DHA RN Exam (Dubai), Practice Questions

A nurse checks the medication rights three times before administering a drug to prevent an error. Which ethical principle does this action best demonstrate?

1. Fidelity
2. Nonmaleficence ✓
3. Justice
4. Veracity

Why: The source defines nonmaleficence as the duty to do no harm, balancing avoidable harm against benefits, and gives the example of checking medication rights three times to prevent errors.

Source: Open RN Nursing Management and Professional Concepts, Ethical Practice

Before performing an assessment or providing care, the nurse must use at least two patient identifiers. According to the source, which pair is acceptable?

1. The patient's name and date of birth, verified against the armband or chart ✓
2. The patient's room number and bed position
3. The patient's diagnosis and provider name
4. The patient's assigned room number combined with their admitting medical diagnosis

Why: The source instructs the nurse to use at least two patient identifiers, such as asking the patient to state their name and date of birth and comparing it to the armband or chart. A room number must never be used as an identifier because a patient may change rooms.

Source: Open RN Nursing Skills, 1.2 Initiating Patient Interaction

According to the source, what is the most common causative organism of an upper respiratory tract infection (common cold)?

1. Respiratory syncytial virus
2. Group A streptococcus
3. Rhinovirus ✓
4. Parainfluenza virus

Why: The source states that although a variety of infectious organisms can lead to a URI, the most common causative organism is rhinovirus.

Source: Open RN Nursing Health Promotion, 15.5 Upper Respiratory Tract Infection

According to the source, the vaginal and rectal swab for group B streptococcus (GBS) is performed at which point, with results valid for up to five weeks?

1. Earlier, at 28 to 30 weeks
2. At 32 to 34 weeks
3. At 39 weeks or later
4. At 35 to 37 6/7 weeks ✓

Why: The source states GBS testing (along with other third-trimester labs) is performed at 35 to 37 6/7 weeks, so results are available before labor and are valid for up to five weeks. Treatment is given during labor rather than antepartum because GBS can recolonize.

Source: Open RN Nursing Health Promotion, 9.10 Third Trimester Prenatal Care

A nurse is witnessing a patient's surgical consent. Which of the following is one of the three required conditions for valid informed consent?

1. Consent must be witnessed by two physicians
2. Consent must be renewed every 24 hours
3. Consent may be obtained after the sedation is given first
4. Consent must be given voluntarily, without coercion ✓

Why: The source states consent must be given voluntarily, without any form of persuasion or coercion. The other two conditions are adequate disclosure by the surgeon and the patient's understanding before receiving sedating medications.

Source: Open RN Nursing Health Alterations, 2.2 Basic Concepts Related to Surgery

According to the source's settings table, a bag valve mask (Ambu bag) attached to an oxygen source should be set to what flow rate and delivers what FiO2?

1. Flow rate 15 L/min; FiO2 100% ✓
2. Flow rate of only 6 L/min delivering an FiO2 of approximately 40 percent
3. Flow rate 10 L/min; FiO2 60%
4. Flow rate 2 L/min; FiO2 28%

Why: The source's settings table states the bag valve mask flow rate should be set to 15 L/minute, resulting in an FiO2 of 100%. The bag is squeezed once every 5 to 6 seconds for an adult or once every 3 seconds for an infant or child.

Source: Open RN Nursing Skills, 11.3 Oxygenation Equipment

According to the source, a febrile seizure occurs in children between six months and five years old who have a fever of at least what temperature?

1. 100.4 degrees F or greater ✓
2. 102 degrees F or greater
3. 99 degrees F or greater
4. 101 degrees F or greater

Why: The source defines a febrile seizure as a generalized seizure in pediatric patients between six months and five years old who have a fever of 100.4 F (38 C) or greater, not associated with a CNS infection.

Source: Open RN Nursing Health Promotion, 16.10 Febrile Seizures

According to the source, what is the goal of surgical treatment for an encephalocele?

1. To drain cerebrospinal fluid into the abdomen
2. To realign the spine using serial casting
3. To place the protruding brain tissue back into the skull ✓
4. To close a hole between the heart's two ventricles

Why: The source states that multiple surgeries may be required to treat encephalocele and place the protruding part of the brain back into the skull. An encephalocele is a sac-like protrusion of brain tissue through an opening in the skull.

Source: Open RN Nursing Health Promotion, 20.6 Congenital and Genetic Disorders

A child is recovering after surgery for hydrocephalus. According to the source, what should parents be taught to monitor for postoperatively?

1. A gradual decrease in the child's head circumference
2. Complete resolution of all learning challenges
3. Redness only at the abdominal reabsorption site
4. Signs of increasing CSF if the shunt becomes blocked ✓

Why: The source states that postoperatively the child requires routine monitoring, and parents must also monitor the child for signs of increasing CSF that may occur if the shunt should become blocked due to mechanical failure or infection.

Source: Open RN Nursing Health Promotion, 12.6 Congenital Conditions

According to the ANA definition cited in the source, evidence-based practice integrates which three components?

1. Cost data, staffing ratios, and organizational policy
2. Physician orders, established agency protocols, accreditation standards, and unit budget goals
3. Utilization review, budgeting, and resource stewardship
4. Best research evidence, clinical expertise, and patient preferences and values ✓

Why: The source states EBP is a lifelong problem-solving approach integrating (1) the best evidence from well-designed research and evidence-based theories, (2) clinical expertise plus assessment of the patient's history/condition and resources, and (3) patient/family/community preferences and values.

