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مذكرة مراجعة

مايو 2026

313 سؤال مع الإجابات الصحيحة، مرتبة للقراءة والمراجعة استعدادا لاختبار التمريض SNLE.

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313 سؤال ظاهر

  1. 1

    A nurse is monitoring a patient receiving warfarin therapy for a deep vein thrombosis. Which laboratory value should the nurse evaluate to determine if the medication is within therapeutic range?

    A Hemoglobin level
    B White blood cell count
    C International normalized ratio (INR) الإجابة الصحيحة
    D Platelet count
  2. 2

    A postoperative infant who had a myelomeningocele repair has a clean, dry surgical incision. Which type of dressing should the nurse apply to protect the site while allowing healing?

    A Dry sterile dressing الإجابة الصحيحة
    B Moist sterile dressing
    C Occlusive transparent dressing
    D No dressing needed
  3. 3

    A home health nurse visits an elderly patient who lives alone and has a history of falls. Which standardized assessment tool is most appropriate for evaluating the patient's fall risk?

    A Barn Scale
    B Hendrich II Fall Risk Model الإجابة الصحيحة
    C GCS Scale
    D Norton Scale
  4. 4

    A multiparous woman in active labor has progressed from 3 cm to 7 cm dilation in 2 hours. She now reports a strong urge to have a bowel movement. What is the nurse's priority action?

    A Provide a bedpan for bowel movement
    B Perform a vaginal examination to assess for full dilation الإجابة الصحيحة
    C Allow the patient to use the toilet
    D Administer prescribed pain medication
  5. 5

    A nurse reads several research studies that suggest increased patient mobility reduces postoperative pain. To determine whether these findings are generalizable to the nurse's own patient population, what should the nurse evaluate first?

    A Research author credentials
    B Sample size and diversity of study populations الإجابة الصحيحة
    C Journal impact factor
    D Publication date
  6. 6

    A charge nurse assigns a task involving sensitive patient information to an intern nurse. Later, the charge nurse assumes the intern is highly competent in all areas because of one positive performance. This cognitive bias is known as:

    A Making decisions based on one positive trait (halo effect) الإجابة الصحيحة
    B Delegating inappropriate tasks to new staff
    C Failing to provide adequate supervision
    D Creating unrealistic expectations
  7. 7

    A patient reports difficulty falling asleep and frequent nighttime awakenings for several months. The nurse reviews the patient's diet and lifestyle. Which vitamin deficiency is most commonly linked to sleep disturbances?

    A Vitamin B12
    B Vitamin C
    C Vitamin D الإجابة الصحيحة
    D Vitamin A
  8. 8

    A patient in a persistent vegetative state receiving long-term enteral nutrition is at highest risk for deficiency of which vitamin?

    A Vitamin D
    B Vitamin B12 الإجابة الصحيحة
    C Vitamin C
    D Folate
  9. 9

    A woman with gestational diabetes delivers a full-term infant. In the first few hours after birth, the nurse should monitor the newborn most closely for which complication?

    A Hyperglycemia
    B Hypoglycemia الإجابة الصحيحة
    C Hypernatremia
    D Hyponatremia
  10. 10

    A public health nurse administers the meningococcal vaccine to pilgrims before they travel to Hajj. This intervention is classified as which level of prevention?

    A Primary prevention الإجابة الصحيحة
    B Secondary prevention
    C Tertiary prevention
    D Quaternary prevention
  11. 11

    A pregnant woman weighs 46 kg, is 164 cm tall (BMI ~17.1), and reports eating approximately 1800 calories per day. Which nursing diagnosis is most appropriate?

    A Balanced nutrition
    B Imbalanced nutrition: less than body requirements الإجابة الصحيحة
    C Imbalanced nutrition: more than body requirements
    D Risk for nutritional deficit
  12. 12

    A patient with active pulmonary tuberculosis is admitted to the medical unit. Which type of infection control precautions should the nurse implement?

    A Contact precautions
    B Droplet precautions
    C Airborne precautions الإجابة الصحيحة
    D Standard precautions only
  13. 13

    A child is suspected of having bacterial meningitis. The child lives with several family members. What is the priority nursing intervention?

    A Educate family about disease transmission
    B Screen family members for symptoms
    C Initiate isolation precautions for the child الإجابة الصحيحة
    D Administer prophylactic antibiotics to family members
  14. 14

    A patient taking lorazepam for anxiety asks the nurse if it is safe to have a glass of wine. The nurse explains that benzodiazepines should not be taken with which substance due to the risk of severe respiratory depression?

    A Caffeine
    B Alcohol الإجابة الصحيحة
    C Tobacco
    D Dairy products
  15. 15

    A mother gives birth to a baby with a cleft palate. Before the infant is discharged, the nurse prioritizes teaching the mother about which aspect of care?

    A Positioning techniques
    B Feeding techniques الإجابة الصحيحة
    C Breathing exercises
    D Wound care
  16. 16

    A community health nurse is planning interventions to reduce tuberculosis transmission in a high-incidence area. Which strategy is most effective at the population level?

    A Regular screening programs
    B BCG vaccination of susceptible populations الإجابة الصحيحة
    C Improved ventilation systems
    D Contact tracing of active cases
  17. 17

    A patient has a blood pressure reading of 196/110 mmHg confirmed on three separate occasions. The nurse classifies this blood pressure as:

    A Mild hypertension
    B Moderate hypertension
    C Severe hypertension الإجابة الصحيحة
    D Hypertensive crisis
  18. 18

    A nurse demonstrates positive self-concept by which of the following behaviors?

    A Acknowledging their own strengths and weaknesses الإجابة الصحيحة
    B Always appearing confident in front of patients
    C Avoiding asking for help from colleagues
    D Focusing only on professional achievements
  19. 19

    A pregnant woman in her third trimester presents with sudden, severe abdominal pain and dark vaginal bleeding. The cervix is closed on examination. The nurse suspects which condition?

    A Placenta previa
    B Abruptio placentae (placental abruption) الإجابة الصحيحة
    C Chorioamnionitis
    D Preterm labor
  20. 20

    A 28-year-old woman who previously had a healthy child has been trying to conceive for 14 months without success. This situation is best defined as:

    A Inability to conceive after 6 months of unprotected intercourse
    B Absence of menstruation for 3 years
    C Inability to carry pregnancy to term after conception
    D Inability to conceive after having at least one previous pregnancy despite 12 months of unprotected intercourse الإجابة الصحيحة
  21. 21

    An elderly patient with an IV cannula becomes restless and complains of itching and difficulty breathing during an infusion. What is the priority nursing action?

    A Discontinue the IV infusion immediately الإجابة الصحيحة
    B Slow down the infusion rate and monitor
    C Administer antihistamine and continue infusion
    D Document the findings and notify the physician later
  22. 22

    A nurse is assessing the weight of a child between 2.5 and 4 years old. What is the expected normal weight range for this age group?

    A 10 to 16 kg الإجابة الصحيحة
    B 8 to 12 kg
    C 15 to 20 kg
    D 12 to 18 kg
  23. 23

    A nurse is assisting with chest tube insertion for a patient with a pleural effusion. The provider places the chest tube at which anatomical location?

    A At the midline
    B Between the 6th and 7th ribs at the midaxillary line الإجابة الصحيحة
    C At the sternal border
    D Between the 3rd and 4th ribs
  24. 24

    A nurse is assessing a patient for appendicitis. The nurse notes that pain increases when pressure is suddenly released from the right lower quadrant. This finding is known as rebound tenderness, which is elicited by:

    A Pain that occurs when pressure is applied
    B Pain that occurs when pressure is suddenly released الإجابة الصحيحة
    C Constant abdominal pain
    D Pain that radiates to the back
  25. 25

    A patient scheduled for a cardiac catheterization tells the nurse, "I don't understand the side effects of this procedure." What is the nurse's best action?

    A Explain the side effects again
    B Notify the surgeon (or proceduralist) to re-consent the patient الإجابة الصحيحة
    C Proceed with the procedure
    D Document that the patient understands
  26. 26

    The head nurse determines that additional nursing staff will be needed for the next fiscal year and begins the recruitment process. This management function is called:

    A Planning
    B Directing
    C Controlling
    D Organizing الإجابة الصحيحة
  27. 27

    A patient scheduled for a right total knee replacement reports a severe allergy to shellfish. Why is this allergy particularly important?

    A Shellfish allergies could indicate a negative reaction to anesthesia
    B The patient cannot receive donor packed red blood cells if needed
    C A seafood allergy can indicate allergy to povidone-iodine (Betadine) used for skin preparation الإجابة الصحيحة
    D A seafood allergy can be a precursor to malignant hyperthermia
  28. 28

    A patient with a permanent pacemaker asks about activity restrictions. Which activity should the nurse advise the patient to avoid?

    A Using a cell phone (keep at least 6 inches away)
    B Doing light exercise
    C Playing contact sports (risk of damage to device) الإجابة الصحيحة
    D Walking regularly
  29. 29

    A patient presents with unilateral calf pain, swelling, and warmth. The nurse suspects which condition?

    A Muscle strain
    B Deep vein thrombosis (DVT) الإجابة الصحيحة
    C Arterial occlusion
    D Cellulitis
  30. 30

    A patient with Parkinson disease develops a stooped posture while taking medication. This finding is most characteristic of which condition?

    A Osteoporosis
    B Parkinson disease الإجابة الصحيحة
    C Arthritis
    D Muscle weakness
  31. 31

    A patient has a blood pressure reading consistently above 140/90 mmHg. According to standard guidelines, this indicates which stage of hypertension?

    A Prehypertension
    B Stage 1 hypertension الإجابة الصحيحة
    C Stage 2 hypertension
    D Hypertensive crisis
  32. 32

    A 20-year-old athletic patient has a mild S3 heart sound on auscultation. What is the most appropriate nursing action?

    A Document as an abnormal finding
    B Recognize this as a normal variant in young adults and athletes الإجابة الصحيحة
    C Order an immediate echocardiogram
    D Prepare for cardiac catheterization
  33. 33

    A hospital manager wants to conduct a study that requires selecting experienced nurse managers as participants. Which sampling method is most appropriate to intentionally select individuals with specific expertise?

    A Stratified sampling
    B Random sampling
    C Purposive sampling (judgmental sampling) الإجابة الصحيحة
    D Convenience sampling
  34. 34

    A newborn has a heart rate of 150 bpm. What is the most appropriate nursing action?

    A Reassure the mother that the baby is fine (normal newborn heart rate is 120-160 bpm) الإجابة الصحيحة
    B Reassess heart rate after 10 minutes
    C Notify the physician immediately
    D Prepare for emergency intervention
  35. 35

    A nurse is managing an intracranial pressure (ICP) monitoring device in the ICU. What is the priority nursing action to ensure accurate readings?

    A Zero the device at the level of the foramen of Monro at the beginning of each shift الإجابة الصحيحة
    B Calibrate the transducer weekly
    C Check alarm settings daily
    D Zero the device at the end of the shift
  36. 36

    An informatics nurse reviews patient records to check for completeness, accuracy, and compliance with documentation standards. This process is known as:

    A Auditing الإجابة الصحيحة
    B Telehealth monitoring
    C Data mining
    D Quality assurance
  37. 37

    A patient with a peptic ulcer is being discharged after a prolonged hospitalization. To prevent recurrence, the nurse emphasizes which teaching point as most important?

    A Optimal nutrition
    B Medication compliance (e.g., proton pump inhibitors, H. pylori eradication) الإجابة الصحيحة
    C Stress management
    D Regular follow-up
  38. 38

    A nurse is teaching a class about male infertility. Which statement is correct?

    A Organic infertility is primary infertility
    B Measles and mumps (especially orchitis) can cause infertility الإجابة الصحيحة
    C Age does not affect male fertility
    D Stress is the leading cause of infertility
  39. 39

    An elderly patient presents with hypoglycemia, hypotension, and hyperpigmentation. The patient is diagnosed with Addison disease. What is the most likely underlying cause?

