المجلس التمريضي الأردني

Q1) Which of the following is the priority nursing intervention for a client who has vomiting after surgery?

A. Measure the amount of vomitus to monitor fluid balance B. Offer water to replace fluids C. Support the surgical incision to maintain its integrity D. Maintain a position that prevents aspiration

Q2) The nurse is assigned to care for a group of clients. Which of the following clients should the nurse assess first?

A. A client 2 days postoperative coronary artery bypass grafting with breath sounds in the lung bases and a temperature of 38.4 C B. A client who had a permanent demand pacemaker inserted 4 hours ago and has occasional pacemaker spikes on the cardiac monitor C. A client who has a peripherally inserted central venous catheter and is reporting swelling of the right arm and shortness of breath D. A client with atrial fibrillation who has an INR of 1.2 and is due to receive a scheduled dose of warfarin

Q3) A nurse enters the room of a client with a documented latex allergy and notices that the respiratory therapist has brought latex- gloves for a scheduled treatment. Which action should the nurse take first?

A. Confirm with the client the severity of previous allergic reactions B. Notify the charge nurse C. Stop the procedure and replace with latex-free supplies D. The therapist can use because the client is the one who is allergic not the therapist

Q4) A nurse reviews newly prescribed medications for clients. Which prescription should the nurse verify with the physician before implementation?

A. Potassium chloride 20 mEq orally for a client with a potassium level of 3.1 mEq/L B. Enoxaparin (Clexane) 40 mg S/C daily for a post-appendectomy adolescent C. Sliding-scale insulin before meals for a client with type 2 diabetes D. Furosemide 20 mg IV for a client with pulmonary edema

Q5) A nurse is caring for a client who has just returned from external fixation device placement for stabilization of a fractured femur. Which of the following interventions are NOT CORRECT to include in the client\'s plan of care?

A. Assess for increasing drainage from pin sites B. Check for loose pins and tighten them if loose C. Monitor pulses distal to the external fixation device D. Perform pin care with a sterile cleaning solution

Q6) A nurse is preparing to reposition an obese heavy client who is unable to assist with movement. A hoist (mechanical lifting device) is available on the unit but using it will require several additional minutes. Which action is most appropriate?

A. Reposition the client manually using a draw sheet B. Ask another staff member to help and reposition the client manually C. Use the client's hoist to reposition the client despite the delay D. Delay repositioning until more staff members become available

Q7) Your colleague nurse is caring for a client with Methicillin-Resistant Staphylococcus Aureus (MRSA) infected wound. Which observation requires your immediate intervention?

A. The nurse removes gloves and then performs hand hygiene after leaving the room B. The nurse wears a gown and gloves while changing the dressing and removes the gown before leaving the room C. The nurse enters the room wearing gloves and performs hand hygiene after glove removal D. The nurse wears glove while changing the dressing and takes them off in the nursing station before attending to another client

Q8) The nurse is caring for a client who has a chest tube attached to closed chest drainage system that is connected to wall suction. The nurse notes continuous, gentle bubbling in the suction control chamber. Which of the following actions should the nurse take?

A. Decrease the wall suction until the bubbling stops in the suction control chamber B. Document as normal findings in the client\'s medical record C. Assess the chest tube insertion site for subcutaneous emphysema D. Notify the physician of a suspected air leak

Q9) What is the appropriate nursing action for a client who is experiencing generalized seizure?

A. Restrain the client to prevent injury B. Insert an oral airway C. Place client in high Fowlers position D. Loosen restrictive clothing

Q10) A nurse preparing IV antibiotic notices that the pharmacy dispensed a medication with the correct name but double the prescribed concentration. The error is identified before the medication reaches the client. Which action should the nurse take?

A. Return the medication to the pharmacy and wait for the correct medication B. Document the occurrence in the medication administration record C. Notify the pharmacy and complete an incidence report according to policy D. Administer half the volume to deliver the prescribed dose and discard the remaining amount

Q11) A 70-year-old client who had a total hip replacement 2 days ago is refusing to ambulate, stating, I am in too much pain to walk. The nurse reviews his record and notes that PRN analgesic is prescribed. What is the nurse\'s priority action?

