DOH Abu Dhabi RN Exam (ex-HAAD), Practice Questions

According to the source, which of the following is an example of an isotonic IV solution?

1. 0.45% normal saline
2. 0.9% normal saline ✓
3. 3% normal saline
4. 5% dextrose in half saline

Why: The source lists 0.9% normal saline (0.9% NaCl) and lactated ringers as examples of isotonic solutions, which have a similar concentration of dissolved particles as blood so the fluid stays in the intravascular space.

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

A nurse prepares to catheterize a male patient with a known enlarged prostate that has made a previous catheterization difficult. Which catheter type does the source describe as designed to more easily navigate the male urethra in this situation?

1. A coude catheter, which has a curved tip for navigating the male urethra with an enlarged prostate ✓
2. A condom catheter, which is applied externally over the penis and attached to drainage tubing
3. A suprapubic catheter, which is inserted through the abdominal wall directly into the bladder
4. A three-way irrigation catheter, which has a large lumen used for continuous bladder irrigation

Why: The source describes the coude catheter tip as a curved tip used to more easily navigate the male urethra, especially with an enlarged prostate. The condom catheter is a non-invasive external device, the suprapubic is surgically placed through the abdominal wall, and the three-way is for irrigation.

Source: Open RN Nursing Skills 2e, 21.2 Basic Concepts (urinary elimination devices)

Before giving digoxin to an infant, a nurse auscultates the apical pulse for one full minute. According to the source, the dose should be withheld and the provider notified if the apical heart rate is below what value?

1. Less than 60 beats per minute
2. Less than 80 beats per minute
3. Less than 120 beats per minute
4. Less than 100 beats per minute ✓

Why: The source states that prior to digoxin administration the nurse auscultates the apical pulse for one minute, and the dose is withheld and the provider notified for an apical heart rate less than 100 beats per minute in infants.

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

A nurse withdraws medication from a glass ampule. Which practice is correct according to the source?

1. Draw glass fragments up with a standard needle to avoid waste
2. Snap the ampule neck toward the hands to control the break
3. Use the blunt fill filter needle to inject the medication into the patient
4. Withdraw with a filter needle, then change it before injecting the patient ✓

Why: The source states medication is withdrawn from an ampule using a blunt fill filter needle to prevent glass particles being drawn up, but filter needles should never be used to inject the patient and must be removed and replaced with an appropriate needle. The ampule neck should be snapped away from the hands.

Source: Open RN Nursing Skills 2e, 18.2 Basic Concepts

A nurse teaches a patient how to self-administer sublingual nitroglycerin for angina. Which instruction reflects the dosing described in the source?

1. Take two tablets at once and then repeat hourly
2. Take one tablet every 5 minutes for a total of three doses ✓
3. Take one tablet only and then do not repeat
4. Take one tablet every 30 minutes until the pain resolves

Why: The source instructs patients to self-administer one tablet every five minutes for a total of three doses, with relief starting within one to two minutes. The other regimens do not match the source.

Source: Open RN Nursing Health Alterations, 5.7 Coronary Artery Disease

A nurse is arranging placement for a patient who needs 24-hour licensed nursing and total assistance with activities of daily living. Which level of care is most appropriate?

1. Assisted living, offering housing, meals, and some ADL help
2. Skilled nursing facility with 24-hour licensed nursing ✓
3. Outpatient care for chronic disease maintenance
4. Home health with intermittent nurse and aide visits

Why: The source describes a skilled nursing facility (nursing home / long-term care) as providing 24-hour licensed nursing for patients who may need total ADL assistance. Assisted living provides safe housing, meals, and assistance with medications and ADLs but not 24-hour licensed nursing.

Source: Open RN Nursing Management and Professional Concepts, Health Care Economics

Evidence supports bedside handoff reports. According to the source, what benefit do bedside handoff reports provide compared with other formats?

1. They eliminate the need to protect patient confidentiality
2. They remove the need for the oncoming nurse to assess the patient
3. They increase patient safety and patient and nurse satisfaction ✓
4. They allow the report to be delegated to assistive personnel

Why: The source states evidence strongly supports that bedside handoff reports increase patient safety, as well as patient and nurse satisfaction, by communicating current, accurate patient information in real time; patient privacy and confidentiality rules must still be kept in mind if others are present.

Source: Open RN Nursing Fundamentals, Communicating With Health Care Team Members

A patient newly diagnosed with genital herpes asks the nurse about treatment. Which statement reflects the source's information?

1. There is no cure, but antiviral medications can prevent or shorten outbreaks ✓
2. A single course of antibiotics will fully cure the herpes virus infection
3. The virus is completely cleared from the body once the lesions have healed
4. Herpes cannot be transmitted to a partner during periods between outbreaks

Why: The source states there is no cure for herpes; antiviral medications can prevent or shorten outbreaks, and daily suppressive therapy can reduce transmission to partners. Once infected, the virus remains in the body even after symptoms are gone.

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

For preventing stomatitis in a patient receiving chemotherapy, the source recommends which oral care measure?

1. Vigorous brushing with a firm-bristled toothbrush
2. Gentle brushing with a soft toothbrush and rinsing ✓
3. Rinsing frequently with an alcohol-based mouthwash
4. Avoiding all oral hydration between meals

Why: The source states nursing interventions for preventing stomatitis include providing good oral hygiene such as gentle brushing with a soft toothbrush and regular rinsing with a nonalcoholic mouthwash, and encouraging adequate oral hydration.

