
absorbed by an organ in the body. Which of the following organs is the most sensitive to radioactive iodine?
A. Brain
B. Lungs
C. Kidney
D. Thyroid

882. A patient is being followed in the clinic for hypertension, adult onset diabetes and obesity. The patient is
apathetic about the learning about nutrition guidelines to reach the goals of weight loss and consumption of a
healthy diet . the patient admitted to eating " whatever is put in front of me". which of the following actions
would the nurse take?
A. Collaborate with the patient to set goals
B. Add a nursing diagnosis of non- compliance
C. Refer to psychiatric screening for depression
D. Discuss nutritional interventions with the spouse

883. A 60 year old man is admitted to the male medical ward with coronary artery disease. The patient has a
history of hypertension, stress high cholesterol, diabetes and smoking. His father died of myocardial infraction .
Which of the following are modifiable risk factors for coronary artery disease?
A. Age and gender
B. Gender and diabetes
C. Family history and smoking
D. Smoking and high cholesterol

884. A nurse completes discharge instructions for a patient who was admitted five days ago with pneumonia.
Which of the following statements by the patient would alert the nurse that more discharge teaching is needed?
A. I need to gradually increase my actives
B. I need to have another chest X-ray in 4-6 weeks
C. I will not need the infuenza or pneumonia vaccine
D. I may experience fatigue and weakness for a prolonged time

885. A 45 year old man is admitted to the surgical ward for stoma. The stoma appears a dark red purple color, is
slightly swollen and leaks scant amount of blood. The is no presence of stool around or on the site. Which
observation requires immediate attention?
A. Color
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B. Edema
C. Absence of stool
D. Presence of blood

886. A nurse is preparing a teaching session for elementary school students about the safety measures of
hazards. Which of the following is the most appropriate topics for safety measure for children at this age?
A. Sport activities
B. Riding bicycle
C. Swimming
D. Driving

887. During her break time, the nurse was eating in the hospital cafeteria when she noticed a female colleague
grasping her neck and unable to speak . which of the following maneuvers is the best to be performed by the
nurse?
A. Epley
B. Heimlich
C. Valsalva
D. Leopold's

888. Patient with meningitis after treatment with effective MCV4. Which of the following confirm that was
effective ?
A. CBC
B. Negative brudzinskis signs

889. Which of the following medication types is given rectal ?

A. Tablet
B. Capsule
C. Injection
D. Suppository

890. intrauterine growth curves were used to classify a 32-week-old preterm new-born. Birth weight and
gestational age shows the infant's growth rate falls below the 10th percentile. What is the priority nursing
diagnosis for a new-born with small for gestational age?
A. Risk for injury related to impaired gluconeogenesis
B. Risk for impaired gas exchange related to meconium aspiration
C. Risk for ineffective thermoregulation related to lack of subcutaneous fat
D. Risk for altered nutrition less than body requirement related to increased metabolic needs

891. During a prenatal examination. The nurse draws blood from a young Rh negative client and explain that an
indirect Coombs test will be performed to predict whether the fetus is at risk for:
A. acute hemolytic disease
B. respiratory distress syndrome
C. Protein metabolic deficiency.
D. pathologic hyperbilirubinemia

892. Which of the following statements will indicate that she understand the nurse's teaching?
A nurse is teaching a 26-year-old primigravida who are 33 weeks pregnant on the how to use a kick
chart.
A. Fetal movements must be counted three times per day
B. Fetal movements are felt best when the women is on her right side
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C. Fetal movements is a reassuring sign which indicates that the fetus healthy

D. The kick chart is used to record fetal movement for the first time during pregnancy
893. Immediately following the birth of a full-term newborn, which of the following is the priority nursing diagnosis
for this newborn?
A. airway clearance related to nasal & oral secretions
B. ineffective thermoregulation related to environmental factors
C. risk for imbalance fluid volume related t weak sucking reflex
D. risk for injury related to immature defense mechanisms

894. An infant arrives in the Emergency Department not breathing and does not have a pulse. When starting CPR,
which of the following arteries is appropriate to perform the pulse checks?
A. carotid
B. Radial
C. Brachial
D. Temporal

895. A 45 years old man admitted with second degree burn injury of 10% in the left arm due to hot water spillage.
During assessment, the nurse would assess the general health of patient and include risk factor for wound
healing process. Inflammatory process of wound healing with which of the following?
A. Vasoconstriction of blood vessels
B. Antibody reaction towards antigen
C. Redness due to vessel dilation
D. Migration of macrophages to ingest the microorganism

