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

Question 1: What continence management does DOH Abu Dhabi require for elderly patients?

Incontinence is an expected part of aging requiring no intervention
Continence management is not a nursing role
Only use indwelling catheters
Assessment of type and cause, individualized management plan including behavioral interventions, pelvic floor exercises, and appropriate continence products (Correct answer)

Correct answer: Assessment of type and cause, individualized management plan including behavioral interventions, pelvic floor exercises, and appropriate continence products

DOH requires comprehensive continence assessment (type, cause, severity), individualized plans including timed voiding, pelvic floor exercises, fluid management, appropriate product selection, and catheter use only as a last resort.

Question 2: When performing hand hygiene using an alcohol-based hand rub, how long should the rubbing procedure take?

60–90 seconds
5–10 seconds
10–15 seconds
20–30 seconds (Correct answer)

Correct answer: 20–30 seconds

WHO guidelines specify that alcohol-based hand rub should be applied and rubbed for 20–30 seconds covering all hand surfaces until hands are dry. This duration ensures adequate antimicrobial contact time.

Question 3: Which assessment finding indicates compartment syndrome in a patient with a lower leg cast?

Cast feels tight but pain is controlled with ibuprofen
Severe pain unrelieved by analgesics, pallor, pulselessness, paresthesia, paralysis (Correct answer)
Mild swelling visible above and below the cast
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 4: What is the 'universal protocol' for preventing wrong-site, wrong-procedure, and wrong-patient surgery?

Pre-operative consent only
Anesthesiologist verification only
Pre-procedure verification, site marking by the surgeon, and time-out before incision (Correct answer)
Radiological confirmation of the surgical site 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 5: A patient taking an MAOI antidepressant needs pain relief. Which medication is absolutely contraindicated?

Meperidine (pethidine) (Correct answer)
Ibuprofen
Paracetamol
Morphine

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 6: Which medication interaction should the nurse be most concerned about when a patient on warfarin is prescribed aspirin?

No interaction exists between warfarin and aspirin
Synergistic anticoagulation/antiplatelet effect dramatically increasing bleeding risk (Correct answer)
Aspirin reverses warfarin's anticoagulant effect
Warfarin metabolism is accelerated, reducing its effectiveness

Correct answer: Synergistic anticoagulation/antiplatelet effect dramatically increasing bleeding risk

Warfarin and aspirin used together significantly increase bleeding risk through two different mechanisms: warfarin inhibits clotting factor synthesis while aspirin irreversibly inhibits platelet aggregation. This combination requires careful risk-benefit assessment and close monitoring.

Question 7: What is the DOH Abu Dhabi requirement for surgical count procedures?

Perform counts at the beginning, before closure of a cavity, at skin closure, and when team members change, with documentation and resolution of discrepancies (Correct answer)
Counts are only done at the end of surgery
Counts are optional for short procedures
Only count instruments

Correct answer: Perform counts at the beginning, before closure of a cavity, at skin closure, and when team members change, with documentation and resolution of discrepancies

DOH mandates surgical counts (instruments, sponges, needles, miscellaneous items) at specific intervals: initial count, before cavity closure, at skin closure, and during personnel changes, with mandatory discrepancy resolution before proceeding.

Question 8: A nurse is caring for a child post-tonsillectomy. Which finding requires immediate reporting?

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

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 9: A patient is admitted with diabetic ketoacidosis (DKA). Which laboratory finding is most consistent with this diagnosis?

Blood glucose >250 mg/dL, pH <7.3, bicarbonate <15 mEq/L, positive ketones (Correct answer)
Normal blood glucose with elevated ketones and normal pH
Blood glucose >126 mg/dL with normal pH and bicarbonate
Low blood glucose with elevated pH and bicarbonate

Correct answer: Blood glucose >250 mg/dL, pH <7.3, bicarbonate <15 mEq/L, positive ketones

DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.3), low bicarbonate (<15 mEq/L), and elevated ketones. This triad results from insulin deficiency causing fat breakdown and ketone production.

