‫‪2019 November‬‬ ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬

‫بسم هللا الرحمن الرحيم‬

‫وقل رب زدني علما‬

‫خيرا تفعل‪...‬حبا تلقي‬

‫‪November‬‬
‫للملف تحديث كل شهر لتعديل ما قد يكون به من اخطاء واضافة الجديد‬

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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
Infection control
1. Which of the following is an example of epidemic point source?
A. Tuberculosis
B. Public health agency
C. Contaminated water source
D. Communicable disease pavilion
2. TB epidemic disease Corona virus measles Small pox chicken pox
Airborne Airborne Airborne Airborne Airborne

3. Meningitis Diphtheria Rubella influenza

Droplet Droplet Droplet Droplet
4. RSV.. ‫؟‬Respiratory syncytial virus (RSV) MRSA isolation ?! Ebola virus
Contact Contact contract
Tuberculosis
 TB epidemic disease
 TB. Wear N95 mask
 TB. Test Mantoux test / PPD TEST
 TB TEST WITHIN 48-72 Hours
 Isoniazid for TB side effect numbness , hepatitis symptoms , stomach upset ,rashes
 Tb accurate test sputum culture and to be done early morning

Meningitis. ...
 Streptococcal pneumonia
 meningococcal vaccine. Hib
 Neck rigidity
 Droplet
 Cloudy CSF
 Lumber puncture
 Surgical mask. No N95 mask

5. A 32 years old man develops chronic productive cough. He has not been feeling hungry and has lost three
kilograms body weight in the past three weeks. On examination of his lung
fields, there was diminished breath sound and widespread crackles. An early
morning sputum culture was sent to the lab.
A. Droplet
B. Contact
C. Airborne
Rationale TB chest XRAY

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

7. A nurse working in medical unit is preparing to with droplet precaution measures in place. The following
personal protective equipment; eyewear. What is the correct sequence foe putting the equipment on?
A. Face Mask, Gown, Eyewear, and Gloves
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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
B. Gown, Face Mask, Eyewear, and Gloves
C. Eyewear, Cloves, Face Mask, and Gown
D. Gloves, Gown, Face Mask, and Eyewear

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

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

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

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

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

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

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

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

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

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

18. Patient with a colostomy complains of itching of the peris tornal skin. On assessment, the skin is covered in a red
rash with white patches visible. What is the most likely cause of this condition?
A. Not changing the pouch regularly
B. Candidiasis
C. Consuming acid-producing foods
D. Dehydration

19. A 33-year-old woman has come to the outpatient clinic for treatment of a vaginal infection. Physical assessment
reveals yellowish excessive, thin offensive and frothy discharge. Which of the following is the most likely
diagnosis?
A. Candidiasis
B. Trichomoniasis
C. Bacterial vaginosis
D. Chlamydia

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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
20. A 5-year-old child is seen in the primary care clinic with headache, malaise for about 2 days and today he has a
fluids for how long the child should be isolated after formation of rashes?
A. 2 days
B. 6 days
C. 10 days
D. 15 days
Rationale chicken pox

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

22. The nurse is assessing a 65-year-old patient, who reports the fatigue, weight loss, night sweats, and a productive
cough with thrick sputum The nurse should immediately initiate isolation precautions for which of the following?
A. Influenza
B. Pertussis
C. Bacterial pneumonia
D. Pulmonary tuberculosis

23. Which of the following diagnostic tests is definitive for TB?

A. Chest x-ray
B. Mantoux test
C. Sputum culture
D. Tuberculin test

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

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

26. A 58 years old man had a permanent night pacemaker inserted. The device is in place and functioning well. The
skin at the incision site is intact and free of infection. What is the most important nursing care outcome?
A. understand functioning and operating of a pacemaker
B. monitor pulse rate and identify need for reporting
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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
C. able to identify the signs of detached pacemaker
D. modify lifestyle and wear pacemaker alert sign

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

28. 10 years old child had and appendectomy yesterday which pain scale should the nurse use to assess the child
pain ?
A. Numeric
B. Faces
C. Flacc
D. Cries

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

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

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

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

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

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

35. Which of the following obstacles up to the implementation of the primary health care strategy
A. Increase the number of health care workers
B. Misinterpretation of PHC concept
C. Decentralization management
D. Few political supervision
36. A 32year old woman has just been told that she is pregnant she states ‘ As mush as I love my children , I had
had hoped we would not have any more “ this statement reflect of which of the following related to pregnancy
A. Anger
B. Denial
C. Guilt
D. Ambivalence

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

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

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

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

41. The nurse listens to patient complains and discussed how each of the complaints can be managed which of the
following is the best description the nurse action ?
A. Promoting patient autonomy
B. Demonstrating sympathy
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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
C. Ensure patient support
D. showing concerns

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

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

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

45. A 16 years old girl admitted to inpatient unit accompanied by her mother who supports her to walk . she looked
very weak and held her head up with her hands . she diagnosed with anorexia nervosa . what is the primary
nursing diagnosis?
A. Risk for injury related to low potassium
B. Body image disturbance related to obesity
C. Imbalance nutrition relate to compulsive overeating
D. Imbalance nutrition related to restricting caloric intake

46. What the purpose of a late vaginal_rectal culture during ante natal screening ?
A. To screen for group B streptococci
B. To detect a Chlamydia infection
C. To screen for gonorrhea
D. To screen for syphilis

47. A woman at 240weeks gestational age has fever body ache and has coughing last 5 days she is sent to hospital
with admission prescriptions for H1N1influenza . which prescription has the highest priority ?
A. Assign private room
B. Vital signs every 4 hours
C. Obtain specimens for culture
D. Ringer lactate IV

48. A woman was diagnosed gestational trophoblastics disease what is the lab investigation was done to diagnose
condition ?
A. Cervical pap smear
B. Serum HCG levels
C. Serum estrogen level
D. Plasma thyroxin level

49. A23-year-old gravid 1 ,para 0 mother is presented to the Antenatal clinic. The health educator educates group of
mothers in the waiting area. Which information regarding fetal circulation the educator should stress on?
A. One umbilical artery and one umbilical vein
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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
B. One umbilical artery and two umbilical veins
C. Two umbilical arteries and one umbilical vain
D. Two umbilical arteries and two umbilical veins

50. What is the major task of the staff nurse during a code blue? )
A. Direct the code
B. Intubate the patient
C. Make treatment decision
D. Coordinate use of the crash cart

51. During a vaginal delivery of woman 38 years old the nurse should consider the risk of which of the following?
A. Acute bleeding and coma
B. Low potassium
C. Brain Injury
D. fetal heart rate

52. Pregnant woman signs and symptoms of hypoglycemia

A. Blurred vision
B. Dry mouth
C. Poly urea
D. Flushing

53. Contraindication immunization for the patient who is received which medication ?
A. Steroids
B. midazolam
C. insulin

54. colonized infection is …germs are on the body but do not make you sick

55. Isoniazid side effect ?

A. Hepatitis symptoms
B. Blindness

56. A 30-year-oldarimigravida postnatal mother come to the clinic on the She complained of feeling shivering,
redness, swelling and pain in her right Blood pressure 90/62 mmHg Hea 84/min Respiratory rate Temperature
38.8 °C Which is the most common organism that causes mastitis?
A. Pseudomonas
B. Escherichia coli
C. Group B streptococcus
D. Staphylococcus aurous

57. Diet for patient with cancer ……………… fresh fruits and vegetables

58. A nurse is conducting a fire safety class and she was explaining that elderly are twice was likely to die at home
from fire accidents compared to younger people therefore the nurse has suggested some safety measures
What should the nurse suggest to prevent fire accidents at home?
A. Have a smoke detectors installed in the houses
B. Invite a family member to sleep with the elderly at nigh
C. Encourage practicing evacuation I case of emergency

Intussuception
59. 5-month-old boy has been vomiting green colored vomit He has intermittent abdominal pain during which he
draws his chest, turns pale and cries forcefully. On observation, the in the stool which has a jelly-like consistency.