Source: Open RN Nursing Management and Professional Concepts, Quality and Evidence-Based Practice

According to the source, which statement is true of a simple partial seizure?

1. The patient loses consciousness for 1-3 minutes
2. It always progresses to a generalized seizure
3. It causes a sudden loss of all muscle tone
4. The patient remains conscious throughout the seizure ✓

Why: The source states the patient remains conscious throughout a simple partial seizure. An aura (unusual sensation), often described as a deja vu feeling, a perceived offensive smell, or sudden pain, occurs before the seizure.

Source: Open RN Nursing Health Alterations, 9.7 Seizures and Epilepsy

The source states there are two types of stroke. An acute stroke caused by a blockage or occlusion of a cerebral or carotid artery is which type?

1. Hemorrhagic
2. Subarachnoid
3. Ischemic ✓
4. Aneurysmal

Why: The source states an acute ischemic stroke is caused by a blockage or occlusion of a cerebral or carotid artery, from plaque forming a thrombus or from an embolism. A hemorrhagic stroke is the second type, caused by a compromised vessel that ruptures and bleeds.

Source: Open RN Nursing Health Alterations, 9.9 Cerebrovascular Accident

A nurse prepares to flush a patient's central venous catheter. Which syringe size is preferred to avoid excessive pressure?

1. A 3-mL syringe
2. A 5-mL syringe
3. A 20-mL syringe
4. A 10-mL syringe ✓

Why: The source states using a 10-mL syringe is preferred for CVADs to avoid increased pressure that can cause a potential rupture, and the nurse should never flush against resistance.

Source: Open RN Nursing Advanced Skills, 4.2 Basic Concepts

According to the source, adults with disabilities report experiencing what compared to the general population?

1. Less mental distress than the general population
2. No difference in mental distress
3. More mental distress than the general population ✓
4. Complete absence of mental health needs

Why: The source states that in addition to challenges accessing health care, adults with disabilities report experiencing more mental distress than the general population, with an estimated 32.9% experiencing frequent mental distress in 2018.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 17.2 Vulnerable Populations

According to the source, infertility is defined as a couple being unable to conceive after what duration of unprotected sex?

1. One year or longer of unprotected sex ✓
2. Three months of unprotected sex
3. Six weeks of unprotected sex
4. Two years of unprotected sex

Why: The source defines infertility as a couple not being able to get pregnant after one year (or longer) of unprotected sex. It states that among women aged 15 to 49 with no prior births, about 1 in 5 are unable to conceive after one year of trying.

Source: Open RN Nursing Health Promotion, 8.6 Fertility

A patient arrives at the emergency department with suspected stroke. Which diagnostic test does the source identify as typically the first performed to determine if a hemorrhagic stroke is occurring?

1. Carotid duplex ultrasound
2. CT scan without contrast ✓
3. Cerebral angiogram
4. Cardiac echocardiogram

Why: The source states a CT scan without contrast is typically the first diagnostic test performed for a suspected CVA to determine if a hemorrhagic stroke is occurring. If hemorrhage is ruled out, further tests identify potential causes of an ischemic stroke.

Source: Open RN Nursing Health Alterations, 9.9 Cerebrovascular Accident

A patient is progressing from NPO status after surgery and is ordered a clear liquid diet. Which item is appropriate for this diet per the source?

1. Creamed soup and pudding
2. Apple juice and clear broth ✓
3. Ground meat and cooked vegetables
4. Applesauce and mashed potatoes

Why: The source lists clear liquids as fluids that are see-through and without residue, giving examples of water, apple juice, clear soda, Jello, popsicles, and broth. Creamed soups and pudding are full liquids; ground meat and applesauce belong to mechanical soft or pureed diets.

Source: Open RN Nursing Fundamentals 2e, 14.3 Applying the Nursing Process

A patient using a peak flow meter has a reading that is 60% of their personal best, with worsening cough and some limitation of activity. According to the source's asthma action plan, this patient is in which zone?

1. Yellow Zone ✓
2. Green Zone
3. Red Zone
4. Blue Zone

Why: The source states peak flow readings of 50 to 79% of personal best indicate the Yellow (Caution) Zone, with worsening symptoms and partial activity limitation. Green Zone is at least 80% of personal best; there is no Blue Zone.

Source: Open RN Nursing Health Alterations, 6.5 Asthma

A nurse witnesses a car crash in which the only occupant is not breathing inside a burning vehicle. Based on the safety principle in the source, the nurse's first priority is to:

1. Begin rescue breathing immediately inside the vehicle to restore oxygenation
2. Perform chest compressions in the car while awaiting emergency services
3. Check for a carotid pulse before deciding whether to remove the person
4. Move the person to a safe place before beginning cardiopulmonary resuscitation ✓

Why: The source uses this exact scenario to illustrate that safety receives priority: the first priority is not to initiate rescue breathing inside the burning car, but to move the person to a safe place where CPR can be safely provided. The other options ignore the environmental danger the source emphasizes.

Source: Open RN Nursing Fundamentals 2e, 5.2 Basic Safety Concepts

According to the source, a DEXA T-score of what value is diagnostic for osteoporosis?

1. Between -1 and -2.5
2. Greater than +1
3. Lower than -2.5 ✓
4. Between 0 and -1

Why: The source states a T-score between -1 and -2.5 indicates osteopenia, and a T-score lower than -2.5 is diagnostic for osteoporosis.