    A Longstanding hypothyroidism
    B Iodine therapy
    C Hyperglycemia
    D Autoimmune destruction of the adrenal cortex الإجابة الصحيحة
  40. 40

    A patient with a chest tube has continuous bubbling in the water seal chamber. The nurse suspects an air leak. What should the nurse assess first?

    A Air leak in the system (check connections, then chest tube site) الإجابة الصحيحة
    B Lung re-expansion (absence of bubbling can indicate re-expansion, but continuous bubbling indicates leak)
    C Tube obstruction
    D Patient positioning
  41. 41

    An asthma patient on high-flow oxygen shows improvement. Which finding indicates this improvement?

    A Lower forced expiration
    B Increased forced inspiration
    C Increased forced expiratory volume (improved forced expiration) الإجابة الصحيحة
    D Lower forced inspiration
  42. 42

    A nurse applies a tourniquet to control severe bleeding from a limb. Prolonged application can lead to which complication?

    A Limb ischemia الإجابة الصحيحة
    B Reduced blood flow (temporary, but ischemia is the serious risk)
    C Nerve compression
    D Muscle fatigue
  43. 43

    A patient who underwent heart valve surgery one week ago now has a new systolic murmur on auscultation. What is the most likely cause?

    A Valve malfunction (e.g., paravalvular leak, prosthetic valve dysfunction) الإجابة الصحيحة
    B Normal post-surgical finding
    C Fluid overload
    D Anesthetic effects
  44. 44

    A patient is restless and agitated, with severe pain, swelling, and cyanosis around the umbilicus (Cullen sign). What is the priority concern?

    A Restlessness and anxiety
    B Severe pain
    C Poor perfusion (possible intra-abdominal hemorrhage or pancreatitis) الإجابة الصحيحة
    D Infection
  45. 45

    An elderly patient with a previous stroke and right-sided hemiplegia needs mobility assistance. What is the most appropriate approach?

    A Independent ambulation with an assistive device (e.g., cane or walker) and supervision الإجابة الصحيحة
    B Dependent ambulation with wheelchair
    C Independent ambulation with no assistance
    D Bed rest with passive range of motion
  46. 46

    A child is diagnosed with chicken pox (varicella). Which skin manifestation is characteristic of this infection?

    A Flat, red macules that do not contain fluid
    B Raised, fluid-filled vesicles on an erythematous base (dew drop on a rose petal) الإجابة الصحيحة
    C Thick, scaly plaques with silver scales
    D Purpuric lesions that do not blanch
  47. 47

    A patient is admitted with acute appendicitis and scheduled for surgery. Which preoperative nursing intervention is most important?

    A Administer a Fleet enema to clear the bowel
    B Keep the patient NPO (nothing by mouth) الإجابة الصحيحة
    C Apply heat to the right lower quadrant
    D Encourage ambulation to reduce inflammation
  48. 48

    A nurse is teaching a patient with stable angina about sublingual nitroglycerin. Which instruction is most important?

    A Take up to 3 doses, 5 minutes apart, and call 911 if pain persists الإجابة الصحيحة
    B Swallow the tablet whole with water
    C Take one dose and wait 30 minutes before taking another
    D Store the medication in a warm, bright location
  49. 49

    A charge nurse has 3 RNs and 1 nursing assistant on shift. Which task is most appropriate to delegate to the nursing assistant?

    A Assessing a post-operative patient for complications
    B Administering insulin to a diabetic patient
    C Providing frequent linen changes for an incontinent patient الإجابة الصحيحة
    D Teaching a patient about discharge medications
  50. 50

    A nurse observes a colleague in the cafeteria who appears to be choking and cannot speak. What is the most appropriate immediate intervention?

    A Leopold maneuvers
    B Trendelenburg position
    C Heimlich maneuver (abdominal thrusts) الإجابة الصحيحة
    D Valsalva maneuver
  51. 51

    A pregnant woman is at highest risk for developing gestational diabetes during which trimester?

    A First trimester
    B Second trimester
    C Third trimester (insulin resistance increases) الإجابة الصحيحة
    D Risk is equal throughout pregnancy
  52. 52

    A patient presents with abnormal tissue growth described as grape-like clusters on ultrasound. This finding is most consistent with which condition?

    A Ectopic pregnancy
    B Molar pregnancy (hydatidiform mole) الإجابة الصحيحة
    C Placenta previa
    D Abruptio placentae
  53. 53

    An infant is born with tracheoesophageal fistula (TEF). What is the priority nursing intervention before surgical repair?

    A Feed the infant small, frequent meals
    B Keep NPO and elevate the head of the bed الإجابة الصحيحة
    C Encourage oral fluids to prevent dehydration
    D Place in prone position for drainage
  54. 54

    A patient with diabetes insipidus presents with excessive thirst and large volumes of dilute urine. Which clinical manifestation is most characteristic of this disorder?

    A Polyuria (excessive urine output) الإجابة الصحيحة
    B Polydipsia (excessive thirst)
    C Weight gain
    D Hypertension
  55. 55

    A nurse is providing perineal care for a postpartum patient. What is the correct technique?

    A Use circular motions around the vulva
    B Apply warm water over the vulva from front to back (anterior to posterior) الإجابة الصحيحة
    C Cleanse from back to front to avoid contamination
    D Use soap and scrub vigorously
  56. 56

    A child with Tetralogy of Fallot suddenly becomes cyanotic and short of breath during a crying spell. Which position is most beneficial to relieve this hypercyanotic episode?

    A Supine with legs elevated
    B Knee-chest position الإجابة الصحيحة
    C Left lateral position
    D Trendelenburg position
  57. 57

    A patient with hypothyroidism is prescribed levothyroxine. When should the nurse advise the patient to take this medication?

    A At bedtime with a snack
    B In the morning on an empty stomach, at least 30-60 minutes before breakfast الإجابة الصحيحة
    C With lunch for better absorption
    D In the evening after dinner
  58. 58

    A patient undergoes a craniotomy for tumor resection. Which post-operative nursing intervention is most appropriate to manage intracranial pressure?

    A Elevate head of bed to 30 degrees الإجابة الصحيحة
    B Keep patient in supine position
    C Encourage neck flexion exercises
    D Apply ice packs to the surgical site
  59. 59

    A patient who had a total hip replacement (posterior approach) is being discharged. Which instruction should the nurse include to prevent dislocation?

    A Avoid hip flexion greater than 90 degrees الإجابة الصحيحة
    B Cross legs when sitting for comfort
    C Sleep on the operative side
    D Perform high-impact exercises immediately
  60. 60

    A patient receiving morphine for postoperative pain has an oxygen saturation of 80% and a respiratory rate of 8 breaths/min. What is the priority nursing action?

    A Increase the morphine dose
    B Stop the medication, administer naloxone, and notify the physician الإجابة الصحيحة
    C Continue monitoring without intervention
    D Give supplemental oxygen only
  61. 61

    When assessing the pulse of a healthy infant, which site is most appropriate and reliable?

    A Radial artery
    B Brachial artery الإجابة الصحيحة
    C Carotid artery
    D Femoral artery
  62. 62

    A patient with diabetes insipidus is receiving desmopressin (DDAVP). What is the priority nursing intervention for this patient?

    A Monitor blood glucose levels
    B Monitor fluid intake and output (strict I&O) الإجابة الصحيحة
    C Restrict protein intake
    D Increase sodium intake
  63. 63

    A pregnant woman with gestational diabetes is at increased risk for which fetal complication?

    A Delivering a large baby (macrosomia) الإجابة الصحيحة
    B Delivering a small baby
    C Preterm labor only
    D Decreased fetal movement
  64. 64

    A pregnant woman arrives at the emergency department in active labor. The nurse assesses the cervix and finds it dilated to 8 cm. What is the priority nursing action?

    A Send her to the parking lot to wait
    B Call for immediate obstetric assistance and prepare for delivery الإجابة الصحيحة
    C Give her deep breathing exercises and transport upstairs
    D Discharge her home to wait
  65. 65

    A nurse enters the room of a frightened child with burns and fractures. What is the most appropriate initial approach?

    A Enter quickly and begin procedures immediately
    B Greet the child gently and speak in a calm manner الإجابة الصحيحة
    C Avoid eye contact to reduce anxiety
    D Bring multiple staff members for restraint
  66. 66

    A postpartum client is diagnosed with mastitis in the right breast. What is the most appropriate nursing advice regarding breastfeeding?

    A Continue breastfeeding from both breasts as tolerated (emptying the affected breast helps resolve infection) الإجابة الصحيحة
    B Breastfeed only from the left breast and pump the right breast
    C Stop breastfeeding completely until infection resolves
    D Switch to formula feeding temporarily for 48 hours
  67. 67

    A nurse explains to a parent that the MMR vaccine protects against which diseases?

    A Measles, Mumps, Rubella الإجابة الصحيحة
    B Meningitis, Malaria, Rickettsia
    C Hepatitis A, B, C
    D Influenza, Pneumonia, Pertussis
  68. 68

    A patient with active pulmonary tuberculosis is admitted. Which type of isolation precautions is required?

    A Droplet precautions
    B Contact precautions
    C Airborne precautions (with N95 respirator and negative pressure room) الإجابة الصحيحة
    D Standard precautions only
  69. 69

    A nurse assesses an infant and finds a bulging anterior fontanelle. This finding most likely indicates:

    A Dehydration
    B Increased intracranial pressure الإجابة الصحيحة
    C Hypoglycemia
    D Normal development
  70. 70

    A pregnant patient with severe preeclampsia is receiving magnesium sulfate. What is the primary purpose of this medication?

    A To prevent seizures (eclampsia) الإجابة الصحيحة
    B To induce labor
    C To reduce blood glucose levels
    D To increase uterine contractions
  71. 71

    A premature newborn with respiratory distress syndrome receives surfactant replacement. Through which route is surfactant administered?

    A Intramuscular injection
    B Oral administration
    C Endotracheal tube (directly into the lungs) الإجابة الصحيحة
    D Subcutaneous injection
  72. 72

    A public health nurse provides meningococcal vaccination to pilgrims before Hajj. This intervention represents which level of prevention?

    A Primary prevention الإجابة الصحيحة
    B Secondary prevention
    C Tertiary prevention
    D Rehabilitation prevention
  73. 73

    A nurse is donning personal protective equipment (PPE) before entering a patient's room. What is the correct sequence?

    A Gloves -> gown -> mask -> goggles
    B Gown -> mask -> goggles -> gloves الإجابة الصحيحة
    C Mask -> gloves -> gown -> goggles
    D Gloves -> goggles -> gown -> mask
  74. 74

    A patient tells the nurse, "An AI chatbot advised me to change my medication dosage." What is the best nursing response?

    A Agree with the AI recommendation
    B Ignore the patient's concern
    C Educate the patient to follow only healthcare provider instructions and never rely on AI for medication changes الإجابة الصحيحة
    D Immediately increase the medication dose
  75. 75

    A patient taking morphine develops respiratory depression with an oxygen saturation of 80%. Which medication should the nurse prepare to administer as an antidote?

    A Ibuprofen
    B Acetaminophen
    C Naloxone (Narcan) الإجابة الصحيحة
    D Aspirin
  76. 76

    A child with chickenpox (varicella) should remain in isolation until:

    A Fever completely subsides
    B All vesicles become dry and crusted (usually about 5-7 days after rash onset) الإجابة الصحيحة
    C Rash disappears completely
    D Appetite returns to normal
  77. 77

    A 7-year-old child weighing 25 kg requires maintenance intravenous fluids over 24 hours. Using the Holliday-Segar method (4-2-1 rule), what is the appropriate daily fluid volume?