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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
Abdominal pal a long. tube-like mass. There is no fever, rash nor diarrhea are hyperactive in all quadrants which
is the most likely form of initial treatment?
A. Manual manipulation
B. Surgical resection
C. Normal saline enema
D. Laparoscopy

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

61. 7month-old infant seen in the Emergency Department suffering from episodes of severe abdominal pain, and
the infant’s stool become like red jelly. Abdominal examination revealed palpable sausage-shaped mass in the
right upper quadrant which of the following is the best diagnosis?
A. Hirschsprung disease
B. Hypertrophic pyloric stenosis
C. Infant colic
D. Intussuception

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

63. 5year-old child was seen to the Emergency Department abdominal pain, palpable sauge-shaped mass, and
Intussusception is suspected Which of the following is the best diagnostic evaluation to?
A. X-ray
B. endoscopy
C. Rectal biopsy
D. Ultrasonograph
Pyloric stenosis
64. Surgery for pyloric stenosis
A. Pylorotomy
B. Pylorectomy
C. Pylorostomy
D. Pyloromyotomy

65. PYLORIC stenosis peristalsis movement ?

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

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

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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
67. month-old infant is admitted to the surgical unit with hypertrophic pyloric stenosis and scheduled
for the surgery. Which of the following is the findings of abdominal examination?
A. palpable olive-like mass in the left side
B. palpable olive-like mass in the right side
C. Palpable olive-like mass moved from left to right
D. Palpable olive-like mass moved from right to left

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

Hirschsprung’s Disease :

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

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

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

A. palpable sausage-shaped mass

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

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

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

74. An 8-month-old infant is admitted with Hirschsprung disease. Which of the following would be a significant
finding in this infant?
A. Depressed anterior fontanel
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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
B. Polyuria, hematuria
C. Weight gain, edema
D. Failure to thrive, constipation

Thyroidectomy

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

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

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

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

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

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

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

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

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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
C. Dressing
D. Back of neck

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

Tonsillectomy

84. 3-year-old child with an elevated body temperature is administered oral aspirin . The nurse records the body
temperature of the child two hours an The American Academy of pediatrics suggests that removal of the tonsils
under certain conditions. Which of the following meets these conditions?
A. times viral tonsillitis per year
B. Infrequent snoring and nasal quality
C. Three times bacterial tonsillitis per year
D. Tonsillitis accompanied by adenoid inflammation

85. 5year-old child is postoperative after tonsillectomy. The nurse should ask the parents to give the child which of
food after discharge from the hospital?
A. Meat and rice
B. Hot dog and potato chips
C. Mashed potatoes and soup
D. Cucumbers and tomato salad

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

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

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

A. Notify the physician

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

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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬
 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
89. nurse is caring for child who is pot tonsillectomy and adenoidectomy the nurse should plan to assess which of
the following complication?
A. Pulmonary hypertension
B. Hemorrhage
C. Hearing loss
D. Orthopnea

90. Which of the following consider contraindication of tonsillectomy ?

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

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

Appendicitis
92. 18-year-old man college student was rushed fainted at the school. He complained of severe quadrant. Upon
palpation, he jerks even with sample was obtained. What is the most likely diagnosis of this patient?
A. Appendicitis
B. Liver Cirrhosis
C. Kidney stones
D. Duodenal ulcer

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

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

A. Remain free of post-surgical complications

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

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

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

Spina bifida
97. 26- Which of the following vitamin supplements can decrease the incidence of Neural tube defects such as
anencephaly and spina bifida new-borns ?
A. Vitamin A
B. Riboflavin
C. Folic Acid
D. Vitamin K

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

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

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

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

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

102. Infant with spina bifida the nurse should monitor

A. Head circumference
B. Abdomen cicumfrance

103. A 40-year-old man is admitted to a Coronary pain. The ECG has normal sinus rhythm with

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leads V1-V4.
Blood pressure 123/69 mmHg
What is the most likely nursing diagnosis?
A. Acute chest pain
B. Myocardial in fraction
C. Decreased cardiac output
D. Ineffective tissue perfusion

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

105. 40-year-old man. smoker, presents to the clinic On examination, the toes are cold to the touch. extremities
is pale to blue. The pedal pulse Examination of the fingers shows small ulceration the skin. Blood glucose testing
is normal and then history of diabetes.
On admission
Blood pressure 140/90 mmHg
Heart rate 86 /min
Respiratory rate 22 /min
Oxygen saturation 98% room air
Which of the following would be most effective?
A. Antibiotic administration
B. Reduced fat intake
C. Smoking cessation
D. Regular exercise

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

107. Which of the following is an example of epidemic point source?

A. Tuberculosis
B. Public health agency
C. Contaminated water source
D. Communicable disease pavilion

108. Which of the following is the most common clinical manifestation of G6PD following ingestion of aspirin?

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A. Kidney failure
B. Acute hemolytic anemia
C. Hemophilia A
D. Thalassemia

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

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

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

112. 49-year-old women presented to the Emergency Department complaint of severe chest pain. The ECG
showed that the patient myocardial infarction. The doctor ordered the nurse to give the 800 mg of aspirin. What
is the primary indication of aspirin in this case?
A. Breaks down the thrombus
B. Decreases the formation of platelet plugs
C. Inhibits the conversion of prothrombine to
D. Interferes with vitamin k to maintain

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

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

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

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

117. The nurse assesses a client with an ileostomy for possible development of which of the following acid-base
imbalances?
A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis

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

A. Approximation ( how well edges come together )

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

120. A nurse is assessing a4-month-old formula fed infant .the parent reported that the infant was irritable, crying
excessively, not sleeping well, and vomiting, gastro esophageal reflux is expected. What nursing intervention
should the nurse expect to each parent ?
A. Place in an infant seat after eating
B. Give frequent feedings
C. Position the child in a swing
D. Thin formula with water

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

122. What does the relationship of the site of the presenting part to the location on maternal pelvis refer to ?
A. Fetal lie
B. Fetal position
C. Fetal presentation
D. Fetal attitude

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123. Temperature 41 c is ……………Hyperpyrexia

124. Caput succedaneum” refers to swelling, or edema, of an infant’s scalp that appears as a lump or
bump on their head shortly after delivery. harmless and is due to pressure put on the infant’s head
during delivery.
125. Pregnant women with genital herpes …. Caesarean section
126. Which thermometer fast and sanitary………………….Tympanic Thermometer
127. Diabetes insipidus …………………………………….. posterior pituitary.

128. Mode of transmission of diphtheria disease …………………… droplets

129. Post Vitrectomy position …………..prone /face down

130. Intussusception disease late stage …………………RED JELLY STOOL

131. Nephrotic syndrome urine color ……………….. Dark

132. Hepatitis A incubation period …………………… about 28 days.(15-50 day)

133. Absent p waves management ………………. Defibrillation

134. A child is postoperative after tonsillectomy diet ………………. Mashed potatoes and soup

135. Prepression and weakness related to deficiency vitamin D

136. Neck rigidity a...........meningitis

137. When checking rectal temperature how depth thermometer should be inserted
A. 2cm
B. 3.5cm
C. 4cm
D. 4.5

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

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

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

141. The American Academy of pediatrics suggests that removal of the tonsils under certain conditions.
Which of the following meets these conditions?
A. times viral tonsillitis per year
B. Infrequent snoring and nasal quality
C. Three times bacterial tonsillitis per year
D. Tonsillitis accompanied by adenoid inflammation

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

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

143. After a code blue, a doctor announced the death of a patient. A signature other begins to show signs of
decreased level of consciousness.
What is the priority intervention of the nurse at this time?
A. Offer a meal
B. Ensure safety
C. Set up an V line
D. Offer a glass of water

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

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

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

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

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

149. A clinical picture of an antisocial personality disorder is a "pervasive pattern of disregard for and violation of
rights of others, deceit, and manipulation".
What will be the priority of care?
A. Safety.
B. Set limitations
C. Behaviours therapy
D. Reduction of environmental stimuli

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

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

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

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

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

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

156. A 48-year-old patient in the male Surgical Ward had his gall bladder removed through laparoscopic
cholecystectomy 24 hours ago. While evaluating his general condition, the patient appears lethargic and
complains of severe nauseated feeling along with discomfort in the abdomen.
What nursing problem needs to be prioritized?
A. Disturbed metabolism due to higher energy demand
B. Weak and lethargic due to low food and fluid intake
C. Nausea and vomiting due to slower gut movement
D. Impaired comfort related to post-surgical effects
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157. While administering medications, the nurse gives an anti-hypertension medication to the wrong patient (see
table)
A Document the entire scenario
B Document vital signs
C Notify doctor
D Notify doctor if blood pressure is below 90/50 mmH
E Induce vomiting
F Administer antidote
G Monitor the patient
What sequence should the nurse follow?
A. A, D, F, G
B. B, C, G, A
C. B, D, E, F
D. B, E, F, G

158. Patient comes to ER with cough, weight loss, fever and night sweats, after chest x – ray the doctor diagnosed
the case tuberculosis and order to give hypertonic solution, what the suitable should be given?
A. Dextrose 10%
B. Normal saline 9%
C. Normal saline 45%
D. Dextrose 5 % % NaCl 0.9%

159. Which of the following tests measures the total quantity of prothrombin in the blood and monitors the
effectiveness of warfarin sodium (Coumarin) herapy and prolonged deficiencies in the extrinsic factor?
A. Thrombin time
B. Prothrombin time
C. Partial prothrombin time
D. Activated partial prothrombin time

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

161. A 6 year old male is diagnosed with Nephrotic syndrome. When nursing care for the patient the plan of diet
should be?
A. high salt, High fat
B. high salt, High cholesterol
C. low salt, low fat
D. low protein, high

162. The Foley Family is caring for their youngest child, Justin, who is suffering from tetralogy of Fallot. Which of
the following positions is

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used for congenital heart condition?
A. Semi fowler's position
B. knee chest position
C. prone position

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

164. A 69-year-old patient was discharged from instructions to have follow-up physiotherapy sessi paralysis as a
result of the brain stroke. A few physiotherapy sessions, he showed fast recovery. sadly that despite his progress
he will remain
Which of the following should be the prioritize patient?
A. Support for health maintenance
B. Increase activity and exercise
C. Identify coping mechanism
D. Enhance self esteem