Source: Open RN Nursing Health Alterations, 10.8 Osteoporosis

A community health nurse evaluates the population's age, gender, race, ethnicity, language, and household composition. According to the source, this falls under which community context factor?

1. Infrastructure
2. Economics
3. Demographics ✓
4. Government/Politics

Why: The source lists demographics as a community context factor, involving evaluation of key population characteristics such as age, gender, race, ethnicity, language, and household composition.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 16.2 Community Health Concepts

As hepatitis progresses, which cluster of signs does the source describe?

1. Jaundice, light-colored stools, and dark-colored urine ✓
2. Bright red rectal bleeding with high fever and chills
3. Productive cough, wheezing, and pleuritic chest pain
4. Swelling of multiple joints with a widespread skin rash

Why: The source states that as the disorder progresses, jaundice, right upper quadrant pain, an enlarged liver, light-colored stools, and dark-colored urine may occur. Early signs are loss of appetite, nausea, vomiting, and fatigue.

Source: Open RN Nursing Health Alterations, 11.15 Hepatitis

Per the source, cyanotic congenital heart defects involve shunting of blood in which direction, causing hypoxia?

1. Left to right through the heart
2. Right to left through the heart ✓
3. Aorta to pulmonary artery
4. Atrium to ventricle only

Why: The source states cyanotic heart defects involve right to left shunting of blood, causing deoxygenated blood to bypass the lungs and be pumped to the body, resulting in decreased oxygen saturation and cyanosis.

Source: Open RN Nursing Health Promotion, 17.3 Categories of Congenital Heart Defects - Acyanotic and Cyanotic Defects

A patient receives an IV antibiotic that requires trough-level monitoring. When should the nurse expect the trough blood level to be drawn?

1. At the time the medication is being administered and is known to be highest in the bloodstream
2. At the exact midpoint between two scheduled doses of the medication
3. Right before the next dose, when the drug is at its lowest in the bloodstream ✓
4. Immediately at the start of the very first infusion of the drug

Why: The source defines a trough level as drawn when the drug is at its lowest in the bloodstream, right before the next dose is given. A peak level (not trough) is drawn when the medication is at its highest level. Correct timing of these draws with administration is essential.

Source: Open RN Nursing Pharmacology 2e, 1.10 Medication Safety

A patient in preterm labor has a prescription for terbutaline. The nurse reviews the record and knows to question the order for which finding stated in the source?

1. A maternal heart rate that is greater than 120 beats per minute ✓
2. A maternal blood pressure of 118/70 with no reported symptoms
3. A maternal respiratory rate of 18 breaths per minute at rest
4. A maternal temperature of 37 degrees Celsius on admission

Why: The source lists tachycardia greater than 120 beats per minute among the contraindications to terbutaline, along with ischemic heart disease, hypertension, arrhythmias, diabetes mellitus, and hyperthyroidism. Terbutaline also carries a boxed warning against prolonged use for more than 48 to 72 hours.

Source: Open RN Nursing Health Promotion, 19.10 Preterm Labor

A premature infant has a patent ductus arteriosus. According to the source, which medication may be given soon after birth to trigger the ductus arteriosus to constrict and close?

1. Prostaglandin E1 infusion
2. Ibuprofen (an NSAID) ✓
3. Digoxin
4. Furosemide

Why: The source states NSAIDs such as ibuprofen or indomethacin may be prescribed for a patent ductus arteriosus; when administered soon after birth, they trigger the PDA to constrict and close. Ibuprofen has a PDA closure efficacy of approximately 70-85%.

Source: Open RN Nursing Health Promotion, 17.5 Applying the Nursing Process to Congenital Heart Defects

A nurse describes the National Patient Safety Goals to a student. Which description is accurate according to the source?

1. Foundational ethical principles that guide nurses in making everyday clinical decisions
2. A payment model that ties a hospital's reimbursement to measured patient outcomes and satisfaction
3. Annual goals and recommendations tailored to seven types of health care agencies based on safety data ✓
4. A structured mnemonic used for standardizing handoff communication between shift changes

Why: The source describes National Patient Safety Goals as goals and recommendations published annually by the hospital accreditation body, tailored to seven different types of health care agencies based on patient safety data from experts and stakeholders, and including evidence-based interventions.

Source: Open RN Nursing Fundamentals, National Patient Safety Goals

During a vaso-occlusive crisis, the source directs the nurse to apply which type of compress to affected joints and to avoid the other?

1. Cold compresses to the joints; avoid applying any warmth
2. Alternating hot and ice packs
3. Dry heating pads only
4. Warm, moist compresses; avoid ice or cold ✓

Why: The source directs applying warm, moist compresses to affected joints and avoiding ice or cold compresses. Warmth causes vasodilation and increases circulation to hypoxic areas, but cold causes vasoconstriction.

Source: Open RN Nursing Health Alterations, 3.8 Sickle Cell Disease

According to the source, the HPV vaccine is recommended for all preteens (boys and girls) at what age?

1. Age 16 or 17 years
2. Age 18 or 19 years
3. Age 6 or 7 years
4. Age 11 or 12 years ✓

Why: The source states the HPV vaccine is recommended for all preteens, including boys and girls, at age 11 or 12 years, and for adults through age 26 years. Adults over 26 should discuss vaccination with their provider.

Source: Open RN Nursing Health Promotion, 8.8 Sexually Transmitted Infections

The source defines a comminuted fracture as which of the following?