Question 10: What is the recommended frequency of fetal movement counting (kick counts) in the third trimester?

Count until 10 movements felt; report if <10 movements in 2 hours (Correct answer)
Count movements every 30 minutes throughout the day
Kick counts are not recommended and have no clinical value
Only count during active fetal periods after meals

Correct answer: Count until 10 movements felt; report if <10 movements in 2 hours

The '10-in-2' method: count fetal movements until 10 are felt. If fewer than 10 movements are felt in 2 hours, contact the healthcare provider. Daily kick counts in the third trimester help detect decreased fetal movement, which may indicate placental insufficiency.

Question 11: What palliative and end-of-life care standards does DOH Abu Dhabi establish for nurses?

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

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

Only check the patient's name
Medication safety is the pharmacist's responsibility only
Eight Rights verification, independent double-check for high-alert medications, barcode scanning, and right documentation of administration and response (Correct answer)
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 13: A patient prescribed furosemide (loop diuretic) should be monitored for which electrolyte imbalance?

Hypokalemia and hypomagnesemia (Correct answer)
Hypernatremia
Hypercalcemia
Hyperkalemia

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 14: What is a normal fetal heart rate during labor?

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

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 15: Under DOH Abu Dhabi policy, what patient information must be verified using two identifiers before any clinical procedure?

Patient's insurance information and nationality
Patient's room number and bed number
Patient's diagnosis and attending physician's name
Patient's full name and DOH/hospital medical record number (MRN) or date of birth (Correct answer)

Correct answer: Patient's full name and DOH/hospital medical record number (MRN) or date of birth

Two patient identifiers (full name and MRN or date of birth) must be verified before every medication administration, blood sampling, procedure, and treatment. Room number and bed number are NOT acceptable identifiers as patients move. This is a universal JCI patient safety requirement.

Question 16: What infection prevention standards does DOH Abu Dhabi mandate for nursing practice?

Infection control is the responsibility of a single department only
Comprehensive infection prevention including hand hygiene, standard and transmission-based precautions, safe injection practices, and surveillance participation (Correct answer)
No specific standards exist in Abu Dhabi
Only hand washing is required

Correct answer: Comprehensive infection prevention including hand hygiene, standard and transmission-based precautions, safe injection practices, and surveillance participation

DOH mandates comprehensive infection prevention programs including WHO hand hygiene compliance, standard and transmission-based precautions, safe injection practices, environmental cleaning standards, and active infection surveillance.

Question 17: Which finding is a positive symptom of schizophrenia?

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

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 18: Which nursing intervention is most effective in preventing hospital-acquired pneumonia in a mechanically ventilated patient?

Suction the airway every hour
Administer prophylactic antibiotics daily
Elevate the head of bed 30–45 degrees and perform regular oral care with chlorhexidine (Correct answer)
Keep the patient supine to prevent tube displacement

Correct answer: Elevate the head of bed 30–45 degrees and perform regular oral care with chlorhexidine

The ventilator bundle includes head-of-bed elevation (30–45°) to reduce aspiration risk and chlorhexidine oral care to reduce oral bacterial load. These are evidence-based VAP (ventilator-associated pneumonia) prevention measures.

Question 19: What is the DOH Abu Dhabi standard for patient assessment on admission?

Only record vital signs
Only complete the admission form
Comprehensive assessment including physical examination, medical history, medication reconciliation, fall risk, nutritional screening, and psychosocial assessment (Correct answer)
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 20: A patient with chronic obstructive pulmonary disease (COPD) is in respiratory failure. Which ABG result indicates the need for mechanical ventilation?

PaO2 of 72 mmHg, PaCO2 of 42 mmHg, pH of 7.38
PaO2 of 58 mmHg, PaCO2 of 50 mmHg, pH of 7.36
PaO2 of 45 mmHg, PaCO2 of 70 mmHg, pH of 7.20 despite maximal oxygen therapy (Correct answer)
PaO2 of 68 mmHg, PaCO2 of 45 mmHg, pH of 7.40

Correct answer: PaO2 of 45 mmHg, PaCO2 of 70 mmHg, pH of 7.20 despite maximal oxygen therapy

Severe hypoxemia (PaO2 <50 mmHg), CO2 retention (PaCO2 >70 mmHg), and respiratory acidosis (pH <7.25) despite maximal conservative therapy indicate impending respiratory failure requiring mechanical ventilation support.

