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أبريل 2026
643 سؤال مع الإجابات الصحيحة، مرتبة للقراءة والمراجعة استعدادا لاختبار التمريض SNLE.
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1
A newborn fails to pass meconium within 48 hours and develops abdominal distension and vomiting. The nurse anticipates which diagnostic test to confirm Hirschsprung disease?
A Perform a barium enema to identify a transition zoneB Obtain a rectal biopsy to assess for absence of ganglion cells الإجابة الصحيحةC Order a CT scan of the abdomen to rule out obstructionD Request an abdominal ultrasound to evaluate bowel wall thickness -
2
A nurse is feeding a 2-month-old infant with a cleft lip and palate. Which position should the nurse use to minimize the risk of formula entering the nasal passages and to promote safe swallowing?
A Supine positionB Upright position الإجابة الصحيحةC Side-lying positionD Prone position -
3
A nurse is educating a patient who has just been prescribed tetracycline for acne. The nurse advises avoiding which food around the time of taking the medication to prevent decreased absorption?
A GrapefruitB Milk الإجابة الصحيحةC Orange juiceD Water -
4
A public health nurse is developing a plan to reduce tuberculosis transmission in a community with a high incidence of active TB. Which intervention should the nurse prioritize as the most effective strategy?
A Screening high-risk individuals for latent TB infectionB Conducting mass BCG vaccination campaigns for all newbornsC Improving ventilation in public places and crowded settingsD Isolating patients with active pulmonary tuberculosis until they are no longer infectious الإجابة الصحيحة -
5
A 28-year-old woman at 10 weeks gestation arrives in the emergency department reporting sharp right lower abdominal pain, moderate vaginal bleeding, and lightheadedness. Her blood pressure is 90/60 mmHg and heart rate 110 bpm. Based on these findings, which condition should the nurse suspect as most likely?
A Acute appendicitisB Ruptured ectopic pregnancy الإجابة الصحيحةC Gestational trophoblastic disease (molar pregnancy)D Threatened miscarriage -
6
A nurse is caring for a patient with advanced COPD who has developed peripheral edema, jugular vein distension, and hepatomegaly. These findings are most consistent with which complication of COPD?
A Pulmonary embolismB Cor pulmonale (right-sided heart failure) الإجابة الصحيحةC PneumoniaD Lung cancer -
7
A nurse in an antenatal clinic is assessing a pregnant woman at 32 weeks who reports bilateral leg swelling that worsens at the end of the day. Which self-care measure should the nurse recommend to manage this symptom?
A Stand while performing all daily activitiesB Rest and elevate legs periodically throughout the day الإجابة الصحيحةC Engage in vigorous exercise to improve circulationD Restrict fluid intake to reduce fluid retention -
8
A 45-year-old woman tells the nurse that she experiences occasional urinary dribbling when she coughs or sneezes. She asks what she can do to improve this symptom. Which recommendation should the nurse provide?
A Reduce daily fluid intakeB Perform Kegel (pelvic floor) exercises regularly الإجابة الصحيحةC Take prophylactic antibioticsD Use an indwelling urinary catheter -
9
A 6-month-old male infant is scheduled for surgical repair of epispadias. The nurse explains to the parents that the primary long-term goal of this surgery is to achieve which outcome?
A Improving cosmetic appearance onlyB Achieving normal urination and future sexual function الإجابة الصحيحةC Preventing recurrent urinary tract infectionsD Improving lower extremity mobility -
10
The nurse manager notices that staff in the pediatric ICU are showing signs of burnout, including emotional exhaustion and increased complaints. Which strategy should the manager implement first to address this issue?
A Tell the staff to accept the situation as a normal part of ICU nursingB Rotate patient care assignments among staff to provide variety and reduce monotony الإجابة الصحيحةC Ignore the complaints unless they escalate into patient safety issuesD Reduce the working hours for all nursing staff -
11
Two nurses are discussing strategies to address the high rate of childhood obesity in their community. One nurse asks, 'What interventions have been shown to reduce body mass index in school-aged children?' This type of question is best described as which of the following?
A A research questionB A problem-focused question الإجابة الصحيحةC A hypothesisD A theory-based question -
12
A nurse researcher is conducting a qualitative study on patient satisfaction with discharge teaching. After analyzing 15 interviews, no new themes emerge and additional interviews yield no new information. This phenomenon is known as what?
A Theoretical frameworkB Data saturation الإجابة الصحيحةC Data triangulationD Data analysis -
13
Parents of a child with an autosomal dominant genetic disorder are planning another pregnancy. They ask the nurse about the risk to future children. What is the nurse's best response?
A Advise them to avoid any future pregnanciesB Refer them to a genetic counselor for personalized risk assessment and family planning options الإجابة الصحيحةC Encourage them to proceed with pregnancy because the risk is only 50%D Suggest they wait until the affected child is older before trying again -
14
A nurse is caring for a 9-month-old infant in the pediatric ward. When an unfamiliar resident physician approaches the crib, the infant starts crying and clings to the nurse. This reaction is most characteristic of which developmental stage?
A Separation anxietyB Fear of strangers (stranger anxiety) الإجابة الصحيحةC Fear of medical proceduresD Fear of pain -
15
A patient with active pulmonary tuberculosis is admitted to the medical unit. Which type of isolation precautions and room ventilation should the nurse implement?
A Standard precautions onlyB Airborne precautions with negative pressure room الإجابة الصحيحةC Droplet precautionsD Contact precautions -
16
A nurse is preparing to give a bed bath to a patient on contact precautions for Clostridioides difficile. The nurse anticipates that the gloves may become heavily soiled during perineal care. Which action should the nurse take to reduce the risk of hand contamination?
A Change to a new pair of gloves after completing the bathB Wear two pairs of gloves (double glove) before starting الإجابة الصحيحةC Use extended-cuff gloves that cover the forearmsD Wash hands frequently with soap and water during the procedure -
17
A newborn is noted to have excessive oral secretions, coughing, and cyanosis during the first feeding. Milk regurgitates from the nose. The nurse suspects which congenital anomaly?
A Hypertrophic pyloric stenosisB Tracheoesophageal fistula الإجابة الصحيحةC Gastroesophageal reflux disease (GERD)D Congenital respiratory infection -
18
A newborn is diagnosed with tracheal atresia and is awaiting surgical repair. What is the priority nursing intervention regarding feeding?
A Continue oral feeding with thickened formulaB Keep the infant NPO (nothing by mouth) الإجابة الصحيحةC Administer clear liquids via bottleD Start IV fluids but also give small oral feeds -
19
A nurse is inserting a nasogastric tube for a patient with a bowel obstruction. After insertion, the nurse aspirates gastric contents and checks the pH. What is the most critical step to ensure patient safety before initiating feeding or medication?
A Selecting the appropriate tube size for the patientB Verifying correct tube placement, preferably by X-ray الإجابة الصحيحةC Lubricating the tube thoroughly to ease passageD Positioning the patient in high Fowler's position -
20
A mother brings her 6-month-old infant to the clinic, reporting that the infant has had ribbon-like, foul-smelling stools since birth and has chronic constipation. The nurse suspects Hirschsprung disease. Which question is most important to ask the mother?
A Have you made any recent changes to the infant's diet?B Did the infant pass meconium within the first 48 hours after birth? الإجابة الصحيحةC Have you started toilet training?D Has the infant had any recent febrile illness? -
21
A nurse is caring for a patient with schizophrenia who repeatedly mimics the nurse's words, saying the last word of each sentence. The nurse documents this behavior as which of the following?
A PerseverationB Echolalia الإجابة الصحيحةC Word saladD Circumstantiality -
22
A patient with schizophrenia tells the nurse, "The voices are telling me that I am worthless." Which response by the nurse is most appropriate to promote medication adherence and reality testing?
A I don't hear any voices, so you should ignore them.B You need to take your antipsychotic medication regularly to help reduce the voices. الإجابة الصحيحةC Try to think positive thoughts when you hear the voices.D The voices are not real; they are a symptom of your illness. -
23
A 58-year-old woman comes to the clinic with complaints of fatigue, weakness, and daytime sleepiness. She has a history of hypothyroidism but admits she often forgets to take her levothyroxine. Her last bowel movement was four days ago. Which laboratory finding would the nurse expect to see in this patient?
A Increased T4 and decreased TSHB Increased T4 and unchanged TSHC Decreased T4 and increased TSH الإجابة الصحيحةD Unchanged T4 and decreased TSH -
24
A nurse receives the following medication orders for a patient with acute pulmonary edema. Which order should the nurse administer first?
A Vancomycin 200 mg orally three times dailyB Cefazolin 250 mg intravenously twice dailyC Furosemide 40 mg intravenously STAT (immediately) الإجابة الصحيحةD Paracetamol 500 mg orally as needed for pain -
25
A community health nurse is reviewing data on a contagious disease. The prevalence of the disease is much higher in children under 5 years of age than in children over 10 years. Which interpretation of this finding is most accurate?
A The incidence rate of the disease is low in the younger age groupB The incidence rate of the disease is high in the younger age group الإجابة الصحيحةC The fatality rate is higher in young childrenD The fatality rate is lower in young children -
26
A nurse is performing a neurological assessment. To assess the patient's peripheral vision, which technique should the nurse use?
A Confrontation visual field testing الإجابة الصحيحةB Snellen eye acuity testC Assessment of extraocular movements (oculomotor function)D None of the above -
27
A 72-year-old man is brought to the clinic by his daughter, who reports that her father has developed a mask-like facial expression, a monotone voice, drooling, and a rigid posture when walking. These findings are most consistent with which neurological disorder?
A Parkinson's disease الإجابة الصحيحةB Substance abuse disorderC Traumatic brain injuryD Transient ischemic attack -
28
A 10-year-old girl presents to the emergency department with heavy menstrual bleeding that has lasted for 10 days. She is pale, dizzy, and has a heart rate of 148 bpm. Laboratory tests show microcytic, hypochromic red blood cells. Which condition is the most likely cause of her symptoms?
A Sickle cell anemiaB Iron deficiency anemia الإجابة الصحيحةC ThalassemiaD Leukemia -
29
A 35-year-old woman complains of fatigue, weight gain, and cold intolerance. Laboratory results show elevated TSH and low free T4, and thyroid peroxidase antibodies are positive. Which condition is the most likely diagnosis?
A Graves' diseaseB Hashimoto thyroiditis الإجابة الصحيحةC Cushing syndromeD Addison disease -
30
A nurse enters a patient's room and finds the patient lying supine in bed with a nasogastric tube in place that is not connected to suction. Which complication is the patient at greatest risk for developing?
A PneumoniaB Aspiration of gastric contents الإجابة الصحيحةC HypoxiaD Atelectasis -
31
A nurse is auditing infection control practices on a medical-surgical unit. Which single intervention has been shown to be most effective in reducing the rate of hospital-acquired (nosocomial) infections?
A Performing hand hygiene before and after every patient contact الإجابة الصحيحةB Wearing gloves and a mask for all direct patient careC Implementing isolation precautions for all patientsD Administering broad-spectrum antibiotics prophylactically -
32
A patient in the post-anesthesia care unit received morphine sulfate 30 minutes ago. The nurse now notes a respiratory rate of 8 breaths per minute and an oxygen saturation of 86% on room air. Which medication should the nurse administer immediately?
A Flumazenil (Romazicon)B Midazolam (Versed)C Naloxone (Narcan) الإجابة الصحيحةD Ondansetron (Zofran) -
33
A nurse manager in a multicultural hospital in Saudi Arabia is leading a team of nurses from different countries and cultural backgrounds. To ensure effective teamwork and collaboration, which element is most important for all team members to share?
A Identical personal values and religious beliefsB The same professional practice guidelinesC Common goals and objectives related to patient care الإجابة الصحيحةD Equivalent educational qualifications and certifications -
34
A nurse finds her colleague crying in the break room after an unsuccessful resuscitation of a child. The colleague appears depressed and distressed. What is the most appropriate initial response by the nurse?
A Tell her she needs to take a few days off until she feels betterB Advise her to go home and spend time with her childrenC Say "There was nothing you could have done to save the child"D Allow her to cry and gently encourage her to talk about the experience الإجابة الصحيحة -
35
A patient who has been immobile for three days after total hip replacement is preparing to ambulate for the first time. The nurse instructs the patient to dangle her legs at the bedside before standing. What complication is the nurse trying to prevent with this instruction?
A Hypotension (orthostatic hypotension) الإجابة الصحيحةB Hip dislocationC HypertensionD Headache -
36
A newborn in the NICU is diagnosed with early-onset sepsis. The nurse understands that the most common source of the causative organism is which of the following?
A The mother's genitourinary tract الإجابة الصحيحةB The mother's bloodstreamC Contamination from breast milkD Environmental contamination in the delivery room -
37
A 36-year-old woman at 18 weeks gestation comes to the antenatal clinic. She reports three first-trimester miscarriages in the past but no live births. How should the nurse document her parity?
A Parity 3B Nullipara الإجابة الصحيحةC MultiparaD Primipara -
38
A pregnant woman at 34 weeks gestation has a blood pressure of 200/87 mmHg on two occasions 4 hours apart. Urinalysis shows no protein, and liver enzymes and platelet count are normal. Which diagnosis is most consistent with these findings?
A Gestational hypertension الإجابة الصحيحةB PreeclampsiaC Chronic hypertensionD Eclampsia -
39
A newborn has a cleft lip on the left side. The nurse is preparing to feed the infant using a specialized bottle. Which position should the nurse place the infant in to minimize formula leakage through the cleft and reduce the risk of aspiration?
A Left lateral positionB Right lateral position الإجابة الصحيحةC Supine positionD Prone position -
40
A nurse is teaching a patient about combined oral contraceptives. The patient asks how the pills prevent pregnancy. Which explanation of the primary mechanism of action is correct?
A Inhibiting ovulation by suppressing FSH and LH release الإجابة الصحيحةB Blocking estrogen receptors in the endometriumC Preventing implantation of a fertilized ovumD Thickening cervical mucus only -
41
A 30-year-old woman who has been taking combined oral contraceptives for two years has a blood pressure of 150/92 mmHg at her annual exam. The nurse suspects that the COCs may be contributing to which condition?
A Hypertension الإجابة الصحيحةB Diabetes mellitusC OsteoporosisD Iron deficiency anemia -
42
A pregnant woman at 28 weeks gestation arrives in the emergency department with severe vaginal bleeding and signs of hemorrhagic shock. The obstetrician determines that an emergency cesarean section is needed immediately. The woman is conscious, alert, and oriented. Who should provide informed consent for the surgery?
A Call the husband to obtain consentB The patient can consent for herself الإجابة الصحيحةC The hospital administrator must consentD The emergency physician can consent on her behalf -
43
A 12-year-old boy is brought to the emergency department after being pulled from a swimming pool. He had respiratory arrest but was resuscitated. Which acid-base disturbance is the most likely major complication following a drowning event?
A SepsisB AlkalosisC Acidosis الإجابة الصحيحةD Hypothermia -
44
A 5-year-old child presents with mild fever, headache, and malaise for two days, and today develops a vesicular rash on the trunk and face. The nurse suspects varicella (chickenpox). Which type of transmission-based precautions should be initiated?
A Airborne precautions الإجابة الصحيحةB Contact precautionsC Droplet precautionsD Standard precautions only -
45
A child with nephrotic syndrome is being discharged home after initial treatment with corticosteroids. The nurse is providing discharge teaching to the mother. Which instruction is most important to emphasize?
A Complete the full course of corticosteroids as prescribed الإجابة الصحيحةB Increase fluid intake to prevent dehydrationC Avoid all physical activity until follow-upD Stop all medications once swelling improves -
46
A child is being discharged from the hospital with a new prescription for eyeglasses due to refractive error. The nurse provides nutritional counseling. Which vitamin is most essential for maintaining healthy vision and should be encouraged in the child's diet?
A Vitamin A الإجابة الصحيحةB Vitamin DC Vitamin CD Vitamin B12 -
47
A pregnant woman at 41 weeks gestation is receiving an oxytocin infusion for induction of labor. The nurse notes that contractions are occurring every 2 minutes, lasting 90 seconds, with 6 contractions in a 10-minute window. What is the priority nursing action?
A Stop the oxytocin infusion and notify the physician immediately الإجابة الصحيحةB Increase the oxytocin dose to achieve stronger contractionsC Continue the current dose and monitor closelyD Add another uterotonic medication to augment labor -
48
A charge nurse is assigning patients to a newly licensed nurse on a medical-surgical unit. Which patient would be most appropriate to delegate to this new nurse?
A A patient who needs assistance with daily bathing and hygiene الإجابة الصحيحةB A patient with acute chest pain and possible myocardial infarctionC A patient with respiratory distress requiring frequent nebulizer treatmentsD A patient with newly diagnosed cardiac arrhythmia on telemetry -
49
A mother comes for her first postnatal visit 15 days after an uncomplicated vaginal delivery. Her vital signs are stable, breasts are soft, but she reports continued bright red lochia. Which aspect of the physical examination requires further evaluation by the nurse?
A Amount and frequency of breastfeedingB Hydration level and breastfeeding techniqueC Activity, exercise, and resting periodsD Uterine size and position (fundal assessment) الإجابة الصحيحة -
50
A nurse is providing prenatal education to a woman with a pre-pregnancy BMI of 22 kg/m². She asks how much weight she should aim to gain during her pregnancy. What is the recommended total weight gain range for this patient?
A 11.5 to 16 kg (25 to 35 lbs) الإجابة الصحيحةB 5 to 10 kg (11 to 22 lbs)C 20 to 25 kg (44 to 55 lbs)D 8 to 12 kg (17.5 to 26.5 lbs) -
51
A pregnant woman at her first prenatal visit asks the nurse when she will be tested for gestational diabetes. At which gestational age is the oral glucose tolerance test routinely scheduled?
A 24 to 28 weeks الإجابة الصحيحةB 12 to 16 weeksC 32 to 36 weeksD 8 to 12 weeks -
52
A patient who underwent a thyroidectomy 6 hours ago now vomits bright red blood. What is the priority nursing action?
A Administer an antiemetic medication as orderedB Assess for signs of bleeding and notify the physician immediately الإجابة الصحيحةC Encourage the patient to drink clear fluidsD Position the patient supine with the head flat -
53
A nurse is teaching a group of women about breast self-examination. When should a woman with regular menstrual cycles perform this examination to obtain the most accurate results?
A During menstruationB After menstruation (approximately days 7 to 10 of the cycle) الإجابة الصحيحةC Just before menstruationD Any time of the month, regardless of cycle -
54
A patient with a chronic cough and fever has a positive Mantoux tuberculin skin test. Which diagnostic test is most accurate for confirming active pulmonary tuberculosis?
A Chest X-rayB Sputum culture for acid-fast bacilli الإجابة الصحيحةC Blood test (interferon-gamma release assay)D CT scan of the chest -
55
A patient is admitted with active pulmonary tuberculosis. To reduce the risk of transmission to other patients and staff, which environmental control should the nurse ensure is in place?
A Positive air pressure roomB Negative air pressure (airborne infection isolation) room الإجابة الصحيحةC Standard precautions only, no special ventilationD Regular patient room with the door kept closed -
56
A midwife in a busy antenatal triage unit is assessing four pregnant women. Which patient should the midwife prioritize to see first?
A A patient with asymptomatic anemia (hemoglobin 10 g/dL)B A patient who needs routine iron supplement teachingC A patient with dyspnea, significant anemia, and shortness of breath at rest الإجابة الصحيحةD A patient with mild lower back discomfort -
57
A patient with Alzheimer's disease becomes angry and refuses to take his prescribed oral medication. What is the most appropriate nursing intervention?
A Force the medication to ensure patient safetyB Ignore the refusal and administer the medication covertlyC Document the refusal and notify the physician الإجابة الصحيحةD Repeatedly explain the need for medication until the patient accepts -
58
A school nurse is teaching a 13-year-old girl about the physical and emotional changes of puberty. The girl asks about premenstrual symptoms. Which symptom is most commonly associated with the premenstrual phase?
A Mood fluctuations (irritability, sadness, anxiety) الإجابة الصحيحةB Increased appetite onlyC Weight lossD Changes in hair texture -
59
A nurse provides teaching to a woman with recurrent vaginal infections about preventive measures. Which statement by the woman indicates that she understands the importance of avoiding practices that kill beneficial vaginal bacteria?
A I will wear cotton underwearB I will wipe from front to back after using the toiletC I will wear a condom to prevent sexually transmitted infectionsD I will avoid douching and using perfumed feminine sprays الإجابة الصحيحة -
60
During a well-baby examination, the nurse palpates a soft, nontender swelling in the scrotum of a male infant that transilluminates with light. This finding is most consistent with which condition?
A ChordeeB Cryptorchidism (undescended testis)C Hydrocele الإجابة الصحيحةD Hypospadias -
61
A sexually active young adult asks the nurse about birth control methods that also reduce the risk of sexually transmitted infections. Which method should the nurse recommend?
A Coitus interruptus (withdrawal)B Intrauterine device (IUD)C Latex condom الإجابة الصحيحةD Combined oral contraceptive pill -
62
A nurse is monitoring a patient receiving supplemental oxygen via nasal cannula. The pulse oximeter reading is 92%. Which reading would the nurse interpret as indicating adequate oxygenation for most patients?
A Less than 90%B 91% to 92%C 93% to 94%D 95% or higher الإجابة الصحيحة -
63
A nurse is teaching a pregnant woman at 32 weeks how to differentiate Braxton Hicks contractions from true labor contractions. Which characteristic is typical of Braxton Hicks (pre-labor) contractions?
A They occur at regular intervals and increase in intensityB They are felt primarily in the abdomen rather than the back الإجابة الصحيحةC They start in the lower back and radiate to the abdomenD They become stronger and more frequent with walking -
64
A patient is informed of a new cancer diagnosis and responds by saying, 'There must be a mistake, these results cannot be mine. I feel fine.' The nurse recognizes this response as which stage of grief according to Kübler-Ross?
A Denial الإجابة الصحيحةB AngerC DepressionD Bargaining -
65
A child with nephrotic syndrome has a urine sample that appears foamy and cloudy. The nurse documents the urine color as which of the following?
A Bright redB Dark brownC Clear yellowD Cloudy white الإجابة الصحيحة -
66
A physician has written a do-not-resuscitate (DNR) order for a patient with end-stage cancer. The patient, who is alert and oriented, tells the nurse, "I want everything done to save my life if my heart stops." What is the nurse's best initial action?
A Explain to the patient that he must accept the DNR orderB Ignore the patient's statement because the doctor made the decisionC Follow hospital policy, which typically requires clarifying the order with the physician الإجابة الصحيحةD Report the physician to the ethics committee -
67
A nurse is educating pilgrims about the required vaccines before traveling to Hajj. The nurse explains that receiving the meningococcal vaccine is an example of which level of disease prevention?
A Primary prevention الإجابة الصحيحةB Secondary preventionC Tertiary preventionD Quaternary prevention -
68
A nurse is assessing a patient with type 1 diabetes who reports nausea, abdominal pain, and has a fruity odor on the breath. The nurse suspects which acute complication?