    A 1200 mL
    B 1400 mL
    C 1600 mL الإجابة الصحيحة
    D 1800 mL
  78. 78

    During a code blue, a nurse states she does not know how to operate the defibrillator. What is the most appropriate action?

    A Continue without the equipment
    B Ask the nurse to learn during the emergency
    C Immediately assign another qualified nurse to operate the equipment الإجابة الصحيحة
    D Postpone resuscitation efforts
  79. 79

    A nurse discovers that she administered the wrong medication to a patient. What is the immediate priority action?

    A Complete the incident report first
    B Notify the physician immediately and monitor the patient الإجابة الصحيحة
    C Wait to see if adverse effects occur
    D Administer the correct medication
  80. 80

    During a home visit, a nurse finds elderly spouses living alone with expired medications and unsafe home conditions. What is the priority intervention?

    A Assess their safety and contact social services الإجابة الصحيحة
    B Clean their home immediately
    C Replace expired medications
    D Contact their daughter who lives far away
  81. 81

    A patient falls while in the nurse's care. What is the appropriate nursing action?

    A Ignore minor falls to avoid paperwork
    B Document the fall, assess for injuries, and notify the physician الإجابة الصحيحة
    C Only report if injuries are visible
    D Help the patient up immediately without assessment
  82. 82

    A woman with irregular menstrual cycles and no significant past medical history wants a safe, non-invasive contraceptive method that does not require a prescription. Which option is best?

    A Male condom الإجابة الصحيحة
    B Intrauterine device (IUD)
    C Combined oral contraceptive pills
    D Diaphragm
  83. 83

    A child is diagnosed with autism spectrum disorder. Which of the following is a known predisposing factor?

    A Dysfunctional family environment
    B Having a twin diagnosed with ADHD
    C History of physical abuse
    D Congenital rubella (maternal rubella infection during pregnancy) الإجابة الصحيحة
  84. 84

    A patient is diagnosed with HIV. Before starting antiretroviral therapy, which laboratory test is most important for assessing immune system status?

    A CD4 count (T-cell count) الإجابة الصحيحة
    B Viral load
    C Complete blood count
    D HIV antibody titer
  85. 85

    In diabetes insipidus, which part of the endocrine system is primarily affected?

    A Adrenal cortex
    B Adrenal medulla
    C Posterior pituitary (deficiency of ADH) الإجابة الصحيحة
    D Anterior pituitary
  86. 86

    A patient has a blood pressure of 125/82 mmHg with no other comorbidities. What is the most appropriate recommendation?

    A Lifestyle and dietary modifications (e.g., DASH diet, exercise) الإجابة الصحيحة
    B Start furosemide (diuretic)
    C Start antihypertensive medication
    D Schedule immediate cardiology consultation
  87. 87

    A conflict occurs between a head nurse and a staff member. The head nurse later addresses the issue directly with the staff member to resolve it. This management approach is called:

    A Confrontation (direct problem-solving) الإجابة الصحيحة
    B Avoidance
    C Accommodation
    D Compromise
  88. 88

    A strict vegetarian who does not eat meat, fish, or dairy is most likely to be deficient in which vitamin?

    A Vitamin B12 (found almost exclusively in animal products) الإجابة الصحيحة
    B Riboflavin
    C Vitamin D
    D Vitamin C
  89. 89

    The purified protein derivative (PPD) tuberculin skin test is administered by which route?

    A Intradermal (into the dermis, forming a wheal) الإجابة الصحيحة
    B Subcutaneous
    C Intramuscular
    D Intravenous
  90. 90

    A physician orders a dose of morphine that the nurse believes is unusually high for the patient's condition. What is the most appropriate nursing action?

    A Administer the dose as ordered
    B Contact the prescribing physician to clarify the order الإجابة الصحيحة
    C Reduce the dose by half
    D Document concerns in the chart only
  91. 91

    A patient with a pulmonary embolism (PE) would most likely present with which signs that the nurse should monitor?

    A Tachypnea and tachycardia الإجابة الصحيحة
    B Leg swelling and warmth (DVT signs, but PE presents with respiratory symptoms)
    C Bradycardia and hypotension
    D Chest pain and bradypnea
  92. 92

    A child undergoes cleft palate repair surgery. Before discharge, what is the most important advice to give the parents?

    A Feeding instructions (use of special nipples, avoiding straws, etc.) الإجابة الصحيحة
    B Bathing techniques
    C Activity restrictions
    D Pain management
  93. 93

    A nurse reviews laboratory results and identifies a critical value that requires immediate intervention. Which value is most critical?

    A Lactate 18 mg/dL (critical if >4 mmol/L) الإجابة الصحيحة
    B Prothrombin time 24 seconds (INR ~2.4, elevated but not immediately critical)
    C Hemoglobin 10 g/dL (mild anemia)
    D Platelet count 150,000 (normal)
  94. 94

    A patient presents with supraventricular tachycardia (SVT). Which ECG finding is most characteristic of this arrhythmia?

    A Narrow QRS complex with regular rhythm (usually) الإجابة الصحيحة
    B Wide QRS complex with irregular rhythm
    C Prolonged QT interval with T-wave inversion
    D Delta waves with shortened PR interval (WPW pattern)
  95. 95

    A patient who received a corneal transplant one week ago develops eye redness, pain, and blurred vision. What is the most likely cause of this complication?

    A Bacterial infection
    B Viral conjunctivitis
    C Rejection reaction الإجابة الصحيحة
    D Dry eye syndrome
  96. 96

    Evidence-based practice in nursing is best defined as:

    A Using only personal clinical experience to make decisions
    B Integrating best research evidence with clinical expertise and patient values الإجابة الصحيحة
    C Following hospital policies without question
    D Implementing the newest available treatments
  97. 97

    A female patient requests that male nurses not enter her room. What is the most appropriate nursing action?

    A Place a sign on the door requesting staff to knock before entering
    B Discuss the request with the head nurse to arrange appropriate staffing, respecting the patient's cultural/religious preference الإجابة الصحيحة
    C Ignore the request as it interferes with patient care
    D Tell the patient that male nurses are required for her care
  98. 98

    A nurse is calculating the tidal volume for a patient on mechanical ventilation. The patient weighs 70 kg. Using 6-8 mL/kg of ideal body weight, what is the appropriate tidal volume range?

    A 420-560 mL الإجابة الصحيحة
    B 350-420 mL
    C 280-350 mL
    D 560-700 mL
  99. 99

    A 15-week pregnant woman presents with a blood pressure of 210/110 mmHg. She had no known hypertension before pregnancy. What is the most likely diagnosis?

    A Chronic hypertension (pre-existing) الإجابة الصحيحة
    B Gestational hypertension (occurs after 20 weeks)
    C Preeclampsia (usually after 20 weeks)
    D HELLP syndrome
  100. 100

    A newborn at 38 weeks gestation weighs 1800 grams (approximately 4 lbs). How should this infant be classified?

    A Small for gestational age (SGA, weight below 10th percentile) الإجابة الصحيحة
    B Very low birth weight (VLBW, <1500g, this is 1800g, so low birth weight but not VLBW)
    C Appropriate for gestational age (AGA)
    D Extremely low birth weight (ELBW, <1000g)
  101. 101

    During fetal monitoring, the nurse notes early decelerations that mirror contractions. What is the most appropriate nursing intervention?

    A Change maternal position to lateral (early decelerations are usually benign, no intervention needed) الإجابة الصحيحة
    B Assess maternal heart rate
    C Administer oxygen to mother
    D Prepare for emergency delivery
  102. 102

    During the third stage of labor, which sign indicates that the placenta has separated from the uterine wall?

    A Fundal rise in the abdomen (uterus becomes globular and rises) الإجابة الصحيحة
    B Decreased vaginal bleeding
    C Shortening of the umbilical cord (cord lengthens)
    D Maternal urge to push
  103. 103

    An infant with a ventriculoperitoneal (VP) shunt presents with a bulging fontanelle, vomiting, and a high-pitched cry. These symptoms most likely indicate:

    A Shunt malfunction (increased intracranial pressure) الإجابة الصحيحة
    B Normal post-operative healing
    C Dehydration
    D Sleep deprivation
  104. 104

    For a child with a cleft lip, what positioning instruction should be given to parents after surgical repair?

    A Avoid prone positioning (to protect the suture line) الإجابة الصحيحة
    B Encourage prone positioning
    C Position only on the left side
    D Position only on the right side
  105. 105

    A child with chickenpox (varicella) is in the pediatric unit. The child should remain in isolation until:

    A All lesions are dry and crusted الإجابة الصحيحة
    B Fever subsides
    C First lesions appear
    D The child feels better
  106. 106

    A child with type 1 diabetes is planning to participate in a school sports activity. What dietary advice should the nurse provide to prevent hypoglycemia?

    A Increase carbohydrate intake before exercise الإجابة الصحيحة
    B Decrease all food intake before exercise
    C Avoid eating before exercise
    D Only drink water before exercise
  107. 107

    A patient with chronic pain has developed tolerance to morphine. The physician may consider adding which medication to manage pain and reduce opioid tolerance? (Note: Naloxone is for overdose, not tolerance.) The intended answer may be "Higher dose morphine" but that's not ideal. I will correct to "Higher dose morphine" as that is what is done for tolerance. Or consider alternative. Given options, the best is higher dose morphine. But also consider opioid rotation. I'll stick with the original correct_choice as "Naloxone" is wrong. I will change correct_choice to "Higher dose morphine" but it's not listed. Actually options: Naloxone, Higher dose morphine, Acetaminophen, Ibuprofen. Naloxone is antidote, not for tolerance. The correct management is increasing dose or rotating opioid. So I will keep "Higher dose morphine" as the intended answer. I'll correct to that.

    A Naloxone
    B Higher dose morphine الإجابة الصحيحة
    C Acetaminophen
    D Ibuprofen
  108. 108

    A charge nurse is implementing a new evidence-based protocol for wound care. Which leadership approach would be most effective for ensuring staff compliance and successful implementation?

    A Autocratic leadership with strict enforcement of new policies
    B Transformational leadership with staff education and involvement in the change process الإجابة الصحيحة
    C Laissez-faire leadership allowing staff to implement changes at their own pace
    D Transactional leadership focusing only on rewards and punishments
  109. 109

    A nurse researcher is evaluating the effectiveness of a new pain management intervention. Which research design would provide the strongest evidence for clinical practice?

    A Descriptive cross-sectional study
    B Qualitative phenomenological study
    C Randomized controlled trial (RCT) الإجابة الصحيحة
    D Case-control study
  110. 110

    A nurse is analyzing an ECG strip and observes: regular rhythm, rate 75 bpm, PR interval 0.18 seconds, QRS duration 0.08 seconds. What is the correct interpretation?

    A Normal sinus rhythm الإجابة الصحيحة
    B Sinus bradycardia
    C First-degree AV block
    D Sinus tachycardia
  111. 111

    A patient weighing 70 kg is prescribed dopamine at 5 mcg/kg/min. The concentration is 400 mg in 250 mL (1600 mcg/mL). What is the correct infusion rate in mL/hr?

    A 13.1 mL/hr الإجابة الصحيحة
    B 15.8 mL/hr
    C 18.2 mL/hr
    D 21.0 mL/hr
  112. 112

    A patient whose father recently died joins a grief support group to cope with his loss. The patient channels his emotions into helping others. Which defense mechanism is he primarily using?

    A Sublimation (channeling unacceptable impulses into socially acceptable activities) الإجابة الصحيحة
    B Displacement
    C Projection
    D Denial
  113. 113

    A postpartum woman presents on day 15 after delivery with bright red vaginal bleeding. What is the priority nursing intervention?

