DOH Nursing Practice Test (Abu Dhabi) — Questions and Answers

Question 1: Which laboratory parameter BEST reflects adequate tissue oxygenation at the cellular level in a critically ill patient?

Normal PaO2 on arterial blood gas
Serum lactate < 2 mmol/L (Correct answer)
SpO2 > 95%
Normal systolic blood pressure

Correct answer: Serum lactate < 2 mmol/L

Serum lactate reflects cellular oxygen utilisation; a lactate < 2 mmol/L indicates aerobic metabolism and adequate tissue oxygenation.

Question 2: Which vital sign is considered the 'fifth vital sign' in modern nursing practice?

Respiratory rate
Pain (Correct answer)
Oxygen saturation
Blood pressure

Correct answer: Pain

Pain is widely recognized as the fifth vital sign because it requires routine assessment alongside temperature, pulse, respiration, and blood pressure. The Joint Commission mandates regular pain assessment in accredited facilities.

Question 3: What is the licensing process for nurses to practice in Abu Dhabi under the Department of Health (DOH)?

Complete DataFlow primary source verification, pass the DOH licensing examination, and obtain a professional license (Correct answer)
Self-declare qualifications online
No license is required
Only submit academic transcripts

Correct answer: Complete DataFlow primary source verification, pass the DOH licensing examination, and obtain a professional license

DOH Abu Dhabi requires nurses to undergo primary source verification through DataFlow, pass the DOH professional licensing examination, and formally apply for and receive a professional practice license.

Question 4: What is the purpose of administering vitamin K to a newborn immediately after birth?

Enhance immune system function
Promote healthy bone development
Prevent hemorrhagic disease of the newborn (vitamin K deficiency bleeding) (Correct answer)
Treat neonatal jaundice

Correct answer: Prevent hemorrhagic disease of the newborn (vitamin K deficiency bleeding)

Newborns have very low vitamin K levels and immature gut flora that cannot yet synthesize it. Vitamin K is essential for synthesis of clotting factors II, VII, IX, and X. Without it, the neonate is at risk for intracranial hemorrhage and other bleeding (VKDB). IM vitamin K at birth prevents this.

Question 5: What is the normal blood pressure range for a healthy 5-year-old child?

120/80 mmHg
140/90 mmHg
80/50 mmHg
95–110/60–70 mmHg (Correct answer)

Correct answer: 95–110/60–70 mmHg

Normal BP for a 5-year-old is approximately 95–110/60–70 mmHg. Blood pressure increases gradually with age. A value of 120/80 mmHg is normal for adults. Hypertension in children is defined as BP ≥95th percentile for age, sex, and height.

Question 6: What is the correct action when a variable deceleration pattern is seen on the fetal monitor during labor?

Document and continue routine monitoring
Increase oxytocin infusion immediately
Perform an emergency cesarean section immediately
Reposition the mother, administer oxygen, and increase IV fluid rate (Correct answer)

Correct answer: Reposition the mother, administer oxygen, and increase IV fluid rate

Variable decelerations result from umbilical cord compression. Initial interventions are: change maternal position (left lateral or hands-and-knees), increase IV fluids to improve placental perfusion, apply oxygen 8–10 L/min via face mask, and notify the physician if decelerations persist.

Question 7: A patient prescribed atorvastatin reports muscle pain and weakness. Which serious complication must be assessed for?

Normal statin myalgia requiring reassurance only
Rhabdomyolysis — check creatine kinase (CK) level immediately (Correct answer)
Peripheral neuropathy requiring a nerve conduction study
Vitamin D deficiency causing the same symptoms

Correct answer: Rhabdomyolysis — check creatine kinase (CK) level immediately

Statins can cause myopathy ranging from mild myalgia to life-threatening rhabdomyolysis (muscle cell breakdown causing myoglobinuria and renal failure). A markedly elevated CK (>10× upper limit of normal with symptoms) confirms rhabdomyolysis. Stop statin immediately if suspected.

Question 8: What stroke rehabilitation nursing does DOH Abu Dhabi define?

Rehabilitation starts only after 2 weeks
Swallowing assessment, positioning for prevention of complications, early mobilization, communication support, functional retraining, and psychological support (Correct answer)
Stroke patients only need bed rest
Only provide physical therapy referral

Correct answer: Swallowing assessment, positioning for prevention of complications, early mobilization, communication support, functional retraining, and psychological support

DOH stroke rehabilitation nursing includes bedside swallowing screening, therapeutic positioning, early mobilization within 24-48 hours, communication aids for aphasia, ADL retraining, and psychological/emotional support for adjustment.

Question 9: A patient develops sudden stridor immediately after endotracheal tube extubation. What is the nurse's priority action?

Reposition the patient to a prone position
Administer an oral antihistamine for suspected allergy
Apply high-flow oxygen and notify the physician immediately (Correct answer)
Encourage the patient to cough and take deep breaths

Correct answer: Apply high-flow oxygen and notify the physician immediately

Post-extubation stridor signals upper airway obstruction; applying oxygen and immediately alerting the physician is the priority while preparing for potential reintubation.

Question 10: A nurse is preparing to insert a nasogastric tube. What is the most reliable method to confirm correct placement?

Visual inspection of the tube's exit point at the nostril
X-ray confirmation (Correct answer)
Auscultation of air insufflation over epigastrium
pH testing of aspirate alone

Correct answer: X-ray confirmation

X-ray is the gold standard for confirming NG tube placement as it directly visualizes the tube position. Auscultation alone is unreliable. pH testing is a useful bedside check but not definitive without X-ray confirmation.

Question 11: A patient is prescribed an ACE inhibitor (lisinopril). Which adverse effect should be included in patient teaching?

Increased potassium excretion causing hypokalemia
Reflex bradycardia
Persistent dry cough and risk of angioedema (Correct answer)
Hypoglycemia in non-diabetic patients

Correct answer: Persistent dry cough and risk of angioedema

ACE inhibitors cause bradykinin accumulation, leading to a characteristic persistent dry cough in 10–15% of patients. Angioedema (swelling of tongue, lips, throat) is rare but life-threatening. ACE inhibitors also cause hyperkalemia (not hypokalemia) by reducing aldosterone.

Question 12: A patient with a sulfa allergy is prescribed trimethoprim-sulfamethoxazole (TMP-SMX). What should the nurse do?

Give the first dose and observe in clinic for 30 minutes
Administer with diphenhydramine premedication
Administer and monitor for mild rash only
Do not administer; notify the physician immediately, as TMP-SMX contains a sulfonamide (Correct answer)

Correct answer: Do not administer; notify the physician immediately, as TMP-SMX contains a sulfonamide

TMP-SMX contains sulfamethoxazole, a sulfonamide antibiotic. A documented sulfa allergy is a contraindication. The prescriber must be notified before administration. Reactions can range from rash and Stevens-Johnson syndrome to anaphylaxis.

Question 13: What geriatric assessment does DOH Abu Dhabi require nurses to perform for elderly patients?

Geriatric assessment is physician-only
Comprehensive geriatric assessment including functional status, cognitive screening, fall risk, nutritional status, polypharmacy review, and social support evaluation (Correct answer)
Use the same assessment as for younger adults
Only assess mobility

Correct answer: Comprehensive geriatric assessment including functional status, cognitive screening, fall risk, nutritional status, polypharmacy review, and social support evaluation

DOH requires comprehensive geriatric nursing assessment covering functional independence (ADLs/IADLs), cognitive screening (MMSE/MoCA), fall risk, nutritional status, medication review for polypharmacy, and social support systems.

Question 14: What is the appropriate method for calculating medication dosage in pediatric patients?

Fixed dose same as adult regardless of weight
Age-based dosing using standard adult dose tables
Body surface area only for all medications
Weight-based dosing (mg/kg), verified against maximum adult dose (Correct answer)

Correct answer: Weight-based dosing (mg/kg), verified against maximum adult dose

Pediatric medications are dosed by weight (mg/kg) because children's body composition, renal and hepatic function differ significantly from adults. The calculated dose must not exceed the maximum adult dose. BSA is used for some chemotherapy drugs.

Question 15: A Glasgow Coma Scale (GCS) score of 8 or less indicates which level of neurological impairment?

Moderate brain injury — consider CT scan
Minimal impairment — routine observations
Mild brain injury — close monitoring required
Severe brain injury — airway protection is a priority (Correct answer)

Correct answer: Severe brain injury — airway protection is a priority

GCS ≤8 defines severe brain injury and typically warrants immediate airway protection, often through endotracheal intubation.

Question 16: What community health nursing services does DOH Abu Dhabi provide?

Home health visits, chronic disease management, health education, school health programs, immunization outreach, and maternal-child wellness visits (Correct answer)
Only hospital discharge follow-up
Community nursing is only for rural areas
No community nursing services exist

Correct answer: Home health visits, chronic disease management, health education, school health programs, immunization outreach, and maternal-child wellness visits

DOH Abu Dhabi community nursing services include home health care, chronic disease management programs, community health education, school health services, immunization campaigns, and maternal-child health visits.

Question 17: Which immunization is recommended at birth for all neonates in the UAE?

Hepatitis B vaccine (Correct answer)
MMR vaccine
Rotavirus vaccine
BCG and Hepatitis B vaccine

Correct answer: Hepatitis B vaccine

In the UAE National Immunization Schedule, neonates receive BCG (tuberculosis prevention) and the first dose of Hepatitis B vaccine at birth. The Hepatitis B birth dose prevents vertical transmission from HBsAg-positive mothers.

Question 18: What is the recommended breastfeeding position to prevent mastitis?

Ensure complete breast drainage by varying feeding positions and ensuring a correct latch (Correct answer)
Limit feeding to 10 minutes per side to prevent nipple trauma
Apply lanolin cream only to prevent infection
Feed only from one breast per session to allow complete rest

Correct answer: Ensure complete breast drainage by varying feeding positions and ensuring a correct latch

Mastitis results from milk stasis and bacterial entry. Varying positions ensures all ducts drain completely. A correct deep latch prevents nipple cracking (which allows bacterial entry). Frequent complete emptying prevents the milk stasis that allows bacterial proliferation.

Question 19: What is the normal range for adult respiratory rate?

8–10 breaths per minute
30–35 breaths per minute
22–26 breaths per minute
12–20 breaths per minute (Correct answer)

Correct answer: 12–20 breaths per minute

A normal adult respiratory rate is 12–20 breaths per minute. Bradypnea is <12/min and tachypnea is >20/min. Respiratory rate is a sensitive early indicator of clinical deterioration.

Question 20: What pain management protocols does DOH Abu Dhabi require nurses to follow?

Pain management is optional
Pain is only assessed in surgical patients
Regular assessment using validated tools, individualized pain management plans, reassessment after interventions, and documentation of response (Correct answer)
Only administer medication when patients request it

Correct answer: Regular assessment using validated tools, individualized pain management plans, reassessment after interventions, and documentation of response

DOH requires regular pain assessment using validated scales (numeric, FLACC, Wong-Baker), individualized pharmacological and non-pharmacological management plans, reassessment after interventions, and thorough documentation.

Question 21: In Abu Dhabi's healthcare system, which National Patient Safety Goals are prioritized according to JCI/DOH frameworks?

