MOHAP RN Exam (UAE), Practice Questions

According to the source, what is the recommended daily water intake for a patient taking lithium?

1. 1.5-3 liters per day ✓
2. 0.5-1 liter per day
3. 4-5 liters per day
4. Fluid should be restricted while taking lithium

Why: The source states the recommended water intake for a patient taking lithium is 1.5-3 liters per day. Adequate hydration and consistent sodium intake help maintain a stable lithium level.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 6.4 Mood Stabilizer - Lithium

A nurse states that a Just Culture means no one is ever held accountable. Which statement correctly describes the limits of Just Culture per the source?

1. Just Culture does not tolerate conscious disregard of clear risks or gross misconduct ✓
2. Just Culture tolerates all errors equally regardless of the behavior category involved
3. Just Culture punishes every error harshly in order to deter staff from future mistakes
4. Just Culture applies only to physicians and providers, and does not apply to nurses at all

Why: The source states that Just Culture does NOT tolerate conscious disregard of clear risks or gross misconduct such as falsifying a record or working intoxicated. Consequences are based on the behavior category: human error, at-risk, or reckless.

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

According to the source, which medication is the first-line drug for anaphylaxis?

1. Diphenhydramine
2. Epinephrine ✓
3. Albuterol
4. A corticosteroid

Why: The source states epinephrine (1:1000) is administered as the first-line drug for anaphylaxis. It helps counteract the severe effects by increasing heart rate, improving breathing, and reducing blood vessel dilation.

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

According to the source, the mitral (apical) area where the apical pulse is normally felt is located at:

1. The second intercostal space right of the sternum
2. The second intercostal space left of the sternum
3. The fifth intercostal space at the midclavicular line ✓
4. The fourth intercostal space right of the sternum

Why: The source states the mitral (apical or left ventricular) area is the fifth intercostal space at the midclavicular line, and the apical pulse is expected to be felt over the midclavicular fifth intercostal space.

Source: Open RN Nursing Skills 2e, 9.3 Cardiovascular Assessment

According to the source, amniocentesis to diagnose fetal genetic abnormalities is typically performed during which interval?

1. Between 10 and 13 weeks' gestation
2. Between 15 and 20 weeks' gestation ✓
3. Between 24 and 28 weeks' gestation
4. After 30 weeks' gestation

Why: The source states amniocentesis may be performed to diagnose fetal genetic abnormalities between 15 and 20 weeks' gestation because amniotic fluid volume is adequate and there are many viable fetal cells. The 10-13 week window is when CVS is performed.

Source: Open RN Nursing Health Promotion, 9.9 Second Trimester Prenatal Care

A neonate has a critical congenital heart defect that depends on patency of the ductus arteriosus until surgery. According to the source, which medication is given to maintain the patent ductus arteriosus?

1. An NSAID such as ibuprofen given orally
2. Acetaminophen given by mouth at intervals
3. Prostaglandin (PGE1) by continuous IV infusion ✓
4. Digoxin given by intermittent scheduled dosing

Why: The source states that with critical defects that depend on patency of the ductus arteriosus, prostaglandin (PGE1) is administered as a temporary measure to maintain the PDA until surgical intervention. It is rapidly metabolized by the lungs and must be given by continuous intravenous infusion.

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

A patient two weeks postpartum develops hallucinations, delusions, and severe agitation. According to the source, what does this represent?

1. A normal variation of the baby blues that will self-resolve
2. A mild and temporary form of perinatal depression treated with rest
3. A psychiatric emergency requiring immediate medical intervention ✓
4. An expected response to sleep deprivation needing no action

Why: The source states postpartum psychosis is a psychiatric emergency requiring immediate medical intervention, involving hallucinations, delusions, disorganized thinking, mania, agitation, and confusion, with risk for self-harm or harm to the infant.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 7.3 Types of Depression

According to the source, long-term oxygen therapy is prescribed for a patient with COPD when oxygen saturation levels are at which value when at rest and in a stable condition?

1. 94% or less
2. 88% or less ✓
3. 92% or less
4. 90% or less

Why: The source states long-term oxygen therapy is prescribed for patients with COPD when oxygen saturation levels are 88% or less when at rest and in a stable clinical condition. The other thresholds are not the value stated.