Question 21: What is the recommended timing for cord clamping in a vigorous term newborn according to current guidelines?

Immediate clamping within 15–30 seconds
Delayed cord clamping at 1–3 minutes after birth (Correct answer)
Clamp when cord stops pulsating, regardless of time
Only after placenta is delivered

Correct answer: Delayed cord clamping at 1–3 minutes after birth

WHO and ACOG recommend delayed umbilical cord clamping (DCC) for at least 1 minute (preferably 1–3 minutes) in vigorous term and preterm newborns. DCC improves iron stores, reduces anemia, and provides additional blood volume from the placenta.

Question 22: Which position should be avoided during the third trimester to prevent supine hypotension syndrome?

Semi-Fowler's (30–45°)
Right lateral (right side-lying)
Supine (flat on back) (Correct answer)
Left lateral (left 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 23: Which immunization is recommended at birth for all neonates in the UAE?

Hepatitis B vaccine (Correct answer)
MMR vaccine
BCG and Hepatitis B vaccine
Rotavirus 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 24: Which action best maintains the therapeutic milieu in an inpatient psychiatric unit?

Unlimited individual freedom without any structure
Allowing only family-initiated conversations about treatment
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 25: A patient with major depression has been taking an MAOI antidepressant and eats aged cheese at dinner. The nurse notes blood pressure of 188/112 mmHg and severe headache. What has occurred?

Normal response to dietary fat intake
Serotonin syndrome from MAOI and tryptophan
Hypertensive crisis due to tyramine interaction (cheese-MAOI interaction) (Correct answer)
Anticholinergic crisis

Correct answer: Hypertensive crisis due to tyramine interaction (cheese-MAOI interaction)

MAOIs inhibit monoamine oxidase, which normally breaks down tyramine in the gut. When tyramine-rich foods (aged cheeses, cured meats, wine) are consumed, tyramine accumulates causing massive norepinephrine release and hypertensive crisis — a potentially fatal interaction.

Question 26: 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 27: 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 28: According to DOH Abu Dhabi, which category of patients must have a documented 'Do Not Attempt Resuscitation' (DNAR) order to prevent CPR?

Any patient who requests it verbally without physician documentation
All patients admitted to the ICU
All patients over age 75 years
Patients where CPR is medically futile or where the patient has made an informed refusal, documented with physician order (Correct answer)

Correct answer: Patients where CPR is medically futile or where the patient has made an informed refusal, documented with physician order

DNAR orders in Abu Dhabi (as per DOH policy and Islamic bioethical principles) require physician documentation, informed patient/family consent where appropriate, and must be reviewed regularly. Verbal requests alone are insufficient; a written physician order must be present for CPR to be withheld legally.

Question 29: Which maternal blood type combinations require administration of Rh immune globulin (RhoGAM)?

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

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 30: 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
Only physician assessment detects deterioration
National Early Warning Score (NEWS) or equivalent scoring system with defined escalation protocols and rapid response team activation criteria (Correct answer)

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 31: What is the DOH Abu Dhabi requirement for nursing quality indicators and benchmarking?

Quality is only measured annually
Track nurse-sensitive indicators including falls, pressure injuries, medication errors, infection rates, and patient satisfaction for benchmarking (Correct answer)
Only patient satisfaction is measured
Quality indicators are not tracked

Correct answer: Track nurse-sensitive indicators including falls, pressure injuries, medication errors, infection rates, and patient satisfaction for benchmarking

DOH requires healthcare facilities to track nursing-sensitive quality indicators including falls rates, pressure injury incidence, medication error rates, HAI rates, and patient satisfaction scores for ongoing benchmarking.