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

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

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

168. A nurse is preparing a sterile field prior the Which of the following procedures illustrates the
nurse to the principles of aseptic technique?
A. Touch the outer 2-inch border of the sterile gloves
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
B. Place the sterile linen-wrapped package on waist level
C. Hold the bottle lip 1-2 inches above sterile pouring the solution
D. Open sterile item while holding outside hand then throw object onto sterile field

169. A 27-year-old women is admitted in the Medical she appears exhausted, dull and apathetic. She order.
Which of the following are additional findings the on the client?
A. Low blood pressure, rapid pulse and respiration
B. Pale skin with bruises, petechia and Eco
C. Lower urinary output and increased thirst.
D. History of frequent flu and sore throat

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

171. An 18-year-old girl was under weight and malnou 163 cm, her body weight was 45 Kg and her
admitted in the Female Medical Ward for severe observed that on the second day she inducing
Dinner. On asking, she replied that inducing helps clear the stomach bacteria.
Which aspect of the nursing care area is altered?
A. Self-concept
B. Health perception
C. Value-belief system
D. Nutrition management

172. A nurse is assigned to care for a patient who Nutrition (TPN). The patient was cyanosed and
Which of the following conditions is a TPN COMPLICATION?
A. Hyperglycemia
B. Pneumothorax
C. Hypervolemia
D. Infection

173. Many injured victims of road traffic accident Emergency Room for treatment. Due to the high
Doctor asked a nurse to perform preliminary assess prioritise them. Which of the following is the best way to
assess?
A. Pain
B. Weight
C. Restlessness
D. Facial expression

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

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

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

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

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

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

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

180. An outpatient nurse is drawing blood from a laboratory analysis.

Which of the following steps is an appropriate this procedure?
A. Use a highly visible vein on ventral side of

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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
B. Immediately draw blood while it is still wet alcohol prep o
C. Vigorously shake specimen tube to mix anticoagulant solution
D. Do not leave a tourniquet on more than more 1 vein

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

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

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

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

185. A nurse is working in a medical unit. She is 65-year-old women with cerebrovascular accident
Home care visits. The nurse teaches the patients wheelchair safely.
Which of the following statements by the teaching was effective?
A. "The breaks should be used when storing
B. "I will push the wheelchair in from of the
C. "I will remove the feet rests from the
D. "When entering the elevator I will pull the that the big wheels enter first"

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

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

188. A nurse is caring for patient who is being admitted with respiratory tract infection. The patient feels cold and
shivering
Blood pressure 110/70 mmHg Heart rate 110 /min Respiratory rate
22 /min Temperature 39.7 C
Which of the following is the best nursing action?
A. Provide a hot drink
B. Cover the patient with light blanket
C. Start the air conditioning system
D. Turn off lights and close curtains

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

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

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

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

193. A nurse is assigned to care for a 32-year-old glomerulonephritis. The nurse is transcribing patient file.
Which of the following orders should the nurse clarify?
A. Bed rest
B. Daily weights
C. Strict intake and output check
D. Frequent blood pressure check

194. A 22-year-old patient is admitted in the male Medical diagnosis of tonsillar abscess. He has high fever and
sever along with dysphagia, difficulty in talking and in opening patient is planned for needle aspiration of the
abscess intravenous antibiotics including penicillin.
What expected outcome of nursing care should be prioritized?
A. Patient is comfortable and has minimum pain
B. Patient is able to communicate appropriately
C. Able to swallow fluids and soft diet more easily
D. Normal body temperature and stable vital signs

195. A 40-year-old man with Hepatitis A is admitted in Medical Ward. He is feeling exhausted, anorexie,
and diarrhoea. He needs hygiene assistance.
Heart rate 80 /min
Blood pressure 125/96 mmHg
Respiratory rate 24 /min Temperature 39.4 C
What nursing problem should be focused first?
A. High fever
B. Low energy level
C. Reduced food intake
D. Stomach discomfort

196. A nurse is caring for a patient diagnosed with abdominal x-ray reveals evidence of pancreatic
sign of biliary disease. What would the nurse most likely instruct the patient
A. Consume a high-protein diet
B. Gradually increase dietary fibre
C. Avoid ingestion of alcoholic beverages
D. Limit activities when the patient is fatigued

197. A 35-year-old patient was admitted to the Emergency Department accompanied by her
include severe epigastria pain, abdominal tende the last 24 hours. She was anorexic and had
Since the last few hours. She was feeling elimination and body fluid loss.
Which of the following should the nurse do to exertion?
A. Explain that she will feel better soon
B. Show support and understanding
C. Encourage her to drink fluids
D. Help he rest undisturbed

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198. 62 year-old female patient is admitted for her left eye cataract removal. She has cataract in both eyes with
no visibility in her left sys. She is scheduled for the surgery .What essential safety precautions must be assessed
preoperatively?
A. Assess and document visual acuity of both eyes
B. Knowledge to prevent eye injury after Surgery
C. Cleanliness of eye and removal of eyeglasses
D. Arrangement of attendant for 24 hours

199. A 57-year-old patient post laparotomy is complain increases with movement. A family member Something.
The unit nurse is preparing to admini for pain control after checking the medication
Blood pressure 110/63 mmHg Heart rate 68 /min Respiratory rate 11
/min Temperature 36.8 C Oxygen saturation 93 %
Which of the following assessments should the administering Morphine to the patient?
A. Monitor heart rate and rhythm
B. Inspect surgical site for bleeding
C. Perform a respiratory assessment
D. end a blood sample to assess renal

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

201. The relative of a 25-year-old post-partum patient stopped her from taking bath until the 40 days
provided with the food by the family that was of saturated fat and a liter of reduced full
asking, she said the diet was good for the milk Which of the following should be the prioritized
patient's understanding about?
A. A healthy and balanced diet is beneficial
B. Breast feed is not affected by mother's diet
C. Maintaining personal hygiene is most
D. Rest and relaxation is necessary to regain

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

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

203. 53-year-old patient who was referred to the primary healthcare center for hyperglycemia him and finds out
that he has been recently says that he does not understand why he needs
Test Result Glucose, fasting 12.2 Normal Values 3.5-6.5 mm
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Which of the following learning needs is indicated?
A. Insulin Alternatives
B. Complications of diabetes
C. Disease process of diabetes
D. Lifestyle and dietary changes

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

205. A 33-year-old man with meningitis presents Department. Healthcare providers plan to precautions.
What is the best nursing practice for this case?
A. Use N95 mask all the time
B. Monitor the negative air pressure
C. Use respiratory protective equipment all the
D. Keep the patients with the same diagnosis

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

207. A 12- year- old boy was brought to the Emergency respiratory arrest due to drowning. Cardiac resuscitation
what is the major complication that might happen if treated after drowning quickly?
A. Sepsis
B. Alkalosis
C. Acidosis
D. Hypothermia

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

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

210. 22-year-old patient is admitted in the male diagnosis of tensile abscess. He has high fever along with
dysphasia, difficulty in talking and in patient is planned for needle aspiration of the intravenous antibiotics
including penicillin.
What nursing problem needs attention first?
A. Imbalance nutrition due to inadequate
B. Acute pain related to throat inflammation
C. Impaired swallowing related to dysphagia
D. Hyperthermia related to acute infection

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

212. 35 year-old man with a history of psychiatric illness has been taking long-term antipsychotic medication for
the past eight years. He has a fine tremor of the hands, delayed motor responses and a flat mood . He says the
he feels restless and anxious all of the time. He has prolonged muscle contractions of the head and his eyes
sometimes roll upwards. He makes his lips and smacks his lips and makes chewing motions with the mouth
Without being aware . The health care provider changes his medication to improve his symptoms
Which of the symptoms is most likely to remain?
A. Prolonged muscle contractions
B. Chewing motions of the mouth
C. Delayed motor response
D. Feelings of restlessness

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

214. 28 year-old married woman is admitted in the Gynecology Ward for the observation after her
miscarriage. She has not been able to sustain any pregnancy since she got married for the past three years
and she had three miscarriages during this time. What intervention is the most appropriate?
A. Family history
B. Past medical history
C. Physical examination
D. Laboratory investigations

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215. A co-worker informs the nurse about experiencing increased level of stress associated daily job
responsibilities .To help cope with professional stress , what should the nurse encourage
A. Make a list daily of unfinished tasks
B. Complete complex mental tasks before physical tasks
C. Acknowledge daily accomplishments
D. Spend time with colleagues away from work

216. IGG can cross the

A. Placenta
B. Milk
C. Cord

217. A nurse has broken a medication vial by mistake. What is the first action should the nurse do?
A. Inform the head nurse
B. hange the vial from the pharmacy
C. Write a report
D. Documenting in nursing

218. A 27-year-old women is admitted in the Medical she appears exhausted, dull and apathetic. She order.
Which of the following are additional findings the on the client?
A. Low blood pressure, rapid pulse and respiration
B. Pale skin with bruises, petechia and eco
C. Lower urinary output and increased thirst.