A HypoglycemiaB Ketoacidosis (diabetic ketoacidosis) الإجابة الصحيحةC Hyperglycemia without ketosisD Diabetic nephropathy -
69
A nurse is caring for a newborn infant of a diabetic mother. To monitor the infant's blood glucose level, which method is typically used?
A Random venous glucose testB Fasting venous glucose testC Heel stick capillary glucose test الإجابة الصحيحةD Oral glucose tolerance test -
70
A nurse is caring for a drowsy but lethargic patient who has a nasogastric tube in place. Under which circumstance would the use of a soft wrist restraint be most appropriate?
A The patient is confused but not attempting to remove tubesB The patient repeatedly tries to remove the nasogastric tube الإجابة الصحيحةC The patient is agitated and yellingD The patient refuses oral medication -
71
A pregnant woman at 32 weeks gestation has a blood pressure of 160/100 mmHg and urine dipstick shows 2+ protein. Which condition is most consistent with these findings?
A Gestational hypertensionB Pre-eclampsia الإجابة الصحيحةC EclampsiaD HELLP syndrome -
72
A pregnant woman at 35 weeks gestation calls the clinic reporting sudden onset of dizziness and double vision. She has a history of elevated blood pressure. What should the nurse advise?
A Schedule a routine prenatal appointment for next weekB Increase fluid intake and restC Come to the emergency department immediately الإجابة الصحيحةD Rest at home and call back if symptoms worsen -
73
A patient with severe pre-eclampsia is started on an intravenous infusion of magnesium sulfate. The nurse explains to the patient that this medication is given primarily for which purpose?
A To lower blood pressureB To prevent seizures (eclampsia) الإجابة الصحيحةC To reduce peripheral edemaD To improve kidney function -
74
A charge nurse is called to a newborn's bedside where a new nurse administered morphine sulfate. The baby is cyanotic and has a respiratory rate of 8 breaths per minute. What is the charge nurse's priority action?
A Administer caffeine citrateB Administer midazolamC Document the event and continue monitoringD Notify the physician immediately and prepare to support ventilation الإجابة الصحيحة -
75
A mother of a newborn asks the nurse about the potential complications of circumcision before signing consent. Which complication should the nurse emphasize as the most significant immediate risk?
A InfectionB Hemorrhage (bleeding) الإجابة الصحيحةC PainD Scarring -
76
A nurse manager and a charge nurse disagree about the monthly staff schedule. The charge nurse feels the manager is not considering staff preferences. This situation best exemplifies which type of conflict?
A Personal conflictB Role conflictC Scheduling conflict الإجابة الصحيحةD Resource conflict -
77
A nurse is assisting during the third stage of labor. Which finding most strongly indicates that the placenta has separated from the uterine wall?
A Maternal blood pressure increasesB The umbilical cord lengthens suddenly الإجابة الصحيحةC Uterine contractions stop temporarilyD Fetal heart rate increases -
78
A nurse researcher wants to examine whether there is a statistical relationship between patient satisfaction scores and cultural background. Which research design is most appropriate for this purpose?
A Correlational study الإجابة الصحيحةB Case-control studyC Randomized controlled trialD Cross-sectional descriptive study -
79
A nurse is educating a patient diagnosed with hepatitis A about how to prevent spreading the virus to family members. Which mode of transmission should the nurse emphasize?
A Fecal-oral route (contaminated food or water) الإجابة الصحيحةB Blood transfusionC Sexual contactD Respiratory droplets -
80
A woman presents with abdominal pain and vaginal spotting at 8 weeks gestation. An ultrasound reveals a gestational sac outside the uterus. The nurse knows that the most common site for an ectopic pregnancy is which structure?
A Fallopian tube (ampullary region) الإجابة الصحيحةB OvaryC CervixD Abdominal cavity -
81
A couple has been trying to conceive for two years. The woman has a history of pelvic inflammatory disease and a hysterosalpingogram shows bilateral blocked fallopian tubes. Which assisted reproductive technology is most appropriate for this couple?
A In vitro fertilization (IVF) الإجابة الصحيحةB Intrauterine insemination (IUI)C Ovulation induction with clomipheneD Surgical tubal ligation reversal -
82
A nurse discovers that a colleague accidentally administered ten times the prescribed dose of an opioid to a patient. What is the nurse's immediate legal and ethical obligation?
A Report the medication error according to facility policy الإجابة الصحيحةB Discuss the error privately with the colleague and not report itC Ignore the situation to avoid conflictD Document the error in the patient's chart but not report it -
83
A nurse is searching for the highest level of evidence to answer a clinical question about a new treatment. Which source provides the strongest level of evidence according to the evidence-based practice hierarchy?
A Cochrane systematic review and meta-analysis الإجابة الصحيحةB Expert opinion from a specialistC Case series and case reportsD Textbook chapters -
84
A patient with HIV is about to start antiretroviral therapy. The nurse reviews the latest lab results. Which tests are essential to determine the patient's disease stage and guide treatment decisions?
A Viral load and CD4+ T-cell count الإجابة الصحيحةB Complete blood count (CBC)C Liver function tests (LFTs)D Kidney function tests (BUN, creatinine) -
85
A child is transferred to the post-anesthesia care unit after an appendectomy. What is the priority nursing intervention for this child?
A Pain assessment and management الإجابة الصحيحةB Restricting oral fluidsC Encouraging early ambulationD Administering prophylactic antibiotics -
86
A nurse is assisting with the placement of an epidural catheter for a laboring woman. To prevent maternal hypotension after the procedure, which intervention should be completed before the epidural is administered?
A Establish a large-bore IV line and administer a fluid bolus الإجابة الصحيحةB Give a prophylactic dose of antibioticsC Check coagulation studies (platelets, PT/PTT)D Obtain a baseline blood pressure and heart rate -
87
A nurse is assisting with the third stage of labor. Which clinical finding indicates that the placenta has separated from the uterine wall?
A Pulsation of the umbilical cord stops الإجابة الصحيحةB Uterine contractions become more frequentC Maternal blood pressure risesD Fetal heart rate increases -
88
A nurse is assessing a patient with chronic obstructive pulmonary disease. The patient has a barrel-shaped chest, increased anteroposterior diameter, and uses accessory muscles to breathe. These findings are most characteristic of which underlying condition?
A Chronic bronchitisB PneumoniaC Emphysema الإجابة الصحيحةD Bronchiectasis -
89
A new nurse tells the charge nurse, 'I feel very attached to my pediatric patient with Sanfilippo syndrome and I cry after every shift.' Which question by the charge nurse best promotes a therapeutic relationship and self-awareness?
A Do you get upset when the patient's family doesn't visit?B Do you feel you compete with the family for the patient's affection?C Are you neglecting your own self-care?D Do you maintain professional boundaries while providing care? الإجابة الصحيحة -
90
A nurse is assessing a 4-year-old child who sustained a head injury. Which standardized scale should the nurse use to evaluate the child's level of consciousness?
A Adult Glasgow Coma ScaleB Pediatric Glasgow Coma Scale الإجابة الصحيحةC AVPU (Alert, Voice, Pain, Unresponsive) scale onlyD Richmond Agitation-Sedation Scale -
91
A patient in the intensive care unit has a central venous pressure (CVP) reading of 24 mmHg (normal 2-8 mmHg). Which clinical signs would the nurse expect to observe in this patient?
A Lung crackles and jugular vein distensionB Pedal edema and lung cracklesC Jugular vein distension and pedal edemaD All of the above الإجابة الصحيحة -
92
A patient with depression suddenly stops speaking in the middle of a sentence and stares blankly, unable to continue. The nurse documents this symptom as:
A Thought blocking الإجابة الصحيحةB Pressure of speechC Flight of ideasD Word salad -
93
A patient with severe anxiety about flying is gradually exposed to images of airplanes, then videos, then sitting in a stationary plane, and finally taking a short flight. This behavioral therapy technique is known as:
A Cognitive restructuringB Systematic desensitization الإجابة الصحيحةC Flooding therapyD Relaxation training -
94
A head nurse implements a new pain management protocol for post-operative patients. Several staff members express doubt about its effectiveness. What should the nurse manager do first?
A Discontinue the technique immediatelyB Train and educate the staff about the technique الإجابة الصحيحةC Ignore staff concernsD Report staff to administration -
95
A nurse manager reviews infection control data and finds that hospital-acquired infection rates are above the target. Which intervention is most effective for reducing these infections?
A Send reminder emails to staffB Post infection rates in the break roomC Ensure staff compliance with hand hygiene protocols الإجابة الصحيحةD Increase environmental cleaning frequency -
96
A patient taking alprazolam for anxiety asks the nurse if it is safe to have a glass of wine with dinner. The nurse explains that combining benzodiazepines with which substance can lead to severe respiratory depression?
A CaffeineB Alcohol الإجابة الصحيحةC FoodD Water -
97
A nurse is evaluating the quality of care on a medical-surgical unit. Which nursing action best reflects the principle of patient-centered care?
A Following hospital protocols strictly without deviationB Involving patients in care planning and decisions الإجابة الصحيحةC Completing tasks as efficiently as possibleD Documenting all care thoroughly in the medical record -
98
A patient with active pulmonary tuberculosis is admitted to the unit. Which combination of isolation precautions and mask type is required to prevent transmission?
A Standard precautions with surgical maskB Airborne precautions with N95 respirator الإجابة الصحيحةC Droplet precautions with surgical maskD Contact precautions with face shield -
99
A patient is one day post-operative following a right total hip replacement via a posterior approach. The nurse instructs the patient to avoid hip flexion beyond 90 degrees and adduction. Which sleeping position is safest for this patient?
A Supine with legs adductedB Side-lying with a pillow between the legs الإجابة الصحيحةC Prone positionD High Fowler's position -
100
A child is brought to the post-anesthesia care unit after a tonsillectomy. Which position should the nurse place the child in to protect the airway and allow drainage of secretions?
A Supine positionB Side-lying position الإجابة الصحيحةC Trendelenburg positionD Semi-Fowler's position -
101
The parents of a 7-year-old child newly diagnosed with type 1 diabetes refuse to share any information about the disease with the child, saying "He is too young to understand." What should the nurse do?
A Respect the parents' wishes and give no informationB Provide age-appropriate information to the child الإجابة الصحيحةC Wait until the child is 18 years oldD Give the child a detailed medical explanation -
102
A 15-year-old patient with newly diagnosed type 1 diabetes needs to learn how to self-administer insulin. Which teaching method is most effective for this age group?
A Ask the parents to administer all dosesB Demonstrate the technique and allow the patient to practice الإجابة الصحيحةC Provide written instructions onlyD Wait for parental approval before teaching -
103
A nurse is assisting with a vaginal delivery. Immediately after the placenta is delivered, the mother begins to bleed heavily. The fundus is boggy. What is the priority nursing action?
A Administer prescribed pain medicationB Perform fundal massage الإجابة الصحيحةC Start a second IV lineD Call the physician -
104
A newborn is born through meconium-stained amniotic fluid and has respiratory distress. Which diagnostic test is most useful to confirm meconium aspiration syndrome?
A Blood test (CBC)B Chest X-ray الإجابة الصحيحةC Abdominal ultrasoundD CT scan of the chest -
105
A hospital is trying to implement a new electronic health record system. Many staff members prefer the old paper system and resist using the new technology. What is the main barrier to this change?
A Lack of fundingB Resistance to change الإجابة الصحيحةC Poor communicationD Inadequate training -
106
A breastfeeding mother is diagnosed with mastitis. She asks the nurse how to manage the condition. What should the nurse encourage?
A Stop breastfeeding immediatelyB Frequent emptying of the affected breast الإجابة الصحيحةC Apply cold compresses onlyD Reduce fluid intake -
107
A patient with chronic hypertension has a urinalysis showing 3+ protein. This finding indicates which level of hypertension severity?
A Mild hypertensionB Moderate hypertensionC Severe hypertension الإجابة الصحيحةD Normal finding -
108
A child with type 1 diabetes is brought to the emergency department with lethargy, deep breathing, and a blood glucose of 450 mg/dL. What odor does the nurse expect to detect on the child's breath?
A Sweet fruity smell الإجابة الصحيحةB Ammonia smellC Metallic smellD No specific smell -
109
A patient is brought to the burn unit with partial-thickness burns involving the face, chest, and hands. What is the priority nursing intervention?
A Pain managementB Airway management الإجابة الصحيحةC IV fluid resuscitationD Wound dressing application -
110
A patient is scheduled for hemorrhoidectomy. The surgeon asks the nurse to position the patient for the procedure. Which position provides optimal exposure for rectal surgery?
A Lithotomy positionB Jackknife position الإجابة الصحيحةC Supine positionD Side-lying position -
111
A patient is immobilized due to a spinal cord injury. To prevent pressure injuries and complications of immobility, how often should the nurse reposition the patient?
A Every hourB Every 2 hours الإجابة الصحيحةC Every 4 hoursD Every 8 hours -
112
A child is diagnosed with tinea capitis (scalp ringworm), presenting with red, itchy patches. The mother asks how the infection was spread. Which mode of transmission should the nurse explain?
A Airborne transmissionB Direct or indirect contact (shared combs, hats) الإجابة الصحيحةC Vector-borne transmissionD Waterborne transmission -
113
A child is diagnosed with measles (rubeola). According to infection control guidelines, how many days after the rash appears should the child remain in isolation?
A 3 daysB 5 days الإجابة الصحيحةC 7 daysD 10 days -
114
A child presents with splenomegaly, growth retardation, and episodic pain crises. These findings are most consistent with which hematologic disorder?
A Iron deficiency anemiaB Sickle cell anemia الإجابة الصحيحةC Aplastic anemiaD Hemolytic anemia -
115
A woman has just confirmed she is pregnant. For a low-risk pregnancy, how often should she receive antenatal care from the time of conception until 28 weeks gestation?
A Once a weekB Every 2 weeksC Every 3 weeksD Every 4 weeks الإجابة الصحيحة -
116
A 36-year-old woman at 18 weeks gestation comes to the antenatal clinic. She reports three previous first-trimester miscarriages but no live births. How should the nurse document her parity?
A Parity 3B Nullipara الإجابة الصحيحةC MultiparaD Primipara -
117
A postpartum woman is 5 days after delivery and reports that her lochia rubra has changed to a foul-smelling, brownish discharge. The nurse suspects which complication?
A Normal lochia serosaB Sign of abnormal hemoglobinC Infection (endometritis) الإجابة الصحيحةD Delayed postpartum hemorrhage -
118
A pregnant woman at 34 weeks gestation has a blood pressure of 150/95 mmHg on two separate occasions. She has no proteinuria. This condition is best identified as:
A Chronic hypertensionB Pregnancy-induced diabetesC Pregnancy-induced hypertension (PIH) الإجابة الصحيحةD Preeclampsia -
119
A 22-year-old G2P1 at 38 weeks gestation is admitted for decreased fetal movement. The non-stress test shows decreased variability. The next morning, the nurse auscultates the fetal heart rate and finds it below 100 bpm. What is the nurse's first action?
A Reassure the mother that the FHR is okayB Notify the physician or midwife immediatelyC Reposition the patient to the left lateral position الإجابة الصحيحةD Ask the mother about the pattern of fetal movement -
120
A postpartum woman who is breastfeeding reports severe nipple soreness on day 3. To relieve her discomfort before the next feeding, the nurse should suggest:
A Lubricate her nipples with expressed breast milk before feeding الإجابة الصحيحةB Dry her nipples with a soft towel after feedingC Apply warm compresses to her nipples just before feedingD Apply soap directly to her nipples and then rinse -
121
A woman is having her first antenatal visit at 10 weeks gestation. Which screening test should the nurse perform to detect cervical neoplasia?
A Papanicolaou (Pap) smear الإجابة الصحيحةB Vaginal-rectal cultureC Rapid plasma reagin (RPR) testD Venereal Disease Research Laboratory (VDRL) test -
122
A 17-year-old mother presents to the primary health center 10 days after delivery. She has fatigue, anemia, fever, and foul-smelling vaginal discharge. Vital signs: BP 80/50, HR 112, RR 35, temp 39.6°C. Which diagnosis is most likely?
A Severe urinary tract infectionB Vesicovaginal fistulaC Puerperal sepsis الإجابة الصحيحةD Postpartum hemorrhage -
123
Both parents have sickle cell disease (homozygous HbS). What is the probability that their child will also have sickle cell disease?
A 100% الإجابة الصحيحةB 50%C 75%D 25% -
124
A community health nurse is scheduled to visit a pregnant woman at home to assess both the mother and the fetus. This type of visit is best described as a:
A Follow-up visit الإجابة الصحيحةB Assessment visitC Systematic visitD Routine visit -
125
A nurse is teaching new parents about safe sleep to reduce the risk of sudden infant death syndrome (SIDS). Which sleep position and environment is recommended?
A Prone positionB Side-lying positionC Supine position with a firm mattress, no blankets or toys الإجابة الصحيحةD Any comfortable position -
126
A nurse is planning a home visit for a pregnant woman to evaluate her health and fetal well-being. This type of visit is best described as an:
A Follow-up visitB Assessment visit الإجابة الصحيحةC Systematic visitD Routine visit -
127
An intern measures a patient's blood sugar one hour after lunch and gets a reading of 30 mg/dL. The patient is awake and talking. What is the nurse's best action?
A Inform the doctor immediatelyB Recheck the blood sugar yourself الإجابة الصحيحةC Ask the intern to recheck itD Give oral glucose immediately -
128
A patient undergoes a sternocleidomastoid muscle resection. The nurse monitors for which early postoperative complication?
A Hemorrhage (hematoma) الإجابة الصحيحةB Wound dehiscenceC Pulmonary embolismD Infection -
129
A pregnant woman at 34 weeks gestation has a blood pressure of 200/87 mmHg. All laboratory results (platelets, liver enzymes, creatinine) are normal, and there is no proteinuria. This finding is most consistent with:
A PreeclampsiaB EclampsiaC Gestational hypertension الإجابة الصحيحةD Chronic hypertension -
130
A child with asthma is prescribed albuterol via nebulizer. Which instruction should the nurse give to the parents before administering the medication?
A Check the child's heart rate before giving albuterol الإجابة الصحيحةB Give a snack before useC Use the medication only when the child is sleepingD Avoid physical activity after use -
131
A child has been diagnosed with asthma. The nurse is teaching the parents about triggers to avoid. Which recommendation is most appropriate?
A Encourage the child to play basketballB Avoid playing with furry animals (e.g., cats, dogs) الإجابة الصحيحةC Avoid all physical activitiesD Keep the child indoors at all times -
132
A patient receiving digoxin for heart failure has a heart rate of 118 bpm and a laboratory report showing low magnesium level. What should the nurse do?
A Administer the digoxin as orderedB Withhold the digoxinC Inform the physician of the findings الإجابة الصحيحةD Increase the digoxin dose -
133
A pregnant woman at 12 weeks gestation calls the clinic reporting bright red vaginal bleeding. She has no pain. What is the nurse's first action?
A Perform a vaginal examinationB Admit her to the hospitalC Do an ultrasound الإجابة الصحيحةD Check her vital signs -
134
A woman in active labor is assessed: cervix 3 cm dilated, 90% effaced, fetal head engaged, contractions every 5-6 minutes lasting 60-90 seconds. Which finding is the most accurate indicator that she is in true labor?
A Head engagementB Cervical dilation and effacement (progressive change) الإجابة الصحيحةC Contraction frequency and durationD Pain intensity -
135
A nurse epidemiologist notes that the incidence rate of a chronic disease has remained stable for 10 years, but the prevalence rate is steadily increasing. This suggests which of the following?
A Longer duration of the disease (improved survival) الإجابة الصحيحةB Shorter duration of the diseaseC Increase in case fatality rateD Better case detection only -
136
A newborn in the NICU is diagnosed with early-onset sepsis. The nurse understands that the most common source of the causative organism is:
A The mother's genitourinary tract الإجابة الصحيحةB The mother's bloodstreamC Breast milkD The hospital environment -
137
A nursing student asks how oxygenated blood reaches the fetus through the umbilical cord. The correct anatomy is:
A Two arteries and one veinB One artery and two veinsC Two veins and one arteryD One vein and two arteries الإجابة الصحيحة -
138
A nurse is teaching a new mother how to care for her newborn's umbilical cord stump. Which instruction is correct?
A Keep the area dry and clean, and allow it to air الإجابة الصحيحةB Apply antibiotic ointment dailyC Cover the stump with a bandageD Clean with alcohol at every diaper change -
139
A newborn has just undergone a routine circumcision. Which instruction should the nurse give to the parents for post-procedure care?
A Apply petroleum jelly to the glans with each diaper change الإجابة الصحيحةB Keep the area dry at all timesC Clean frequently and put on a diaperD Apply antibiotic cream -
140
A nurse tells a distraught patient, "I will stay here with you for a while." This therapeutic communication technique is best described as:
A Offering self الإجابة الصحيحةB AcceptingC ReassuringD Supporting -
141
A 10-year-old child is admitted to the pediatric unit and requires pain assessment. Which pain rating scale is most appropriate for this child's developmental level?
A Faces Pain Scale (Wong-Baker) الإجابة الصحيحةB Numeric Rating Scale (0-10)C Visual Analog ScaleD Behavioral Pain Scale -
142
A child is admitted with severe diarrhea and vomiting. The nurse suspects rotavirus infection. Which transmission route is most important for preventing spread?
A Fecal-oral route الإجابة الصحيحةB Airborne dropletsC Blood-borneD Vector-borne -
143
A newborn is diagnosed with spina bifida occulta. Which physical finding is characteristic of this condition?
A Intact skin over the spine, often with a tuft of hair or dimple الإجابة الصحيحةB Open neural tube with exposed meningesC Visible sac containing spinal fluidD Paralysis of the lower extremities -
144
If both parents have sickle cell disease (homozygous for HbS), what is the probability that each child will have the disease?
A 100% الإجابة الصحيحةB 75%C 50%D 25% -
145
A nurse is administering the hepatitis B vaccine to a newborn. What is the recommended vaccination schedule (birth, then at what ages)?
A 0, 1, and 6 months الإجابة الصحيحةB 0, 2, and 6 monthsC 0, 1, and 12 monthsD 0, 3, and 6 months -
146
A patient asks how combined oral contraceptive pills prevent pregnancy. The nurse explains the primary mechanism of action is:
A Suppressing ovulation by inhibiting LH and FSH secretion الإجابة الصحيحةB Blocking sperm penetration of the cervixC Altering cervical mucus to be thickD Preventing implantation of the fertilized egg -
147
A patient with heart failure has bilateral lower extremity edema. What is the priority nursing intervention to manage this symptom?
A Restrict fluid intake الإجابة الصحيحةB Increase activity levelC Elevate the legsD Monitor daily weight -
148
A patient with acute chest pain is prescribed nitroglycerin. What is the preferred route of administration for rapid relief?