Source: Open RN Nursing Health Alterations, 6.6 COPD

According to the source, the acronym HELLP in HELLP syndrome stands for which set of findings?

1. Hypertension, edema, low protein, low platelets
2. Hyperglycemia, elevated lipids, and low potassium
3. Hemorrhage, elevated leukocytes, and low pressure
4. Hemolysis, elevated liver enzymes, and low platelets ✓

Why: The source states HELLP is an acronym for Hemolysis, Elevated Liver enzymes, and Low Platelets, a serious complication of severe preeclampsia that can cause hepatic rupture and life-threatening bleeding. ACOG diagnostic criteria include LDH >=600 units/L and platelets <100,000.

Source: Open RN Nursing Health Promotion, 19.5 Hypertensive Disorders of Pregnancy

The source lists bisphosphonates (e.g., alendronate) for osteoporosis. How do they act according to the source?

1. They slow bone loss by inhibiting bone breakdown ✓
2. They stimulate new bone formation directly
3. They replace calcium lost from the bones
4. They act as a synthetic form of parathyroid hormone

Why: The source states bisphosphonates (such as alendronate and risedronate) slow bone loss and reduce fracture risk by inhibiting bone breakdown.

Source: Open RN Nursing Health Alterations, 10.8 Osteoporosis

According to the source, ageism is best defined as:

1. The study of the social, psychological, and biological aspects of the aging process
2. Stereotyping and discrimination against individuals or groups on the basis of their age ✓
3. The normal physiologic decline in organ function that accompanies advancing age
4. The natural tendency of many older adults to withdraw from their social roles and activities after retirement

Why: The source defines ageism as the stereotyping and discrimination against individuals or groups on the basis of their age. Gerontology is the study of aging, and the other options describe physiologic aging and social withdrawal rather than ageism.

Source: Open RN Nursing Fundamentals 2e, 19.2 Care of the Older Adult - Basic Concepts

A patient on long-term first-generation antipsychotic therapy shows lip smacking, puckering, eye blinking, and grimacing. According to the source, these hallmark symptoms indicate which condition?

1. Neuroleptic malignant syndrome
2. Metabolic syndrome
3. Anticholinergic toxicity
4. Tardive dyskinesia (TD) ✓

Why: The source states tardive dyskinesia is a syndrome of movement disorders that can occur with first-generation antipsychotics, with hallmark symptoms of smacking and puckering lips, eye blinking, grimacing, and twitching. It can persist despite discontinuation.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 11.3 Schizophrenia

According to the source, which maneuvers do health care providers perform to detect developmental dysplasia of the hip in newborns?

1. The Leopold maneuvers
2. The McRoberts maneuver
3. The Barlow and Ortolani maneuvers ✓
4. The Ortolani and Kernig maneuvers

Why: The source states health care providers perform the Barlow and Ortolani maneuvers during physical examination to detect DDH, feeling for a click with subluxation, dislocation, or reduction. Females are at higher risk for DDH.

Source: Open RN Nursing Health Promotion, 12.6 Congenital Conditions

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 characteristic best describes a 'never event'?

1. A minor error intercepted by chance before it could reach the patient
2. Any patient complaint that requires investigation but causes no lasting harm
3. An expected complication that occurs despite following the standard of care
4. A clearly identifiable, measurable, serious, and preventable adverse event ✓

Why: The source defines never events as adverse events that are clearly identifiable, measurable, serious (resulting in death or significant disability), and preventable. An intercepted error describes a near miss, and an unavoidable complication is not a never event.

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

A patient with acute methamphetamine intoxication develops severe agitation and hyperthermia. According to the source, which intervention should be AVOIDED?

1. Intravenous benzodiazepines
2. Physical restraints ✓
3. External cooling blankets
4. Airway management

Why: The source states physical restraints should be avoided because patients who physically struggle against restraints undergo isometric muscle contractions associated with lactic acidosis, hyperthermia, sudden cardiac collapse, and death. IV benzodiazepines and cooling are used instead.

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

A nurse instructs a patient scheduled for surgery about fasting. For at least how long should the patient avoid food before the procedure?