Falls prevention exclusively
Correct patient identification, effective communication, safe medication use, preventing infections, surgical safety, fall prevention (Correct answer)
Patient identification and communication only
Only medication safety and infection control

Correct answer: Correct patient identification, effective communication, safe medication use, preventing infections, surgical safety, fall prevention

JCI-adopted National Patient Safety Goals relevant to Abu Dhabi cover: correct patient identification (two identifiers), effective communication (SBAR, read-back), medication safety (high-alert drugs, look-alike/sound-alike), HAI prevention, safe surgery (surgical safety checklist), and fall prevention.

Question 22: Which sign indicates the placenta is separating and ready for delivery?

Fetal tachycardia above 180 bpm
Lengthening of the umbilical cord and a gush of blood (Correct answer)
Maternal hypotension and bradycardia
Return of regular contractions

Correct answer: Lengthening of the umbilical cord and a gush of blood

Signs of placental separation include: lengthening of the umbilical cord, a sudden gush of blood, the uterus becoming globular and firmer, and the fundus rising in the abdomen. These occur 5–15 minutes after delivery of the baby.

Question 23: What postoperative assessment does DOH Abu Dhabi require in the recovery unit?

Post-anesthesia care is the anesthesiologist's sole responsibility
Continuous monitoring of vital signs, airway patency, consciousness level, pain, surgical site, IV fluids, and Aldrete score for discharge readiness (Correct answer)
Only check blood pressure once
Only observe until the patient is awake

Correct answer: Continuous monitoring of vital signs, airway patency, consciousness level, pain, surgical site, IV fluids, and Aldrete score for discharge readiness

DOH recovery nursing includes continuous vital sign monitoring, airway management, consciousness assessment, pain management, surgical site observation, fluid balance monitoring, and Aldrete scoring for safe discharge from recovery.

Question 24: A patient post-anterior MI develops hypotension, tachycardia, raised JVP, and cool clammy skin. Which type of shock is most consistent with these findings?

Neurogenic shock
Cardiogenic shock (Correct answer)
Distributive (septic) shock
Hypovolaemic shock

Correct answer: Cardiogenic shock

Elevated JVP with hypotension and cold peripheries following a large MI indicates cardiogenic shock due to left ventricular pump failure with venous congestion.

Question 25: In the ABCDE primary trauma survey, what does 'D' assess?

Drug administration history
Decontamination of hazardous materials
Dressings and wound care
Disability — neurological status using GCS and pupils (Correct answer)

Correct answer: Disability — neurological status using GCS and pupils

'D' in the primary survey stands for Disability, assessed by the Glasgow Coma Scale, pupil size/reactivity, and limb movement.

Question 26: A nurse working in Abu Dhabi receives a phone order from a physician. What is the safest practice?

Write down the order, read it back verbatim to the physician for confirmation, then document with time and signature (Correct answer)
Immediately carry out the verbal order without documentation
Ask the physician to fax the order before acting
Decline verbal/phone orders entirely under DOH policy

Correct answer: Write down the order, read it back verbatim to the physician for confirmation, then document with time and signature

Verbal and telephone orders are high-risk for miscommunication. Best practice (DOH/JCI): write the order, read it back exactly, receive confirmation, document with the date/time and a note of 'verbal order — read back confirmed.' Physician countersigns at the earliest opportunity.

Question 27: What does a Glasgow Coma Scale score of 8 or below indicate?

Moderate concussion needing observation only
Normal neurological function under sedation
Severe brain injury; airway protection required (Correct answer)
Mild brain injury with full recovery expected

Correct answer: Severe brain injury; airway protection required

GCS ≤8 defines a severe brain injury and indicates that the patient cannot protect their own airway. Intubation is generally indicated at GCS ≤8. The GCS scores eye, verbal, and motor responses, with a maximum of 15.

Question 28: What early warning system does DOH Abu Dhabi require for detecting patient deterioration?

Early warning is only for ICU patients
No early warning system is used
National Early Warning Score (NEWS) or equivalent scoring system with defined escalation protocols and rapid response team activation criteria (Correct answer)
Only physician assessment detects deterioration

Correct answer: National Early Warning Score (NEWS) or equivalent scoring system with defined escalation protocols and rapid response team activation criteria

DOH mandates use of standardized early warning scoring systems (NEWS/PEWS) with defined trigger thresholds for escalation, including specific criteria for rapid response team activation by any clinical staff member.

Question 29: Norepinephrine is the first-line vasopressor for septic shock. What is its primary mechanism of action?

Dopaminergic receptor stimulation increasing renal perfusion
Alpha-1 agonism causing vasoconstriction and increased SVR (Correct answer)
Beta-1 agonism that increases heart rate and contractility
Phosphodiesterase inhibition improving cardiac output

Correct answer: Alpha-1 agonism causing vasoconstriction and increased SVR

Norepinephrine primarily stimulates alpha-1 adrenergic receptors, causing potent vasoconstriction that restores mean arterial pressure in distributive shock.

Question 30: What is the DOH Abu Dhabi standard for neonatal resuscitation readiness?

Pre-delivery equipment checks, trained personnel at every delivery, NRP-certified staff available, and regular simulation training (Correct answer)
Resuscitation is only prepared for known high-risk deliveries
Resuscitation equipment is checked monthly
Only obstetricians perform neonatal resuscitation

Correct answer: Pre-delivery equipment checks, trained personnel at every delivery, NRP-certified staff available, and regular simulation training

DOH requires resuscitation equipment verification before every delivery, NRP-certified personnel present at all deliveries, additional team availability for high-risk situations, and regular simulation-based training.

Question 31: What is the DOH Abu Dhabi requirement for nurse competency in emergency response?

All clinical nurses must maintain BLS certification, with unit-specific advanced certifications (ACLS, PALS) and regular emergency simulation drills (Correct answer)
Only physicians respond to emergencies
Emergency training is completed once on hire
Only ICU nurses need emergency training

Correct answer: All clinical nurses must maintain BLS certification, with unit-specific advanced certifications (ACLS, PALS) and regular emergency simulation drills

DOH requires all clinical nurses to maintain current BLS certification, with additional certifications (ACLS, PALS, NRP) based on clinical area, plus participation in regular emergency simulation exercises and drills.

Question 32: What occupational health nursing services does DOH Abu Dhabi require in healthcare facilities?

Occupational health is outsourced to external agencies
Only manage workplace injuries
No occupational health services are needed
Pre-employment health screening, vaccination programs, needlestick injury management, workplace hazard assessment, and staff wellness programs (Correct answer)

Correct answer: Pre-employment health screening, vaccination programs, needlestick injury management, workplace hazard assessment, and staff wellness programs

DOH requires occupational health nursing services including pre-employment screening, staff immunization programs, needlestick and occupational exposure management, workplace hazard identification, and employee wellness initiatives.

Question 33: An ICU patient has a central venous pressure (CVP) of 1 mmHg and a mean arterial pressure (MAP) of 52 mmHg. What does this most likely indicate?

Right heart failure
Cardiac tamponade
Fluid overload
Hypovolaemia requiring fluid resuscitation (Correct answer)

Correct answer: Hypovolaemia requiring fluid resuscitation

Low CVP combined with low MAP indicates insufficient circulating volume, pointing to hypovolaemia that requires prompt fluid resuscitation.

Question 34: What are the DOH Abu Dhabi continuing professional development requirements for nurses?

CPD is optional but recommended
Nurses must accumulate specified CPD hours during each license renewal cycle covering clinical and professional topics (Correct answer)
Only attend one conference per year
CPD is not required in Abu Dhabi

Correct answer: Nurses must accumulate specified CPD hours during each license renewal cycle covering clinical and professional topics

DOH Abu Dhabi mandates that nurses complete a minimum number of CPD hours during each licensing cycle, covering clinical competency updates, patient safety, quality improvement, and professional development.

Question 35: What wound care standards does DOH Abu Dhabi mandate for nursing practice?

Use the same dressing for all wounds
Evidence-based wound assessment, appropriate dressing selection based on wound characteristics, regular reassessment, and documentation of healing progress (Correct answer)
Wound care is performed only by wound care specialists
Only clean wounds with saline

Correct answer: Evidence-based wound assessment, appropriate dressing selection based on wound characteristics, regular reassessment, and documentation of healing progress

DOH wound care standards include comprehensive assessment (size, depth, tissue type, exudate), evidence-based dressing selection, regular reassessment intervals, healing progress documentation, and referral criteria.

Question 36: What is the DOH Abu Dhabi standard for managing pediatric emergencies?

Pediatric-specific triage using validated tools, age-appropriate vital sign parameters, weight-based medication dosing, and family-centered emergency care (Correct answer)
Only pediatric specialists manage emergencies
Transfer all children to adult emergency departments
Use adult assessment parameters for children

Correct answer: Pediatric-specific triage using validated tools, age-appropriate vital sign parameters, weight-based medication dosing, and family-centered emergency care

DOH pediatric emergency standards include specific triage systems (e.g., Pediatric Assessment Triangle), age-appropriate vital sign reference ranges, weight-based treatment protocols, and family-centered care approaches.

Question 37: What research and evidence-based practice standards does DOH Abu Dhabi promote in nursing?

Participate in nursing research, implement evidence-based practice guidelines, contribute to quality improvement projects, and use research to inform clinical decisions (Correct answer)
Evidence-based practice is optional
Research is not relevant to nursing practice
Only academic nurses conduct research

Correct answer: Participate in nursing research, implement evidence-based practice guidelines, contribute to quality improvement projects, and use research to inform clinical decisions

DOH promotes nursing research participation, implementation of evidence-based clinical guidelines, involvement in quality improvement initiatives, and the use of current research evidence to guide clinical decision-making.

Question 38: A patient on warfarin therapy has an INR of 8.5 and is actively bleeding. What is the antidote?

Stop warfarin and wait 48 hours
Vitamin K IV and fresh frozen plasma (FFP) (Correct answer)
Protamine sulfate IV
Tranexamic acid

Correct answer: Vitamin K IV and fresh frozen plasma (FFP)

For life-threatening bleeding with supratherapeutic INR, warfarin must be reversed immediately. Vitamin K reverses warfarin's mechanism (blocking vitamin K-dependent clotting factors); FFP provides immediate clotting factors. 4-factor PCC is preferred over FFP when available.

Question 39: Which type of hallucination is most commonly reported in schizophrenia?

Gustatory hallucinations
Visual hallucinations
Tactile hallucinations
Auditory hallucinations (hearing voices) (Correct answer)

Correct answer: Auditory hallucinations (hearing voices)

Auditory hallucinations (hearing voices) occur in approximately 70% of patients with schizophrenia and are the most diagnostically significant. The voices may comment on behavior, converse with each other, or give commands. Visual hallucinations are more common in delirium or organic causes.

Question 40: Which color-coded wristband system is standardized for patient safety in Abu Dhabi DOH-regulated facilities?