A. Ambulate the client despite pain, as early mobility is important post-hip surgery B. Respect the client\'s refusal and document it in the chart C. Administer the PRN analgesic, then return to ambulate him in 30 minutes D. Request assistance from another staff to ambulate him and give analgesia immediately after procedure

Q12) A client experiences urge incontinence. Which intervention is most appropriate?

A. Restrict fluids to the minimum B. Schedule toileting intervals C. Maintain indwelling catheter use D. Encourage bed rest

Q13) A hospitalized client reports sleeping only 2 hours per night due to nursing interruption and a noisy environment. Which nursing intervention is most appropriate as a first step?

A. Cluster care activities, minimize nighttime interruptions, and dim lights at bedtime B. Request a PRN sedative-hypnotic prescription C. Reassure the client that sleep disturbance is expected in the hospital and he will have a good sleep after discharge D. Move the client to a room with fewer clients to reduce noise

Q14) A client with a new colostomy is discharged home. The client states: I will just change the bag whenever it gets full, probably once a week. Which response by the nurse best addresses a critical safety and skin integrity concern?

A. That is reasonable, just change it when it\'s convenient for you B. Empty pouch when ⅓ full; change appliance every 3--5 days to prevent skin breakdown C. You only need to change it if you notice leaking or odor D. Once weekly is fine if you keep the area clean with soap and water

Q15) The nurse notes in the medication history that the client is taking Allopurinol (Zyloric). The nurse interprets that the client has which disorder?

A. Rheumatoid arthritis B. Gout C. Osteoarthritis D. Multiple sclerosis

Q16) The nurse is teaching a client with type 1 diabetes mellitus about regular and NPH (intermediate-acting insulin) insulin therapy. Which of the following statements by the client would require additional information and need more attention?

A. I will always check my blood glucose level prior to using the sliding scale B. I will draw up regular insulin into the syringe first and NPH insulin second C. I will eat breakfast within 30 minutes of taking my morning NPH and regular insulin D. I will use the sliding scale to determine my NPH insulin dose with meals

Q17) The nurse will monitor and educate for which adverse effect in a client receiving an anticholinergic drug?

A. Increase urination B. Diaphoresis C. Dry mouth D. Extra saliva

Q18) The nurse is caring for a client with anemia of chronic kidney disease. Which among the following is the preferred initial therapy for this client?

A. Furosemide (Lasix) B. Erythropoiesis-stimulating agents (ESAs) C. Serotonin antagonists D. Iron replacement agents

Q19) The nurse is caring for a client who has a prescription for Nalbuphine 10 mg/70 kg subcutaneously once. The client weighs 50 kg. The nurse has Nalbuphine 10 mg/1 mL available. How many ml should the nurse administer to the client?

A. 0.71 (mL/dose) B. 1.21 (ml/dose) C. 2.53 (mL/dose) D. 3.24 (mL/dose)

Q20) As a nurse caring for a client following subtotal thyroidectomy. Levothyroxine (Levotiron), 25 mcg P.O. daily, is prescribed by the physician. What is the expected therapeutic effect?

A. Lower body temperature and ease feeling warm B. Decrease metabolism and improve body weight C. Decrease skin moisture and sweating D. Lowers daytime tiredness and fatigue

Q21) When teaching a client about taking a newly prescribed antiepileptic medication at home, the nurse will include which instruction?

A. Driving is allowed after 2 weeks of therapy B. If seizures reoccur, take a double dose of the medication C. Antacids can be taken with the antiepileptic medication to reduce gastrointestinal adverse effects D. Take the medication at the same time every day

Q22) The nurse caring for a client who will be starting anticoagulant therapy. What is the primary goal of this therapy?

A. Preventing atherosclerosis formation B. Dissolving an existing thrombus C. Preventing thrombus formation D. Dilating the vessel around a clot

Q23) A 42-year-old client arrived to the emergency department after a motor vehicle accident. The nurse notes absent breath sounds on the left side and the chest x-ray shows black area on left side and tracheal deviation to the right. What should be the nurse\'s priority intervention?

A. Suction the client's nose and throat for 15 seconds to clear thick secretions B. Increase the oxygen concentration FiO2 to 100% and notify the respiratory therapist C. Prepare for chest tube insertion for chest decompression D. Manually ventilate with mask and bag until he is connected to ventilator

Q24) A 45-year-old client has sudden shortness of breath 12 hours post-cholecystectomy. His respiratory rate is 28 breaths/minute, and SpO2 dropped from 96% to 89% on room air. What should the nurse do first?