219. Which of the following represents secondary infertility?

A. Male infertility
B. A couple that does not conceive
C. Infertility that occurs after previous pregnancy
D. Infertility lasts for more than 3 years

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

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

222. Which of the following statements best describes for patient myopia?
A. They must hold a paper at arm's length or greater to read it
B. They can see close-up objects clearly, but distance objects are out of focus
C. They can see distant objects clearly, but close up objects are out of focus
D. They are unable to focus horizontal and vertical rays of light on the retina simultaneously

223. A 17-year-old women went to the Emergency Department complaining of fever, sore throat, and hoarseness
of voice. Laboratory tests were done , (see lab results).
Test Result Normal values
Hb 120.5 120-158 g/L
HCT 0.39 0.36-0.47 g/L
RBC 4.0 3.8-5.1 × 1022/L
WBC 14.2 4-10.5 × 109/L
Throat culture positive Beta Haemolytic Non found Streptococcus
Which of the following would be the possible complication for the patient condition?
A. Cellulitis
B. Bacterial cholangitis
C. Infective endocarditis
D. Rheumatic heart disease

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

225. A nurse is preparing to administer an intravenous infusion of 2000 ml of Ringer's lactate over 12-hours. The
administration set has a chamber that delivers 15 drops per ml. How many drops per minute should be
administered?
A. 14
B. 24
C. 42
D. 56.

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

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

228. A 14- nurse manager assigns tasks according to clinical competencies of the [Link] of the following is
the management function?
A. Delegating
B. Evaluating
C. Planning
D. Controlling

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

230. 3-year-old child with an elevated body temperature is administered oral aspirin . The nurse records the body
temperature of the child two hours and finds that it is still elevated. What is the most likely underlying
physiology for the delayed response in action of the aspirin?
A. High gastric pH
B. Thin epidermis
C. Low muscle tone
D. Short intestines

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

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

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

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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
234. A 8- year-old child was admitted with suspected appendicitis. A nurse was evaluating the child’s condition
and the mother stated that the child did have his bowel movement for the past two days and requested for
natives. What is the risk of giving laxative to patient with appendicitis?
A. Pain
B. Fever
C. Rupture
D. Diarrhea

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

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

237. A 14- nurse manager assigns tasks according to clinical competencies of the [Link] of the following is
the management function?
A. Delegating
B. Evaluating
C. Planning
D. Controlling

238. A 16-year-old girl was found unconscious in her home by her mother. She brought to the hospital by
ambulance. The patient has no previously known medical history. On arrival, the nurse performs an assessment
for level of consciousness and notes a Glasgow Coma Score of five. The nurse notes the patient's breathe smells
like acetone or fingernail paint remover. What is the priority therapeutic goal?
A. Increase blood glucose
B. Increase serum osmolarity
C. Increase circulatory volume
D. Decrease intracranial pressure

239. A 61-year-old man is being discharged from the post-operative Care Unit following a transurethral resection
of the prostate. The nurse provides discharge information regarding the care of the bladder catheter.
Which method would be most effective in bladder retraining for this patient?
A. Scheduled urination every 2-3 hours
B. Limit fluid intake before sleeping time
C. Perform pelvic floor exercises daily
D. Increase fluid intake during the day time

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

36
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬

241. A 9-year-old child is admitted to the Emergency Department injury. The child is oriented to the place, person
and time, spontaneously, obeys commands. The nurse is doing aped Coma Scale (PGCS). Which of the following
score the nurse should record?
A. 3
B. 8
C. 12
D. 15

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

243. 4 weeks of gestation neonate is admitted to the Neonatal Intensive Unit immediately after delivery with
respirator distress syndrome de 1.
hart rate 140 /min
respiratory rate 77 /min
Temperature 36.5
Which of the following method of feeding is recommended to promote with of this premature?
A. Enteral feeding of breast milk
B. Enteral feeding of premature formula
C. Oral breast feeding
D. Oral premature formula

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

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

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

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247. A nurse is preparing a medication order of 100 mg IV stat. The available hydrocortisone is 200mg per 5 ml
distilled water for injection. Which of the following is the correct administered?
A. 4.5 ML
B. 3.5 ML
C. 2.5 ML
D. 1.5 ML

248. Which of the following is a newly promoted nurse manager’s first priority?
A. Check all nursing care documents are correct
B. Supervise direct nursing care to all patients
C. Complete evaluation of all new nurses
D. Develop unit clinical operational plan

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

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

251. A patient with a colostomy complains of itching of the peris tornal skin. On assessment, the skin is covered in
a red rash with white patches visible. what is the most likely cause of this condition?
A. Not changing the pouch regularly
B. Candidiasis
C. Consuming acid-producing foods
D. Dehydration

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

253. A 56-year-old man was admitted with complaint working for three days. The nurse is preparing to administer
infusion of saline 1000 ml over six hours. What is the hourly infusion rate that the nurse needs to infusion
therapy in mL/hour?
A. 155
B. 167
C. 119
D. 200

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

255. A 47-year-old man is diagnosed with tuberculosis (TB) and negative pressure room. Which of the following
should wear a facemask?
A. Patient's health care providers
B. All people who enter the patient's room
C. Person has close contact with the patient
D. Family members who are at risk for infection

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

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

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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
258. A 65-year-old man is undergoing pre-operative preparation fond scope procedure in which the physician will
visualize the large and distal part of the small bowel with a camera attached to the flexible tube. Which of the
following positions is the most appropriate?
A. Left lateral Sim's
B. Right lateral recumbent
C. Trendelenbreg
D. Prone3

259. A postoperative patient has on order to discontinues the foley 11:30 AM, the nurse removes the Foley
intact. At 1:00 PM, the patient complains of feeling the need to urinate and voids 30 ce.
The nurse should assess the patient for signs of which of the following?
A. Urinary retention
B. Urinary tract infection
C. Cystitis
D. Haematuria

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

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

262. The nurse in the Critical Care Unit is preparing a plan of care for a postoperative cardiac transplant client.
Which of the following maintain highest priority intervention?
A. Apply sequential compression devices to prevent deep vein thrombosis
B. Assist the client in changing positions slowly to prevent hypotension
C. Encourage coughing and deep breathing to prevent paranoia
D. Use careful hand washing and aseptic technique to prevent infection

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

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

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

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

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

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

269. A nurse check the medication chart of a patient, which has the following order; Paracetamol 500mg P.O.
QID. How many times a day should the nurse administer the medication?
A. Once
B. Twice
C. Three times
D. Four times

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

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

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

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

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

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

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276. 49-year-old women presented to the Emergency Department complaint of severe chest pain. The ECG
showed that the patient myocardial infarction. The doctor ordered the nurse to give the 800 mg of aspirin. What
is the primary indication of aspirin in this case?
A. Breaks down the thrombus
B. Decreases the formation of platelet plugs
C. Inhibits the conversion of prothrombine to
D. Interferes with vitamin k to maintain

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

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

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

280. Acommunity nurse assigned to work in a Makkah, one of the most multicultural cities in Saudi Arab has to
interact with multicultural population every day What is the most important step the nurse should do before
with the clients?
A. Asking the client about his/her cultural background
B. Conducting an appropriate culturological assessment
C. Ensuring that the client has his/her a privacy
D. Looking at the client's file to take history
281. The nursing director wants to evaluate the quality of nursing care at the in-patient areas. The management
team will evaluate on quarterly basis the documentation and the relationship between the patient's length of
stay and the quality of care which of the following is the most important data source to identify the quality of
care?
A. Patient's complaints and time taken to resolve them
B. Patient's satisfaction level at the time of discharge
C. Details of nursing notes for patient's progress
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282. A 28-year-old women is accompanied by her mother to the ward. She is admitted for her affective disorders
with anger recent events and stammering spells. She has panic followed by apathy and listless Ness. How should
the nurse manage the patient?
A. Be supportive and use therapeutic communication
B. Improvise sign language to control forgetfulness
C. Maintain calm environment and avoid argument
D. Anger management and speech therapy

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

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

284. A patient returns to a clinic for a follow-up visit and is diagnosed as positive for Human Immunodeficiency
Virus ( HIV). The patient expresses fear related to lack of finances, fear of social avoidance, and hopelessness.
Which of the following nursing actions should provide the most patient
support?
A. Referral to a physician infectious disease specialist
B. Referral to a community-based HIV clinic
C. Referral to the local public health department
D. Recommendation to disclose the diagnosis to family

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

286. Which of the following represents secondary infertility?

A. Male infertility
B. A couple that does not conceive
C. Infertility that occurs after previous pregnancy
D. Infertility lasts for more than 3 years

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

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

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

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

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

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

292. During a night shift a medical doctor complains of back pain and asks the t nurse to give him morphine 5 mg
IM. Which of the following actions indicates professionalism in handing the ation by the nurse?