Source: Open RN Nursing Health Alterations, 4.4 Applying the Nursing Process to Cancer Treatment

A patient requires immediate surgery to control active hemorrhage in order to preserve life. According to the source's classification of surgical urgency, this surgery is best described as which type?

1. Elective surgery
2. Urgent surgery
3. Emergent surgery ✓
4. Palliative surgery

Why: The source defines emergent surgeries as those performed immediately to preserve the patient's life, giving control of hemorrhage as an example. Urgent surgeries are done within 24 to 48 hours, and elective surgeries can be delayed without affecting outcomes.

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

A nurse notes bleeding on a postoperative surgical dressing. According to the source, what should the nurse do to allow follow-up assessment of the bleeding?

1. Remove the whole dressing to inspect the wound edges directly
2. Circle the drainage on the dressing with a permanent marker ✓
3. Apply a tourniquet above the surgical site
4. Elevate the surgical site above heart level

Why: The source states that if bleeding is present on a dressing, the nurse should circle the drainage in permanent marker for follow-up assessments. If excessive bleeding occurs, reinforce the dressing and notify the surgeon.

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

The warning signs of acute compartment syndrome are known as the six P's. According to the source, which sign is typically the first?

1. Pain disproportionate to the injury ✓
2. Pallor of the affected extremity
3. Paralysis of the affected limb
4. Pulselessness felt distal to the injury

Why: The source states pain is typically the first sign of ACS, described as severe, unrelenting pain disproportionate to the injury and unresponsive to opioid administration.

Source: Open RN Nursing Health Alterations, 10.6 Fracture

According to the source, which of the following is an example of an adaptive emotion-focused coping strategy?

1. Avoiding the stressful condition and the situation entirely
2. Withdrawing completely from any stressful environment or place
3. Engaging in mindfulness, meditation, or physical activity ✓
4. Misusing alcohol or other substances to blunt the discomfort

Why: The source lists emotion-focused coping (an adaptive strategy) as including mindfulness, meditation, yoga, humor, spiritual pursuits, physical activity, breathing exercises, and social support. Avoidance, withdrawal, and substance misuse are listed as maladaptive responses.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 9.2 Basic Concepts

A patient is prescribed intravenous phenytoin for status epilepticus. The source states it must be given slowly with cardiac monitoring for what reason?

1. Its tendency to cause severe and prolonged hypoglycemia
2. Its incompatibility with 0.9% normal saline solution
3. Its risk of causing acute kidney injury and oliguria
4. Its effect on the myocardium and potential for arrhythmias ✓

Why: The source states IV phenytoin must be administered slowly because of its effect on the myocardium and potential for arrhythmia development, and the patient should be on cardiac monitoring. It also notes phenytoin is incompatible with IV dextrose.

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

The source lists complications that can result from improper patient positioning during surgery. Which of the following is included?

1. Malignant hyperthermia, severe acidosis, and dysrhythmias
2. Aspiration pneumonia, hypoventilation, and airway collapse
3. Wound dehiscence with evisceration of abdominal contents
4. Nerve damage, pressure injuries, or musculoskeletal strain ✓

Why: The source states complications associated with positioning can include nerve damage, pressure injuries, or musculoskeletal strain. Padding and frequent assessments help prevent these.

Source: Open RN Nursing Health Alterations, 2.4 Intraoperative Nursing Care

According to the ANA as cited in the source, advocacy is best defined as which of the following?

1. The investigation of health care services to prevent money being wasted on unnecessary care
2. A civil wrong under private law that causes physical or emotional harm to the patient
3. A reimbursement model that ties a hospital's payment to measured patient outcomes and safety
4. The act or process of pleading for, supporting, or recommending a cause or course of action ✓

Why: The source cites the ANA definition of advocacy as the act or process of pleading for, supporting, or recommending a cause or course of action, and identifies it as an ANA Standard of Professional Performance.

Source: Open RN Nursing Management and Professional Concepts, Advocacy

The source identifies which finding as the most sensitive indication of malignant hyperthermia?

1. An extremely elevated core body temperature above 111 F
2. A rise in end-tidal CO2 with falling oxygen saturation ✓
3. A sudden drop in the serum potassium level
4. The onset of jaw and upper chest muscle rigidity

Why: The source states the most sensitive indication of malignant hyperthermia is an unexpected rise in the end-tidal carbon dioxide (ETCO2) level with a decrease in oxygen saturation. An extremely elevated body temperature is described as a late sign.

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

According to the source, hand, foot, and mouth disease is most commonly caused by which virus?

1. Parvovirus B19
2. Coxsackievirus A type 16 ✓
3. Respiratory syncytial virus
4. Rotavirus

Why: The source states most cases of hand, foot, and mouth disease are caused by Coxsackievirus A type 16, and it commonly affects pediatric patients under seven years of age.

Source: Open RN Nursing Health Promotion, 16.22 Other Pediatric Disorders

According to the source, respiratory distress syndrome (RDS) in the preterm infant is commonly caused by a lack of what substance?

1. Brown fat
2. Pulmonary surfactant ✓
3. Meconium
4. Bilirubin

Why: The source states RDS is commonly caused by a lack of pulmonary surfactant, which keeps the alveoli open and prevents them from collapsing during exhalation. RDS is common in infants born before 34 weeks of gestation.

Source: Open RN Nursing Health Promotion, 20.2 Preterm Birth

According to the source, tuberculosis is caused by Mycobacterium tuberculosis and spreads by which route?