A Sublingual الإجابة الصحيحةB OralC IntramuscularD Intravenous -
149
A nurse manager encourages staff to participate in scheduling decisions and supports shared governance. This leadership style is best described as:
A CollaborativeB AutocraticC Laissez-faireD Democratic الإجابة الصحيحة -
150
A patient reports episodes of suddenly feeling detached from their body and having gaps in memory for recent events. Which symptom is characteristic of dissociation?
A Memory loss (amnesia) الإجابة الصحيحةB HallucinationsC DelusionsD Mood swings -
151
A postoperative patient tells the nurse, "I am too tired to walk today." The nurse insists and forces the patient to ambulate despite the patient's refusal. Which ethical principle has the nurse violated?
A Autonomy الإجابة الصحيحةB BeneficenceC Non-maleficenceD Justice -
152
At 2 to 8 weeks of pregnancy, the developing human is at which stage of development?
A ZygoteB MorulaC Blastocyst الإجابة الصحيحةD Fetal -
153
A nurse enters her unique ID and password to log into the electronic health record system. This security process is called:
A Authentication الإجابة الصحيحةB AuthorizationC ValidationD Verification -
154
A nurse is assessing a child for dehydration. Which finding is the least reliable indicator of hydration status?
A Skin turgorB Mucous membrane moistureC Respiratory symptoms (e.g., tachypnea) الإجابة الصحيحةD Urine output -
155
A postpartum woman has heavy vaginal bleeding, but the uterine fundus is firm and well-contracted. What is the most likely cause of the bleeding?
A Uterine atonyB Perineal lacerations الإجابة الصحيحةC Retained placental fragmentsD Coagulopathy -
156
The prevalence of obesity in Saudi Arabia has increased dramatically over the past two decades. This pattern is best described as a(n):
A EndemicB Epidemic الإجابة الصحيحةC PandemicD Sporadic occurrence -
157
A postpartum woman requires an urgent surgical procedure. She is alert and oriented. Who should provide informed consent?
A Her husbandB Her fatherC The woman herself الإجابة الصحيحةD Her mother -
158
A patient with peripheral arterial disease comes to the emergency department with leg pain. The physician suspects advanced atherosclerosis. If the disease has progressed, where would the patient likely feel pain at rest?
A CalfB Ankle or foot الإجابة الصحيحةC KneeD Thigh -
159
A 28-year-old woman G4P4, 4 days postpartum, presents with massive vaginal bleeding. The fundus is firm. What is the likely cause?
A Uterine atonyB Perineal lacerations الإجابة الصحيحةC SepsisD Retained placenta -
160
A patient underwent a below-knee amputation for gangrene one week ago. He now reports feeling pain in his missing foot. The nurse should teach him about which phenomenon?
A Phantom limb pain الإجابة الصحيحةB Signs of infectionC Wound careD Physical therapy exercises -
161
A nurse needs to transfer a heavy, immobile patient from the bed to a wheelchair for an X-ray. Which equipment is safest for both the patient and the nurse?
A Manual lifting by two staffB Mechanical lift (Hoyer lift) الإجابة الصحيحةC Slide boardD Gait belt -
162
A head nurse articulates a clear vision for improving patient safety, inspires staff to adopt new practices, and motivates them through recognition. This leadership style is:
A Transformational الإجابة الصحيحةB TransactionalC AutocraticD Democratic -
163
A nurse is reviewing immunization recommendations for older adults. Which vaccines are routinely recommended for elderly patients?
A Influenza and pneumococcal vaccines الإجابة الصحيحةB MMR and varicellaC HPV and meningococcalD Hepatitis A and B -
164
An international nurse has just moved to Saudi Arabia to work in a hospital. Which experience is she most likely to encounter initially?
A Language barrier onlyB Culture shock الإجابة الصحيحةC Professional isolationD Technical difficulties -
165
A patient presents with fatigue, muscle pain, and low mood. Laboratory tests show low serum 25-hydroxyvitamin D. Which vitamin deficiency is responsible for these symptoms?
A Vitamin D الإجابة الصحيحةB Vitamin B12C Vitamin CD Vitamin A -
166
A patient is scheduled for rectal surgery. The physician orders a special bath to cleanse the perineal area. Which type of bath should the nurse prepare?
A Bed bathB Sitz bath الإجابة الصحيحةC Partial bathD Cleansing bath -
167
A midwife is caring for a woman in active labor. To reduce the risk of infection and unnecessary intervention, how often should vaginal examinations be performed?
A With each contractionB As frequently as possibleC Every 4 hoursD Limited to as few as necessary (e.g., every 2-4 hours if normal) الإجابة الصحيحة -
168
A nurse performs an amniotomy (artificial rupture of membranes) to augment labor. Immediately after the procedure, which parameter should the nurse monitor most closely?
A Fetal heart rate (for decelerations) الإجابة الصحيحةB Maternal blood pressureC Urine outputD Maternal temperature -
169
A patient with thalassemia is scheduled to receive a blood transfusion. What is the nurse's first action before starting the transfusion?
A Check vital signsB Cross-match and type the blood group الإجابة الصحيحةC Insert an IV lineD Obtain informed consent -
170
A newborn is born to a mother with poorly controlled gestational diabetes. The nurse should monitor the newborn for which metabolic complication?
A HyperglycemiaB Hypoglycemia الإجابة الصحيحةC HypercalcemiaD Hypocalcemia -
171
A nurse collects a heel-stick blood sample from a newborn for phenylketonuria (PKU) screening. The purpose of this test is to:
A Detect metabolic disorders الإجابة الصحيحةB Check blood glucose levelC Determine blood typeD Assess for infection -
172
A patient on warfarin therapy has an INR of 6.5 and is bleeding from a minor cut. Which medication should the nurse prepare to administer as the antidote?
A Protamine sulfateB Vitamin K (phytonadione) الإجابة الصحيحةC NaloxoneD Flumazenil -
173
A postpartum woman continues to have lochia rubra (bright red discharge) with small clots on day 6 after delivery. This finding is considered abnormal if it:
A Lasts more than 3 days الإجابة الصحيحةB Lasts more than 7 daysC Has a heavy flow with large clotsD Has a foul odor -
174
A nurse needs to administer an intramuscular injection to a 2-year-old child. The dorsogluteal site is contraindicated primarily because of the risk of:
A Injury to the sciatic nerve الإجابة الصحيحةB Poor drug absorptionC Increased painD Infection -
175
A patient has a positive test for Clostridioides difficile. Which type of transmission-based precautions should the nurse implement?
A Contact precautions الإجابة الصحيحةB Droplet precautionsC Airborne precautionsD Standard precautions only -
176
A nurse is assessing a patient's heart rate. Where is the point of maximal impulse (PMI) or apical pulse best auscultated?
A Fifth intercostal space, left midclavicular line الإجابة الصحيحةB Second intercostal space, right sternal borderC Third intercostal space, left sternal borderD Fourth intercostal space, left midaxillary line -
177
A patient has difficulty with balance and coordination after a stroke. Which part of the brain is most likely affected?
A Cerebellum الإجابة الصحيحةB CerebrumC BrainstemD Medulla oblongata -
178
A woman sustains a fourth-degree perineal tear during vaginal delivery. This injury extends through which structures?
A Anal sphincter and rectal mucosa الإجابة الصحيحةB Skin and subcutaneous tissue onlyC Perineal muscles (no anal involvement)D Anal sphincter only (not the mucosa) -
179
A nurse is orienting a new graduate. What is the primary role of the professional nurse in any healthcare setting?
A Coordinate patient careB Provide direct patient care الإجابة الصحيحةC Supervise other nursing staffD Manage the unit -
180
A patient is diagnosed with malaria after returning from a tropical region. This disease is classified as which type of infection?
A Vector-borne disease الإجابة الصحيحةB Bacterial infectionC Viral infectionD Fungal infection -
181
A public health nurse is planning strategies to reduce tuberculosis transmission in a high-incidence community. Which intervention is most effective?
A Active case finding (screening) and prompt treatment الإجابة الصحيحةB Isolation of all suspected cases onlyC Ensuring medication compliance for active casesD Hand hygiene -
182
A child is returned to the unit after a tonsillectomy and adenoidectomy. Which position should the nurse place the child in to minimize bleeding and protect the airway?
A Side-lying or prone الإجابة الصحيحةB SupineC Fowler'sD Trendelenburg -
183
A patient with increased intracranial pressure (ICP) has a head injury. To optimize cerebral perfusion, the nurse should position the patient's head at what angle?
A Elevated 30 degrees الإجابة الصحيحةB Flat (0 degrees)C Elevated 90 degreesD Turned to the side -
184
A nurse is monitoring a child with a ventriculoperitoneal shunt for signs of increased intracranial pressure. Which activity is most likely to transiently elevate ICP in a child?
A Strong crying الإجابة الصحيحةB Quiet behaviorC SleepingD Eating -
185
A nurse is performing passive range-of-motion exercises on an unconscious patient. While moving the patient's elbow, the nurse feels firm resistance. What is the appropriate first action?
A Stop the movement immediately الإجابة الصحيحةB Apply more force to overcome resistanceC Continue slowlyD Ask the patient to relax -
186
A postpartum woman is diagnosed with subinvolution of the uterus. Which medication does the nurse anticipate administering to promote uterine contraction?
A Methergine (methylergonovine) الإجابة الصحيحةB Oxytocin (Pitocin)C Magnesium sulfateD Terbutaline -
187
A patient is receiving intravenous fluids through a peripheral IV. The nurse notices swelling, redness, and warmth along the vein, and the patient reports pain. These findings indicate:
A Phlebitis الإجابة الصحيحةB InfiltrationC ThrombosisD Embolism -
188
A patient is receiving IV fluids. The nurse notes that the hand is swollen, cool to the touch, and the infusion has slowed. This complication is most likely:
A PhlebitisB Infiltration الإجابة الصحيحةC ThrombosisD Infection -
189
During the Hajj season, a nurse at a clinic sees many pilgrims with fever, cough, and sore throat. Which respiratory infection is most common in this setting (excluding tuberculosis)?
A TuberculosisB Influenza الإجابة الصحيحةC PneumoniaD MERS-CoV -
190
A patient scheduled for surgery becomes anxious and tells the nurse, "I have changed my mind; I do not want the operation." What should the nurse do first?
A Proceed with the surgery preparationB Have the physician re-confirm informed consent الإجابة الصحيحةC Cancel the surgery immediatelyD Sedate the patient to reduce anxiety -
191
A patient with chronic obstructive pulmonary disease (COPD) is admitted with shortness of breath. Which position will best facilitate breathing?
A SupineB High Fowler's position الإجابة الصحيحةC TrendelenburgD Side-lying -
192
A patient comes to the outpatient clinic every day requesting a dressing change for a small, clean surgical wound that does not require daily changes. What is the nurse's best response?
A Ask a family member to do the dressingB Perform the dressing change as requestedC Explain that hospital resources prioritize care based on medical necessity الإجابة الصحيحةD Refuse the patient completely without explanation -
193
A patient reports difficulty breathing when walking short distances. On auscultation, the nurse expects to hear which adventitious breath sound?
A CracklesB Wheezes الإجابة الصحيحةC StridorD Rhonchi -
194
A patient who has been refusing food begins to eat a small amount of pureed diet. During the meal, the patient coughs and sputters. What should the nurse do?
A Keep the patient lying flatB Help the patient sit fully upright and provide support الإجابة الصحيحةC Perform abdominal thrusts immediatelyD Continue feeding slowly -
195
A patient presents with yellow discoloration of the skin and sclera. Which laboratory test should the nurse anticipate checking?
A HemoglobinB Serum bilirubin الإجابة الصحيحةC CreatinineD Glucose -
196
A patient is scheduled for a liver biopsy. To minimize the risk of bleeding and optimize access, the nurse should position the patient in which position?
A Left side-lyingB Right side-lying الإجابة الصحيحةC SupineD Prone -
197
A community health nurse is implementing malaria prevention programs. Which environmental control measure is most effective?
A Use of prophylactic antibioticsB Eliminate stagnant water sources (reduce mosquito breeding) الإجابة الصحيحةC Avoid sunlight exposureD Use air conditioning -
198
A child is in the recovery room after a tonsillectomy. The nurse monitors for which primary postoperative complication?
A InfectionB Bleeding (hemorrhage) الإجابة الصحيحةC PainD Nausea -
199
A newborn exhibits excessive drooling, choking, and cyanosis during the first feeding. These symptoms are classic for which congenital anomaly?
A Fever onlyB Coughing, choking, cyanosis during feeding الإجابة الصحيحةC ConstipationD Weight gain -
200
An epidemiologist reviews mortality data and finds that widespread use of a certain vaccine has led to a dramatic reduction in deaths from childhood diseases. Which vaccine has had the most significant impact on mortality?
A MMR vaccineB DTaP vaccine (diphtheria, tetanus, pertussis) الإجابة الصحيحةC Hepatitis B vaccineD Polio vaccine -
201
A child has three episodes of vomiting and diarrhea in the past 8 hours. The nurse notes dry mucous membranes, decreased tears, and a sunken fontanel. This represents which degree and type of dehydration?
A Mild isotonic dehydrationB Moderate hypotonic dehydration الإجابة الصحيحةC Severe hypertonic dehydrationD No dehydration -
202
A nurse measures a pregnant woman's fundal height at 20 cm from the symphysis pubis to the top of the fundus. This measurement corresponds to approximately how many weeks of gestation?
A 16 weeksB 20 weeks الإجابة الصحيحةC 24 weeksD 18 weeks -
203
A nurse receives a medication from the pharmacy that is different from what the physician ordered. What is the correct action?
A Administer the medication from the pharmacyB Contact the physician to rewrite the order الإجابة الصحيحةC Administer half the doseD Skip the dose -
204
A nurse observes a colleague yelling at an intern for failing to take vital signs on a patient. What should the observing nurse do first?
A Ignore the situationB Report the incident to the charge nurse الإجابة الصحيحةC Confront the nurse directlyD Tell the intern to file a complaint -
205
A nurse removes a blanket from under a febrile child to help lower the temperature. This action promotes heat loss primarily through which mechanisms?
A Radiation onlyB Evaporation and conduction الإجابة الصحيحةC Convection onlyD Conduction only -
206
An infant presents with severe dehydration (lethargy, sunken eyes, absent tears, and prolonged capillary refill). What is the appropriate treatment?
A Advise the mother to give oral rehydration solutionB Insert an IV cannula and administer IV fluids الإجابة الصحيحةC Give antiemetic medications onlyD Wait and observe for 2 hours -
207
A patient requires supplemental oxygen. Which device delivers the highest concentration of oxygen (up to 90-95%)?
A Nasal cannula (1-6 L/min)B Non-rebreather mask الإجابة الصحيحةC Simple face maskD Venturi mask -
208
A nurse researcher is evaluating the strength of evidence for a clinical intervention. According to the evidence-based practice hierarchy, which study design provides the strongest level of evidence?
A Case studyB Cohort studyC Randomized controlled trial (RCT) الإجابة الصحيحةD Cross-sectional study -
209
A newborn has respiratory distress, and the nurse suspects congenital diaphragmatic hernia. Which diagnostic imaging study is most useful for initial diagnosis?
A CT scanB Chest X-ray الإجابة الصحيحةC UltrasoundD MRI -
210
A person at a restaurant suddenly cannot speak, cough, or breathe after eating a piece of meat. The nurse should perform which maneuver?
A Chest compressionsB Back blows onlyC Heimlich maneuver (abdominal thrusts) الإجابة الصحيحةD Abdominal thrusts followed by back blows -
211
A patient who struck another person is agitated, sweating, and has dilated pupils. This behavior is most consistent with which level of anxiety?
A Mild anxietyB Moderate anxietyC Severe anxiety الإجابة الصحيحةD Panic level anxiety -
212
A patient presents with unintentional weight loss, increased appetite, hyperactivity, and heat intolerance. These symptoms are most consistent with:
A Diabetes mellitusB Hyperthyroidism الإجابة الصحيحةC DepressionD Malabsorption syndrome -
213
A child is diagnosed with hyperthyroidism. The nurse is teaching the mother about dietary management. Which advice is most appropriate?
A Increase intake of iodine-rich foods (e.g., seaweed, iodized salt)B Avoid iodine-rich foods الإجابة الصحيحةC Increase calcium intakeD Restrict protein intake -
214
A child is brought to the emergency department with severe respiratory distress, stridor, and a crowing sound on inspiration. The child is drooling and sitting upright. What is the priority nursing intervention?
A Administer oxygenB Prepare for intubation (airway management) الإجابة الصحيحةC Give bronchodilatorsD Position upright (already sitting) -
215
A nurse suspects Hirschsprung disease in a newborn with delayed passage of meconium and abdominal distension. Which non-invasive diagnostic test is often performed first?
A Rectal biopsy (invasive)B Contrast enema (barium enema) الإجابة الصحيحةC Anorectal manometryD CT scan -
216
A patient asks how combined oral contraceptives work. The nurse explains that they prevent pregnancy through which mechanisms?
A Inhibition of ovulation onlyB Cervical mucus thickening onlyC Endometrial thinning onlyD All of the above (ovulation inhibition, mucus thickening, endometrial changes) الإجابة الصحيحة -
217
A nurse is teaching a new mother about her infant's stool patterns. What are the three types of stool normally seen in healthy infants?
A Meconium, transitional, and breast milk/formula stool الإجابة الصحيحةB Hard, soft, and liquidC Green, yellow, and brownD Formed, loose, and watery -
218
A patient develops acute kidney injury after severe dehydration from vomiting and diarrhea. The most common cause of acute renal failure in this setting is:
A Prerenal azotemia الإجابة الصحيحةB Acute tubular necrosisC Postrenal obstructionD Glomerulonephritis -
219
A nurse manager is implementing a fall prevention program on a geriatric unit. Which intervention is most effective in reducing falls?
A Raising all bed railsB Installing bathroom sensors and bed alarms الإجابة الصحيحةC Frequent rounding and monitoringD Using physical restraints -
220
A nurse manager makes all decisions without input from staff and closely supervises every task. This leadership style is known as:
A DemocraticB Laissez-faireC Autocratic الإجابة الصحيحةD Transformational -
221
A child with Tetralogy of Fallot experiences a hypercyanotic ("tet") spell. Which symptom is characteristic of this congenital heart defect?
A Cyanosis (bluish skin due to right-to-left shunt) الإجابة الصحيحةB Abdominal distensionC Clubbing of fingersD Dyspnea on exertion -
222
A nurse researcher has an idea for a new method to prevent pressure ulcers but has not yet tested it. Before implementing the method on patients, the researcher should:
A Use it immediatelyB Wait for institutional review board (IRB) approval الإجابة الصحيحةC Conduct a research study firstD Ask colleagues for their opinion -
223
A nurse collects data on the number of pneumonia cases that developed on a unit after implementing a new oral care protocol. This type of evaluation is best described as:
A Process evaluation الإجابة الصحيحةB Outcome evaluationC Structure evaluationD Input evaluation -
224
A woman is diagnosed with an incomplete abortion at 10 weeks gestation. She has heavy bleeding and an open cervical os. What is the standard management?
A Expectant management (wait and see)B Surgical evacuation (dilatation and curettage) الإجابة الصحيحةC Medical management with misoprostolD Observation only -
225
A nurse is reviewing risk factors for hypertension in the Saudi population. Which factor is most significant contributor to the high prevalence?
A GeneticsB Lifestyle factors and obesity الإجابة الصحيحةC AgeD Gender -
226
A researcher divides a city into geographic clusters and then randomly selects entire clusters to include in a study. This sampling method is called:
A Simple random samplingB Systematic samplingC Cluster sampling الإجابة الصحيحةD Stratified sampling -
227
A patient who has just received a terminal cancer diagnosis appears emotionless and says, "No, there must be a mistake." According to Kübler-Ross, which stage of grief is the patient exhibiting?
A Denial, anger, bargaining, depression, acceptance الإجابة الصحيحةB Shock, denial, anger, acceptanceC Sadness, anger, acceptanceD Denial, acceptance -
228
A patient reports seeing small black dots or "cobwebs" floating in their field of vision that move with eye movement. These symptoms are most consistent with:
A Retinal detachment (flashing lights, curtain)B Vitreous floaters الإجابة الصحيحةC Glaucoma (halos around lights, pain)D Cataracts (cloudy vision) -
229
A newborn has a small dimple and tuft of hair over the lower spine but no visible sac or neurological deficits. This finding is characteristic of:
A Open neural tube defect (myelomeningocele)B Closed neural tube defect (spina bifida occulta) الإجابة الصحيحةC HydrocephalusD Paralysis of lower limbs -
230
A nurse is explaining the female reproductive system to a patient. What are the functions of the fallopian tubes?
A Egg transport onlyB Hormone production (estrogen)C Fertilization site onlyD Both egg transport and fertilization site الإجابة الصحيحة -
231
A newborn of a diabetic mother is jittery, lethargic, and refuses to feed. The nurse checks a heel-stick glucose and it is 35 mg/dL. What is the priority intervention?
A Start IV fluids with dextrose الإجابة الصحيحةB Force-feed the infant formulaC Wait and observe for 30 minutesD Give oral glucose water -
232
A patient in the ICU has a central venous pressure (CVP) reading of 24 mmHg (normal 2-8 mmHg). This finding indicates:
A Hypovolemia (low blood volume)B Hypervolemia (fluid overload) الإجابة الصحيحةC Normal CVPD Dehydration -
233
A nurse is preparing to transfer a patient from the medical unit to the operating room. What is the highest priority during the transfer process?
A Completing documentationB Ensuring patient safety الإجابة الصحيحةC Transferring quicklyD Communicating with the OR team -
234
While transferring a patient on a stretcher to the dialysis unit, the patient becomes hypotensive. A student nurse asks the nurse to explain how the dialysis machine works. What should the nurse do first?
A Teach the student about the machineB Continue the transfer to the dialysis unitC Stop and assess the hypotensive patient الإجابة الصحيحةD Call for help -
235
A postoperative patient's heart rate has increased from a pre-operative baseline of 80 bpm to 120 bpm. What should the nurse do?
A Consider this a normal response to surgeryB Notify the physician of the significant change الإجابة الصحيحةC Continue routine monitoringD Administer a beta-blocker -
236
A nurse receives a medication delivery from the pharmacy that contains a different drug than what was ordered on the MAR. Who should be notified immediately?
A The physicianB The pharmacist الإجابة الصحيحةC The nurse supervisorD The patient -
237
A patient taking a monoamine oxidase inhibitor (MAOI) for depression has a sudden, severe headache and elevated blood pressure after eating aged cheese. Which body system is primarily affected by this drug interaction?
A Neurological systemB Gastrointestinal systemC Respiratory systemD Cardiovascular system (hypertensive crisis) الإجابة الصحيحة -
238
A patient presents with fever, nausea, vomiting, and abdominal pain that started in the periumbilical area and migrated to the right lower quadrant. The patient also has rebound tenderness. What is the most likely diagnosis?
A Lower right quadrant pain (nonspecific)B Appendicitis الإجابة الصحيحةC GastroenteritisD Diverticulitis -
239
A child with thalassemia major receives regular blood transfusions. Which long-term complication is most concerning?
