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. 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
d. Rationale TB chest XRAY

3. 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. D. Family members who are at risk for infection

4. 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

5. 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 off?
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

6. 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

7. 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
C. Airborne precautions
D. Standard precautions

8. 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
 C. Airborne precautions
D. Standard precautions

9. 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

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

11. A 45 year old patient is admitted with pulmonary tuberculosis. The unit nurse placed the patient in isolation room with
negative air pressure and prepared all PPE at the entrance of the room. Which of the following PPE is the most important for
the nurse when caring for this patient?
A. Hair cover
B. Sterile gloves
C. N95 respirator
D. Protective goggle

12. 8 month-old child diagnosed with bronchiolitis due to respiratory ncytial virus (RSV) is admitted to the pediatric hospital.
The nurse should initiate which of the following isolation precaution?
A. Contact
B. Airborne
C. Standard
D. Droplet

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

14. A eight 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. A 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 began 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. In order to reduce the risk of disease transmission from a patient with diphtheria, which of the following standard precautions
would the nurse implement?
A. Airborne
B. Contact
C. Droplet
D. Ventilatory

19. 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

20. 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

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

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

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

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

25. A 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

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

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

28. The nurse is assigned to care for the a patient with Ebola virus disease. Which of the following is the most common
mode of transmission for Ebola virus?
A. Vector
B. Airborne
C. Direct contact
D. Common vehicle

29. A nurse is caring a patient diagnosed with pulmonary tuberculosis and she has to wear N95 mask when she enters to the
parent room. Based on the cycle of infection, which of the following is the reason to use the mask?
A. Break the transmission chain at the portal of entry.
B. Break the transmission chain at the portal exit
C. Kill the agent exits in the patients room.
D. Eliminate the reservoir of the bacteria

30. After receiving the initial treatment of TB , a 27 years old woman in the chest disease ward was given discharge
instruction on dietary management , medication, regimen, hygiene care and follow up visits. What is the instructions
need to be emphasized the most?
A. Increase protein diet to promote healing
B. More rest and relaxation to restore therapy
C. Maintain daily exercise schedule to improve health
D. Dispose sputum as guided to avoid spread of disease
31. A patient is admitted to the emergency room with an unknown infection disorder. Which of the following is the most
important measure a nurse implement to reduce the risks of transmitting these microorganisms other?
A. Hand hygiene
B. Wearing gloves
C. Wearing a mask
D. Wearing a gown

32. A nurse is assigned to care for a patient with small that needs to be placed on airborne precaution. Which of the
following item should be used before entering the patient room?
A. Gloves and gown
B. Gloves and goggles
C. Gloves and mask
D. Gloves , gown N 95

33. Which of the following is the primary level of prevention?

A. Detect and treat existing disease
B. Prevent illness or injury occurring
C. Reduce the extent and severity of health problem
D. Minimize disability and restore to prevent function

34. A Nurse is surgical unit prepares for a wound dressing. While she is preparing. She sneeze over the dressing trolley
without wearing a facemask. Which of the following is the most appropriate action should the nurse take?
A. set up a new sterile field
B. put on a mask and continue working
C. continue working the most sterile field
D. Replace the equipment she thinks is contaminated

35. Which of the following is the most effective infection control precaution to prevent nosocomial infection?
A. Hand washing before and after patient contact
B. Wearing gloves and mask for direct patient care
C. Isolation precaution
D. Broad spectrum antibiotic

36. A 16 month old child is hospital in the intensive care unit with multi resistant sepsis. On the 3rd day. She had explosive
diarrhea. A stool sample was sent to the laboratory for C. difficle investigation. Which of the following transmission
based precaution is most appropriate?
A. Combination airborne and droplet
B. Contact
C. Droplet
D. Airborne

37. When planning discharge teaching for a patient hospitalized for treatment of the 3rd burns over 30% of the body, a
nurse knows it is most important to include instructions regarding the loss of large amounts of serum occurring with
burns and the resulting loss of immune function. Which of the following instructions should be include?
A. Wash hands frequently each day
B. Wear supplemental oxygen at night
C. Wear masks while in public spaces
D. Take a multiple vitamin tablet night

38. A 20 year old woman is hospitalized with a strong and uncontrollable cough and has difficulty breathing while
coughing. A doctor writes an order for the patient to be transported from the medical surgical department to the
radiology department for an xray examination. The nurse prepares to transfer the patient and considers standard
precautions and additional transmission precautions. Who of the following would be required to wear a mask?
A. Radiology staff
B. Nurse and patient
 C. Patient
D. Nurse

39. 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

40. Complication of thyroidectomy

A. Distension
B. Bleeding
C. Vocal cord injury

41. 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

42. A Post thyroidectomy patient transferred to ward and developed tetany the nurse suspected that patient has ?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D.
43. A nurse Wayne is aware that a positive Chvostek’s sign indicate
A. Hypocalcemia
B. Hyponatremia
C. Hypokalemia
D. Hypermagnesemia

44. 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.

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

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

47. 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
48. A nuclear plant experienced a leakage, and all involved workers were brought to the Emergency Department for
treatment . the medical team prescribed potassium iodide for the workers to block radioactive iodine to be absorbed by
an organ in the body. Which of the following organs is the most sensitive to radioactive iodine?
A. Brain
B. Lungs
C. Kidney
D. Thyroid

49. The nurse care for a 60 year old woman who history hypertension, hypothyroidism and elevated cholesterollevels. She
takes tablets daily for each of the health problem. The doctor orders a routine dual- x-ray absorptiometry test that shows
decrease bone density. Which medication most likely contributed the test result?
A. Statins
B. Anti-hypertensive
C. Synthetic thyroid hormones
D. Cholesterol absorption inhibitors

50. A 36 years old man ha undergone a subtotal thyroidectomy ago. he Is suspected to develop tetany after the surgery.
Which of the following symptoms best indicates tetanus?
A. Tingling in the fingers
B. Pain in hands and feet
C. Tension on the suture lines
D. Bleeding on the back of the dressing

51. The nurse is assessing 50 year old woman whose thyroid enlarged. A blood sample was collected and an analysis
confirm diagnosis.
TSH 0.12 normal 0.4-6.5
Free 210 normal 50-140.
Thyroxin T4 normal 4.5-11.2
A. Thyroidectomy
B. Incision and drainage
C. polythyroidectomy
D. adrenalectomy

52. 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

53. 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

54. 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
55. 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

56. 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

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

58. 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

59. 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

60. - 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

61. 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

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

63. 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

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

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

65. Treatment of nephritic syndrome is corticosteroids

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

67. A 66 year old woman with a history of unstable angina and hypertension present to the emergency department with a
dull chess pain that she describes as similar to heartburn. The pain radiates down the left arm. She had taken sublingual
nitro-glycerine tablets with any relief any electrocardiograph is perform and shows elevated S T segments. Which
medication is most likely to given to dissolve the thrombus?
A. Heparin
B. Warfarin
C. Streptokinase
D. Aspirin

68. A 62 year man with a history of intracerebral bleeding three months ago, was referred primary health care following
acute starch symptoms. Brain CT scan is normal and the patient is receiving oxygen by nasal cannula at 4LPM
BP 185/105 HR 82 RR 18 TEM 36.6 SO2 93%
Which of the following medication would be ordered first?
A. RtPA
B. Aspirin
C. Dopamine
D. Nicardipine
69. A nurse checks the medication chart of a patient, which has the following order, nitroglycerin Tab sublingual. Which of
the following medication administration routes should the nurse use?
A. In the nose
B. In the eyelid
C. Under the skin
D. Under the tongue
70. A 28 year man admitted to orthopedic ward complaining of throbbing pain in casted leg. Which of the following
nursing intervention should be taken first?
A. Remove the cast
B. Notify a doctor
C. Assess pedal pulse
D. Administer PRN medication

71. A 62 year old woman presents to the clinic with a primary compliant of fatigue. An assess shows a smooth and
reddened tongue with a loss of papillae and pallid mucous membranes. She complaints of a sense of constant fullness of
the stomach, with a decreased appetite and two three loose bowel movement per day. A neurological assessment shows
numbness in the feet and lower legs. The patient type of test would the most likely?
A. Schilling
B. Erythropoietin
C. Folic acid levels
D. Vitamin B12 levels

72. A mother of a patient who is on antipsychotic drug asked a doctor about some more detail about the drug. The doctor
told the mother that her son is taking an atypical antipsychotic drug. Which of the following is an examples of this type
of drug?
A. Thioridazine
B. Clozapine
C. Chlorpromazine
D. Haloperidol

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

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

75. 13-year-old patient is admitted for diarrhea and vomiting. He looks pale and lethargic. A nurse is preparing to give IV
hypotonic solution.
Blood pressure 110/70 mmHg
Heart rate 76 /min
Respiratory rate 18 /min
Temperature 36.1°C
Which IV solution is most appropriate?
A. 0.9% saline
B. Lactated ringers
C. 10% dextrose in water
D. 0.45% sodium chloride

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

77. physician orders an intravenous fluid of D5NS at 100cc/hr. This is an example of which of the solution?
A. hyper alimentation
B. hypertonic
C. hypotonic
D. isotonic

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

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

80. Digoxin not given to pàtient who has which of the following ?
A. tachycardià
B. hypertension
C. tachypnea
D. bradycardia

81. Atropine is indicated for increase

A. Heart rate
B. Respiratory rate

82. Morphine side effect ?

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

83. patient with ongoing magnesium sulfate the nurse should be alert to ?
A. temperature
B. respiratory rate
C. heart rate

84. Soldier was brought to triage area after being exposed to chemical weapons. Signs and symptoms of nerve gas exposure
were noticed. A nurse prepares for medical management. Which medication should the nurse prepare for the patient?
A. Atropine
B. Adrenaline
C. Sodium nitrate
D. Sodium thiosulphate

85. Nitroglycine administration route :

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

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

87. 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 the
extremities (see lab results)
Normal Values
Result Test
134-146 mmol/L
145 Sodium
3.5-5.2 mmol/L 6.8 Potassium
2.15-2.62 mmol/L 2.50 Calcium
Which of the following is the best medication?
A. Naloxone (Narcan)
B. Hydralazine (Apresoline)
C. Potassium chloride (KCI)
D. Sodium polystyrene sulfonate (Kayexalate

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

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

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

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

92. 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

93. 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

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

95. 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

96. 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
dictation?
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

97. 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

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

99. A home care patient with chronic Obstructive reports an upset stomach. The patient is taking and triamcinolone
acetonide (azmacort). Which of the following counselling should be given
A. Theo-dur on an empty stomach
B. Theo-dur and azmacort at the same time
C. Theo-dur and azmacort 12 hours apart
D. Theo-dur with milk or crackers
100. Which of the following vitamins is necessary for wound healing process?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin K

101.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

102.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

103. A nurse received the serum digoxin level result for the patient the day and notes that the result is 2.6 ng/mL (see lab
result) Test result normal value Digoxin (men) 2.6 0.8-2ng/mL Which of following nursing actions is the
mostimportant?
A. Notify the physician
B. Check previous vital signs of patient
C. Record normal value on nursing note
D. Administer scheduled dose of medication

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

105. A 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

106. 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

107. 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 perminute should be administered?