A. Call another doctor to manage

B. Refer him to Emergency Room
C. Administer morphine to doctor
D. Ask him to write a prescription first

293. 62 year-old female patient is admitted for her left eye cataract removal. She has cataract in both eyes
with no visibility in her left sys. She is scheduled for the surgery .What essential safety precautions must be
assessed preoperatively?
A. Assess and document visual acuity of both eyes
B. Knowledge to prevent eye injury after Surgery
C. Cleanliness of eye and removal of eyeglasses

294. A nurse is caring for a patient diagnosed with abdominal x-ray reveals evidence of pancreatic
sign of biliary disease. What would the nurse most likely instruct the patient
A. Consume a high-protein diet
B. Gradually increase dietary fibre
C. Avoid ingestion of alcoholic beverages
D. Limit activities when the patient is fatigued

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

A. Staffing

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B. Financial
C. Performance
D. Knowledge-based

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

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

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

299. The nurse is assessing a child who has Tetralogy of Fallot observed that the child is having clubbing in his
fingernails Which of the flowing might be the reason for this clubbing?
A. Prolonged tissue hypoxia
B. Delayed physical growth
C. Inactive bone marrow
D. Pulmonary fibrosis

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

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

302. Digoxin not given to pàtient who has ?

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

303. Atropine is indicated for increase

A. Heart rate
B. Respiratory rate

304. Morphine can cause ?

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

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

306. A 70-year-old man presents to the clinic with difficulty sleeping at night. He has not had a good night's rest
for several months and feels exhausted. He needs to place three pillows behind his back in order to sleep.
Examination of the lungs reveals crackles and wheezing Auscultation of the heart confirms an S1 gallop.
Which of the following is the most likely underlying health problem?
A. Asthma
B. Pulmonary stenosis
C. Right-sided heart failure
D. Left-sided heart failure

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

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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
B. Pulmonary hypertension
C. Left-sided ventricle failure
D. Splenomegaly

308. a nurse was newly appointed to work in the Surgical Ward. She was assigned to take care of an obese
patient who just had an open laparotomy. Her mentor told her to pay attention to the surgical
associated with obesity. Which of the following postoperative complications the nurse should consider as a
high risk complication?
A. lunger
B. Gastric pain
C. Hemorrhage
D. Impaired wound healing

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

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

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

312. The nurse was planning care for a 25-year-old primigravida post-partum mother who had engorgement due
to poor feeding technique. the left preast appeared red and swollen and was diagnosed as
Which of the following is the best education for the mother
A. Avoid wearing brassiere
B. Begin suckling on the right breast
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
C. Stop pumping milk from the left breast
D. Take antibiotics till the soreness subsides

313. 11- child is admitted to the paediatrics ward with acute lymphocytic leukemic, and has had joint pain for
several weeks. Physical findings ude widespread ecchymosis , generalized lymphadenopathy,
hepatosplenomegaly, and pallor. Lab work shows a low hemoglobin level, RBC count, low WBC count low
hematocrit , and low platelets. Which high risk is expected?
A. Infection
B. Fractures
C. Dehydration
D. Hepatitis

314. A 56-year-old man with a history of COPD was rushed to the ER Department with chest pain,
shortness of breath, fewer and a cough. Upon assessment , crackles can be heard over the low obes. The
patient looks pale and lethargic (see image).
Blood pressure 110/70 mmHg
Heart rate 130 /min
Respiratory rate 9 /min
Temperature 38.1 C
Oxygen saturation 85 %
What is the most likely condition?
A. Bronchial asthma
B. Respiratory failure
C. Pulmonary embolism
D. Myocardial infraction

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

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

317. Mother came to the Outpatient Department with an infant having cleft and palate. The infant was
underweight, so the nurse has to consider ching the proper way of feeding the child in the treatment plan.
Which of the following is the proper way of feeding
A. Use a non-squeezable bottle during feeding
B. Feed infant in an upright, sitting position
C. Enlarge nipple holes of bottle to allow more milk to pass through
D. Feed infant longer than 45 minutes to allow more food to be

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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
318. 18- A four-year old child is seen in the Emergency Department with a spiral fracture of the left arm . The x-
ray examination showed previously broken healed bones. What is your immediate action?
A. Call social services to immediately arrange foster care for the child
B. Ask the child about the previous accidents and management
C. Report the child abuse to the local authorities
D. Try to establish rapport and trust with the child’s family

319. 26- Which of the following vitamin supplements can decrease the incidence of Neural tube defects such as
anencephaly and spina bifida new-borns ?
A. Vitamin A
B. Riboflavin
C. Folic Acid
D. Vitamin K

320. 32- 5-year-old child was brought to the Emergency Room with a fractured ght forearm. He had several
bruises on his body but showed no signs of ain while palpating them. He seemed scared and did not answer any
questions asked. Why should the nurse discuss this case with the nurse manager?
A. Continuity of care
B. Rule out child abuse
C. Psychological support
D. Fracture management

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

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

323. 5-year-old child was admitted with Nephrotic Syndrome. A nurse noticed that the child has slight facial
puffiness with mild pitting edema on his hands and feet. there was no distended abdomen Which type of diet
the nurse should order for the child?
A. High protein, high salt diet
B. Low protein, low fibre diet
C. Low protein, normal salt diet
D. Normal protein, low salt diet

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

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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬

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

326. A nurse is providing education to a patient who is being discharged after olecystectomy and has been placed
on a low fat diet. Which of the following foods should be avoided by the patient?
A. Canned beans
B. Whole milk
C. Rice
D. Fish

327. 66- nurse is caring for a child with a diagnosis of pneumonia. The plan of nre includes nebulizer treatments
and chest physiotherapy. When should the nurse perform chest physiotherapy?
A. Prior to the nebulizer treatment
B. After the nebulizer treatment
C. Intermittently during the nebulizer treatment
D. Continuously during the nebulizer treatment

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

329. 69- ve minutes post-birth, a neonate has a heart rate of 98, irregular eathing, actively moves all extremities,
but has bluish hands and feet, as ll as a weak and timid cry. Which is the correct APGAR assessment score?
A. 9
B. 8
C. 7
D. 6

330. nurse is taking care of a patient who underwent abdominal surgery three days ago. The patient has not been
able to breathe deeply and uses to get out of bed since the surgery due to pain. Also, the patient nplains of
shortness of breath, and the lung sounds are diminished on auscultation.
Blood pressure 120/70 mmHg
Heart rate 75 /min
Respiratory rate 22 /min
Temperature 36.4 ℃
Oxygen saturation 89%
Which of the following conditions should the nurse suspect?
A. Sepsis
B. Atelectasis
C. Congestive heart failure
D. Emphysema
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬

331. 43- A 45-year-old distressed and restless patient in the Psychiatric Ward was unable to sleep during the
nights for the last two days. He was ordered sleep medication which was to be administered at 10 pm. At the
time medicine administration, the patient was found asleep in bed Which of the following action should the
nurse take regarding the dication?
A. Discard medicine and cancel the order
B. Leave it at the bed side for the patient
C. Wake him up and administer
D. Hold, record and report

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

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

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

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

335. patient recently underwent Coronary Artery Bypass Graft. The nursing diagnosis includes sleep deprivation
related to the intensive care environment What would the goal for this diagnosis be?
A. The patient takes naps during the day
B. The patient ambulates three hours post-surgery
C. The patient is free of pain in the first hour post-surgery
D. The patient gets four hours of uninterrupted sleep during the night

336. A 78-year-old woman who lives in a long-term care facility has been ving repeated episodes of urinary tract
infections. She is prescribed then amine mandelate one gram to be taken by mouth four times per before meals
and at bedtime. The nurse advises the patient that she need to remove milk from the diet while taking the
medication. What is the primary purpose for this dietary advice?
A. To prevent mal absorption of medication
B. Decrease risk of gastrointestinal upset
C. Reduces effectiveness of medication
D. To make the urine acidic
52
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337. nurse is preparing an order of Amydramine 30 mg PO BD. The available check is 15 mg /5 ml. What is the
correct dosage of the medication to be administered?
A. 5 ML
B. 10 ML
C. 15 ML
D. 20 ML

338. 33-year-old patient in her 13th week of pregnancy has come for her routine gynecological
Appointment. According to the ultrasound, her fetus is a female. She already has three daughters but her
family wants the male child, so she asked the nurse guidance to terminate her pregnancy. The Nurse
explained that baby's gender is determined by the father. She later involved her husband in the Discharge
planning and finally helped the father agree to continue the mother's [Link] professional obligation
is fulfilled through the nursing implementation?
A. Influenced decision making
B. Incident prevention beforehand
C. Empathetic leadership approach
D. Sympathetic knowledge sharing

339. Newborn stomach capacity

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

356. Which of the following instruction should be given to the parents about colostomy care?
A. Use baby powder after stoma cleaning
B. Empty the pouch when it is completely full
C. Avoid tight diapers around the infant abdomen.
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
D. Use baby wipes to clean the skin around the stoma

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

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

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

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

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

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

363. A patient was on a course of lithium carbonate drug. During the nurse found that he complained from
nystagmus, visual hallucination, and oliguria. Which of the following drug related complications best symptoms?
A. Overdose
B. Mild toxicity
C. Severe toxicity
D. Moderate toxicity
364. nurse is caring for a child with a diagnosis of pneumonia. The plan of nre includes nebulizer treatments and
chest physiotherapy. When should the nurse perform chest physiotherapy?
A. Prior to the nebulizer treatment
B. After the nebulizer treatment
C. Intermittently during the nebulizer treatment
D. Continuously during the nebulizer treatment

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

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

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

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

369. A gravid 8 para 8 women has just delivered a 4.5Kg infant a pregnancy. Which of the following is a possible
complication?
A. Postpartum depression
B. Maternal hypoglycemia
C. Postpartum hemorrhage
D. Pregnancy-induced hypertension
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬

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

371. 62 year-old male patient in the Cardiac Surgery Ward is admitted for the coronary artery bypass surgery. he
has unstable angina for thepast one year and is apprehensive about the open-heart surgery .What essential
assessment needs immediate attention ?
A. Fear and anxiety regarding procedure
B. Need for spirometer and breathing exercise

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

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

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

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

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

377. The nurse is receiving a child postoperative tonsillectomy. Which of the following nursing assessment is
suitable for the postop care?
E. Encourage the child to cough spontaneously
F. Observe for subtle signs of haemorrhage
G. Place the child in the prone position
H. Suction the mouth to clear the airway Because of violent behaviour

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

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

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

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

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

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

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

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

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

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

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

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

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

60
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬

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

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

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

394. Surgery for pyloric stenosis

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

395. Neonatal mortality rate :

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

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

397. A nurse is preparing to administer 25 mg iron dextran inject patient with iron deficiency anemia .the nurse
knows this d to subcutaneous tissue and wants to administer the drug safely which of the best administration
techniques ?
A. .Z-track
B. deep im
C. c. use large gauge
D. insert needle at 45 angle

398. A surgical nurse is assigned to care for a woman who had undergone vaginal hysterectomy. The nurse
performed assessment. Which of the following potential problem that the nurse should observe?
A. Pain
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
B. Fever
C. Anxiety
D. Bladder dysfunction

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

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

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

26A newborn is diagnosed with hypospadias. When teaching the parents of this child, the nurse should tell them to
avoid which of the following before the hypospadias repair?
A. circumcision
B. drinking acidic juices
C. urinary catheterization
D. riding a bicycle

401. Nitroglycine administration route :

A. Intramuscular
B. Sublingual
C. Subcutaneous
D. Oral

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

403. When assessing the funds level At 36 week it is at the

A. Umbilicus
B. Symphysis pubis
C. Xiphoid process

404. Post Vitrect-omy position …Prone

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

406. Ear drops in adult up and back , in infant down and bak
407. Hyperpyrexia above 40C
62
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
408. Alzheimer deficiency in serotonin

409. Abdominal assessment. 1. Inspection 2. Auscultation 3. Percussion [Link]........ very important

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

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

412. when we should stop magnesium sulphate ( Respiratory Depression, Hypotension , Bradycardia deep
tendon Reflex )

413. Antidote of magnesium sulphate is ( calcium gluconate )

414. Morphine antidote is naloxone / narcan

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

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

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

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

419. When taking a BP, select the appropriate cuff size; a cuff that is too small will yield a falsely high reading, and
a cuff that is too large will yield a falsely low one
420. Complication of diabetic mother hypoglycaemic and macrocosmic

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

422. Patient with BP230/180 is consider Hypertensive Crisis

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

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

425. A women was discharged from gynecological ward after gestational trophoblastic disease (molar pregnancy)
Which of the following is the best advice to give her?
A. Never to fall pregnant again
B. To request the doctor to sterilize her
C. To consider having her uterus removed
D. to avoid falling pregnant for at least one year
63
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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬

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

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

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

429. CPR in Adult is 30:2 120

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

431. Brachial artery t check pulse in infants

432. Prolactin Hormone promote Milk production

433. TB test Mantoux / PPD test result within 48-72Hours

434. Umbilical Cord one big vein& Two small arteries

435. Post thyroidectomy position lateral position

436. Pulse deficit is the different between apical beats and brachial pulse

437. Rligion that prohibits blood transfusion jehovah

438. According to information provider in the accompanying graphic, a transverse colostomy would be expected
to produce which of the following (see image)?

A. Fluid faces
B. Mushy feces
C. Semi-fluid feces

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 2019 November ‫اجعل من يراك يدعو لمن رباك الملف الثاني‬
D. Solid feces
439. What is the correct interpretation onto the rhythm strip?
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular flutter
D. Premature atrial contractions

440. MI in ECG ST elevation

441. Patient with REFLUX which part is responsible

442. Mongolian Spots

443. Child 8 months with vomiting and diarrhoea since 3 days the doctor order for oral hydraxon salt how many
ml oral ORS per kg you will give
A. 25
B. 50 75 ‫هنا لو المطلوب نختار‬per kg
C. 75
D. 100 ‫لو المطلوب الجرعه وفي هذه الحاله هيعطيك وزن الطفل‬
75 ‫نضرب الوزن في‬

‫تل‬

65
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Part 2
1. Hirschsprung disease: A congenital abnormality (birth defect) of the bowel in which there is absence of the
ganglia (nerves) in the wall of the bowel. Nerves are missing starting at the anus and extending a variable
distance u
2. p the bowel or failure to pass meconium for 24hours after birth

3. Wearing /Donning PPE is

Hand wash then Gown then Mask then Goggle then Glove

4. Removing / Doffing PPE is

Gloves the Goggle then Gown then Hand Hygiene then Mask
5. The following are ways of determining expected date of delivery when LMP is unknown Except :
A. Naegele rule
B. Quickening
C. Mc Dolands rule
D. Batholomew rule of 4

6. In the Bartholomew rule of 4 when the level of the fundus is midway between the umbilicus and xyphoid
process the estimated age of gestation is
A. 5th moth
B. 6th moth
C. 7th month
D. 8th month
In Bartholomews Rule of 4. the landmarks used are the symphysis pubis. umbilicus and xyphoid
process. At the level of the umbilicus. the AOG is approximately 5 months and at the level of the
xyphoid process 9 months. Thus. midway between these two landmarks would be considered as 7
months AOG.
7. Woman postpartum ceasrean section which type of food highly recommended … Protein
8. Doctor order to give the patient tablet medication 1000mg and the stock is 250mg what the nurse should do
give 4 tablet
9. Pregnant woman diagnosised with cancer what is the chance of the baby to have the disease 50%

10. Post cardiac surgery patient developed ST elevation on ECG which medication the nurse should give to
prevent clot formation :
A. Heparin
B. Warfarin
C. Aspirin

11. Diabetic mother the baby will have hypoglycaemia

12. Health education after cardiac surgery before discharge

Avoid heavy lifiting , drink 6-8 glasses of water daily ,do not swim or take a bath until the doctor will allow
you
13. Causes of central nervous system defect in early pregnancy is Folic acid
14. Which developmental age group is most likely to regress when ill?
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A. Adolescent
B. Infant
C. Toddler
D. Child

15. Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both
physical and emotional components. ‫تعريف‬pain ‫مهم جدا‬
16. Most common in children than adult Intussusception typically presents between 6 and 36 months
17. Patient in cast the nurse should do Neurological Assessment

18. Pain assessment tool in 4 years old child is worng-Baker

/ face pain ranting scale

19. BMI =weight/hight

20. Patient came to ER with abdominal trauma b Doctor order to do x ray the nurse know why x ray should be
done to role out liver and kidney reputure
21. Shortness of breath during lying down / flat is Orthopnea

22. Low albumin level indicate Malnutrition

23. Amniocentesis amniotic fluid test (AFT) low or high result indicate chromosomal abnormality

24. Choice during bradycardia is Atropine

25. What the term bradycardia mean?

A. Slow heart beat
B. Grossly irregular heartbeat
C. A heart rate of over 90 per minute
D. A heartbeat that has regular “skipped” beats

26. CPR in Adult is 30: 2

27. Patient with diabetes before exercise the nurse should advise him Orange juice

28. Renal biopsy position is prone

29. SLE avoiddirect exposure to Sun

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30. Early signs of ICP is Restlessness

31. A Barium Enema is a fluoroscopic examination of the large intestine ....... ‫احفظها زي اسمك‬

32. precise oxygen can be given through Venturi Mask

33. Patient with seizure the nurse know that the position during seizure attack is Lateral position

34. Heparin should not be aspirated or massage after given

35. After colostomy when it will be functioning 2 – 4 days

36. Post gastroscopy the nurse should observe GAGE reflex before start eating

37. patient developed autonomic dysreflexia the nurse should checked for the bladder and bowel irritability
38. Discharge teaching start …….. from admission
39. Patient with thoughts of sucide …….. one is to one observation
40. Patient with spinal cord injury moving by Rolling and keep his back straight
41. pOld age high risk for vitamins A &n D deficiency
42. To ensure good humidification of oxygen make sure that oxygen not excess 6 L/Min

43. Patient for EEG procedure Avoid coffee prior procedure

44. based upon the legal guidelines for documentation , which of following corrective action is incorrect ? A.
Never erase entries do line and write error
B. erase the incorrect notes then write the correct

45. A 75 old patient has Parkinson disease which best food for him
A. Clear liquid
B. Liquid
C. Solid
D. Semi solid

46. A client calls the clinic after a home pregnancy test is positive. Which hormone
will be cause this result?
A. Progesterone
B. Estrogen
C. Alpha-fetoprotein
D. Human chorionic gonadotropin

47. During a home assessment of a 2-year old, which behavior indicates normal
development?
A. Tries to cut food with a knife
B. Knows how to eat with a fork
C. Uses a cup to drink
D. Pours milk into cereal bow

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48. When caring for an elderly client who has visual and hearing impairments,
which of the following should the nurse assess?
A. Cognitive decline
B. Sensory overloa
C. Confusion and anger
D. Social isolation