    A Massage the fundus and empty the bladder (to rule out uterine atony or retained products) الإجابة الصحيحة
    B Administer oxytocin medication
    C Position the client in Trendelenburg position
    D Encourage increased fluid intake
  114. 114

    A patient diagnosed with diabetes mellitus would most likely exhibit which classic symptom?

    A Excessive thirst (polydipsia) الإجابة الصحيحة
    B Decreased appetite
    C Weight gain
    D Bradycardia
  115. 115

    A patient is diagnosed with MRSA (Methicillin-resistant Staphylococcus aureus) in a surgical wound. What type of isolation precautions should be implemented?

    A Contact precautions with private room (or cohorting) الإجابة الصحيحة
    B Negative pressure room
    C Airborne precautions only
    D Standard precautions only
  116. 116

    A patient presents with fatigue, easy tiredness, and brittle spoon-shaped nails (koilonychia). These symptoms are most likely due to:

    A Iron deficiency anemia الإجابة الصحيحة
    B Malnutrition
    C Vitamin B12 deficiency
    D Hyperthyroidism
  117. 117

    A patient with a valid Do Not Resuscitate (DNR) order is currently on mechanical ventilation and stable. What is the appropriate nursing action?

    A Transfer the patient to the medical ward (if ICU level of care is no longer needed) الإجابة الصحيحة
    B Remove mechanical ventilation immediately
    C Continue aggressive treatment in ICU
    D Ignore the DNR order due to current ventilation
  118. 118

    A nurse is consistently late for shifts, causing the night shift nurse to stay overtime. Another nurse reports this issue to the charge nurse. What is the most appropriate initial action?

    A Thank the reporting nurse and privately discuss the tardiness issue with the late nurse الإجابة الصحيحة
    B Immediately suspend the tardy nurse
    C Ignore the complaint as it is not a direct concern
    D Publicly reprimand the late nurse in front of other staff
  119. 119

    A patient on lithium therapy presents with hallucinations, confusion, and severe neurological symptoms. What level of toxicity does this indicate?

    A Mild toxicity (nausea, tremor)
    B Moderate toxicity (ataxia, confusion)
    C Severe toxicity (seizures, coma, neurological symptoms) الإجابة الصحيحة
    D Therapeutic level
  120. 120

    A nurse is triaging patients in the emergency department. Which patient should be seen first?

    A Patient with chest pain (possible cardiac emergency) الإجابة الصحيحة
    B Patient with a minor laceration
    C Patient with stable vital signs
    D Patient with chronic back pain
  121. 121

    A patient with active pulmonary tuberculosis is admitted. What type of isolation precautions should be implemented?

    A Contact precautions
    B Droplet precautions
    C Airborne precautions (N95 respirator, negative pressure) الإجابة الصحيحة
    D Standard precautions
  122. 122

    A nurse manager involves staff in decision-making and allows group input before making final decisions. What leadership style does this represent?

    A Autocratic
    B Democratic الإجابة الصحيحة
    C Laissez-faire
    D Transformational
  123. 123

    A child wears glasses for vision correction. What dietary recommendation should the nurse provide to the parents to support eye health?

    A Foods rich in vitamin A الإجابة الصحيحة
    B Foods rich in vitamin C
    C Foods rich in vitamin D
    D Foods rich in vitamin K
  124. 124

    A child presents with a vesicular rash, fever, and malaise. The nurse suspects chickenpox. These symptoms are most likely due to:

    A Measles
    B Chickenpox (varicella) الإجابة الصحيحة
    C Scarlet fever
    D Fifth disease
  125. 125

    Which task is most appropriate for a registered nurse to delegate to unlicensed assistive personnel (UAP)?

    A Medication administration
    B Patient assessment
    C Daily hygiene activities (bathing, oral care, toileting) الإجابة الصحيحة
    D Care plan development
  126. 126

    A nurse observes an ECG rhythm showing chaotic, irregular waveforms with no identifiable P waves, QRS complexes, or T waves. What rhythm does this represent?

    A Atrial fibrillation
    B Ventricular tachycardia
    C Ventricular fibrillation الإجابة الصحيحة
    D Asystole
  127. 127

    A nurse is administering the BCG (Bacillus Calmette-Guérin) vaccine to an infant. What is the correct route of administration?

    A Intradermal الإجابة الصحيحة
    B Subcutaneous
    C Intramuscular
    D Intravenous
  128. 128

    A pregnant woman in the third trimester presents with painless vaginal bleeding. Ultrasound shows the placenta completely covers the internal cervical os. This type of placenta previa is classified as:

    A Marginal placenta previa
    B Partial placenta previa
    C Complete (total) placenta previa الإجابة الصحيحة
    D Low-lying placenta
  129. 129

    A child undergoes a tonsillectomy. In the immediate postoperative period, what is the optimal positioning to protect the airway and allow drainage?

    A Supine with head extended
    B Prone position
    C Semi-Fowler position with head turned to the side الإجابة الصحيحة
    D Trendelenburg position
  130. 130

    A newborn is scheduled for tracheoesophageal fistula (TEF) repair. What is the priority preoperative nursing intervention?

    A Keep the infant NPO (nothing by mouth) الإجابة الصحيحة
    B Administer prophylactic antibiotics
    C Position in Trendelenburg
    D Start IV fluids immediately
  131. 131

    A mother presents with vaginal bleeding two weeks after delivery. This type of bleeding is classified as:

    A Primary postpartum hemorrhage (within 24 hours)
    B Early postpartum hemorrhage (within 24 hours)
    C Late postpartum hemorrhage (24 hours to 6 weeks) الإجابة الصحيحة
    D Secondary lochia
  132. 132

    A patient with placental abruption (abruptio placentae) presents with a rigid, board-like abdomen. Which sign is most characteristic of this condition?

    A Painless vaginal bleeding
    B Rigid, board-like abdomen (due to concealed hemorrhage and uterine irritability) الإجابة الصحيحة
    C Soft, boggy uterus
    D Intermittent cramping
  133. 133

    A nurse assesses a newborn's umbilical cord stump and notes redness, warmth, and purulent drainage at the base. This finding indicates:

    A Dry, dark cord stump (normal)
    B Reddened base around umbilicus (possible infection, omphalitis) الإجابة الصحيحة
    C Clear serous drainage (normal during healing)
    D Normal cord separation
  134. 134

    During pregnancy, hemodilution occurs primarily due to:

    A Decreased red blood cell production
    B Increased plasma volume (greater increase than RBC mass) الإجابة الصحيحة
    C Iron deficiency
    D Decreased cardiac output
  135. 135

    Laboratory results for a patient with hyperthyroidism will typically show:

    A Increased TSH levels
    B Decreased TSH levels (negative feedback) الإجابة الصحيحة
    C Normal TSH levels
    D Fluctuating TSH levels
  136. 136

    Even small amounts of hypoxia in a patient following brain surgery can cause:

    A Decreased blood pressure
    B Increased intracranial pressure (cerebral vasodilation) الإجابة الصحيحة
    C Improved neurological function
    D Reduced cerebral edema
  137. 137

    A patient is taking warfarin for atrial fibrillation. Which laboratory test should the nurse monitor to evaluate the effectiveness of the medication?

    A International Normalized Ratio (INR) الإجابة الصحيحة
    B Hemoglobin level
    C White blood cell count
    D Platelet count
  138. 138

    Which hormone is primarily responsible for endometrial proliferation and breast development during puberty?

    A Estrogen الإجابة الصحيحة
    B Progesterone
    C Follicle-stimulating hormone (FSH)
    D Luteinizing hormone (LH)
  139. 139

    A mother with type 1 diabetes has just delivered a healthy newborn. How should her insulin dosage be adjusted in the immediate postpartum period?

    A Decrease the insulin dosage (insulin requirements drop dramatically after delivery) الإجابة الصحيحة
    B Increase the insulin dosage
    C Keep the dosage the same
    D Discontinue insulin temporarily
  140. 140

    An infant is covered with a blanket. Heat loss from the infant to the blanket and surrounding air occurs primarily through which two mechanisms?

    A Conduction (direct contact with blanket) and radiation (to cooler surfaces) الإجابة الصحيحة
    B Elaboration and radiation
    C Conduction and evaporation
    D Convection and evaporation
  141. 141

    A patient after rectal surgery (e.g., hemorrhoidectomy) complains of perineal pain. What comfort measure is most appropriate?

    A Sitz bath (warm water soaks) الإجابة الصحيحة
    B Ice packs
    C Heating pad
    D Prone positioning
  142. 142

    A patient presents with shock symptoms following a spinal cord injury, but exhibits bradycardia instead of tachycardia. Which type of shock is most likely?

    A Neurogenic shock (loss of sympathetic tone, bradycardia and hypotension) الإجابة الصحيحة
    B Hypovolemic shock (tachycardia)
    C Cardiogenic shock (tachycardia or bradycardia)
    D Septic shock (tachycardia, fever)
  143. 143

    A postpartum mother continues to have heavy bleeding despite uterine massage and ensuring an empty bladder. The nurse's priority action is to:

    A Notify the physician immediately الإجابة الصحيحة
    B Continue uterine massage
    C Administer pain medication
    D Encourage ambulation
  144. 144

    A nurse assesses a postpartum patient on day 2. Which finding should be reported to the physician immediately?

    A Lochia rubra with large blood clots (greater than a quarter) or saturating one pad per hour الإجابة الصحيحة
    B Lochia rubra (normal for days 1-3)
    C Soft uterus (should be firm; boggy uterus indicates atony)
    D Breast engorgement (common on day 2-3)
  145. 145

    A patient with lung cancer has started chemotherapy and is unable to finish meals. The nurse suspects the most likely cause of decreased appetite is:

    A Altered taste sensation (dysgeusia from chemotherapy) الإجابة الصحيحة
    B Difficulty swallowing
    C Nausea and vomiting
    D Dental problems
  146. 146

    A patient presents with back pain and a pulsatile abdominal mass. These are characteristic symptoms of:

    A Aortic aneurysm (abdominal aortic aneurysm) الإجابة الصحيحة
    B Chest pain and shortness of breath
    C Leg pain and swelling
    D Headache and dizziness
  147. 147

    A nurse reviews an ECG strip showing a heart rate of 55 beats per minute with regular P waves followed by QRS complexes. How should this rhythm be documented?

    A Sinus bradycardia الإجابة الصحيحة
    B Sinus tachycardia
    C Normal sinus rhythm
    D Sinus arrhythmia
  148. 148

    A child with suspected appendicitis has abdominal pain when the nurse flexes the right hip and internally rotates the thigh. This finding is known as:

    A McBurney sign (tenderness at McBurney point)
    B Rovsing sign (pain in RLQ with palpation of LLQ)
    C Obturator sign الإجابة الصحيحة
    D Psoas sign
  149. 149

    Combined oral contraceptives primarily prevent pregnancy by:

    A Thickening cervical mucus
    B Preventing ovulation (suppression of FSH/LH) الإجابة الصحيحة
    C Altering endometrial lining
    D Reducing sperm motility
  150. 150

    A patient presents with fatigue, diarrhea, fever, and dry cough. These symptoms are most consistent with which viral illness?

    A Influenza
    B Gastroenteritis
    C COVID-19 الإجابة الصحيحة
    D Pneumonia
  151. 151

    An infant with cleft lip and palate is being fed before surgical repair. Which position is optimal to reduce nasal regurgitation and aspiration?

    A Supine position
    B Side-lying position
    C Upright position (semi-upright or sitting) الإجابة الصحيحة
    D Prone position
  152. 152

    A newborn is diagnosed with esophageal atresia. What is the priority preoperative intervention?

    A Administer antibiotics
    B Continuous suction with a double-lumen catheter (Replogle tube) to prevent aspiration الإجابة الصحيحة
    C Position in Trendelenburg
    D Begin enteral feeding
  153. 153

    A newborn with esophageal atresia presents with which classic symptoms?