1. Contact with contaminated food or drinking water sources
2. Direct contact of the organism with the patient's intact skin
3. Through the air when an infected person coughs or sneezes ✓
4. Through the bite of an infected mosquito or other insect vector

Why: The source states TB is a contagious bacterial infection that spreads through the air when an infected person coughs or sneezes, releasing small infectious droplets. It is not spread by food, water, intact skin contact, or insect vectors.

Source: Open RN Nursing Health Alterations, 6.9 Tuberculosis

A tracing shows decelerations that begin during the contraction with the nadir occurring after the peak. According to the source, what do these indicate?

1. Benign fetal head compression
2. Reassuring fetal well-being
3. Umbilical cord compression only
4. Fetal hypoxia (nonreassuring) ✓

Why: The source defines a late deceleration as one that begins during the contraction and continues after it, with the nadir after the peak, and states it is nonreassuring and indicates fetal hypoxia. Early decelerations from head compression are benign; variable decelerations reflect cord compression.

Source: Open RN Nursing Health Promotion, 10.5 Fetal Heart Rate Monitoring

An infant on digoxin is also receiving a diuretic. According to the source, which electrolyte imbalances lower the threshold for digoxin toxicity?

1. Hypercalcemia and hypernatremia
2. Hyperkalemia and hypermagnesemia
3. Hypokalemia and hypomagnesemia ✓
4. Hyponatremia and hyperchloremia

Why: The source states hypokalemia and hypomagnesemia cause a lower threshold for digoxin toxicity, so nurses must monitor potassium and magnesium levels, especially if the patient is concurrently receiving diuretics that can deplete electrolytes.

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

The hospital accreditation body has issued a sentinel event alert on inadequate handoff communication. According to the source, inadequate handoffs have been linked to which harms?

1. Budget shortfalls, staffing cutbacks, and reduced operating funds for the unit
2. Wrong-site surgery, treatment delays, falls, and medication errors ✓
3. Loss of the agency's accreditation and revocation of individual nursing licenses
4. Increased reliance on mandatory overtime and floating nurses to other units

Why: The source states the hospital accreditation body issued a sentinel event alert on inadequate handoff communication, which has been linked to wrong-site surgery, treatment delays, falls, and medication errors.

Source: Open RN Nursing Management and Professional Concepts, Collaboration Within the Interprofessional Team

According to the source, at approximately what age does separation anxiety normally begin?

1. At birth
2. Around 2 years of age
3. Around 4 years of age
4. Around 8 months of age ✓

Why: The source states separation anxiety is a normal part of pediatric development that starts around eight months of age and usually resolves in toddlerhood.

Source: Open RN Nursing Health Promotion, 14.3 Effects of Illness and Hospitalization on a Pediatric Client and Family

A nurse is evaluating a patient's response after transfusing one unit of red blood cells. According to the source, by approximately how much can the hemoglobin be anticipated to increase per unit?

1. 3 g/dL
2. 5 g/dL
3. 1 g/dL ✓
4. 0.5 g/dL

Why: The source states that for each unit of RBCs transfused, the patient's hemoglobin level can be anticipated to increase by 1 g/dL. Nurses evaluate effectiveness by monitoring the hemoglobin level.

Source: Open RN Nursing Health Alterations, 3.5 Anemia

According to the source, which statement best distinguishes aseptic technique from sterile technique?

1. Asepsis creates a protective barrier, while sterile technique attacks all microorganisms ✓
2. Asepsis eliminates all microbes, while sterile technique only reduces their number
3. Asepsis is used only in surgery, while sterile technique is used for all routine care
4. There is no meaningful clinical difference between the two related terms

Why: The source states asepsis is creating a protective barrier from pathogens, whereas sterile technique (surgical asepsis) is a purposeful attack on microorganisms that seeks to eliminate every potential microorganism in and around a sterile field. Sterile technique is the standard for surgery, invasive wound management, and central line care.

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

According to the source, type 2 diabetes is characterized by which of the following?

1. The immune system destroying the beta islet cells of the pancreas over time
2. A complete absence of any insulin production from the moment of birth
3. A pregnancy-related process that always resolves completely after the baby is born
4. Cells becoming resistant to insulin and/or the pancreas not producing enough insulin ✓

Why: The source states that in type 2 diabetes the body's cells become resistant to the effects of insulin and/or the pancreas does not produce sufficient insulin. Autoimmune beta-cell destruction describes type 1 diabetes.

Source: Open RN Nursing Health Alterations, 7.5 Diabetes Mellitus

A community health nurse is caring for rural residents. According to the source, which of the following is a rural risk factor for health disparities?

1. An excess availability of specialist physicians in the local area
2. Very high rates of employer-provided commercial health insurance
3. Geographic isolation and limited access to health care specialists ✓
4. An abundance of convenient public transportation options for all

Why: The source states rural risk factors for health disparities include geographic isolation, lower socioeconomic status, higher rates of health risk behaviors, limited access to health care specialists, and limited job opportunities, intensified by lower rates of insurance coverage.

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

According to the source, the diagnostic tool for PCOS is the Rotterdam criteria, which require the presence of how many of three defined factors?

1. Two of the three factors ✓
2. All three of the factors
3. One of the three factors
4. Any one factor plus a positive genetic test

Why: The source states the diagnostic tool for PCOS is the Rotterdam criteria, which require the presence of two out of three factors: menstrual irregularity, evidence of hyperandrogenism, and polycystic ovaries on ultrasound, occurring without another clinical cause.