A. Administering the prescribed narcotic analgesic as the client is in pain B. Elevate head of bed and initiate prescribed oxygen therapy C. Encourage the client to cough forcefully D. Document the findings and keep assessing the client every 2 hours

Q25) An adult client with a fractured right tibia and fibula had a full-leg plaster cast applied 4 hours ago. The client reports deep, continuous, and severe right leg pain despite receiving IV morphine. What intervention should the nurse perform first?

A. Administer double the dose of prescribed analgesics and monitor for effectiveness B. Loosen or remove the cast and notify the physician immediately C. Elevate the limb above heart level D. Apply ice cold compresses to the affected leg

Q26) A client is receiving an intravenous infusion of chemotherapy through a peripheral intravenous line for breast cancer management. She complained of a burning and stinging sensation at the insertion site, the nurse notes localized swelling. What is the priority nursing action?

A. Slow down the infusion rate and apply a warm compress over the site B. Stop the infusion and avoid flushing the line C. Flush the line with normal saline to dilute the medication D. Instruct the client that mild burning is an expected side effect of chemotherapy

Q27) The nurse is assigned for to care for a group of adult clients. Which client requires the nurse's most immediate intervention?

A. A 65-year-old client with Chronic Obstructive Pulmonary Disease (COPD) whose current oxygen saturation is 88% while receiving 2 L/min of oxygen B. A 42-year-old client who is 1-day post-operative following appendectomy and is requesting a scheduled dose of oral pain medication C. An 18-year-old client admitted with acute appendicitis who reports a sudden, severe escalation in abdominal pain accompanied by a heart rate of 130 b/m D. A 38-year-old client with a known history of sickle cell disease who reports joint pain in both knees

Q28) A nurse is caring for a client with end-stage renal disease on hemodialysis. Which dietary modification should the nurse emphasize to prevent complications?

A. High potassium diet B. Low protein diet C. Low Phosphorus diet D. Unrestricted fluid intake

Q29) A client receiving intravenous heparin infusion after an acute myocardial infarction, suddenly reports a severe headache and left-sided weakness. What is the nurse\'s priority response?

A. Administer aspirin 325 mg immediately B. Obtain an ECG and document findings C. Stop the infusion and notify the physician D. Reposition the client and reassess in 15 minutes

Q30) An adult client with Asthma has a baseline SpO₂ of 89% and is admitted for an exacerbation of symptoms. The nurse notes wheezes, increasing respiratory distress, SpO₂ 84%, and use of accessory muscles. Which intervention takes priority?

A. Apply a 100% non-rebreather mask B. Prepare for immediate intubation C. Administer oxygen via Venturi mask (28-60%) D. Administer oxygen and nebulized bronchodilator then reassess in few minutes

Q31) A client with septic shock is receiving norepinephrine infusion. Which assessment findings should the nurse report immediately?

A. Mean Arterial Pressure of 63 mmHg B. Urine output of 70 mL/hr C. High Lactate of 5.2 mmol/L D. Heart rate 95 beats/min

Q32) A client with heart failure with Ejection Fraction 30%. She calls the clinic nurse and report a 3 kilogram weight gain in 24 hours and mild ankle swelling. The nurse should:

A. Advise her to come to the clinic for evaluation by the physician B. Reassure her that this is normal and schedule a routine follow-up C. Tell her to restrict fluids to 500 ml/day and call back tomorrow D. Instruct her to double her diuretic dose for two days

Q33) A nurse is caring for adult client with Diabetic Ketoacidosis. After 2 hours of insulin and normal saline infusion, the blood glucose is 252 mg/dL. The client is now alert, and potassium is 4.2 mEq/L. What is the priority nursing action?

A. Increase the insulin drip rate to clear ketones faster B. Stop the insulin infusion and keep saline only C. Switch to subcutaneous insulin and oral fluids D. Switch IV to dextrose containing fluid and continue insulin

Q34) A client with a Pulmonary Embolism (PE) is receiving a heparin infusion. The aPTT is 99 seconds. The client is hemodynamically stable. What should the nurse do?