    A Vomiting and diarrhea
    B Coughing, choking, and cyanosis during the first feeding الإجابة الصحيحة
    C Fever and lethargy
    D Abdominal distension and constipation
  154. 154

    A child with nephrotic syndrome presents with generalized edema and frothy urine. Which clinical manifestations are characteristic of this condition?

    A Hematuria and oliguria
    B Edema and proteinuria الإجابة الصحيحة
    C Fever and flank pain
    D Hypertension and azotemia
  155. 155

    A patient is taking isoniazid (INH) for latent tuberculosis. The nurse should monitor for which common side effect?

    A Hepatotoxicity
    B Peripheral neuropathy (due to vitamin B6 depletion) الإجابة الصحيحة
    C Ototoxicity
    D Nephrotoxicity
  156. 156

    A patient is prescribed isoniazid (INH). To prevent peripheral neuropathy, the nurse should expect the physician to prescribe which vitamin?

    A Vitamin B1 (thiamine)
    B Vitamin B6 (pyridoxine) الإجابة الصحيحة
    C Vitamin B12 (cobalamin)
    D Vitamin C
  157. 157

    A patient undergoes intravenous pyelography (IVP). After the procedure, what is the priority nursing intervention to prevent contrast-induced nephropathy?

    A Maintain strict bed rest for 24 hours
    B Encourage increased fluid intake الإجابة الصحيحة
    C Monitor vital signs every 15 minutes
    D Apply ice packs to the injection site
  158. 158

    A child with nephrotic syndrome is in remission. To prevent recurrence, the nurse teaches the parents to prioritize which action?

    A Teach daily urine protein monitoring (dipstick)
    B Ensure strict adherence to prescribed medications (e.g., corticosteroids) الإجابة الصحيحة
    C Implement a low-sodium diet
    D Encourage increased physical activity
  159. 159

    A child presents with right lower quadrant pain, nausea, and low-grade fever, suspected of appendicitis. What is the first nursing action?

    A Administer pain medication as ordered
    B Prepare the patient for an ultrasound or CT scan الإجابة الصحيحة
    C Apply heat to the abdomen
    D Encourage oral fluid intake
  160. 160

    A patient with hepatic encephalopathy received lactulose enemas, and ammonia levels are now normal, but the patient remains comatose. The nurse suspects the patient may have taken which substance?

    A Acetaminophen overdose
    B Glutamine supplements (can increase ammonia in brain) الإجابة الصحيحة
    C Alcohol withdrawal medication
    D High-protein supplements
  161. 161

    A nurse is teaching nursing students about hormone pathways. Which statement correctly describes the synthesis and secretion of oxytocin?

    A Oxytocin is both synthesized and secreted by the posterior pituitary gland
    B Oxytocin is synthesized in the hypothalamus and secreted by the posterior pituitary gland الإجابة الصحيحة
    C Oxytocin is synthesized and secreted by the anterior pituitary gland
    D Oxytocin is produced and secreted directly by the adrenal medulla
  162. 162

    A graph shows that as DTP and measles vaccination rates increased from 1986 to 1999, mortality rates from these diseases decreased. What relationship is demonstrated?

    A As vaccination rates increase, the number of deaths increases
    B As vaccination rates increase, the number of deaths decreases الإجابة الصحيحة
    C Vaccination rates have no effect on the number of deaths
    D Death rates fluctuate independently of vaccination rates
  163. 163

    A nurse is conducting a prenatal class for women at 39 weeks gestation. Which topic should be the primary focus?

    A Pain management strategies during labor الإجابة الصحيحة
    B Proper nutrition during pregnancy
    C Exercise routines for the third trimester
    D Signs of postpartum depression
  164. 164

    A pregnant woman with gestational diabetes demonstrates understanding of her condition when she states:

    A I need to monitor my blood sugar levels regularly
    B I'm at risk of having a large for gestational age baby (macrosomia) الإجابة الصحيحة
    C I should avoid all carbohydrates in my diet
    D I can stop checking my glucose after delivery
  165. 165

    A nurse is teaching pregnant women about red flags that may indicate potential fetal loss. Which sign should be reported immediately?

    A Headache
    B Vaginal bleeding الإجابة الصحيحة
    C Mild nausea
    D Leg cramps
  166. 166

    A patient is taking progestin-only oral contraceptives (mini-pills). Which common side effect should the nurse discuss?

    A Spotting (irregular bleeding) الإجابة الصحيحة
    B Weight gain
    C Severe headaches
    D Breast tenderness
  167. 167

    A patient wants to take nitroglycerin every 3 minutes instead of every 5 minutes because an AI chatbot suggested it. What is the nurse's best response?

    A Agree with the AI recommendation
    B Explain the correct dosing protocol (every 5 minutes for up to 3 doses) and emphasize not relying on AI for medication dosing الإجابة الصحيحة
    C Tell the patient to consult their physician only
    D Ignore the patient's concern
  168. 168

    A mother brings her child who is prescribed iron supplements for iron deficiency anemia. What advice should the nurse provide to enhance absorption?

    A Give the iron supplement with citrus juice (vitamin C enhances absorption) الإجابة الصحيحة
    B Administer the iron supplement with milk
    C Take the iron supplement with antacids
    D Give the iron supplement with tea or coffee
  169. 169

    A patient with iron deficiency anemia is non-compliant with her prescribed iron therapy. What potential consequence should the nurse discuss with the patient if non-compliance continues?

    A Decreased cognitive function (fatigue, poor concentration) الإجابة الصحيحة
    B Increased bone density
    C Improved energy levels
    D Enhanced immune response
  170. 170

    Vaccination for Hajj pilgrims to prevent meningococcal meningitis is an example of which level of prevention?

    A Primary prevention الإجابة الصحيحة
    B Secondary prevention
    C Tertiary prevention
    D Quaternary prevention
  171. 171

    A child with nephrotic syndrome may present with which symptom?

    A Hypotension
    B Abdominal pain (due to ascites or edema) الإجابة الصحيحة
    C Hypertension (can occur but not characteristic)
    D Bradycardia
  172. 172

    A female patient with no symptoms tests positive for Chlamydia. This type of infection is considered:

    A Subclinical (asymptomatic infection) الإجابة الصحيحة
    B Acute
    C Chronic
    D Latent
  173. 173

    According to WHO recommendations, how many antenatal visits are recommended during a normal pregnancy?

    A 6-8 visits
    B 8-10 visits الإجابة الصحيحة
    C 10-12 visits
    D 12-14 visits
  174. 174

    A cancer patient has cachexia documented in the chart. During assessment, the nurse expects to observe:

    A Muscle wasting (severe weight loss, muscle atrophy) الإجابة الصحيحة
    B Fluid retention
    C Weight gain
    D Increased appetite
  175. 175

    A public health nurse is planning strategies to reduce the spread of tuberculosis. Which method is most effective at the community level?

    A BCG vaccine (in high-burden countries) الإجابة الصحيحة
    B Isolation precautions for active cases
    C Antibiotic prophylaxis for latent cases
    D Contact tracing
  176. 176

    Agranulocytosis (severe neutropenia) is a rare but serious side effect most commonly associated with which type of medication?

    A Atypical antipsychotics (e.g., clozapine) الإجابة الصحيحة
    B Beta blockers
    C ACE inhibitors
    D Proton pump inhibitors
  177. 177

    A child presents with acute abdominal pain, vomiting, and red jelly-like stool. These findings are classic for:

    A Red jelly-like stool (intussusception) الإجابة الصحيحة
    B Projectile vomiting (pyloric stenosis)
    C High fever
    D Decreased bowel sounds
  178. 178

    A child with Hirschsprung disease typically presents with which primary symptoms?

    A Constipation and failure to thrive الإجابة الصحيحة
    B Diarrhea and weight loss
    C Vomiting and dehydration
    D Abdominal pain and fever
  179. 179

    A nurse notices an increasing number of pressure injuries on a ward and reports the trend to the manager for corrective action. This action represents:

    A Advocacy
    B Case management
    C Quality improvement الإجابة الصحيحة
    D Risk management
  180. 180

    A patient is scheduled for a hysterectomy. Who is primarily responsible for explaining the procedure, risks, and obtaining informed consent?

    A Staff nurse
    B Physician (surgeon) الإجابة الصحيحة
    C Social worker
    D Nurse manager
  181. 181

    A patient with schizophrenia reports an inability to experience pleasure (anhedonia). This symptom is classified as:

    A Positive symptom (hallucinations, delusions)
    B Negative symptom (affective flattening, anhedonia, avolition) الإجابة الصحيحة
    C Anxiety disorder
    D Manic episode
  182. 182

    A patient with Addison disease (adrenal insufficiency) typically presents with which characteristic skin finding?

    A Hyperpigmentation (bronze skin due to increased ACTH) الإجابة الصحيحة
    B Pale skin
    C Moon face (Cushing syndrome)
    D Buffalo hump (Cushing syndrome)
  183. 183

    A patient with Cushing syndrome (hypercortisolism) typically presents with which characteristic physical finding?

    A Moon face (rounded, red, full face) الإجابة الصحيحة
    B Weight loss
    C Hyperpigmentation (Addison disease)
    D Muscle hypertrophy
  184. 184

    A newborn is delivered to a mother with gestational diabetes mellitus (GDM). What is the most likely complication to expect in this newborn immediately after birth?

    A Hypoglycemia الإجابة الصحيحة
    B Hyperglycemia
    C Hyperthermia
    D Bradycardia
  185. 185

    A large-for-gestational-age newborn is born to a mother with gestational diabetes. What should be the priority monitoring focus for this newborn?

    A Blood glucose levels الإجابة الصحيحة
    B Blood pressure
    C Respiratory rate
    D Heart rate
  186. 186

    A premature newborn is suspected of having Respiratory Distress Syndrome (RDS). Which clinical signs would confirm this diagnosis?

    A Nasal flaring and tachypnea الإجابة الصحيحة
    B Bradycardia and hypertension
    C Fever and increased appetite
    D Normal respiratory rate and pink color
  187. 187

    A nursing student asks a nurse for her password and ID to access the system to obtain patient information. How would this request be classified?

    A Privacy violation
    B Security breach (improper access attempt)
    C Authorization violation الإجابة الصحيحة
    D Confidentiality breach
  188. 188

    A physician wants to use a nurse's logged-in computer to view lab results. What should the nurse do?

    A Allow the physician to use her login credentials
    B Log out and allow the physician to log in with his own credentials الإجابة الصحيحة
    C Share the screen while remaining logged in
    D Ask the physician to wait until she finishes her work
  189. 189

    Several nurses request assistance from the head nurse regarding a patient care issue. This represents which type of communication?

    A Downward communication (manager to staff)
    B Upward communication (staff to manager) الإجابة الصحيحة
    C Lateral communication (peer to peer)
    D Diagonal communication (across different levels and departments)
  190. 190

    A patient has undergone cardiac catheterization via the femoral artery. What is the appropriate position for this patient immediately post-procedure?

    A Lying flat with the affected leg straight (to prevent bleeding) الإجابة الصحيحة
    B High Fowler's position
    C Trendelenburg position
    D Semi-Fowler's position
  191. 191

    A patient has burns on both arms and the face. What is the best location to assess the pulse in this patient?

    A Radial pulse (may be burned or inaccessible)
    B Carotid pulse (in the neck, usually not burned)
    C Femoral pulse (groin area, often spared) الإجابة الصحيحة
    D Pedal pulse
  192. 192

    A nurse is caring for patients with lower extremity amputations. What is the correct positioning approach?