896. A 56 year old patient, who is post triple coronary artery bypass surgery, remained intubated for two days.
While assessing the patient. Body temperature, which of the following routes the nurse must exclude to avoid
cardiac dysrhythmia?
A. Skin strip
B. Axillary
C. Tympanic
D. Rectal

897. The doctor ordered to give nitroglycerine sublingual to a patient with angina. What is the most likely effect
that drug has on the patient body?
A. Increase heart rate
B. Increase blood pressure
C. Increase blood supply to the heart
D. Increase myocardial oxygen consumption

898. A 26-year old patient came for lithotripsy of her kidney. She was accompanied by her husband. Her vital
signs were stable and was overweight. Her investigations released her pregnancy test as positive and were two
moths pregnant.
Which of the following action the nurse should take for this patient?
A. Prepare for physical examination
B. Hold procedure and inform
C. Have the consent signs
D. Prepare for lithotripsy

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899. A 66 year old woman was admitted to the hospital with a history of hypertension he presents with breathing
difficulties that worsen with activity and while sleeping. He is weak and feel that her heart misses beats. An
electrocardiogram confirms atrial fibrillation, right ventricular hypertrophy and deviation towards the right.
Which of the following is the most likely origin of the disorder?
A. Hypertension
B. Rheumatic fever
C. Atherosclerosis

Genetic predispositionA female teenager was diagnosed with sickle cell anemia informs a nurse that her school
arranged a hiking activity in nearby mountains. She shows excitement while forming the nurse about her new water
bottle for this trip?
What is the appropriate initial response by the nurse?
A. What do your parents think?
B. You realize that this type of activity might cause a pain crisis
C. You need to get approval from your doctor before attending this activity
D. It is great you are hydrating yourself in preparation of this activity

900. A 35 years old patient was admitted to the medical ward through emergency department accompanied by
her . her chief complains include severe epigastric pain, abdominal tenderness and distension for the last 24
hours . she was anorexia and had passed sex watery diarrhea since few hours. She was feeling lethargic due to
frequent elimination action is required?
A. Provide fluids to drink
B. Arrange soft diet
C. Check vital signs
D. Inform physician

901. A 36 year old man present to the hospital with complaints of breathing difficulties and fever. The patient had
undergone a liver transplant one year before upon assessment a yellowish colored skin was noted on entire
body
HR 102 RR29 BP 110/80 TEM 39.2 HB 11 WBCS 4 RBS 3.5
Which complication is most likely to occur?
A. Bleeding
B. Embolism
C. Superinfection
D. organ rejection

902. A 23 year old patient was admitted to evaluate pyrexia of unknown origin. According to her mother, her
fever spiked every night to 38.5 until morning for the last two weeks. The patient was quiet, uninterested in her
surroundings, had language barrier and her personal hygiene was not maintained. At lunch time , she refused to
eat the hospital food , but her yelled at her in front of others and forced her to eat . what basic need of the
patient is disturbed according to maslow hierarchy ?
A. Self esteem
B. Self-actualization
C. Safety and security
D. Food water and shelter

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903. A 62 year old man present to the clinic with complains of hearing loss in the left ear the hearing loss has
been progressive over the past year. A semi-transparent, a pale grey color and clear of cerumen. A weber test is
performed and the sound lateralized to the right ear. Which type of hearing loss is suspected?
A. Left-sided conductive
B. Right-sided conductive
C. Left-sided sensorineural
D. Right-sided sensorineural

904. A 42 year old man with thalassemia received a packed cell transfusion. The nurse assess the stability of his
condition after transfusion by monitoring the vital signs and general condition every two hour. When should the
nurse immediately report the patient condition ?
A. Sever headache and raised blood pressure
B. Raised body temperature and flushed skin
C. Joint pain, body ache listlessness
D. Restlessness & bradycardia

905. A patient with sever varicose veins of the left leg presents to the clinic. The patient states that three days
ago the right leg became very swollen and the skin on the right half area was very darkly colored. The capillary
refill in the fingers is three seconds and on the right toes is four seconds.
A. Teach the patient self blood monitoring
B. Assess the patient to sided heart failure
C. Encourage the patient to joint an exercise class
D. Teach the patient how to apply thigh high anti embolic stocking

906. A 26 year old patient in the gynecology ward complained of pain and swelling in episiotomy stitches on her
second post natal day. On examination, the localized swelling, redness, foul smell and pussy discharge were
identified at the stitches site after examination, the nurse checked her vital signs
BP 116/58 RR 28 HR 132 TEM 39.8
Which of the following should the nurse do prior patient examination by the gynecologist?
A. Arrange dressing instruments
B. Maintain patient privacy
C. Arrange stitch removal kit
D. Collect detailed history