Blue = allergy, red = DNAR, green = fall risk
White = allergy, orange = fall risk, black = DNAR
No standardized color coding exists in Abu Dhabi
Red = allergy, yellow = fall risk, purple = DNAR (Correct answer)

Correct answer: Red = allergy, yellow = fall risk, purple = DNAR

DOH Abu Dhabi adopted standardized color-coded wristbands: Red for allergy, Yellow for fall risk, Purple (or Pink) for DNAR. This standardization aligns with international patient safety initiatives to reduce errors when patients transfer between units or facilities.

Question 41: What is the distinguishing feature between delirium and dementia?

Delirium affects only elderly patients; dementia can occur at any age
Dementia is always reversible; delirium is not
Delirium has acute onset and fluctuating course; dementia is gradual and progressive (Correct answer)
Both have identical acute onset and fluctuating course

Correct answer: Delirium has acute onset and fluctuating course; dementia is gradual and progressive

Delirium is characterized by acute onset (hours to days), fluctuating consciousness and attention, and is usually reversible when the cause is treated. Dementia has an insidious onset and progressive course without fluctuating consciousness. Both can coexist.

Question 42: A patient with diabetic ketoacidosis (DKA) initially has serum K+ of 5.8 mmol/L. As insulin infusion begins, what electrolyte change should the nurse anticipate?

Magnesium will increase due to renal retention
Calcium will rise causing hypercalcaemia
Potassium will fall rapidly as insulin drives K+ into cells (Correct answer)
Sodium will drop significantly requiring hypertonic saline

Correct answer: Potassium will fall rapidly as insulin drives K+ into cells

Insulin facilitates cellular uptake of potassium; once insulin infusion begins, serum potassium drops rapidly and requires close monitoring with replacement.

Question 43: Which regulatory body governs healthcare licensing and quality in Abu Dhabi?

Dubai Health Authority (DHA)
Health Authority Abu Dhabi (HAAD) — now integrated into DOH
Department of Health (DOH) Abu Dhabi (Correct answer)
Ministry of Health and Prevention (MOHAP) only

Correct answer: Department of Health (DOH) Abu Dhabi

The Department of Health (DOH) Abu Dhabi is the regulatory authority for all healthcare entities and professionals in the Emirate of Abu Dhabi. HAAD was the predecessor and was transformed into DOH in 2018. MOHAP regulates at the federal level across all UAE emirates.

Question 44: What is the DOH Abu Dhabi process for handling nursing professional misconduct?

Misconduct is not investigated
Only criminal courts handle misconduct
Formal investigation, opportunity to respond, disciplinary committee hearing, and sanctions ranging from warning to license revocation (Correct answer)
Only verbal warnings are issued

Correct answer: Formal investigation, opportunity to respond, disciplinary committee hearing, and sanctions ranging from warning to license revocation

DOH handles professional misconduct through formal investigation, providing the nurse opportunity to respond, disciplinary committee review, and graduated sanctions from warnings to suspension or license revocation.

Question 45: A nurse notes that a patient's IV infusion of potassium chloride 40 mEq/L is running through a peripheral line at 40 mEq/hr. What is the concern?

Peripheral infusion of concentrated potassium at this rate causes vein damage and risk of cardiac arrest (Correct answer)
The rate is too slow and requires increase
Potassium should always run at this concentration
No concern; this is a standard peripheral IV potassium protocol

Correct answer: Peripheral infusion of concentrated potassium at this rate causes vein damage and risk of cardiac arrest

IV potassium concentration via peripheral line should not exceed 10 mEq/100 mL (or 10 mEq/hr). High concentrations cause chemical phlebitis and vein sclerosis. Rapid IV potassium can cause fatal cardiac arrhythmias. Central line is preferred for concentrated replacement.

Question 46: What suicide risk assessment does DOH Abu Dhabi require nurses to perform?

Suicide risk assessment is only for psychiatrists
Only ask if the patient feels sad
Suicide assessment is not performed in Abu Dhabi
Structured risk assessment using validated tools, safety planning, environmental safety measures, continuous observation when indicated, and interdisciplinary referral (Correct answer)

Correct answer: Structured risk assessment using validated tools, safety planning, environmental safety measures, continuous observation when indicated, and interdisciplinary referral

DOH requires structured suicide risk assessment using validated screening tools, development of safety plans, implementation of environmental precautions, continuous observation for high-risk patients, and immediate psychiatric referral.

Question 47: What is the 'universal protocol' for preventing wrong-site, wrong-procedure, and wrong-patient surgery?

Radiological confirmation of the surgical site only
Anesthesiologist verification only
Pre-procedure verification, site marking by the surgeon, and time-out before incision (Correct answer)
Pre-operative consent only

Correct answer: Pre-procedure verification, site marking by the surgeon, and time-out before incision

The Universal Protocol (JCI/WHO) consists of three components: (1) Pre-procedure verification checklist, (2) Site marking with indelible marker by the operating surgeon while the patient is awake, and (3) Time-out immediately before incision with all team members actively participating.

Question 48: A patient with schizophrenia reports hearing voices that command them to harm others. What is the priority nursing action?

Administer PRN antipsychotic medication only and document
Assess for immediate danger to self or others and initiate safety measures (Correct answer)
Reassure the patient that the voices are not real
Isolate the patient until the voices stop

Correct answer: Assess for immediate danger to self or others and initiate safety measures

Command hallucinations to harm others require immediate risk assessment (intent, plan, means, target) and safety measures including constant observation, removal of means, and notification of the treatment team. Patient and public safety is the priority in psychiatric emergencies.

Question 49: Which type of isolation precaution is required for a patient with active pulmonary tuberculosis?

Airborne precautions (Correct answer)
Contact precautions
Standard precautions only
Droplet precautions

Correct answer: Airborne precautions

Active pulmonary TB is transmitted via airborne particles (droplet nuclei <5 microns) that remain suspended in air. Airborne precautions require a negative-pressure room and N95 respirators for staff.

Question 50: What does the 'patient fall risk assessment' score determine in a DOH-regulated hospital?

Eligibility for surgical intervention
Whether to discharge the patient sooner
Staffing ratios on the unit
Level of fall prevention interventions required (bed alarm, non-slip footwear, call bell within reach, supervision) (Correct answer)

Correct answer: Level of fall prevention interventions required (bed alarm, non-slip footwear, call bell within reach, supervision)

Validated fall risk tools (Morse Fall Scale, STRATIFY) categorize patients as low/medium/high risk. Higher risk scores trigger more intensive interventions: bed/chair alarms, frequent rounding, non-slip footwear, bed in lowest position, call bell accessible, and in some cases additional supervision.

Question 51: What is the priority assessment for a patient admitted following a suicide attempt?

Administer standardized depression scale questionnaire first
Assess current suicidal ideation, intent, plan, lethality of method, and means access (Correct answer)
Obtain a complete medical history before any psychiatric assessment
Contact family for collateral history before speaking with the patient

Correct answer: Assess current suicidal ideation, intent, plan, lethality of method, and means access

Immediate risk assessment after a suicide attempt includes: current SI (ideation, intent), plan (specificity), lethality of previous attempt, access to means, and protective factors. This guides the level of observation and safety planning. Medical stability is assessed simultaneously.

Question 52: Which finding during a head-to-toe assessment requires immediate action?

Mild pedal edema in both feet
Blood pressure of 118/76 mmHg
Unequal pupils (anisocoria) with altered level of consciousness (Correct answer)
A healing surgical incision with no redness

Correct answer: Unequal pupils (anisocoria) with altered level of consciousness

Unequal pupils combined with altered consciousness suggest raised intracranial pressure or brainstem involvement — a neurological emergency requiring immediate escalation. The other findings are either normal or non-urgent.

Question 53: What patient safety standards does DOH Abu Dhabi require all healthcare facilities to implement?

Only hand hygiene standards
Safety standards only apply to government hospitals
Safety standards are optional
National patient safety goals including correct identification, effective communication, medication safety, surgical safety, infection control, and fall prevention (Correct answer)

Correct answer: National patient safety goals including correct identification, effective communication, medication safety, surgical safety, infection control, and fall prevention

DOH mandates implementation of national patient safety goals across all licensed facilities, covering patient identification, communication, high-alert medications, surgical safety, infection prevention, and fall reduction.

Question 54: Which intervention prevents dumping syndrome in a post-gastrectomy patient?

Eat small, frequent meals low in simple sugars and avoid fluids with meals (Correct answer)
Eat large meals three times a day with plenty of water
Lie down immediately after eating to slow gastric emptying
Increase dietary fiber and eat slowly

Correct answer: Eat small, frequent meals low in simple sugars and avoid fluids with meals

Dumping syndrome occurs when gastric contents rapidly enter the small intestine. Small meals low in simple carbohydrates reduce osmotic load; separating fluids from solids slows gastric transit. Lying down after eating is actually helpful to slow transit.

Question 55: A 7-year-old has a blood glucose of 38 mg/dL and is conscious and able to swallow. What is the priority treatment?

Give 15 g of fast-acting carbohydrates orally and recheck glucose in 15 minutes (Correct answer)
Wait for physician orders before treating
Administer IV dextrose 50% immediately
Give IM glucagon injection

Correct answer: Give 15 g of fast-acting carbohydrates orally and recheck glucose in 15 minutes

The '15-15 rule' for conscious hypoglycemic children: give 15 g of fast-acting carbohydrate (4 oz juice, glucose tablets), wait 15 minutes, recheck blood glucose. If still <70 mg/dL, repeat. IV dextrose and glucagon are for unconscious patients.

Question 56: A patient taking lithium carbonate reports coarse tremor, confusion, and vomiting. Lithium level is 2.8 mEq/L. What is the priority action?

Give anti-tremor medication and document the findings
Administer the next scheduled lithium dose and monitor closely
Stop lithium immediately, establish IV access, and initiate hydration and monitoring (Correct answer)
Reduce the lithium dose by half and recheck levels in 1 week

Correct answer: Stop lithium immediately, establish IV access, and initiate hydration and monitoring

Lithium toxicity at levels >2.0 mEq/L (therapeutic: 0.6–1.2 mEq/L) causes neurotoxicity (tremor, confusion, ataxia), GI symptoms, and in severe cases, seizures and cardiac arrhythmias. Lithium must be stopped, IV fluids administered to enhance renal excretion, and dialysis considered for severe toxicity.

Question 57: A nurse is caring for a child post-tonsillectomy. Which finding requires immediate reporting?

Mild throat pain rated 4/10
Slight fever of 37.8°C on post-op day 1
Preference for cold fluids only
Frequent swallowing or vomiting fresh blood (Correct answer)

Correct answer: Frequent swallowing or vomiting fresh blood

Frequent swallowing is a sign the child is swallowing blood from post-tonsillectomy hemorrhage — a serious surgical complication. Along with vomiting fresh blood, these are red flags for secondary hemorrhage. Immediate surgical evaluation is required.

Question 58: What is the recommended frequency for repositioning an immobile patient to prevent pressure injuries?

Every hour only at night
Every 2 hours (Correct answer)
Every 8 hours
Every 4 hours

Correct answer: Every 2 hours

Evidence-based guidelines recommend repositioning every 2 hours for immobile patients to relieve pressure over bony prominences. For patients on high-specification foam mattresses, a 4-hour schedule may be appropriate, but 2 hours is the standard.

Question 59: What chronic disease management role does DOH Abu Dhabi assign to nurses?