Source: Open RN Nursing Health Promotion, 18.18 Polycystic Ovary Syndrome

A patient who is legally competent states they wish to refuse a recommended treatment plan. According to the Patient's Bill of Rights, what is the patient entitled to?

1. To make the decision and refuse treatment, but only after a family member co-signs the refusal form
2. To make decisions about the plan of care and to refuse a recommended treatment to the extent permitted by law and hospital policy ✓
3. To refuse only medications, because all recommended procedures must be legally completed once ordered
4. To have the refusal overridden by the provider whenever the recommended treatment is judged medically necessary for recovery

Why: The Patient's Bill of Rights states the patient has the right to make decisions about the plan of care and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy, and to be informed of the medical consequences. The patient is then entitled to other appropriate care or transfer.

Source: Open RN Nursing Fundamentals, 3.3 Patient's Bill of Rights

Per the source, most women in which age range should have a PAP smear every three to five years, depending on their risk factors?

1. Between the ages of 21 and 65 ✓
2. Between the ages of 30 and 50
3. Between the ages of 18 and 40
4. Between the ages of 45 and 70

Why: The source states most women between the ages of 21 and 65 should have a PAP smear every three to five years, depending upon their risk factors. The PAP smear is a cytological study that screens for cancer in the cervix before symptoms occur.

Source: Open RN Nursing Health Promotion, 8.10 Female Reproductive System Disorders

According to the source, which is the primary diagnostic test for COPD that can detect the disease even before symptoms are recognized?

1. Arterial blood gas
2. Chest X-ray
3. Sputum culture
4. Spirometry ✓

Why: The source identifies spirometry as the primary diagnostic test for COPD, able to detect it even before symptoms appear, and used to determine severity and set treatment goals. ABG, chest X-ray, and sputum are additional tests, especially during exacerbations.

Source: Open RN Nursing Health Alterations, 6.6 COPD

Per the source, a fibroadenoma of the breast is best described as which type of finding?

1. A painless, solid, noncancerous tumor ✓
2. A fluid-filled cyst that fluctuates with the cycle
3. A malignant tumor of the milk ducts
4. An infected, inflamed breast abscess

Why: The source describes fibroadenomas as painless, solid, noncancerous tumors found in breast tissue, most common in women between 14 and 35 years old. They are typically well-defined, round, and rubbery, and usually less than 2.5 centimeters in diameter.

Source: Open RN Nursing Health Promotion, 18.4 Benign Breast Disorders

According to the source, overflow incontinence - in which small amounts of urine leak from a bladder that is always full - tends to occur in which patients?

1. Males with enlarged prostates that prevent complete bladder emptying ✓
2. Older women who have developed weak pelvic floor muscles from previous vaginal deliveries and menopause
3. Patients with dementia who cannot reach the toilet in time
4. Patients with an overactive detrusor muscle

Why: The source states overflow incontinence occurs when small amounts of urine leak from a bladder that is always full, and this condition tends to occur in males with enlarged prostates that prevent complete emptying of the bladder. Functional incontinence, by contrast, involves normal bladder control but difficulty reaching the toilet.

Source: Open RN Nursing Fundamentals, 16.4 Urinary Incontinence

A patient with influenza (a viral infection) requests an antibiotic. Based on the source, what is true about antibiotics for this patient?

1. Antibiotics will effectively shorten the overall duration and severity of the patient's viral influenza illness
2. Antibiotics are the first-line treatment for all respiratory illnesses
3. Antibiotics should be prescribed to prevent the virus from spreading
4. Antibiotics do not work against viral infections such as colds or influenza ✓

Why: The source states antibiotics are used to treat bacterial infections and do not work against viral infections such as colds or influenza. Overprescription of antibiotics for nonbacterial infections is a factor in antibiotic resistance; the nurse educates the patient about effective treatment for the type of pathogen.

Source: Open RN Nursing Fundamentals, 9.5 Treating Infection

The source states that after approximately 36 weeks of gestation, routine prenatal visits are scheduled how often?

1. Monthly until delivery
2. Weekly until delivery ✓
3. Every two weeks until delivery
4. Only when symptoms occur

Why: The source states that until approximately 28 weeks the pregnant woman has monthly visits, and after approximately 36 weeks prenatal visits will be weekly until delivery. Monthly visits apply earlier in pregnancy.

Source: Open RN Nursing Health Promotion, 9.6 Prenatal Care

According to the source, when should antibiotics be administered for suspected meningococcal meningitis?

1. Only after CSF culture and sensitivity results have returned
2. After a 24-hour period of clinical observation
3. Immediately upon diagnosis, not delayed for lab results ✓
4. Only once a petechial rash has developed

Why: The source states that due to the severity of this disorder, antibiotics should be administered immediately upon diagnosis of suspected meningococcal meningitis and not delayed while waiting for lab confirmation.

Source: Open RN Nursing Health Promotion, 16.13 Meningococcal Meningitis

A patient is diagnosed with gonorrhea. According to the source, sexual partners within what time frame should be notified and examined?

1. Within the past 7 days
2. Within the past year
3. Within the past 60 days ✓
4. Within the past two weeks

Why: The source states that for both gonorrhea and chlamydia, all sexual partners within the past 60 days should be notified and examined, keeping in mind that having no symptoms does not mean a person is infection-free.

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

A nurse suspects, but is not certain, that an older adult patient is being abused by a caregiver. According to the source's principle of mandatory reporting, what should the nurse do?