907. A woman delivered her baby boy 3 hours ago with caput succedaneum. Which of the following the nurse
expects to find when she examines the newborn baby caput?
A. Soft, fluctuant mass filed with fluid
B. Bilateral mass on both biparietal boons
C. A mass with clear edges that end at the suture lines
D. A hard mass that is filled with blood

908. When caring for a client who has acute respiratory distress syndrome, a nurse elevates the head of the bed
to 30 degrees. What is the reason for this intervention?
A. Reduce abdominal pressure on the diaphragm.
B. Promote bronchodilation and effective airway clearance
C. Decrease pressure on medullary centre which stimulates breathing
D. Promote retraction of intercostal accessory muscle of respiration.
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909. A nurse need to take the temperature of an adult comatose patient his rectum. How far into the rectum
should the thermometer be inserted reliable temperature?
A. 1.5 cm
B. 2.5 cm
C. 3.5 cm
D. 4.5 cm

910. A 60 year old man is recovering in a hospital ward three days after hip arthroplasty. He has not had a bowel
movement since the operation and complains of feeling bloated up on examination reveals abdominal
distension and hypoactive bowel the patient rate his pain at a level 7 at rest and 9 with movement pain scale of
1-10. He is taking opioid analgesics. The nurse care plan based on diagnosis altered bowel elimination surgical
intervention as evidence by lack of bowel movement. Which of the following is the most appropriate
intervention?
A. Request an increased opioid dosage
B. Perform passive range of motion exercise
C. Encourage increase fluid intake
D. Provide soft foods based on bland diet

911. A 40year old client underwent and exploratory laparotomy with anesthesia. An assessment of abdominal 36
hours postoperative showed abdominal distension and an absent of bowel sound. Which complication is most
likely?
A. Paralytic ileus
B. Hemorrhage
C. Rupture colon
D. Intussusception

912. A patient with carpal tunel syndrome ( CTS) is being prepare surgery . which of the following appropriate to
delegate to a assistant?
A. Assess wrist and hand of patient for discoloration
B. Assist patient with self care activities such as bathing
C. Check digits of the hand for painful tingling sensation
D. Initiate application of a splint for immobilization during the

913. A nurse I the medical surgical unital is review a plan of care elderly client with chronic obstruction
pulmonary disease ( COPD) limited mobility . the nurse notes that the physical therapist change in the plan of
care to progress ambulation from 50 to 100 times a day. Which action in necessary to ensure that the client
need are?
A. Inform physical therapist of client respiratory status before progressing to ambulation
B. Instruct physical therapist not to proceed with ambulation nurse presence
C. Inform physician about physical decision to ambulation
D. Cancel referral to physical therapist

914. After teaching a 54 year old patient with angina on how to take nitroglycerin sublingual PRN. Which of the
following statements reflect the patient understanding?
A. I have to take this medication once i need it only
B. It is ok to take one tablet daily to prevent the heart attack
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C. I can take two tablets together at once if the attack is
D. This medication will regulate my heart beats and I will be

915. A 7 year old child is assessed with a urinary tract infection BP 99/55 TEMP 36.4 . which of the following is
the most appropriate nursing action?
A. Notify the physician immediately
B. Notify the nurse manager immediately
C. Document the findings in the nurse note
D. Put the patient in Trendelenburg position

916. The physician writes the following order. Vancomycine 500mg intravenous injection. The infusion is to be
mixed with 200 ml of 0.9% normal saline and administered through a central. The nurse order the medication
from the pharmacy. Which reviewing the chart, the nurse notes the patient has a penicillin allergy.
A. Withhold the medication and notify the physician
B. Suggest an additional order for antihistamine
C. Dilute in 500 ml prior to administration
D. Administer the medication as ordered

917. A 55 year old underwent total hip replacement. Two hours post. post-operative an orthopedic unit nurse
notes the patient was lethargic and dizzy
Hb9.8 normal 13-17
What nursing intervention is the most appropriate?
A. Start I V fluids
B. Administer paracetamol 1gm iv
C. Call blood bank and request one unit of packed RBS
D. Encourage ambulation to reduce enhance recovery

918. While evaluating a child in the Emergency Department, the nurse notices that despite. Feeling warm to
touch, the patient has bluish bail beds and bluish lips. Which of the following should the nurse immediately
assess?
A. Respiration
B. Temperature
C. Pulse
D. Blood pressure