1. At least 2 hours
2. At least 12 hours
3. At least 24 hours before surgery
4. At least 6 to 8 hours ✓

Why: The source states patients are typically advised to avoid food for at least 6 to 8 hours before the procedure. NPO status reduces the risk of aspiration during anesthesia by minimizing gastric secretions.

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

According to the source, a physical examination is a systematic data collection method that uses which four techniques?

1. Inspection, auscultation, palpation, and percussion ✓
2. Interview, history, chart review, and referral
3. Observation, questioning, listening, and documenting
4. Assessment, diagnosis, planning, and evaluation

Why: The source states a physical examination uses the techniques of inspection, auscultation, palpation, and percussion. Percussion is an advanced technique typically performed by providers.

Source: Open RN Nursing Fundamentals 2e, 4.3 Assessment

According to the source, where is the neonate with gastroschisis or omphalocele cared for around the time of corrective surgery, and what nutritional support may be needed afterward?

1. On a general postpartum unit with routine oral feedings only
2. In a NICU before and after surgery; parenteral nutrition may be needed ✓
3. At home with scheduled outpatient follow-up and no special nutrition
4. In an isolation room on total bowel rest with no nutrition provided

Why: The source states the neonate with gastroschisis or omphalocele is cared for in a NICU both before and after surgery. After the repair, infants may have problems digesting food and absorbing nutrients and may require parenteral nutrition.

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

According to the source, how is chronic pain distinguished from acute pain in terms of duration?

1. Chronic pain lasts less than 24 hours
2. Chronic pain is ongoing and persistent for longer than six months ✓
3. Chronic pain always causes increased pulse, respirations, and blood pressure
4. Chronic pain resolves as soon as the painful stimulus is removed

Why: The source states chronic pain is ongoing and persistent for longer than six months and typically does not cause a change in vital signs or diaphoresis. Acute pain, by contrast, has limited duration, a specific cause, and usually causes increased pulse, respirations, and blood pressure.

Source: Open RN Nursing Fundamentals, 11.2 Comfort Basic Concepts

A nurse uses pH testing to help verify a patient's NG tube placement. Gastric aspirate should have a pH of which value?

1. Greater than 7.0
2. Between 6 and 7
3. Exactly 7.0, a neutral value
4. Less than or equal to 5.5 ✓

Why: The source states that if used, gastric aspirate should have a pH of less than or equal to 5.5 using pH indicator paper. However, pH testing should not be the sole method of verification because formula and medications can alter pH.

Source: Open RN Nursing Advanced Skills, 5.2 Basic Concepts

According to the source, Hildegard Peplau developed a model describing which four levels of anxiety?

1. Low, medium, high, and extreme
2. Mild, moderate, severe, and panic ✓
3. Acute, chronic, situational, and generalized
4. Stage 1, stage 2, stage 3, and stage 4

Why: The source states that Hildegard Peplau developed a model describing four levels of anxiety: mild, moderate, severe, and panic. Interventions can be tailored based on the level of anxiety the patient is experiencing.

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

According to the source, which equipment should be ensured available at the bedside at all times for a child with epiglottitis?

1. A lumbar puncture kit
2. A tracheostomy tray ✓
3. A chest tube tray
4. A nasogastric tube

Why: The source states the nurse should ensure a tracheostomy tray is available at the bedside at all times, and should not let patients leave the unit without adequate monitoring and resuscitation equipment.

Source: Open RN Nursing Health Promotion, 15.9 Epiglottitis

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 nurse ignored a barcode-scanner error message and administered the medication anyway, believing the warning was unimportant. In the Just Culture model, this is an example of which behavior, and how is it managed?

1. At-risk behavior, managed by coaching and monitoring ✓
2. Simple human error, managed by consoling the individual
3. Reckless behavior, managed by punitive action
4. Appropriate practice, requiring no intervention

Why: The source gives ignoring a barcode-scanner error message as an example of at-risk behavior — a behavioral choice that increases risk where the risk is unrecognized or believed justified. It is managed by coaching, incentives for safer behavior, situational awareness, and monitoring.

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

According to the source, which intravenous solution is an example of an isotonic solution used to raise blood pressure in patients with fluid volume deficit?