A. 14
 B. 24
C. 42
D. 56

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

109. 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. 190
D. 217

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

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

112. 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

113. The following syringe contains 2 gm of morphine sulphate, how many grams are there in 1 ml:
A. 0.5 gm
B. 1 gm
C. 2 gm
D. 4 gm

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

115. A nurse is assigned to care for a patient in medical ward who has a physician order of 1500ml of normal saline 0.9% to
be administered over 12 hour period. Which of the following is the infusion rate?
A. 75 ml/hr
B. 100ml/hr
C. 125ml/hr
D. 150ml/hr

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

117. A 37year old female prevented to the Emergency room with complain of symptomatic bradycardia appropriate nursing
intervention include establish intervention access what is the possible drug to be given in the IV solution ?
A. Digoxin
B. Atropine
C. Anticoagulant
D. Calcium channel blocker

118. A 25 year old woman present to the emergency room with decrease reflexes, hypoventilation, hypotension, and fuced
pupils, a family member who is accompanying the patient has bottle of diazepam which the label states was recently
family member also indicates that the patient has a depression. What intervention should the nurse expect to administer?
A. Naloxone
B. Active charcoal
C. Tap water enema
D. Magnesium sulfate to reduce the risk seizure

119. Nurse gives health education to patient In outpatient department regarding a medication . she told him "avoid working
outdoors in a hot weather, excessive sweating ad during l water daily Which of the following is most likely medication?
A. Diazepam
B. Haloperidol
C. Lithium carbonate
D. Monoamine oxidase inhibitor

120. During CPR of an admitted patient following the cardiac arrest. Two Dc shocks and one dose of epinephrine was given.
A third dose was delivered followed by anti arrhythmic medication . what medication is the most likely to be given
next?
A. Adenosine
B. Lidocaine 2 mg
C. Epinephrine 1 mg
D. Sodium bicarbonate

121. 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

122. A patient comes to the emergency unit with cough and severe dyspnea. The patient’s medical history revealed a
diagnosis of chronic heart failure and chronic obstructive pulmonary disease.
Blood pressure 110/70 mmhg
Heart rate 87/min
Respiratory rate 23/min
Temperature 37.3 C
Which of the following diagnostic tests will be most beneficial to a nurse to figure out if there is an exacerbation of
heart failure?
A. B-type natriuretic peptide (BNP)
B. arterial blood gas (ABG)
C. cardiac enzymes (CK-MB)
D. chest x-ray
123. 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

124. 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

125. The nurse is caring for a 60-year-old in the Medical-Surgical Unit. On entering the room the nurse finds the patient
alert, oriented and. The skin color appears healthy and pink. The nurse observes electrocardiogram and notices absent P-
waves. Which initial action is the most important?
A. Defibrillate
B. Cardio version
C. Pacemaker preparation
D. Intravenous amiodarone

126. During health education for a patient on Monooamine oxidase inhibitor (MAOI) the nurse instruct him to avoid certain
foods that can interact with the MAOI. Food containing with of the following contents should be avoided?
A. Alcohol
B. Caffeine
C. Tyra mine
D. Folic acid

127. After teaching a 54 year old patient with angina on how to take nitroglycerin sublingual PRN. Which of the following
statements reflect the patient understanding?
A. I have to take this medication once i need it only
B. It is ok to take one tablet daily to prevent the heart attack
C. I can take two tablets together at once if the attack is
D. This medication will regulate my heart beats and I will be

128. A 45 year old client who diagnosed with brain was schedule for craniotomy. It is important to preventing the developing
of cerebral edema after surgery. What medication would the nurse expect to prescribed the client?
A. Steroids
B. Diuretics
C. Ant convulsions
D. Antihypertensive

129. On orientation day, a nurse educator said to a new nurse" our hospital provides the highest level of specialized
healthcare in an integrated educational and research setting" which of the following aspects of the hospital's strategic
plan is indicated by this statement?
A. Vision
B. Policy
C. Values
D. Mission

130. A head nurse of an intensive care unit wrote a report about the needs of her department and gave it to the nursing
supervisor. Which of the following types of communication is this?
A. Upward
B. Horizontal
C. Diagonal
 D. Downward

131. A head nurse of a coronary care unit delegated staff scheduling to a senior nurse in that unit. Which of the following
steps must the head nurse implement before delegating tasks?
A. Negotiate with the senior
B. Take signature of senior
C. Explain task to senior
D. Make sure hospital policies for delegating tasks

132. A 45 year old patient has a colostomy bag attached as a result of benign mass removal, while conducting the discharge
teaching session, the nurse assessed the patient's wife understanding of the teaching. Which of the following steps of
nursing process is exercised here?
A. Implementation
B. Planning
C. Assessment
D. Evaluation

133. Which of the following is correct nursing process order?

A. Diagnosis, assess, plan, evaluate, implement
B. Assess, diagnosis, plan, implement, evaluate
C. Evaluate, assess, plan, implement, diagnosis.
D. Plan, assess, diagnosis, evaluate, implement

134. A nurse calls a physician regarding a change in a patient's condition. A physician gives orders over the telephone for stat
arterial blood gases. Which of the following is the best intervention to be implemented?
A. Give order stat to health unit coordinator to input in computer
B. Write down order and read it back to physician
C. Write down order for ABGs immediately
D. Call respiratory therapist stat to draw the ABGs

135. 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

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

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

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

A. it ignores the incompetent personnel
B. cannot be used in emergency situations
C. decreases collaboration among the team
D. may end up in inappropriate decision making
139. 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

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

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

142. post-operative patient who underwent an abdominal procedure requests a pain medication from the nurse and rates the
pain at a level nine. There a standing order for narcotic administration. When the nurse opera the narcotic box and
performs a count, the number of pills remaining in the box is different than the number of pills recorded on 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

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

144. 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

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

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

146. 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

147. surgeon instructs a nurse to serve as a witness to an elderly patient’s informed consent for surgery. During
A. the explanations to the patient, it becomes clear that the patient is confused and does not understand the
B. procedure, but reluctantly sign the consent form. The nurse should:
A. Sign the form as a witness, making a nation that the patient did not appear to understand
B. Not sign the form as a witness and notify the nurse supervisor
C. Not sign the form and answer the patient’s questions after the surgeon leaves he room
148. A community nurse assigned to work in a Makkah, one of the most multicultural cities in Saudi Arab has to interact
with multicultural population every day What is the most important step the nurse should do before with the clients?
A. Asking the client about his/her cultural background
B. Conducting an appropriate culturological assessment
C. Ensuring that the client has his/her a privacy
D. Looking at the client's file to take history
149. The head nurse meets with staff nurses to discuss ways to improve communication among shifts Which of the following
statement best exemplifies the final stage of conflict management?
A. "We need to clearly define the nature of the conflict”
B. " I will evaluate the outcomes of the strategies used monthly
C. " Let us create a time line for the implementation of our strategies”
D. " I have to force you to follow the rules to resolve the issue”

150. 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

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

152. 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

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

154. which of the following is the most appropriate action for a head nurse starting at a new hospital?
A. Make immediate change at the unit
B. Plan and coordinate new strategies
C. Assess unit activities for at least three months
D. Ask about the previous head nurse managerial style
155. 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

156. 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.

157. 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

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

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

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

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

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

A. incident report
B. care plan
C. kadex

162. 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

163. During the assessment phase of a preoperative interview, the patient reports feeling nervous. The patient conveys to the
nurse that a parent died in surgery due to malignant hyperthermia .to whom would this information be most important ?
A. PACU NURSE
B. SCRUB NURSE
C. ANAESTHESIA TEAM
 D. CHARGE NURSE

164. a charge nurse in the nurse was noted poor staffing schedule in one of the shift. The schedule causedproblems among
staff members in the unit. The women the charge nurse should bring the problem to?
A. Supervisor
B. Chief nurse
C. Follow charge nurse
D. Grievance committee

165. nurse responsible for narcotic medication loses on ampule morphine. She reports the problem to nurse manager. Which
of the following is the first thing she should say according to the SBAR approach?
A. I have lost one ampule of morphine
B. We should ask the nurse about the morphine
C. I think I left the lid of narcotics box open
D. We should open an investigation into problem

166. A nurse intervention a patient recently admitted to long term care facility to obtain information on the patient health
perception. The nurse encourage the patient to elaborate this change. Which of the following type of question would be
the most effective in this situation?
A. Analytical
B. Focused
C. Closed
D. Open ended

168. A nurse enters the room of a patient named Ahmed Saeed to administered medication but the patient not
wear his identification bracelet. Which of the following is the most appropriate nursing action?
A. Ask the patient are you Ahmed Saeed?
B. Ask the patient what is your name
C. Ask the patient hat mediation do you take

169. Research data to be collected from children on nursing unit. What type of consent is the most appropriate ?
A. Informed written consent
B. Consent signed by parents
C. Consent from physician
D. Hospital administration consent

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

171. .What is a characteristic of democratic leadership style?

A. More changes
B. Structured work
C. Staff participation
D. No leader decision

172. Which of the following vaccines in highly recommended to be taken by pilgrims before Haji season?
A. Meningococcal meningitis
B. Tuberculosis
C. Hepatitis A
D. Polio myelitis

173. Which of the following is the main reason the makes nurses concerned about adolescents health status?
A. Take risky behaviors
B. Consider themselves as adult
C. Have more health issues
D. Transitional period to adulthood

174. A patient fell in the bathroom and his left leg was fractured, in order to communicate information about the
patient to the next shift. Which of the following documentation should be used by the nurse at the nurse at the
end of the shift?
A. Kardex record
B. Assignment record
C. Shift report
D. Incident report

175. A woman informed a nurse that she was never vaccinated against rubella. Which of the following is the best
nursing advice?
A. No need for her to be distress, rubella is not harmful to the fetus
B. The vaccine can be administered any time during her pregnancy
C. She can get pregnancy any time after receiving the vaccine
D. She should be vaccinated after delivery of the baby she get discharge

176. A 29 year old woman had been diagnosed with a 3 cm ovarian cyst. Which of the following is the appropriate
step in management?
A. Cyst aspiration
B. Hormonal therapy
C. Cyst removal by laparoscopy
D. Examination after next menstruation

177. A diabetic mother delivered a full term neonate by Caesarean section infant is admitted to the neonatal
intensive care unit for observation. This infant is at risk of which of the following complication?
A. Pneumothorax atelectasis
B. Hyperglycemia
C. Atelectasis
D. Hypoglycemia

178. The midwife was assessing a 36 year old gravis 4 para 2mother. The patient was in labour for 10 hour and
had extraction. Two saturated pads were fully soaked with blood with hours been admitted in the post natal
ward. Which of the following is the appropriate nursing diagnosis?
A. Anxiety related to blood loss
B. Fatigue related to lack of oral intake
C. Activity intolerance due to discomfort
D. Fluid volume deficit due to uterine atony

179. Which dietary intake should be initiated in pregnant woman?

A. Yogurt
B. Soft cheese
C. Processed cheese
D. Pasteurized milk

180. A 33 old woman presented to the ER with general weakness. The laboratory investigation indicated VIT D
deficiency. Which of the following nutrient should be recommended as a good source of vitamin?
A. Rice
B. Green tea
C. Orange juice
D. Fish liver oils
181. The midwife was caring for a 30 year old gravida 3 para 3 postpartum normal delivery mother. After three
hours, the patient was restless, her skin was cool, clammy and feeling thirsty. What will be midwife’s initial
action?
A. Notify the doctor
B. Check the vital sign
C. Give patient a drink
D. Start fundal massage

182. Which of the following statement indicate nursing action during the first hour after delivery of the placenta?
A. Monitor of mothers hemoglobin
B. Assess maternal vital signs every 15 minutes
C. Ensure that the mother mobilize and empty her bladder
D. Administer 10 units of oxytocin via IV line to ensure uterus is well contracted.

183. Which of the following nursing responsibilities should be done immediately following administration of
lumbar epidural anesthesia to a woman in labor?
A. Reposition from side to side
B. Administer oxygen
C.
D. Assess for maternal hypotension

184. A nurse is assessing the uterus of a G5P4 patient immediately after delivery. The nurse notes the fundus is
not contracted. Which of the following is the most appropriate immediate action should be taken?
A. Massage the fundus
B. Assess the bladder
C. Elevated the mother's legs
D. Encourage the mother to void

185. A nurse is assisting during a normal vaginal delivery on a 22 year diabetic patient. The head was delivered
without any complication head suddenly retracts against the perineum prompting the physician to immediately
ask for the nurse assistance with this dystocia. Which of the following will be the nurse appropriate action to
impacted shoulders of the infant?
A. Fracture the infants clavicle.
B. Prepare patient for immediate cesarean section
C. Apply fundal pressure to displace anterior shoulder
D. Perform supra public pressure to release anterior shoulder

186. At labor room, a nurse assessed the condition of the patient and gathered the following data. Cervical
dilatation 2-5minutes lasting 40-60seconds increasing bloody show leg discomfort with heaviness what is the
significance of the data?
A. Patient on the first stage of labor
B. Patient on the third stage of labor
C. Patient on the second stage of labor
D. Patient is experience a prolonged labor

187. A primigravida mother is having her baby through normal vaginal delivery. The baby is completely delivered
but the mother is still experiencing the uterine contractions.
A. Beginning of the third stage of labour
B. Indication of increase in vaginal bleeding
C. Need for reducing the rate of intravenous oxytocin
D. Uterine contraction will gradually reduce then stop.