Chronic disease management is physician-only
Chronic disease management does not involve nurses
Patient education, self-management support, medication adherence monitoring, lifestyle counseling, and coordination of multidisciplinary care (Correct answer)
Only check vital signs at follow-up visits

Correct answer: Patient education, self-management support, medication adherence monitoring, lifestyle counseling, and coordination of multidisciplinary care

DOH assigns nurses significant roles in chronic disease management including patient education, supporting self-management skills, monitoring medication adherence, lifestyle counseling, and coordinating care across disciplines.

Question 60: What palliative and end-of-life care standards does DOH Abu Dhabi establish for nurses?

Palliative care only applies to cancer patients
End-of-life care is not addressed in Abu Dhabi regulations
Holistic care including pain and symptom management, psychosocial support, cultural and spiritual care, family involvement, and advance care planning (Correct answer)
Only provide comfort measures in the final hours

Correct answer: Holistic care including pain and symptom management, psychosocial support, cultural and spiritual care, family involvement, and advance care planning

DOH establishes comprehensive palliative care standards including expert symptom management, emotional and spiritual support, cultural sensitivity, family-centered care, advance care planning, and bereavement support.

Question 61: What disaster and emergency preparedness role do DOH Abu Dhabi nurses have?

Nurses have no role in disaster preparedness
Only follow physician instructions during disasters
Disaster planning is only for military healthcare
Participate in facility disaster plans, maintain triage competency, engage in regular drills, and know roles in the emergency operations plan (Correct answer)

Correct answer: Participate in facility disaster plans, maintain triage competency, engage in regular drills, and know roles in the emergency operations plan

DOH requires nurses to be familiar with facility disaster plans, maintain mass casualty triage competency, participate in regular emergency drills, and understand their specific roles within the institutional emergency response framework.

Question 62: What is the DOH Abu Dhabi requirement for nutritional assessment and management in nursing?

Nutritional assessment is not a nursing role
Only weigh patients on admission
Screen all patients using validated tools on admission, refer at-risk patients to dietitian, monitor intake, and implement nutrition care plans (Correct answer)
Nutrition is only managed by dietitians

Correct answer: Screen all patients using validated tools on admission, refer at-risk patients to dietitian, monitor intake, and implement nutrition care plans

DOH requires nutritional screening using validated tools (e.g., Malnutrition Screening Tool) on admission, referral of at-risk patients, intake monitoring, weight tracking, and implementation of individualized nutrition care plans.

Question 63: What dementia care standards does DOH Abu Dhabi establish for nursing?

Only administer sedative medications
Dementia patients do not require specialized care
Dementia care is only for specialized facilities
Person-centered care, environmental modifications, behavioral management strategies, family education, safety measures, and dignity preservation (Correct answer)

Correct answer: Person-centered care, environmental modifications, behavioral management strategies, family education, safety measures, and dignity preservation

DOH dementia care standards emphasize person-centered approaches, adapted communication techniques, safe environments, non-pharmacological behavior management, family education and support, and maintaining patient dignity and quality of life.

Question 64: A mechanically ventilated patient with COPD exacerbation has the following ABG: pH 7.28, PaCO2 68 mmHg, HCO3 28 mEq/L. What acid-base disturbance is present?

Respiratory alkalosis with metabolic compensation
Respiratory acidosis with partial metabolic compensation (Correct answer)
Mixed metabolic and respiratory alkalosis
Metabolic acidosis with respiratory compensation

Correct answer: Respiratory acidosis with partial metabolic compensation

Low pH with elevated PaCO2 defines respiratory acidosis; the elevated bicarbonate reflects partial renal (metabolic) compensation occurring over time.

Question 65: When monitoring a patient with a pulmonary artery catheter (Swan-Ganz), which measurement BEST reflects left ventricular preload?

Cardiac output measured by thermodilution
Pulmonary artery occlusion pressure (PAOP/PCWP) (Correct answer)
Systemic vascular resistance (SVR)
Central venous pressure (CVP)

Correct answer: Pulmonary artery occlusion pressure (PAOP/PCWP)

PAOP (wedge pressure) reflects left atrial pressure and left ventricular end-diastolic pressure, making it the best surrogate for left ventricular preload.

Question 66: What is the DOH Abu Dhabi nursing protocol for blood transfusion management?

No specific protocol exists
Two-nurse verification of patient identity and blood product, vital sign monitoring at specified intervals, and immediate action for transfusion reactions (Correct answer)
Blood transfusion monitoring is the physician's responsibility
Only check the blood bag label

Correct answer: Two-nurse verification of patient identity and blood product, vital sign monitoring at specified intervals, and immediate action for transfusion reactions

DOH requires two-nurse bedside verification of patient identity against the blood product, vital sign monitoring at baseline, 15 minutes, and regular intervals, with immediate protocols for managing transfusion reactions.

Question 67: What health promotion activities does DOH Abu Dhabi encourage for elderly populations?

Only medication compliance education
Health promotion is not relevant for elderly patients
Physical activity programs, fall prevention education, chronic disease self-management, social engagement promotion, and cognitive stimulation activities (Correct answer)
Health promotion stops after age 65

Correct answer: Physical activity programs, fall prevention education, chronic disease self-management, social engagement promotion, and cognitive stimulation activities

DOH promotes health in elderly populations through adapted physical activity, fall prevention education, chronic disease self-management support, social engagement facilitation, cognitive stimulation programs, and preventive health screening.

Question 68: What is the DOH Abu Dhabi position on informed consent for surgical procedures?

Verbal consent is sufficient for all surgical procedures
Written informed consent by a competent patient (or legal guardian) before elective surgery is mandatory (Correct answer)
Consent is only required for procedures under general anesthesia
The surgeon alone can consent on the patient's behalf

Correct answer: Written informed consent by a competent patient (or legal guardian) before elective surgery is mandatory

DOH Abu Dhabi requires written informed consent from competent adult patients before surgical procedures. Elements include: nature of procedure, risks, benefits, alternatives, and right to refuse. For incapacitated patients, the legal guardian/next of kin provides consent within DOH and UAE legal frameworks.

Question 69: A patient prescribed fluoxetine (SSRI) and tramadol concurrently is at risk for which condition?

Malignant hyperthermia
Neuroleptic malignant syndrome
Serotonin syndrome (Correct answer)
Anticholinergic syndrome

Correct answer: Serotonin syndrome

Both fluoxetine (increases serotonin via reuptake inhibition) and tramadol (weak serotonin reuptake inhibitor + mu-opioid agonist) increase serotonergic activity. The combination increases risk of serotonin syndrome: tremor, clonus, hyperthermia, agitation, and tachycardia. MAOIs with serotonergic drugs carry the highest risk.

Question 70: A child with Type 1 diabetes becomes sweaty, pale, and tremulous before lunch. Blood glucose is 58 mg/dL. What is the most appropriate action?

Give intramuscular glucagon and call the physician
Hold the insulin and give a high-fat snack
Administer the scheduled insulin dose and have lunch immediately
Give 15 g of rapid-acting carbohydrate (e.g., 4 oz juice) and recheck in 15 minutes (Correct answer)

Correct answer: Give 15 g of rapid-acting carbohydrate (e.g., 4 oz juice) and recheck in 15 minutes

The child is hypoglycemic (BG <70 mg/dL) and symptomatic. The 15-15 rule applies: 15 g fast carbohydrate, recheck after 15 minutes. Insulin should not be given until hypoglycemia is corrected. Fat slows carbohydrate absorption and is inappropriate.

Question 71: What does the acronym APGAR stand for, and what is a normal score at 1 minute?

Appearance, Pulse, Grimace, Activity, Respiration; 7–10 is normal (Correct answer)
Alertness, Pressure, Gas exchange, Activity, Reflex; 5–7 is acceptable
Airway, Pulse, Grimace, Activity, Respiration; 8–10 only is normal
Appearance, Pulse, Grimace, Alertness, Respiration; 4–6 is normal

Correct answer: Appearance, Pulse, Grimace, Activity, Respiration; 7–10 is normal

APGAR: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), Respiration. Scored 0–2 each, maximum 10. Score 7–10 at 1 minute = normal. 4–6 = moderate depression. <4 = severe depression requiring resuscitation.

Question 72: A patient on corticosteroid therapy requires surgery. What medication adjustment is required?

Discontinue corticosteroids 24 hours before surgery
Administer stress-dose corticosteroids (hydrocortisone) perioperatively to prevent adrenal crisis (Correct answer)
No adjustment needed; the surgical team manages cortisol
Double the oral dose and continue as normal

Correct answer: Administer stress-dose corticosteroids (hydrocortisone) perioperatively to prevent adrenal crisis

Chronic corticosteroid use suppresses the HPA axis, impairing the body's ability to mount a cortisol stress response to surgery. Stress-dose steroids (hydrocortisone 50–100 mg IV every 6–8 hours) are required perioperatively to prevent adrenal crisis (hypotension, vomiting, shock).

Question 73: What is the primary purpose of the Abu Dhabi Healthcare Information and Cyber Security Standard (ADHICS)?

Oversee medical device registration in Abu Dhabi
Regulate nursing education curricula
Manage pharmaceutical supply chains
Protect patient health information and ensure cybersecurity in healthcare systems (Correct answer)

Correct answer: Protect patient health information and ensure cybersecurity in healthcare systems

ADHICS establishes baseline requirements for protecting health information, electronic systems, and patient data privacy in Abu Dhabi healthcare facilities. Compliance is mandatory for DOH-licensed entities. It aligns with international standards (ISO 27001, NIST) adapted to the UAE context.

Question 74: What documentation standards does DOH Abu Dhabi mandate for nursing care?

Documentation is optional
Accurate, timely, legible documentation of all assessments, interventions, evaluations, and patient responses in approved formats (Correct answer)
Verbal handover replaces written documentation
Only document medications given

Correct answer: Accurate, timely, legible documentation of all assessments, interventions, evaluations, and patient responses in approved formats

DOH requires nursing documentation that is accurate, timely, legible, and complete, covering all assessments, care interventions, patient responses, and clinical decisions in approved electronic or paper formats.

Question 75: Which finding during a prenatal visit at 20 weeks indicates the fundal height is appropriate?

Fundal height measures 28 cm above the symphysis
Fundal height measures 20 cm at the umbilicus (Correct answer)
Fundal height measures 10 cm below the umbilicus
Fundal height is at the xiphoid process

Correct answer: Fundal height measures 20 cm at the umbilicus

Between 20–36 weeks, fundal height (in cm) roughly equals gestational age (in weeks) ±2 cm — a useful clinical rule. At 20 weeks, the fundus should be at or near the umbilicus (approximately 20 cm). Discrepancies suggest growth restriction or multiple gestation.

Question 76: What is the normal duration of a full-term pregnancy?

36–38 weeks only
38–42 weeks (280 days from LMP) (Correct answer)
44–48 weeks
32–36 weeks

Correct answer: 38–42 weeks (280 days from LMP)

Full-term pregnancy is defined as 38–42 weeks gestation (280 days from the first day of the last menstrual period). The estimated due date is calculated by Naegele's rule: LMP + 1 year − 3 months + 7 days. Deliveries at 37–38+6 weeks are 'early term.'