1. 0.45% Sodium Chloride (0.45% NaCl)
2. 0.9% Normal Saline (0.9% NaCl) ✓
3. 3% Sodium Chloride (3% NaCl)
4. 5% Dextrose in Water after the dextrose is metabolized

Why: The source identifies 0.9% Normal Saline as an isotonic solution whose concentration is similar to blood, so it stays in the intravascular space and is used for hypovolemia to raise blood pressure. 0.45% NaCl is hypotonic, 3% NaCl is hypertonic, and D5W becomes hypotonic once metabolized.

Source: Open RN Nursing Fundamentals 2e, 15.3 Intravenous Solutions

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

Three days after delivery, a new mother reports tearfulness, mild irritability, and feeling overwhelmed, but is still able to care for herself and her baby. According to the source, this is most consistent with which condition?

1. Postpartum depression
2. Baby blues ✓
3. Postpartum psychosis
4. Persistent depressive disorder

Why: The source describes the baby blues as affecting up to 70% of women, beginning within a few days of delivery with emotional lability, tearfulness, mild irritability, and feeling overwhelmed. These are usually mild, self-limited, and resolve within about two weeks.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 7.3 Types of Depression

According to the source, which of the Four T's is the MOST common cause of postpartum hemorrhage, accounting for about 70% of cases?

1. Trauma from lacerations
2. Tissue (retained placenta)
3. Tone (uterine atony) ✓
4. Thrombin (clotting disorder)

Why: The source states the most common cause of PPH is uterine atony (Tone), which causes 70% of PPH cases. The Four T's are Tone, Trauma, Tissue, and Thrombin; the others are less common causes.

Source: Open RN Nursing Health Promotion, 10.9 Complications During the Third Stage of Labor

During a first-trimester visit the nurse auscultates the fetal heart rate. According to the source, what is the expected range?

1. 90 to 110 beats per minute
2. 120 to 180 beats per minute
3. 100 to 140 beats per minute
4. 110 to 160 beats per minute ✓

Why: The source states the expected fetal heart rate is 110 to 160 beats per minute. The other ranges do not match the value given in the text.

Source: Open RN Nursing Health Promotion, 9.8 First Trimester Prenatal Care

According to the source, oliguria in hospitalized adults is further defined as urine output of what amount?

1. Less than 0.5 mL of urine per kilogram per hour for adults ✓
2. Less than 500 mL of urine over a full 24-hour period regardless of the patient's weight
3. Less than 2.5 liters of urine over 24 hours
4. Absence of urine output over a 24-hour period

Why: The source defines oliguria as decreased urine output (less than 500 mL in 24 hours), and in hospitalized patients further defines it as less than 0.5 mL of urine per kilogram per hour for adults and children. New oliguria should be reported because it can indicate dehydration, fluid retention, or decreasing kidney function.

Source: Open RN Nursing Fundamentals, 16.2 Elimination Basic Concepts

A patient reports 'the worst headache of my life' with sudden onset. According to the source, this classic presentation is most associated with which condition?

1. Transient ischemic attack
2. Thrombotic ischemic stroke
3. Embolic ischemic stroke
4. Hemorrhagic stroke ✓

Why: The source states patients experiencing a hemorrhagic CVA often report 'having the worst headache of my life' with sudden onset and no known cause. Other signs may include nausea, vomiting, photophobia, and a stiff neck.

Source: Open RN Nursing Health Alterations, 9.9 Cerebrovascular Accident

A community experiences a devastating flood that causes multiple losses. According to the source, this event that is uncommon and involves extensive losses is categorized as which type of crisis?

1. Adventitious (social) crisis ✓
2. Maturational crisis
3. Developmental crisis
4. Situational crisis from job loss

Why: The source describes an adventitious (also called social) crisis as an event that is uncommon or unanticipated, often involving multiple or extensive losses, occurring due to a major natural or man-made event such as a flood, fire, or hurricane.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 3.5 Crisis and Crisis Intervention

According to the source, an esophagram is obtained on approximately which postoperative day after esophageal atresia repair, and for what purpose?

1. Day 1, in order to confirm airway placement
2. Day 10, in order to remove all of the sutures
3. Day 5, in order to evaluate for a leak ✓
4. Day 14, in order to begin oral medications

Why: The source states that postoperatively an esophagram is obtained on approximately postoperative Day 5 to evaluate for a leak. If there is no leak after surgical intervention, feedings can be started, and anti-reflux medication is typically prescribed.