1. A bone that is partially broken but not separated
2. A bone that is crushed into multiple pieces ✓
3. A bone broken at an angle across the shaft
4. A bone twisted apart in a spiral pattern

Why: The source defines a comminuted fracture as a bone crushed into pieces. A greenstick fracture is partially broken, an oblique is broken at an angle, and a spiral is twisted apart.

Source: Open RN Nursing Health Alterations, 10.6 Fracture

According to the source, which nursing action helps prevent atelectasis and pneumonia in the postoperative patient?

1. Keeping the patient on strict flat bed rest for a full 48 hours
2. Restricting fluids to prevent lung congestion
3. Encouraging early ambulation and incentive spirometry ✓
4. Withholding coughing to protect the incision

Why: The source states early ambulation promotes expansion of lungs and movement of secretions, and teaching incentive spirometry and coughing/deep breathing helps prevent atelectasis (collapse of alveoli) and pneumonia.

Source: Open RN Nursing Health Alterations, 2.5 Postoperative Nursing Care

A nurse suspects an older adult is being abused. According to the source, which assessment action is recommended during evaluation?

1. Interview the elder only in the presence of the caregiver
2. Avoid documenting any observed injuries
3. Interview the elder alone, if possible, to ensure safety and candor ✓
4. Delay assessment until the family agrees to it

Why: The source states that during assessment for elder abuse it is crucial to interview the elder alone, if possible, to ensure their safety and candor, use validated screening tools, and document findings thoroughly and objectively.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 15.4 Abuse and Neglect

A nurse is feeding a newborn with a cleft lip and cleft palate before surgical repair. According to the source, in which position should the newborn be fed?

1. Lying flat and completely supine
2. Prone with the head turned to one side
3. Held in an upright position ✓
4. Side-lying with the head positioned lower

Why: The source states that to ensure adequate nutrition and reduce aspiration risk, the newborn with cleft lip and/or cleft palate should be fed in an upright position. Alternative feeding methods such as special nipples are also used because these infants can easily aspirate formula or breastmilk.

Source: Open RN Nursing Health Promotion, 16.5 Cleft Lip and Cleft Palate

Which diagnostic test does the source identify as the gold standard for diagnosing peptic ulcer disease because it allows direct visualization of ulcers?

1. Esophagogastroduodenoscopy (EGD) ✓
2. Barium swallow
3. Abdominal CT scan
4. Stool occult blood test

Why: The source identifies the EGD as the gold standard because it allows visualization of ulcers, and biopsies can be taken during an EGD to assess for H. pylori. A barium swallow is an alternative if the patient cannot undergo an EGD.

Source: Open RN Nursing Health Alterations, 11.10 Peptic Ulcer Disease

According to the source, telehealth is best described as which of the following?

1. An in-person surgical procedure that is performed at a small clinic in a rural community
2. A federal educational loan repayment program offered to health care provider professionals
3. A specific type of government health insurance coverage available only to armed forces veterans
4. The use of digital technologies to deliver medical care and health services across locations ✓

Why: The source defines telehealth as the use of digital technologies to deliver medical care, health education, and public health services by connecting multiple users in separate locations, improving access in underserved areas by removing barriers of time, distance, and provider scarcity.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 17.2 Vulnerable Populations

A nurse manager uses Lewin's change model to implement a new policy. Which option lists the three steps of this model in order?

1. Plan, Do, Study
2. Assess, Diagnose, Evaluate
3. Duty, Breach, Harm
4. Unfreeze, Change, Refreeze ✓

Why: The source describes Lewin's Unfreeze-Change-Refreeze model: Unfreeze agitates the status quo and increases driving forces, Change moves to a new equilibrium, and Refreeze stabilizes the new behavior via new policies so change is sustained.

Source: Open RN Nursing Management and Professional Concepts, Leadership and Management

According to the source, which statement about the low transverse cesarean incision is correct?

1. It is made vertically along the midline of the abdomen
2. It is used only in emergencies due to higher complication risk
3. It carries a higher risk of uterine rupture in later pregnancies
4. It is the most common incision and can allow future vaginal births ✓

Why: The source states the low transverse incision is the most common type, made horizontally just above the pubic hairline, is cosmetically favorable with less pain and fewer complications, and can make future vaginal births possible. The vertical incision is reserved for emergencies and carries higher rupture risk.

Source: Open RN Nursing Health Promotion, 10.8 Complications During the Second Stage of Labor

According to the source, what are the six rights of medication administration that must be verified before administering a medication?

1. Right patient, drug, dose, provider, pharmacy, and cost
2. Right patient, diagnosis, dose, time, route, and refusal
3. Right drug, dose, allergy, history, education, and refusal
4. Right patient, drug, dose, time, route, and documentation ✓

Why: The source lists the six rights of medication administration as Right Patient, Right Drug, Right Dose, Right Time, Right Route, and Right Documentation. These must be verified by the nurse at least three times before administering a medication; additional rights (history/assessment, drug interactions, refusal, education) extend the list up to ten.

Source: Open RN Nursing Skills, 15.2 Basic Concepts of Administering Medications

According to the source, because naloxone has a relatively short duration of effect, the individual should be monitored for recurrence of opioid toxicity for at least how long after the last dose?