919. A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIDH). Which of the
following should be a priority intervention for the client?
A. Monitoring hourly intake and output
B. Pressure ulcer prevention strategies
C. Encourage client to eat foods rich in potassium
D. Restricting fluid intake of the client to less than 1000ml per day

920. A 75 year old man is pale and lethargic . he weights 105kg and is bedridden with urine and stool
incontinence. Which of the following is the appropriate nursing diagnosis?
A. Risk for falls
B. Risk for infection
C. Risk for fluid imbalance
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D. Risk for impaired skin integrity

921. A patient, who had abdominal surgery six days ago, has been ambulating in the halls without much difficulty.
however, on seventh postoperative day, the patient complains of increased pain at incisional site and is walking
bent over. What is the most likely cause of the ?
A. Intestinal inflammation
B. Pulmonary edema
C. Wound infection
D. Deep vein thrombosis

922. A clinical instructor was explaining to his students about the discharge planning. One of the students asked
about the timing of initiating the discharge planning?
A. When patient asks for discharge
B. On admission to acute care setting
C. After successful recovery from surgery
D. When the treating physician agreed to discharge

923. A nurse is completing the preoperative assessment of the patient who is scheduled for vein ligation and
stripping. The nurse should explain that which of the following is included in the patient postoperative plan of
care ?
A. Apply cold packs
B. Wearing elasticized stockings
C. Ambulating with axillary crutches.
D. Participating in physical therapy.

924. A patient was admitted to the emergency room due to abdominal pain, upon assessment, positive psoas
signs was noted. The patient was rushed to the operating Room for stat appendectomy. Before a naso gastric
tube postoperatively?
A. Patient feels hungry
B. Upon patient request
C. Flatus repotted by patient
D. Patient consciousness is regained

925. A 40 year old man was admitted gastrectomy for subtotal gastrectomy . he was diagnosed as gastric cancer
he has month of fatigue, intermittent. He had a history of sever abdominal pain, loss appetite, vomiting and two
episodes of hematemesis first day postoperative. The nurse assesses the drainage of nasogastric tube. Which of
the following is expected drainage color?
A. Bile green
B. Bright red
C. Dark brown
D. Cloudy white

926. During the initial assessment, a registered nurse decided to apical pulse of a patient with coronary artery
disease. Which position is best of the patient to be placed in to measure pulse?
A. Prone position
B. Supine position
C. Position on his /her left side
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D. Position on his /her right side

927. Which of the following interventions is appropriate for the diagnosis of risk for injury of patient that has a
pacemaker ?
A. Offer back rubs to promote relaxation
B. Instruct patient in dorsiflexion exercise of ankles
C. Have patient avoid exposure to magnetic resonance image
D. Observe incision site for the redness purulent drainage warm ,soreness

928. A patient is brought to the emergency department suffering from inhalation up on assessment, a nurse
observe that the patient aggressive and confused
Which of the following is the most likely explanation?
A. Pain
B. Mania
C. Anxiety
D. Hypoxia

929. A patient has a hip fracture complaining of sever pain. He nurse finds no analgesic was ordered. She calls the
orthopedic doctor by telephone and received a medication order.
What is the most appropriate nursing action to ensure correct medication order taken ?
A. Write down the order and get pharmacy o supply
B. Write down the order and get medication immediately with another registered nurse
C. Get another registered to witness, nurse write down the order and read back to the doctor
D. Write down the medication and after serving get the doctor to witness

930. old child is admitted to the Postoperative Care Unit following in heart transplant. The nurse administers
cyclosporine by intravenous infusion. Fifteen minutes later the child has difficult breathing, his skin feels cold
and clammy and he appears restless. Which of the following is the most appropriate initial nursing action?
A. Ensure airway patency
B. Administer oxygen therapy
C. Discontinue intravenous infusion
D. Administer intramuscular epinephrine

931. A woman patient with , fever, weight loos, and watery diarrhea is being admitted to health care facility.
During assessment the nurse notices the patient abdomen is concave. additional assessment should proceed in
which order?
A. Palpation, auscultation, and percussion
B. Percussion, palpation, and auscultation
C. Palpation, percussion, and, auscultation
D. Auscultation, percussion, and palpation

932. A nurse responsible for narcotic medication loses on ampule morphine. She reports the problem to nurse
manager. Which of the following is the first thing she should say according to the SBAR approach?
A. I have lost one ampule of morphine
B. We should ask the nurse about the morphine
C. I think I left the lid of narcotics box open
D. We should open an investigation into problem