1. Wait until abuse is proven before reporting anything
2. Report the suspected abuse to the appropriate agency ✓
3. Confront the caregiver directly and take no further action
4. Document the concern but avoid reporting it

Why: The source states mandated reporters who suspect neglect or abuse should contact the appropriate agency immediately and describe the situation, reporting what they know. Reporting is based on suspicion, not proof; the receiving department determines whether it meets criteria for investigation.

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

According to the source, which gastrointestinal complication of prematurity involves injury to the cells lining the bowel and has a lower risk in infants fed only breast milk?

1. Transient tachypnea of the newborn
2. Necrotizing enterocolitis (NEC) ✓
3. Meconium aspiration syndrome
4. Esophageal atresia

Why: The source describes necrotizing enterocolitis (NEC) as injury to the cells lining the bowel, and states premature babies who receive only breast milk have a much lower risk of getting NEC. NEC is diagnosed by intramural gas on abdominal X-ray.

Source: Open RN Nursing Health Promotion, 20.2 Preterm Birth

A nurse teaches a patient starting warfarin about diet. Which instruction is consistent with the source?

1. Completely eliminate all green, leafy vegetables from the diet
2. Increase intake of cranberry juice and grapefruit daily
3. Add a daily vitamin K supplement to boost the drug effect
4. Eat a normal, balanced diet with consistent vitamin K intake ✓

Why: The source advises patients to eat a normal, balanced diet to maintain a consistent intake of vitamin K, such as green leafy vegetables, and to avoid cranberries and grapefruit because they increase warfarin's effect and bleeding risk. Eliminating vitamin K foods entirely or supplementing is not advised.

Source: Open RN Nursing Pharmacology 2e, 6.12 Blood Coagulation Modifiers

A nurse cares for a patient with acute renal failure caused by hypovolemia and decreased cardiac output. According to the source, this is classified as which type of injury?

1. Intrarenal
2. Postrenal
3. Postobstructive
4. Prerenal ✓

Why: The source states prerenal injury is caused by factors external to the kidneys that reduce renal blood flow, such as hypovolemia, decreased cardiac output, and vascular obstruction. Intrarenal involves direct tissue damage, and postrenal involves urinary obstruction.

Source: Open RN Nursing Health Alterations, 8.5 Acute Renal Failure

The source describes premature ovarian insufficiency (POI) as ovarian failure occurring before a woman reaches what age?

1. 50 years of age
2. 35 years of age
3. 40 years of age ✓
4. 45 years of age

Why: The source states POI, sometimes referred to as premature menopause, occurs when a woman's ovaries fail before she is 40 years of age. Causes may include chemotherapy or pelvic radiation, but the cause is often unexplained.

Source: Open RN Nursing Health Promotion, 8.6 Fertility

According to the source, what is the most common cause of bronchiolitis?

1. Human parainfluenza virus type 3
2. Rhinovirus
3. Respiratory syncytial virus (RSV) ✓
4. Adenovirus

Why: The source states bronchiolitis is most commonly caused by respiratory syncytial virus (RSV), though it can also be caused by rhinovirus, metapneumovirus, adenovirus, coronavirus, and parainfluenza virus.

Source: Open RN Nursing Health Promotion, 15.10 Bronchiolitis

A nurse notes continuous bubbling in the water seal chamber of a patient's chest tube drainage system. Based on the source, this finding may indicate which problem?

1. An air leak ✓
2. Normal expected drainage
3. Complete lung re-expansion
4. Adequate suction pressure

Why: The source states continuous bubbling in the water seal chamber may indicate an air leak; the nurse should try to identify and correct external leaks and notify the provider if the tube is dislodged or the leak cannot be corrected, as it can indicate a worsening pneumothorax. It is not a normal or reassuring finding.

Source: Open RN Nursing Advanced Skills, 6.2 Chest Tube Basic Concepts

According to the source, tumor lysis syndrome occurs when tumor cells break down in response to treatment. Which electrolyte pattern does it describe?

1. Decreased serum potassium together with an increased serum calcium level
2. Increased uric acid, phosphorus, and potassium; decreased calcium ✓
3. Increased sodium with decreased serum phosphorus levels
4. Decreased uric acid with increased serum calcium levels

Why: The source states tumor lysis syndrome causes increased serum levels of uric acid, phosphorus, and potassium and decreased levels of calcium, along with signs of kidney failure. Treatment includes aggressive hydration and rasburicase to decrease uric acid.

Source: Open RN Nursing Health Alterations, 4.3 Cancer

According to the source, severe liver damage may occur if a healthy adult patient takes more than which amount of acetaminophen in 24 hours?

1. 3,200 mg
2. 2,000 mg
3. 4,000 mg ✓
4. 6,000 mg

Why: The source states severe liver damage may occur if an adult takes more than 4,000 mg of acetaminophen in 24 hours, with lower limits of 3,200 mg for older adults and 2,000 mg for chronic alcoholics. 6,000 mg is not a figure given in the source.

Source: Open RN Nursing Fundamentals 2e, 11.4 Pain Management

According to the source, a patient is typically diagnosed with constipation when they have how many bowel movements?

1. Less than one bowel movement per day
2. Less than three bowel movements per week ✓
3. Less than five bowel movements per week
4. Fewer than three bowel movements per day

Why: The source states a patient is typically diagnosed with constipation if they have less than three bowel movements per week. Constipation can result from slowed peristalsis, dehydration, lack of fiber, opioids, or abdominal surgery; the goal of treatment is a bowel movement at least every 72 hours.