A. Continue the infusion at the current rate; the level is acceptable B. Administer protamine sulfate to reverse the effect C. Increase the rate to maintain therapeutic anticoagulation D. Review heparin protocol for the client and institution holding or decreasing the infusion, and notify the physician

Q35) A client with rheumatoid arthritis has been taking Methotrexate. She reports increased fatigue, mouth sores, and her white blood cells are 2.8 cells/micL, Hb 9.2 g/dL. What is the nurse\'s priority concern and the appropriate intervention?

A. Bone marrow suppression, hold the medication and notify the physician B. The fatigue is a common side effect; reassure and continue the medication C. Anemia from rheumatoid arthritis, request iron studies D. Viral infection, advise rest and fluids

Q36) A client with prolonged vomiting is admitted with: Na⁺ 138 mEq/L, K⁺ 2.9 mEq/L, HCO₃⁻ 34 mEq/L, pH 7.51. Which prescribed intervention is expected initially for the client?

A. Encourage slow breathing B. Administer sodium bicarbonate C. Prepare for mechanical ventilation D. Administer potassium chloride IV infusion

Q37) A client receiving continuous enteral nutrition through a gastrostomy tube develops coughing, dyspnea, and decreased oxygen saturation. What is the nurse\'s best response?

A. Pause the feeding and check tube placement and tolerance B. Reduce the infusion rate and continue monitoring respiratory status C. Administer supplemental oxygen while completing the feeding D. Reposition the client and reassess after the feeding is completed

Q38) The nurse is caring for a client with advanced liver cirrhosis. Which of the following assessment findings connected to this condition?

A. Black, tarry stool B. Bright red-streaked stool C. Light red -colored stool D. Yellowish, dry, rocky stool

Q39) The nurse in an outpatient clinic is caring for a client with Addison disease who has been taking hydrocortisone 20 mg daily for the last 8 years. Which client data is most important to report to the physician?

A. Blood pressure of 140/90 mm Hg B. Low-grade fever of 37.9 C C. Mild increase in fasting blood glucose D. Weight gain of 2.7 kg in 3 months

Q40) A client with chronic kidney disease has an ECG showing peaked T-waves and widened QRS complexes. Potassium is 6.8 mEq/L. Which prescribed intervention should the nurse implement first?

A. Administer sodium polystyrene sulfonate (Kayexalate) orally B. Initiate cardiac monitoring and administer IV calcium gluconate C. Prepare the client for emergent hemodialysis D. Administer IV regular insulin with normal saline

Q41) A client underwent a thoracocentesis for a pleural effusion. After 30 minutes, the client developed sudden dyspnea, a respiratory rate of 36 breaths/min, oxygen saturation of 84%, and absent breath sounds on the affected side. What is the nurse\'s priority action?

A. Place the client in Trendelenburg position and assess breathing sounds B. Turn client to right lateral position and assess breathing sounds C. Administer prescribed analgesics and reassess in one hour D. Administer oxygen and obtain chest X-ray prescription

Q42) The client tells the psychiatric mental nurse that he intends to kill his wife once he is discharged. Which of the following actions is the nurse expected to do?

A. The nurse should recommend the client to be restrained B. The nurse has a duty to inform his physician and follow institution procedures to ensure safety of the possible victim C. Nothing, the nurse has a duty to maintain the client's confidentiality D. The nurse should not take his word seriously and discharging him with sort follow up visit

Q43) Which of the following tasks in psychiatric mental health should be performed by a registered nurse and not a practical nurse?

A. Observing a client's during meal intake B. Reporting a change in behaviour C. Conducting a suicide risk assessment D. Observing clients during morning rounds

Q44) The nurse on the psychiatric mental health unit is leading a group session. Shortly after the session begins, a newly admitted client with schizophrenia stands and starts to leave the room. Which of the following actions should the nurse take?

A. In a loud, firm voice, direct the client to come back to the room B. Gently grasp the client\'s arm and redirect the client back to the seat C. Reinforce the unit rules and importance of attending group sessions D. Remain silent and allow the client to leave the room with another staff member

Q45) The nurse is caring for a client with social anxiety disorder. Which of the following situations would most likely worsen the client\'s symptoms?