Question 77: Which action best maintains the therapeutic milieu in an inpatient psychiatric unit?

Allowing only family-initiated conversations about treatment
Unlimited individual freedom without any structure
Consistent routine, clear limit-setting, and involving patients in their care planning (Correct answer)
Strict isolation of patients from peers for safety

Correct answer: Consistent routine, clear limit-setting, and involving patients in their care planning

A therapeutic milieu provides safety through predictable structure (consistent daily routine), clear boundaries (limit-setting), and empowers patients through participation in care. Peer interaction and group activities are therapeutic components. Isolation is counter-therapeutic.

Question 78: What elder abuse screening does DOH Abu Dhabi require nurses to perform?

Elder abuse screening is not necessary
Elder abuse is not a healthcare concern
Only screen when abuse is obvious
Recognize signs of physical, emotional, financial abuse and neglect, mandatory reporting to designated authorities, and documentation (Correct answer)

Correct answer: Recognize signs of physical, emotional, financial abuse and neglect, mandatory reporting to designated authorities, and documentation

DOH requires nurses to recognize indicators of elder abuse (unexplained injuries, withdrawal, malnutrition, poor hygiene, financial irregularities), mandatorily report to designated authorities, and document findings objectively.

Question 79: Which assessment finding in a neonate at 10 minutes of life requires immediate resuscitation?

Apgar score of 3 with persistent central cyanosis and poor muscle tone (Correct answer)
Heart rate of 145 beats per minute
Apgar score of 7 with peripheral cyanosis (acrocyanosis) only
Respiratory rate of 45 breaths per minute

Correct answer: Apgar score of 3 with persistent central cyanosis and poor muscle tone

An APGAR score of 3 indicates severe neonatal depression (central cyanosis, bradycardia, absent or weak breathing, limp tone). Immediate resuscitation with positive pressure ventilation and further interventions per NRP guidelines are required. Score of 7+ is reassuring.

Question 80: A DOH-licensed nurse in Abu Dhabi is approached by a journalist asking about a patient's condition. What is the correct response?

Share general information if no names are used
Decline to provide any information; direct them to the hospital's media relations team (Correct answer)
Share information if the journalist shows official press credentials
Provide information if the patient's family has verbally consented

Correct answer: Decline to provide any information; direct them to the hospital's media relations team

Patient confidentiality is a fundamental right under UAE law and DOH standards. No clinical information may be shared with media without the patient's written consent and hospital media relations approval. Even family members have specific boundaries on what can be shared without patient consent.

Question 81: What does 'open disclosure' mean in the context of DOH Abu Dhabi patient safety standards?

Publishing all hospital infection rates online
Sharing patient data with the government for research purposes
Openly communicating to a patient and/or family when something has gone wrong in their care, including an apology (Correct answer)
Disclosing hospital financial information to patients before admission

Correct answer: Openly communicating to a patient and/or family when something has gone wrong in their care, including an apology

Open disclosure is a professional and ethical obligation to tell patients and families when something has gone wrong with their care, express genuine empathy and apology, explain what happened and why, and describe what will be done to prevent recurrence. It is a core component of patient safety culture.

Question 82: What is the correct nursing response to a patient in the psychiatric unit who is about to hit another patient?

Lock the other patient in their room and walk away
Step between them, use a calm firm voice, direct the agitated patient to a quiet area, and call for assistance (Correct answer)
Physically restrain the patient without warning
Ignore the behavior to avoid escalation

Correct answer: Step between them, use a calm firm voice, direct the agitated patient to a quiet area, and call for assistance

De-escalation is the first-line response: use a calm, firm voice, maintain safe distance, redirect to a quiet space, and call for backup. Physical intervention (restraint) is a last resort when de-escalation fails and safety is at risk. Follow facility policy on team response.

Question 83: Which nursing assessment is most important in a patient receiving magnesium sulfate for preeclampsia?

Fetal heart rate only
Daily weight and dietary intake
Blood pressure every 4 hours
Respiratory rate, deep tendon reflexes, and urine output (Correct answer)

Correct answer: Respiratory rate, deep tendon reflexes, and urine output

Magnesium sulfate toxicity progresses: first, loss of DTRs (patella reflex) at ~7–10 mEq/L, then respiratory depression at ~10–13 mEq/L, then cardiac arrest. Respiratory rate <12/min, absent DTRs, or urine output <25 mL/hr require stopping the infusion. Calcium gluconate is the antidote.

Question 84: A patient in Abu Dhabi refuses a blood transfusion on religious grounds. What is the nurse's responsibility?

Contact the patient's family to override the decision
Respect the patient's autonomous decision, document the informed refusal, and notify the treating team to explore alternatives (Correct answer)
Request a court order immediately without discussing alternatives
Proceed with the transfusion because it is life-saving

Correct answer: Respect the patient's autonomous decision, document the informed refusal, and notify the treating team to explore alternatives

Patient autonomy includes the right to refuse treatment, including blood transfusions, even on religious grounds. The nurse must document the informed refusal, ensure alternatives are explored (cell salvage, EPO, volume expanders), and the team must respect the decision. UAE law and Islamic bioethics both support informed patient autonomy.

Question 85: Which procedure is used in Abu Dhabi healthcare facilities to safely handle chemotherapy waste?

Place in regular clinical waste bin with biohazard label
No special handling required if the drug is diluted sufficiently
Flush liquid chemotherapy waste down the drain
Double bag in purple/black chemotherapy waste bags, seal, label as cytotoxic, dispose in dedicated cytotoxic waste stream (Correct answer)

Correct answer: Double bag in purple/black chemotherapy waste bags, seal, label as cytotoxic, dispose in dedicated cytotoxic waste stream

Cytotoxic/chemotherapy waste poses a carcinogenic, mutagenic, and teratogenic hazard. Dedicated purple cytotoxic waste bags, double-bagging, closed-loop disposal, PPE (gown, gloves, mask), and segregation from other clinical waste are required per DOH and international waste management standards.

Question 86: A patient is prescribed digoxin 0.125 mg daily. Which assessment finding warrants withholding the dose?

Blood pressure of 125/80 mmHg
Respiratory rate of 16 breaths per minute
Apical pulse of 68 bpm with no symptoms
Apical pulse of 52 bpm and patient reports nausea and visual disturbances (yellow halos) (Correct answer)

Correct answer: Apical pulse of 52 bpm and patient reports nausea and visual disturbances (yellow halos)

Bradycardia (<60 bpm), nausea, and visual disturbances (xanthopsia — seeing yellow-green halos) are classic signs of digoxin toxicity. The drug must be withheld, the physician notified, and a digoxin level drawn. Hyperkalemia and hypomagnesemia potentiate toxicity.

Question 87: What is the DOH Abu Dhabi standard for managing patients with substance use disorders?

Only provide detoxification
Substance use disorders are not treated in Abu Dhabi
Substance use is only a legal matter
Evidence-based assessment, withdrawal management, harm reduction strategies, therapeutic interventions, and referral to rehabilitation services (Correct answer)

Correct answer: Evidence-based assessment, withdrawal management, harm reduction strategies, therapeutic interventions, and referral to rehabilitation services

DOH supports evidence-based management of substance use disorders including validated assessment tools, safe withdrawal management, harm reduction approaches, motivational interviewing, and referral to specialized rehabilitation.

Question 88: A G1P0 woman is in active labor. The nurse notes late decelerations on the monitor. What is the most likely cause?

Fetal head compression during contractions
Fetal sleep cycle
Uteroplacental insufficiency (Correct answer)
Umbilical cord compression

Correct answer: Uteroplacental insufficiency

Late decelerations (onset after peak of contraction, slow return to baseline) are caused by uteroplacental insufficiency — the intervillous blood flow is insufficient to oxygenate the fetus during contractions. This is an ominous finding requiring position change, oxygen, and physician notification.

Question 89: An adult patient weighing 80 kg requires a dopamine infusion at 5 mcg/kg/min. The solution concentration is 400 mg in 250 mL. What is the infusion rate in mL/hr?

15 mL/hr (Correct answer)
12 mL/hr
8 mL/hr
20 mL/hr

Correct answer: 15 mL/hr

Step 1: 5 mcg/kg/min × 80 kg = 400 mcg/min. Step 2: 400 mg/250 mL = 1.6 mg/mL = 1,600 mcg/mL. Step 3: 400 mcg/min ÷ 1,600 mcg/mL = 0.25 mL/min. Step 4: 0.25 × 60 = 15 mL/hr.

Question 90: A child with a febrile seizure has stopped convulsing. What is the priority nursing action?

Administer antipyretics immediately to prevent recurrence
Insert an oral airway and prepare for intubation
Restrain the child to prevent injury during possible recurrence
Position on side, maintain airway, administer oxygen, and assess neurological status (Correct answer)

Correct answer: Position on side, maintain airway, administer oxygen, and assess neurological status

After the seizure ends, the priority is maintaining a patent airway by positioning the child on their side (recovery position) to prevent aspiration, assessing breathing, and applying oxygen. The child will typically be post-ictal and sleepy.

Question 91: Which finding should the nurse report immediately in a patient receiving heparin therapy?

aPTT of 60–80 seconds (therapeutic range met)
Urine output of 45 mL/hr
Mild bruising at the injection site
Sudden back pain and decreased blood pressure (Correct answer)

Correct answer: Sudden back pain and decreased blood pressure

Sudden back pain with hypotension in a heparinized patient suggests retroperitoneal hemorrhage or aortic dissection/hemorrhage — a life-threatening complication. This requires immediate physician notification and possible reversal with protamine sulfate.

Question 92: Which extrapyramidal side effect of antipsychotics is considered a medical emergency?

Drug-induced Parkinsonism
Tardive dyskinesia
Neuroleptic malignant syndrome (NMS) (Correct answer)
Acute dystonia

Correct answer: Neuroleptic malignant syndrome (NMS)

NMS is a rare but life-threatening reaction to antipsychotics characterized by hyperthermia, muscle rigidity, altered consciousness, and autonomic instability. Mortality can reach 10–20% without treatment. Antipsychotic must be stopped immediately and supportive care (hydration, dantrolene, bromocriptine) initiated.

Question 93: Which maternal blood type combinations require administration of Rh immune globulin (RhoGAM)?

Rh-positive mother regardless of baby's blood type
Rh-negative mother with Rh-positive baby or unknown paternity (Correct answer)
Both parents Rh-positive
Only if the baby is Rh-positive and mother is type O

Correct answer: Rh-negative mother with Rh-positive baby or unknown paternity

RhoGAM prevents Rh sensitization in Rh-negative women exposed to Rh-positive fetal blood. It is given at 28 weeks and within 72 hours of delivery if the baby is Rh-positive (or type is unknown). Also given after any pregnancy loss, amniocentesis, or abdominal trauma in Rh-negative women.

Question 94: What child safeguarding responsibilities does DOH Abu Dhabi assign to nurses?