49. A prim gravida in active labor is about 9 days post term the client diseires a bilateral pudendal block
anesthesia before delivery , after the nurse explains this type of anesthesia to the client which of the
following location identified by the client as the area of relief would indicate to the nurse that teachin was
effective?
A. Back
B. Perineum
C. Funds
D. Abdomen

50. What are the last items should be removal for nurse work in isolation room?
A. Gown
B. Mask
C. Gloves
D. Face protector

51. When a client with mid-stage Alzheimer's disease becomes agitated, which intervention should the nurse
use?
A. Placing the client in a darkened room.
B. Leading the client to a group activity.
C. Turning on the television.
D. Putting an arm around the client's waist

52. After being robbed and beaten by an unknown assailant, a patient is diagnosed with post-traumatic stress
disorder (PTSD). When developing a plan of care for the patient, which of these interventions will the
healthcare provider plan to implement first?
A. Ensure the patient is taking medications as prescribed
B. Assist the patient in recalling the details of the event
C. Teach the patient coping skills to deal with anxiety
D. Promote the establishment of a trusting relationship

53. A patient is diagnosed with agoraphobia. Which of the following would the
healthcare identify as a characteristic of this disorder?
A. Refuses to use a public restroom
B. Avoids being in the presence of clowns
C. Avoids interacting with strangers
D. Fears the use of public transportation

54. The children of a patient diagnosed with Alzheimer's disease (AD) tell the healthcare provider, "Our mother
seems better during the day, but she gets very confused and agitated in the late afternoon and evenings."
How should the healthcare provider document the patient's behavior?

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A. Delirium
B. Sundowning
C. Psychosis
D. Depression

55. A newly-admitted patient's medication orders include donepezil hydrochloride

(Aricept). The nurse knows this medication is prescribed for
A. Bipolar disorder
B. Schizophrenia
C. Alzheimer's disease
D. Major depression

56. At her six-week postpartum appointment, the client tells the nurse that she wants to resume oral
contraception as soon as possible. Because the client is breast-feeding, the nurse knows that the best option
is
A. Testosterone
B. Oxytocin
C. Estrogen
D. Progestin

57. patient diagnosed with delirium sees the intravenous (IV) tubing and believes it to be a snake. How should
the healthcare provider document this behavior?
A. Hallucination
B. Illusion
C. Confusion
D. Delusion

58. When assessing a patient with severe depression, which of the following would
the healthcare provider identify as a cognitive alteration?
A. Powerlessness
B. Anxiety
C. Low self-esteem
D. Somatic Delusions

59. The doctor order furosemide 40mg BID for patient with edema. What the nurse expected?
A. Hypocalcaemia
B. Hypokalemia
C. Hypercalcaemia
D. Hyperkalemia

60. A mother tells the nurse that her 8-year old doesn't eat as much as her toddler or
teenager. The nurse should explain that school-age children have a lower
A. Growth rate
B. Metabolic rate
C. Hormone level
D. Activity level

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61. A 32-year old client refuses to have any analgesia or anesthesia during her birth experience. As the nurse
assists her during the second stage of her labor, which position should she use to begin pushing?
A. Lying on her left side in the Sims' position
B. Lithotomy position with high stirrups
C. Knee-chest position with head elevated
D. Squatting with her body curved into a "C" position

62. When planning to teach a patient with a new colostomy, which food should the
nurse recommend to avoid odors in the stool?
A. Cucumbers
B. Yogurt
C. Peanut butter
D. Eggs

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

64. The healthcare provider is reviewing the International Normalized Ratio (INR) results of a patient with a
history of embolic stroke. Which of the following indicates a therapeutic value for this patient?
A. 1.5
B. 0.5
C. 4.1.
D. 2.5

65. If a drug is 50% protein-bound, it means that

A. 50% of the drug destroys protein
B. 50% less protein should be eaten
C. 50% will pass through the intestines
D. 50% of the drug is available

66. nurse is monitoring a 4-year-old child for signs of increased intracranial pressure after a fall from a bicycle,
resulting in head trauma. Which of the following signs or symptoms should be reported immediately?
A. Inability to identify short words
B. Repeated vomiting
C. Falling asleep at 10 pm
D. Bulging anterior fontanel

67. A patient who has a history of chronic back pain requires a higher dose of an opioid medication in order to
achieve adequate pain relief. The healthcare provider suspects that these findings are a result of which of
the following?
A. Pseudoaddiction
B. Dependence
C. Addiction
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D. Tolerance

68. A 26-year old client comes to the birthing center in early active labor. She is full-term and membranes are
intact. The nurse locates fetal heart sounds above the client's umbilicus at midline. The nurse should
continue to assess that the fetus is in which position?
A. Breech
B. Face
C. Transverse
D. Cephalic

69. During her first prenatal appointment, a 24-year old primigravada asks the nurse how the doctor could tell
she was pregnant "just by looking inside." The nurse explains that the client had a positive Chadwick’s sign,
which is a
A. Bluish color of the cervix and vaginal walls
B. Slight displacement of the uterus to the right
C. Pronounced softening of the cervix
D. Presence of a mucous plug at the cervix

70. When a mother enters the playroom of the pediatrics unit to visit her 3-year old son, he does not
immediately go to her. A reason for his behavior is
A. The child has become self-centered.
B. The child is angry and withdrawn.
C. The child has adapted to the hospital setting.
D. The child is displaying normal behavior.

71. A patient with pre-eclampsia is admitted to the unit with an order for magnesium sulfate. The nurse will
understand that the therapy is effective if
A. Scotomas are present
B. Ankle clonus is increased
C. No seizures occur
D. Blood pressure drops

72. An hour after the vaginal birth of a term neonate weighing 10 lb 8 oz (4763 gm), which of the following
should the nurse monitor closely?
A. Hyponatremia
B. Hypercalcemia
C. Hyperbilirubinemia
D. Hypoglycemia

A neonate weighing more than 4,000 g is considered large for gestational age (LGA) and at risk for hypoglycemia, due
to glycogen stores being rapidly depleted. Hyperbilirubinemia may develop if bruising occurred during delivery, but
will not be apparent at one hour post-birth

73. A patient has just been admitted to the hospital for observation. Based on the laboratory results, what is the
patient's primary problem? Hematocrit 45\% Hemoglobin 15g/dl (150g/L) Platelets 50 x 10\^9/L
A. Right upper quadrant pain
B. Productive cough
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C. Recurrent nosebleeds
D. Deep vein thrombosis

74. The healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of
these is most helpful in evaluating this patient's long-term glucose management?
A. Hemoglobin A1c
B. Fasting blood glucose level
C. Urine specific gravity
D. The patient's food diary

75. While caring for a patient following a laryngectomy, the patient suddenly becomes pale and nonresponsive,
with a BP of 90/40. The initial action should be to
A. Move the emergency cart to the bedside
B. Place the client in Trendelenburg position
C. Administer atropine intravenously
D. Increase the infusion of Dextrose in normal saline (D5NS)

76. Which of the following conditions most commonly causes acute glomerulonephritis?
A. A congenital condition leading to renal shutdown
B. End-stage kidney failure
C. Chronic viral destruction of the glomeruli
D. Prior infection with Group A Streptococcus within the past 10-14 days

77. A patient is admitted to the emergency department after sustaining abdominal injuries and a broken femur
from a motor vehicle accident. The patient is pale, diaphoretic, and is not talking coherently. Vital signs upon
admission are temperature 98.0 F (36.3 C), heart rate 130 beats/minute, respiratory rate 34 breaths/minute,
blood pressure 50/40mmHg. The healthcare provider suspects which type of shock?
A. Distributive
B. Neurogenic
C. Cardiogenic
D. Hypovolemic

78. A patient is admitted to the medical unit with a diagnosis of hepatitis. When preparing to administer
intravenous medications, the healthcare provide understands that the patient's diagnosis primarily impacts
which phase of pharmacokinetics?
A. Distribution
B. Excretion
C. Metabolism
D. Absorption

79. The healthcare provider is caring for a patient with a diagnosis of first-
degree atrioventricular (AV) block. Which of these waveform patterns identifiedon the cardiac monitor is
consistent with this arrhythmia?
A. QRS complexes are dropped randomly
B. No association between the P waves and QRS complexes
C. Significant shortening of the PR interval
D. Slowed conduction through the AV node.
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80. The nurse is assisting a doctor with the removal of a central venous catheter. To prevent complications, the
patient should be instructed to
A. Turn his head to the left side and hyperextend the neck while looking up
B. Take slow, deep breaths as the catheter is advanced.
C. Perform the Valsalva maneuver as the catheter is pulled.
D. Turn his head to the right while grasping the siderails.