Question 32: 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)
No license is required
Self-declare qualifications online
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 33: Which position is most appropriate for a patient experiencing respiratory distress?

Supine
Trendelenburg
High Fowler's (90°) (Correct answer)
Prone

Correct answer: High Fowler's (90°)

High Fowler's position (head of bed at 90°) maximizes diaphragm excursion and lung expansion by using gravity to lower abdominal organs away from the diaphragm, reducing the work of breathing.

Question 34: What is the DOH Abu Dhabi standard for managing patients with substance use disorders?

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

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

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

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

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

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 37: A G4P3 mother is delivering her fourth baby rapidly. The nurse notes the umbilical cord prolapsed ahead of the baby's head. What is the immediate action?

Allow delivery to proceed since it will be rapid
Apply traction to the cord to deliver the placenta first
Place the mother in Trendelenburg and wait for the physician to decide
Manually hold the presenting part off the cord with a gloved hand and call for emergency cesarean (Correct answer)

Correct answer: Manually hold the presenting part off the cord with a gloved hand and call for emergency cesarean

Umbilical cord prolapse is an obstetric emergency. The presenting part must be manually elevated off the cord to relieve compression and preserve fetal oxygenation while preparing for emergency cesarean. The cord should be kept warm and moist. Every second counts.

Question 38: Which laboratory parameter BEST reflects adequate tissue oxygenation at the cellular level in a critically ill patient?

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

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

38–42 weeks (280 days from LMP) (Correct answer)
36–38 weeks only
32–36 weeks
44–48 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 40: What is the recommended temperature and route for assessment in an infant under 2 years?

Rectal temperature; normal range 36.6–38.0°C (Correct answer)
Oral temperature; normal range 36.4–37.4°C
Tympanic temperature in both ears averaged
Axillary temperature only for all ages

Correct answer: Rectal temperature; normal range 36.6–38.0°C

Rectal temperature is the most accurate measurement in infants and young children (under 2 years). Normal rectal temperature is 36.6–38.0°C (97.9–100.4°F). Oral temperature is unreliable in this age group. Axillary is used as a screening tool only.

Question 41: What is the DOH Abu Dhabi framework for mental health nursing practice?

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

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 42: What does a positive non-stress test (NST) indicate?

A reactive NST with at least 2 accelerations in 20 minutes indicates fetal well-being (Correct answer)
A positive NST always indicates fetal distress requiring immediate delivery
NST detects only uterine contractions, not fetal heart rate
A non-reactive NST is always normal in post-term pregnancies

Correct answer: A reactive NST with at least 2 accelerations in 20 minutes indicates fetal well-being

In NST terminology, a 'reactive' (not 'positive') NST is reassuring, showing at least 2 FHR accelerations (≥15 bpm for ≥15 seconds) in 20 minutes. A non-reactive NST requires further evaluation (biophysical profile, contraction stress test). The term 'positive' is used for CST.

Question 43: A patient presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea. What is the nurse's priority diagnostic action?

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

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 44: What enhanced recovery after surgery (ERAS) protocols does DOH Abu Dhabi support?

ERAS only applies to colorectal surgery
Only early mobilization is recommended
Evidence-based protocols including preoperative carbohydrate loading, early mobilization, multimodal analgesia, early oral nutrition, and reduced IV fluid use (Correct answer)
ERAS is not practiced in Abu Dhabi

Correct answer: Evidence-based protocols including preoperative carbohydrate loading, early mobilization, multimodal analgesia, early oral nutrition, and reduced IV fluid use

DOH supports ERAS protocols incorporating preoperative optimization, reduced fasting with carbohydrate drinks, multimodal opioid-sparing analgesia, early mobilization, early oral nutrition, and goal-directed fluid therapy.

Question 45: Which electrolyte imbalance is most commonly associated with life-threatening cardiac dysrhythmias in ICU patients?

Hypomagnesaemia
Hypercalcaemia
Hypernatraemia
Hypokalamia (Correct answer)

Correct answer: Hypokalamia

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

Question 46: A postpartum patient has severe perineal pain, swelling, and a tense bluish mass near the episiotomy site. What has occurred?