A. Shopping in a crowded store B. Moving into a new home with the spouse C. Speaking in front of peers at a professional convention D. Attending an appointment with a new health care provider

Q46) Which of the following therapeutic technique is the most appropriate for a client with loose association and word salad?

A. Voicing doubt B. Voice dismissal C. Making observations D. Seeking clarification and validation

Q47) Which of the following nursing interventions is most appropriate for a client diagnosed with schizophrenia who complains of social isolation?

A. Do not argue, negotiate, or try to reason with the client B. Provide positive reinforcement for client's voluntary interaction with others C. Explore feelings and help the client seek more appropriate ways of dealing with them D. Convey acceptance of client's need for the false belief but indicate that you do not share it

Q48) A client hospitalized with major depressive disorder has remained in bed most of the morning. Which of the following nursing interventions is the most appropriate for this client?

A. Allow uninterrupted rest throughout the day B. Encourage gradual participation in simple self-care activities C. Tell the client recovery depends on motivation D. Wait for family members to encourage self-care activities

Q49) A client with avoidant personality traits refuses group therapy, saying, "Everyone will judge me." What is the most therapeutic response by the nurse?

A. You must attend group therapy to solve this problem B. Group therapy is part of your treatment plan, so you can't skip it C. All other clients are concerned with themselves, and will not judge you D. I understand your feeling, tell me more about what you think might happen if you attend the group

Q50) Which of the following is CORRECT regarding Obsessive-Compulsive Disorder (OCD)?

A. It is characterized by ritualistic behavior that causes stress B. Fear is the most applicable nursing diagnosis associated with OCD C. The recurrent compulsions aim to reduce the anxiety associated with obsessions D. It can result in agoraphobia and social isolation

Q51) Which of the following is a common symptom of mania?

A. Increased need for sleep B. Decreased self-esteem C. Excessive involvement in risky activities D. Psychomotor delay

Q52) A client with Post-Traumatic Stress Disorder (PTSD) becomes visibly distressed after hearing a loud noise. What is the nurse's initial response?

A. Use a calm voice and orient the client B. Touch the client's shoulder to reassure her C. Ask the client to explain the trauma in more details D. Tell the client there is nothing to be afraid

Q53) A client admitted for a heroin overdose received naloxone. The client's breathing pattern improved. Two hours later, the client reports muscle aches, abdominal cramps, shivering and says, "I feel terrible". What is the most accurate assessment of the situation?

A. The client is experiencing a relapse B. Symptoms of opiate withdrawal C. The client is exhibiting a prodromal symptom of seizures D. An allergic reaction to naloxone is occurring

Q54) The nurse is caring for a client with schizophrenia who is receiving clozapine (Leponex). what would be a priority for the nurse to monitor the client for?

A. Waist circumference and weight B. WBC count and absolute neutrophil count C. Fasting serum glucose level and lipid panel D. Blood pressure and pulse while sitting and standing

Q55) Which of the following is nurse assessment to evaluate the affective status in the older people?

A. Power of concentration and judgment B. Cognitive impairments C. Ability to engage in mathematical calculations D. The long and short-term memory

Q56) During a home visit, the community health nurse notices loose electrical wires that may increase the risk of injury. What should the nurse do?

A. Avoid the hazard and continue her visit as it is not a nursing responsibility B. Educate the family about the hazard and recommend they repair it C. Report the family to local primary health centre immediately without discussing the issue D. Attempt to fix the electrical wiring after taking the family\'s permission

Q57) Which of the following statements about HIV prevention is CORRECT?

A. HIV can be prevented by avoiding mosquito bites B. Homosexuality increases the risk of HIV transmission C. HIV is transmitted through coughing and sneezing D. Sharing food with a person living with HIV can transmit the infection

Q58) A 70-year-old man asks the community health nurse why he should receive the pneumococcal vaccine. What is the best response?

A. Older adults benefit from vaccination if they had recurrent pneumonia in the past B. The vaccine helps reduce the risk of sever pneumonia C. The vaccine is recommended for children but can be given to adults to prevent flu D. Vaccination is recommended after the age of 65

Q59) What is the best method to facilitate communication with an older adult who has hearing impairment?

A. Speak loudly from behind him B. Speak clearly and slowly while facing him C. Ask him to cover his eyes when you speak to help him focus on hearing D. Use written instructions always instead of verbal communication

Q60) The parents of a child with asthma ask the school nurse how to prevent asthma attacks at school. What is the best response?