A HepatomegalyB Bleeding tendenciesC Heart failure (due to iron overload) الإجابة الصحيحةD Joint deformity -
240
A nurse is suctioning a child's endotracheal tube. To avoid hypoxia and bradycardia, each suction pass should be limited to how many seconds?
A Less than 5 secondsB Less than 10 seconds الإجابة الصحيحةC Less than 30 secondsD Less than 40 seconds -
241
A pregnant woman with severe pre-eclampsia is admitted. Which medication is given intravenously to prevent eclampsia (seizures)?
A Magnesium sulfate الإجابة الصحيحةB PhenytoinC CarbamazepineD Valproic acid -
242
A postpartum mother is diagnosed with deep vein thrombosis (DVT) in her left leg. Which of the following instructions should the nurse prioritize to prevent complications and promote recovery?
A Walk regularly as tolerated الإجابة الصحيحةB Elevate the leg and apply ice packsC Maintain strict bed restD Massage the affected leg frequently -
243
A patient with sudden-onset severe shortness of breath and chest pain after a central line placement is found to have absent breath sounds on the left. Which symptom is most commonly associated with tension pneumothorax?
A Severe chest painB Difficulty breathing (dyspnea) الإجابة الصحيحةC Tracheal deviation toward the unaffected sideD Hypotension -
244
A 60-year-old man with a history of gout presents with an acutely swollen, painful right big toe. Which dietary modification should the nurse emphasize to prevent future flares?
A Avoid foods high in purines (e.g., red meat, shellfish) الإجابة الصحيحةB Increase intake of low-sodium foodsC Eat more high-fiber foodsD Choose low-fat dairy products -
245
A nurse is caring for a newborn whose mother had poorly controlled gestational diabetes. Within the first few hours after birth, the nurse should monitor the infant for which common complication?
A Hypoglycemia الإجابة الصحيحةB HyperglycemiaC Pathologic jaundiceD Macrosomia (large body size at birth) -
246
A nursing manager on a busy medical-surgical unit has received approval to hire two additional registered nurses. What is the first step in the staffing process?
A Initiate recruitment (post job openings, advertise) الإجابة الصحيحةB Conduct interviews with candidatesC Plan orientation for new hiresD Schedule training sessions -
247
A public health nurse is preparing educational materials for pilgrims traveling to Hajj. The nurse explains that receiving the meningococcal vaccine before travel is an example of which level of prevention?
A Primary prevention الإجابة الصحيحةB Secondary preventionC Tertiary preventionD Quaternary prevention -
248
Malaria continues to cause millions of deaths annually across multiple continents, affecting large populations in Africa, Asia, and South America. This global pattern is best described as a(n):
A Endemic (constant presence in a region)B Epidemic (sudden increase in a specific area)C Pandemic (widespread across countries or continents) الإجابة الصحيحةD Outbreak (localized cluster) -
249
Two staff nurses disagree about the best way to schedule weekend shifts. The nurse manager brings them together and helps them reach a mutual agreement without involving a third party. This conflict resolution method is called:
A Negotiation (direct discussion between parties) الإجابة الصحيحةB Mediation (third-party facilitator)C Arbitration (third-party decision maker)D Collaboration (working together on a solution) -
250
A patient with unilateral leg swelling, warmth, and tenderness is suspected of having a deep vein thrombosis (DVT). Which diagnostic test is considered the gold standard for confirming the diagnosis?
A Positive Perthes testB Doppler ultrasound (venous duplex) الإجابة الصحيحةC D-dimer blood testD Venography (contrast X-ray) -
251
A patient with suspected meningitis complains of severe headache and neck stiffness. The nurse notes that the patient turns away from the overhead light and asks to dim the room. This sensitivity is known as:
A Photophobia (sensitivity to light) الإجابة الصحيحةB Phonophobia (sensitivity to sound)C Tactile hypersensitivityD Temperature intolerance -
252
A woman undergoes a dilation and curettage (D&C) for incomplete miscarriage. The nurse provides discharge instructions. To reduce the risk of infection, the woman should avoid sexual intercourse for which period?
A 1 weekB 2 weeks الإجابة الصحيحةC 4 weeksD 6 weeks -
253
A newborn with congenital diaphragmatic hernia has herniated abdominal organs into the chest cavity, causing mediastinal shift. This condition primarily affects cardiac function by causing:
A Decreased cardiac output (due to compression) الإجابة الصحيحةB Increased cardiac outputC Cardiac arrhythmiasD Heart failure -
254
A patient experiences episodes of hypomania (elevated mood, increased energy, decreased need for sleep) lasting several days, alternating with periods of major depression. The symptoms do not meet full criteria for mania. This presentation is most consistent with:
A Bipolar I disorder (full mania)B Bipolar II disorder (hypomania + depression) الإجابة الصحيحةC Cyclothymic disorder (chronic fluctuations, less severe)D Major depressive disorder (no hypomania) -
255
During a physical assessment, the nurse notes that the patient's fingernails are spoon-shaped (koilonychia) with a concave curvature. This finding is most commonly associated with which condition?
A Nutritional deficiency (especially iron deficiency anemia) الإجابة الصحيحةB Chronic fungal infectionC Previous trauma to the nail bedD Genetic disorder (e.g., ectodermal dysplasia) -
256
A nurse is assessing a surgical wound and notes thin, clear, watery drainage. This type of exudate is classified as:
A Serous (clear, watery) الإجابة الصحيحةB Purulent (thick, yellow/green)C Serosanguineous (pink, blood-tinged)D Sanguineous (bright red, bloody) -
257
A prenatal ultrasound reveals a neural tube defect with a sac containing meninges and spinal cord tissue (myelomeningocele). Which imaging study provides the most detailed anatomic information for surgical planning?
A CT scan of the spineB Magnetic resonance imaging (MRI) of the spine الإجابة الصحيحةC Ultrasound (already done for diagnosis)D X-ray of the spine -
258
A nurse performs a gestational age assessment on a term newborn at 40 weeks using the square window sign (flexing the wrist). What angle between the palm and forearm is expected in a full-term infant?
A 30 degreesB 45 degreesC 90 degreesD 0 degrees (wrist remains straight, minimal flexion) الإجابة الصحيحة -
259
A patient is one day post-appendectomy (open surgery). Which position should the nurse encourage to promote comfort, facilitate drainage, and reduce tension on the incision?
A Supine positionB Semi-Fowler's position الإجابة الصحيحةC Prone positionD Trendelenburg position -
260
A pregnant woman at 10 weeks presents with vaginal bleeding, lower abdominal pain, and passage of tissue. On speculum exam, the cervical os is open, and fetal parts are visible. This presentation is most consistent with which type of abortion?
A Threatened abortion (closed os, viable pregnancy)B Inevitable abortion (open os, no tissue passage yet)C Incomplete abortion (open os, some tissue retained) الإجابة الصحيحةD Missed abortion (closed os, nonviable fetus retained) -
261
The Saudi Ministry of Health requires Hajj pilgrims to receive the quadrivalent meningococcal vaccine. This vaccination is considered which type of prevention?
A Primary prevention (preventing disease before exposure) الإجابة الصحيحةB Secondary prevention (early detection)C Tertiary prevention (managing established disease)D Universal precaution (standard infection control) -
262
During the annual Hajj pilgrimage, several cases of meningococcal meningitis are reported among pilgrims from different countries. This sudden increase in cases in a specific geographic area is best described as:
A Endemic (constant low-level presence)B Pandemic (global spread)C Epidemic (outbreak in a defined region) الإجابة الصحيحةD Sporadic (isolated cases) -
263
A nurse reviews an ECG showing U waves, ST-segment depression, and a flattened T wave. The patient's medication list includes furosemide. Which electrolyte imbalance is most likely contributing to these findings?
A HyperkalemiaB Hypokalemia (due to loop diuretic) الإجابة الصحيحةC HypercalcemiaD Hyponatremia -
264
A charge nurse enters a patient's room and finds two nurses arguing loudly about a treatment plan while the patient is visibly anxious. What is the most appropriate immediate response?
A Ignore the situation and walk awayB Join the discussion to mediateC Tell both nurses to stop arguing, act professionally, and leave the patient's room الإجابة الصحيحةD Report the incident to administration after the shift -
265
A nurse receives report on four postoperative patients. Which patient should be assessed first?
A A patient with stable vital signs 6 hours after surgeryB A patient who is 1 hour post-appendectomy with vital signs within normal limits الإجابة الصحيحةC A patient who is ready for discharge teachingD A patient waiting for routine morning medications -
266
A patient with active pulmonary tuberculosis is admitted to the medical unit. To prevent transmission, which type of infection control precautions should the nurse implement?
A Contact precautionsB Droplet precautionsC Airborne precautions (with N95 respirator) الإجابة الصحيحةD Standard precautions only -
267
A primigravida at 36 weeks gestation presents with a blood pressure of 170/100 mmHg, 3+ proteinuria, and generalized edema. She then experiences a tonic-clonic seizure. This clinical picture is diagnostic of:
A Preeclampsia (without seizures)B Gestational hypertensionC Eclampsia (preeclampsia with seizures) الإجابة الصحيحةD HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) -
268
A patient is scheduled for an emergency cholecystectomy in 2 hours. What is the priority nursing action to prepare the patient for surgery?
A Check and document vital signsB Keep the patient NPO (nothing by mouth) الإجابة الصحيحةC Obtain informed consentD Start an IV line -
269
A healthy primigravida at 37 weeks gestation with no complications and normal fetal assessment asks the nurse when she can expect delivery. The most appropriate plan is:
A Induce labor immediately at 37 weeksB Schedule a cesarean section for 38 weeksC Continue routine prenatal monitoring and expect spontaneous labor up to 40 weeks الإجابة الصحيحةD Discharge home with no further follow-up -
270
A nurse needs to administer a medication prescribed at 0.1 mg/kg. The available concentration is 10 mg/mL, and the patient weighs 20 kg. How many milliliters should the nurse administer?
A 0.2 mL الإجابة الصحيحةB 0.02 mLC 2 mLD 20 mL -
271
A patient is diagnosed with HELLP syndrome (hemolysis, elevated liver enzymes, low platelets). Which medication is contraindicated due to the risk of bleeding?
A Aspirin (antiplatelet) الإجابة الصحيحةB Magnesium sulfate (neuroprotection)C Corticosteroids (fetal lung maturity)D Antihypertensive agents (e.g., labetalol) -
272
According to World Health Organization recommendations, a healthy newborn should receive vitamin K prophylaxis to prevent hemorrhagic disease of the newborn. What is the recommended dose and route?
A 0.5 to 1 mg intramuscularly الإجابة الصحيحةB 2 mg intramuscularlyC 0.1 mg intramuscularlyD 5 mg intramuscularly -
273
A child with nephrotic syndrome has significant proteinuria. The nurse expects the urine appearance to be:
A Clear and diluteB Dark and frothy (foamy) الإجابة الصحيحةC Bright yellowD Red or cola-colored -
274
A nurse is explaining kidney function to a patient. The primary role of the glomerulus is to:
A Produce hormones (erythropoietin, renin)B Filter blood to form ultrafiltrate الإجابة الصحيحةC Concentrate urine (loop of Henle)D Regulate electrolyte balance (distal tubule) -
275
A child returns to the unit after a tonsillectomy. The nurse monitors for signs of postoperative bleeding. Which early finding suggests active bleeding?
A Vomiting bright red bloodB Frequent swallowing (swallowing blood) الإجابة الصحيحةC Decreased blood pressure (late sign)D Pallor (late sign) -
276
A child with sickle cell anemia presents with severe pain in the long bones, fever, and swelling of the hands and feet. Which factor is most likely to trigger a vaso-occlusive crisis?
A Infection (e.g., viral illness) الإجابة الصحيحةB Moderate exerciseC High oxygen concentrationD Cold exposure (vasoconstriction) -
277
A child is 6 hours post-tonsillectomy and is ready for clear liquids. Which beverage is most appropriate to offer?
A Apple juice (non-acidic, clear) الإجابة الصحيحةB Lemon juice (acidic, irritating)C Orange juice (acidic, may cause burning)D Pineapple juice (acidic) -
278
During a school screening, a nurse notes that a child's spine has a lateral curvature with a visible "C" or "S" shape. This condition is known as:
A Kyphosis (forward curvature, hunchback)B Scoliosis (lateral curvature) الإجابة الصحيحةC Lordosis (backward curvature, swayback)D Spinal compression fracture -
279
A woman is planning to become pregnant. Which supplement should the nurse recommend to reduce the risk of neural tube defects such as spina bifida?
A Iron supplementsB Folic acid (vitamin B9) الإجابة الصحيحةC CalciumD Vitamin D -
280
A nurse is teaching a community group about skin cancer prevention. The nurse advises avoiding outdoor sun exposure during which hours to reduce ultraviolet radiation exposure?
A 8:00 AM to 2:00 PMB 10:00 AM to 4:00 PM (peak UV intensity) الإجابة الصحيحةC 12:00 PM to 6:00 PMD 2:00 PM to 8:00 PM -
281
A fair-skinned patient asks the nurse about ways to prevent skin cancer. Which recommendation is most effective?
A Apply moisturizer dailyB Use broad-spectrum sunscreen with SPF 30 or higher الإجابة الصحيحةC Take vitamin D supplementsD Wear only light-colored clothing -
282
The nurse is teaching about primary prevention of skin cancer. Which of the following is NOT considered primary prevention?
A Avoiding sun exposure during peak hoursB Using sunscreen regularlyC Performing regular skin self-examinations (secondary prevention) الإجابة الصحيحةD Seeking shade when outdoors -
283
A nurse finds that a confused and agitated patient has been restrained by nursing staff without a physician's order. What is the most appropriate initial action?
A Remove the restraints immediately (as they are unauthorized)B Request a physician's evaluation and file an incident report الإجابة الصحيحةC Continue the restraints until the end of the shiftD Document the incident only -
284
The Saudi Ministry of Health requires all Hajj pilgrims to present proof of vaccination against a specific bacterial infection known to cause outbreaks in crowded settings. Which vaccine is mandatory for Hajj?
A BCG (tuberculosis)B Hepatitis AC Meningococcal (meningitis) الإجابة الصحيحةD Yellow fever -
285
A postpartum woman visits the clinic 15 days after delivery. She reports continued bright red lochia (lochia rubra) and pelvic discomfort. What is the nurse's priority intervention?
A Monitor vital signsB Assess the lochia characteristics and perform a fundal examination الإجابة الصحيحةC Start empirical antibioticsD Schedule a routine follow-up in 2 weeks -
286
A patient receiving a blood transfusion suddenly develops fever, chills, and shortness of breath. What is the nurse's first action?
A Stop the transfusion and infuse normal saline through new tubing الإجابة الصحيحةB Slow the transfusion rate and monitor symptomsC Administer an antipyreticD Check oxygen saturation -
287
A woman in active labor asks the nurse how to tell if her contractions are true labor. Which characteristic best distinguishes true labor contractions from Braxton-Hicks?
A They occur at regular intervals that become closer together الإجابة الصحيحةB They remain constant in intensity and frequencyC They decrease with rest or position changeD They occur irregularly and unpredictably -
288
An infant is born with a cleft palate but no cleft lip. The parents ask the nurse when the surgical repair is typically performed. What is the usual timing for cleft palate repair?
A 6 to 9 months of ageB 12 to 19 months of age الإجابة الصحيحةC 24 to 36 months of ageD 3 to 5 years of age -
289
A pregnant woman with risk factors for gestational diabetes asks the nurse when she will be screened. At which gestational age is the routine oral glucose tolerance test typically performed?
A 16 to 20 weeksB 20 to 24 weeksC 24 to 28 weeks الإجابة الصحيحةD 32 to 36 weeks -
290
A postpartum woman has a perineal laceration. The nurse assesses the fundus and finds it firm and well-contracted. This finding suggests that any bleeding is likely due to:
A Uterine atony (soft fundus)B Perineal laceration (fundus firm, bleeding from lower tract) الإجابة الصحيحةC Retained placental fragments (fundus may be soft)D Coagulopathy -
291
A newborn's APGAR scores are 7 at 1 minute and 8 at 5 minutes. The nurse interprets these scores as indicating:
A A severely depressed newborn requiring resuscitationB A normal, healthy newborn with good transition الإجابة الصحيحةC A moderately depressed newborn needing observationD A critical condition requiring immediate intervention -
292
A premature infant in the NICU exhibits nasal flaring, grunting, and intercostal retractions. The nurse suspects respiratory distress syndrome (RDS). This clinical picture is most characteristic of:
A Pneumonia (infection)B Transient tachypnea of the newbornC Respiratory distress syndrome (RDS) due to surfactant deficiency الإجابة الصحيحةD Bronchiolitis (viral) -
293
A head nurse wants to improve data protection for patient information in the electronic health record. Which action is most effective for ensuring user accountability?
A Set individual passwords for each nurse (unique login credentials) الإجابة الصحيحةB Allow staff to use shared computers without individual loginsC Keep patient files open on the deskD Allow unlimited access to all records -
294
A nurse manager allows staff to make their own patient assignments and schedule their shifts with minimal supervision. This leadership style is best described as:
A Autocratic (centralized control)B Democratic (shared decision-making)C Laissez-faire (hands-off, high autonomy) الإجابة الصحيحةD Transformational (inspirational change) -
295
A patient with chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG) showing pH 7.30, PaCO2 65 mmHg, HCO3 24 mEq/L. The nurse interprets this as:
A Compensated respiratory acidosisB Uncompensated respiratory acidosis الإجابة الصحيحةC Metabolic alkalosisD Normal values -
296
A nurse is teaching a new mother how to care for her newborn's umbilical cord stump. Which instruction is correct to promote drying and prevent infection?
A Fold the diaper so that it sits below the cord stump الإجابة الصحيحةB Cover the stump with a dry gauze padC Apply topical antiseptic ointment dailyD Keep the stump moist with alcohol -
297
A patient with a new colostomy reports that the skin around the stoma has become dark purple and painful. This finding suggests which complication?
A Normal pink stoma colorB Ischemia or necrosis of the peristomal skin/stoma (compromised blood flow) الإجابة الصحيحةC Mild swelling (edema)D Clear, normal output -
298
A woman with gestational diabetes delivers a 4800 g (10.6 lb) infant at 39 weeks. The nurse should monitor the newborn most closely for which condition?
A Hyperglycemia (high blood sugar)B Hypoglycemia (low blood sugar, common in LGA infants of diabetic mothers) الإجابة الصحيحةC Respiratory distress syndrome (less common at term)D Birth trauma (macrosomia increases risk, but hypoglycemia is immediate metabolic concern) -
299
A nurse is educating parents about risk factors for acute otitis media in infants. Which anatomical characteristic increases susceptibility to ear infections?
A Long, narrow eustachian tubesB Short, wide, and horizontal eustachian tubes الإجابة الصحيحةC Large tympanic membraneD Small ear canal -
300
A nurse is preparing to administer vitamin K to a newborn. Which intramuscular injection site is recommended for this age group?
A Deltoid muscleB Dorsogluteal (buttocks)C Vastus lateralis (anterolateral thigh) الإجابة الصحيحةD Ventrogluteal (hip) -
301
An infant born with myelomeningocele (spina bifida) is at risk for developing hydrocephalus. Which parameter should the nurse monitor frequently to detect increasing intracranial pressure?
A Daily weightB Head circumference (measurements and percentiles) الإجابة الصحيحةC Length (height)D Blood pressure -
302
A newborn has APGAR scores of 9 at 1 minute and 9 at 5 minutes. After the initial assessment and routine care, what should the nurse do next?
A Continue routine newborn care (vitamin K, eye prophylaxis, bathing) الإجابة الصحيحةB Discharge the infant immediatelyC Call the pediatrician for a consultD Start early feeding without delay -
303
A term newborn fails to pass meconium within the first 24 hours of life and develops abdominal distension and vomiting. The nurse suspects which condition?
A Normal variation (meconium can take up to 48 hours)B Hirschsprung disease (congenital aganglionic megacolon) الإجابة الصحيحةC Intestinal obstruction (e.g., meconium ileus)D Feeding intolerance (mild) -
304
A woman of reproductive age is diagnosed with a 3 cm simple ovarian cyst on ultrasound. She is asymptomatic. What is the recommended follow-up plan?
A Immediate surgical removalB Repeat ultrasound after the next menstrual period الإجابة الصحيحةC Re-evaluate in 6 monthsD Re-evaluate in 1 year -
305
The Saudi Ministry of Health requires all Hajj pilgrims to receive the quadrivalent meningococcal vaccine. This vaccine is considered a primary prevention measure for which disease?
A Hepatitis AB BCG (tuberculosis)C Meningococcal meningitis الإجابة الصحيحةD Yellow fever -
306
A woman comes to the clinic 15 days postpartum with persistent bright red lochia (rubra) that has not changed to lochia serosa. What is the nurse's first intervention?
A Administer broad-spectrum antibioticsB Assess the lochia for amount, odor, and consistency, and check the fundus الإجابة الصحيحةC Check vital signsD Perform a pelvic examination -
307
A patient develops fever, chills, and dyspnea 30 minutes after starting a blood transfusion. What is the priority nursing action?
A Give oral antihistamineB Stop the transfusion and infuse normal saline through new tubing الإجابة الصحيحةC Slow the transfusion rate to halfD Administer intravenous corticosteroids -
308
A nurse is teaching a primigravida how to recognize true labor contractions. Which characteristic indicates true labor?
A Contractions occur every 5 to 10 minutes but are irregularB Contractions increase in intensity, duration, and frequency over time الإجابة الصحيحةC Contractions last 30 seconds and do not changeD Contractions are felt only in the lower abdomen -
309
A child is born with a complete cleft palate. The parents ask when the surgical repair is typically performed. The nurse explains that cleft palate repair is usually done at which age?
A 6 to 12 monthsB 12 to 19 months (before speech develops) الإجابة الصحيحةC 2 to 3 yearsD 4 to 5 years -
310
A pregnant woman with a BMI of 32 is scheduled for gestational diabetes screening. At what gestational age should the oral glucose tolerance test be performed?
A 20 to 24 weeksB 24 to 28 weeks (standard screening window) الإجابة الصحيحةC 28 to 32 weeksD 32 to 36 weeks -
311
A nurse assesses a postpartum woman with a perineal laceration. The fundus is firm and midline. This finding is consistent with:
A Proper uterine involution (no uterine atony) الإجابة الصحيحةB Uterine atony (fundus would be boggy)C Retained placental fragments (fundus may be boggy)D Infection (fundus tender) -
312
A newborn has APGAR scores of 7 at 1 minute and 9 at 5 minutes. The nurse interprets this as:
A A severely depressed infant requiring resuscitationB A normal, healthy newborn with good adaptation الإجابة الصحيحةC A moderately depressed infant needing further observationD A critical situation requiring NICU transfer -
313
A premature infant in the neonatal intensive care unit exhibits nasal flaring, grunting, and subcostal retractions. The nurse suspects respiratory distress syndrome (RDS). This condition is most commonly caused by:
A PneumoniaB AsthmaC Surfactant deficiency (hyaline membrane disease) الإجابة الصحيحةD Bronchiolitis -
314
The head nurse wants to enhance confidentiality of patient records. Which measure is most effective for controlling access to electronic health information?