Source: Open RN Nursing Fundamentals, 16.6 Constipation

An infant with a congenital heart defect shows abdominal distension and edema in the feet and lower legs. According to the source, these findings most suggest which complication?

1. Left-sided heart failure
2. A hypercyanotic Tet spell
3. Right-sided heart failure ✓
4. Polycythemia

Why: The source states right-sided heart failure causes blood to back up to the rest of the body, commonly manifesting as abdominal distension from liver engorgement and ascites, and edema in the feet and lower legs.

Source: Open RN Nursing Health Promotion, 17.4 Complications of Congenital Heart Defects

A nurse teaches a postoperative patient to use an incentive spirometer to prevent atelectasis. According to the source, the patient should hold each breath for about 5 seconds and repeat the technique how often?

1. 10 times every hour while awake ✓
2. 3 times every 4 hours
3. Once per shift
4. 20 times before each meal

Why: The source states the patient should breathe in slowly and deeply, hold the breath for 5 seconds or as tolerated, and repeat this technique 10 times every hour while awake. The incentive spirometer is used to prevent and treat atelectasis after surgery.

Source: Open RN Nursing Skills 2e, 11.2 Basic Concepts of Oxygenation

A nurse is communicating with an older patient who has impaired hearing. Which evidence-based strategy should the nurse use?

1. Shout each word loudly so the patient with impaired hearing can clearly hear the entire message
2. Stand behind the patient to avoid distraction while speaking
3. Position yourself 2-3 feet away and face the patient directly in a well-lit environment ✓
4. Speak in long, complex sentences to provide full detail

Why: For patients with impaired hearing the source recommends positioning yourself 2-3 feet away, facing the patient directly in a well-lit environment to facilitate lip-reading, minimizing background noise, and refraining from shouting. Language should be simplified into short, simple sentences.

Source: Open RN Nursing Fundamentals, 2.3 Communicating With Patients

According to the source, a patient with bacterial pharyngitis is no longer infectious after how long of antibiotic therapy?

1. 48 hours
2. 72 hours
3. 24 hours ✓
4. One week

Why: The source states the patient is no longer infectious after 24 hours of antibiotic therapy.

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

According to the source, which newborn finding is a risk factor for neonatal sepsis?

1. Low birth weight ✓
2. A high Apgar score
3. Post-term gestation only
4. Maternal blood type O

Why: The source lists newborn risk factors for sepsis as premature birth, low birth weight, fetal distress, and a low Apgar score. Maternal risk factors include chorioamnionitis and a positive Group Beta Streptococcus infection.

Source: Open RN Nursing Health Promotion, 20.5 Neonatal Sepsis

Using the CURE hierarchy, a nurse has two competing needs. Which should be addressed first?

1. Assisting a weak patient who is on a bed alarm to walk to the restroom safely
2. Documenting a completed routine physical assessment
3. A patient with a rapid fluttering heartbeat and shortness of breath ✓
4. Washing a patient's hair to improve their comfort

Why: The source gives this exact example: a critical need (rapid fluttering heartbeat plus shortness of breath) takes priority over an urgent need (assisting a weak patient on a bed alarm to the restroom). Critical needs require immediate action and never fall below urgent, routine, or extra activities.

Source: Open RN Nursing Management and Professional Concepts, Prioritization

A nurse assesses the lower extremities of a patient at risk for DVT. According to the source, which set of findings should be reported as suspicious for a DVT?

1. Unilateral extremity edema, redness, warmth, and calf pain ✓
2. Bilaterally symmetric pallor with coolness of both lower extremities
3. Generalized itching of the skin without any associated swelling
4. Symmetric ascending numbness affecting both of the patient's feet

Why: The source states the extremities should be assessed for unilateral edema, redness, warmth, and calf pain, examining both legs simultaneously because signs can be subtle. The other findings are not the DVT signs described.

Source: Open RN Nursing Health Alterations, 5.11 Deep Vein Thrombosis

A child is diagnosed with pinworm. According to the source, what is recommended regarding treatment of the household?

1. Treat only the one child who has active symptoms
2. Treat only family members who report itching
3. No treatment of other household members is needed
4. Treat everyone in the household to prevent recurrence ✓

Why: The source states treatment consists of anti-parasitic medications, and it is recommended to treat everyone in the household to prevent recurrence, even if they have no symptoms.

Source: Open RN Nursing Health Promotion, 16.22 Other Pediatric Disorders

A patient scheduled for surgery tells the nurse, "I signed the form, but I still don't understand what the surgeon is going to remove." What is the nurse's most appropriate action based on the source?

1. Explain the surgical procedure, its benefits, and its risks in full detail to the patient personally
2. Reassure the patient that signing the form means consent is already complete
3. Witness the signature again and document that teaching was fully completed
4. Notify the provider and advocate for further discussion before the form is acted upon ✓

Why: The source states it is the provider's responsibility to discuss the treatment, and that if the patient expresses questions or lack of understanding, the nurse has an ethical responsibility to notify the provider and advocate for further discussion. It also states it is not the nurse's role to provide the information, so explaining the procedure or reassuring the patient would be incorrect.

Source: Open RN Nursing Fundamentals 2e, 1.6 Legal & Ethical Considerations

A nurse cares for a patient with an arteriovenous fistula in the left arm for hemodialysis. According to the source, which measure protects the integrity of the fistula?