188. A mother is the outpatient Clinic for her first post natal visit on the 15th day her normal vaginal delivery. Her
physical examination reveals a stable condition, breasts are soft and her sanitary napkin has bright coloured
rubra. Which of the following needs further evaluation?
A. Amount and frequency of breast feeding
B. Hydration level and bleeding breast feeding
C. Activity, exercise and resting periods
D. Uterine size and position

189. A midwife is discussing the birth spacing measures with a mother whose first baby boy is a 1 year old and
was born with spina bifida. The midwife has explained the possible causes of condition of the baby and the
measures is necessary if the mother is planned for a next pregnancy?
A. Increase iron and calcium supplements
B. Multivitamin and folic acid intake
C. Genetic screening
D. Immunization before and during pregnancy

190. A 32 weeks pregnant patient present for her follow up appointment in the antenatal clinic. She complains of
experiencing frequent heartburn. Which of the following is the most appropriate advice to the patient?
A. Drink plain water between meals
B. Raise head of the bed
C. Eat favorite foods
D. Lie down for one hour after taking food

191. A midwife visits a mother four weeks after delivery. The mother is breastfeeding her baby but she requests
the midwife to suggest alternative formula milk as she has to return back to her job and her baby will stay in a
day care center. Which of the following teaching plans is suitable for the mother?
A. Supplementary medications with bottle feeding
B. Combined schedule of the breastfeed and top feed
C. Hygiene practices with bottle feeding
D. How to express and save milk

192. A women in labor is progressing well. She has been diagnosed with a large fibroid in the fundus. What should
the nurse observe her for after delivery?
A. Thrombophlebitis
B. Postpartum depression
C. Postpartum hemorrhage
D. Loss of bladder tone during puerperium

193. Which of the following assessment is contraindicated while providing intrapartum nursing care for a patient
with HELLP syndrome?
A. Heart sounds
B. Blood studies
C. Leopold's maneuvers
D. Deep tendon reflexes

194. For which of the following issues should the nurse observe the movie closely during the 4TH stage of labor?
A. Uterine irritability
B. Signs of infection
C. Signs of bleeding
D. Unwillingness to breastfeed

195. 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
196. 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

197. 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

198. 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

199. 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

200. A 36 years old woman is in her 18 weeks pregnancy came to antenatal clinic and assessed by the nurse. She has three
previous abortion during the first trimesters prior to pregnancy. How the nurse will document the status of the mother?
A. Parity
B. Nullipara
C. Multipara
D. Primipara

201. During vaginal examination the nurse palpated the posterior fontanel to be at the right side and upper
quadrant of the maternal pelvis ?
A. ROP
B. LOP.
C. ROA
D. LOA

202. A 38 years old gravida 5 para 3 post natal mother delivered via caesarean section. On the fourth post
operative day the mid wife noted human's sign was positive . human's sign is result by pain which of the
following leg site?
A. Calf
B. Foot
C. Heel
D. Thigh

203. Which of the following vaccines are safe to administer to pregnant women?
A. Measles
B. Tetanus
C. Rubella
D. Varicella

204. Which of the following is independent function of primary health care nurse?
A. Complete history and nursing assessment
B. Referral for diagnostic evolution
C. Medical examination
D. Psychotherapy referral

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

206. A 50 year old woman is attending the outpatient clinic for annual check up. Which of following should be
reported if inspected during breast examination?
A. Everted nipples
B. Symmetrical visible
C. Dimple in the left breast
D. Right breast is slightly larger than left breast

207. A pregnant woman is 36 weeks pregnant was admitted to antenatal ward for observation after being
involved in a car accident the refuses when the nurse tried to touch her abdomen to perform examination
saying it is painful. She also present mild vaginal bleeding . Which of the following is the most appropriate
diagnosis
A. Placenta previa
B. Tubal pregnancy
C. Abruptio placenta
D. Inevitable abortion

208. Mother of nine children, three of them with congenital anomalies and one down syndrome, she is a primary
school graduate, with low financial status, she is not using any method of family planning . according, the
primary health are nurse has referred her for counseling.
Which of the following is a model concerned with disability as from of social injustice due to stigma, or
discrimination
A. Health belief
B. Biomedical
C. Sociopolitical
D. Economic

209. A primiparous mother is calling the clinic to report that her baby often regurgitates small amount of breast
milk which of the following is appropriate nursing advice the mother?
A. Elevate the head of the bed
B. Feed the baby when he is too hungry
C. Attend to the clinic with the baby
D. Put the baby in prone position after feeding

210. A 10 month old infant is admitted to the surgical ward with hydrocephalus. Which of the following .indicate
increased intracranial pressure?
A. Bulging
B. Decrease blood pressure
C. Rapid, shallow breathing
D. Increase body temperature

211. A multigravida and 37 weeks pregnant mother presents t the antenatal Clinical. Her condition of the stable
and her baby position and heart rate are normal. Which of the following discussion is more appropriate with thr
mother?
A. Observer until the 40weeks complete
B. Family planning and birth spacing
C. Arrange for caesarean section
D. Possible of induced labor.

212. A 26 years old patient in the gynecological ward complained of pain and swelling in her episiotomy stitches
on her second post-natal day. On examination the localized swelling redness foul smell and pussy discharge were
identified at the stitches site after examination the nurse checked vital sings BP 116/28 HR 132 RR 28 TEM
39.8. which of the following should the nurse do prior to the patient examination by the gynecologist?
A. Arrange dressing instrument
B. Maintain patient privacy
C. Arrange stitch removal kit
D. Collect detailed history

213. A 28-year-old primigravida who is pregnant at 16 weeks of attended at the emergency department because
of dark brow discharge. investigation showed a decline in pregnancy test for which of the following is the most
likely type of the spontaneous abortion?
A. Missed
B. Threatened
C. Incomplete
D. Inevitable

214. A nurse is educating a primigravida woman who is pregnant at 30weeks on breast feeding. Which of the
following statement by the woman indicates that she needs additional teaching?
A. Breast milk can stored at room temperature
B. Breast feeding should be based on baby demand
C. Baby can beheld in different ways during feeding
D. Breast feeding helps the uterus to return to pregnancy size

215. Which of the following vaccines should be given to a 9 months old ?

A. Hepatitis
B. Varicella & measles
C. Oral polio and bacillus cellmate Guerin
D. Measles and meningo conjugate quadrivalent ( MCV4)

216.nurse is instructing a female client how to do breast self-exam. Which of the followings is the best time to perform this
exam?
A. After ovulation
B. After the period
C. Two weeks after period
D. Three days before period

217. A nurse is explaining pudendal block anesthesia to primigravida women who is inactive labor. Which of the
following relief areas identified by the woman would indicate that teaching was effective?
A. Back
B. Perineum
C. Fundus
D. Abdomen

218. Which of the following classifications of placenta previa is applicable when the placental edge is 5 cm away from the
internal cervical OS?
A. Total
B. Partial
C. Marginal
D. Complete

219. A postdate pregnant woman is admitted for the induction of labour. Her fetal heart rate and vital signs are
within normal range her intravenous line is maintained and she is to be started on low doses of labour inducing
medication. Which of the following medication the mother is likely to receive intravenously ?
A. Oxytocin
B. Cervidil
C. Cytotec
D. Cytoxin

220. Which of the following patients are at risk for cord prolapse?
A. Fetus that remains at high station
B. Mother with oligohydramnios
C. Presenting part at station +
D. Intact membranes

221. While taking care of the a patient with a spinal cord injury, the patient suddenly complains of pounding
headache upon assessment the patient was found to have diaphoresis , drop in heart and elevated blood
pressure , autonomic dysreflexia is suspected and the head on the bed is elevate . which of the of the following is
the most appropriate to important immediately?
A. Notify the physician
B. Assess bladder for distension
C. Continue to monitor for next hour

222. vital statistics and control of communicable disease serve many function. Which of the following is the basic
function for health?
A. Public
B. Mental
C. Education
D. Maternal & child

223. A 6 months old infant mother decided to wean her child. Which of the following is the best principle of
weaning process?
A. Start the weaning process by 8 month of life
B. Gradually replace one breast session at a time
C. Discontinues the nighttime feeding first
D. Allow the child to take a bottle of milk or juice bed

224. A midwife is conducting a health a health education session to the primigravid mothers. The session is about
antepartum care to ensure the health of the mother their babies. Which of the following statement made by
mother suggest their appropriate understandings of anti-partum periods ?
A. Beginning of labor till the baby birth
B. Diagnosis of pregnancy till the baby birth
C. Last three months of pregnancy
D. Forty days after the child is born

225. A 41 weeks pregnant was admitted to labor and delivery unit for induction with oxytocin infusion 3 hour
later her contraction are 5 to 6 in 10 minutes and strong which of the following is he best nursing action?
A. Gives an analgesic
B. Stop the oxytocin & inform the doctor
C. Gives psychological support
D. Change position to left lateral

226. A 25 year woman was admitted to medical ward for anorexia chemotherapy the nursing diagnosis was
imbalanced nutrition less than body requirements related to dysfunctional eating pattern which of the following
is the best way to evaluate the outcome of nursing care of this patient?
A. Record daily weight
B. Monitor vital signs accurately
C. Schedule meals with family members
D. Offer small portions of favorites

227. Total ante natal visits ?

10 -12 visit ( every 4 weeks in the first 28 weeks , every 2 weeks in 32-36 weeks , every week from 36weeks -
40weeks )

228. What is the antenatal assessment schedule for women the period of conception and 28 weeks of gestation?
A. Once a week
B. Every 2 week
C. Every 3 weeks
D. Every 4 weeks

229. A nurse is instructing a 20years old nulligravida woman about side effect of oral contraceptive. Which of the
following if stated by the woman indicates for further education?
A. Nausea
B. Headache
C. Weight gain
D. Ovarian cancer

230. A 33 week pregnant mother is on her routine medications that include iron supplement , folic acid ,
multivitamins and calcium supplement , despite all medication her hemoglobin has not been increase since last
two month, she is experiencing more fatigue and lethargy since past few weeks
HB 80 ..... HCT 0.22
Which of the following intervention is the most desired?
A. Add vitamin c to increase drug absorption
B. Start injectable multivitamins as per regimen
C. Advise increase intake of organ meat and fortified food
D. Advise increased food intake by frequent small meals and snacks

231. A primigravida attend the antenatal clinic for her routine visit the nurse performed an abdominal palpitation
and found the fundus to be midway between the symphysis pubis and the umbilicus what are the weeks of
gestation according to this findings ?
A. 8 Weeks
B. 16 weeks
C. 24 weeks
D. 28 weeks

232. What is the meaning of the acronym A of REEDA which is used to assess the perineum after birth?
A. The status of edges of the perineal wound it should be closed
B. Presence of discharge from the perineal wound
C. The presence of bruising of the perineal area
D. Excessive swelling of the perineal area

233. A pregnant woman has visited the antenatal clinic her last menstrual date was on 10th August this year. Her
menstrual cycle was regular at 28 day. What is the expected date of delivery?
A. 17th may next year
B. 20st may next year
C. 23rd may next year
D. 25th may next year
234. A 30 years old woman , gravid 3 para 2 in her20 weeks pregnancy was complaining of increase leucorrheoa
during past weeks the nurse reassured the mother and explained the reason of this secretions ?
A. Vaginal infection
B. Expansion of uterus
C. Stimulation of cervix
D. Production of estrogen

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

236. Which of the following assessment findings indicates laceration of the canal in the fourth stage of labor?
A. Red-brown lochia
B. Firm contracted uterus
C. Fundus is palpated at the level of the umbilicus
D. More than 1 saturated perineal pad per hour

237. Which of the following must be checked during the third day of post-partum period by the nurse?
A. The flow of milk
B. Uterine prolapse
C. Exclusive breast feeding
D. Complete involution of uterus

238. A child with sever bronchial asthma is started on prednisone. Which of the following is a side effect of
prednisone that might be exhibited by the child?
A. Anoreia
B. Weight loss
C. Anemia and fever
D. Neurologic symptoms

239. A woman was rushed to the emergency room because if vaginal bleeding mild cramps, tenderness over the
uterus, and closed cervix. After the assessment, it was suspected that the patient may be lead to inevitable
abortion. What is the possible management of this patient?
A. bed rest
B. surgical management
C. induction of oxytocin
D. dilatation and curettage

240. Which of the following nursing responsibilities should be done immediately following administration of lumbar
epidural anesthesia to a woman in labour?
A. reposition from side to side
B. administer oxygen
C. increase IV fluid as indicated
D. assess for maternal hypotension

241. the antenatal clinic, a 9-month pregnant woman notifies the nurse that e is concerned that she gained 15Kg
during this pregnancy and she is and needs to start a diet program. which of the following is the best nursing
response?
A. This weight gain is normal during pregnancy
B. You can reduce the carbohydrates in your diet
C. Wait till you have the baby and start a diet program
D. This weight is lower than you should gain during pregnancy
242. Intrauterine growth curves were used to classify a 32-week-old preterm new-born. Birth weight and
gestational age shows the infant's growth rate falls below the 10th percentile. What is the priority nursing
diagnosis for a new-born with small for gestational age?
A. Risk for injury related to impaired gluconeogenesis
B. Risk for impaired gas exchange related to meconium aspiration
C. Risk for ineffective thermoregulation related to lack of subcutaneous fat
D. Risk for altered nutrition less than body requirement related to increased metabolic needs

243. 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

244. 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

245. 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

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

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

248. 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

249. which of the following statement described the latent phase?