A Lock all computers in the nursing stationB Assign unique login IDs and passwords to each nurse (audit trail) الإجابة الصحيحةC Convert to paper records onlyD Limit computer access to specific hours -
315
A patient's blood pressure is measured at 190/120 mmHg on two separate occasions. The patient reports a severe headache and blurred vision. This finding is classified as:
A Stage 1 hypertensionB Stage 2 hypertensionC Hypertensive crisis (urgent or emergency) الإجابة الصحيحةD High-normal blood pressure -
316
A nurse manager provides staff with complete autonomy to make decisions and solve problems on their own, with minimal guidance. This leadership style is known as:
A AutocraticB Democratic (participative)C Laissez-faire (delegative) الإجابة الصحيحةD Transformational -
317
A patient with an acute exacerbation of COPD has an arterial blood gas showing pH 7.31, PaCO2 68, and HCO3 24. The nurse interprets this as:
A Compensated respiratory acidosisB Uncompensated respiratory acidosis الإجابة الصحيحةC Metabolic acidosisD Normal values -
318
A nurse is providing umbilical cord care to a newborn. Which action promotes drying and reduces infection risk?
A Fold the diaper so that it sits below the cord stump الإجابة الصحيحةB Fold the diaper so that it covers the cord stumpC Cover the stump with a dry gauze padD Apply antibiotic ointment to the base -
319
A patient with a colostomy notices that the skin around the stoma has become dark purple and the stoma itself is discolored. This finding is most concerning for:
A Normal pink stoma (healthy)B Ischemia or necrosis (compromised blood flow) الإجابة الصحيحةC Normal mucus productionD Mild peristomal edema -
320
A woman with gestational diabetes delivers a 4800 g infant at 39 weeks. The nurse should monitor the newborn for which early complication?
A HyperglycemiaB Hypoglycemia (due to fetal hyperinsulinism) الإجابة الصحيحةC Respiratory distress syndrome (less common at term)D Jaundice -
321
A nurse is educating parents about prevention of otitis media. Which anatomical factor in infants increases the risk of middle ear infections?
A Long, narrow eustachian tubeB Short, wide, and horizontal eustachian tube الإجابة الصحيحةC Large tympanic membraneD Small ear canal -
322
A child is diagnosed with rubella (German measles). Which type of transmission-based precautions should the nurse initiate?
A Contact precautionsB Droplet precautions (with surgical mask) الإجابة الصحيحةC Airborne precautions (N95 respirator)D Standard precautions only -
323
A nurse is preparing to administer intramuscular vitamin K to a newborn. Which muscle site is preferred for this injection?
A DeltoidB Vastus lateralis الإجابة الصحيحةC Gluteus maximusD Rectus femoris -
324
An infant is born with myelomeningocele (spina bifida). The nurse monitors for signs of hydrocephalus. Which measurement is most important to track daily?
A Weight gainB Head circumference الإجابة الصحيحةC Body temperatureD Blood pressure -
325
A newborn has APGAR scores of 8 at 1 minute and 9 at 5 minutes. After providing initial care (drying, warming, airway), what should the nurse do next?
A Feed the baby immediatelyB Continue routine newborn care procedures (vitamin K, eye prophylaxis, bathing) الإجابة الصحيحةC Initiate discharge planningD Call the pediatrician for evaluation -
326
A term newborn has not passed meconium by 48 hours of life and presents with abdominal distension and bilious vomiting. Which congenital condition should the nurse suspect?
A Meconium ileus (cystic fibrosis)B Hirschsprung disease (aganglionic megacolon) الإجابة الصحيحةC Necrotizing enterocolitisD Pyloric stenosis -
327
A postpartum woman who is breastfeeding reports painful, hard breasts on day 3 postpartum. To prevent severe engorgement, what should the nurse advise?
A Stop breastfeeding and switch to formulaB Apply cold compresses after each feedingC Breastfeed frequently (every 1.5 to 3 hours) الإجابة الصحيحةD Wear a tight-fitting bra -
328
A 30-year-old woman is found to have a 3 cm simple ovarian cyst on routine ultrasound. She is asymptomatic. What is the recommended management?
A Immediate surgical removalB Repeat ultrasound after the next menstrual period (likely functional cyst) الإجابة الصحيحةC Start hormonal therapyD Perform a biopsy -
329
A nurse is counseling a patient about the risks and benefits of combined oral contraceptives (COCs). Which cancers have an increased risk with long-term COC use?
A Breast and cervical cancer الإجابة الصحيحةB Ovarian and endometrial cancer (decreased risk)C Breast and ovarian cancerD Cervical and endometrial cancer -
330
A patient asks about the protective effects of combined oral contraceptives (COCs). Which cancers have a decreased risk with long-term COC use?
A Breast and cervical cancer (increased)B Ovarian and endometrial cancer (decreased) الإجابة الصحيحةC Breast and ovarian cancerD Cervical and endometrial cancer -
331
A patient is 4 hours post-abdominal surgery and received a long-acting analgesic intraoperatively. The prescribed PRN pain medication is every 4 hours. The patient rates pain as 8/10 but it has only been 2 hours since the last dose. What should the nurse do?
A Inform the physician to request an earlier dose or alternative pain management الإجابة الصحيحةB Administer half of the prescribed doseC Ignore the patient's complaintD Wait the full 4 hours before giving the PRN dose -
332
A patient is recovering from an open appendectomy. Which position is most appropriate to minimize pain from the incision and promote drainage?
A High Fowler's position (semi-upright) الإجابة الصحيحةB Prone positionC Lithotomy positionD Supine position -
333
A patient's family member complains to the charge nurse that no nurse has come to administer the patient's scheduled asthma inhaler due to short staffing. What should the charge nurse do first?
A Go personally to administer the medication الإجابة الصحيحةB Explain the work pressure to the family memberC Call another nurse to handle itD Document the complaint and wait -
334
A nursing student checks a diabetic patient's blood glucose level after breakfast and obtains a reading of 30 mg/dL. The patient is awake and talking. What should the charge nurse do first?
A Have the charge nurse repeat the test to verify the result الإجابة الصحيحةB Let the student repeat the test againC Inform the doctor immediatelyD Ignore and document the result -
335
A rural hospital implements a telemedicine program that allows patients to consult with specialists remotely. One of the main benefits of telehealth is:
A Increased healthcare costsB Improved access to healthcare services (especially for remote areas) الإجابة الصحيحةC Reduced quality of careD Limited availability of specialist consultation -
336
During the Hajj season, the Ministry of Health recommends influenza vaccination for all pilgrims. This vaccination is an example of which level of prevention?
A Primary prevention (preventing infection before exposure) الإجابة الصحيحةB Secondary prevention (early diagnosis)C Tertiary prevention (managing complications)D Quaternary prevention (avoiding overmedicalization) -
337
A child is exposed to chickenpox at school. The nurse informs the parents that a vaccine is available to prevent or reduce the severity of the disease. Which vaccine is used for chickenpox?
A Varicella vaccine الإجابة الصحيحةB MMR (measles, mumps, rubella)C Hepatitis B vaccineD Pneumococcal vaccine -
338
An infant presents with non-bilious projectile vomiting after feedings, visible peristaltic waves, and a palpable olive-shaped mass in the upper abdomen. These findings are characteristic of:
A Projectile vomiting (pyloric stenosis) الإجابة الصحيحةB Bilious vomiting (malrotation)C ConstipationD Diarrhea -
339
A 27-year-old woman is brought to the emergency department in active labor and requires an emergency cesarean section. Her husband is not present, and she is unconscious. Who should provide informed consent?
A Her legal guardian (if appointed) or the hospital ethics committee الإجابة الصحيحةB Hospital administrationC The emergency physician (in emergency, implied consent)D The nursing supervisor -
340
A community health nurse visits a woman at home who has not been diagnosed with any condition. The nurse finds a random blood glucose of 300 mg/dL and refers her to a health center for further evaluation. This referral is an example of which level of prevention?
A Primary prevention (prevention of disease onset)B Secondary prevention (early detection and referral) الإجابة الصحيحةC Tertiary prevention (managing established disease)D Health promotion (general wellness) -
341
A woman experiences a spontaneous abortion (miscarriage) at 10 weeks gestation. Chromosomal analysis of the products of conception shows aneuploidy. The most common cause of first-trimester spontaneous abortion is:
A Chromosomal abnormalities الإجابة الصحيحةB Maternal infection (e.g., cytomegalovirus)C Hormonal imbalance (e.g., luteal phase defect)D Trauma -
342
A child undergoes cleft palate repair. The nurse is teaching the mother about post-operative feeding. Which statement by the mother indicates a need for further teaching?
A I will feed my child with a spoon الإجابة الصحيحةB I will use a soft, specialized cleft palate nippleC I will feed slowly and allow time for swallowingD I will burp the child frequently -
343
Public health officials are investigating an outbreak of a sexually transmitted disease in a community. Which method is best to identify the source and contacts?
A Interview infected individuals and their sexual contacts (contact tracing) الإجابة الصحيحةB Cluster sampling of the general populationC Laboratory testing of all residents onlyD Mass screening of asymptomatic individuals -
344
A patient participating in a clinical research study decides halfway through that she no longer wishes to continue. What should the nurse tell the patient?
A You can withdraw from the study at any time without penalty الإجابة الصحيحةB You must complete the study to maintain data integrityC Withdrawal will negatively affect the study results, so please reconsiderD You need permission from the principal investigator to withdraw -
345
A breastfeeding mother is diagnosed with mastitis. The nurse should advise which of the following as part of management?
A Stop breastfeeding to rest the breastB Take the full course of prescribed antibiotics الإجابة الصحيحةC Apply cold compresses onlyD Reduce fluid intake -
346
A student nurse measures a patient's postprandial blood glucose and obtains a value of 30 mg/dL. The patient is awake and alert. What should the charge nurse do first?
A Have the student repeat the measurementB The charge nurse should repeat the test to verify الإجابة الصحيحةC Call the doctor immediatelyD Give oral glucose immediately -
347
A patient who underwent a partial gastrectomy is now eating small meals. The patient reports feeling full after only a few bites and experiences nausea. This complication is known as:
A Early satiety (reduced gastric capacity) الإجابة الصحيحةB Gastric hypermotilityC Increased appetite (hunger)D Delayed gastric emptying (gastroparesis) -
348
A 60-year-old patient presents with rectal bleeding and a palpable mass on digital rectal exam. The physician needs to visualize the entire colon to evaluate for polyps or cancer. Which procedure is indicated?
A Hemorrhoidectomy (surgical removal of hemorrhoids)B Colonoscopy (examination of entire colon with biopsy capability) الإجابة الصحيحةC Sigmoidoscopy (only distal colon)D Rectal biopsy (only of palpable lesion) -
349
A child diagnosed with nephrotic syndrome presents with periorbital edema, generalized swelling, and weight gain. The nurse understands that the hallmark clinical finding in nephrotic syndrome is:
A Edema (due to hypoalbuminemia and sodium retention) الإجابة الصحيحةB Weight lossC Hypotension (typically normotensive or hypertensive)D Dehydration -
350
A 71-year-old woman in a nursing home falls down stairs. Her medications include warfarin, metformin, loratadine, and diclofenac. The nurse should be most alert for which complication?
A Bleeding (due to warfarin, especially after trauma) الإجابة الصحيحةB Bone fractureC Brain concussionD Hypoglycemia (metformin risk is low, but possible) -
351
A nurse is caring for a patient who speaks a different language and comes from a different culture. What is the most appropriate way to communicate effectively?
A Obtain a qualified medical interpreter الإجابة الصحيحةB Use hand gestures and nonverbal cuesC Ask a family member to interpretD Use a translation app on a phone -
352
A nurse is assessing a newborn for jaundice. Physiologic jaundice typically appears at what time after birth?
A 3 to 4 days after birth (peaks day 3-5 in term infants) الإجابة الصحيحةB Within 24 hours after birth (pathologic)C 1 week after birth (late onset)D 2 weeks after birth (prolonged) -
353
A newborn is receiving phototherapy for hyperbilirubinemia. Which nursing intervention is most important during treatment?
A Cover the infant's eyes with eye shields (to prevent retinal damage) الإجابة الصحيحةB Cover the genitals with a diaperC Monitor temperature frequentlyD Change position every 2 hours -
354
A mother changes her newborn's diaper and notices a small amount of blood. The infant is otherwise well and feeding normally. The most likely cause is:
A Pseudomenstruation (due to withdrawal of maternal hormones) الإجابة الصحيحةB Medications given to the babyC Birth trauma (e.g., adrenal hemorrhage)D Urinary tract infection -
355
A postpartum nurse is assessing a woman with a boggy uterus and heavy bleeding. The most common cause of uterine atony is:
A Prolonged or rapid labor (uterine muscle fatigue) الإجابة الصحيحةB Multiple gestationsC Macrosomic infantD Advanced maternal age -
356
A patient with a nasogastric tube (NGT) is found lying flat in bed with the tube disconnected from suction. The patient is drowsy. Which complication is the patient at highest risk for?
A Aspiration of gastric contents الإجابة الصحيحةB Gastric bleedingC Tube infectionD Tube displacement into the trachea -
357
A public health nurse is planning tuberculosis prevention strategies. Which intervention is most effective at the population level to reduce transmission?
A BCG vaccination (especially in high-burden countries) الإجابة الصحيحةB Isolation of all suspected cases onlyC Antibiotics for all contactsD Masking of healthcare workers only -
358
A child is 8 hours post-tonsillectomy and is allowed clear liquids. Which beverage is most appropriate?
A Filtered apple juice (non-acidic, clear) الإجابة الصحيحةB Orange juice (acidic, irritating)C Milk (dairy may increase mucus, not clear liquid)D Coffee (caffeine, not recommended for children) -
359
A child is unconscious in the recovery room after a tonsillectomy. To protect the airway and allow drainage of secretions, the nurse should place the child in which position?
A Prone (face-down) or side-lying الإجابة الصحيحةB Supine (face-up)C Fowler's (sitting up)D Trendelenburg (head down, feet up) -
360
A nurse instructs a patient on how to collect a clean-catch midstream urine specimen. The best time to collect the specimen for routine urinalysis is:
A Early morning (first void, most concentrated) الإجابة الصحيحةB After mealsC Before bedtimeD Any time of day -
361
A patient is preparing to give a urine sample for culture. Which instruction should the nurse give regarding fluid intake?
A Increase fluid intake to ensure adequate sample volume الإجابة الصحيحةB Restrict fluids for 8 hours before collectionC Take antibiotics before collectionD Fast overnight -
362
A child presents with fever, arthritis, and a red, raised rash. The nurse suspects acute rheumatic fever. The nurse should ask about a recent history of:
A Pharyngitis (group A streptococcal throat infection) الإجابة الصحيحةB Heart disease (rheumatic heart disease is a complication)C Joint infectionD Kidney disease (post-streptococcal glomerulonephritis) -
363
A patient tells the nurse that they are taking medications prescribed by an online artificial intelligence (AI) service without seeing a doctor. What is the nurse's best response?
A This is unsafe; you need a prescription from a licensed physician after a proper evaluation الإجابة الصحيحةB Continue using the medications as directedC Reduce the dose to halfD Take the medications with food -
364
A patient asks the nurse what "over-the-counter" (OTC) medicines mean. The nurse explains that OTC drugs are:
A Non-prescription drugs that can be purchased without a doctor's order الإجابة الصحيحةB Prescription drugs requiring a physician's orderC Drugs available only in hospitalsD Experimental drugs not yet approved -
365
A nurse is screening a patient for sickle cell disease. Which test is used as a rapid screening test for the presence of hemoglobin S?
A Sickle test (sickledex or solubility test) الإجابة الصحيحةB Complete blood count onlyC Hemoglobin electrophoresis (confirmatory)D Genetic testing (DNA analysis) -
366
A woman is admitted for labor induction at 41 weeks gestation. Which medication is commonly used to induce uterine contractions?
A Oxytocin (Pitocin) infusion الإجابة الصحيحةB Prostaglandin (cervical ripening agent)C Epidural anesthesia (for pain)D Antibiotics (prophylaxis) -
367
A nurse is performing allergy skin testing. The intradermal injection should be administered at which angle to the skin?
A Parallel (5 to 15 degrees, almost flat) الإجابة الصحيحةB 90 degrees (perpendicular)C 45 degreesD 30 degrees -
368
A nurse performs Homan's sign on a patient with unilateral leg swelling. This test is used to assess for:
A Deep vein thrombosis (DVT) – though not highly sensitive/specific الإجابة الصحيحةB Bone fractureC Muscle strainD Nerve damage -
369
A patient with suspected meningitis has resistance to passive neck flexion and flexion of the hips and knees when the neck is flexed. This classic sign is known as:
A Kernig's sign الإجابة الصحيحةB Babinski sign (toe extensor response)C Chvostek's sign (facial twitching, hypocalcemia)D Trousseau's sign (carpal spasm, hypocalcemia) -
370
A school nurse screens a child for scoliosis. The nurse observes a lateral curvature of the spine. Scoliosis is defined as:
A Lateral deviation (curvature) of the spine الإجابة الصحيحةB Forward curvature (kyphosis)C Infection of the spineD Tumor of the spine -
371
A nurse is teaching a 12-year-old patient how to self-administer insulin injections. Which method is most appropriate for this age group?
A Practice on an animal model (e.g., a foam or orange model is typical) الإجابة الصحيحةB Inject immediately without practiceC Watch a video onlyD Read written instructions only -
372
A patient receives long-term mannitol therapy for increased intracranial pressure. The nurse should monitor for which adverse effect?
A Hypotension (due to osmotic diuresis and hypovolemia) الإجابة الصحيحةB HypotensionC BradycardiaD Dehydration -
373
The nurse assesses a patient with abdominal pain by pressing down on the abdomen and then quickly releasing. The patient reports increased pain upon release. This technique is called rebound tenderness and is a type of:
A Palpation (deep palpation then release) الإجابة الصحيحةB Inspection (visual examination)C Percussion (tapping)D Auscultation (listening with stethoscope) -
374
A child is scheduled for surgery for Hirschsprung disease. In the preoperative period, what is the most important nursing assessment?
A Monitor vital signs (baseline) الإجابة الصحيحةB Administer a preoperative enema (as ordered)C Maintain NPO status according to guidelinesD Give prophylactic antibiotics as ordered -
375
A patient has signed a surgical consent form. Later, the patient tells the nurse, "The surgeon didn't explain the risks of the procedure." What should the nurse do?
A Contact the surgeon immediately to discuss the patient's concern and have the surgeon re-consent الإجابة الصحيحةB Proceed with the surgery as the form is signedC Get another consent form and have the patient sign againD Cancel the surgery -
376
A patient is 4 hours post-abdominal surgery and received intraoperative long-acting analgesia. The PRN order allows pain medication every 4 hours. The patient rates pain 9/10 at 3 hours. What should the nurse do?
A Inform the physician of the uncontrolled pain and request an alternative or earlier dose الإجابة الصحيحةB Give half the prescribed doseC Ignore the patient's complaintD Wait the full 4 hours before giving medication -
377
A 25-year-old primigravida, 3 days postpartum, has breast engorgement and poor feeding technique. Her left breast is red, swollen, and tender. She is diagnosed with mastitis. Which education is most important?
A Take the full course of prescribed antibiotics and continue breastfeeding from both breasts الإجابة الصحيحةB Avoid wearing a brassiereC Stop pumping milk from the affected breastD Take antibiotics until the soreness subsides (complete the course) -
378
A nurse reviews the medication administration record for a patient. Which medication should be given first based on priority?
A Cefazolin (antibiotic) twice dailyB Paracetamol every 6 hours (for pain/fever)C Vancomycin three times daily (antibiotic) الإجابة الصحيحةD Amlodipine once daily (antihypertensive) -
379
A patient with a right leg fracture is learning to use axillary crutches. The nurse identifies that weakness in which muscle group would most impair crutch walking?
A Forearm muscles (grip and wrist extensors) الإجابة الصحيحةB Biceps muscleC Shoulder depressors and elbow extensors (triceps)D Wrist flexors -
380
A nurse is preparing to administer Rho(D) immune globulin (RhoGAM) to an Rh-negative mother who has just delivered an Rh-positive newborn. The primary purpose of this medication is to prevent:
A Maternal illnessB Neonatal hemolytic diseaseC Production of anti-D antibodies in the mother (preventing sensitization) الإجابة الصحيحةD Reoccurrence of Rh-positive baby in future pregnancies -
381
A patient receives an intramuscular injection of furosemide. The nurse should monitor for which electrolyte imbalance as a common side effect?
A Hypokalemia (potassium wasting) الإجابة الصحيحةB HyperkalemiaC HyponatremiaD Hypercalcemia -
382
A child has a gastrostomy tube that becomes accidentally dislodged. The nurse instructs the mother to take which immediate action?
A Cover the stoma site with sterile gauze and bring the child to the hospital الإجابة الصحيحةB Attempt to reinsert the tube at homeC Keep the child NPO and observe for symptomsD Wait and see if the stoma closes spontaneously -
383
A postoperative patient with sickle cell disease has developed tolerance to opioids and is reporting severe pain. Which leadership approach is most appropriate?
A Administer another dose of opioid immediately without reassessmentB Tell the patient that pain is expected after surgeryC Gather the healthcare team to develop an updated, individualized pain management plan الإجابة الصحيحةD Educate the patient on non-pharmacological pain relief methods only -
384
A patient receiving oxytocin for labor induction develops frequent, continuous uterine contractions (tachysystole). The nurse stops the oxytocin. What is the most likely consequence of this uterine hyperstimulation?
A Umbilical cord prolapseB Placental abruptionC Decreased time for exchange of oxygen and waste products in the placenta (fetal hypoxia) الإجابة الصحيحةD Increased maternal blood pressure -
385
A nurse is assessing four pregnant women for risk of complications during pregnancy and labor. Which patient is at highest risk?
A G4P3, 34 years old, nurseB G0P1 (G1P0+1), 18 years old, housewife (teen, nullipara) الإجابة الصحيحةC G2P1, 28 years old, teacherD G3P2, 30 years old, factory worker -
386
A patient's electrocardiogram shows a "sawtooth" pattern of atrial activity at a rate of 300 bpm with a ventricular rate of 150 bpm. This rhythm is most consistent with:
A Atrial fibrillation (irregularly irregular, no sawtooth)B Atrial flutter (sawtooth or F waves) الإجابة الصحيحةC Ventricular tachycardia (wide QRS)D Sinus tachycardia (normal P waves) -
387
A 15-year-old female has never had a menstrual period (primary amenorrhea). She has short stature, webbed neck, and a broad chest. Which condition should be ruled out?