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

A nurse tells a patient, 'I will be back in an hour to check your pain,' and returns as promised. Which ethical principle does this demonstrate?

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

Why: The source defines fidelity as keeping promises, giving the exact example of telling a patient 'I will be back in an hour to check your pain' and then doing so.

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

A patient will take a proton pump inhibitor long term for peptic ulcer disease. The source notes long-term PPI use is associated with an increased occurrence of what, so calcium supplements may be recommended?

1. Fractures ✓
2. Kidney stones
3. Hyperglycemia
4. Hypertension

Why: The source states long-term use of PPIs has been associated with an increased occurrence of fractures, so calcium supplements may be recommended. Research also indicates a higher risk of developing dementia with long-term PPI use.

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

A school-aged child presents with poor hygiene, body odor, is inappropriately dressed for the weather, and is frequently hungry. According to the source, these findings are most consistent with which type of maltreatment?

1. Neglect ✓
2. Physical abuse
3. Sexual abuse
4. Emotional abuse

Why: The source lists signs of child neglect including poor hygiene or body odor, being inappropriately dressed for weather, appearing malnourished, being constantly hungry or begging for food, and being left unsupervised for long periods.

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

A charge nurse is making assignments. Which patient is most appropriate to assign to an LPN/VN, consistent with the LPN example in the source?

1. A newly admitted patient who requires a complete admission assessment and an individualized plan of care
2. A patient whose condition is rapidly deteriorating and needs evaluation
3. A patient with stable heart failure needing routine oral medication and I&O monitoring ✓
4. A patient requiring discharge teaching on a new self-care regimen

Why: The source's LPN/VN example assignment is a patient with STABLE heart failure — collecting assessment data, monitoring intake/output, administering routine oral medication, documenting, and reporting to the RN. Full assessment, care planning, evaluation, and teaching remain RN responsibilities.

Source: Open RN Nursing Management and Professional Concepts, Delegation and Supervision

From about 16-18 weeks until 36 weeks, the source states the fundal height in centimeters approximately equals what?

1. The gestational age of the fetus in weeks ✓
2. The maternal weight gain in kilograms
3. The estimated fetal weight in hundreds of grams
4. The number of prior pregnancies

Why: The source states that from 16 to 18 weeks until 36 weeks, the fundal height measured in centimeters is approximately equal to the gestational age of the fetus in weeks, measured from the symphysis pubis to the top of the uterus. After 36 weeks this relationship no longer holds.

Source: Open RN Nursing Health Promotion, 9.9 Second Trimester Prenatal Care

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

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

According to the source, the initial treatment of clubfoot to gradually realign the foot involves which intervention?

1. A single surgical release at birth
2. Serial casting with casts changed routinely ✓
3. A Pavlik harness worn continuously until age four years
4. Immediate amputation of rigid tissue

Why: The source states clubfoot treatment includes serial casting to remodel the soft tissue, with casts routinely changed approximately five to nine times, followed by bracing with a boot and bar.

Source: Open RN Nursing Health Promotion, 12.6 Congenital Conditions

A newborn undergoes critical congenital heart defect screening at 24 hours of age. According to the source, where is the pulse oximetry measured?

1. Both the right and left hands measured at the same time
2. The forehead and one foot simultaneously
3. The left hand and the left foot only
4. The right hand (preductal) and either foot (postductal) ✓

Why: The source states pulse oximetry is performed at 24 hours of age on the right hand (preductal) and either foot (postductal); if both readings are >=95% with no more than a 3% difference, the infant is at less risk for critical defects.

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

The source states that on an ECG, ischemia to cardiac muscle tissue is indicated by which finding?

1. ST segment elevation
2. A widened QRS complex
3. ST segment depression ✓
4. An absent P wave

Why: The source states ischemia is indicated by ST segment depression, injury by ST segment elevation, and infarcted (dead) tissue produces a Q wave change. The other options are not the ischemia marker described.

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

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

According to the source, the initial resuscitation steps use the mnemonic TABC, which stands for what?