A. First 3 cm of cervical dilatation
B. From onset of labour to full dilatation
C. When the cervix is 100% effaced
D. Time of progress from 4 cm to 7 cm

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

251.Amniotic fluid importance . surrounds ,cushion ,protect baby . allow the fetus to move freely ,
maintain body temperature to the fetus , and contain urine from the fetus cushion

252. A 34-weeks-pregnant mother experiences a sudden gush o from her vagina and mild uterine contractions. She
informs about her condition and requests if she could wait until the delivery. Which of the following is the best
desired response for report to the hospital?
A. Intravenous fluids and medicines need to be administer
B. Observation is necessary to identify premature labor
C. Pain and fluid flow both need to be controlled
D. Fetal heart sound monitoring is necessary

253. 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

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

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

256. 38weeks-pregnant woman complains that she has been craving to eat non food substance What is the term
that describes this pregnant mother’s condition?
A. Pica
B. Bulimia
C. Anorexia
D. Binge eating

257. pregnant client is making her first Antepartum visit. She has a two year old son born at 40 weeks. a 5 year
old daughter born at 38 weeks and 7 year old twin daughters born at 35 weeks. She had a spontaneous abortion
3 years ago at 10 weeks. Using the GTPAL format the nurse should identify that the client is:
A. G4 T3 P2 A1 L4
B. G5 T2 P2 A1 L4
C. G5 T2 P1 A1 L4
D. G4 T3 P1 A1 L4
258. 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 Temperature37.5 Which of the following is the most likely diagnosis?
A. Endometritis
B. Uterine atony
C. Vulvar hematoma
D. laceration of the genital tract

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

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

261. Mother of nine children, three of them with congenital anomalies and one down syndrome; she is primary
school graduate, with low financial status. She is not using any method of family planning. So, the primary health
care nurse has referred her for counseling. Which of the following is the best health education method that can
be used?
A. community organization
B. individual counseling
C. group discussion
D. health class

262. 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

263. A postdate pregnant woman is admitted for the induction of labour. Her fetal heart rate and vital signs are
within normal range her intravenous line is maintained and she is to be started on low doses of labour inducing
medication. Which of the following medication the mother is likely to receive intravenously ?
A. Oxytocin
B. Cervidil
C. Cytotec
D. Cytoxin

264. 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

265. 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

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

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

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

269. 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

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

271. Which of the following statements describe puerperal infection ?

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

272. When would the nurse schedule a woman for a glucose tolerance test?
A. 6th-10th week of pregnancy
B. 12th-16th week of pregnancy
C. 24th-28th week of pregnancy
D. 32th-36th week of pregnancy
273. A new-born has a diagnosed Developmental Dysplasia of the Hip (DDH) and is using a Pavlik Harness as
treatment. Which of the following mechanical factors is associated with DDH?
A. Intrauterine breech position
B. Caesarean section
C. Small infant size
D. Single fetus

274. 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

275. 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

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

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

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

279. 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

Mastitis question
280. Mastitis caused by ...... E.colia Streptococcus, & V aureus

281. 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.”

282. 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

283. 41- A nurse is giving health education for a mother who has mastitis. Which of the following if stated by the
mother about what she needs to do, indicate that additional education is needed?
A. Take antibiotics
B. Use analgesics
C. Wear a supportive bra
D. Stop breast-feeding

284. 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

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

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

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

288. Mastitis is an infection of the breast that occurs most often 2-4 days after childbirth. Which of the following
is considered first line treatment of mastitis?
A. Drainage of breast abscess
B. Antibiotic therapy and cessation of breast feeding
C. Antibiotic therapy and continuation of breast feeding
D. Advice mother to stop breastfeeding until infection is clean

289. 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

290. 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

291. 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

292. 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

293. 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

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

295. A woman was diagnosed with gestational trophoblastic disease. What is the lab investigation was done to
diagnose the disease condition?
A. cervical pap smear
B. serum HCG levels
C. serum estrogen levels
D. plasma thyroxine levels

296. While the nurse is performing postpartum assessment for a primiparous mother delivered 2 hours ago, she
found the following:
Fundus

level: Midway between symphysis pubis and umbilicus

Position: At the mid line
Consistency: Contracted
Lochia: Constantly
Which of the following is the most likely diagnosis?
A. full bladder
B. Perineal hematoma
C. Birth canal laceration
D. Retained placental part

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

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

299. 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

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

301. A nurse in the postnatal ward is assigned for a multiparous patient has just delivered a healthy newborn.
When should the nurse plan to take the patient vital signs?
A. Every hour for the first 2 hours
B. Every 30 minutes during the first hour
C. Every 15 minutes during the first hour
D. Every 5 minutes for the first 30 minutes

302. which valuable information can be obtained from perform abdominal palpation ( lepoids maneuvers ) during
the later pregnancy?
A. Weight of the fetus
B. Gestational age of the fetus
C. Number of fetus in current pregnancy
D. Location and presentation of the fetus
303. A nurse who is caring for a woman in labor, prepares to auscultate fetal heart rate by using Doppler
ultrasound device. How does the nurse determine that the fatel heart sounds are correctly?
A. Notify if the heart rate is greater than 140 BPM
B. Placing the diaphragm of the Doppler on the woman abdomen
C. Palpating the maternal radial pulse while listening to the rate
D. Performing Leopold's manoeuvres first to determine the fetal heart

304. 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.

305. Molar pregnancy sings .......... Rapid increase of uterine growth

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

307. A 25 years old patient with history of amenorrhea for two month was admitted for hydatiform mole
investigation. Which signs and symptoms would the nurse observe ?
A. Hypotension
B. Hyperglycemia
C. Rapid uterine growth
D. Painful uterine contraction

308. 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

309. 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

310. 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

311. Multiparous mother is attending at the outpatient clinic 2 weeks after er delivery for follow up. While the
nurse is assessing the mother, she would not palpate the fundus. Which of the following is the most appropriate
nursing action?
A. Document normal finding
B. Massage the fundus to be firm
C. Assess lochia amount and color
D. Admit the mother to the hospital
312. A pregnant woman of 15 week gestation age and Rh –ve has an abortion admitted in the ward what should
the nurse do for this woman ?
A. Administer Rheum within 72hour
B. Do not give Rheum since it is not used with abortion
C. Do not give Rheum since the pregnancy is more than 12
D. Make certain she received Rheum on her first clinic visit

313. Lochia red fleshy odor mean :

A. Normal
B. Infection
C. Bleeding

314. 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

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

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

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

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

319. 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

320. Puerperal sepsis symptoms is ?

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

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

322. 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

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

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

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

A. Normal
B. Infection
C. Dehydration
D. Hemorrhage

326. 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

327. A nurse was assessing a newborn delivery by a mother infected with Neisseria gonorrhea. What is the
complication that can occur to the newborn?
A. Deafness
B. Blindness
C. Mental retardants
D. Hyperbilirubinemia

328. A full term mother presents in the antenatal clinic with mild lower abdominal contraction and show watery
discharge for her vagina. She told the midwife that she may be starting her child birth. She is admitted in the
labor and delivery unit, support well and is lying down on the bed.
What knowledge guide is necessary as first intervention ?
A. Assessment of cervix
B. Medication and induction
C. Reassurance and support
D. Mode of delivery

329. A pregnant woman visits the Outpatient clinic complaining of excessive vaginal secretion. Which of the
following is the appropriate nursing assessment?
A. Fetal heart rate
B. Fundal height
C. Signs of infection of labor
D. Fetal presentations and position

330. A pregnant mother with sickle cell anemia is in labor. What should the nurse to ensure the safety of the
infant?
A. Control pain
B. Administer oxygen
C. Monitor fetal heart rate
D. Monitor maternal vital signs

331. A nurse is preparing to administer RhoGam to Rh-negative women who has delivered a Rh-positive newborn
. Which of the following is prevented by this intervention ?
A. Maternal illness
B. Neonatal illness
C. Production of antibodies
D. Re- occurrence of Rh positive baby in next mother

332. A 34 years old woman was diagnosed with breast cancer and underwent surgery. She is currently receiving
monthly chemotherapy she telephone the clinic and notifies the nurse that she developed a sore throat. Which
of the following foods would be the most appropriate to recommended?
A. Fresh fruits and vegetables
B. Seafood
C. Dried fruits nuts
D. pasteurized cheese
333. Both parent have sickle anemia disease ?
A. 100%.
B. 50%.
C. 75%.
D. 25%

334. Both parent have sickle anemia trait the percentage for the child to have the disease ?
A. 100%.
B. 50%.
C. 75%.
D. 25%

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

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

337. A 15 month old child is admitted for hypospadias repair. After surgery, which of the following instruction
should be given to the parents?
A. Limit activity for 2 weeks
B. Avoid apply ointment or powder
C. Give a child a diet that is high in protein
D. Isolate the child from other children with the infection

338. A two hour old newborn baby is given to the mother to start on breastfeeding. The mother is reluctant as
the thinks is too early for the baby. The mother finally agrees to breast feed the baby after the midwife has
discussed the advantages of early of breast feeding. Which of the following statement mad by the mother
suggests her correct understanding?
A. Improve natural immunity
B. Strengthens sucking reflex
C. Stimulates gut movement

339. Establishes baby's hydrationA 111 month old boy with cleft lip & palate was discharged from the hospital
after surgery. The nurse provided the parents with teaching. Which of the following statement by the parents
indicate appropriate understanding of the teaching instruction?
A. I should avoid that my infant's cry's as much as possible
B. I will use a spoon to feed my child after the surgery
C. I will put my child in his abdomen after feeding
D. I will use lotion to ease my child's lip irritation

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

341. A baby born at 38 weeks of gestation with birth weight 1800 ram. which of the following is the classification of
this infant?
A. Low birth weight
B. Very low birth weight
C. Appropriate for gestational age
D. Small for gestational age

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

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

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

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

345. Immediately following the birth of a full-term newborn, which of the following is the priority nursing
diagnosis for this newborn?
A. airway clearance related to nasal & oral secretions
B. ineffective thermoregulation related to environmental factors
C. risk for imbalance fluid volume related t weak sucking reflex
D. risk for injury related to immature defense mechanisms

346. A full term newborn is admitted to NICU with a diagnosis of meningocele. Which of the following admission
assessment is needed?
A. Specific gravity of urine
B. Head circumference
C. Weight and length
D. Palpation of the abdomen

347. A nurse is caring for a full term newborn who was delivered five minutes ago. The infant's Apgar score was 8
at one minutes and five minutes. Which of the following has the highest priority ?
A. Assessing the infant's red reflex
B. Preventing heat loss from the infant
C. Maintaining the infant in the supine position
D. Administering humidified oxygen to the infant

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

349. A 30 weeks of gestational age preterm is admitted to the neonatal intensive care unit 2 hours . the neonate
starts to have grunting tachypnea, and nasal flaring. Which of the following is responsible factors for diagnosis of
the premature ?
A. Bronchial spasm
B. Immature bronchioles
C. Lack of surfactant
D. Pulmonary over load

350. 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

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

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

353. A23-year-old gravid 1 ,para 0 mother is presented to the Antenatal clinic. The health educator educates group
of mothers in the waiting area. Which information regarding fetal circulation the educator should stress on?
A. One umbilical artery and one umbilical vein
B. One umbilical artery and two umbilical veins
C. Two umbilical arteries and one umbilical vein
D. Two umbilical arteries and two umbilical veins

354. 37 weeks of gestation neonate is admitted to the Neonatal Intensive Care Unit immediate after delivery
because the mother has fever in the last 2 days before delivery. Which of the following is most expected finding
for neonatal sepsis?
A. decreased urinary output
B. poor feeding
C. stable body weight
D. sudden hyperthermia

355. 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 streptococcuss

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

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

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

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

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

361. 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

362. A neonatal is admitted to the NICU with a meningomyelocele. HR130 .. RR 28..... TEM 36.7 which of the
following action the nurse should perform to prevent infection of the meningomyelocele sac ?

A. Wash the sac with betadine every shift

B. Expose the defect to the room air
C. Apply antibiotic cream every 24 hours
D. Cover he sac with moist sterile saline dressing

363. A baby born at 38 weeks of gestational with birth weight 1800gram. Which of the following is the
classification of this infant?
A. Low birth weight
B. Very low birth weight
C. Appropriate for gestational age
D. Small for gestational age

364. 24 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

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

366. When assess newborn wight in scale the nurse must avoid heat loss by;
A. Radiation
B. Evaporation
C. Conduction
D. Convection

367. A nurse is caring for a newborn in Well Born Nursery she warps the baby with blanket and ensures the
nursey temperature is suitable for the babies. What type of heat loss is the nurse preventing?
A. Radiation
B. Conduction
C. Convention
D. Evaporation

368. 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

369. A neonate is admitted to the neonatal care unit with a meningomyelocele HR 130 RR 28 TEM 36.7 which of
the following actions should the nurse perform to prevent infection of the meningomyelocele sac?
A. Wash the sac with betadine every shift
B. Expose the defect the room air
C. Apply antibiotic cream every 24 hours
D. Cover the sac with sterile dressing

370. If full term infant weight 3 kg at birth, approximately should the infant weight be at 12 months old ?
A. 7 kg
B. 9 kg
C. 11kg
D. 13kg

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

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

373. 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

374. 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

375. A baby born at 35-week was admitted in neonatal intensive 27hours ago, physical examination
revealed yellow discoloration sclera and mucus membrane. The result of bilirubin level every 170mol.
The infant was diagnosed with neonatal jaundice physician order to start single phototherapy. Which
of following should the nurse consider as a priority during phototherapy of this newborn?