1. At least thirty minutes
2. At least four hours ✓
3. At least twelve hours
4. At least twenty-four hours

Why: The source states the individual should be monitored for recurrence of signs and symptoms of opioid toxicity for at least four hours from the last dose of naloxone, and people who overdosed on long-acting opioids like fentanyl require prolonged monitoring.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 14.2 Substances: Use, Intoxication, and Overdose

According to the source, what is the most common type of conjunctivitis?

1. Bacterial conjunctivitis with thick purulent discharge
2. Allergic conjunctivitis from environmental allergens
3. Fungal conjunctivitis from an eye injury
4. Conjunctivitis caused by a viral infection, usually adenovirus ✓

Why: The source states the most common type is conjunctivitis caused by a viral infection, usually adenovirus.

Source: Open RN Nursing Health Promotion, 16.6 Conjunctivitis

According to the source, what maintains the corpus luteum in early pregnancy until the placenta takes over progesterone production?

1. Human placental lactogen (hPL)
2. Follicle-stimulating hormone (FSH)
3. Relaxin
4. Human chorionic gonadotropin (hCG) ✓

Why: The source states that human chorionic gonadotropin (hCG) produced by the fertilized egg maintains the corpus luteum, which secretes progesterone until mid-pregnancy when the placenta begins producing progesterone. Increased estrogen and progesterone actually block FSH and LH secretion.

Source: Open RN Nursing Health Promotion, 9.4 Changes During Pregnancy

Regarding the surgical safety checklist, when does the source indicate prophylactic antibiotics should be administered?

1. Immediately after the surgical incision has been closed
2. Only if a wound infection later develops
3. During the postoperative recovery period
4. Within the recommended time frame before incision ✓

Why: The source states appropriate administration of prophylactic antibiotics within the recommended time frame is verified before incision takes place. The preoperative section notes antibiotics such as cefazolin are given approximately 60 minutes before incision.

Source: Open RN Nursing Health Alterations, 2.2 Basic Concepts Related to Surgery

According to the source, meconium in the amniotic fluid is considered a sign of fetal distress and is usually triggered by what?

1. Excessive fetal weight gain in the final weeks of pregnancy
2. Maternal hyperglycemia crossing the placenta to the fetus
3. Decreased fetal oxygenation triggering a reflex to expel bowel contents ✓
4. Delayed clearance of fetal lung fluid after a cesarean delivery

Why: The source states meconium in the amniotic fluid is a sign of fetal distress, usually caused by decreased fetal oxygenation that triggers a fetal reflex to expel bowel contents, which can be inhaled during delivery.

Source: Open RN Nursing Health Promotion, 20.3 Post-term Birth

A nurse receives an order for total parenteral nutrition (TPN) for a patient who has only a peripheral IV. Based on the source, what should the nurse do?

1. Infuse the TPN slowly through the peripheral IV
2. Clarify the order with the prescribing provider ✓
3. Dilute the TPN with saline before infusing it
4. Administer the TPN by gravity drip only

Why: The source states TPN is a very concentrated solution that must be administered via a central line, and if a nurse receives a TPN order for a patient without central line access, the order should be clarified with the prescribing provider.

Source: Open RN Nursing Advanced Skills, 1.2 Basic Concepts of Venipuncture and Intravenous Therapy

A nurse recognizes thyroid storm in a patient with hyperthyroidism. According to the source, which findings characterize this life-threatening emergency?

1. Fever, tachycardia, and hypertension ✓
2. Hypothermia, bradycardia, and hypotension
3. Weight gain and constipation
4. Decreased level of consciousness with hypothermia

Why: The source describes thyroid storm as a severe manifestation of hyperthyroidism with fever (hyperthermia), tachycardia, and hypertension, requiring immediate hospitalization. Hypothermia, bradycardia, and hypotension characterize myxedema coma in hypothyroidism.

Source: Open RN Nursing Health Alterations, 7.6 Thyroid Disorders

According to the source, how does the nurse correctly perform fundal massage to prevent uterine inversion?

1. Apply firm continuous downward traction directly on the delivered umbilical cord
2. Place one hand on the fundus and support the lower uterine segment with the other hand ✓
3. Press both hands deeply into the lower abdomen at the same time over the bladder
4. Massage only the cervix through the vaginal canal using two lubricated fingers

Why: The source states fundal massage is performed by placing one hand on the fundus while the other hand supports the lower uterine segment near the symphysis pubis to prevent uterine inversion. The goal is to make the uterus contract into a small, hard ball.

Source: Open RN Nursing Health Promotion, 19.3 Hemorrhage (Perinatal)

According to the source, a fibroid (also called a leiomyoma) is best described as which type of growth?

1. A malignant tumor arising from the endometrial lining tissue
2. A fluid-filled cyst that forms within the ovarian follicle
3. An outpouching of the bladder wall into the vaginal canal
4. A benign, solid tumor from the smooth muscle of the uterus ✓

Why: The source defines a fibroid, also called a leiomyoma, as a benign, solid tumor that develops from the smooth muscle tissue of the uterus. It notes about 50 percent of women with fibroids are asymptomatic.

Source: Open RN Nursing Health Promotion, 18.11 Fibroids

A nurse cares for an infant hospitalized with bronchiolitis. According to the source, how should the infant be positioned for optimal lung expansion?

1. Placed flat and supine on the mattress
2. Held in an upright position with head of bed elevated ✓
3. Positioned prone with the face turned
4. Placed in Trendelenburg with feet raised

Why: The source states to hold infants with bronchiolitis in an upright position and elevate the head of the bed for children, as these positions allow optimal lung expansion and improved gas exchange.