    A Above knee amputation: elevate stump on pillow; Below knee amputation: avoid pillow elevation and apply ice as ordered to reduce edema الإجابة الصحيحة
    B Above knee amputation: keep flat without pillow; Below knee amputation: elevate on multiple pillows
    C Both above knee and below knee amputations should be elevated on pillows continuously
    D Both above knee and below knee amputations should avoid pillow elevation
  193. 193

    A nurse palpates an olive-like mass in the epigastric area of a 6-week-old infant who has been projectile vomiting. This finding is most characteristic of:

    A Intussusception (sausage-shaped mass in RUQ)
    B Pyloric stenosis (olive-shaped mass in epigastrium) الإجابة الصحيحة
    C Hirschsprung disease (distended abdomen)
    D Gastroesophageal reflux
  194. 194

    A patient with eclampsia is receiving magnesium sulfate. What is the primary mechanism of action of this medication?

    A Reduces blood pressure by vasodilation
    B Prevents seizures by CNS depression (anticonvulsant effect) الإجابة الصحيحة
    C Increases urine output by diuretic effect
    D Stabilizes cardiac rhythm by electrolyte balance
  195. 195

    A pregnant client is diagnosed with preeclampsia. Which clinical findings would the nurse expect to assess?

    A High blood pressure with increased blood glucose
    B High blood pressure with proteinuria الإجابة الصحيحة
    C Low blood pressure with peripheral edema
    D Normal blood pressure with severe headaches
  196. 196

    A nurse is administering antibiotics to a patient when she receives a call about another patient experiencing severe pain. What is the most appropriate immediate action?

    A Write a brief note and complete full documentation later
    B Tell the patient to wait 10 minutes while finishing current task
    C Leave current patient to immediately assess the patient in pain
    D Complete the antibiotic administration before responding to the call (finish the task at hand, then respond) الإجابة الصحيحة
  197. 197

    A mother in the delivery room has a hemoglobin level of 6 g/dL. The nurse should monitor this client primarily for risk of:

    A Excessive bleeding (severe anemia can contribute to postpartum hemorrhage)
    B Hypoxia (low oxygen carrying capacity) الإجابة الصحيحة
    C Infection
    D Hypertension
  198. 198

    A primigravida in active labor is experiencing severe pain during the first stage of labor. What is the most appropriate pain management option at this stage?

    A Epidural anesthesia (commonly used for pain relief in active labor) الإجابة الصحيحة
    B Opioid analgesics (can be used but may cause neonatal depression)
    C Spinal anesthesia (for cesarean section or late labor)
    D General anesthesia (rare for vaginal delivery)
  199. 199

    What hormonal changes occur near the onset of labor?

    A Increased progesterone and decreased prostaglandins
    B Decreased progesterone and increased prostaglandins الإجابة الصحيحة
    C Increased estrogen and decreased oxytocin
    D Decreased cortisol and increased aldosterone
  200. 200

    A 7-year-old child weighing 25 kg requires daily maintenance fluids. Using the Holliday-Segar method (4-2-1 rule), the appropriate daily fluid requirement is:

    A 1200 mL/day
    B 1400 mL/day
    C 1600 mL/day الإجابة الصحيحة
    D 1800 mL/day
  201. 201

    During a physical examination of a male infant, the nurse notes that one testis is not palpable in the scrotum. What is the most likely diagnosis?

    A Hydrocele (fluid-filled swelling)
    B Varicocele (varicose vein)
    C Cryptorchidism (undescended testis) الإجابة الصحيحة
    D Testicular torsion (acute pain, swelling)
  202. 202

    A patient is diagnosed with measles (rubeola). What type of isolation precautions should be implemented?

    A Contact precautions
    B Droplet precautions
    C Airborne precautions (N95 respirator) الإجابة الصحيحة
    D Standard precautions only
  203. 203

    A patient presents with a widespread maculopapular rash on the palms and soles, characteristic of secondary syphilis. This rash indicates which stage of syphilis?

    A Primary stage (chancre)
    B Secondary stage (rash, mucous patches) الإجابة الصحيحة
    C Latent stage (asymptomatic)
    D Tertiary stage (gummas, neurological symptoms)
  204. 204

    A patient exhibits excessive attention-seeking behavior, emotional instability, and theatrical mannerisms. These symptoms are most consistent with which personality disorder?

    A Borderline personality disorder (instability, impulsivity, abandonment fear)
    B Narcissistic personality disorder (grandiosity, need for admiration)
    C Histrionic personality disorder (dramatic, attention-seeking, shallow emotions) الإجابة الصحيحة
    D Antisocial personality disorder (disregard for rights of others)
  205. 205

    A patient with schizophrenia is taking antipsychotic medication and develops muscle rigidity. What condition is the patient most likely experiencing?

    A Tardive dyskinesia (late onset, involuntary movements)
    B Extrapyramidal side effects (EPS) such as dystonia, akathisia, pseudoparkinsonism الإجابة الصحيحة
    C Parkinson disease (unrelated to medication)
    D Neuroleptic malignant syndrome (fever, rigidity, autonomic instability)
  206. 206

    A patient with hebephrenic (disorganized) schizophrenia is most likely to exhibit which symptom?

    A Flat affect
    B Inappropriate affect and disorganized behavior الإجابة الصحيحة
    C Paranoid delusions
    D Catatonic behavior
  207. 207

    A patient reports hearing voices that tell him to harm himself. What is the priority nursing diagnosis?

    A Risk for violence: self-directed related to command hallucinations الإجابة الصحيحة
    B Disturbed thought processes related to psychosis
    C Social isolation related to auditory hallucinations
    D Risk for violence related to auditory hallucinations
  208. 208

    A patient experiencing a panic attack is hyperventilating. Which acid-base imbalance is most likely to occur?

    A Respiratory acidosis (hypoventilation)
    B Metabolic acidosis
    C Respiratory alkalosis (hyperventilation causes low CO2) الإجابة الصحيحة
    D Metabolic alkalosis
  209. 209

    How should a nurse assess skin turgor in a neonate to evaluate for dehydration?

    A Pinch the skin on the forehead
    B Pinch the skin on the abdomen using two fingers الإجابة الصحيحة
    C Pinch the skin on the chest
    D Pinch the skin on the thigh
  210. 210

    A child presents with red jelly-like stools suggesting intussusception. What is the most appropriate initial diagnostic and therapeutic intervention?

    A Plain abdominal X-ray
    B Ultrasonography with possible pneumatic or hydrostatic reduction الإجابة الصحيحة
    C CT scan of the abdomen
    D Barium enema
  211. 211

    During which stage of team development do members typically experience conflict, arguments, and resistance to group tasks?

    A Forming (orientation)
    B Storming (conflict and competition) الإجابة الصحيحة
    C Norming (cohesion and cooperation)
    D Performing (productive work)
  212. 212

    A patient is shouting and standing very close to the nurse because he did not receive his dinner. What is the best therapeutic response?

    A Please calm down; I will call the kitchen to bring your food in minutes الإجابة الصحيحة
    B We are sorry, but this is a morning shift problem
    C You need to step back and lower your voice immediately
    D Let me get the charge nurse to handle this situation
  213. 213

    Sudden cases of meningitis appearing during the Hajj season in a specific region would be classified as:

    A Endemic (constant presence in a region)
    B Epidemic (sudden increase in a specific area) الإجابة الصحيحة
    C Pandemic (global spread)
    D Sporadic (isolated cases)
  214. 214

    A patient is experiencing a panic attack with hyperventilation and chest tightness. What is the priority nursing intervention?

    A Provide a calm, quiet environment الإجابة الصحيحة
    B Administer oxygen with antidepressant medications
    C Encourage rapid deep breathing exercises
    D Immediately sedate the patient
  215. 215

    A patient is crying and refuses to answer when the nurse asks why. What should the nurse do?

    A Remain with the patient in silence (offering presence) الإجابة الصحيحة
    B Leave the patient to give privacy
    C Insist the patient explain their feelings
    D Call the family to find out what is wrong
  216. 216

    A 28-year-old patient presents with sudden unilateral vision loss, eye pain with movement, and central scotoma. Ophthalmologic examination reveals optic disc swelling. What is the most likely underlying condition associated with optic neuritis?

    A Multiple sclerosis (optic neuritis is a common first presentation) الإجابة الصحيحة
    B Diabetic retinopathy
    C Hypertensive retinopathy
    D Glaucoma
  217. 217

    A 65-year-old hypertensive patient presents with severe back pain and abdominal pain. On physical examination, a pulsatile abdominal mass is palpated. What is the most likely diagnosis?

    A Aortic aneurysm (abdominal aortic aneurysm) الإجابة الصحيحة
    B Myocardial infarction
    C Renal colic
    D Peptic ulcer disease
  218. 218

    A 68-year-old chronic smoker presents with progressive dyspnea and chronic productive cough. Physical examination reveals an increased anteroposterior chest diameter giving a barrel-shaped appearance. What is the most likely diagnosis?

    A Emphysema (barrel chest is characteristic) الإجابة الصحيحة
    B Pneumonia
    C Pulmonary edema
    D Pleural effusion
  219. 219

    A nurse is caring for a child who just underwent a tonsillectomy. What is the most appropriate initial positioning for this patient?

    A Position the child supine with head elevated
    B Position the child in prone position to facilitate drainage الإجابة الصحيحة
    C Position the child in Trendelenburg position
    D Position the child in high Fowler's position
  220. 220

    After fertilization, the zygote typically enters the uterus for implantation at which stage?

    A 2-4 days (as a morula or early blastocyst)
    B 6-10 days (implantation occurs around day 6-10 after ovulation) الإجابة الصحيحة
    C 1-2 days (still in fallopian tube)
    D 10-14 days
  221. 221

    A nurse involves parents in teaching and educating them about their child's condition. This nursing action represents which ethical principle?

    A Autonomy
    B Beneficence
    C Empowerment (enabling patients and families to take control of their health) الإجابة الصحيحة
    D Justice
  222. 222

    An elderly cancer patient decides to discontinue treatment despite the nurse's recommendations. The nurse respects the patient's decision. This demonstrates which ethical principle?

    A Beneficence (doing good)
    B Non-maleficence (do no harm)
    C Autonomy (respect for patient's self-determination) الإجابة الصحيحة
    D Justice (fairness)
  223. 223

    A nurse is performing a painful procedure on a child. Which intervention would be most appropriate to reduce the child's pain and anxiety?

    A Administer sedation before the procedure
    B Allow the child to choose items for distraction during the procedure الإجابة الصحيحة
    C Restrain the child to complete the procedure quickly
    D Perform the procedure without preparation
  224. 224

    A nurse reviews a normal CTG (cardiotocography) tracing. What is the most appropriate nursing action?

    A Notify the physician immediately
    B Continue routine monitoring and reassure the patient الإجابة الصحيحة
    C Reposition the patient
    D Administer oxygen
  225. 225

    What is the primary purpose of a sharps container in healthcare settings?

    A Store medications safely
    B Dispose of used needles and sharp instruments الإجابة الصحيحة
    C Store sterile instruments
    D Collect laboratory specimens
  226. 226

    After administering an intramuscular injection, what should the nurse avoid doing?

    A Apply gentle pressure to the injection site
    B Massage the injection site vigorously (can cause tissue damage and alter absorption) الإجابة الصحيحة
    C Monitor for adverse reactions
    D Document the injection
  227. 227

    To prevent infection in a TPN triple-lumen catheter, what is the best practice?

    A Dedicate one lumen exclusively for TPN الإجابة الصحيحة
    B Change dressing daily (should be sterile every 3-7 days depending on policy)
    C Use any of the three lumens interchangeably daily
    D Rotate lumens every shift
  228. 228

    Hashimoto thyroiditis (chronic autoimmune thyroiditis) can cause which neurological symptom if untreated?

    A Disorientation (severe hypothyroidism can cause myxedema, confusion) الإجابة الصحيحة
    B Seizures
    C Paralysis
    D Memory loss
  229. 229

    By what percentage does blood volume increase during pregnancy?