A. ensure proper fitting of eye covering (patches)

B. monitor bilirubin levels every 48 hours
C. feed the infant formula every 4 to 5 hours
D. avoid removing the infant from phototherapy

376. A nurse prepares to administer a vitamin K injection to a full term the mother wants to know the
importance of the injection Which of the following is the best nurse response to the mother

A. needed for blood clotting to prevent hemorrhage

B. accelerate the growth and development of infants
C. help in maintain healthy gut and passage of meconium
D. protect the infant from developing sever respiratory distress

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

378. A nurse performing nursing care plan for a neonate after a birth, which intervention has the highest nursing
priority neonate?
A. btained a dextrostix
B. give the initial bath
C. Give the vitamin k injection
D. cover the neonate head with a cap
379. During physical assessment of a male infant genitalia, the nurse found that one of the testes are enlarged.
Which of the following could be the reason for swollen testes?
A. Chordee
B. Cryptorchidism
C. Hydrocele
D. Hypospadias

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

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

382. 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

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

384. A nurse is caring for a female newborn who born with an imperforate anus. When assessing the newborns
urine, she should notify the doctor immediately if the newborn's urine contains which of the following?
A. meconium
B. sugar
C. albumin
D. crystals

385. A newborn has diagnosed Development Dysplasia of hip DDH and is using a Pavlik Harness as treatment .
A. Multiple
B. Acetabular dysplasia
C. Subluxation
D. Dislocation

386. 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

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

388. A healthy baby is born normally via vaginal delivery and when transferred to newborn until the nurse
administered vitamin K intramuscularly. Which sits recommended for vitamin K injection ?
A. Biceps
B. Deltoid
C. Vastus lateralis
D. Gluteus maximus

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

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

391. 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

392. A woman delivered her baby boy 3 hours ago with caput succedaneum. Which of the following the nurse
expects to find when she examines the newborn baby caput?
A. Soft, fluctuant mass filed with fluid
B. Bilateral mass on both biparietal boons
C. A mass with clear edges that end at the suture lines
D. A hard mass that is filled with blood

393. A mother asked the nurse that while she was changing the diapen for her female newborn, she noticed a brick
red stain on it. What is the best response by the nurse?
A. It is a sign of low iron excretion
B. It is expected in female newborn
C. It is due to medication given to the mother
D. it due to medication given to the newborn
394. 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

395. The normal systolic Bp for new Born:-

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

396. Neonatal mortality rate :

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

397. New born stomach capacity

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

Age for surgery repair

398. Cleft lip 3 – 6 month after surgery consideration elbow restrain after surgery the infant should not be
allow to cry and the infant not allow to breast feed by sucking . never to put the baby prone position after cleft
lip repair surgery

399. Cleft palate 12 – 18 month position after surgery prone position ,

400. Consideration after cleft lip and cleft palate is :

 Burping the child frequently every 15 minutes
 To prevent cleft lip and cleft palate the pregent woman u should advice:
 Folic acide 400 iu
 Increase green vegetables & Citrus intake
 Feeding up right setting position

Questions
401. A 32year 0i847ytfc10

402. old gravid 1 and para, is now planning to become pregnant within the next year. The patient herself had born with born
with neural tube defects, which were surgically repaired in early childhood. The nurse recommends that the patient begin taking
tablet of folic acid. How many micrograms would be most appropriate
for this patient?
A. 400
B. 600
C. 1800
D. 4000

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

404. A nurse is assigned to care for a child after a cleft palate repair which of the following types of restraints is very effective
for child?
A. Mummy restraint
B. Elbow restraint
C. Wrist restraint
D. Mitt restraint

405. A 4 month old infant returned immediately from OR room post cleft lip repair which of the following nursing intervention
should be considered?
A. Apply elbow restrain
B. Apply suction when needed
C. Measure temperature
D. Put infant in prone position

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

407. Mother came to the Outpatient Department with an infant having cleft and palate. The infant was underweight, so the nurse
has to consider Teaching 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 small

408. 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
counselling 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

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

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

411. A nurse is caring for 14 month old immediately after a surgical repair of cleft palate. In which position of the following
should the nurse put the child?
A. Prone
B. LateralSupine

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

Spina bifida
413. 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

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

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

415. 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

416. 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

417. 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

418. Infant with spina bifida the nurse should monitor

A. Head circumference
B. Abdomen circumference

419. Position for the baby with spina bifida is :

A. prone position
B. back
C. supine

420. A full term infant is admitted to NICU with a diagnosis of Spina vital signs are stable. Which of the following positions is
suitable for this infant?
A. Supine position
B. Semi-fowler position
C. Prone position
D. Sitting position

Hirschsprung’s Disease :
421. 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
intestine

422. A 24 hours after delivery , the nurses noted that the newborn failed to pass meconium. This indicates which of the
following condition?
A. GERD
B. Pyloric stenosis
C. Failure to thrive
D. Hirsch sprung disease

423. 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

424. 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

425. 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

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

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

428. 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

429. 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

430. 3-week-old newborn is diagnosed with Hirschsprung disease Which of the following preoperative care should
included in the plan of care?
A. Restricting oral intake to clear fluids
B. Administering a tap water enema
C. Inserting a gastrostomy tube
D. Using povidone-iodine to prepare the perineum

Intussusceptions
431. A nurse is taking a history from the infant parents who have a suspected diagnosis of intussusception. Which
of the following assessment question would be most helpful?
A. Do you breast feeding your child ?
B. What does your child's stool look like?
C. How often your child urinating?
D. What is the colour of your child' urine?

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

433. 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

434. 7month-old infant seen in the Emergency Department suffering from episodes of severe abdominal pain,
and the infant’s stool become like red jelly. Abdominal examinassions revealed palpable sausage-shaped mass in
the right upper quadrant which of the following is the best diagnosis?
A. Hirschsprung disease
B. Hypertrophic pyloric stenosis
C. Infant colic
D. Intussuception

435. 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

436. A 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
437. A 5-week-old newborn was admitted to pediatric Ward with pyloric stenosis, the newborn has weight loss,
and projectile vomiting during feeding . They scheduled surgical repair of pyloric stenosis Which of the following
postoperative intervention for this
A. IV fluid infant is retaining adequate amount by mouth
B. Administration of proper analgesia until infant discomfort resolve
C. Start feeding immediately after postoperative
D. Vomiting is uncommon in the first24-48 hrs

438. Surgery for pyloric stenosis movement?

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

439. PYLORIC stenosis peristalsis movement ?

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

440. 1 month-old infant is admitted to the surgical unit with hypertrophic pyloric stenosis and scheduled for the
surgery. Which of the following is the findings of abdominal examination?
A. palpable olive-like mass in the left side
B. palpable olive-like mass in the right side
C. Palpable olive-like mass moved from left to right
D. Palpable olive-like mass moved from right to left

441. 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

442. 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

443. A 5 week old newborn admitted paediatric ward with pyloric stenosis the newborn has weight loss, and
projectile vomiting after feeing. Which of the following abdominal organs are directly affected when stenosis
diagnosed?
A. Stomach and duodenum
B. Stomach and oesophagus
C. Liver and spleen
D. Liver and bile duct

444. Tetralogy of Fallot where is it located :

A. right heart side
B. left heart side

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

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

447. Which of the following instruction should be given to the parents about colostomy care?
A. Use baby powder after stoma cleaning
B. Empty the pouch when it is completely full
C. Avoid tight diapers around the infant abdomen.
D. Use baby wipes to clean the skin around the stoma

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

449. 11- child is admitted to the pediatrics ward with acute lymphocytic LEUKEMIA , and has had joint pain for
several weeks. Physical findings ude widespread ecchymosis, generalized lymphadenopathy,
hepatosplenomegaly, and pallor. Lab work shows a low hemoglobin level, RBC count, low WBC count low
hematocrit , and low platelets. Which high risk is expected?
A. Infection
B. Fractures
C. Dehydration
D. Hepatitis

450. A nurse is teaching a group of new mothers in the post-natal ward on how to manage breast engorgement
after they are discharged to home. Which of the following statements by the mother will indicate to the nurse
that they understood how to prevent engorgement of the breasts?
A. breast feed every 4 hours
B. breast feeding during the day and bottle feeds at night
C. breast feed every 2-3 hours during the day and stop at night
D. breastfeed the baby every 2-3 hours during the day and night

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

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

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

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

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

456. A 15-year-old girl is admitted to the hospital with diarrhea. She has been repeatedly vomiting for now weak
and lethargic. She is oriented to time to questions appropriately. The nurse prepares temperature using an
electronic thermometer. Which measurement would be most appropriate?
A. Oral
B. Rectal
C. Axillary
D. Tympanic

457. Fastest and most sanitary thermometer is :

A. Glass
B. Electronic
C. Chemical
D. Tympanic

Vaccination

458. How to storage vaccines in ICE

459. 9 month vaccine :

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

460. 1 year vaccine :

A. Opv
B. Hib
C. DTap
D. Hepatitis A and varicella

461. 18 month vaccine :

A. Rota
B. Hepatitis B
C. Hepatitis A

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

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

463. Measles vaccine administration route

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

464. DTap vaccine administration route

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

465. 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

466. A 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

467. 6month-old boy with hydrocephalus is admitted to the pediatric surgical Ward for ventriculoperitoneal Shunt
(VPS) insertion. Which of the following findings should be of the most concern when assessing the child
postoperative?
A. Sunken fontanelle and irritability
B. decreased head circumference
C. poor feeding and pupillary change
D. headache and excessive sleepiness

468. Which of the following routes is used to administered Diphtheria, Tetanus and pertussis DTP vaccine?
A. Oral
B. Intramuscular
C. Subcutaneous
D. Intradermal

469. The nurse are reviewing the immunized schedule if the 11-month of baby Which of the disease should the
nurse expect the infant that here immunized against?
A. Pertussis, Tetanus, polio, and varicella
B. Polio, Pertussis, Tetanus, and Diphtheria
C. Varicella, polio, Tuberculosis, and pertussis
D. Measles, Mumps. Rubella, and Tuberculosis
470. Less than 24 hours after postpartum calls a nurse in the Mother/Infant Unit. She reports that she has very
heavy bright-red bleeding. being discharged, a mother who is newly What would be the best advice to give her?
A. "Don't worry about it; it is normal."
B. "Call your doctor and ask what to do."
C. "Lie down, massage lower abdomen. If it does not work then come to the hospital immediately."
D. "Lie down for about an hour. Then check your bleeding, if it is still as heavy, call me back."

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

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

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

474. 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

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

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

table) Points Indicator less than 98 /min Heart rate 28 /min irregular Respiratory rate Muscle tone
Minimal flexion of the
extremities Reflex irritability Grimace Body pink, extremities blue Colour
What is the total Apgar Sore?
A. 0
B. 3
C. 5

Paediatrics
477. Toddler is admitted to the pediatric room with several episodes of diarrhea 3 days . the child is diagnosed with
gastroenteritis. Which organism is responsible about the most diarrhea episodes in children?
A. Rota
B. Bacillus magissterium
C. Shigella
D. Staphylococcus

478. A child with a diagnosis of Tetralogy of Fallot is scheduled to be discharge from the hospital. the nurse who is planning
discharge education should instruct the caregivers that during a hyper cyanotic spell, which position is most likely to benefit the
child?
A. Supine
B. Prone.
C. side-lying
D. Knee-chest

479. 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

480. which of the following is the leading cause of injury for children who are more than five years old ?
A. accidental suffocation
B. motor vehicle
C. congenital anomalies
D. drowning

481. A 1-year-old girl admitted to podiatric 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

482. 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

483. 5-year-old child was brought to the Emergency Room with a fractured right forearm. He had several bruises on his body
but showed no signs of an 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

484. 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

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

486. 5-year-old child admitted to the pediatric ward with fracture arm. While assessing the child, the se notices a bruises in the
child's back. This is the third time in 1 month that the parent brings the child to hospital. ich time, the child family provides
vague explanations for various uries. Which of the following e pediatric nurse's priority intervention?
A. Prevent the parents from visiting the child
B. Question the parents about the child's injury
C. Encourage the child to tell the truth about his injury
D. Report suspicion of abuse the proper hospital authorities

487. A child with a ventriculoperitoneal shunt discharge is anticipated after 2 days, the nurse is teaching the parents about signs
of shunt malfunction. Which of the following sings indicate shunt malfunction?
A. Depressed fontanel
B. Vomiting , lethargy
C. Increase heart rate
D. Hematuria

488. A 3 year old child is seen to the emergency department experiencing a seizure at home. Three is no previous of seizure.
The mother inform that she does not believe the child epilepsy. Which of the following is the best response?
A. No need to worry because epilepsy is easily treated
B. Very few child have actual epilepsy
C. The seizure may or may not epilepsy
D. Your child has had only one seizure
TPN

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

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

491. The nurse is planning care for several children who were admitted during the shift. Daily weights should be the plan of care
for the child who is receiving:
A. Total parenteral nutrition (TPN)
B. Supplement oxygen
C. Intravenous anti-ineffective
D. Chest physiotherapy
492. 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

493. 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

494. 28-year-old male is recovering from a moderate concussion following a motor vehicle accident 2 weeks ago, when he
suddenly develops an increased thirst, craving Coldwater. The patient urinates very large amount of dilute, water like urine with
specific gravity of 1.001 to 1.005 the patient is MOST likely developing
A. Diabetic mellitus
B. Diabetic insipidus
C. Hypothyroidism

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

496. year-old woman with inflammatory bowel disease is scheduled to undergo a procedure in which a stoma will be formed in
the right lower quadrant, five centimeters below the waistline. The nurse advises the patient on how to avoid potential post
operative intestinal obstruction. Which of the following types of food best
recommended post-operatively?
A. Broccoli and fish
B. Meats and cauliflower
C. Yogurt and parsley
D. Corn and seeds

497. A nurse is providing education to a patient who is being discharged after olecystectomy and has been placedon 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