Source: Open RN Nursing Health Promotion, 15.10 Bronchiolitis

According to the American Heart Association as cited in the source, what is the most important priority for newborn survival during resuscitation?

1. Administering epinephrine as early as possible after birth
2. Obtaining intravenous or umbilical access first of all
3. Beginning chest compressions immediately after delivery
4. Establishing adequate lung inflation and ventilation after birth ✓

Why: The source states that according to the American Heart Association, the most important priority for newborn survival is the establishment of adequate lung inflation and ventilation after birth.

Source: Open RN Nursing Health Promotion, 20.9 Neonatal Resuscitation

According to the source, early-onset neonatal sepsis occurs within which time frame after birth?

1. Within 3 to 7 days of birth ✓
2. After the first week up to the first month
3. Beyond the first month of life
4. Within the first 30 minutes of birth

Why: The source states early-onset neonatal sepsis occurs within 3 to 7 days of birth, late-onset occurs after the first week up to the first month, and very late-onset occurs beyond the first month in NICU infants.

Source: Open RN Nursing Health Promotion, 20.5 Neonatal Sepsis

A caregiver asks what to give a child with varicella for fever. According to the source, which medication should NOT be used and why?

1. Aspirin, due to the risk of Reye's syndrome ✓
2. Acetaminophen, due to potential liver injury
3. Ibuprofen, due to bleeding
4. Calamine lotion, due to rash spread

Why: The source states aspirin should not be used in pediatric patients with varicella due to the increased risk of developing Reye's syndrome; acetaminophen can be administered for fever or pain.

Source: Open RN Nursing Health Promotion, 16.21 Varicella

A nurse is caring for a patient taking a medication with a low (small) therapeutic index. What does this value indicate about the drug?

1. A large window exists between effective and toxic concentrations
2. The drug is relatively safe and rarely needs blood-level monitoring
3. The drug has no measurable toxic concentration at any dose
4. A narrow window exists between effective and toxic concentrations ✓

Why: The source states a small (low) therapeutic index number means a small therapeutic window between the effective and toxic concentration, so blood levels are often measured frequently (as with phenytoin). A large index number indicates a wide, safer window, which is the opposite of the correct choice.

Source: Open RN Nursing Pharmacology 2e, 1.10 Medication Safety

According to the source, preterm birth is defined as an infant born alive before how many weeks of pregnancy?

1. Before 32 weeks of pregnancy
2. Before 39 weeks of pregnancy
3. Before 37 weeks of pregnancy ✓
4. Before 42 weeks of pregnancy

Why: The source defines preterm birth as infants born alive before 37 weeks of pregnancy. Subcategories include extremely preterm (less than 28 weeks) and very preterm (28 to less than 32 weeks).

Source: Open RN Nursing Health Promotion, 20.2 Preterm Birth

According to the source's Aseptic Non-Touch Technique (ANTT), a 'key part' refers to:

1. Any sterile equipment part such as needle hubs, syringe tips, and dressings ✓
2. Any nonintact skin, potential insertion site, or vascular access site
3. The patient's paper medical record and the provider's written orders
4. The unlicensed assistive personnel who is helping with the procedure

Why: The source defines a key part as any sterile part of equipment used during an aseptic procedure, such as needle hubs, syringe tips, needles, and dressings. A key site, by contrast, is any nonintact skin, potential insertion site, or access site for medical devices.

Source: Open RN Nursing Skills 2e, 4.3 Aseptic Technique

According to the source, hypoglycemia during pregnancy is defined as a blood glucose below what value?

1. Below 60 mg/dL ✓
2. Below 70 mg/dL
3. Below 50 mg/dL
4. Below 80 mg/dL

Why: The source states hypoglycemia during pregnancy is diagnosed at lower levels than in nonpregnant patients and is defined as a blood glucose less than 60 mg/dL. The other values do not match the definition given.

Source: Open RN Nursing Health Promotion, 19.8 Gestational and Pregestational Diabetes

A patient weighs 70 kilograms and is 1.75 meters tall. Using the metric BMI formula from the source, what is the patient's approximate BMI?

1. 22.9 ✓
2. 25.7
3. 18.9
4. 28.0

Why: The source gives BMI = weight(kg)/height(m)^2. Here 1.75^2 = 3.0625, and 70/3.0625 = 22.9. This falls in the desirable range of 18.5-24.9. The other values do not result from the correct arithmetic.

Source: Open RN Nursing Fundamentals 2e, 14.3 Applying the Nursing Process

A nurse receives a written order containing an ISMP error-prone abbreviation such as 'qd'. According to the source, what is the appropriate action?

1. Clarify with the provider and have the order rewritten without it ✓
2. Administer as written since the intent is usually obvious
3. Interpret the abbreviation independently and proceed with the dose
4. Transcribe the abbreviation into the MAR exactly as received

Why: The source states that if a nurse receives a prescription containing an error-prone abbreviation, it should be clarified with the provider and the order rewritten without the abbreviation. These abbreviations are frequently misinterpreted and should never be used, so administering or transcribing them as written is unsafe.

Source: Open RN Nursing Pharmacology 2e, 2.5 Preventing Medication Errors

A hospitalized patient has a seizure that requires medical treatment. Which medications does the source list as those that may be administered as prescribed to stop it?