    A 30-35%
    B 40-50% (plasma volume increases by about 40-50%) الإجابة الصحيحة
    C 55-60%
    D 20-25%
  230. 230

    A patient with diphtheria requires which type of isolation precautions?

    A Contact precautions
    B Droplet precautions الإجابة الصحيحة
    C Airborne precautions
    D Standard precautions only
  231. 231

    A child presents with growth retardation, splenomegaly, hepatomegaly, and skeletal abnormalities. Which condition is most likely?

    A Sickle cell disease
    B Thalassemia (major or intermedia) الإجابة الصحيحة
    C Iron deficiency anemia
    D Hemophilia
  232. 232

    When administering magnesium sulfate to a pregnant patient, which assessments are essential to monitor for toxicity? (Select all that apply) – The question format expects a single answer, but I will provide the correct combination as per the options.

    A Deep tendon reflexes, respiratory rate, urinary output الإجابة الصحيحة
    B Blood pressure only
    C Fetal heart rate only
    D Temperature and pulse only
  233. 233

    When a nurse provides information to a family so they can make healthcare decisions, this represents:

    A Enabling
    B Empowering الإجابة الصحيحة
    C Advocating
    D Counseling
  234. 234

    A patient who is overly focused on past events during therapy and avoids discussing present issues is demonstrating:

    A Resistance (unconscious defense against exploring certain topics) الإجابة الصحيحة
    B Counter-resistance
    C Transference (projecting feelings onto therapist)
    D Counter-transference (therapist's feelings toward patient)
  235. 235

    A pregnant woman at 39 weeks gestation presents with ruptured membranes but no contractions. What is the priority nursing action?

    A Notify the physician immediately
    B Prepare for immediate cesarean section
    C Attach CTG to monitor fetal heart rate (assess fetal well-being after rupture of membranes) الإجابة الصحيحة
    D Position patient in Trendelenburg
  236. 236

    A patient develops bone and joint pain, fever, and malaise weeks after cardiac surgery. This most likely represents:

    A Cardiac tamponade
    B Postcardiotomy syndrome (an inflammatory reaction) الإجابة الصحيحة
    C Infective endocarditis
    D Pulmonary embolism
  237. 237

    Documentation in nursing practice is:

    A An optional activity when time permits
    B A hindrance to patient safety and self-care
    C An integral part of every nurse's job (legal and professional requirement) الإجابة الصحيحة
    D Only required for high-risk patients
  238. 238

    A child with a respiratory infection produces yellow sputum and has abnormal breath sounds. Which adventitious sound would most likely be heard?

    A Wheezing (high-pitched, musical)
    B Rhonchi (low-pitched, snoring, often clears with cough) الإجابة الصحيحة
    C Stridor (harsh, inspiratory, upper airway)
    D Fine crackles (high-pitched, interstitial fluid)
  239. 239

    A patient taking haloperidol (an antipsychotic) develops pseudoparkinsonism (tremor, rigidity, bradykinesia). This is a common side effect of which type of medication?

    A Pseudoparkinsonism (extrapyramidal symptom) الإجابة الصحيحة
    B Hypertension
    C Bradycardia
    D Hyperglycemia
  240. 240

    A patient with active pulmonary tuberculosis is admitted. What type of isolation is required?

    A Contact precautions
    B Droplet precautions
    C Airborne precautions الإجابة الصحيحة
    D Standard precautions
  241. 241

    The primary method to prevent tuberculosis transmission at the community level in high-burden countries is:

    A BCG vaccine الإجابة الصحيحة
    B N95 respirator masks
    C Hand hygiene
    D Surface disinfection
  242. 242

    A nurse is discussing a patient's private information in the hallway. What should you remind her about?

    A Patient autonomy
    B Confidentiality الإجابة الصحيحة
    C Informed consent
    D Documentation standards
  243. 243

    Two nurses are having a disagreement about patient care in front of others. What is the most appropriate action?

    A Report them to the supervisor immediately
    B Talk with them privately about concerns (address conflict discreetly) الإجابة الصحيحة
    C Document the incident in writing
    D Ignore the situation
  244. 244

    A patient's gown becomes soiled during a procedure. What should the nurse do?

    A Continue with the procedure
    B Document the incident
    C Go and change the gown (maintain patient dignity and hygiene) الإجابة الصحيحة
    D Ask the patient to change it
  245. 245

    What is the antidote for magnesium sulfate toxicity?

    A Calcium gluconate الإجابة الصحيحة
    B Naloxone
    C Flumazenil
    D Atropine
  246. 246

    An infant with pyloric stenosis presents with projectile vomiting. What is the primary symptom of this condition?

    A Diarrhea
    B Vomiting (non-bilious, projectile) الإجابة الصحيحة
    C Fever
    D Constipation
  247. 247

    Which patient should not receive live vaccines (e.g., MMR, varicella, yellow fever)?

    A Patient with diabetes
    B Patient taking high-dose steroids (immunosuppressed) الإجابة الصحيحة
    C Patient with hypertension
    D Elderly patient
  248. 248

    A postpartum woman has a contracted (firm) uterus but continues to bleed heavily. What is the most likely cause?

    A Uterine atony (uterus would be boggy)
    B Retained placenta
    C Perineal or vaginal lacerations الإجابة الصحيحة
    D Coagulation disorder
  249. 249

    A patient with spina bifida (myelomeningocele) has a surgical wound. What type of dressing is most appropriate to keep the wound moist and promote healing?

    A Dry sterile dressing
    B Moist (non-adherent) dressing الإجابة الصحيحة
    C Pressure dressing
    D No dressing needed
  250. 250

    A patient has eye pain with yellow-green discharge. What should you advise?

    A Apply warm compresses
    B Avoid touching the eyes (prevent spread of infection) الإجابة الصحيحة
    C Use antibiotic drops (prescribed)
    D Flush with normal saline
  251. 251

    What is the primary purpose of a Pap smear (Papanicolaou test)?

    A Detect ovarian cancer
    B Detect cervical cancer (precancerous and cancerous cells) الإجابة الصحيحة
    C Diagnose pregnancy
    D Screen for STDs
  252. 252

    During pregnancy, which hormone is primarily secreted by the placenta to maintain the uterine lining?

    A Estrogen
    B Progesterone الإجابة الصحيحة
    C Oxytocin
    D Prolactin
  253. 253

    Which strategy is most effective in reducing the spread of tuberculosis in the community?

    A Implementing a national BCG vaccination campaign
    B Contact tracing, screening, and treatment of active and latent cases الإجابة الصحيحة
    C Improving ventilation systems
    D Regular chest X-rays
  254. 254

    A patient with pregnancy-induced hypertension (PIH) is at highest risk. Which condition predisposes to PIH?

    A Multiple pregnancy (e.g., twins, triplets) الإجابة الصحيحة
    B Maternal age under 20
    C Single pregnancy
    D Low maternal weight
  255. 255

    A patient with sepsis typically presents with which clinical manifestation?

    A Bradycardia
    B Hypothermia or hyperthermia
    C Tachycardia (early sign) الإجابة الصحيحة
    D Decreased respiratory rate
  256. 256

    To reduce separation anxiety in hospitalized children, the nurse should:

    A Increase the number of nursing staff
    B Decrease the number of nursing staff (consistent caregivers) الإجابة الصحيحة
    C Limit parental visits
    D Restrict visiting hours
  257. 257

    A postpartum client with a history of hemorrhage has been having uterine contractions for 4 hours and needs to use the bathroom. What should the nurse do?

    A Give her a bedpan
    B Help her sit up first, then assist to stand (prevent falls and orthostatic hypotension) الإجابة الصحيحة
    C Allow her to walk independently
    D Catheterize the patient
  258. 258

    To evaluate if a mother understands umbilical cord care instructions, the nurse should ask her to:

    A Explain the procedure in her own words
    B Demonstrate the cleaning technique (return demonstration) الإجابة الصحيحة
    C Repeat the written instructions
    D Sign a consent form
  259. 259

    When involving families in patient care, the nurse is practicing:

    A Enabling
    B Empowering الإجابة الصحيحة
    C Encouraging
    D Educating
  260. 260

    A patient is found unconscious without a pulse. The medical record indicates no DNR order. What should the nurse do?

    A Do not resuscitate due to patient condition
    B Begin CPR immediately الإجابة الصحيحة
    C Wait for physician orders
    D Call the family first
  261. 261

    A woman is having irregular contractions that decrease with walking. Which symptom indicates false labor rather than true labor?

    A Cervical dilation and effacement (true labor)
    B Irregular contractions that decrease with activity (false labor, Braxton-Hicks) الإجابة الصحيحة
    C Progressive cervical changes (true labor)
    D Regular, increasing contractions (true labor)
  262. 262

    Which laboratory test is the gold standard for confirming the diagnosis of sickle cell anemia?

    A Sickling test (Sickledex) - screening
    B Hemoglobin electrophoresis (definitive) الإجابة الصحيحة
    C Complete blood count
    D Reticulocyte count
  263. 263

    After tonsillectomy, what is the appropriate position for the patient to promote drainage and prevent aspiration?

    A Supine with head elevated
    B Side-lying to promote drainage الإجابة الصحيحة
    C Prone position
    D High Fowler position
  264. 264

    A 28-year-old primigravida at 16 weeks gestation presents with dark brown vaginal discharge. Investigation reveals a decline in pregnancy test levels and ultrasound shows a nonviable pregnancy with no fetal heartbeat. The cervical os is closed. What is the most likely type of spontaneous abortion?

    A Missed abortion (nonviable pregnancy retained, closed os) الإجابة الصحيحة
    B Threatened abortion (viable, closed os, bleeding)
    C Incomplete abortion (open os, some tissue passed)
    D Inevitable abortion (open os, no tissue passed)
  265. 265

    An infant has undergone cleft lip repair surgery. What is the optimal position to protect the suture line and prevent stress on the repair?

    A Supine position
    B Prone position
    C Side-lying position
    D Upright or semi-upright position الإجابة الصحيحة
  266. 266

    A mother with 9 children is experiencing difficulty coping with family management. What is the primary factor influencing her situation?

    A Physical health problems
    B Socioeconomic factors (financial strain, lack of resources) الإجابة الصحيحة
    C Educational level only
    D Age of the children
  267. 267

    What is the most effective method for preventing tuberculosis transmission in healthcare settings?

    A Universal precautions only
    B Airborne precautions with negative pressure rooms (and N95 respirators) الإجابة الصحيحة
    C Contact precautions
    D Droplet precautions
  268. 268

    What is the primary nursing consideration for a patient preparing for Hajj pilgrimage?

    A Medication management only
    B Pre-travel health assessment and vaccinations الإجابة الصحيحة
    C Travel insurance verification
    D Spiritual counseling
  269. 269

    Which vaccine is considered primary (mandatory) for Hajj pilgrims to prevent meningococcal disease?

    A Meningococcal vaccine الإجابة الصحيحة
    B Hepatitis A vaccine
    C Yellow fever vaccine
    D Typhoid vaccine
  270. 270

    A patient is taking oral iron supplements for iron deficiency anemia. Which beverage enhances iron absorption?

    A Orange juice (vitamin C) الإجابة الصحيحة
    B Apple juice
    C Milk (calcium inhibits absorption)
    D Coffee (inhibits absorption)
  271. 271

    A child after tonsillectomy and adenoidectomy is ready for clear liquids. Which juice is most appropriate to avoid irritation and bleeding risk?

    A Orange juice (acidic, irritating)
    B Apple juice (non-acidic, clear) الإجابة الصحيحة
    C Cranberry juice (acidic)
    D Grape juice (may be acidic)
  272. 272

    A patient collapses in the cafeteria and appears to be choking, unable to speak. What is the first action the nurse should take?

    A Call for help
    B Begin chest compressions
    C Perform abdominal thrusts (Heimlich maneuver) الإجابة الصحيحة
    D Check for pulse
  273. 273

    A 9-year-old child has a simple fracture of the tibia. What is the typical bone healing time for a child this age?