A. The child should avoid attending school activity B. Avoid trigger factors and make sure the child has his inhaler with him all the time C. Stay home when prolusion is high in the environment D. Make sure the school has parents' number to call when the asthma attack occurs

Q61) The BCG vaccine is administered as soon as possible after birth. What is the combined rout-purpose of the vaccine?

A. Intradermal-protects from sever tuberculosis B. Orally-protects from Poliomyelitis C. Intramuscular-protects from sever pneumonia D. Subcutaneous-protects from influenza

Q62) A community health nurse provides health education to adolescents about the harmful effects of smoking. This activity is an example of which level of prevention?

A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Palliative care

Q63) A 5th-grade student with epilepsy attends school regularly. What should the school nurse do if the student experiences a seizure?

A. Insert an airway into the student\'s mouth B. Protect the student from injury and monitor the seizure until it ends C. Hold the student\'s arms and legs firmly to limit shaking D. Give the student sips of water to avoid tongue injury

Q64) Which of the following should be completed by the community health nurse after every home visit?

A. Document complete community hazard survey B. Document the assessment, interventions, and recommendations accurately C. Document sibling's heath status and school environment D. Document the family neighbours' heath information

Q65) Which of the following is a key role of community health nurse in home visiting?

A. Providing financial assistance advice B. Offering individual therapy sessions C. Assessing health needs and providing education D. Conducting minor surgical procedures

Q66) A parent asks the community health nurse how to help a child with Attention-Deficit/Hyperactivity Disorder (ADHD) improve concentration during homework. Which recommendation is most appropriate?

A. Allow the child to study with other children B. Give short assignments with long breaks C. Provide a quiet environment with short, structured tasks D. Encourage watching television during breaks while studying

Q67) Which of the following interventions helps reduce complications after a cerebrovascular accident (stroke)?

A. Encouraging long periods of daily activity with nutritional support B. Providing early rehabilitation and range-of-motion exercises C. Limit friends' visit and recommend family members to stay with client D. Avoiding physical therapy by family members without the presence of therapist

Q68) A pregnant woman is diagnosed with partial placenta previa at 28 week. Which of the following should be implemented?

A. Bed rest and limited activity B. Platelet infusion and continuous fatal heart monitoring C. Plan for caesarean delivery at 32-34 weeks D. Educate woman on Labor induction with oxytocin

Q69) A pregnant woman in labor had her membrane ruptured 20 hours ago and her temperature is 38.5C. Which nursing action is most appropriate?

A. Continue labor without additional interventions B. Administer prescribed antibiotics and observe further signs of infection C. Delay delivery until maternal temperature decreases D. Encourage oral fluids and reassess after two hours

Q70) Which of the following is an effective strategy to manage postpartum afterpains?

A. Lying in a prone position with a pillow or blanket under shoulders B. Taking analgesics as prescribed before breastfeeding C. Avoiding breastfeeding to prevent uterine contractions D. Ignoring the pain as it is self-limiting

Q71) A mother complains of mild flu symptoms 3 day postpartum and after she had the postpartum rubella vaccination. What is the most appropriate nursing action?

A. This is serious rubella vaccine complication, inform the physician immediately and isolate the women B. It is expected to have mild flu symptoms after this vaccine, continue to observe with no specific intervention C. Inform physician and prepare to administer anti-viral medication D. Inform physician and prepare to administer antibiotics

Q72) A pregnant woman in the third trimester presents for a routine antenatal visit. She is found to have weak, infrequent uterine contractions that are not effectively causing cervical dilation or fetal descent. Fetal heart rate is reassuring, and there are no signs of maternal or fetal distress. Which nursing intervention is most appropriate as the initial action?

A. Prepare the woman for immediate caesarean birth B. Encourage ambulation and change of maternal position C. Induce delivery by administering oxytocin infusion immediately D. Induce delivery by performing artificial rupture of membranes

Q73) A laboring woman has received pethidine intravenously (IV), 90 minutes before giving birth. Which medication should be available to reduce the postnatal effects of pethidine on the neonate?