1. Oral carbamazepine or valproate
2. IV levetiracetam or phenobarbital only
3. IV lorazepam, diazepam, or midazolam ✓
4. Subcutaneous epinephrine

Why: The source states that when a seizure requires medical treatment, medications such as IV lorazepam, diazepam, or midazolam may be administered as prescribed. Levetiracetam, phenytoin, and phenobarbital are listed for maintaining a seizure-free state after the seizure.

Source: Open RN Nursing Health Alterations, 9.7 Seizures and Epilepsy

According to the source, inhaled corticosteroids such as fluticasone and budesonide are used in asthma for which purpose?

1. Rapid relief of acute bronchospasm during an attack
2. Immediate reversal of hypoxemia in the Red Zone
3. Bronchoconstriction testing of airway responsiveness
4. Long-term prevention by reducing airway inflammation ✓

Why: The source states inhaled corticosteroids are anti-inflammatory medications that reduce airway inflammation and are used for long-term prevention and management of asthma symptoms. Rapid relief is provided by SABAs, not inhaled corticosteroids.

Source: Open RN Nursing Health Alterations, 6.5 Asthma

According to the WHO 'Warm Chain' described in the source, delaying the newborn's first bath is recommended because the vernix does what?

1. Promotes bilirubin excretion
2. Reduces the risk of infection
3. Prevents heat loss ✓
4. Stimulates brown fat metabolism

Why: The source states the WHO Warm Chain delays bathing until the second or third day of life (or at least 24 hours) so that vernix prevents heat loss. It also recommends immediate drying and skin-to-skin contact.

Source: Open RN Nursing Health Promotion, 12.3 Common Complications During the Neonatal Period

A patient asks the nurse who is responsible for obtaining the signed consent for their upcoming surgery. Who holds this responsibility?

1. The surgeon ✓
2. The perioperative nurse
3. The anesthesiologist
4. The surgical technologist

Why: The source states that while the responsibility of obtaining signed consent lies with the surgeon, nurses play a crucial role by assisting in obtaining and witnessing the patient's signature and clarifying facts presented by the physician.

Source: Open RN Nursing Health Alterations, 2.2 Basic Concepts Related to Surgery

According to the source, homelessness can significantly affect health in three ways. Which of the following is one of these ways?

1. Substantially improved access to routine preventative health care services
2. Complete elimination of the risk of developing any chronic illness at all
3. Guaranteed uninterrupted continuity of medical care across all providers
4. Health conditions that are difficult to treat because of homelessness ✓

Why: The source states homelessness affects health in three ways: health problems caused by homelessness, health problems that cause homelessness, and health conditions that are difficult to treat because of homelessness. The average age of death among homeless people is the mid-50s.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 17.2 Vulnerable Populations

According to the source, without treatment, symptoms of mild alcohol withdrawal generally begin within what timeframe after the last drink?

1. 6 to 36 hours ✓
2. 1 to 2 hours
3. 4 to 5 days
4. 7 to 10 days

Why: The source states that without treatment, symptoms of mild alcohol withdrawal generally begin within 6 to 36 hours after the last drink and resolve within one to two days. Symptoms include anxiety, agitation, restlessness, insomnia, tremor, and diaphoresis.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 14.3 Withdrawal Management/Detoxification

A nurse reviews that a patient's lisinopril was withheld on the morning of surgery. What is the stated rationale for withholding this medication?

1. They increase the risk of bleeding during surgery
2. They increase the risk of hypotension in surgery ✓
3. They increase the risk of hypoglycemia in surgery
4. They increase the aspiration risk during surgery

Why: The source states ACE inhibitors (captopril, lisinopril) and angiotensin receptor blockers are withheld because they increase the risk of hypotension during surgery.

Source: Open RN Nursing Health Alterations, 2.3 Preoperative Nursing Care

A nurse identifies a significant unsafe, unethical practice and decides to report it. According to professional nursing guidance in the source, where does whistleblowing typically begin?

1. With a post on social media
2. By reporting anonymously to the news media
3. Internally, via the chain of command ✓
4. With a private accrediting body, which confers protection

Why: The source states whistleblowing typically begins internally via the chain of command and may require external reporting to a regulator. It also notes that private accrediting bodies (such as the hospital accreditation body) do NOT confer whistleblower protection.

Source: Open RN Nursing Management and Professional Concepts, Advocacy

According to the source, type 1 diabetes results from which underlying process?

1. Cellular resistance to the effects of circulating endogenous insulin hormone
2. Chronic overproduction of excessive amounts of insulin by the pancreas
3. The immune system destroying beta islet cells, causing absolute insulin deficiency ✓
4. Excess glucagon secretion from an insulin-secreting intestinal tumor

Why: The source states that in type 1 diabetes the immune system mistakenly attacks and destroys beta islet cells, leading to an absolute deficiency of insulin. Cellular insulin resistance and insufficient production describe type 2 diabetes.

Source: Open RN Nursing Health Alterations, 7.5 Diabetes Mellitus

A patient is found unresponsive with pinpoint pupils and slow, shallow breathing. According to the source, these signs make up the opioid overdose triad, which also includes which finding?

1. Hypertension and tachycardia
2. Dilated pupils and tremor
3. Decreased level of consciousness ✓
4. Elevated body temperature

Why: The source states the typical signs of opioid overdose are referred to as the opioid overdose triad and include pinpoint pupils, respiratory depression, and decreased level of consciousness.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 14.2 Substances: Use, Intoxication, and Overdose

A patient is being tested for the cause of peptic ulcer disease. The source describes the urea breath test as very specific for detecting what?