Only social workers handle child safeguarding
Child safeguarding is not a nursing concern
Recognize signs of abuse or neglect, mandatory reporting to designated authorities, document findings objectively, and provide supportive care (Correct answer)
Only report physical abuse

Correct answer: Recognize signs of abuse or neglect, mandatory reporting to designated authorities, document findings objectively, and provide supportive care

DOH mandates that nurses recognize indicators of physical, emotional, sexual abuse, and neglect, report to designated child protection authorities, document findings objectively, and provide trauma-informed supportive care.

Question 95: What neonatal assessment must DOH Abu Dhabi nurses perform immediately after birth?

Only cord clamping
Apgar scoring at 1 and 5 minutes, vital signs, physical examination, gestational age assessment, and initiation of skin-to-skin contact (Correct answer)
Only weigh the baby
Assessment is delayed until the pediatrician arrives

Correct answer: Apgar scoring at 1 and 5 minutes, vital signs, physical examination, gestational age assessment, and initiation of skin-to-skin contact

DOH requires immediate neonatal assessment including Apgar scoring at 1 and 5 minutes, comprehensive vital signs, systematic physical examination, gestational age assessment, and facilitation of immediate skin-to-skin bonding.

Question 96: What is the DOH Abu Dhabi protocol for managing high-risk pregnancies?

High-risk pregnancies are only managed by obstetricians
Enhanced monitoring including more frequent assessments, fetal surveillance (CTG/NST), specialized care plans, and multidisciplinary team coordination (Correct answer)
All pregnancies are managed the same way
No specific protocol exists for high-risk pregnancies

Correct answer: Enhanced monitoring including more frequent assessments, fetal surveillance (CTG/NST), specialized care plans, and multidisciplinary team coordination

DOH high-risk pregnancy nursing includes increased assessment frequency, continuous or regular fetal monitoring (CTG/NST), individualized care plans, bed rest management, and coordination with obstetric and neonatal teams.

Question 97: Which assessment finding is an early sign of hypovolemic shock?

Hypotension with systolic <90 mmHg
Cyanosis and mottled skin
Anxiety and restlessness with tachycardia (Correct answer)
Unresponsiveness and absent urine output

Correct answer: Anxiety and restlessness with tachycardia

In early (compensated) hypovolemic shock, the body maintains blood pressure through sympathetic compensation, but early signs include anxiety, restlessness, and tachycardia. Hypotension is a late, decompensated sign indicating severe blood loss.

Question 98: What is the DOH Abu Dhabi standard for antenatal assessment by nurses?

Comprehensive assessment including vital signs, fundal height, fetal heart rate, urine testing, weight monitoring, and screening for gestational diabetes and pre-eclampsia (Correct answer)
Antenatal assessment is physician-only
Only check blood pressure at each visit
Only assess at the first visit

Correct answer: Comprehensive assessment including vital signs, fundal height, fetal heart rate, urine testing, weight monitoring, and screening for gestational diabetes and pre-eclampsia

DOH antenatal nursing assessment includes vital signs, fundal height measurement, fetal heart auscultation, urine dipstick, weight monitoring, gestational diabetes screening, pre-eclampsia surveillance, and psychosocial assessment.

Question 99: What intraoperative nursing responsibilities does DOH Abu Dhabi define?

Only monitor vital signs
Surgical count management, sterile field maintenance, specimen handling, patient positioning, monitoring, and documentation of all intraoperative events (Correct answer)
Only hand instruments to the surgeon
Intraoperative nursing is not defined in Abu Dhabi

Correct answer: Surgical count management, sterile field maintenance, specimen handling, patient positioning, monitoring, and documentation of all intraoperative events

DOH defines intraoperative nursing roles including surgical instrument/sponge/needle counts, maintaining sterile technique, proper specimen management, safe patient positioning, continuous monitoring, and comprehensive documentation.

Question 100: Which finding is a positive symptom of schizophrenia?

Alogia (poverty of speech)
Avolition (lack of motivation)
Flat affect and social withdrawal
Hallucinations, delusions, and disorganized speech (Correct answer)

Correct answer: Hallucinations, delusions, and disorganized speech

Positive symptoms represent an excess or distortion of normal function: hallucinations, delusions, disorganized thinking/speech, and disorganized or catatonic behavior. Negative symptoms (flat affect, alogia, avolition, anhedonia) represent loss of normal function.

Question 101: A patient's INR is 3.8 (therapeutic range 2.0–3.0 for atrial fibrillation). They have no active bleeding. What is the nurse's action?

Administer the next scheduled dose and recheck INR in 1 week
Continue the current dose; 3.8 is within an acceptable range
Give vitamin K IV immediately without consulting the physician
Hold the next warfarin dose and notify the physician for dose adjustment (Correct answer)

Correct answer: Hold the next warfarin dose and notify the physician for dose adjustment

An INR of 3.8 is above the therapeutic range for atrial fibrillation (2.0–3.0), increasing bleeding risk. The next dose should be held and the prescriber notified for dose adjustment. The INR will be rechecked after the hold. IV vitamin K is reserved for INR >10 or active bleeding.

Question 102: What is the DOH Abu Dhabi standard for safe patient handling and mobility?

Risk assessment for all patient handling tasks, use of mechanical aids when indicated, safe patient handling policies, and staff training in ergonomics (Correct answer)
Only use mechanical lifts for bariatric patients
Patient handling does not require assessment
Manual lifting is acceptable for all patients

Correct answer: Risk assessment for all patient handling tasks, use of mechanical aids when indicated, safe patient handling policies, and staff training in ergonomics

DOH mandates safe patient handling programs including risk assessment for every handling task, mechanical aids for high-risk transfers, comprehensive policies, and regular staff training in ergonomic techniques.

Question 103: A neonate is born at 34 weeks gestation. What is the primary concern in the first 24 hours?

Respiratory distress syndrome due to surfactant deficiency (Correct answer)
Neonatal abstinence syndrome
Hyperbilirubinemia from Rh incompatibility
Hypoglycemia from gestational diabetes

Correct answer: Respiratory distress syndrome due to surfactant deficiency

Premature infants at 34 weeks have immature lungs with insufficient surfactant production, making respiratory distress syndrome (RDS) the primary immediate risk. Surfactant therapy and respiratory support are the primary interventions.

Question 104: According to the Surviving Sepsis Campaign guidelines, what is the recommended initial IV fluid bolus for septic shock?

30 mL/kg of crystalloid within 3 hours (Correct answer)
1 litre of 0.45% normal saline over 4 hours
10 mL/kg of 5% dextrose
20 mL/kg of colloid (albumin 5%)

Correct answer: 30 mL/kg of crystalloid within 3 hours

The Surviving Sepsis Campaign recommends at least 30 mL/kg of IV crystalloid within the first 3 hours of recognising septic shock.

Question 105: A primigravida at 39 weeks has regular contractions every 5 minutes lasting 50 seconds. Cervix is 5 cm dilated, 80% effaced. What stage of labor is she in?

Latent phase of stage 1 labor
Stage 2 labor (pushing phase)
Active phase of stage 1 labor (Correct answer)
Stage 3 labor (placental delivery)

Correct answer: Active phase of stage 1 labor

Stage 1 labor spans onset of contractions to full dilation (10 cm). The latent phase ends at 6 cm; the active phase runs from 6 cm to 10 cm. At 5 cm, the patient is transitioning from latent to active phase — technically late latent/early active. Stage 2 begins at 10 cm.

Question 106: What is the purpose of the Surgical Safety Checklist (WHO) as adopted by DOH Abu Dhabi?

Document surgeon credentials before each case
Provide a billing record for surgical procedures
Replace the surgical consent form
Prevent surgical errors by ensuring critical safety checks at sign-in, time-out, and sign-out phases (Correct answer)

Correct answer: Prevent surgical errors by ensuring critical safety checks at sign-in, time-out, and sign-out phases

The WHO Surgical Safety Checklist reduces surgical mortality and complications through three phases: Sign-In (before anesthesia), Time-Out (before incision — final verification of patient, site, procedure), and Sign-Out (before leaving OR — instrument count, specimen labeling). Its use is mandatory in DOH-accredited facilities.

Question 107: Which cardiac rhythm requires immediate unsynchronised defibrillation?

Atrial fibrillation with rapid ventricular response
Ventricular fibrillation (Correct answer)
Third-degree (complete) heart block
Sustained ventricular tachycardia with a pulse

Correct answer: Ventricular fibrillation

Ventricular fibrillation produces no cardiac output and is a shockable rhythm requiring immediate unsynchronised defibrillation.

Question 108: What is the most appropriate nursing response when a toddler's parent asks to stay during a painful procedure?

Allow parents to stay only during non-painful procedures
Insist parents leave for all invasive procedures to maintain sterility
Ask the parent to leave to avoid emotional interference
Allow the parent to stay if they wish; presence reduces child anxiety (Correct answer)

Correct answer: Allow the parent to stay if they wish; presence reduces child anxiety

Family-centered care supports parental presence during procedures. Research shows parental presence reduces anxiety and distress in young children. Parents should be given the option and prepared for what they will see. Sterility concerns relate to technique, not visitor presence.

Question 109: What telehealth nursing standards does DOH Abu Dhabi establish?

Defined scope for telehealth consultations, documentation requirements, patient consent, privacy protection, and technology competency standards (Correct answer)
No standards exist for telehealth nursing
Only physicians provide telehealth
Telehealth nursing is prohibited

Correct answer: Defined scope for telehealth consultations, documentation requirements, patient consent, privacy protection, and technology competency standards

DOH has established telehealth nursing standards covering scope of virtual consultations, documentation requirements, informed consent, patient privacy protection, technology competency, and quality assurance measures.

Question 110: A patient prescribed furosemide (loop diuretic) should be monitored for which electrolyte imbalance?

Hyperkalemia
Hypernatremia
Hypokalemia and hypomagnesemia (Correct answer)
Hypercalcemia

Correct answer: Hypokalemia and hypomagnesemia

Loop diuretics inhibit the Na-K-2Cl cotransporter in the loop of Henle, causing loss of sodium, potassium, magnesium, and chloride. Hypokalemia and hypomagnesemia are common adverse effects requiring supplementation monitoring, especially significant in patients on digoxin.

Question 111: A patient's SpO2 drops suddenly to 87% on room air. What is the nurse's immediate priority action?

Obtain an arterial blood gas sample
Notify the physician
Administer a bronchodilator
Apply supplemental oxygen via non-rebreather mask (Correct answer)

Correct answer: Apply supplemental oxygen via non-rebreather mask

Applying supplemental oxygen immediately corrects hypoxemia and prevents further deterioration of tissue oxygenation.

Question 112: A patient in the ICU is found unresponsive with no pulse. What is the nurse's FIRST priority action?

Call for the crash cart
Begin high-quality chest compressions (Correct answer)
Apply defibrillator pads
Administer epinephrine 1 mg IV

Correct answer: Begin high-quality chest compressions

High-quality chest compressions are the first intervention in cardiac arrest as they maintain circulation to vital organs until definitive treatment is available.

Question 113: A patient with Addison's disease is brought to the emergency department in crisis. Which intervention is highest priority?