    A 4-6 weeks (children heal faster than adults) الإجابة الصحيحة
    B 6-8 weeks
    C 8-10 weeks
    D 10-12 weeks
  274. 274

    A nurse is teaching a new mother about newborn bathing. How often should a newborn be bathed?

    A Daily with soap and water
    B Twice a week with warm water and mild soap الإجابة الصحيحة
    C Every other day with plain water
    D Three times a week with antiseptic soap
  275. 275

    A patient after an open appendectomy should be placed in which position to promote comfort and facilitate drainage?

    A Supine
    B Fowler's position (semi-upright) الإجابة الصحيحة
    C Prone
    D Left lateral
  276. 276

    The rising prevalence of obesity in Saudi Arabia over the past two decades is best described as:

    A Endemic (constant presence)
    B Epidemic (rapid increase in a specific population) الإجابة الصحيحة
    C Pandemic (worldwide)
    D Sporadic (isolated cases)
  277. 277

    MERS-CoV (Middle East Respiratory Syndrome Coronavirus) is primarily transmitted through:

    A Airborne droplets (respiratory transmission) الإجابة الصحيحة
    B Direct contact
    C Fecal-oral route
    D Vector-borne
  278. 278

    Tuberculosis is transmitted through which route?

    A Contact transmission
    B Airborne transmission (droplet nuclei) الإجابة الصحيحة
    C Droplet transmission (large droplets)
    D Vector-borne transmission
  279. 279

    Rotavirus gastroenteritis is primarily transmitted through:

    A Airborne droplets
    B Fecal-oral route الإجابة الصحيحة
    C Direct contact
    D Blood contact
  280. 280

    A nurse finds a dose of acetaminophen left on a table by another nurse. What should be the first action?

    A Dispose of the medication
    B Verify the patient room number and check the medication chart before administering (or discarding if not verified) الإجابة الصحيحة
    C Return it to the pharmacy
    D Give it to the patient
  281. 281

    What is the recommended Hepatitis B vaccination schedule for infants?

    A 0, 1, 6 months (birth, 1-2 months, 6-18 months) الإجابة الصحيحة
    B 0, 2, 4 months
    C 0, 1, 2 months
    D 0, 3, 6 months
  282. 282

    A patient with preeclampsia requires close monitoring. What are the two primary parameters the nurse should closely monitor?

    A Blood pressure and proteinuria الإجابة الصحيحة
    B Heart rate and blood glucose
    C Temperature and respiratory rate
    D Oxygen saturation and urine output
  283. 283

    A pregnant woman presents with vaginal bleeding and abdominal pain. Ultrasound reveals tissue at the cervical os, and the internal os is open. What type of abortion is this?

    A Inevitable abortion (open os, bleeding, no tissue passed yet) الإجابة الصحيحة
    B Threatened abortion (closed os, bleeding)
    C Incomplete abortion (open os, some tissue passed)
    D Missed abortion (closed os, nonviable)
  284. 284

    A woman delivers in the emergency department due to no available beds. What is the most common cause of postpartum hemorrhage the nurse should anticipate?

    A Uterine atony (most common cause overall) الإجابة الصحيحة
    B Cervical lacerations
    C Retained placental fragments
    D Coagulation disorders
  285. 285

    A postpartum patient has a firm, contracted uterus but continues to have a steady trickle of bright red bleeding. What is the most likely cause?

    A Perineal or vaginal laceration الإجابة الصحيحة
    B Uterine atony (boggy uterus)
    C Retained placental tissue
    D Coagulation disorder
  286. 286

    An infant refuses both breastfeeding and bottle feeding. What is the most appropriate immediate nursing intervention?

    A Start IV 5% dextrose (if ordered, after assessing for hypoglycemia) الإجابة الصحيحة
    B Force feed with a syringe
    C Wait until the baby gets hungry
    D Offer different formula types
  287. 287

    A child presents with a fracture. How should the nurse assess for compromised circulation (neurovascular status)?

    A Check capillary refill time after blanching الإجابة الصحيحة
    B Assess skin temperature only
    C Check pulse rate
    D Observe skin color changes
  288. 288

    A mother refuses to vaccinate her child. What is the best nursing response?

    A Educate that vaccination prevents serious diseases (provide evidence-based information) الإجابة الصحيحة
    B Respect her decision completely without discussion
    C Threaten to call child services
    D Schedule a follow-up appointment only
  289. 289

    A nurse is about to administer digoxin to a patient with a potassium level of 5.8 mEq/L (high) and low magnesium. What should the nurse do?

    A Notify the physician (high potassium increases risk of digoxin toxicity, especially with hypomagnesemia) الإجابة الصحيحة
    B Give the medication as ordered
    C Withhold the medication only
    D Check normal values first
  290. 290

    A nurse finds a patient who has fallen on the floor during the night shift. What is the first priority action?

    A Assess for injury and take vital signs الإجابة الصحيحة
    B Help the patient up immediately
    C File an incident report first
    D Ask another nurse to handle it
  291. 291

    A nurse wants to establish the effectiveness of a prevention intervention based on multiple previous studies. What type of research method is most appropriate?

    A Systematic review (and meta-analysis) الإجابة الصحيحة
    B Case study
    C Experimental design (RCT)
    D Survey research
  292. 292

    A nurse overhears colleagues discussing confidential patient information in the hallway. What is the most appropriate action?

    A Advise them privately about confidentiality الإجابة الصحيحة
    B Report to supervisor immediately
    C Ignore the situation
    D Join the conversation
  293. 293

    Vitamin D absorption is enhanced when taken with which vitamin?

    A Vitamin A
    B Vitamin C
    C Vitamin E
    D Vitamin K الإجابة الصحيحة
  294. 294

    A newborn is delivered to a mother with gestational diabetes mellitus (GDM). What is the priority nursing intervention for this infant?

    A Initiate oral feeding immediately
    B Monitor blood glucose levels closely الإجابة الصحيحة
    C Administer IV fluids
    D Start phototherapy
  295. 295

    As a charge nurse, you witness a conflict between a physician and a staff nurse regarding patient care. What is your most appropriate initial action?

    A Ignore the situation and let them resolve it
    B Document the incident immediately
    C Intervene calmly and facilitate communication between both parties الإجابة الصحيحة
    D Report the physician to administration
  296. 296

    A patient states he read online that nitroglycerin should be taken every 3 minutes, but the hospital policy states every 5 minutes. He refuses to follow the policy. What is the nurse's best response?

    A Tell the patient he must follow hospital policy
    B Explain the rationale for the 5-minute interval (to prevent hypotension) and address his concerns الإجابة الصحيحة
    C Give the medication according to his preference
    D Contact the physician to change the order
  297. 297

    A breastfeeding mother asks about the best position for nighttime feeding to allow both mother and baby to rest. Which position is most beneficial?

    A Cradle hold
    B Cross-cradle hold
    C Side-lying position الإجابة الصحيحة
    D Football hold
  298. 298

    A nurse is assessing a pregnant woman at 36 weeks of gestation. The fundal height is expected to correspond closely with the gestational age in weeks. What is the approximate fundal height in centimeters at this stage of pregnancy?

    A 30 cm
    B 36 cm الإجابة الصحيحة
    C 32 cm
    D 40 cm
  299. 299

    A patient has overdosed on morphine and is unresponsive with pinpoint pupils and respiratory depression. What is the antidote?

    A Flumazenil (benzodiazepine antidote)
    B Naloxone (opioid antagonist) الإجابة الصحيحة
    C Atropine (for bradycardia)
    D Epinephrine (for anaphylaxis)
  300. 300

    A patient has an arterial blood gas: pH 7.25, PaCO2 55 mmHg, HCO3- 24 mEq/L. This represents which acid-base imbalance?

    A Compensated respiratory acidosis (HCO3 would be elevated if chronic)
    B Uncompensated respiratory acidosis (low pH, high CO2, normal HCO3) الإجابة الصحيحة
    C Compensated metabolic acidosis
    D Uncompensated metabolic acidosis
  301. 301

    A patient with prolonged vomiting from gastric outlet obstruction would most likely develop which acid-base imbalance?

    A Respiratory acidosis
    B Respiratory alkalosis
    C Metabolic acidosis
    D Metabolic alkalosis (loss of gastric acid, H+ and Cl-) الإجابة الصحيحة
  302. 302

    A patient with active pulmonary tuberculosis is admitted to the hospital. What type of isolation precautions should be implemented?

    A Contact precautions
    B Droplet precautions
    C Airborne precautions الإجابة الصحيحة
    D Standard precautions only
  303. 303

    Which medication is considered first-line treatment for active tuberculosis?

    A Amoxicillin
    B Isoniazid (part of the 4-drug regimen: INH, rifampin, ethambutol, pyrazinamide) الإجابة الصحيحة
    C Ciprofloxacin
    D Azithromycin
  304. 304

    An 18-month-old child is due for routine immunizations. Which vaccination is typically administered at this age?

    A Hepatitis B vaccine (birth, 1-2 months, 6-18 months)
    B MMR booster (first dose at 12-15 months, booster at 4-6 years, but some schedules give second dose at 18 months) الإجابة الصحيحة
    C DTaP booster (given at 15-18 months)
    D Rotavirus vaccine (given at 2,4,6 months)
  305. 305

    A newborn with a cleft lip is being prepared for feeding. What is the most appropriate nursing intervention?

    A Use a standard bottle with regular nipple
    B Position the infant supine during feeding
    C Use a specialized feeder with a soft squeezable bottle (e.g., Haberman feeder) الإجابة الصحيحة
    D Feed only through nasogastric tube
  306. 306

    What is the safest sleep position for a healthy infant to reduce the risk of Sudden Infant Death Syndrome (SIDS)?

    A Side-lying position
    B Prone position (on stomach)
    C Supine position (on back) الإجابة الصحيحة
    D Any position is acceptable
  307. 307

    A mother with gestational diabetes delivers a baby. What is the most common immediate complication in the newborn?

    A Hyperglycemia
    B Hypoglycemia الإجابة الصحيحة
    C Hypernatremia
    D Hypercalcemia
  308. 308

    A patient returns from appendectomy surgery. What is the most appropriate initial position for this patient?

    A Trendelenburg position
    B Left lateral position
    C Semi-Fowler's position (to reduce tension on incision and promote drainage) الإجابة الصحيحة
    D Prone position
  309. 309

    An epidemic refers to the occurrence of disease that is:

    A Always present in a community at expected levels (endemic)
    B Occurs in multiple countries simultaneously (pandemic)
    C Occurs in excess of normal expectancy in a community الإجابة الصحيحة
    D Affects only immunocompromised individuals
  310. 310

    A 3-week-old infant presents with projectile vomiting and a palpable olive-shaped mass in the epigastrium. Which condition is most likely?

    A Intussusception (sausage-shaped mass)
    B Pyloric stenosis الإجابة الصحيحة
    C Gastroesophageal reflux
    D Necrotizing enterocolitis
  311. 311

    A psychiatric patient is prescribed a benzodiazepine (e.g., alprazolam) for anxiety. Which substance should be avoided while taking this medication?

    A Caffeine
    B Alcohol (can cause severe CNS depression, respiratory depression) الإجابة الصحيحة
    C Vitamin supplements
    D Over-the-counter pain relievers
  312. 312

    Which type of leadership style involves shared decision-making between the leader and team members?

    A Autocratic
    B Democratic الإجابة الصحيحة
    C Laissez-faire
    D Cooperative
  313. 313

    What is the correct sequence for putting on personal protective equipment (PPE)?

    A Gloves, gown, mask, eye protection
    B Gown, mask, eye protection, gloves الإجابة الصحيحة
    C Mask, gown, gloves, eye protection
    D Eye protection, mask, gown, gloves