1. Bleeding within the ulcer
2. The presence of H. pylori ✓
3. The exact ulcer location
4. Anemia from blood loss

Why: The source states urea breath tests are very specific for the presence of H. pylori. The patient ingests a urea-containing compound; if H. pylori is present, it breaks down the urea, which is detected in the breath sample.

Source: Open RN Nursing Health Alterations, 11.10 Peptic Ulcer Disease

According to the source, which finding is classified as a POSITIVE sign of pregnancy?

1. Auscultation of the fetal heart rate ✓
2. Amenorrhea reported by the patient
3. Bluish discoloration of the cervix (Chadwick sign)
4. A positive urine pregnancy test

Why: The source classifies positive signs of pregnancy as cues provided by the fetus: auscultation of the fetal heart rate, palpable fetal movement, and visualization of the fetus via ultrasound. Amenorrhea is presumptive, while Chadwick sign and a positive pregnancy test are probable signs.

Source: Open RN Nursing Health Promotion, 9.3 Diagnosing Pregnancy

For a patient with thrombocytopenia, the source lists which measure to protect the patient from injury that can cause bleeding?

1. Encourage vigorous flossing
2. Administer aspirin for comfort
3. Use rectal suppositories and enemas for relief of constipation
4. Use a soft toothbrush and avoid intramuscular injections ✓

Why: The source lists protecting the patient from bleeding by avoiding intramuscular injections, using a soft toothbrush, using an electric razor, and avoiding rectal suppositories and straining with constipation. Aspirin and NSAIDs are avoided.

Source: Open RN Nursing Health Alterations, 3.10 Thrombocytopenia

During NG tube insertion, the patient begins coughing, and pulse oximetry readings decrease with cyanosis. According to the source, what should the nurse do?

1. Advance the tube much more quickly past the airway
2. Ask the patient to swallow water and continue
3. Apply suction to the tube to clear it
4. Withdraw the tube until normal breathing resumes ✓

Why: The source states the nurse should monitor for signs of incorrect placement such as coughing, decreased pulse oximetry, and cyanosis; if these occur, the tube should immediately be withdrawn until normal breathing resumes.

Source: Open RN Nursing Advanced Skills, 5.2 Basic Concepts

According to the source, health inequities are defined as which of the following?

1. Avoidable differences in health status seen within and between communities ✓
2. Unavoidable differences in health that result solely from the normal aging
3. Differences in health status that cannot be measured or observed at all
4. The total combined number of separate illnesses present in a population

Why: The source defines health inequities as avoidable differences in health status seen within and between communities, noting that health and illness follow a social gradient in which lower socioeconomic position is associated with worse health.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 16.2 Community Health Concepts

A nurse plans to administer prescribed cefazolin before a patient's surgery. Approximately how long before the incision should this antibiotic be given?

1. 60 minutes before the incision ✓
2. 30 minutes before the incision
3. 2 hours before the incision
4. 4 hours before the incision

Why: The source states antibiotics are typically given approximately 60 minutes prior to the incision to ensure adequate levels are present to combat bacteria introduced during surgery.

Source: Open RN Nursing Health Alterations, 2.3 Preoperative Nursing Care

A nurse selects an intramuscular injection site for an adult. Which site does the source identify as preferred, and why?

1. The vastus lateralis, because it is preferred for adults over infants
2. The ventrogluteal site, because it has the greatest muscle thickness and few nerves and vessels ✓
3. The deltoid site, because it is the largest and most developed muscle available in the arm
4. The dorsogluteal site, because it lies safely away from all major nerves and blood vessels

Why: The source states the ventrogluteal site is preferred in adults because it has the greatest muscle thickness, is free of nerves and blood vessels, and has a small fat layer, giving less painful administration and optimal absorption. The vastus lateralis is preferred for infants, and the deltoid is recommended for vaccinations.

Source: Open RN Nursing Skills 2e, 18.3 Evidence-Based Practices for Injections

A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). According to the source, the SpO2 target range for this patient is often:

1. 94% to 100%
2. 88% to 92% ✓
3. 80% to 85%
4. 100% at all times

Why: The source states that for patients with chronic respiratory conditions such as COPD, the target range for SpO2 is often lower at 88% to 92%. The 94-100% range is the general adult target, not the COPD-specific target.

Source: Open RN Nursing Skills 2e, 1.3 Vital Signs

A nurse advises the parent of a child with diarrhea about diet. According to the source, which foods are recommended as easily tolerated?

1. Fried, greasy, and heavily spiced table foods
2. Whole milk, cheese, and other dairy
3. High-sugar fruit juices and soda
4. Bananas, oatmeal, toast, rice, and applesauce ✓

Why: The source states patients should consume foods that are easily tolerated such as bananas, oatmeal, toast, rice, applesauce, and soup or broth.

Source: Open RN Nursing Health Promotion, 16.9 Diarrhea

A nurse is offering fluids to a child after a tonsillectomy. According to the source, which fluids should be AVOIDED?

1. Red, purple, and brown colored fluids ✓
2. Clear and cold fluids offered in small amounts
3. Cool water sipped slowly from a cup
4. Ice chips given one at a time

Why: The source states to provide clear and cold fluids in small amounts but to AVOID red, purple, and brown colors because they can be mistaken for blood. Straws and sharp objects should also be avoided.

Source: Open RN Nursing Health Promotion, 15.7 Pharyngitis, Tonsillitis, & Adenoiditis