A Polycystic ovary syndrome (PCOS) – often presents with oligomenorrheaB Turner syndrome (45,XO) – characteristic features الإجابة الصحيحةC Hypothyroidism (can cause delayed puberty)D Anorexia nervosa (hypothalamic amenorrhea) -
388
A nurse is preparing to administer the MMR (measles, mumps, rubella) vaccine to a 5-year-old child. The preferred route of administration is:
A Intramuscular (IM)B Subcutaneous (Subcut) الإجابة الصحيحةC IntradermalD Oral -
389
A nurse is inserting a nasogastric tube. To estimate the correct insertion length, the nurse should measure from the:
A Tip of the nose to the stomach (estimated by NEX method)B Tip of the nose to the earlobe to the xiphoid process (NEX) الإجابة الصحيحةC Mouth to the stomachD Nose to the umbilicus -
390
When administering ear drops to an adult patient, the nurse pulls the auricle:
A Downward and forward (for children under 3 years)B Upward and back (for adults and older children) الإجابة الصحيحةC Straight downD Forward only -
391
A patient is starting total parenteral nutrition (TPN). The nurse knows that TPN must be started gradually (e.g., at half rate then advanced) to prevent which complication?
A Hypoglycemia (if stopped abruptly, not started)B Hyperglycemia (due to rapid carbohydrate load) الإجابة الصحيحةC HyponatremiaD Hyperkalemia -
392
A patient on antihypertensive medication experiences orthostatic hypotension. To minimize this side effect, the nurse advises taking the medication:
A At bedtime (to reduce fall risk when supine) الإجابة الصحيحةB With mealsC In the morning on an empty stomachD As needed when symptoms occur -
393
A breastfeeding newborn develops jaundice that persists beyond the first week and peaks around 2-3 weeks of life. This is known as breastfeeding jaundice (late onset). The typical onset is:
A 1 to 2 weeksB 2 to 4 weeks (often peaks at 2-3 weeks) الإجابة الصحيحةC 4 to 6 weeksD 6 to 8 weeks -
394
A nurse is providing prenatal counseling about nutrition. Which vitamin is most critical in the first trimester to prevent neural tube defects?
A Vitamin B9 (folic acid) الإجابة الصحيحةB Vitamin CC IronD Calcium -
395
A 36-week pregnant woman reports irregular, mild contractions and a closed cervix on examination. She asks what she should do during the contractions. The nurse advises:
A Encourage regular walking (activity may help if it's false labor) الإجابة الصحيحةB Complete bed restC Frequent position changesD Deep breathing exercises -
396
A nurse is inserting a nasogastric tube for a patient before abdominal surgery. During insertion, the patient begins to cough and is unable to speak. What should the nurse do?
A Stop insertion immediately and withdraw the tube (possible tracheal placement) الإجابة الصحيحةB Continue insertion, as slight gagging is normalC Advance the tube faster to pass the tracheaD Ask the patient to swallow water -
397
A patient sustains a spinal cord injury above T6. The nurse monitors for signs of neurogenic shock. Which vital sign pattern is characteristic of neurogenic shock?
A Tachycardia and hypertensionB Bradycardia and hypotension (due to unopposed vagal tone) الإجابة الصحيحةC Normal heart rate and low blood pressureD High heart rate and normal blood pressure -
398
A patient with a strangulated inguinal hernia requires emergency surgery. The nurse explains that the goal of the surgery is to:
A Restore blood supply to the affected bowel (if viable) and repair the hernia الإجابة الصحيحةB Remove the hernia sac completelyC Strengthen the abdominal wall onlyD Reduce inflammation -
399
A patient undergoes vulvar carcinoma surgery. To promote healing and reduce edema, the nurse should position the patient:
A Recumbent (lying down, often with legs slightly abducted) الإجابة الصحيحةB Prone (lying on abdomen)C Sitting upright (Fowler's)D Side-lying -
400
In early pregnancy, human chorionic gonadotropin (hCG) is primarily secreted by which structure?
A The embryo (trophoblast cells of the developing embryo, then the placenta) الإجابة الصحيحةB The ovary (corpus luteum)C The uterus (endometrium)D The placenta (later in pregnancy) -
401
The female paraurethral glands (Skene's glands) open into the urethra and provide lubrication. Which glands in males are homologous to Skene's glands?
A Cowper's glands (bulbourethral glands) – provide pre-ejaculateB Bartholin's glands (vestibular glands, female)C Skene's glands (female paraurethral glands) الإجابة الصحيحةD Prostate gland (male) -
402
A nurse is assessing a dark-skinned patient for jaundice. The best location to detect early icterus is:
A The sclera (difficult in dark skin), better to check the hard palateB The hard palate (oral mucosa) الإجابة الصحيحةC The fingernailsD The palms of the hands -
403
A 3-day-old newborn has not passed meconium and presents with abdominal distension and vomiting. The nurse suspects Hirschsprung disease. Which test is diagnostic for Hirschsprung disease?
A Abdominal X-ray (may show obstruction but not diagnostic)B Rectal biopsy (absence of ganglion cells confirms diagnosis) الإجابة الصحيحةC Abdominal ultrasoundD CT scan -
404
A newborn with congenital diaphragmatic hernia has herniated abdominal organs into the chest. This causes mediastinal shift and compression of the heart. The cardiac complication is:
A Increased cardiac outputB Decreased cardiac output (due to decreased filling and compression) الإجابة الصحيحةC Normal cardiac functionD Irregular heartbeat -
405
A pregnant woman at 32 weeks complains of leg cramps, especially at night. The nurse suspects low calcium. During the cramp, what should the nurse instruct the woman to do?
A Extend the knee and dorsiflex the foot (stretch the calf muscle) الإجابة الصحيحةB Flex the kneeC Rotate the ankleD Elevate the leg -
406
A 56-year-old patient presents with sudden onset of left eye pain, blurred vision, and seeing halos around lights. Examination shows increased intraocular pressure and a fixed, mid-dilated pupil. The most likely diagnosis is:
A Cataract (gradual vision loss, no pain)B Acute angle-closure glaucoma الإجابة الصحيحةC Retinal detachment (flashing lights, curtain)D Conjunctivitis (redness, discharge) -
407
Hypospadias repair is usually performed before the age of 3 years to:
A Allow normal penile development and avoid psychological trauma (before body image concerns) الإجابة الصحيحةB Prevent infectionC Improve cosmetic outcome onlyD Improve fertility -
408
A patient with newly diagnosed cancer tells the nurse, "I don't believe that is my diagnosis, this is not mine." This response is characteristic of which stage of grief?
A Denial الإجابة الصحيحةB AngerC BargainingD Depression -
409
A child with Tetralogy of Fallot has clubbing of the fingers. The underlying cause of clubbing in this condition is:
A Chronic infectionB Prolonged tissue hypoxia (chronic low oxygen saturation) الإجابة الصحيحةC Nutritional deficiencyD Genetic factors -
410
A nurse is measuring the fundal height of a pregnant woman at 32 weeks. The woman becomes dizzy, lightheaded, and pale. What is the nurse's immediate action?
A Turn the woman onto her left side (relieves supine hypotension) الإجابة الصحيحةB Elevate her legsC Give her waterD Check blood pressure -
411
A patient with prolonged vomiting due to gastric sleeve surgery is at risk for metabolic alkalosis. Which arterial blood gas finding is expected?
A Decreased pH (acidosis)B Elevated oxygen levelsC Elevated bicarbonate (HCO3) due to loss of gastric acid الإجابة الصحيحةD Low oxygen saturation -
412
A child is diagnosed with measles. Which type of transmission-based precautions should be implemented?
A Contact precautionsB Droplet precautionsC Airborne precautions (N95 respirator) الإجابة الصحيحةD Standard precautions only -
413
A 4-month-old infant is due for routine immunizations. Which vaccine should be administered at this age?
A DTaP (diphtheria, tetanus, pertussis) الإجابة الصحيحةB MMR (first dose at 12-15 months)C Varicella (first dose at 12-15 months)D HPV (9-12 years) -
414
An elderly patient presents with sudden onset of slurred speech, facial droop on the right side, and weakness of the right arm. The nurse suspects:
A Myocardial infarctionB Stroke (cerebrovascular accident) الإجابة الصحيحةC Bell's palsy (peripheral facial weakness, no arm weakness)D Seizure -
415
A patient sustains a burn injury that involves the epidermis, dermis, and subcutaneous tissue. The burn appears charred and is painless due to nerve destruction. This is classified as a:
A First-degree burn (epidermis only)B Second-degree burn (epidermis and part of dermis)C Third-degree burn (full thickness, into subcutaneous tissue) الإجابة الصحيحةD Fourth-degree burn (involving muscle/bone) -
416
A strict vegetarian (vegan) who consumes no animal products is at risk for deficiency of which vitamin?
A Vitamin A (found in plants as beta-carotene, can convert)B Vitamin B12 (only found in animal products, fortified foods) الإجابة الصحيحةC Vitamin C (abundant in plants)D Vitamin D (sunlight, fortified foods) -
417
A patient with burns involving the face, chest, and extremities is brought to the emergency department. What is the priority nursing concern?
A Pain managementB Airway management (risk of inhalation injury, edema) الإجابة الصحيحةC Fluid resuscitation (Parkland formula)D Wound care -
418
The myometrium is the middle layer of the uterine wall. Its primary function is to:
A Produce hormones (estrogen, progesterone)B Contract during labor and menstruation (uterine contractions) الإجابة الصحيحةC Provide site for egg implantation (endometrium)D Shed during menstruation (endometrium) -
419
A patient has received repeated intramuscular injections in the same deltoid site over several months. The nurse notes a hard, fibrotic area at the injection site. This complication is called:
A Deep vein thrombosisB Muscle fibrosis (due to repeated trauma) الإجابة الصحيحةC Tissue necrosisD Hematoma -
420
An elderly woman reports urinary incontinence and a feeling of pelvic pressure. The nurse recommends exercises to strengthen the pelvic floor muscles. These exercises are known as:
A Surgery (last resort)B Kegel exercises الإجابة الصحيحةC Medications (anticholinergics)D Bed rest -
421
A working mother wants to continue breastfeeding but cannot be with her infant during the day. Which feeding plan is most appropriate?
A Cow's milk only (not recommended for infants under 1 year)B Formula with multivitamins (exclusive formula)C Combined breast and formula feeding (partial breastfeeding with expressed milk or formula when away) الإجابة الصحيحةD Water with supplements (inadequate) -
422
A patient who underwent a total thyroidectomy develops tetany (muscle cramps, tingling). The nurse suspects which electrolyte imbalance?
A Hypokalemia (low potassium)B Hypocalcemia (low calcium, due to accidental parathyroid removal) الإجابة الصحيحةC Hyponatremia (low sodium)D Hyperkalemia (high potassium) -
423
A patient receives a Mantoux tuberculin skin test. The induration measured at 72 hours is 6.5 mm. In a person with no known risk factors, this result is considered:
A Latent (would need 10mm or more)B Suspected (equivocal, borderline) الإجابة الصحيحةC Active (no, active requires clinical symptoms and culture)D Normal (negative) -
424
A breastfeeding woman develops mastitis. The most common causative organism is:
A Streptococcus pyogenesB Staphylococcus aureus (including MRSA) الإجابة الصحيحةC Escherichia coliD Pseudomonas aeruginosa -
425
A patient has a bleeding wound. The immediate first aid measure to control bleeding is:
A Apply direct pressure with a sterile gauze الإجابة الصحيحةB Apply heatC Elevate the limb onlyD Apply ice -
426
A nurse is teaching a patient about adequate hydration. Which urine color indicates good hydration?
A Dark yellow (concentrated)B Light yellow (pale straw) الإجابة الصحيحةC Clear (may be overhydration)D Amber (dehydrated) -
427
A patient with a chronic cough and fever has a positive Mantoux test. Which test is most accurate for confirming active pulmonary tuberculosis?
A Chest X-ray (shows abnormalities but not specific)B Tuberculin skin test (screening only)C Sputum culture for acid-fast bacilli (definitive) الإجابة الصحيحةD Blood test (IGRA, but not confirmatory for active disease) -
428
A patient is diagnosed with COVID-19. According to current infection control guidelines (based on droplet and contact), which type of precautions should the nurse implement?
A Contact precautions onlyB Droplet precautions (plus contact) الإجابة الصحيحةC Airborne precautions (N95) for aerosol-generating proceduresD Standard precautions only -
429
The BCG (Bacillus Calmette-Guérin) vaccine is given to prevent which disease?
A Measles (MMR)B Tuberculosis (especially severe forms in children) الإجابة الصحيحةC Diphtheria, pertussis, tetanus (DPT)D Hepatitis B -
430
Parents of a hospitalized child want to take the child home early against medical advice. Which form must they sign before discharge?
A Informed consent (for treatment)B Discharge Against Medical Advice (AMA) form الإجابة الصحيحةC Medical waiver (general)D Hospital release form (standard) -
431
A child presents to the clinic with multiple bruises in various stages of healing, and the explanation given by the caregiver does not match the injuries. What is the nurse's immediate action?
A Document the findings in the child's chartB Report the suspected abuse to child protective services (mandated reporting) الإجابة الصحيحةC Call the parents for an explanationD Order X-rays for all bruises -
432
A nurse suspects child abuse based on physical findings. The primary reason for mandatory reporting is:
A For legal documentationB To protect the child from further harm (suspected abuse) الإجابة الصحيحةC Hospital policy onlyD Insurance requirements -
433
A nurse provides discharge teaching to a new mother about umbilical cord care. Which instruction is correct?
A Cover the cord with the diaperB Keep the diaper folded below the cord and clean the base with alcohol (or keep dry) الإجابة الصحيحةC Apply antibiotic ointment dailyD Wrap the cord tightly with gauze -
434
A patient requires high-concentration oxygen. Which device delivers the highest FiO2 (up to 90-95%)?
A Nasal cannula (24-44%)B Simple mask (40-60%)C Non-rebreather mask (85-95% with good seal) الإجابة الصحيحةD Venturi mask (24-50%, precise FiO2) -
435
A woman is planning to become pregnant. The nurse advises taking folic acid supplements to prevent which type of birth defect?
A Anemia (iron deficiency)B Neural tube defects (spina bifida, anencephaly) الإجابة الصحيحةC Congenital heart defectsD Cleft lip and palate -
436
An Rh-negative woman delivers an Rh-positive infant. To prevent Rh sensitization, Rho(D) immune globulin (RhoGAM) should be administered within:
A 24 hours (ideally within 72 hours)B 48 hoursC 72 hours (recommended) الإجابة الصحيحةD 1 week -
437
The Malnutrition Universal Screening Tool (MUST) is a five-step screening tool to identify adults at risk of malnutrition. Which parameter does MUST primarily use?
A Body Mass Index (BMI) and unintentional weight loss الإجابة الصحيحةB Blood pressureC Heart rateD Temperature -
438
A full-term fetus is in frank breech presentation at 37 weeks. The physician may attempt which procedure to turn the fetus to cephalic presentation?
A External cephalic version (ECV) الإجابة الصحيحةB Immediate cesarean sectionC Vaginal delivery without interventionD Wait and observe for spontaneous version -
439
A patient with traumatic brain injury develops cerebral edema. Which medication is most effective for reducing intracranial pressure?
A Corticosteroids (not recommended for TBI)B Osmotic diuretic (mannitol) or hypertonic saline الإجابة الصحيحةC Antiepileptic drugs (phenytoin)D Antibiotics (for infection) -
440
A patient with a confirmed peptic ulcer complains of epigastric pain. Which analgesic is safest for pain management in this patient?
A Ibuprofen (NSAID, worsens ulcer)B Diclofenac (NSAID)C Aspirin (NSAID, contraindicated)D Paracetamol (acetaminophen, does not affect gastric mucosa) الإجابة الصحيحة -
441
A patient comes to the emergency department with a panic attack triggered by being on a tall building. The nurse documents the diagnosis as acrophobia. What does acrophobia mean?
A Fear of heights الإجابة الصحيحةB Fear of flying (aviophobia)C Fear of water (hydrophobia)D Fear of closed spaces (claustrophobia) -
442
A 40-year-old man is brought to the emergency department after a motor vehicle accident. His Glasgow Coma Scale (GCS) is: Eye opening = 4 (spontaneous), Verbal response = 4 (confused), Motor response = 5 (localizes to pain). What is his total GCS score?
A 11B 12C 13 (4+4+5=13) الإجابة الصحيحةD 14 -
443
In a school of 1000 students, 150 students are diagnosed with measles during an outbreak. What is the percentage of affected students?
A 10%B 15% (150/1000 = 0.15) الإجابة الصحيحةC 20%D 25% -
444
A breastfed newborn develops jaundice at day 9 of life that is not associated with hemolysis or other pathology. This is known as breastfeeding jaundice (late onset). The typical timing of onset is:
A 5 to 7 daysB 9 days (can start around day 4-7 and persist; often peaks at 7-10 days) الإجابة الصحيحةC 2 weeksD 3 weeks -
445
A nurse administers a medication and then realizes that a serious error almost occurred but was caught before reaching the patient. This event should be documented as a:
A Incident report (actual adverse event)B Near miss report (error that did not reach the patient) الإجابة الصحيحةC Adverse event report (patient harm)D Sentinel event report (death or serious harm) -
446
To reduce the risk of sudden infant death syndrome (SIDS), the American Academy of Pediatrics recommends that healthy infants be placed to sleep in which position?
A Prone (on stomach)B Side-lying (not recommended due to risk of rolling to prone)C Supine (on back) on a firm mattress الإجابة الصحيحةD Any comfortable position -
447
A nurse is conducting a literature review to answer a clinical question. Which type of study provides the strongest level of evidence according to the evidence-based practice hierarchy?
A Case-control studyB Cohort studyC Randomized controlled trial (RCT)D Systematic review and meta-analysis of RCTs الإجابة الصحيحة -
448
A newborn with respiratory distress is suspected of having a congenital diaphragmatic hernia. Which imaging study is most useful for initial diagnosis?
A CT scanB Chest X-ray (shows abdominal contents in chest) الإجابة الصحيحةC Ultrasound (prenatal), but after birth, X-ray is firstD MRI -
449
A nurse is providing teaching to a woman with recurrent urinary tract infections. Which beverage may help prevent UTIs?
A Cranberry juice (may reduce bacterial adherence) الإجابة الصحيحةB Orange juiceC Apple juiceD Grape juice -
450
A pregnant woman at 34 weeks has a breech presentation. The fetus is otherwise healthy, and there are no contraindications. What is the appropriate management?
A Immediate cesarean section (usually done at term if breech persists)B Continue monitoring and consider external cephalic version at 37 weeks الإجابة الصحيحةC Tell her she cannot deliver vaginally (vaginal breech delivery is possible but with risks)D Emergency delivery -
451
A nurse is teaching a pregnant woman about safety during pregnancy. Which statement by the patient indicates an incorrect understanding?
A Over-the-counter medications can be unsafe during pregnancyB I can take any herbal remedies, as they are natural (incorrect, many are unsafe) الإجابة الصحيحةC I should avoid alcohol completelyD I need folic acid supplementation -
452
A patient is prescribed tetracycline for acne. The nurse instructs the patient to avoid taking tetracycline with which substance because it decreases absorption?
A WaterB Food (but especially dairy products)C Milk (calcium binds tetracycline) الإجابة الصحيحةD Juice -
453
A breastfeeding mother develops breast engorgement and mastitis in the left breast. Which advice is most important?
A Do not wear a bra (may help but not most important)B Continue breastfeeding from both breasts (including the affected side) to empty the breast الإجابة الصحيحةC Stop breastfeedingD Use an antipyretic (manages fever but does not treat infection) -
454
A nurse is performing an abdominal assessment. The correct sequence of techniques is:
A Inspection, auscultation, percussion, palpation (auscultate before palpation to avoid altering bowel sounds) الإجابة الصحيحةB Palpation, percussion, auscultation, inspectionC Auscultation, inspection, palpation, percussionD Percussion, palpation, inspection, auscultation -
455
A patient with beta-thalassemia major requires regular blood transfusions. To manage iron overload from transfusions, which chelation therapy is commonly used?
A Deferasirox (oral chelator) الإجابة الصحيحةB Deferoxamine (subcutaneous or IV)C Iron supplements (contraindicated)D Blood transfusion (primary treatment, but not for iron overload) -
456
A patient opens eyes spontaneously, is oriented to time, place, and person, and obeys commands. What is the Glasgow Coma Scale score?
A 12B 13C 14D 15 (E4 V5 M6) الإجابة الصحيحة -
457
A patient on warfarin has an INR of 6.5 and is bleeding from a minor cut. Which medication should be given as the antidote?
A Vitamin K (phytonadione) الإجابة الصحيحةB Protamine sulfate (for heparin)C Naloxone (for opioids)D Flumazenil (for benzodiazepines) -
458
An infant presents with projectile vomiting after feedings, visible peristalsis, and a palpable olive-shaped mass. The nurse suspects pyloric stenosis. The main symptom is:
A DiarrheaB Non-bilious projectile vomiting الإجابة الصحيحةC ConstipationD Abdominal pain -
459
A nurse notes that a patient's fingernails are spoon-shaped (koilonychia). This finding is most commonly associated with:
A Iron deficiency anemia الإجابة الصحيحةB General malnutritionC Calcium deficiencyD Vitamin D deficiency -
460
A patient is diagnosed with bacterial meningitis. Which type of transmission-based precautions should be initiated?
A Contact precautionsB Airborne precautions (for Neisseria meningitidis, droplet is sufficient unless performing aerosol-generating procedures)C Droplet precautions (for at least 24 hours after starting antibiotics) الإجابة الصحيحةD Standard precautions only -
461
A nurse is reviewing recommended vaccines for elderly patients. Which two vaccines are routinely recommended for adults aged 65 years and older?
A Influenza (flu) vaccine and pneumococcal vaccine (PCV13/PPSV23) الإجابة الصحيحةB MMR and varicella (not routinely for elderly)C Hepatitis A and B (if at risk)D Tetanus and diphtheria (Td/Tdap every 10 years) -
462
A child is diagnosed with rotavirus gastroenteritis. Which type of isolation precautions should the nurse implement?
A Droplet precautionsB Airborne precautionsC Contact precautions (contact with feces, contaminated surfaces) الإجابة الصحيحةD Standard precautions only -
463
A patient presents with a chronic cough, night sweats, weight loss, and hemoptysis. The most likely diagnosis is:
A Pneumonia (acute, fever, productive cough)B Bronchitis (acute cough, no systemic symptoms)C Tuberculosis (TB) الإجابة الصحيحةD Asthma (wheezing, reversible) -
464
A patient with a urinary tract infection is advised to increase fluid intake. The recommended daily water intake to help flush bacteria is:
A 1 to 2 litersB 2 to 3 liters (approximately 8-12 cups) الإجابة الصحيحةC 3 to 4 litersD 4 to 5 liters -
465
A woman in the first stage of labor is fully dilated and has the urge to push. What should the nurse instruct the patient to do?
A Push with contractions (bearing down) الإجابة الصحيحةB Reassess the patient for cervical dilation (should be 10 cm)C Prepare for cesarean sectionD Increase oxytocin dose -
466
A patient with acute appendicitis is being assessed. Which physical examination finding is most characteristic of appendicitis?