1. Tone, Assessment, Blood pressure, Color
2. Temperature, Apgar, Bilirubin, and Circulation
3. Temperature, Airway, Breathing, Circulation ✓
4. Trauma, Airway, Bleeding, Cyanosis

Why: The source states the initial resuscitation steps use the mnemonic TABC for Temperature, Airway, Breathing, and Circulation, beginning with drying the baby and placing them under a radiant warmer.

Source: Open RN Nursing Health Promotion, 20.9 Neonatal Resuscitation

A nurse is preparing a patient for general anesthesia and reinforces the need to remain NPO. Why does general anesthesia require the patient to have an empty stomach?

1. To lower the risk of hypothermia
2. To speed up anesthetic metabolism
3. To prevent malignant hyperthermia
4. To reduce the risk of aspiration ✓

Why: The source states that general anesthesia requires an empty stomach to reduce the risk of aspiration, whereas local anesthesia can be administered regardless of the patient's eating status. Fasting status is a key characteristic affecting anesthesia selection.

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

Using an internal pressure catheter, what does the source state is the normal resting uterine tone?

1. 2-5 mmHg
2. 20-25 mmHg
3. 40-50 mmHg
4. 10-12 mmHg ✓

Why: The source states resting uterine tone measured by an internal pressure catheter is 10-12 mmHg, with contraction intensity at the acme ranging from 40 mmHg (mild) to 70 mmHg (strong) and up to 100 mmHg during pushing. 40-50 mmHg describes contraction intensity, not resting tone.

Source: Open RN Nursing Health Promotion, 10.4 The P's of Labor

A patient has an elevated, expansive mood with increased energy lasting four days but no marked impairment and no need for hospitalization. According to the source, this describes which type of episode?

1. Manic episode
2. Major depressive episode
3. Hypomanic episode ✓
4. Mixed episode with psychosis

Why: The source defines a hypomanic episode as abnormally and persistently elevated, expansive, or irritable mood with increased activity lasting at least four consecutive days, but which is not severe enough to cause marked impairment or require hospitalization.

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

When beginning a blood transfusion, the source directs the RN to remain with and monitor the patient for at least how long as the transfusion begins at a slow rate?

1. At least 15 minutes ✓
2. At least 60 minutes
3. At least 5 minutes
4. At least 2 hours

Why: The source states the RN remains with and monitors the patient for a transfusion reaction for at least 15 minutes as the transfusion begins at a slow rate of 2 mL/min (120 mL/hour), because most transfusion reactions occur within the first 15 minutes.

Source: Open RN Nursing Health Alterations, 3.5 Anemia

Before every intervention, a nurse verifies the patient's name and date of birth and double-checks high-risk medications. According to the source, these actions support which QSEN competency?

1. Informatics
2. Evidence-Based Practice
3. Safety ✓
4. Teamwork and Collaboration

Why: The source describes the Safety competency as minimizing risk of harm to patients and providers through system effectiveness and individual performance, supported by a culture of safety, double-checking high-risk medications, and verifying patient name and DOB before every intervention.

Source: Open RN Nursing Management and Professional Concepts, Advocacy

A nurse recognizes a task is beyond their own scope and asks a specialist for assistance. Which IPEC core competency does this best reflect?

1. Values/Ethics
2. Teams and Teamwork
3. Interprofessional Communication
4. Roles/Responsibilities ✓

Why: The source describes the Roles/Responsibilities competency as using knowledge of one's own and others' roles to assess and address patient needs, recognizing one's own limitations, and asking for assistance.

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

A patient is admitted after a stroke and requires objective monitoring of level of consciousness. According to the source, which tool is frequently used for this purpose?

1. The Braden Scale
2. The Glasgow Coma Scale ✓
3. The PQRSTU method
4. Gordon's Functional Health Patterns

Why: The source states the Glasgow Coma Scale is frequently used to objectively monitor level of consciousness in patients with neurological damage such as a head injury or cerebrovascular accident (stroke). It is part of a routine neurological exam performed by registered nurses.

Source: Open RN Nursing Skills 2e, 6.3 Neurological Exam

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

According to the source, each written order for a physical restraint or seclusion is limited to which maximum duration for an adult?

1. 4 hours for adults ✓
2. 2 hours for adults
3. 1 hour for adults
4. 8 hours for adults

Why: The source states each written order for a physical restraint or seclusion is limited to 4 hours for adults, 2 hours for children and adolescents ages 9 to 17, and 1 hour for patients under 9. The 2-hour and 1-hour limits apply to younger age groups, not adults.