498. 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

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

500. 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

501. 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

502. 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

503. 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

504. 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

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

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

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

508. 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

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

510. 39- A 23-year-old woman presents to the clinic with an intense headache that rates at a level 8 on the 1-10 scale.
Additionally, she feels nauseous is sensitive when exposed to bright light. Cerebrospinal fluid samples sent to the laboratory for
analysis and complete blood count. Testing both kerning’s and Brzezinski’s sign are positive. The patient is admitted the
hospital and one hour later she has a seizure. In the period mediately following the seizure, the nurse stays at the bedside to vide
on-going care. Which of the following assessments has priority at this time?
A. Blood pressure
B. Respiratory drive
C. Pupillary changes
D. Level of consciousness

511. 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

512. 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

513. 65-year-old man is undergoing pre-operative preparation fond scope procedure in which the physician will
visualize the large and distal part of the small bowel with a camera attached to the flexible tube. Which of the
following positions is the most appropriate?
A. Left lateral Sim's
B. Right lateral recumbent
C. Trendelenbreg
D. Prone

514. 60-year-old man is being discharged from the post-operative Care Unit following a transurethral resection of the prostate.
The nurse provides discharge information regarding the care of the bladder catheter. Which method would be most effective in
bladder retraining for this patient?
A. Scheduled urination every 2-3 hours
B. Limit fluid intake before sleeping time
C. Perform pelvic floor exercises daily
D. Increase fluid intake during the daytime

515. 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

516. 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

517. NA 17-year-old women went to the Emergency Department complaining of fever, sore throat, and hoarseness of voice.
Laboratory tests were done (see lab results).
Test Result Normal values
Hb 120.5 120-158 g/L
HCT 0.39 0.36-0.47 g/L
RBC 4.0 3.8-5.1 × 1022/L
WBC 14.2 4-10.5 × 109/L
Throat culture positive Beta Haemolytic Non foundStreptococcus
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

518. 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

519. A 3-year-old child is admitted to the Medical Ward for vomiting, and dehydration. The nurse sat with the parents to
comply admission interview and wanted to get as much information as
Which of the following communication techniques should the nurse
A. Use of question containing the word "how"
B. Use of question with direct comments to clarify
C. Use of statements that indicate patient will be fine
D. Use of leading question and those involving yes or no
520. An ICU nurse reviews the chart of a 47-year-old man patient mechanical ventilator for a long time. Artorial
blood gas resul see lab results).
Test Result Normal Values
ABG HCO3 24 22-28 mmd/L
ABG PCO3 10.66 4.7-6.0 KPa
PH 7.16 7.36-7.45
ABG PO2 6.13 10.6-14.2 KPa
SA O2 81 95-100 %
What condition the patient is experiencing presently?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

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

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

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

524. 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

525. 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

526. 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

527. 48-year-old man was admitted to the extensive anterior MI. During the night consciousness. The cardiac monitor showed
VF2 checked carotid and found no pulse. Which is the best emergency management?
A. Cardiac thumb twice
B. Cardioversion, 50 joules
C. Electrical shock, 200 joules
D. Chest compression for five cycles

528. 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

529. 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

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

A. s t depression
B. st elevation
C. short st
D. none of the above

531. 40-year-old man is admitted to a Coronary pain. The ECG has normal sinus rhythm withleads 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

532. 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

533. 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

534. 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

535. 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

536. 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

537. 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

538. 9-year-old woman patient in the Medical Ward is in a semiconscious .Her pancreatic cancer is metastasized to her liver and
lungs and she admitted for supportive treatment. Her physicians discussed with the ily that she will not be given the
Cardiopulmonary Resuscitation to save life if she goes into the cardiac arrest. Her two sons agreed but the daughter is
indecisive. Which of the following is the critical thinking behind not providing discounted pulmonary resuscitation?
A. Unilateral judgment of health professionals
B. Refusal of patient’s right to treatment
C. Ethical dilemma and indecisiveness
D. Mercy killing to ease suffering

539. 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

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

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

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

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

543. 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

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

545. 42-year-old woman is brought to the Emergency severe chest pain radiating to the left neck physician instructs nurses to
start the Morphine Aspirin (MONA) protocol. What is the top priority of nursing care?
A. Administer oxygen according to the physician
B. Administer aspirin according to the physician
C. Administer morphine according to the physician
D. Administer nitro-glycerine according to the physician

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

547. 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

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

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

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

551. 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

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

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

554. 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

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

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

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

558. 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

559. 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 exprienced

560. A 70-year-old women with a history of hypertension companies of lack of appetite due to bloating and constipation. The
abdomen is distended and examination shows a positive fluid wave. palpation of the abdomen confirms guarding and tenderness
over the right upper quadrant lower eg edema 3+ and pitting bilaterally are also present. She has kilograms since her last
appointment three weeks before4.5
164/92 mmHg Blood pressure
90 /min Heart rate
26 /min Respiratory rate
37.1C Temperature
92% on room air
Oxygen saturation
What is the most likely underlying health problem?
A. Hepatic congestion
B. Pulmonary hypertension
C. Left-sided ventricle failure
D. Splenomegaly
561. A 70-year-old man presents to the clinic with difficulty sleeping at night. He has not had a good night's rest for several
months and feels exhausted. He needs to place three pillows behind his back in order to sleep. Examination of the lungs reveals
crackles and whee Auscultation of the heart confirms an S gallop. Which of the following is the most likely underlying health
problem?
A. Asthma
B. Pulmonary stenosis
C. Right-sided heart failure
D. Left-sided heart failure

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

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

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

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

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

567. 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

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

569. A 56-year-old patient was diagnosed with instructions about administration of insulin Regular Insulin andNeutral
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

570. 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

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

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

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

574. 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 hould the nurse implement?
A. Wrap the lower extremities with warm
B. Use a Doppler ultrasound to reassess the
C. Elevate the extremities above heart level
D. Place a bed cradle over the bed to levitate

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

576. 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”

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

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

579. 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

580. 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

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

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

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

585. 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

586. 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

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

588. 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

589. 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

590. 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
591. 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

592. 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

593. 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

594. 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

595. 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

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

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

598. 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

599. 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

600. 33-year-old patient in her 13th week of pregnancy has come for her routine gynaecological Appointment. According to the
ultrasound, her fetus is a female. She already has three daughters but her family wants the male child, so she asked the nurse
guidance to terminate her pregnancy. The Nurse explained that baby's gender is determined by the father. She later involved her
husband in the Discharge planning and finally helped the father agree to continue the mother's pregnancy. What professional
obligation is fulfilled through the nursing implementation?
A. Influenced decision making
B. Incident prevention beforehand
C. Empathetic leadership approach
D. Sympathetic knowledge sharing

601. 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

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

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

604. The nurse is assigned to care for several patients, who should be assessed first by the nurse?
A. A diabetic patient who will be discharged
B. A patient with rheumatoid arthritis who has
C. An asthmatic patient who is due for
D. A patient with surgical incision who require

605. 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

606. 9-year-old child is admitted to paediatric word diagnosed with Glomerulonephritis (AGN). The mother ask the nurse why
you the blood pressure frequently which of the following the nurse should be respond based on knowledge.
A. Acute hypertension must be anticipated and identified
B. Hypotension leading to sudden shock
C. Blood pressure fluctuations are a common side effect of therapy
D. Blood pressure fluctuation are a sign that the condition has become chronic

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

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

A. daily care activity
B. medication chart

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

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

611. 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

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

613. 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

614. 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

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

616. Treating pregnant woman diagnose with syphilis is considère

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

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

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

619. 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

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

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

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

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

624. 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's response
A. antiviral medications can be prescribed to destroy virus
B. Clinical signs can be mild flu-like symptoms to fatal encephalitis
C. If patient has West Nile virus, symptoms will progressively worsen
D. If patient used insect repellent, virus would have been destroyed when mosquito made skin contact

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

626. 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
627. During meningitis outbreak in one of the hospitals, the nun-immune staff were given an immunoglobulin in order to
prevent them from the infection. What is the type of immunity that will be developed by these staff?
A. active
B. long-term
C. natural
D. passive

628. 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

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

630. 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

631. 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

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

633. 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

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

635. 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

636. 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

637. A 65-year-old women visited the gynaecological 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

638. 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 surgery

639. 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

640. 62 year-old male patient in the Cardiac Surgery Ward is admitted for the coronary artery bypass surgery. He has unstable
angina for the past 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

641. 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

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

643. 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, diarrhoea and muscle twitches. Which electrolyte is most likely elevated? m
A. Calcium
B. Sodium
C. Magnesium
D. Potassium

644. 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

645. Normal systolic Bp for new born:-

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

646. The doctor touch the bed by the sterile gloves the nurse should:
A. Ask him to change the gloves and to give him new one
B. Let him to complete the Central line procedure

647. MR Ahmed admitted to ICU with congestive heart disease his vital signs BP 110/60 HR 120 . stroke volume 80 the nurse
expected cardiac output to be
A. 180
B. 1700
C. 2400
D. 9600 cardiac output = stroke volume x Heart rate

648. 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

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

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

651. 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

652. A surgical nurse is assigned to care for a woman who had undergone vaginal hysterectomy. The nurse performed
assessment. Which of the following potential problem that the nurse should observe?
A. Pain
B. Fever
C. Anxiety
D. Bladder dysfunction

653. 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

654. 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

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

656. 50year-old male was diagnosed with subdural underwent burr hole craniotomy for subdural hematoma days ago. In order
to detect the sign of meningitis as one of which of the following indicates the patient hasm meningitis?
A. Negative Kernig's signs
B. Positive Brudzinski's sign
C. Absence of nuchal rigidity
D. Glasgow comma scale of 14 points

657. 10 years old boy diagnosis appendicitis has serve pain, the tool of pain scale to be use is:
A. Face pain rating
B. Flacc rating scale

658. 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)"
659. 33-year old man presents to the emergency department with high grade fever, tachycardia, and tachypnea. What is an
appropriate nursing intervention for the patient’s fever?
A. provide dry clothing
B. keep limbs close to the body
C. cover the patient’s scalp with a cap
D. measure the patient’s fluid intake and output

660. A 78-year-old alert and oriented patient is returning from the radiology Department and the nurse is preparing to transfer
the patient from the wheelchair back into the bed. The nurse places the belt on the Patient and prepares to lift the patient from
the chair Which body mechanics would be most appropriate?
A. Widen leg stance
B. Bend over to lift
C. Rotate from the waist
D. Maintain base of gravity in the feet

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

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

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

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

665. 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
666. A nurse is caring for a pregnant patient who is diagnosed with abruption placenta. Which of the following findings of
assessment would indicate a concealed hemorrhage?
A. Maternal tachycardia
B. Decrease in fundal height
C. Rigid, board like abdomen
D. Acceleration in fetal heart rate

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

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

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

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

670. 54- community health nurse visited a postnatal primigravida mother who went back to work. The nurse instructed the
woman the different positions breast-feeding in order to lessen the burden of the mother at night. Which of the following
position will the nurse recommend for the mother night?
A. Cradle hold
B. Football hold
C. Reclining position
D. Side lying position

671. 45- multiparous mother is attending at the outpatient clinic 2 weeks after er delivery for follow up. While the nurse is
assessing the mother, she would not palpate the fundus. Which of the following is the most appropriate nursing action?
A. Document normal finding
B. Massage the fundus to be firm
C. Assess lochia amount and color
D. Admit the mother to the hospital

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

A. Specific in scope
B. Easily understood
C. Focused on the past
D. Kept in a private place

673. 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

674. 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

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

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

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

678. Which of the following uses for abdominal examination

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

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

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

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

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

683. 133-patient is being weaned off from the mechanical ventilator is about to hook the endotracheal tube to oxygen at FiO2 of
40 Which of the following oxygen administration device is the best the nurse in this situation?
A. Ambo bag
B. Ventura mask
C. Tracheostomy collar
D. T-piece/ Briggs

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

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

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

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

688. A nurse received the serum digoxin level result for the patient the day and notes that the result is 2.6 ng/mL (see lab result)
Test result normal value Digoxin (men) 2.6 0.8-2ng/mL. Which of following nursing actions is the mostimportant?
A. Notify the physician
B. Check previous vital signs of patient
C. Record normal value on nursing note
D. Administer scheduled dose of medication

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

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

690. In the 12th week of gestation, a client completely expels the products of conception. Because the client is Rh-negative, the
nurse must:
A. Administer RhoGam within 72 hours
B. Make certain she receives RhoGAM on her first clinic visit
C. Not give RhoGam since it is not the birth of a stillborn
D. Make certain the client does not receive RhoGAM since thegestation only lasted 12 weeks

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

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

693. 30 years old women absent her menstruation for 5 months and her menstrual cycle come every 28 days, she controlled her
diet and do heavy exercise this women condition?
A. Pregnancy
B. Primary amenorrhea
C. Secondary amenorrhea

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

695. A nurse noticed that the digit probe of the pulse oximeter that is attacked to the right forefinger of a patient is not reading.
Which of the following is the most appropriate action that the nurse must take at this time?
A. Change the location of the pulse oximeter
B. Get a new pulse oximeter sensor probe other than a digit probe
C. Maintain position and check it after two hours
D. Assume oxygen saturation is at normal level