A Fever (common but not specific)B Rebound tenderness (Blumberg sign) in the right lower quadrant الإجابة الصحيحةC Nausea (nonspecific)D Loss of appetite (common but not specific) -
467
A breastfeeding mother has mastitis in her left breast. To promote resolution, the nurse advises the mother to continue breastfeeding from:
A The affected breast onlyB The unaffected breast onlyC Both breasts (including the affected side, as emptying is key) الإجابة الصحيحةD Stop breastfeeding -
468
Hydrocephalus is a condition characterized by:
A Enlargement of the head (due to increased CSF volume)B Increased head circumference (macrocephaly)C Accumulation of cerebrospinal fluid in the ventricles ("water on the brain") الإجابة الصحيحةD Brain swelling (cerebral edema) -
469
A newborn is diagnosed with spina bifida occulta. Which external finding is characteristic of this condition?
A Paralysis (not present in occulta)B A tuft of hair, dimple, or skin discoloration over the lower spine الإجابة الصحيحةC Muscle weaknessD Sensory loss -
470
A nurse is caring for a newborn after circumcision. The most serious complication to monitor for in the immediate postoperative period is:
A Urinary retention (temporary, not life-threatening)B Infection (late complication)C Hemorrhage (bleeding) – can be significant الإجابة الصحيحةD Hematuria (blood in urine, common after procedure) -
471
A patient develops a skin rash, itching, and dyspnea after starting an intravenous antibiotic. What is the nurse's priority action?
A Continue the medication and monitor vital signsB Stop the IV infusion immediately and notify the physician (possible anaphylaxis) الإجابة الصحيحةC Reduce the medication doseD Administer an antihistamine as ordered -
472
A nurse is explaining vital signs to a student. Pulse pressure is defined as:
A Heart rate variabilityB The difference between systolic and diastolic blood pressure (SBP – DBP) الإجابة الصحيحةC Mean arterial pressureD Arterial pressure wave amplitude -
473
A postpartum woman has risk factors for deep vein thrombosis. Which medication is commonly used for prophylaxis?
A Heparin (unfractionated)B Warfarin (not immediate, requires monitoring)C Enoxaparin (low-molecular-weight heparin, often used postpartum) الإجابة الصحيحةD Aspirin (less effective for DVT prophylaxis) -
474
A patient taking lithium for bipolar disorder should have which electrolyte monitored regularly to prevent toxicity?
A Potassium (lithium can cause nephrogenic diabetes insipidus, but sodium is more critical)B Sodium (low sodium increases lithium reabsorption and toxicity) الإجابة الصحيحةC Calcium (lithium may affect parathyroid)D Magnesium -
475
A patient with schizophrenia says, "Shop, hop, bop, top." This speech pattern is an example of:
A Flight of ideas (rapid shifts between topics with loose associations)B Clang association (rhyming or punning association) الإجابة الصحيحةC Word salad (incoherent mixture of words)D Neologism (made-up words) -
476
In the PICO framework for evidence-based practice, the letter "P" stands for:
A ProblemB Population (patient or problem) الإجابة الصحيحةC PracticeD Procedure -
477
To prevent otitis media in infants, which feeding practice is recommended?
A Keep the baby supine during feeding (bottle propping increases risk)B Feed the baby in an upright position and burp after bottle feeding الإجابة الصحيحةC Clean the ears regularlyD Use ear drops prophylactically -
478
A nurse is 5 months pregnant. Which patient assignment would be safest to avoid exposure to infectious diseases?
A Patient with measles (airborne, high risk for pregnant nurse)B Patient with pneumonia (depends on cause)C Patient with shingles (varicella-zoster, risk if not immune)D Patient with C. difficile (contact precautions, low risk to pregnant nurse with hand hygiene) الإجابة الصحيحة -
479
A 9-year-old child has a femur fracture. Approximately how long does it take for a femoral shaft fracture to heal in a child this age?
A 1 to 2 weeksB 3 to 4 weeks (children heal faster than adults; typically 4-6 weeks) الإجابة الصحيحةC 5 to 6 weeksD 8 to 10 weeks (adult healing time) -
480
A nasogastric tube (NGT) is inserted for a patient with a bowel obstruction. The primary purpose of the NGT in this situation is:
A Gavage (feeding) – not with obstructionB Decompression (removing gastric contents to relieve pressure) الإجابة الصحيحةC Medication administrationD Drainage of bile -
481
A nurse is teaching a patient with recurrent urinary tract infections about preventive measures. Which beverage has been shown to reduce UTI risk?
A Coffee (diuretic, no evidence)B Cranberry juice (may prevent bacterial adherence) الإجابة الصحيحةC Grape juice (no evidence)D Orange juice (acidic, but not proven) -
482
A woman with a normal pre-pregnancy BMI asks the nurse how much weight she should gain during pregnancy. The recommended total weight gain range is:
A 5 to 10 kg (11-22 lbs) – too lowB 11 to 16 kg (25-35 lbs) for normal BMI الإجابة الصحيحةC 17 to 20 kg (37-44 lbs) – for underweightD 21 to 25 kg (46-55 lbs) – excessive -
483
A pregnant woman at 40 weeks asks how many weeks are in each trimester. The nurse explains that each trimester is approximately:
A 12 weeksB 13 weeks (total 39 weeks; term is 40 weeks, so trimesters are about 13-14 weeks) الإجابة الصحيحةC 13.5 weeksD 14 weeks -
484
A patient presents with severe respiratory distress, absent breath sounds on one side, and a deviated trachea away from the affected side. The most likely diagnosis is:
A Tension pneumothorax الإجابة الصحيحةB Simple pneumothoraxC Pleural effusionD Hemothorax -
485
A nurse administers eye drops. The drops are placed into the conjunctival sac rather than directly onto the cornea to:
A Prevent corneal injury (avoid direct contact with sensitive cornea) الإجابة الصحيحةB Increase systemic absorptionC Reduce side effectsD Improve patient comfort -
486
A patient develops hives, itching, and difficulty breathing during a blood transfusion. What is the immediate action?
A Stop the transfusion (allergic reaction, possible anaphylaxis) الإجابة الصحيحةB Slow the infusion rateC Give an antihistamineD Monitor vital signs -
487
A patient with chronic obstructive pulmonary disease (COPD) has a barrel-shaped chest. This finding is classically associated with:
A Emphysema (hyperinflation, loss of elastic recoil) الإجابة الصحيحةB Pneumonia (consolidation)C Asthma (reversible obstruction, not typically barrel chest)D Chronic bronchitis (blue bloater, but barrel chest can occur in both) -
488
A community health nurse wants to change negative perceptions about mental health patients. Which approach is most effective?
A Provide evidence-based information and education about mental illness الإجابة الصحيحةB Share positive personal experiencesC Organize awareness campaignsD Involve healthcare professionals in destigmatization -
489
A patient undergoing a cesarean section wishes to remain awake during the procedure. Which type of anesthesia is most appropriate?
A Spinal anesthesia (neuraxial block, awake and pain-free) الإجابة الصحيحةB General anesthesia (unconscious)C Local anesthesia (only for superficial procedures)D IV sedation (may cause drowsiness, not adequate for surgery) -
490
A postpartum mother has a boggy uterus and heavy bleeding. The nurse performs fundal massage and ensures the bladder is empty. The uterus remains soft. What should the nurse do next?
A Notify the physician immediately (need for uterotonics like oxytocin, misoprostol) الإجابة الصحيحةB Continue massage for another 10 minutesC Administer oxytocin as orderedD Check vital signs -
491
A 65-year-old patient with a history of hypertension presents with palpitations. The ECG shows a regular rhythm with a sawtooth baseline at a rate of 300 bpm and a ventricular rate of 150 bpm. The nurse identifies this rhythm as:
A Atrial fibrillationB Atrial flutter الإجابة الصحيحةC Ventricular tachycardiaD Supraventricular tachycardia -
492
A 15-year-old female has never menstruated (primary amenorrhea). She is short in stature, has a webbed neck, and a broad chest. Which condition should the nurse suspect and rule out first?
A Polycystic ovary syndromeB Turner syndrome الإجابة الصحيحةC Thyroid dysfunctionD Pregnancy -
493
A nurse is preparing to administer the MMR vaccine to a 5-year-old child. Which route and site are appropriate for this vaccine?
A Intramuscular, deltoidB Subcutaneous, outer upper arm الإجابة الصحيحةC Intradermal, forearmD Oral, by mouth -
494
A nurse is inserting a nasogastric tube for a patient with a bowel obstruction. To estimate the correct insertion length, the nurse should measure from the:
A Tip of the nose to the sternumB Tip of the nose to the earlobe, then down to the xiphoid process الإجابة الصحيحةC Mouth to the sternumD Earlobe to the umbilicus -
495
A nurse is administering ear drops to an adult patient. To straighten the ear canal, the nurse should pull the auricle:
A Downward and forwardB Upward and back الإجابة الصحيحةC Straight into the ear canalD Downward and back -
496
A patient is started on total parenteral nutrition (TPN). The nurse knows that the infusion rate must be increased gradually over several days to prevent which complication?
A HypoglycemiaB Hyperglycemia الإجابة الصحيحةC Electrolyte imbalanceD Fluid overload -
497
A patient on an antihypertensive medication complains of dizziness when standing up. The nurse advises the patient to take the medication at which time to minimize orthostatic hypotension?
A Stop the medicationB Take the medication at mealtimeC Take the medication before bedtime الإجابة الصحيحةD Switch to another medication -
498
A nurse is teaching a pregnant woman about the trimesters of pregnancy. The mother correctly identifies the antepartum period as:
A The first three months of pregnancyB The second three months of pregnancyC The last three months of pregnancy الإجابة الصحيحةD The entire pregnancy period -
499
A physician orders 600 mL of intravenous fluid to be infused over 5 hours. The drop factor is 15 gtts/mL. The nurse calculates the infusion rate as:
A 20 gtts/minB 25 gtts/minC 30 gtts/min الإجابة الصحيحةD 35 gtts/min -
500
A child is hospitalized with persistent vomiting from viral gastroenteritis. The nurse should monitor the child closely for which acid-base imbalance?
A Metabolic acidosisB Metabolic alkalosis الإجابة الصحيحةC Respiratory acidosisD Respiratory alkalosis -
501
An infant with suspected hypertrophic pyloric stenosis has been vomiting after feeds. The nurse expects which acid-base disorder on laboratory results?
A Metabolic acidosisB Metabolic alkalosis الإجابة الصحيحةC Respiratory acidosisD Respiratory alkalosis -
502
A patient is receiving total parenteral nutrition (TPN). While waiting for the next TPN bag from the pharmacy, the nurse should prepare which equipment to ensure safe administration?
A Prepare the IV setB Bring an IV pump with a macro drip chamberC Prepare an infusion pump الإجابة الصحيحةD Check patient identification -
503
Before administering any medication, the nurse uses a bar code scanning system. What is the primary purpose of this action?
A To confirm the patient's name onlyB To scan the bar code on the patient's wristband and medication (five rights verification) الإجابة الصحيحةC To verify the room numberD To check the time of administration -
504
A newborn is admitted to the emergency department with diarrhea and vomiting. Serum sodium is 140 mEq/L. Which type of intravenous fluid should the nurse anticipate administering?
A Hypotonic solutionB Isotonic solution الإجابة الصحيحةC Hypertonic solutionD Colloid solution -
505
A nurse is explaining implantation to a student. Which hormones are primarily responsible for preparing the endometrium for implantation of the ovum?
A FSH and LHB Progesterone and estrogen الإجابة الصحيحةC Testosterone and cortisolD Insulin and glucagon -
506
A nurse is preparing to administer methergine (methylergonovine) for postpartum hemorrhage. Which assessment is the priority before giving this medication?
A Blood pressure (contraindicated in hypertension) الإجابة الصحيحةB Heart rateC TemperatureD Respiratory rate -
507
A child with Tetralogy of Fallot suddenly becomes cyanotic and short of breath during a crying spell. The nurse should place the child in which position to relieve the hypercyanotic episode?
A Supine positionB Trendelenburg positionC Knee-chest position الإجابة الصحيحةD Side-lying position -
508
A nurse measures a patient's blood pressure using a cuff that is too small for the patient's arm circumference. How will this affect the reading?
A Falsely low blood pressure readingB Falsely high blood pressure reading الإجابة الصحيحةC Accurate readingD No effect on reading -
509
A newborn is being screened for developmental dysplasia of the hip (DDH). Which physical examination finding indicates a positive test for DDH?
A Negative Ortolani test (no click)B Positive Ortolani test (audible click with abduction) الإجابة الصحيحةC Barlow test onlyD X-ray only -
510
A breastfed newborn develops jaundice that persists beyond the first week and peaks around 2-3 weeks of life. This is known as breastfeeding jaundice (late onset). The typical onset is:
A 1 to 2 weeksB 2 to 4 weeks الإجابة الصحيحةC 4 to 6 weeksD 6 to 8 weeks -
511
A patient with a spinal cord injury above T6 presents with bradycardia and hypotension. The nurse recognizes these as signs of:
A Bradycardia and hypotension الإجابة الصحيحةB Tachycardia and hypertensionC Bradycardia and hypertensionD Tachycardia and hypotension -
512
A patient undergoes surgery for vulvar carcinoma. To promote healing and reduce edema, the nurse should position the patient in which position?
A Recumbent (lying down) الإجابة الصحيحةB Semi-Fowler'sC ProneD Trendelenburg -
513
Which male glands are functionally similar to the female paraurethral (Skene's) glands because they secrete lubricating mucus into the urethra?
A Cowper's glands الإجابة الصحيحةB Bartholin's glandsC Skene's glandsD Prostate glands -
514
A nurse is preparing to administer a nasogastric tube feeding. Which intervention should be performed before each feeding to verify tube placement?
A Aspirate gastric contents and check pH الإجابة الصحيحةB Check the temperature of the formulaC Measure the previous outputD Position the patient in supine -
515
A charge nurse overhears a staff nurse speaking disrespectfully to a patient. What is the best initial action for the charge nurse?
A Apologize to the patient on behalf of the staffB Tell the nurse to be kind in front of the patientC Inform the head nurse and file a reportD Speak privately with the nurse about professional behavior الإجابة الصحيحة -
516
Arterial blood gas results: pH 7.28, HCO3 18 mEq/L, PCO2 51 mmHg. The nurse interprets this as:
A Respiratory acidosis with partial compensationB Metabolic acidosis with partial compensation الإجابة الصحيحةC Respiratory alkalosisD Normal ABG values -
517
According to WHO recommendations, a low-risk pregnant woman should have how many antenatal visits during her pregnancy?
A 6 to 8 visitsB 8 to 10 visits الإجابة الصحيحةC 10 to 12 visitsD 12 to 15 visits -
518
A patient with high cholesterol asks the nurse about dietary changes. Which diet is most appropriate?
A High protein, low carbohydrate dietB Low saturated fat, high fiber diet الإجابة الصحيحةC High fat, low sodium dietD Low protein, high sugar diet -
519
A nurse is teaching a patient with hyperlipidemia. Which lifestyle modification is most important?
A Increase smoking and alcohol consumptionB Dietary modification and regular exercise الإجابة الصحيحةC Avoid all physical activitiesD Eat more fried foods -
520
A patient on mechanical ventilation should be placed in which position to reduce the risk of ventilator-associated pneumonia?
A Trendelenburg positionB Semi-Fowler's position (30-45 degrees) الإجابة الصحيحةC Prone positionD Supine position -
521
A child at 18 months of age is due for routine immunizations. Which vaccines are typically given at this visit?
A MMR boosterB Hepatitis AC VaricellaD All of the above (MMR, varicella, and hepatitis A depending on schedule) الإجابة الصحيحة -
522
A nurse is administering the hepatitis B vaccine to a newborn. What is the recommended vaccination schedule?
A At birth, 1-2 months, 6-18 months الإجابة الصحيحةB At 2, 4, 6 monthsC At 12, 15, 18 monthsD At birth only -
523
The Saudi Ministry of Health requires Hajj pilgrims to receive which vaccine as a primary prevention measure?
A Meningococcal vaccination الإجابة الصحيحةB Hepatitis B vaccinationC Influenza vaccinationD Tetanus vaccination -
524
A nurse is implementing tuberculosis control measures in a community. Which intervention is most effective in preventing spread?
A Isolation of infectious patients and proper ventilation الإجابة الصحيحةB Hand hygiene onlyC Antibiotics for all contactsD Vaccination only -
525
A patient on heparin infusion develops bleeding. The nurse should prepare which antidote?
A Vitamin KB Protamine sulfate الإجابة الصحيحةC Fresh frozen plasmaD Naloxone -
526
A patient is one day post-thyroidectomy. The nurse should monitor for which potential complications?
A Blood glucose levelsB Calcium levels (hypocalcemia) and airway patency الإجابة الصحيحةC Liver function testsD Kidney function tests -
527
A nurse assesses a pressure ulcer that presents as a fluid-filled blister. This ulcer is classified as stage:
A Stage 1 (non-blanchable erythema)B Stage 2 (partial thickness, blister or shallow ulcer) الإجابة الصحيحةC Stage 3 (full thickness, subcutaneous fat visible)D Stage 4 (exposed bone, muscle, or tendon) -
528
A physician orders paracetamol 1 gram QID for a patient. The pharmacy supplies 250 mg tablets. What is the appropriate nursing action?
A Ask the pharmacy to provide 1 g tabletsB Call the doctor to recheck the dosageC Give the patient four 250 mg tablets الإجابة الصحيحةD Hold the medication and document in nursing notes -
529
A nurse manager floats a nurse from the medical ward to the cardiac care unit (CCU). Which patient assignment is most appropriate for this nurse?
A Patient just transferred from coronary artery surgeryB Patient with unstable angina on heparin infusionC Patient needing discharge education about coronary stenting الإجابة الصحيحةD Patient on admission needing assessment -
530
An 11-year-old child is diagnosed with diabetes insipidus. The nurse understands that which gland is primarily affected?
A Posterior pituitary (ADH deficiency) الإجابة الصحيحةB Adrenal medullaC Anterior pituitaryD Adrenal cortex -
531
A doctor orders ofloxacin otic. The nurse knows that this medication is given by which route?
A NasalB EyeC Ear الإجابة الصحيحةD Sublingual -
532
A nurse asks a patient, "Are you having pain right now?" This type of question that can be answered with "yes" or "no" is called:
A Direct questionB Indirect questionC Open-ended questionD Closed-ended question الإجابة الصحيحة -
533
A newborn is suspected of having esophageal atresia with tracheoesophageal fistula. Which early signs should the nurse expect?
A Coughing, choking, and cyanosis during first feeding الإجابة الصحيحةB Excessive crying and irritabilityC Poor weight gain over weeksD Frequent vomiting without respiratory symptoms -
534
When feeding an infant with esophageal atresia, what symptoms typically occur?
A Coughing and choking with feeding الإجابة الصحيحةB Excessive salivation onlyC Normal feeding toleranceD Rapid weight gain -
535
A nurse is planning care for a newborn with esophageal atresia. Which nursing diagnosis is the priority?
A Ineffective airway clearance الإجابة الصحيحةB Altered nutrition: less than body requirementsC Risk for infectionD Impaired skin integrity -
536
A 6-month-old infant is due for routine immunizations. Which vaccine should be administered at this age?
A MMRB Hepatitis BC DTaP الإجابة الصحيحةD BCG -
537
A patient with preeclampsia is receiving magnesium sulfate. Her serum magnesium level is 2 mEq/L. The nurse should assess which clinical parameter to monitor for magnesium toxicity?
A Deep tendon reflexes (patellar reflex) الإجابة الصحيحةB Blood pressureC Urine outputD Heart rate -
538
A patient is one day post-appendectomy. Which position should the nurse encourage to promote comfort and reduce tension on the incision?
A Fowler's positionB Semi-Fowler's position الإجابة الصحيحةC Supine positionD Prone position -
539
A pregnant woman has a family history of sickle cell anemia. The nurse expects which test to be performed on the newborn to diagnose sickle cell disease?
A Complete blood count (CBC)B Hemoglobin electrophoresis الإجابة الصحيحةC Blood glucoseD Bilirubin level -
540
A nurse counsels a pregnant woman about folic acid supplementation. The primary benefit is to:
A Prevent neural tube defects in the fetus الإجابة الصحيحةB Prevent maternal anemia onlyC Improve bone densityD Reduce morning sickness -
541
A patient produces 300 mL of urine in 24 hours. This is classified as:
A Oliguria (less than 400 mL/day) الإجابة الصحيحةB Anuria (less than 50-100 mL/day)C Polyuria (greater than 2500 mL/day)D Normal output (800-2000 mL/day) -
542
A patient refuses to ambulate after hip replacement surgery due to pain. What should the nurse do first?
A Document the patient's refusalB Notify the physicianC Explain the importance of ambulation and offer pain medication الإجابة الصحيحةD Force the patient to ambulate -
543
A nurse instructs a mother to keep bath water temperature between 38-40°C. This represents heat transfer by:
A Radiation (heat from body to cooler environment)B Convection (heat transfer through air or fluid movement)C Evaporation (heat loss through vaporization)D Conduction (direct contact with water) الإجابة الصحيحة -
544
Immediately after delivery of a newborn, what is the priority nursing action?
A Cover the baby with a warm blanket and place on the mother's chest الإجابة الصحيحةB Administer vitamin K intramuscularlyC Perform a heel stick for glucoseD Apply eye ointment -
545
The nurse places a newborn on the mother's chest immediately after birth. What is the primary benefit of this action?
A Promotes mother-infant bonding and early breastfeeding الإجابة الصحيحةB Prevents hypothermia onlyC Improves breathingD Facilitates cord clamping -
546
A nurse is caring for a patient with active pulmonary tuberculosis. Which personal protective equipment is required?
A N95 respirator الإجابة الصحيحةB Surgical maskC Face shield onlyD Gloves only -
547
A patient with suspected tuberculosis is admitted. What is the first action the nurse should take?
A Place the patient in a negative pressure (airborne infection isolation) room الإجابة الصحيحةB Start empiric antibioticsC Obtain a sputum cultureD Perform a chest X-ray -
548
A patient is being discharged after an appendectomy. Before discharge, the nurse should monitor for which complication?
A Signs of bleeding (hemorrhage) الإجابة الصحيحةB Vital signs onlyC Pain levelD Bowel sounds -
549
A patient experiencing a panic attack is hyperventilating and trembling. What is the most appropriate response by the nurse?
A Ask, "What is happening to you right now?" in a calm voice الإجابة الصحيحةB Tell them to calm downC Leave them alone to de-escalateD Restrain the patient -
550
A patient with schizophrenia is started on an antipsychotic medication. The primary therapeutic benefit of this class of drugs is:
A Reduces psychotic symptoms (hallucinations, delusions) الإجابة الصحيحةB Improves mood onlyC Prevents seizuresD Reduces anxiety only -
551
In a triage situation with multiple patients, which patient should the physician see first?
A Patient with a minor lacerationB Patient with shortness of breath and oxygen saturation 85% الإجابة الصحيحةC Patient with a headache and normal vitalsD Patient with an ankle sprain -
552
A patient who is angry breaks several dishes in the dayroom. This behavior is an example of:
A Verbal expressionB Non-verbal expression (behavioral expression) الإجابة الصحيحةC Emotional regulationD Cognitive processing -
553
A patient is diagnosed with COVID-19. According to current infection control guidelines, which type of precautions should the nurse implement?