81. During an assessment of a patient's abdomen, a pulsating abdominal mass isnoted by the healthcare
provider. Which of the following should be the healthcare provider's next action?
A. Ask the patient to perform a Valsalva maneuver
B. Measure the abdominal circumference
C. Obtain an order for a bladder scan
D. Assess femoral pulses

82. Rhogam is most often used to treat____ mothers that have a ____ infant.
A. RH negative, RH negative
B. RH negative, RH positive
C. RH positive, RH negative
D. RH positive

83. At her first prenatal appointment, the client states that her last menstrual period began on February 5, 2017
and ended on February 10, 2017. Using Naegele’s rule her estimated date of birth would be
A. November 5, 2017
B. November 17, 2017
C. November 12, 2017
D. October 29, 2017

84. The healthcare provider is caring for a 3-month-old infant diagnosed with infectious gastroenteritis. The
infant is lethargic and the mucous membranes are dry. Which additional finding would support a diagnosis of
moderate dehydration?
A. Increased capillary refill
B. Sunken fontanelle
C. Increased thirst
D. Anuria

85. The earliest identifying sign for a developing pressure sore is a localized
_______.
A. loss of sensation
B. change in color
C. edema
D. coolness to touch
86. A patient who is diagnosed with Parkinson's disease (PD) states, I can't tie my shoelaces anymore." The
healthcare provider recognizes that this patient's problem is due to a deficiency in which of these
neurotransmitters?
A. Norepinephrine
B. Glutamate
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C. Dopamine
D. Serotonin
87.
Ventricular Tachycardia
Serious life threatening

88. When the nurse on duty accidentally bumps the bassinet. the neonate throws out its arms. hands opened.
and begins to cry. The nurse interprets this reaction as indicative of which of the following reflexes?
A. Startle reflex
B. Babinski reflex
C. Grasping reflex
D. Tonic neck reflex

89. A primigravida client at 25 weeks gestation visits the clinic and tells the nurse that her lower back aches
when she arrives home from work. The nurse should suggest that the client perform:
A. Tailor sitting
B. Leg lifting
C. Shoulder circling
D. Squatting exercises

90. Which type of lochia should the nurse expect to find in a client 2 days PP?
A. Foul-smelling
B. Lochia serosa
C. Lochia alba
D. Lochia rubra

91. On the first PP night. a client requests that her baby be sent back to the nursery so she can get some sleep.
The client is most likely in which of the following phases?
A. Depression phase
B. Letting-go phase
C. Taking-hold phase
D. Taking-in phase

92. What type of milk is present in the breasts 7 to 10 days PP?

A. Colostrum
B. Hind milk
C. Mature milk
D. Transitional milk

93. A nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period. When the
nurse locates the fundus. She notes that the uterus feels soft and boggy. Which of the following
nursing interventions would be most appropriate initially?
A. Massage the fundus until it is firm
B. Elevate the mother’s legs
C. Push on the uterus to assist in expressing clots
D. Encourage the mother to void
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94. Late deceleration patterns are noted when assessing the monitor tracing of a woman whose labor is being
induced with an infusion of Pitocin. The woman is in a side-lying position. and her vital signs are stable and
fall within a normal range. Contractions are intense. last 90 seconds. and occur every 1 1/2 to 2 minutes. The
nurse's immediate action would be to:
A. Change the woman’s position
B. Stop the Pitocin
C. Elevate the woman’s legs
D. Administer oxygen via a tight mask at 8 to 10 liters/minute

95. A laboring client is in the first stage of labor and has progressed from 4 to 7 cm in cervical dilation. In which
of the following phases of the first stage does cervical dilation occur most rapidly?
A. Preparatory phase
B. Latent phase
C. Active phase
D. Transition phase

96. A client arrives at the hospital in the second stage of labor. The fetus' head is crowning. the client is bearing
down. and the birth appears imminent. The nurse should:
A. Transfer her immediately by stretcher to the birthing unit
B. Tell her to breathe through her mouth and not to bear down
C. Instruct the client to pant during contractions and to breathe through her mouth
D. Support the perineum with the hand to prevent tearing and tell the client to pant

97. After doing Leopold's maneuvers. the nurse determines that the fetus is
in the ROP position. To best auscultate the fetal heart tones. the Doppler is placed:
A. Above the umbilicus at the midline
B. Above the umbilicus on the left side
C. Below the umbilicus on the right side
D. Below the umbilicus near the left groin

98. A nurse in the labor room is performing a vaginal assessment on a

pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina.
Which of the following would be the initial nursing action?
A. Place the client in Trendelenburg’s position
B. Call the delivery room to notify the staff that the client will be transported immediately
C. Gently push the cord into the vagina
D. Find the closest telephone and stat page the physician

99. A nurse in the delivery room is assisting with the delivery of a newborn infant. After the delivery of the
newborn. the nurse assists in delivering the placenta. Which observation would indicate that the placenta
has separated from the uterine wall and is ready for delivery?
A. The umbilical cord shortens in length and changes in color
B. A soft and boggy uterus
C. Maternal complaints of severe uterine cramping
D. Changes in the shape of the uterus

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100. A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant
following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the
client for which of the following risks associated with placenta previa?
A. Disseminated intravascular coagulation
B. Chronic hypertension
C. Infection
D. Hemorrhage

101. A nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which of the
following is noted on the external monitor tracing during a contraction?
A. Early decelerations
B. Variable decelerations
C. Late decelerations
D. Short-term variability

102. A nurse is reviewing the record of a client in the labor room and notes that the nurse midwife has
documented that the fetus is at (-1) station. The nurse determines that the fetal presenting part is:
A. 1 cm above the ischial spine
B. 1 fingerbreadth below the symphysis pubis
C. 1 inch below the coccyx
D. 1 inch below the iliac crest

103. A nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes
the presence of episodic accelerations on the electronic fetal monitor tracing. Which of the following actions
is most appropriate?
A. Document the findings and tell the mother that the monitor indicates fetal well-being
B. Take the mother’s vital signs and tell the mother that bed rest is required to conserve oxygen.
C. Notify the physician or nurse-midwife of the findings.

104. A nurse is monitoring a client in active labor and notes that the client is having contractions every 3
minutes that last 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 BPM.
Which of the following nursing actions is most appropriate?
A. Encourage the client’s coach to continue to encourage breathingexercises
B. Encourage the client to continue pushing with each contraction
C. Continue monitoring the fetal heart rate
D. Notify the physician or nurse midwife

105. A nurse is performing an assessment of a client who is scheduled for a Cesarean delivery. Which
assessment finding would indicate a need to contact the physician?
A. Fetal heart rate of 180 beats per minute
B. White blood cell count of 12.000
C. Maternal pulse rate of 85 beats per minute
D. Hemoglobin of 11.0 g/dL

106. A nurse is caring for a client in labor. The nurse determines that the client is beginning in the second
stage of labor when which of the following assessments is noted?
A. The client begins to expel clear vaginal fluid
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B. The contractions are regular
C. The membranes have ruptured
D. The cervix is dilated completely

107. A pregnant woman at 32 weeks' gestation complains of feeling dizzy and lightheaded while her
fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be to:
A. Assess the woman’s blood pressure and pulse
B. Have the woman breathe into a paper bag
C. Raise the woman’s legs
D. Turn the woman on her left side..

108. When involved in prenatal teaching. the nurse should advise the clients that an increase in vaginal
secretions during pregnancy is called leukorrhea and is caused by increased:
A. Metabolic rates
B. Production of estrogen
C. Functioning of the Bartholin glands
D. Supply of sodium chloride to the cells of the vagina

109. A 60-year-old women is admitted to the following a neck dissection for laryngeal cancer
lymph nodes and the sternocleidomastoid muscle, Which of the following is the best post-operative
A. Risk for infection
B. Impaired nutrition
C. Ineffective airway clearance
D. Impaired verbal communication

110. A mother brings her 2-month-old child in to the urgent care clinic reporting that shortly after the
child developed a fever, his voice became muffled, and he began drooling. Inspiratory stridor is present. The
priority action of the healthcare provider is to
A. Obtain an order for an antibiotic
B. Inspect the child's throat for a foreign object
C. Ask the mother if the child has any allergies
D. Call for immediate assistance

111. What major factor should alert a nurse to discount an infant who is febrile?
A. Shivering
B. Tachycardia
C. Mottled skin
D. Increased respiratory rate

112. A female patient complains of abdominal discomfort. Watery stool has been
eaking from her rectum. This could be a sign of
A. fecal impaction
B. constipation
C. bowel incontinence
D. diarrhea

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

114. The nurse was evaluating nursing care plan for 50 year-old female patient who has been scheduled
for lithotripsy due to urinary calculusWhich of the following is the priority evaluation?
A. Edema
B. Acute pain *
C. Knowledge deficits
D. Urinary tract infection

115. A nurse diagnosis a patient with readiness for the This diagnosis is classified within which of the
Nursing diagnoses?
A. Acute nursing diagnoses
B. Risk nursing diagnoses
C. Wellness nursing diagnoses
D. Possible nursing diagnoses

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

117. A child with a peanut allergy has also recently been diagnosed with [Link] healthcare provider
instructs the parents on ways to prevent the child coming in contact with peanuts. This is because the child
is at increased risk for which of these problems?
A. Painful rash and urticaria
B. Anaphylaxis and respiratory failure
C. Headache and seizures
D. Projectile vomiting and diarrhea

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

‫وللملف تحديث كل شهر ان شاء هللا‬

‫مد يد االحسان‬......‫كن بالناس رحيما‬

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‫باإلحسان‬ ‫كن محسنا فيما بقي فلربما تجزي عن االحسان‬