A. Fentanyl (Sublimaze) B. Promethazine (Phenergan) C. Naloxone (Narcan) D. Nalbuphine (Nubain)

Q74) The nurse is assessing a pregnant woman who has severe preeclampsia and is receiving IV magnesium sulfate. Which of the following findings would indicate that the desired therapeutic effect of the medication has been achieved?

A. Proteinuria 1+ B. Absence of seizure activity C. Reduction of uterine contractions D. Blood pressure of 130/80 mm Hg

Q75) A 30-year-old pregnant woman at 32 weeks of gestation has been diagnosed with Gestational Diabetes Mellitus (GDM). The nurse is teaching the woman about complications of poorly controlled glucose. Which of the following is the most likely fetal complication associated with uncontrolled gestational diabetes?

A. Intrauterine growth restriction and oligohydramnios B. Fetal macrosomia and risk of birth trauma C. Neural tube defects and chromosomal abnormalities D. Post-term pregnancy with decreased placental size

Q76) Oxytocin is being administered to augment labor. Which assessment finding requires the nurse to stop the infusion immediately?

A. Contractions every four minutes, lasting 60 seconds B. Cervical dilation is progressing one centimeter per hour C. Contractions every minute lasting 90 seconds with late decelerations D. Moderate discomfort during contractions during the first stage

Q77) A nurse is conducting a comprehensive physical examination for a pregnant woman at 28 weeks\' gestation. What findings is expected if Goodell's and Chadwick's signs are present?

A. The presence of human chorionic gonadotropin in the urine B. A blowing sound matching the maternal pulse C. Softening of the cervix and bluish discoloration of the vagina D. The fetus floats in amniotic fluid when gently tapping the cervix or lower abdomen

Q78) A nurse is caring for a 5-year-old child with asthma. The nurse is providing an education about the use of MDIs (Metered Dose Inhalers). The nurse knows that:

A. Drugs used as MDIs can be used without physician prescription B. The MDI instrument should be used only with a peak flow meter C. The child should not exceed the number of ordered puffs unless symptoms persist D. The child should hold their breath for 10 seconds after pressing the puffer

Q79) A school nurse develops a care plan for a child who has Diabetes Insipidus. What should be included in the plan?

A. Restrict bathroom access during class B. Allow unrestricted access to water and restroom facilities C. Avoid drinking fluids while in school hours D. Encourage the child to postpone voiding

Q80) A child with Thalassemia major is scheduled for blood transfusion every 2 weeks. What is the priority nursing intervention to prevent infection during transfusions?

A. Instructing the child and parents to wear face masks during procedure B. Instructing the child to drink enough fluids during and after the procedure C. Strict hand hygiene before and after all client contact D. Dispose of used bags, tubing, and needles in biohazard containers

Q81) A 4-month-old infant diagnosed with uncomplicated Gastroesophageal Reflux (GER) with frequently spits up. Which health maintenance instruction for the parents should the nurse include to reduce reflux episodes at home?

A. Place the infant in a prone position immediately after feeding to maximize gastric emptying B. Hold the infant upright for 20 to 30 minutes after feedings and avoid vigorous rocking or movement C. Switch the infant from formula to a clear liquid for 24 hours every week to rest the stomach D. Feed the infant large volume of formula twice a day to reduce the frequency of lower esophageal sphincter opening

Q82) Which of the following represent parent\'s understanding of promoting respiratory health to their child who is diagnosed with Cystic Fibrosis?

A. Chest physiotherapy should only be done if my child is ill B. Daily airway clearance techniques help prevent complications C. Exercise is to be avoided as much as possible D. Respiratory treatments are not usually needed when symptoms improve

Q83) An 8-year-old child with Nephrotic Syndrome has been taking high-dose cortisone for few weeks. He covers his face and sadly says, \"I look like a monster. My cheeks are huge and everyone at school laughs at me.\" Which nursing intervention best supports the child to deal with the distress of his body image?

A. Recommend that the parents allow him to be absent from school to avoid peer interactions until the swelling and treatment stops B. Advise the parents to reduce to half the dose of medication to reduce the facial swelling C. Reassure him that his face looks nice, and no one will notice the change, and he should be grateful his kidneys are recovering D. Encourage him to express feelings and gently explain that the \'moon face\' appearance is a temporary side effect of his medication and will disappear after stopping the medication

Q84) A child with heart defect had cardiac catheterization. What is the most important nursing intervention for the child post catheterization?