1. Use the patient's left arm for all routine blood pressure measurements
2. Flush the fistula with heparin solution between dialysis treatments
3. Avoid blood pressure measurements and blood draws in the fistula arm ✓
4. Use the fistula for routine IV medications given between treatments

Why: The source states special care must be taken to preserve fistula integrity, including avoidance of blood pressure measurements, blood draws, or procedures that constrict blood flow in the AV extremity. Fistulas are used only for dialysis and are not flushed between treatments.

Source: Open RN Nursing Health Alterations, 8.6 Chronic Kidney Disease

A nurse administers a diuretic to a patient with heart failure. Based on the source, which electrolyte imbalance should the nurse monitor for as a potential effect of the therapy?

1. Hyperkalemia
2. Hypernatremia
3. Hypokalemia ✓
4. Hypercalcemia

Why: The source states diuretics can cause hypokalemia and other electrolyte imbalances, so electrolytes must be monitored and potassium supplementation may be required. The other imbalances are not identified.

Source: Open RN Nursing Health Alterations, 5.8 Heart Failure

According to the source, stridor is a characteristic symptom of which severity of croup?

1. Mild croup
2. Severe croup ✓
3. Resolving croup
4. Early croup

Why: The source states that if swelling worsens, a high-pitched sound called stridor can occur as the patient breathes through an obstructed airway; stridor is a characteristic symptom of severe croup.

Source: Open RN Nursing Health Promotion, 15.8 Croup

According to the source, patients are encouraged to schedule their first prenatal visit at which point?

1. Between 4 and 6 weeks of gestation
2. Between 14 and 16 weeks of gestation
3. Between 8 and 12 weeks of gestation ✓
4. At the time of a missed period

Why: The source states patients are encouraged to schedule their first prenatal visit sometime between 8 and 12 weeks of gestation. The other windows are not the recommended range stated in the text.

Source: Open RN Nursing Health Promotion, 9.6 Prenatal Care

A nurse inadvertently administered a wrong medication because two look-alike, sound-alike drugs were stored together. Using the Just Culture model, how should this simple human error be managed?

1. Report the nurse to the nursing regulatory authority for disciplinary action
2. Console the individual and fix the system or process ✓
3. Terminate the nurse for a conscious disregard of risk
4. Take no action because no harm was intended

Why: The source states simple human error is managed by CONSOLING the individual and fixing the system or process, for example when root cause analysis reveals look-alike/sound-alike meds stored together and labeling or storage is changed. Punitive action is reserved for reckless behavior.

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

A nurse monitors a patient's chest tube drainage. According to the source, drainage averaging more than which amount for 4 hours should be reported because it may indicate vascular injury requiring surgical repair?

1. More than 50 mL/hour
2. More than 200 mL/hour ✓
3. More than 100 mL/hour
4. More than 500 mL/hour

Why: The source states the provider should be notified if drainage averages more than 200 mL/hour for 4 hours, as this may indicate a vascular injury that requires surgical repair. The other amounts are not the threshold stated.

Source: Open RN Nursing Advanced Skills, 6.3 Nursing Responsibilities for Clients With Chest Tube Drainage Systems

According to the source, a diagnosis of Bipolar I disorder requires that the individual has had at least which of the following?

1. One manic episode ✓
2. Two major depressive episodes
3. A hypomanic episode only
4. Two years of cyclothymic symptoms

Why: The source states that individuals with Bipolar I disorder have had at least one manic episode and often experience additional hypomanic and depressive episodes. One manic episode can change a diagnosis from depression to bipolar disorder.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 8.2 Basic Concepts of Bipolar Disorders

Birth is imminent and an opioid is prescribed for labor pain. According to the source, why might the nurse use clinical judgment to withhold it?

1. Opioids have essentially no effect on the fetus during this late stage of labor
2. Opioids dangerously raise the maternal platelet count during the second stage
3. Opioids can cause neonatal respiratory depression if birth occurs while circulating ✓
4. Opioids strengthen uterine contractions and thereby speed the delivery of the fetus

Why: The source states that if birth is imminent and an opioid can cause neonatal respiratory depression, the nurse may use clinical judgment and withhold the opioid. Opioids cross the placenta and, if the fetus is born while the drug circulates, depressed respirations may result.

Source: Open RN Nursing Health Promotion, 10.6 Pain Management During Labor and Delivery

Per the source, by what age should the anterior fontanelle normally close?

1. 2 months of age
2. 18 months of age ✓
3. 6 months of age
4. 12 months of age

Why: The source states the anterior fontanelle should close by 18 months of age, while the posterior fontanelle should close by 2 months of age. Atypical head circumference growth can indicate developmental disorders.

Source: Open RN Nursing Health Promotion, 13.3 Stages of Child Development

According to the source, anaphylaxis is which type of hypersensitivity reaction?

1. Type I hypersensitivity ✓
2. Type II hypersensitivity
3. Type III hypersensitivity
4. Type IV hypersensitivity

Why: The source states anaphylaxis is a Type I hypersensitivity reaction that occurs rapidly and systemically, and if not promptly treated, it can be fatal. It involves release of inflammatory mediators in response to an allergen.

Source: Open RN Nursing Health Alterations, 4.5 Autoimmune and Hypersensitivity Reactions

In the New York Heart Association Functional Classification described in the source, which class has symptoms of heart failure at rest, with any physical activity causing further discomfort?