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

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

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

699. 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

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

701. Pregnant women with genital herpes .... Caesarean section

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

703. Nephrotic syndrome urine color .................... Dark urine

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

705. Complication of MI is Dysrhythmias

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

707. Gestational diabetic mother can be treated with Diet management

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

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

709. Basal skull fracture signs................... Racoon eyes

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

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

712. For physical assessment steps for the foot is

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

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

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

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

716. 71-year-old male was diagnosed with subdural underwent burr hole craniotomy for subdural hernatoma days ago. In order
to detect the sign of meningitis as one of which of the following indicates the patient has meninge?
A. Negative Kernig's signs
B. Positive Brudzinski's sign
C. Absence of nuchal rigidity
D. Glasgow comma scale of 14 points

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

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

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

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

721. 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

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

723. 70 years-old woman is admitted to the cardiac care unit wit atrial fibrillation and is receiving intravenous diltiazem and
heparin What is the most likely nursing diagnosis?
A. High risk for infection
B. High risk for impaired gas exchange
C. High risk for decreased cardiac output
D. High risk for disturbed sensory perception

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

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

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

727. A 44 year-old woman presented to the Emergency Department with eye pain and redness. She was diagnosed with uveitis
related to a viral infection. The doctor prescribe dexamethasone eye drops.Where is the correct place to instill eye drops?
A. Above the eyelid
B. Directly into the cornea
C. Into the conjunctiva sac
D. Outside the conjunctiva sac
728. A 22-year-old man presents to the Emergency Department complaints of breathing difficulties. He appears restless and
reports that he has had a cough with thick green sputum for days. The nurse performs auscultation over the lung fields.
Blood pressure 130/80
Heart rate 100
Respiratory rate 24
Temperature 39
Which clinical finding is most likely heard over the right lower?
A. Decreased vocal resonance
B. Decreased fremitus
C. Tympani
D. Bronchial

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

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

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

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

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

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

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

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

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

738. 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 "

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

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

741. A 15-year-old girl is admitted after a Motor Vehicle Accident child has a fracture in her left leg and a wound
in her face. When dealing with this child the nurse should be aware that important task to achieve during this
age is which of the following?
A. Initiative versus guilt
B. Industry versus inferiority
C. Trust versus mistrust
D. Identity vs. Role confusion
742. A 9-month-old child who has a repair cleft palate the nurse explaining mother on how she will give feeds to her child.
Which of the following instruction can be expected to include feeling education?
A. Open cup
B. Tea spoon
C. Bottle feed
D. Special bottle feed

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

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

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

746. 27 years old female brought to the Emergency Room accompanied by her husband. He described that she had marked
Weight loss with episodes of emesis in the past three months. She is diagnosed as having anorexia. She reported feeling Febrile,
but had not measured her temperature. Her White Blood Count was 11,000/mm3.
Which of the following most Likely describe her diagnostic criteria for her anorexia?
A. Restricting food intake
B. Fear of gaining weight
C. Problems with body image
D. Binge eating disorder

747. 66 old women presents to the emergency department triage unit with labored breathing. She appeared anxious and is
sweating profusely across the forehead. The symptoms had begun Suddenly one hour before. The jugular veins appear distended
and she has a productive cough. On Auscultation the respiration is wet and not clear with coughing..
Blood pressure 148/88 mmHg
Heart rate 94/min
Respiratory rate 26/min
Temperature 37.0◦C
Which triage acuity rating is most appropriate?
A. Urgent
B. Emergent
C. Non-urgent
D. Resuscitation

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

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

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

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

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

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

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

755. A 9-year-old girl is seen in the emergency department because of a fracture in the right fibula. Which of the following is
the expected response to parent question about bone healing period of the girl?
A. 4-6 weeks
B. 2-4 weeks
C. 6-8 weeks
D. 8-10 weeks
 (child
1)Behaviour of
the child

(child 1)
The child
completes the
project on time

(child 2)
The child
forgets apart of
their uniform

(child 3)
The child
perform well
and gets 90%
marks

(child 4)
The child
completely meal
on time

Responses on
the child's
behaviour

The teacher
rewards for
discipline

The teacher
wants singly
instructs not to
repeat AGAIN

The teacher
doesn't appears
the child

The Maker gives

an ice cream to
the child

756. A school nurse is monitoring the behaviour of different children. Which child should the nurse expect to show an aversive
type of reinforcing stimulus (see image)?
A. Child 1
B. Child 2
C. Child 3
D. Child 4
757. A 13-weeks-pregnant, multi gravida women is anxious and apprehensive she has five children and is not willing to
continue with this pregnancy She is requesting the midwife to abort the fetus. She is under weight malnourished and is over
worked.
BMI 17 Kg/m2
What intervention is desired immediately?
A. Admission and intravenous line management for induction
B. Family planning and birth control measures
C. Dietary management and supplements
D. Support, reassurance and counselling

758. which of the following is the most appropriate action for a nurse Manager starting at a new hospital?
A. Observe staff while keeping presence and role unknown
B. Plan and coordinate new strategies with top level management
C. Introduce self and observe unit activities for at least three months
D. Meet with each staff member separately about needed unit charges

759. A nurse explains to a patient that an endoscopy tube will be inserted down the throat during a gastroscopy
which will cause gagging, but it must be swallowed. What type of communication the endoscopy nurse has used
here?
A. Assertive
B. Interactive
C. Formative
D. Informative

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

761. 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

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

763. a 30-year-old man was brought to the hospital by ambulance sitter felling from a height of 10 meters. He was mechanically
ventilated on after a Glasgow Coma Score showed a level of six. The nurse is observe for any changes in perceptual, sensory or
cognitive Which of the following is an expected patient's response at this time?
A. Slowly obeys commands
B. Exhibits no motor response
C. Reacts towards painful stimuli
D. Uses incomprehensible words
764. A 46-year-old women is admitted in the Medical Ward for systemic lupus erythematous, complaining of joint pain with
dull aching pain in the number region. She has butterfly rashes on her face. Which of the following should be the first nursing
intervention for this patient?
A. Skin care and cortisone ointment as ordered
B. Pain relieving measures and physiotherapy
C. Assess back pain and monitor urine output
D. Analgesics as ordered warm environment

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

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

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

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

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

770. 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
771. A 72-year-old patient presents to the medical clinic drooling with a blank, masklike facial expression and a high pitched,
monotone, weak wike When walking, the patient does not swing the arms normally, but holds hem stiffly rigid. What is the
most likely diagnosis?
A. Parkinson's disease
B. Substance abuse
C. Traumatic brain injury
D. Transient ischemic attack

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

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

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

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

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

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

778. A 57-year-old man is admitted to the Cardiac Unit with palpitation headache, and chest tightness. On auscultation S3
gallop and murmur can be heard (see image).
Blood pressure 97/60 mmHg
Heart rate 170 /min
Respiratory rate 25 /min
Temperature 37.3 C
What is the ECG rhythm of the patient?
A. Atrial fibrillation
B. Ventricular tachycardia
C. Ventricular fibrillation
D. Supra-ventricular tachycardia

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

780. 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

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

782. 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.

783. After Bee sting which of the white blood cell is the most likely elevated
A. Eosinophils
B. Basophils
C. Monocytes
D. Neutrophils
784. 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 "

785. Post operative breathing exercise importance

A. Prevent atelectasis
B. Move secretion

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

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

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

789. Postpartum or puerperal infection is any clinical infection of the genital canal that occurs within 28 days after miscarriage,
induced abortion, or childbirth. The definition used in the United States continues to be then presence of a fever of 38° C
(100.4° F) or higher on 2 successive days of the first 10 postpartum days, starting 24
hours after birth.

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

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

792. Alhj vaccine is Hib vaccine meningitis vaccine

793. Nerve cause tooth pain ..... V

794. Hypoglossal nerve 12th cranial nerve ............ innervates tongue muscle

795. MI ... ST elevation , Ischemia ..............ST depression

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

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

798. Serotonin Alzheimer ... dopamine schizophrenia

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

800. 452. 11 month baby weight 8 kg has vomiting 7 times how many ml orally he can received ?
A. 200
B. 600
C. 800
D. 1200
Weight x 75

801. Patient has low platelet low hemoglobin low WBCs

A. Prevent bleed
B. Check vital
C. Reverse isolation

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

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

804. Baby boy birth weight is 3 kg what the expected weight ate age of 1 year ?
A. 7
B. 9
C. 11
D. 13

805. Gastric suction can cause :

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

806. CPR DEPTH ONE THIRD OF CHEST = 1.5 INCH =4CM IN INFANTS , IN ADULT 2 INCH = 5CM
CPR Technique IS :
A. 30:2 120
B. 15:2 100

808. Basilic vein A

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

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

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

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

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

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

815. Patient feeling hand numbness which medication should receive

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

816. Post limb amputation pain :

A. Phantom
B. Radiating
C. Shooting

817. Mother of nine children, three of them with congenital anomalies Down syndrome; she is a primary school graduate, with
low status. She is not using any method of family planning. According primary health care nurse referred her for counseling
Which of the following types of home visits that the community her nurse should conduct for this client?
A. Systematic routine
B. Selective
C. Follow up
D. Field trip

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

819. According to Ramsey sedation scale pt in icu on sedation on assessment patient deep sleep and not response to light what is
score
A. 2
B. 3
C. 4
D. 6

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

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

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

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

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

824. A nurse is caring for a client who is having an allergic reaction febrile , flushed what the first nursing action
A. Stop blood transfusion immediately
B. Replace the blood with saline.
C. Administer an antihistamine.
D. Place the client flat with the feet elevated.

825. The nurse is monitoring a client receiving a blood transfusion after 30 minutes when the client develops a cough with
shortness of breath. The client also complains of a headache and a racing heart. What should the nurse do first?
A. Stop transfusion immediately
B. Replace the blood with saline.
C. Administer an antihistamine.
D. Slow the infusion rate

Important Notes : if reaction happened within the first 15 minutes ....... Stop blood transfusion immediately .
if reaction happened after 15 minutes......... slow infusion rate first cause of overload then inform
the physician

826. During a patient's blood transfusion, which of the following are associated with an allergic reaction? the nurse
should recognize that
A. Diarrhea and rapid onset of chills
B. Itching and asthmatic wheezing
C. Low back pain and acute renal failure
D. Distended neck veins and a rise in venous pressure

827. 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

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

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

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

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

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

833. A nurse admits a client sent from the health care provider’s office. The nurse calls the provider to obtain prescriptions.
Which action does the nurse take?
A. Hold treatments until the provider signs the prescriptions received.
B. Read each prescription back to the provider prior to ending the call.
C. Have the provider provide the prescriptions to another nurse as well.
D. Verify the prescriptions with the charge nurse before beginning treatment.

834. ABG reading was low PH ,HIGH PCO2 , NORMAL Hco3 what the interpretation ?
A. Compensated respiratory acidosis
B. Uncompensated respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis

835. A 47 years old newly been diagnosed as having gastroesophageal reflux disease (GERD) comes to the clinic for
follow up appointment. The nurse prepares health education on the cause and care of GERD. Which of the following stomach
area is associated with the diagnosis? (See image)
A- 1
B- 2
C- 3
D- 4

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

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

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

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

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

841. A diabetic mellitus patient had left low-knee amputation. The nurse in the surgical unit has been doing wound care for
three days. The nurse evaluated the wound's condition to review the care plan. Which sign shows poor glucose control in wound
healing?
A. Swelling of the stump
B. Bleeding of the stump
C. Mild redness of the wound site
D. Separation of the wound edges

842. 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

843. 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

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

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

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

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

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

848. Otitis media surgery is myringotomy

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

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

A Knowledge deficit related to diabetes mellitus

B Anxiety related to new diagnosis of diabetes mellitus
C Altered nutrition more than body requirement
D Altered health maintenance related to elevated blood glucose
E Altered in fluid and electrolyte balance to ketoacidosis
F Risk for infection related to chronic disease

852. An insulin dependent diabetic patient is admitted to the hospital in ketoacidosis. Of the nursing diagnoses
shown in the table which is the two with the HIGHEST priority?
A. A, C
B. E, F
C. D, E
D. D-B,E

853. A30 years old married man presents to the clinic with complaints of feeling sad for the past three months. Heis 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

854. 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

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

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

A. Approximation ( how well edges come together )

857. Which food consider low potassium diet ?

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

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

859. 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

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

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

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

862. Excess iodine affects with organ first?

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

863. 46-year-old patient is in the male Urology Ward after the surgical removal of the stone from his left kidney through
percutaneous nephrolithotomy under general anesthesia. He has nurse and dull acting pain in left lumbar region. His
nephrostomy bag ia attached through atube in his left kidney for a few days ( see image) What findings should alert the nurse to
report to the physician immediately?
A. Abdominal discomfort and conniption
B. Severe pain and discomfort at surgical site
C. Presence of blood and stone gravels in urine
D. Urine output less than the identified amount