A Contact precautionsB Droplet precautions (plus contact) الإجابة الصحيحةC Airborne precautionsD Standard precautions only -
554
A breastfed newborn develops jaundice at day 9 of life that is not associated with hemolysis or other pathology. The typical timing of onset for breastfeeding jaundice (late onset) is:
A 5-7 daysB 9 days (can start around day 4-7 and persist; often peaks at 7-10 days) الإجابة الصحيحةC 2 weeksD 3 weeks -
555
While inserting a nasogastric tube, which assessment finding most strongly suggests accidental placement of the tube into the patient's airway?
A Inability to speak الإجابة الصحيحةB Slight discomfortC Tearing eyesD Mild coughing -
556
A nurse instructs a mother to keep bath water temperature between 38-40°C. This represents which type of heat transfer?
A RadiationB ConvectionC EvaporationD Conduction الإجابة الصحيحة -
557
A nurse is teaching a patient about sources of vitamin D. Which food is a rich dietary source of vitamin D?
A Liver oil (e.g., cod liver oil) الإجابة الصحيحةB Orange juiceC White breadD Green tea -
558
After a surgical procedure, the nurse should prioritize monitoring which vital sign as an early indicator of complications?
A Respiration rate الإجابة الصحيحةB Blood pressureC Heart rateD Temperature -
559
A patient is prescribed pain medication every 4 hours. After administration, the patient complains of continued severe pain after only 15 minutes. What should the nurse do first?
A Give another dose immediatelyB Reassess the patient after 15 minutes الإجابة الصحيحةC Wait for the next scheduled doseD Change to a different medication -
560
A nurse is making an ethical decision about a patient's care. Which ethical principle is the foundation for respecting a patient's right to make their own healthcare choices?
A Autonomy الإجابة الصحيحةB BeneficenceC Non-maleficenceD Justice -
561
When developing a nursing care plan, which ethical principle should the nurse prioritize to ensure the patient's right to self-determination?
A Autonomy الإجابة الصحيحةB BeneficenceC Non-maleficenceD Justice -
562
A pregnant woman at 32 weeks presents with sudden, painful vaginal bleeding and a firm, tender uterus. The nurse suspects that the placenta has separated prematurely from the uterine wall. This condition is known as:
A Placenta previaB Placenta abruption الإجابة الصحيحةC Retained placentaD Placental insufficiency -
563
The Ministry of Health requires Hajj pilgrims to receive the meningococcal vaccine. This intervention is classified as which level of prevention?
A Primary prevention الإجابة الصحيحةB Secondary preventionC Tertiary preventionD Quaternary prevention -
564
A postpartum woman has heavy vaginal bleeding, but the uterine fundus is firm and well-contracted. The nurse suspects that the bleeding is likely due to:
A Uterine atonyB Cervical laceration الإجابة الصحيحةC Retained placentaD Coagulation disorder -
565
A nurse performs an Apgar score on a newborn at 3 minutes (score 7) and again at 5 minutes (score 10). The nurse interprets these scores as indicating:
A Normal baby الإجابة الصحيحةB Severely depressed babyC Moderately depressed babyD Critical baby -
566
A newborn in the NICU has difficulty breathing, nasal flaring, and grunting. The nurse suspects respiratory distress syndrome. This condition is most commonly caused by:
A PneumoniaB Respiratory Distress Syndrome (surfactant deficiency) الإجابة الصحيحةC BronchiolitisD Asthma -
567
An infant presents with projectile vomiting after feedings, weight loss, and a palpable olive-shaped mass in the upper abdomen. The nurse suspects:
A IntussusceptionB Pyloric stenosis الإجابة الصحيحةC GastroenteritisD Appendicitis -
568
A nurse accidentally administers the wrong medication, causing harm to the patient. Which ethical principle has been violated?
A AutonomyB Nonmaleficence (do no harm) الإجابة الصحيحةC BeneficenceD Justice -
569
A nurse manager implements a policy requiring unique passwords for all staff to access electronic health records. This practice supports which aspect of patient data protection?
A Password protection (confidentiality) الإجابة الصحيحةB Open accessC Verbal communicationD Written notes -
570
A patient with thalassemia major receives regular blood transfusions. To prevent iron overload, the nurse anticipates administering which medication?
A Iron supplementsB Deferoxamine (chelator) الإجابة الصحيحةC Folic acidD Vitamin B12 -
571
A patient with bipolar disorder experiences episodes of mania followed by periods of depression. This pattern is best defined as:
A Sudden change from mania to depression الإجابة الصحيحةB Persistent low moodC Anxiety episodesD Memory problems -
572
A woman is in the first stage of labor. The nurse notes that the cervix is dilated to 6 cm. This finding is characteristic of which phase of stage 1?
A Dilated 6 cm (active phase) الإجابة الصحيحةB Complete dilatation (transition)C CrowningD Delivery of placenta -
573
A patient has a blood pressure reading of 145/95 mmHg on two separate occasions. According to current guidelines, this reading is classified as:
A Stage 1 hypertension (130-139/80-89 is stage 1; 140/90 is stage 2? Actually JNC8: 140/90 is stage 1? Let's use standard: 130-139/80-89 = stage1; >=140/90 = stage2. So 145/95 is stage2)B Stage 2 hypertension الإجابة الصحيحةC PrehypertensionD Normal -
574
A democratic leadership style is effective in many situations. In which situation would democratic leadership be least appropriate?
A Team meetingsB Emergency situations (requires rapid, decisive action) الإجابة الصحيحةC Planning sessionsD Training programs -
575
A nurse manager trusts employees to make decisions and complete tasks with minimal supervision. This leadership style is known as:
A AutocraticB DemocraticC Laissez-faire الإجابة الصحيحةD Transformational -
576
A nurse manager encourages staff participation in decision-making and values their input. This leadership style is called:
A AutocraticB Democratic الإجابة الصحيحةC Laissez-faireD Bureaucratic -
577
An elderly patient taking a diuretic has frequent urination and is at risk for falls at night. Which assistive device should the nurse provide?
A WheelchairB Bedside commode الإجابة الصحيحةC Indwelling catheterD Walking aid -
578
During a physical assessment, the nurse notes that one leg appears shorter than the other. The nurse suspects a possible dislocation of which bone?
A Hip fractureB Fibula dislocation الإجابة الصحيحةC Muscle strainD Ligament tear -
579
A child is diagnosed with marasmus, a form of severe acute malnutrition. This condition is caused by a deficiency of:
A Vitamins onlyB Calories and proteins (overall energy deficit) الإجابة الصحيحةC Minerals onlyD Fats only -
580
A patient with hypoxia (low oxygen) develops rapid, deep breathing. The nurse expects the arterial blood gas to show:
A Metabolic acidosisB Uncompensated respiratory alkalosis due to hypoxia الإجابة الصحيحةC Respiratory acidosisD Metabolic alkalosis -
581
A patient with a colostomy notices that the skin around the stoma has become dark purple. This finding is most concerning for:
A Pink color (normal)B Dark purple skin around stoma (ischemia/necrosis) الإجابة الصحيحةC Mild swellingD Normal drainage -
582
A nurse is teaching a patient about dietary sources of vitamin D. Which foods are rich in vitamin D?
A Fruits and vegetablesB Fish and egg yolk الإجابة الصحيحةC Grains and cerealsD Dairy products only -
583
A newborn is receiving phototherapy for hyperbilirubinemia. What is the most important nursing intervention during treatment?
A Check temperatureB Cover baby's eyes (to prevent retinal damage) الإجابة الصحيحةC Monitor feedingD Change position -
584
A nurse assesses a patient's apical pulse for one minute and radial pulse simultaneously. The apical rate is 90 bpm and the radial rate is 84 bpm. The difference between these two rates is called:
A Pulse pressureB Pulse deficit الإجابة الصحيحةC Pulse rateD Pulse rhythm -
585
A patient is one day post-appendectomy. Which position should the nurse encourage to reduce tension on the incision and promote comfort?
A SupineB High Fowler الإجابة الصحيحةC TrendelenburgD Left lateral -
586
The combination vaccine that protects against measles, mumps, and rubella is abbreviated as:
A MMSB MMR الإجابة الصحيحةC MRMD RMM -
587
A nurse assesses a 6-month-old infant and notes a bulging anterior fontanelle. This finding is most concerning for:
A Sunken fontanelle (dehydration)B Bulging fontanelle (increased intracranial pressure) الإجابة الصحيحةC Normal fontanelleD Closed fontanelle -
588
A nurse assesses a patient after thyroidectomy for Chvostek's and Trousseau's signs. These signs indicate which electrolyte imbalance?
A HypercalcemiaB Hypocalcemia الإجابة الصحيحةC HypernatremiaD Hyponatremia -
589
A nurse is evaluating a patient's risk for falling after surgery. Which standardized assessment tool is commonly used to predict fall risk?
A Glasgow Coma ScaleB Morse Fall Scale الإجابة الصحيحةC Norton Scale (pressure ulcer risk)D Braden Scale (pressure ulcer risk) -
590
A nurse assesses a patient's skin and notes multiple non-blanching purplish lesions measuring 2–10 mm in diameter distributed over the hands and body. Which term best describes this finding?
A Petechiae (pinpoint hemorrhages smaller than 2 mm)B Mottling (reticular or marbled skin discoloration)C Ecchymosis (large bruise-like discoloration greater than 1 cm)D Purpura (purple hemorrhagic lesions measuring 2–10 mm) الإجابة الصحيحة -
591
A patient has hearing loss in the left ear. To perform the Weber test, the nurse places a tuning fork on the:
A Left ear (not Weber; Rinne uses ear)B Right earC Middle of the forehead (vertex) الإجابة الصحيحةD Behind the ear -
592
A patient receiving a blood transfusion develops dyspnea, headache, and hypertension. The nurse suspects circulatory overload. These symptoms are characteristic of:
A Allergic reactionB Fluid overload (transfusion-associated circulatory overload, TACO) الإجابة الصحيحةC Hemolytic reactionD Febrile reaction -
593
A patient is suspected of having sickle cell disease. Which laboratory test is used to confirm the diagnosis?
A Complete blood count (CBC)B Hemoglobin electrophoresis الإجابة الصحيحةC Peripheral blood smearD Iron studies -
594
A nurse administers a tuberculin skin test (Mantoux) to screen for tuberculosis. This injection is given by which route?
A IntramuscularB Intradermal الإجابة الصحيحةC SubcutaneousD Intravenous -
595
A patient develops hives and itching during an intravenous infusion of a medication. What is the priority action?
A Reduce the doseB Stop the infusion immediately الإجابة الصحيحةC Continue treatment and monitorD Increase monitoring -
596
A patient receiving intravenous fluids develops crackles in the lungs and worsening edema. The nurse suspects fluid overload. What should the nurse do?
A Stop the infusion immediately (or slow to keep-vein-open rate)B Reduce the infusion rate الإجابة الصحيحةC Increase the doseD Switch to a different fluid -
597
The meningococcal vaccine required for Hajj pilgrims is an example of which level of disease prevention?
A Primary الإجابة الصحيحةB SecondaryC TertiaryD Quaternary -
598
A newborn with tracheoesophageal fistula (TEF) is most likely to have which anatomical type?
A Type A (esophageal atresia without fistula)B Type B (esophageal atresia with proximal fistula)C Type C (esophageal atresia with distal fistula, most common) الإجابة الصحيحةD Type D (esophageal atresia with both proximal and distal fistulas) -
599
A newborn with tracheoesophageal fistula (TEF) presents with excessive salivation, coughing, and cyanosis during feeding, as well as abdominal distension. The nurse recognizes these as signs of:
A Excessive salivationB Cyanosis during feedingC Abdominal distensionD All of the above الإجابة الصحيحة -
600
An infant is born with a cleft lip and palate. Which feeding method is most appropriate to help the infant achieve adequate nutrition?
A Regular bottle feedingB Specialized feeding bottles (e.g., Haberman, pigeon nipple) الإجابة الصحيحةC Nasogastric tube feedingD Intravenous nutrition -
601
A pregnant woman with risk factors for gestational diabetes should be screened at which gestational age?
A 20-24 weeksB 24-28 weeks الإجابة الصحيحةC 28-32 weeksD 32-36 weeks -
602
The Saudi Ministry of Health mandates which vaccine for all Hajj pilgrims to prevent outbreaks of meningitis?
A Meningococcal vaccine الإجابة الصحيحةB Yellow fever vaccineC Hepatitis A vaccineD Typhoid vaccine -
603
A nurse overhears two colleagues discussing a patient's medical history in the hospital cafeteria. What should the nurse remind them about?
A Patient confidentiality (HIPAA/legal obligation) الإجابة الصحيحةB Documentation accuracyC Medication safetyD Infection control -
604
According to WHO recommendations, a low-risk pregnant woman should have approximately how many antenatal visits?
A 8-12 visits الإجابة الصحيحةB 4-6 visitsC 14-16 visitsD 20-24 visits -
605
An infant with hypertrophic pyloric stenosis has been vomiting frequently. The nurse expects which acid-base imbalance on arterial blood gas?
A Metabolic alkalosis (loss of gastric acid) الإجابة الصحيحةB Metabolic acidosisC Respiratory alkalosisD Respiratory acidosis -
606
A patient with active pulmonary tuberculosis is admitted. Which precautions are most effective in preventing transmission?
A Airborne precautions (N95 respirator, negative pressure room) and isolation الإجابة الصحيحةB Contact precautions onlyC Droplet precautions onlyD Standard precautions only -
607
A patient is diagnosed with hyperthyroidism (Graves' disease). The nurse anticipates which type of medication as first-line treatment?
A Antithyroid medications (methimazole, propylthiouracil) الإجابة الصحيحةB Thyroid hormone supplements (levothyroxine)C Calcium supplementsD Beta blockers only (symptom management) -
608
A nurse needs to administer an intramuscular injection to a 2-year-old child. Which muscle site is preferred?
A Vastus lateralis الإجابة الصحيحةB DeltoidC DorsoglutealD Rectus femoris -
609
A head nurse assigns an assistant nurse to provide patient care. Under what condition should the assistant nurse work?
A Under direct supervision of a registered nurse الإجابة الصحيحةB IndependentlyC Only during day shiftsD Only for basic care -
610
A mother is visibly stressed after her child is diagnosed with cancer. To reduce her anxiety, what should the nurse do?
A Provide emotional support and clear information الإجابة الصحيحةB Avoid discussing the diagnosisC Refer to another departmentD Prescribe sedatives -
611
A patient is suspected of having sickle cell anemia. Which test confirms the diagnosis?
A Hemoglobin electrophoresis الإجابة الصحيحةB Complete blood countC Blood glucose testD Liver function test -
612
A pregnant woman arrives at the emergency department in active labor. What should the nurse do first?
A Assess cervical dilation الإجابة الصحيحةB Give pain medicationC Call the familyD Prepare discharge papers -
613
A school nurse is planning an obesity prevention program. Which intervention is most effective for school-aged children?
A Nutrition education and physical activity الإجابة الصحيحةB Medication therapyC Surgical interventionsD Restricting all food intake -
614
A nurse is assessing risk factors for accidents in adolescents. Which factors are most common?
A Risk-taking behavior and inexperience الإجابة الصحيحةB Physical disabilitiesC Chronic diseasesD Medication side effects -
615
A patient is 8 hours post-tonsillectomy and is allowed clear liquids. Which juice is most appropriate?
A Apple juice (non-acidic, clear) الإجابة الصحيحةB Orange juice (acidic, irritating)C Cranberry juice (acidic)D Grape juice (may be acidic) -
616
A nurse is caring for a child with hydrocephalus and a ventriculoperitoneal shunt. Which nursing consideration is most important?
A Monitor intracranial pressure (signs of increased ICP) الإجابة الصحيحةB Restrict fluid intakeC Encourage physical activityD Administer antibiotics -
617
A child is exposed to chickenpox. Which vaccine can prevent or reduce the severity of the disease?
A Varicella vaccine الإجابة الصحيحةB MMR vaccineC Hepatitis B vaccineD Polio vaccine -
618
A nurse reviews an ECG strip showing a regular rhythm with a rate of 180 bpm, narrow QRS complexes, and no visible P waves. This rhythm is most consistent with:
A Atrial tachycardia الإجابة الصحيحةB Ventricular tachycardiaC Atrial bradycardiaD Ventricular bradycardia -
619
A physician prescribes morphine sulfate for a 70-kg adult with severe pain. The recommended dose is 0.1 mg/kg. Which dose should the nurse administer?
A 5 mgB 7 mg الإجابة الصحيحةC 10 mgD 14 mg -
620
A charge nurse floats a nurse from a general medical unit to the intensive care unit. Which patient assignment is most appropriate for this nurse?
A Patient requiring vital signs monitoring (stable, routine care) الإجابة الصحيحةB Critical patient requiring specialized ICU careC Post-operative patient with complicationsD Patient requiring complex medication administration -
621
A pregnant woman in active labor arrives at the emergency department. No delivery room is available. What is the most appropriate action?
A Transfer to another hospitalB Have her wait until a room is availableC Deliver in the emergency department الإجابة الصحيحةD Deliver in the hallway -
622
A patient with severe diarrhea for 2 days presents with dry mucous membranes, decreased skin turgor, and hypotension. The nurse suspects which type of shock?
A Hypovolemic shock الإجابة الصحيحةB Cardiogenic shockC Septic shockD Neurogenic shock -
623
A nurse reviews an ECG strip showing a regular rhythm with a rate of 170 bpm, narrow QRS complexes, and no visible P waves. The most likely diagnosis is:
A Atrial tachycardia الإجابة الصحيحةB Ventricular tachycardiaC Atrial bradycardiaD Ventricular bradycardia -
624
A physician orders morphine for a child. The safe pediatric dose is 0.1-0.2 mg/kg/dose. For a child weighing 20 kg, which dose is appropriate?
A 0.1 mg/kg (2 mg total)B 0.2 mg/kg (4 mg total) الإجابة الصحيحةC 0.3 mg/kg (6 mg)D 0.4 mg/kg (8 mg) -
625
A patient with severe dehydration requires intravenous fluid resuscitation. Which initial fluid order is most appropriate?
A Normal saline 500 mLB Dextrose 5% 1000 mLC Lactated Ringer's 250 mLD Normal saline 1000 mL الإجابة الصحيحة -
626
A charge nurse floats a nurse from a medical-surgical unit to the intensive care unit. Which task should be assigned first to the floated nurse?
A Vital signs monitoring on stable patients الإجابة الصحيحةB Medication administration for unstable patientsC Complex wound careD Critical patient assessment -
627
A pregnant woman in active labor arrives at the emergency department. The delivery rooms are full. What is the best action?
A Transfer to another hospitalB Let her wait for a delivery roomC Deliver in the emergency room الإجابة الصحيحةD Deliver in the corridor -
628
A patient has severe diarrhea for 2 days and presents with dry skin and hypotension. The nurse recognizes this as:
A Hypovolemic shock الإجابة الصحيحةB Cardiogenic shockC Septic shockD Neurogenic shock -
629
A child with pyloric stenosis is scheduled for surgery. Preoperatively, which feeding method is appropriate?
A BreastfeedingB Nasogastric tube (NGT) for decompression and IV fluids الإجابة الصحيحةC IV fluids only (NPO), NGT for decompressionD Oral formula feeding -
630
A patient presents with tachycardia (heart rate 120 bpm) and hypotension (BP 85/50 mmHg). The most likely cause is:
A Fluid volume deficit (hypovolemia) الإجابة الصحيحةB Hypertensive crisisC BradycardiaD Hypervolemia -
631
A patient with vitamin D deficiency has no respiratory symptoms. On chest auscultation, the nurse expects to hear:
A Normal breath sounds الإجابة الصحيحةB WheezingC CracklesD Stridor -
632
A patient is considering combined oral contraceptives (COCs). Which medical condition is a contraindication to COC use?
A Hypertension (uncontrolled) الإجابة الصحيحةB HypotensionC DysmenorrheaD Normal blood pressure -
633
A mother of a child with type 1 diabetes should monitor for signs of diabetic ketoacidosis. Which symptom is most concerning?
A Vomiting (can indicate DKA) الإجابة الصحيحةB DizzinessC Signs of placenta previa (not relevant)D Painless vaginal bleeding (not relevant) -
634
A patient with right-sided hemiplegia is at risk for pressure ulcers. What is the most effective preventive measure?
A Turn the patient every 1-2 hours (repositioning) الإجابة الصحيحةB Apply moisturizing cream to the backC Keep patient in the same positionD Use a heating pad -
635
A physician orders 1 gram of a medication by mouth four times daily. The pharmacy supplies 250 mg tablets. How many tablets should the nurse give per dose?
A 2 tabletsB 3 tabletsC 4 tablets (1000 mg / 250 mg = 4) الإجابة الصحيحةD 5 tablets -
636
A nurse needs to administer an intramuscular antibiotic to a 4-year-old child. Which muscle is preferred?
A Vastus lateralis الإجابة الصحيحةB VentroglutealC DeltoidD Dorsogluteal -
637
A patient is taking the progestin-only pill (mini-pill). Which common side effect should the nurse discuss?
A Premenstrual syndromeB Irregular bleeding (spotting between periods) الإجابة الصحيحةC Weight gainD Hair loss -
638
A patient with bipolar disorder is discharged after electroconvulsive therapy (ECT). The patient arrives alone for a follow-up appointment. What is the most important question the nurse should ask?
A Do you have a family member with you? (safety after ECT) الإجابة الصحيحةB Do you have car keys?C Do you have transportation?D Should I call the doctor? -
639
A patient has taken an overdose of a central nervous system depressant and is comatose. What is the nurse's greatest concern?
A SeizureB Renal failureC Myocardial infarctionD Respiratory failure (airway protection) الإجابة الصحيحة -
640
A patient with sudden shortness of breath after chest trauma has absent breath sounds on the left and a deviated trachea to the right. Which clinical sign is most indicative of tension pneumothorax?
A Bilateral breath soundsB Deviated trachea الإجابة الصحيحةC Normal percussionD Clear chest X-ray -
641
A nurse is assessing four laboring women. Which patient is at highest risk for complications during labor?
A Office worker (sedentary, but not high risk)B Factory worker (physical demands, possible exposure to hazards, but not specifically high risk) الإجابة الصحيحةC TeacherD Nurse -
642
A patient with iron deficiency anemia is advised to take iron supplements. Which beverage enhances iron absorption?
A Coffee (inhibits absorption)B Tea (inhibits absorption)C Orange juice (vitamin C enhances absorption) الإجابة الصحيحةD Milk (calcium inhibits absorption) -
643
A 70 kg patient is started on mechanical ventilation. The nurse expects the physician to set an initial tidal volume of approximately 6-8 mL/kg ideal body weight. Which of the following tidal volume settings falls within this recommended range?
A 450 mL الإجابة الصحيحةB 380 mLC 600 mLD 700 mL
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