Source: Open RN Nursing Fundamentals 2e, 5.7 Restraints

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 patient on a medical unit expresses suicidal ideation. According to the source, which nursing intervention is described as a priority nursing intervention to prevent suicide?

1. Scheduling outpatient follow-up counseling
2. Establishing a safe care environment ✓
3. Encouraging the patient to keep a mood journal
4. Providing education about antidepressant medications

Why: The source explicitly states that establishing a safe care environment is a priority nursing intervention for preventing suicide. This includes environmental risk assessment and removing objects that could be used for self-harm.

Source: Open RN Nursing Mental Health and Community Concepts 2e, 1.6 Establishing Safety

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

After the nurse provides education, a competent patient refuses a prescribed medication. According to the source, what should the nurse do?

1. Document the refusal and any education provided, and notify the prescribing provider ✓
2. Administer the medication anyway because it was prescribed
3. Crush the refused medication finely and conceal it in the patient's food or pudding
4. Remove the medication from the record without documenting

Why: The source states that after proper education, the patient has the right to refuse medication in accordance with the Nurses Code of Ethics and respect for autonomy. The refusal event should be documented in the patient chart and the prescribing provider notified.

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

A nurse considers using skin turgor to assess hydration in an older adult. According to the source, why is this not reliable?

1. Older adults always have excess fluid volume that falsely tents the skin during testing
2. Older adults have decreased skin elasticity, so other assessments for dehydration should be included ✓
3. Skin turgor can only be assessed on the abdomen
4. Turgor is only affected by overhydration, not dehydration

Why: The source states skin turgor is not a reliable method to assess for dehydration in older adults because they have decreased skin elasticity, so other assessments for dehydration should be included. Turgor is the skin's elasticity, checked by tenting the skin on the lower arm.

Source: Open RN Nursing Skills, 14.4 Integumentary Assessment

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

A nurse reviews the six domains of quality health care identified by the IOM/National Academy of Medicine (mnemonic STEEEP). Which list correctly names these six domains?

1. Structured, Trained, Educated, Ethical, Empowered, Prepared
2. Standardized, Tested, Evaluated, Evidence-based, Examined, Proven
3. Safe, Timely, Effective, Efficient, Equitable, Patient-centered ✓
4. Safe, Thorough, Ethical, Efficient, Equal, Preventive

Why: The source lists the IOM six domains of quality (mnemonic STEEEP) as Safe, Timely, Effective, Efficient, Equitable, and Patient-centered. These describe avoiding harm, reducing delays, using scientific knowledge, avoiding waste, ensuring quality does not vary by group, and respecting patient preferences.

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

A patient is admitted with a hip fracture. Within which time frame is surgical repair typically required?

1. Within 6 hours
2. Within 12 hours
3. Within 48 hours ✓
4. Within 24 hours

Why: The source states hip fractures typically require surgical repair within 48 hours of the injury. In about half of cases hip arthroplasty is needed; otherwise ORIF is performed.

Source: Open RN Nursing Health Alterations, 10.6 Fracture

The American Association of Critical-Care Nursing recommends, per the source, that feeding tube position be checked and documented at which frequency?

1. Once per shift only
2. Every 12 hours
3. Only once after the initial insertion
4. Every four hours and before feedings ✓

Why: The source states the position of a feeding tube should be checked and documented every four hours and prior to administration of enteral feedings and medications by measuring visible tube length against the length documented at X-ray verification.

Source: Open RN Nursing Advanced Skills, 5.2 Basic Concepts

A patient with acute renal failure has a dangerously elevated serum potassium. According to the source, which treatment may be prescribed to quickly lower potassium levels in the blood?

1. Administer oral and intravenous potassium supplements
2. Provide a diet that is high in potassium-rich foods
3. Withhold all intravenous fluids from the patient
4. Insulin with glucose and/or potassium binders as prescribed ✓

Why: The source states insulin with glucose and/or potassium binders may be prescribed to quickly lower potassium levels in the blood during acute renal failure. Giving potassium or a high-potassium diet would worsen the hyperkalemia.