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

865. while school nurse was teaching a group of 14 years old children one of them remark 'you are too young yo be our teacher!
you are not much older than we are how should the nurse respond?
A. How do you think I am
B. We need to stay focused on the topic
C. Do you think you can teach it any better
D. I think I am qualified to teach this group
866. A 9 A cardiac monitor for a patient in a Coronary Care unit shows abnormal ECG rhythm with heart rate of 159 beats,
QRS complex (0.18 second), and absent P wave. What could be the type of possible dysrhythmia?
A. Sinus tachycardia
B. Ventricular tachycardia
C. Ventricular fibrillation
D. Supraventricular tachycardia

867. 9year-old child has a fractured femur and full leg cast has been Which of the following is a physiologic effect of
immobilization?
A. Venous stasis
B. Increase metabolic rate
C. Positive nitrogen balance
D. D Increased need for oxygen

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

869. The maximum time for suctioning in adults is:

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

870. 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

871. 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

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

873. 8-year-old child was admitted to the pediatric ward diagnosed with B-thalassemia. The nurse is planning to give health
education to the mother. Which of the following educational needs is recommended for the mother?
A. compliance to hydroxyurea
B. compliance to hemosiderosis
C. compliance to disferal
D. compliance to Iron supplement
874. A patient who is admitted denies any medication allergies. medical records state, "No known drug allergies." A medic been
sent to the pharmacy for gentamicin. The pharmacist record in the pharmacy of an allergy to the medication. Which of the
following is the best way for the nurse to pro
A. Administer the medication with Benadryl (Diphen
B. Notify the doctor of the allergy and request new orders
C. Investigate further then call the doctor for clar
D. Give the medication as ordered by the physician

875. 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

876. 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

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

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

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

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

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

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

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

884. 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

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

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

887. Position after head trauma ?

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

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

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

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

891. Height of enema is ?

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

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

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

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

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

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

897. 25-year-old woman has a family history of breast cancer. The nurse reviews the procedure for breast self-
examination (BSE) and tells her that the best time for a woman to perform a breast self-examination is:

A. a few days before her period.

B. during her menstrual period.
C. on the last day of menstrual flow.
D. 3- 7days after the beginning of her period

898. The nurse is instructing a female client how to do breast self exam. Which of the following is the best time to
perform this exam?
A. After ovulation
B. After period
C. Two weeks after period
D. Three days before period

899. Mass media disadvantage ?

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

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

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

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

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

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

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

A. Steroids
B. Insulin
C. Midazolam

906. Radon cancer mostly affected ?

A. Lung
B. Cervical
C. Prostate
907. Post MI medication ?
A. Heparin
B. Aspirin
C. Warfarin

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

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

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

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

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

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

914. A 45 year-old patient is admitted in the Intensive Care Unit and has been on a mechanical ventilator for five
days. Which weaning parameter indicates the patient has enough muscle strength to breathe?
A. Normal electrolytes
B. Positive fluid balance
C. Negative inspiratory force
D. Increased minute ventilation
915. A nurse is inserting a nasogastric tube for a 65-year-old patient with paralytic ileus Immediately after insertion
200 ml of milky appearing drainage was noted in the bag. The nurse is not sure if the distal end of the tube is in
the stomach. What is the most appropriate technique confirm positioning?
A. X-ray of stomach
B. Check pH of drainage
C. Aspirate more fluid and check if color change
D. Flush with 100 ml saline and auscultate over stomach

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

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

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

919. The mother with hypothyroidism high risk for ?

A. Preterm labor
B. Hemorrhage
C. Congenital anomalies

920. 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

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

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

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

924. 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

925. 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

926. 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

927. 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

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

929. 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
930. The nurse listens to patient complains and discussed how each of the complaints can be managed which of the
following is the best description the nurse action ?
A. Promoting patient autonomy
B. Demonstrating sympathy
C. Ensure patient support
D. showing concerns

931. 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

932. 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

933. 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

934. A nurse is caring for child who is pot tonsillectomy and adenoidectomy the nurse should plan to assess which
of the following complication?
A. Pulmonary hypertension
B. Hemorrhage
C. Hearing loss
D. Orthopnea

935. 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

936. 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

937. 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
938. 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

939. 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

940. 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

941. Pregnant woman signs and symptoms of hypoglycemia

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

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

943. Isoniazid side effect ?

A. Hepatitis symptoms
B. Blindness

944. A43-year-old woman fell and hit her head. She was admitted to the hospital and put on observation for a
possible closed head injury. The patient's orders include hourly checks for increasing intracranial pressure and
nursing interventions to reduce intracranial pressure.during the assessment, the nurse notes the intracranial
pressure is 16 mmhg . Which is the most appropriate nursing Intervention?
A. Provide an intravenous fluid bolus
B. Position patient in semi-fowler's
C. Prepare for hypothermia induction
D. Hyperventilate with positive pressure

945. A 46-year-old man diabetic patient is admitted to the surgical department because he has gangrened leg due
to uncontrolled blood sugar and contamination of leg ulcer. The admission plan is to do under knee amputation
of the left leg. The nurse is explaining to the patient that this will cause a permanent disability.
Which of the following statements is the best description for permanent disability?
A. Problems in body function and loss
B. Difficulties to experience life situations
C. Difficulties in executing activities
D. Loss of interaction with community

946. A 35-year-old woman presents to the clinic with complaints of itching and pain in the eyes. there are large
amounts of watery discharge and mucous from both eyes. The whites of the eyes are pink-colored and irritated.
the doctor orders a prescription for eye drops that contain prednisolone. The nurse educates the patient on
correct administration. Which advice is most important?
A. Irrigate the eye with saline before administration
B. Continue taking medication until the bottle is empty
C. Prior to administration block tear ducts with fingers
D. Apply to the inner aspect of conjunctival sac

947. - A 30-year-old pregnant lady in her 33 weeks pregnancy. When the nurse assesses the health condition of the
lady, she provides nursing care and health teaching. Which of the following types of home visiting is the best to
be conducted?
A. Selective
B. Follow up
C. Fieled trip
D. systemtic

948. 25 weeks-pregnant, primary gravid woman is on her first antenatal visit, completing physical examination and
history, the midwife found out her husband has sickle cell anemia minor.
What should be the most appropriate plan of care?
A. Genetic counselling
B. Identify severity of disease
C. Discuss the chances of transferring
D. Amniocentesis to identify genetic abnormality

949. A6-year-old child is diagnosed with sickle. cell disease is admitted with severe pain in upper and lower
extremities. What type of crisis that the child experiences?
A. Sequestration
B. Aplastic Lae.
C. Vasoocclusive
D. Hyperhemolytic

950. Mother of a sickle cell anemia child is asking why her child can't go hiking with his friends.Which of the
following complications hiking can leads to ?
A. Enhance iron absorption
B. Decrease oxygen consumption
C. Inhibit hemoglobin production
D. Precipitate vaso-oclusive crisis

951. The nurse admits a client who is in sickle cell crisis. The nurse should prepare for which intervention as a
priority in the management of the client?
A. Pain management with an opioid
B. Intravenous fluid therapy
C. Oxygen administration
D. Blood transfusion

952. A nurse is assigned to care for a patient with a diagnosis of thrombotic stroke. The nurse knows that this type
of stroke is MOST LIKELY caused by:
A. Blockage of large vessels as a result of atherosclerosis
B. Emboli produced from valvular heart disease
C. Decreased cerebral blood flow due to circulatory failure
D. A temporary disruption in oxygenation of the brain

953. During hospital admission of a homeless patient with mental illness , the nurse tells him that he needs an
immediate shower because he is smelly and looks horrible which o the following explains the nurse action?
A. Judgmental
B. Responsible
C. Professional
D. Empathically

954. A community Nursing nurse is planning to conduct prenatal teaching and community assembly for pregnant
adolescents. Which teaching strategy would be most effective?
A. Offering open sessions for pregnant adolescents and anyone else who wants to attend
B. Designing posters that girls can view individually in community Nursing centre
C. Preparing group class sessions for teaching pregnant adolescents together
D. Conducting one to one teaching sessions for both mothers and daughters

955. A 55 year old underwent total hip replacement. Two hours post. post-operative an orthopedic unit nurse notes the patient
was lethargic and dizzy Hb9.8 normal 13-17
What nursing intervention is the most appropriate?
A. Start I V fluids
B. Administer paracetamol 1gm iv
C. Call blood bank and request one unit of packed RBS
D. Encourage ambulation to reduce enhance recovery

956. A 57 year old man is admitted to the cardiac unit with palpations, headache, and chest tightness, on
auscultation S3 gallop and a diagnostic murmur can be heard, a doctor orders 2.5mg of verapamil slow IV push.
However, the ventricular rate does not slow down BP 95/62 HR 170 RR 25 TEMP. 36.9 what next action
should the nurse expect?
A. Vagal maneuver
B. Sedation and intubation
C. Another dose of verapamil
D. Synchronized cardio version

957. This ECG is showed ?

A. Normal rhythm
B. Supraventricular tachycardia
C. Atrial fibrillation
D. Ventricular fibrillation

958. A nurse is working in a medical unit. She is 65yearold 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 en first

959. A urinalysis is best evaluated for accurate results if the specimen is analyzed within which of the following?
A. 1 hour of collection or refrigerated until analyzed
B. 1 hour of collection or left at room temperature
C. 2 hours of collection
D. 4 hours of collection

960. A 62 year old patient present to the emergency department and complains of muscle cramps nausea
vomiting and fatigue. The outside temp 45 and had been working outside day all day in the sun. he says that his
fingers are numb and cannot feel anything with them. BP 106/58 HR 99 RR 22 TEM 37.4 which of the
following electrolyte will be below the normal range?
A. Chromium
B. Magnesium
C. Potassium
D. Bicarbonate
961. Dexamethasone ............ accelerates maturation of fetal lung .
962. Hirschsprung disease failure of neonate to pass stool )Meconium ) for 24 hours
963. Apgar score done at 1 minute and 5 minutes at birth
964. most common cause of diarrhoea in paediatric ........................ virus rotavirus ,
965. Meconium is................. Dark green stool in newborn
966. Diet for patient with cancer .................. fresh fruits and vegetables
967. Diagnostic test for sickle cell anemia before birth is Amniotic fluid aspiration sample
968. colonized infection is ...germs are on the body but do not make you sick
969. Incentive spirometry is ?

A. Use to prevent atelectasis after surgery

970. Beneficence refers to actions that promote the well-being of others. The nurse who is exemplifying
beneficence takes positive actions to help clients
971. After rectal surgery what bath type ................. Sitz bath
972. After testicle removal the client should avoid heavy lifting
973. Weber test :how is the Weber test done...... By placing a 512 vibrating tuning fork on the patient forehead
(midline), where you can hear a buzzing noise.
974. Vitamin A deficiency cause ? Night Blindness
975. Brachial artery t check pulse in infants
976. Prolactin Hormone promote Milk production
977. TB test Mantoux / PPD test result within 48-72Hours accurate test is sputum culture
978. Umbilical Cord one big vein& Two small arteries
979. Pulse deficit is the different between apical beats and brachial pulse
980. Rligion that prohibits blood transfusion Jehovah
981. Spina pifida position Prone position
982. Sound lung in heart failure .cracks
983. Postion after hemorroidectomy ?...........................antriolatral position.....lateral
The left anterolateral position is an excellent alternative for hemorrhoidectomy under local anesthesia. The pain
over the pubis and the low backache, frequently encountered in the prone position, are totally eliminated. Exposure
of the operative fields is excellent.
984. Post Vitrect-omy position ...Prone
985. Ear Drops in infant down and back , in Adult up and back
986. Ear drops in adult up and back , in infant down and bak
987. Hyperpyrexia above 40C
988. Alzheimer deficiency in serotonin
989. Abdominal assessment. 1. Inspection 2. Auscultation 3. Percussion
4.palpation........ very important
990. During new born assessment the nurse found extra finger in the new born hand
Polydactyl
991. During new born assessment the nurse found two digits are fused together
Syndactyly

992. when we should stop magnesium sulphate ( Respiratory Depression,

Hypotension , Bradycardia deep tendon Reflex )
993. Antidote of magnesium sulphate is ( calcium gluconate )
994. Morphine antidote is naloxone / Narcan
995. Hydrocephalus signs ( Bulging anterior fontanel & increase head circumference )
996. Naloxone - Digioxin should not be given if heart rate less than 60 or bradycardia
997. OPV oral polio vaccine ..... mixed of live attenuated polovirus
998. Postpartum perineal assessment acronym is REEDA ( Redness-Edema-Ecchymosis-Discharge-Approximation
999. 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.
1000. Complication of diabetic mother hypoglycaemic and macrocosmic
1001. OPV vaccine is live attenuated virus (poliovirus) vacine
1002. Patient with BP230/180 is consider Hypertensive Crisis
1003. Complication of MI ....... Dysrthysmias , heart failure , pulmonary edema , angina , pericarditis , Dressler
syndrome
1004. Causes of MI ...................atherosclerosis , coronary artery disease , elevated cholesterol level , hypertension,
smoking , obesity , stress
1005. Watery rice diarrhoea ....... cholera
1006. Temperature 41 c is ...............Hyperpyrexia