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933. The nurse care for a 60 year old woman who history hypertension, hypothyroidism and elevated cholesterol
levels. She takes tablets daily for each of the health problem. The doctor orders a routine dual- x-ray
absorptiometry test that shows decrease bone density. Which medication most likely contributed the test
result?
A. Statins
B. Anti-hypertensive
C. Synthetic thyroid hormones
D. Cholesterol absorption inhibitors

934. A 56 year old present to the emergency department experiencing left sides eye discomfort for the past 3
hours, left eye was blurred while vision in the right eye remained examination showed increased intra-ocular
pressure in the left eye pupil of the left also reacted slowly to light. which is the most likely health problem?
A. Detached retina
B. Macular hole
C. Glaucoma
D. Cataract

935. patient is admitted to the Emergency Department with broken nose And no other facial fractures or injuries.
What category of surgery would repair a broken nose fall under?
A. Urgent
B. Elective
C. Emergency
D. Immediate

936. A 38 years old gravida 5 para 3 post natal mother delivered via caesarean section. On the fourth post
operative day the mid wife noted human's sign was positive . human's sign is result by pain which of the
following leg site?
A. Calf
B. Foot
C. Heel
D. Thigh

937. Which of the following vaccines are safe to administer to pregnant women?
A. Measles
B. Tetanus
C. Rubella
D. Varicella

938. During nursing assessment, the nurse document the presence of skin breaks, abrasion, blister, or sallow
cater, edema , and infection. According to recognized staging system , what is the classification of this pressure
ulcer?
A. Stage 1
B. Stage II
C. Stage III
D. Stave IV
939. The nurse has attempted to administer a breath to a patient who was found unconscious on the floor. There
was resistance to air entering the patient air way. Which of the following action should the nurse take next?
A. Feel for air movement from the patient nose

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B. Perform finger seep in then patient mouth
C. Hyperextended the patient neck
D. Administer abdominal thrusts

940. The nurse has attempted to administer a breath to a patient who was found unconscious on the floor. There
was resistance to air entering the patient air way. Which of the following action should the nurse take next?
A. Feel for air movement from the patient nose
B. Perform finger seep in then patient mouth
C. Hyperextended the patient neck
D. Administer abdominal thrusts

941. Which one of the following is the reservoir for the pathogens causing Hepatitis C?
A. Blood
B. Bowel
C. Bladder
D. Bronchioles

942. Which of the following can be considered as a major development in nursing home visits in terms of
information technology ?
A. Medication dispensing
B. Telehealth
C. Patient monitoring
D. Prevention of epidemiological disease

943. Which of the following contraceptive method offers protection against sexually transmitted infection?
A. Coitus interrupt
B. Intra uterine device
C. Latex condom
D. Oral contraceptive

944. Which of the following risk can be determined by Alpha fetoprotein analysis screening test ?
A. Neural tube defects
B. Placental insufficiency
C. Hydrous fatalism
D. Intra uterine growth retardation

945. Research data to be collected from children on nursing unit. What type of consent is the most appropriate ?
A. Informed written consent
B. Consent signed by parents
C. Consent from physician
D. Hospital administration consent

946. What is a characteristic of democratic leadership style?

A. More changes
B. Structured work
C. Staff participation
D. No leader decisions
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947. Which of the following vaccines in highly recommended to be taken by pilgrims before Haji season?
A. Meningococcal meningitis
B. Tuberculosis
C. Hepatitis A
D. Polio myelitis

948. Which of the following is the main reason the makes nurses concerned about adolescents health status?
A. Take risky behaviors
B. Consider themselves as adult
C. Have more health issues
D. Transitional period to adulthood

949. A child with rheumatic fever is having sever pain , tenderness and swelling in his left joint what should the
nurse do to alleviate his pain?
A. Apply heat on the affected joint
B. Put the joint in flexion position
C. Apply clod compresses to the joints
D. Ask the child to walk for 15 minutes

950. A 30 weeks of gestational age preterm is admitted to the neonatal intensive care unit 2 hours . the neonate
starts to have grunting tachypnea, and nasal flaring. Which of the following is responsible factors for diagnosis of
the premature ?
A. Bronchial spasm
B. Immature bronchioles
C. Lack of surfactant
D. Pulmonary over load