Give oral fludrocortisone and monitor blood pressure
Administer IV hydrocortisone and normal saline immediately (Correct answer)
Restrict fluid intake to prevent hyponatremia
Administer insulin to manage associated hyperglycemia

Correct answer: Administer IV hydrocortisone and normal saline immediately

Addisonian crisis is life-threatening acute adrenal insufficiency characterized by severe hypotension, hyponatremia, hyperkalemia, and hypoglycemia. IV hydrocortisone replaces deficient cortisol and IV normal saline corrects hypovolemia.

Question 114: A patient taking an MAOI antidepressant needs pain relief. Which medication is absolutely contraindicated?

Ibuprofen
Paracetamol
Morphine
Meperidine (pethidine) (Correct answer)

Correct answer: Meperidine (pethidine)

The meperidine-MAOI combination causes serotonin syndrome — a potentially fatal interaction characterized by hyperthermia, muscle rigidity, myoclonus, and autonomic instability. Meperidine increases serotonin; MAOIs prevent its breakdown. All opioids (especially fentanyl and tramadol) carry some risk, but meperidine is absolutely contraindicated.

Question 115: What is the DOH Abu Dhabi protocol for pediatric medication safety?

No special considerations for pediatric medications
Use adult dosing guidelines
Estimate doses based on age
Weight-based dosing calculations, independent double-check by two nurses, use of appropriate measuring devices, and age-appropriate formulations (Correct answer)

Correct answer: Weight-based dosing calculations, independent double-check by two nurses, use of appropriate measuring devices, and age-appropriate formulations

DOH pediatric medication safety requires weight-based dose calculation (mg/kg), mandatory independent double-check, use of oral syringes (not household spoons), and selection of age-appropriate formulations.

Question 116: What is the DOH Abu Dhabi protocol for managing aggressive or violent patients?

De-escalation techniques first, team approach, pharmacological intervention if needed, restraint only as last resort with continuous monitoring and documentation (Correct answer)
Physical restraint is the first response
Call security immediately
Aggressive patients are discharged

Correct answer: De-escalation techniques first, team approach, pharmacological intervention if needed, restraint only as last resort with continuous monitoring and documentation

DOH protocol prioritizes verbal de-escalation, followed by team-based intervention, pharmacological management if needed, with physical restraint only as a last resort requiring physician order, continuous monitoring, and detailed documentation.

Question 117: Which assessment finding indicates compartment syndrome in a patient with a lower leg cast?

Mild swelling visible above and below the cast
Severe pain unrelieved by analgesics, pallor, pulselessness, paresthesia, paralysis (Correct answer)
Cast feels tight but pain is controlled with ibuprofen
Itching under the cast

Correct answer: Severe pain unrelieved by analgesics, pallor, pulselessness, paresthesia, paralysis

Compartment syndrome is identified by the 6 P's: Pain (unrelieved), Pressure (increased), Pallor, Pulselessness, Paresthesia, and Paralysis. It is a surgical emergency requiring immediate fasciotomy. Casts must be split and bivalved promptly.

Question 118: Which position should be avoided during the third trimester to prevent supine hypotension syndrome?

Supine (flat on back) (Correct answer)
Left lateral (left side-lying)
Semi-Fowler's (30–45°)
Right lateral (right side-lying)

Correct answer: Supine (flat on back)

Supine hypotension syndrome (aortocaval compression syndrome) occurs when the gravid uterus compresses the inferior vena cava in the supine position, reducing venous return and cardiac output. Left lateral position is preferred as it displaces the uterus off the vena cava.

Question 119: A nurse is educating a patient prescribed oral bisphosphonates (alendronate) for osteoporosis. What is the most critical instruction?

Take with milk or antacids to reduce stomach upset
Crush the tablet and mix with food if swallowing is difficult
Take with a full glass of plain water, remain upright for 30 minutes, take on empty stomach (Correct answer)
Take at bedtime for best absorption

Correct answer: Take with a full glass of plain water, remain upright for 30 minutes, take on empty stomach

Bisphosphonates can cause esophageal ulceration. To prevent this: take on an empty stomach with plain water (food, coffee, and antacids reduce absorption), remain upright (sitting/standing) for at least 30 minutes, and do not crush or chew. Take first thing in the morning before any food.

Question 120: What end-of-life care considerations does DOH Abu Dhabi identify for elderly patients?

Advance care planning discussions, comfort-focused care, symptom management, spiritual and cultural support, family involvement, and bereavement support (Correct answer)
End-of-life care is the family's responsibility
Only provide pain medication
End-of-life care does not require nursing involvement

Correct answer: Advance care planning discussions, comfort-focused care, symptom management, spiritual and cultural support, family involvement, and bereavement support

DOH end-of-life care for elderly patients includes facilitating advance care planning, providing comfort-focused symptom management, addressing spiritual and cultural needs, supporting family involvement, and providing bereavement care.

Question 121: What is a normal fetal heart rate during labor?

110–160 beats per minute (Correct answer)
100–110 beats per minute
60–90 beats per minute
170–200 beats per minute

Correct answer: 110–160 beats per minute

Normal fetal heart rate baseline is 110–160 bpm. Bradycardia is <110 bpm for ≥10 minutes; tachycardia is >160 bpm for ≥10 minutes. Accelerations (15 bpm above baseline for 15 seconds) are reassuring signs of fetal well-being.

Question 122: A patient presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea. What is the nurse's priority diagnostic action?

Administer aspirin 300 mg orally
Obtain a 12-lead ECG (Correct answer)
Establish two large-bore IV lines
Administer sublingual glyceryl trinitrate

Correct answer: Obtain a 12-lead ECG

A 12-lead ECG is the priority to confirm or rule out STEMI and guide time-sensitive reperfusion decisions.

Question 123: Which electrolyte imbalance is most commonly associated with life-threatening cardiac dysrhythmias in ICU patients?

Hypomagnesaemia
Hypercalcaemia
Hypokalamia (Correct answer)
Hypernatraemia

Correct answer: Hypokalamia

Hypokalaemia reduces myocardial cell membrane stability and significantly increases the risk of ventricular dysrhythmias including VF.

Question 124: What is the DOH Abu Dhabi nursing protocol for preventing healthcare-associated infections?

Infection prevention is only during outbreaks
Implement care bundles for central lines, urinary catheters, and ventilators including daily necessity review and evidence-based insertion/maintenance practices (Correct answer)
Only use antibiotics prophylactically
Only clean rooms between patients

Correct answer: Implement care bundles for central lines, urinary catheters, and ventilators including daily necessity review and evidence-based insertion/maintenance practices

DOH requires implementation of evidence-based care bundles: CLABSI bundle (hand hygiene, maximal barriers, chlorhexidine, optimal site), CAUTI bundle (assess daily need), VAP bundle (HOB elevation, oral care, sedation vacation).

Question 125: A nurse is caring for a premature infant in an incubator. What is the purpose of the incubator?

Monitor blood glucose continuously
Provide oxygen therapy exclusively
Prevent all infections through complete isolation
Maintain thermoregulation and reduce insensible water loss (Correct answer)

Correct answer: Maintain thermoregulation and reduce insensible water loss

Premature infants lack adequate subcutaneous fat and brown fat reserves for thermoregulation. Incubators maintain a neutral thermal environment (NTE), reducing metabolic oxygen demand and insensible water loss. Temperature control is critical for survival.

Question 126: A primiparous woman is breastfeeding and reports sore, cracked nipples. What is the most appropriate advice?

Stop breastfeeding temporarily and use formula
Apply ice packs before each feeding session
Feed for no longer than 5 minutes per side
Ensure correct latch-on technique: baby's mouth covers the areola, not just the nipple (Correct answer)

Correct answer: Ensure correct latch-on technique: baby's mouth covers the areola, not just the nipple

Sore cracked nipples are almost always caused by incorrect latch-on where the infant sucks only the nipple tip. Correcting latch-on so the infant takes the full areola into the mouth eliminates nipple trauma. Expressed breast milk on the nipple aids healing.

Question 127: Which laboratory test should be monitored regularly in a patient taking valproic acid for bipolar disorder?

Blood glucose levels only
Thyroid function tests
Liver function tests (LFTs) and complete blood count (CBC) (Correct answer)
Serum creatinine only

Correct answer: Liver function tests (LFTs) and complete blood count (CBC)

Valproic acid (valproate) is associated with hepatotoxicity and thrombocytopenia. LFTs detect liver damage; CBC detects platelet count reduction. Serum valproate levels are also monitored. Thyroid monitoring is required for lithium, not valproate.

Question 128: What discharge planning requirements does DOH Abu Dhabi mandate for nurses?

Begin discharge planning on admission, coordinate with multidisciplinary team, provide patient education, arrange follow-up, and ensure medication understanding (Correct answer)
Only provide a discharge summary
Discharge planning is the physician's sole responsibility
Discharge planning begins on the day of discharge

Correct answer: Begin discharge planning on admission, coordinate with multidisciplinary team, provide patient education, arrange follow-up, and ensure medication understanding

DOH requires discharge planning from admission, including multidisciplinary coordination, comprehensive patient/family education, follow-up appointment scheduling, medication counseling, and teach-back verification.

Question 129: A patient's wound is draining thick, yellow-green fluid. How should the nurse document this finding?

Sanguineous drainage
Purulent drainage (Correct answer)
Serosanguineous drainage
Serous drainage

Correct answer: Purulent drainage

Purulent drainage is thick, opaque, and yellow-green in color, indicating bacterial infection and leukocyte activity. Serous is clear/watery, serosanguineous is pink-tinged, and sanguineous is bright red (fresh blood).

Question 130: What is the recommended site for intraosseous (IO) access in a child in cardiac arrest when IV access cannot be established?

Proximal tibia, 1–2 cm below the tibial tuberosity (Correct answer)
Distal femur above the knee
Iliac crest
Distal tibia at the ankle

Correct answer: Proximal tibia, 1–2 cm below the tibial tuberosity

The proximal tibia is the preferred IO site in children because it is easily accessible, has a flat medial surface, and is distant from chest compressions. IO access provides rapid vascular access for fluids and medications when IV access fails.

Question 131: What is the most common cause of postpartum hemorrhage?

Coagulopathy
Uterine atony (Correct answer)
Retained placental fragments
Genital tract lacerations

Correct answer: Uterine atony

Uterine atony (failure of the uterus to contract after delivery) accounts for ~80% of postpartum hemorrhage. Risk factors include prolonged labor, multiparity, overdistended uterus (twins, polyhydramnios), oxytocin augmentation, and magnesium sulfate use. The '4 T's': Tone, Tissue, Trauma, Thrombin.

Question 132: A postpartum patient develops a fever of 38.5°C on day 3. Uterine tenderness is present on palpation. What is the likely diagnosis?

Mastitis from breastfeeding
Normal postpartum fever
Urinary tract infection
Endometritis (uterine infection) (Correct answer)

Correct answer: Endometritis (uterine infection)

Puerperal fever (>38°C after 24 hours postpartum and within 10 days) with uterine tenderness suggests endometritis — infection of the uterine lining. Risk factors include prolonged labor, PROM, multiple vaginal examinations, and cesarean delivery. Broad-spectrum antibiotics are required.

Question 133: A breastfeeding mother asks why her colostrum is yellow-orange in color. What should the nurse explain?