1. Class IV ✓
2. Class I
3. Class II
4. Class III

Why: The source defines NYHA Class IV as symptoms at rest with any activity causing further discomfort, also called end-stage heart failure qualifying for hospice care. Class I has no limitation, II slight, III marked limitation.

Source: Open RN Nursing Health Alterations, 5.8 Heart Failure

The surgical safety checklist includes confirming patient identity. According to the source, this step primarily helps prevent which type of error?

1. Wrong-patient procedures ✓
2. Retained surgical sponges
3. Anesthesia overdose
4. Surgical site infection

Why: The source states patient identity is verified by cross-checking name, date of birth, and other identifying information, and that this step helps prevent wrong-patient procedures. Counting instruments prevents retained foreign objects.

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

According to the source, what is the primary symptom of pediculosis capitis (head lice)?

1. Fever
2. Itching ✓
3. Hair loss
4. Pain

Why: The source states the primary symptom of pediculosis capitis is itching. Nits (eggs) are typically attached to the hair shaft, but their presence alone does not confirm active infection.

Source: Open RN Nursing Health Promotion, 16.18 Pediculosis Capitis (Lice)

A nurse cares for a patient after a thyroidectomy who develops numbness, tingling, and muscle cramping with positive Chvostek's and Trousseau's signs. According to the source, this complication is caused by which of the following?

1. Injury to the laryngeal nerve during thyroid gland removal
2. Hypoparathyroidism from trauma to the parathyroid glands ✓
3. Airway compromise from postoperative hemorrhage and swelling
4. An adverse reaction to prior radioactive iodine therapy

Why: The source states hypoparathyroidism can occur due to unintended removal of or trauma to the parathyroid glands during surgery, causing low serum calcium with numbness, tingling, muscle cramping, and Chvostek's and Trousseau's signs, treated with calcium and vitamin D. Laryngeal nerve injury causes hoarseness, not hypocalcemia.

Source: Open RN Nursing Health Alterations, 7.6 Thyroid Disorders

A nurse is asked to report compliance with core measures. What are core measures as described in the source?

1. Annual patient safety goals that are tailored to seven different types of care settings
2. Foundational ethical principles that guide nurses in making everyday clinical decisions
3. National standards of care for common conditions proven to reduce complications ✓
4. Estimates of an agency's yearly revenue and expenses used for operating budget planning

Why: The source defines core measures as national standards of care and treatment for common conditions, proven to reduce complications, with hospitals reporting compliance to the hospital accreditation body and health authorities. Examples include stroke, cardiac care, and immunizations.

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

A nurse assesses a patient with untreated hypothyroidism. Based on the source, which set of findings is expected?

1. Weight loss, heat intolerance, palpitations, and tachycardia
2. Exophthalmos, frequent diarrhea, restlessness, and tremors
3. Fatigue, cold intolerance, weight gain, and bradycardia ✓
4. Fever, hypertension, restlessness, and profuse sweating

Why: The source lists fatigue and weakness, cold intolerance, weight gain, bradycardia, and hypotension among manifestations of hypothyroidism, reflecting a decreased metabolic rate. Weight loss, heat intolerance, tachycardia, and exophthalmos are hyperthyroid findings.

Source: Open RN Nursing Health Alterations, 7.6 Thyroid Disorders

According to the source, Leopold's maneuvers are included in the provider's physical exam beginning at what gestational age?

1. At 24 weeks or more of gestation
2. At 28 weeks or more of gestation
3. At 32 weeks or more of gestation ✓
4. At 36 weeks or more of gestation

Why: The source states that at 32 weeks or more of gestation the physical exam includes Leopold's maneuvers, a set of four steps performed when palpating the abdomen to determine fetal lie, back, fundal parts, and presentation. The earlier weeks are not the value stated.

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

A patient with an acute ischemic stroke is being evaluated for alteplase. Which finding does the source list as a contraindication to the medication?

1. Age under 40 years
2. Blood pressure below 120/80
3. A first-time stroke
4. Age over 80 years ✓

Why: The source lists alteplase contraindications as age over 80 years, use of anticoagulants, and a history of stroke and diabetes.

Source: Open RN Nursing Health Alterations, 9.9 Cerebrovascular Accident

A nurse measures orthostatic blood pressure on a patient with suspected fluid volume deficit. Which change is considered abnormal and should be reported per the source?

1. A rise in systolic blood pressure of 5 mmHg on standing
2. No measurable change in either blood pressure or pulse rate between the lying and standing positions
3. A decrease in systolic BP greater than 20 mmHg or diastolic BP greater than 10 mmHg, or light-headedness ✓
4. A decrease in heart rate of 5 beats per minute on standing

Why: The source states that for orthostatic blood pressure measurement, a decrease in systolic BP greater than 20 mmHg or diastolic BP greater than 10 mmHg, or light-headedness, is abnormal and should be reported, with fall precautions implemented. The patient lies five minutes, then BP and pulse are measured standing after one to three minutes.

Source: Open RN Nursing Fundamentals, 15.6 Applying the Nursing Process (Fluids)

A school-aged child recovering from influenza developed continual vomiting followed by lethargy and delirium after receiving aspirin. According to the source, which serious condition should be suspected?

1. Febrile seizure
2. Meningitis
3. Reye's syndrome ✓
4. Epiglottitis

Why: The source states Reye's syndrome is a rare but serious illness associated with the use of aspirin during viral illness such as influenza or varicella. The initial symptom is continual vomiting followed by lethargy and delirium.

Source: Open RN Nursing Health Promotion, 16.22 Other Pediatric Disorders