951. A 28years old patient in the medical ward was admitted to rule out her recurrent headache for the last year.
On the second day of her admission she complain of sever generalized headache . after identify the intensity
duration and severity the nurse informed physician and administered paracetamol and recorded the details in
the nursing notes after half hour when the nurse asked the patient replied that the pain was relieved and she
felt better what the nursing process step?
A. Nursing problem
B. Implementation
C. Assessment
D. Evaluation

952. A physician has ordered gavage feeding every 4 hours for A 12-week-old infant with failure to thrive. in order
to know how far toinsert the feeding tube.The nurse should measure the distancefrom which of the following?
The tip of the infant's nose to the ear and then to the xiphoid process of the sternum

953. A 7 years old child is admitted to pediatric medical. Ward his urine analysis result revealed massive
proteinuria. T he child was diagnosed with Nephrotic Syndrome. Which of the following medication can prevent
the relapses of the child condition?
A. Antibiotics
B. Corticosteroids
C. Diuretics
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D. Immunosuppressive

954. A nurse is explaining pudendal block anesthesia to primigravida women who is inactive labor. Which of the
following relief areas identified by the woman would indicate that teaching was effective ?
A. Back
B. Perineum
C. Fundus
D. Abdomen
955. A 10 years old child had an appendectomy yesterday. Which pain scale should the nurse use to assess child
pain?
A. Numeric
B. Faces
C. FLACC
D. Cries

956. A nurse is caring for child who is post tonsillectomy and adenoidectomy. The nurse should the nurse plan to
assess which of the following complication?
A. Pulmonary hypertension
B. Hemorrhage
C. Hearing loss
D. orthopnea

957. A 36 years old woman is in her 18 weeks pregnancy came to antenatal clinic and assessed by the nurse. She
has three previous abortion during the first trimesters prior to pregnancy. How the nurse will document the
status of the mother?
A. Parity
B. Nullipara
C. Multipara
D. Primipara

958. During vaginal examination the nurse palpated the posterior fontanel to be at the right side and upper
quadrant of the maternal pelvis ?
A. ROP
B. LOP.
C. ROA
D. LOA

959. During meningitis outbreak in one of the hospital the non-immune staff members were given
immunoglobulin in order to prevent them from the infection. What is the type of immunity will be developed by
those staff?
A. Active
B. Long term
C. Natural
D. Passive

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960. A 34 years old woman was diagnosed with breast cancer and underwent surgery. She is currently receiving
monthly chemotherapy she telephone the clinic and notifies the nurse that she developed a sore throat. Which
of the following foods would be the most appropriate to recommended?
A. Fresh fruits and vegetables
B. Seafood
C. Dried fruits nuts
D. pasteurized cheese

961. a 6 years old child diagnosed with Sickle cell anemia is admitted with sever pain in upper and lower
extremities. Which of the following priority should the nurse concern?
A. hydration and pain management
B. nutrition and restricted hydration
C. Nutrition and manage infection
D. Manage pain and infection

962. A primiparous mother is calling the clinic to report that her baby often regurgitates small amount of breast
milk which of the following is appropriate nursing advice the mother?
A. Elevate the head of the bed
B. Feed the baby when he is too hungry
C. Attend to the clinic with the baby
D. Put the baby in prone position after feeding

963. A 10 month old infant is admitted to the surgical ward with hydrocephalus. Which of the following .indicate
increased intracranial pressure?
A. Bulging
B. Decrease blood pressure
C. Rapid, shallow breathing
D. Increase body temperature

964. A 2 years old girl is hospitalized with a diagnosis of bronchiolitis. She is receiving oxygen therapy. Which of
the following would be the best indicator the effectiveness of the of oxygen therapy?
A. Oxygen saturation 84%
B. Oxygen saturation 90%
C. Respiration rate 12bpm
D. Respiration rate 25bpm

965. Infant mortality is a critical indicator of children health status. Which of the following statements probably
describes the " infant mortality " term?
A. Deaths of infant during the first year of the life per 100 live births
B. Death of infants during the first year of life per 1000 live births
C. Death of infants during the first year of life per 10000 live births
D. Death of infants during the first year of life per 10000 live births

966. A pregnant mother with sickle cell anemia is in labor. What should the nurse to ensure the safety of the
infant?
A. Control pain
B. Administer oxygen
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C. Monitor fetal heart rate
D. Monitor maternal vital signs

967. A nurse is preparing to administer RhoGam to Rh-negative women who has delivered a Rh-positive newborn
. Which of the following is prevented by this intervention ?
A. Maternal illness
B. Neonatal illness
C. Production of antibodies
D. Re- occurrence of Rh positive baby in next mother

968. A multigravida and 37 weeks pregnant mother presents t the antenatal Clinical. Her condition of the stable
and her baby position and heart rate are normal. Which of the following discussion is more appropriate with thr
mother?
A. Observer until the 40weeks complete
B. Family planning and birth spacing
C. Arrange for caesarean section
D. Possible of induced labor.