Yellow colostrum is a sign of jaundice in the mother and should not be fed to the infant
Colostrum is rich in immunoglobulins, protein, and beta-carotene, which gives it its color and provides passive immunity (Correct answer)
The color will turn white once true milk comes in and is perfectly normal but has no special properties
The color indicates breast infection (mastitis) requiring antibiotic treatment

Correct answer: Colostrum is rich in immunoglobulins, protein, and beta-carotene, which gives it its color and provides passive immunity

Colostrum (produced in the first 2–4 days) is thick, yellow-orange, and rich in secretory IgA, lactoferrin, leukocytes, growth factors, and protein. It provides passive immunity, laxative effect (meconium passage), and perfect early nutrition. Its color comes from beta-carotene.

Question 134: Which medication requires a test dose before the first full dose due to risk of anaphylaxis?

Oral ferrous sulfate
IM vitamin B12
IV iron dextran (Correct answer)
Oral folic acid

Correct answer: IV iron dextran

IV iron dextran (not iron sucrose or ferric carboxymaltose) carries a significant risk of anaphylaxis and requires a test dose of 25 mg over 5 minutes with monitoring for 30–60 minutes before the full therapeutic dose. Oral iron and other IV iron formulations have different risk profiles.

Question 135: According to KDIGO criteria, which urine output threshold defines oliguria in acute kidney injury (AKI)?

< 30 mL/hr for 1 hour regardless of weight
< 0.5 mL/kg/hr for 6 hours (Correct answer)
< 1 mL/kg/hr for 2 hours
< 400 mL in 24 hours

Correct answer: < 0.5 mL/kg/hr for 6 hours

KDIGO defines oliguria as urine output < 0.5 mL/kg/hr for at least 6 consecutive hours, which is Stage 1 AKI.

Question 136: Which laboratory value indicates adequate control of diabetes mellitus over the past 3 months?

Random blood glucose of 220 mg/dL
Fasting blood glucose of 180 mg/dL
HbA1c of 9.5%
HbA1c of 6.8% (Correct answer)

Correct answer: HbA1c of 6.8%

HbA1c reflects average blood glucose over 2–3 months. The ADA target for most adults with diabetes is HbA1c <7%. A value of 6.8% is within acceptable control. HbA1c of 9.5% indicates poor long-term control.

Question 137: What is the recommended chest compression-to-ventilation ratio for single-rescuer adult CPR per AHA/ERC guidelines?

50:2
30:2 (Correct answer)
15:2
5:1

Correct answer: 30:2

Current guidelines recommend a 30:2 compression-to-ventilation ratio for single-rescuer adult CPR to minimise interruptions to chest compressions.

Question 138: A pregnant patient at 10 weeks has hyperemesis gravidarum. Which finding indicates the need for hospitalization?

Mild nausea without vomiting in the morning only
Ketonuria, 5% weight loss from pre-pregnancy weight, inability to tolerate any oral fluids (Correct answer)
Nausea limiting food intake to one meal per day
Vomiting 3 times per day with adequate hydration

Correct answer: Ketonuria, 5% weight loss from pre-pregnancy weight, inability to tolerate any oral fluids

Hyperemesis gravidarum requiring hospitalization is defined by persistent vomiting, dehydration (ketonuria), significant weight loss (>5% pre-pregnancy weight), and inability to tolerate any oral intake. IV fluid and antiemetic therapy are needed to prevent Wernicke's encephalopathy from thiamine deficiency.

Question 139: Which nursing intervention is MOST appropriate for a patient with raised intracranial pressure (ICP)?

Elevate the head of bed to 30–45 degrees (Correct answer)
Position the patient flat to maximise cerebral blood flow
Encourage vigorous coughing to clear airway secretions
Administer hypotonic IV fluids to dilute cerebral oedema

Correct answer: Elevate the head of bed to 30–45 degrees

Elevating the head of bed 30–45 degrees promotes venous drainage from the cranial vault, thereby reducing ICP.

Question 140: According to DOH Abu Dhabi, what is the required frequency for checking and documenting vital signs in a general medical ward patient?

Only when the patient requests it
Once daily for all ward patients
Every hour regardless of clinical condition
Frequency depends on clinical condition and physician orders; minimum typically every 4–8 hours for stable patients (Correct answer)

Correct answer: Frequency depends on clinical condition and physician orders; minimum typically every 4–8 hours for stable patients

Vital sign frequency in Abu Dhabi hospitals is guided by the patient's acuity, physician orders, and clinical deterioration protocols (EWS/NEWS). Stable ward patients may be monitored every 4–8 hours; deteriorating or high-risk patients require more frequent assessment. Clinical judgment drives frequency.

Question 141: What is the DOH Abu Dhabi framework for mental health nursing practice?

Mental health nursing follows the same protocols as general nursing
Recovery-oriented care focusing on patient empowerment, evidence-based interventions, therapeutic relationships, and community integration support (Correct answer)
Only medication administration for psychiatric patients
Mental health is not a nursing specialty in Abu Dhabi

Correct answer: Recovery-oriented care focusing on patient empowerment, evidence-based interventions, therapeutic relationships, and community integration support

DOH mental health nursing follows a recovery-oriented model emphasizing patient empowerment, evidence-based therapeutic interventions, building therapeutic relationships, family involvement, and supporting community reintegration.

Question 142: Which intervention is priority for a patient in acute pulmonary edema?

Place in Trendelenburg position to improve venous return
Lay flat, administer oral furosemide, and monitor every 4 hours
Sit upright, apply high-flow oxygen, and administer IV furosemide as ordered (Correct answer)
Administer IV fluids to improve cardiac output

Correct answer: Sit upright, apply high-flow oxygen, and administer IV furosemide as ordered

Acute pulmonary edema is a medical emergency. Sitting the patient upright reduces venous return and lung congestion. High-flow oxygen corrects hypoxemia. IV furosemide rapidly reduces preload by promoting diuresis. Oral medications act too slowly.

Question 143: What is the DOH Abu Dhabi standard for patient assessment on admission?

Comprehensive assessment including physical examination, medical history, medication reconciliation, fall risk, nutritional screening, and psychosocial assessment (Correct answer)
Only record vital signs
Only complete the admission form
Assessment is performed by physicians only

Correct answer: Comprehensive assessment including physical examination, medical history, medication reconciliation, fall risk, nutritional screening, and psychosocial assessment

DOH requires comprehensive nursing admission assessment covering physical examination, complete medical and surgical history, current medication reconciliation, fall risk, nutritional screening, pain assessment, and psychosocial evaluation.

Question 144: What is the DOH Abu Dhabi standard for medication administration safety?

Only check the patient's name
Eight Rights verification, independent double-check for high-alert medications, barcode scanning, and right documentation of administration and response (Correct answer)
Medication safety is the pharmacist's responsibility only
Follow the 5 Rights only

Correct answer: Eight Rights verification, independent double-check for high-alert medications, barcode scanning, and right documentation of administration and response

DOH extends medication safety beyond the basic 5 Rights to include right reason, right response monitoring, and right documentation, plus mandatory independent double-checks for high-alert medications and barcode verification.

Question 145: What cultural competency standards does DOH Abu Dhabi establish for nursing practice?

Cultural competency training is not provided
Only cater to local Emirati customs
Cultural considerations are not relevant to healthcare
Respect for diverse cultural and religious practices, language-appropriate communication, culturally sensitive care delivery, and awareness of Islamic healthcare considerations (Correct answer)

Correct answer: Respect for diverse cultural and religious practices, language-appropriate communication, culturally sensitive care delivery, and awareness of Islamic healthcare considerations

DOH cultural competency standards require respect for diverse cultural and religious practices, provision of interpreter services, culturally sensitive care including Islamic considerations (prayer times, Ramadan, modesty), and family-centered approaches.

Question 146: What is the DOH Abu Dhabi protocol for managing post-anesthesia complications?

Complications rarely occur
Complications are managed only in ICU
Only call the anesthesiologist for all complications
Prepared management protocols for nausea/vomiting, hypothermia, respiratory depression, hypotension, emergence delirium, and anaphylaxis (Correct answer)

Correct answer: Prepared management protocols for nausea/vomiting, hypothermia, respiratory depression, hypotension, emergence delirium, and anaphylaxis

DOH requires recovery nurses to have protocols for managing common post-anesthesia complications including PONV, hypothermia, respiratory depression, hemodynamic instability, emergence delirium, and allergic reactions.

Question 147: Which international accreditation body is commonly recognized for healthcare facilities in Abu Dhabi?

Australian Council on Healthcare Standards (ACHS)
Joint Commission International (JCI) (Correct answer)
The Leapfrog Group
National Committee for Quality Assurance (NCQA)

Correct answer: Joint Commission International (JCI)

Joint Commission International (JCI) is the most widely recognized accreditation body for healthcare organizations internationally, including in Abu Dhabi and across the UAE. Accreditation by JCI indicates compliance with global standards for patient safety and quality.

Question 148: Which nursing assessment is most important after administering morphine for post-operative pain?

Bowel sounds and last bowel movement
Level of pain using a numeric scale
Respiratory rate and oxygen saturation (Correct answer)
Blood pressure alone

Correct answer: Respiratory rate and oxygen saturation

Opioids like morphine cause respiratory depression as their primary serious adverse effect. Monitoring respiratory rate and SpO2 is critical to detect early respiratory compromise. Naloxone (reversal agent) must be immediately available.

Question 149: What health promotion activities does DOH Abu Dhabi require nurses to perform?

Patient education on lifestyle modifications, chronic disease prevention, screening programs participation, and community health awareness campaigns (Correct answer)
Health promotion is only for public health officers
Health promotion is not a nursing role
Only distribute educational brochures

Correct answer: Patient education on lifestyle modifications, chronic disease prevention, screening programs participation, and community health awareness campaigns

DOH expects nurses to actively promote health through individualized patient education, lifestyle modification counseling, participation in screening programs, and engagement in community health awareness initiatives.

Question 150: Which nursing intervention is MOST effective in preventing ventilator-associated pneumonia (VAP)?

Daily sedation vacation combined with oral care using chlorhexidine (Correct answer)
Maintaining the patient in a flat supine position
Routine prophylactic systemic antibiotics
Changing ventilator circuits every 24 hours

Correct answer: Daily sedation vacation combined with oral care using chlorhexidine

Daily sedation vacation reduces ventilator days and oral chlorhexidine reduces oropharyngeal colonisation; together they are the most evidence-based VAP prevention bundle components.

Question 151: A high peak airway pressure alarm sounds on a mechanically ventilated patient. What should the nurse do FIRST?

Increase the FiO2 setting
Call the physician immediately
Administer a bronchodilator via the ventilator circuit
Check the ventilator circuit for kinks or obstruction (Correct answer)

Correct answer: Check the ventilator circuit for kinks or obstruction

Kinked or obstructed tubing is the most common, easily correctable cause of high peak airway pressure and should be ruled out first.

DOH Nursing Practice Test (Abu Dhabi)

The Department of Health (DOH) Abu Dhabi nursing licensure exam is a computer-based Prometric/Pearson VUE test that evaluates the clinical competence, professional standards, and patient safety knowledge required to practice nursing in Abu Dhabi, UAE.

150

Questions

150 min

Time Limit

60%

To Pass

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