A. Monitor for bleeding at the catheter insertion site B. Monitor pulses, skin color, and temperature in the affected extremity C. Keep the affected extremity straight and immobilized for 8 hours D. Instruct the child to drink large amounts of fluids

Q85) Which of the following intervention should the nurse consider when caring for hospitalized adolescent?

A. Always include parents during examinations and procedures B. Encourage adolescent to stay in room and limit activities to prevent self-harm C. Provide honest information and realistic expectations about treatments and recovery D. Prevent contact with friends through visits, or phone calls as possible

Q86) The nurse assesses a child who has been treated for acute asthma exacerbation. Which client assessment is the best indicator that treatment has been effective?

A. Episodes of spasmodic coughing have decreased B. Wheezes are audible during breathing C. Oxygen saturation has increased from 88% to 93% D. Peak expiratory flow rate has dropped from 212 L/min to 127 L/min

Q87) During hospitalization, a child with sickle cell disease asks why he needs to drink fluids? Which of the following statements is the best explanation?

A. Fluids prevents blocking of blood vessels B. Fluids helps increase of your hemoglobin quickly C. Fluids improve appetite and replace the need for medication D. Fluids stop the disease process and pain episodes

Q88) A child with chronic kidney disease receives calcium carbonate. The nurse explains that this medication is prescribed to:

A. Lower phosphate absorption from food B. Increase calcium excretion in urine C. Reduce risk for urinary tract infections D. Reduce proteinuria and improves edema

Q89) What instructions should the nurse give for parents of a newborn who is at risk for dehydration?

A. Breastfeed the newborn 8 to 12 times per day and night B. Ensure newborn has at least 12 wet diapers/day C. Recognize early signs of dehydration including bulging fontanels D. Include herbal tea and plain water in summer as part of their feeding

Q90) A nurse is inserting an IV catheter for an infant with Tetralogy of Fallot. During the procedure, the infant starts crying and becomes dyspneic with profound cyanosis. Which action should the nurse take first?

A. Administer prescribed PRN morphine B. Initiate oxygen via high flow nasal cannula C. Position the infant in knee chest position D. Apply a cold, wet washcloth directly across the infant\'s anterior chest wall

Q91) An experienced ICU team requires minimal supervision. The manager allows them to self-assign patients and make care interventions within policy. Which leadership style best fits, assuming the team is skilled, experienced, and self‑motivated?

A. Laissez‑faire B. Autocratic C. Democratic D. Transactional

Q92) When newly developed team members start arguing about responsibilities, competition, and discussions arise. Which stage of team dynamics is occurring?

A. Forming B. Storming C. Norming D. Performing

Q93) During a meeting, team members generate many ideas to be discussed and evaluated. This method of problem-solving is called:

A. Experimentation B. Brainstorming C. Verification D. Intuition

Q94) Which of the following is correct about the evidence-based practice?

A. Evidence-based practice is limited to the physician B. Evidence-based practice encourages professional development C. Evidence-based practice is the same as critical thinking D. Evidence-based practice is time consuming

Q95) Which is the main factor to consider in the nursing scheduling process?

A. The hospital infrastructure readiness B. The patient safety and acuity level C. The cost and financial impact D. The nurses' preferences

Q96) Which of the following statements describes the nurses' role in the primary care model?

A. Administration of the patient's medication B. Coordination of the patient's care from admission to discharge C. Providing intravenous site care for all patients D. Managing the patient's discharge plan only

Q97) A friend of a registered nurse in a hospital asked her about the diagnosis of a patient who was a neighbour. If the nurse gave that information, this can be considered as:

A. Malpractice B. Negligence C. Liability D. Breach of confidentiality

Q98) In what stage of Lewin's Change Theory does the manager select the best choice and implement it?

A. Moving B. Unfreezing C. Refreezing D. Expansion

Q99) Which of the following terms describes the process of getting work done through others to accomplish organizational goals?

A. Motivation B. Planning C. Delegation D. Decision making

Q100) What is the first step of the Quality Control Process?

A. Evaluate the leadership in the organization B. Take educational or corrective action if the criterion has not been met C. Determine the criterion or standard to be measured D. Collected information, analyse it, and determined whether the standard has been met

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