969. A neonatal is admitted to the NICU with a meningomyelocele. HR130 .. RR 28….. TEM 36.7 which of the
following action the nurse should perform to prevent infection of the meningomyelocele sac ?
A. Wash the sac with betadine every shift
B. Expose the defect to the room air
C. Apply antibiotic cream every 24 hours
D. Cover he sac with moist sterile saline dressing

970. A patient was on regular dose haloperidol. The nurse noticed that he start developing side effects in the
form stopped posture with shuffling gait and pill-rolling movement of his hands. Which of the following is most
likely the side effect?
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Pseudo parkinsonism

971. A pregnant woman visits the Outpatient clinic complaining of excessive vaginal secretion. Which of the
following is the appropriate nursing assessment?
A. Fetal heart rate
B. Fundal height
C. Signs of infection of labor
D. Fetal presentations and position

972. A nurse is caring a one year old child with congestive heart failure . which nursing goals appropriate?
A. Relieving pain
B. Improving myocardial efficiency
C. Maintaining thermoregulation
D. Promoting oral feeding

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973. Registered nurses must be able to measure blood pressure accurately. What could possibly result in
incorrect high blood pressure reading ?
A. Bladder cuff is to wide
B. Cuff is deflated too quickly
C. Cuff is wrapped too loosely
D. Arm is above the level of the heart

974. A patient was brought to the emergency room because of a sudden onset of difficulty in breathing. The
result to a stat X ray revealed fluid accumulation in the pleural space. The doctor order for an immediate
thoracentesis. Which of the following sites should be prepared ?
A. Between 5th and 6th
B. Between 6th and 7th
C. Between 7th and 8th
D. Between 8th and 9th

975. A 60 year old with gout visited the Medical Clinic and advice to increase fluid intake. Which of following is
the benefit of increase fluid?
A. Decrease inflammation
B. Increase calcium absorption
C. Promote the execration of uric acid
D. Provide a cushion for weakened bones

976. Which of the following pain assessment scale is the most is the most appropriate for seven year-old boy who
twisted his ankle while playing football at school?
A. Numeric
B. Behavioral
C. Wrong- baker faces
D. Simple decretive

977. During the working phase of the helping relationship, the patient was crying while disclosing his problems to
the nurse. Then in the middle of their conversion, the patient becomes silent. Which of the following should the
nurse do?
A. Ask question
B. Introduce another topic
C. Stay with client and be silent
D. Terminate session immediately

978. Which of the following patient care plan is the most appropriate for a 37 years old post appendectomy
woman who is at risk of pneumonia ?
A. Restrict fluid intake
B. Teach how to use spirometer
C. Encourage ambulation as tolerated
D. Avoid coughing and deep breathing

979. A 37 YEARS OLD FEMALE PRESENTED TO THE Emergency room with complains of symptomatic bradycardia.
Appropriate nursing interventions include establishing IV access. What is the possible drug to be administered in
the IV solution?
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A. Digoxin
B. Atropine
C. Anticoagulant
D. A calcium channel blocker

980. During the night shift routine rounds, a nurse found that a patient complain of sleep disturbance due to
frequent voiding several times at night. Which of the following is the best condition that describes the patient
complain?
A. Dysuria
B. Polyuria
C. Nocturia
D. Hematuria

981. A 29-year-old woman is receiving an intravenous infusion of 5% dextrose in 0.45% sodium chloride. the
intravenous line had been started one day prior and now the patient complains of tenderness at the site. On
examination, the site is pink colored, swollen and tender to the touch. Which side effect of intravenous infusion
problem is most likely?
A. Infiltration
B. Phlebitis
C. Catheter sepsis
D. Air embolism

982. A 25-year-old woman present to the Emergency Room with acute gastritis and signs of moderate
dehydration. Which is the most appropriate nursing diagnosis?
A. Infection
B. Fluid volume deficit
C. Activity intolerance
D. Fluid volume excess

983. A 2-year-old child is admitted to pediatric ward. The mother cannot stay the child and she will visit him in the
weakened only. Which of the following nursing action indicates an understanding of the emotional needs this
child?
A. Give her a warm bath to calm down
B. Allow the child to suck on a pacifier
C. Ask the parents to bring the child favorite toy
D. Tell he parents that frequently visiting is unnecessary