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

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

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

According to the source, tetanus is caused by which bacterium?

1. Neisseria meningitidis
2. Staphylococcus aureus
3. Streptococcus pyogenes
4. Clostridium tetani ✓

Why: The source states tetanus is an infection caused by the bacterium Clostridium tetani, found in soil, dust, or animal feces, and is preventable with vaccination (DTaP or Tdap).

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

A patient with diabetes is experiencing severe hypoglycemia and cannot swallow safely. According to the source, what treatment may be required?

1. Oral glucose tablets placed in the cheek
2. Offer a carbohydrate-containing meal by mouth despite the swallowing difficulty
3. Withholding all treatment until the patient can swallow
4. A glucagon injection or intravenous administration of dextrose ✓

Why: The source states that if a patient is experiencing severe hypoglycemia and cannot swallow, a glucagon injection or intravenous administration of dextrose may be required. Oral carbohydrate (the 15-15 rule) is appropriate only when the patient is alert and able to swallow.

Source: Open RN Nursing Skills, 19.2 Blood Glucose Monitoring

The source defines recurrent pregnancy loss as having how many spontaneous miscarriages?

1. One spontaneous miscarriage
2. Two or more spontaneous miscarriages ✓
3. Four or more spontaneous miscarriages
4. Any miscarriage after 20 weeks

Why: The source states a reproductive endocrinologist can help women with recurrent pregnancy loss, which it defines as having two or more spontaneous miscarriages.

Source: Open RN Nursing Health Promotion, 8.6 Fertility

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, how is surfactant administered to a newborn with respiratory distress syndrome?

1. Given orally mixed in with the newborn's feedings
2. By an intramuscular injection into the infant's thigh
3. Through a nasogastric tube passed into the stomach
4. Directly into the lungs through an endotracheal tube ✓

Why: The source states surfactant is administered directly into the newborn's lungs through an endotracheal tube, usually shortly after birth of a premature infant showing signs of RDS.

Source: Open RN Nursing Health Promotion, 20.2 Preterm Birth

According to the source, Stage 0 cancer, also known as carcinoma in situ, means what?

1. The cancer has spread to distant parts of the body
2. Abnormal cells are localized to their initial layer ✓
3. The tumor is larger than four centimeters in size
4. Multiple nearby lymph nodes have cancer present

Why: The source states Stage 0 is known as carcinoma in situ, meaning cancerous or abnormal cells are present but localized to the initial layer of cells where they were first discovered. Stage IV means the cancer has spread to remote parts of the body.

Source: Open RN Nursing Health Alterations, 4.3 Cancer

A nursing student is reviewing pharmacokinetics. Which sequence correctly lists the four stages a medication passes through in the body?

1. Absorption, metabolism, distribution, and elimination
2. Metabolism, absorption, distribution, and excretion
3. Absorption, distribution, metabolism, and excretion ✓
4. Distribution, absorption, excretion, and metabolism

Why: The source defines pharmacokinetics as the four stages of absorption, distribution, metabolism, and excretion, abbreviated ADME. Absorption occurs first as the drug enters circulation, then distribution, then metabolism (breakdown), then excretion. The other orderings rearrange these stages incorrectly.

Source: Open RN Nursing Pharmacology 2e, 1.2 Pharmacokinetics

According to the source, epinephrine is administered during neonatal resuscitation when the heart rate remains below which value despite effective resuscitation?

1. Below 100 bpm
2. Below 80 bpm
3. Below 40 bpm
4. Below 60 bpm ✓

Why: The source states epinephrine is administered if the heart rate remains less than 60 bpm despite effective resuscitation, at a typical dose of 0.01-0.03 mg/kg IV or via endotracheal tube.

Source: Open RN Nursing Health Promotion, 20.9 Neonatal Resuscitation

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

A nurse practices in a rural region and provides remote care by phone and video. According to the source, this level of care is known as which of the following?

1. Telehealth, remote care via phone or video ✓
2. Outpatient care within a clinic building
3. Home health delivered in the patient's residence
4. Urgent care for same-day nonemergency needs

Why: The source describes telehealth as remote care via phone or video, noting it is important in rural areas and during COVID-19. This is distinct from home health, which involves nursing, aide, and therapy visits delivered in person in the home.

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