984. A conflict occurred for a patient with chronic renal failure with regards to the patient's needs, family needs,
the physician's advice, and the hospital polices and rules. What is the first commitment for the nurse who
provides care for the patient
A. Physician
B. Hospital
C. Family
D. Client

985. showed no signs of pain while palpating them. seemed scared and did not answer any questions asked Which
of the following should the nurse do to gain the child's body trust?
A. Arrange meal
B. Comfort measures
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C. Show the playing area
D. Therapeutic communication

986. A nurse accidentally dropped a medication ampule, informed the charge nurse and complicated an incident
report form. Which of the following best describes the nurse role?
A. Responsiveness
B. Timely decision making
C. Profession accountability
D. Abiding by moral obligation

987. Patient receiving potassium sparing diuretics should be monitoring. Which of the following ?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia

988. A 26 years old patient in the gynecological ward complained of pain and swelling in her episiotomy stitches
on her second post-natal day. On examination the localized swelling redness foul smell and pussy discharge were
identified at the stitches site after examination the nurse checked vital sings BP 116/28 HR 132 RR 28 TEM
39.8. which of the following should the nurse do prior to the patient examination by the gynecologist?
A. Arrange dressing instrument
B. Maintain patient privacy
C. Arrange stitch removal kit
D. Collect detailed history

989. A 4 month old infant returned immediately from OR room post cleft lip repair which of the following nursing
intervention should be considered?
A. Apply elbow restrain
B. Apply suction when needed
C. Measure temperature
D. Put infant in prone position

990. Patient diagnosed with vitamin c deficiency. Which of the following pups of foods would the nurse most
likely instruct the patient to add to ?
A. Broccoli, tomatoes, strawberries, potatoes
B. Legumes, egg, oats, meat
C. Yeast, fish , bananas, nuts
D. Milk, liver, rice, beans

991. During clinical assessment, the nurse suspected that a child has been psychological abuse. Which statement
by the child is most likely support the suspicion?
A. My parents tell me that iam stupid
B. My parents hurts me to get attention from the doctors
C. My mother forces not give meals on times
D. My uncle show me picture of nude people

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992. While a nurse is assessing vital signs of newborn infant first hour of delivery. HR 170 RR 70 TEM 36 . the
nurse would interpret these finding as in the discharge instruction
A. Anemia
B. Cold distress .
C. Heart defects
D. Hyperglycemia

993. A 30 year old married woman has dilatation and curettage as a therapeutic abortion. A nurse was preparing
for discharge instruction. Which of the following should the nurse include in discharge instruction?
A. Taking high protein diet
B. Use tampons during swimming
C. Avoid sexual intercourse for two weeks
D. Continue on bedrest for two weeks at home

994. Which of the following is the study of interactions are relationship between living organism and their
environment ?
A. Ecology.
B. Pathology
C. Microbiology
D. Parasitology

995. A 6 years old preschool returned from the operating room after tonsillectomy. A nurse received the patient
from recovery room. Which position the nurse place the child post tonsillectomy?
A. Supine
B. Side lying
C. Low fowler
D. High fowler

996. female teenager was diagnosed with sickle cell anemia inform a nurse school arranged a hiking activity in
nearby mountains. She shows excitement while informing the nurse about her new water bottle for this trip.
What is the appropriate initial response by the nurse?
A. "what do your parents think?"
B. "you realize that this type of activity might cause you a pain crisis"
C. "you need to get approval from your doctor before attending this activity"
D. ."it is great that you are hydrating yourself in preparation of this activity

997. A child with thalassemia was given desferoxamine (Desferal);which of the following should alert the nurse to
notify the
physician?
A. Decreased hearing
B. Hypertension
C. Red urine
D. Vomiting

998. Which of the following should be included in the nursing care to a woman during 2nd stage of labor?
A. Shave the perineum
B. Administer enema to the woman
C. Careful evaluation of prenatal history
D. Watch breathing, bear down with each contortion

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999. The nurse who is planning to discharge education should instruct the caregivers that during hyper cyanotic
spell, which position is the most likely to benefits the child ?
A. Supine
B. Prone
C. Side lying
D. Knee chest position

1000. A mother is asking the nurse how is sickle cell could be deducted. Which of the following is at test detected
sickle cell disease of traits?
A. Hemoglobin electrophoresis
B. Bone marrow aspiration
C. Complete blood count
D. Free erythrocyte protoporphyrin

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