Normal postpartum edema
Rectocele
Hematoma formation (Correct answer)
Wound infection

Correct answer: Hematoma formation

A postpartum vulvar or perineal hematoma presents as a painful, tense, blue-purple mass resulting from vessel injury during delivery. Blood accumulates in the subcutaneous tissue. Small hematomas may be managed conservatively; large or expanding ones require surgical drainage.

Question 47: A nurse notices a patient's IV site is swollen, cool, and pale. What complication has occurred?

Infiltration (Correct answer)
Thrombosis
Phlebitis
Air embolism

Correct answer: Infiltration

Infiltration occurs when IV fluid leaks into surrounding tissue instead of the vein. Signs include swelling, pallor, coolness, and discomfort at the site. The IV must be discontinued immediately and the area elevated.

Question 48: What is the DOH Abu Dhabi standard for safe patient handling and mobility?

Only use mechanical lifts for bariatric patients
Risk assessment for all patient handling tasks, use of mechanical aids when indicated, safe patient handling policies, and staff training in ergonomics (Correct answer)
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 49: Which nursing intervention is MOST effective in preventing ventilator-associated pneumonia (VAP)?

Maintaining the patient in a flat supine position
Daily sedation vacation combined with oral care using chlorhexidine (Correct answer)
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 50: What occupational health nursing services does DOH Abu Dhabi require in healthcare facilities?

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

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

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

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 52: 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
Encourage the patient to cough and take deep breaths
Apply high-flow oxygen and notify the physician immediately (Correct answer)

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 53: Which sign or symptom indicates increased intracranial pressure (ICP)?

Pinpoint pupils bilaterally with normal consciousness
Tachycardia, hypotension, and fever
Diplopia alone without headache
Cushing's triad: bradycardia, hypertension, irregular respirations (Correct answer)

Correct answer: Cushing's triad: bradycardia, hypertension, irregular respirations

Cushing's triad (bradycardia, widened pulse pressure/hypertension, and irregular respirations) is a late, ominous sign of severely raised ICP indicating brainstem compression. Early signs include headache, vomiting, and papilledema.

Question 54: A pregnant patient at 10 weeks has hyperemesis gravidarum. Which finding indicates the need for hospitalization?

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

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 55: A child with suspected epiglottitis arrives at the emergency department. What action should the nurse avoid?

Attempting to visualize the throat with a tongue depressor (Correct answer)
Positioning the child in a comfortable upright position
Starting IV access
Administering nebulized epinephrine

Correct answer: Attempting to visualize the throat with a tongue depressor

In epiglottitis, inserting a tongue depressor or attempting throat examination can trigger laryngospasm and complete airway obstruction. The airway must be secured in a controlled setting (OR with anesthesia backup) before any oral examination.

Question 56: What dementia care standards does DOH Abu Dhabi establish for nursing?

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

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

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

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 58: A post-operative patient suddenly develops fever of 38.5°C on day 1. What is the most likely cause?

Wound infection
Deep vein thrombosis
Urinary tract infection from catheter
Atelectasis due to shallow breathing post-anesthesia (Correct answer)

Correct answer: Atelectasis due to shallow breathing post-anesthesia

Fever in the first 24–48 hours post-operatively is most commonly caused by atelectasis (collapsed alveoli from shallow breathing, pain, and immobility). Incentive spirometry, deep breathing, and ambulation are the treatment. Wound infections typically present after day 5.

Question 59: What suicide risk assessment does DOH Abu Dhabi require nurses to perform?

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

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

Verbal handover replaces written documentation
Documentation is optional
Accurate, timely, legible documentation of all assessments, interventions, evaluations, and patient responses in approved formats (Correct answer)
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 61: What neonatal assessment must DOH Abu Dhabi nurses perform immediately after birth?

Only cord clamping
Assessment is delayed until the pediatrician arrives
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

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 62: What is the recommended hand hygiene compliance monitoring approach in DOH-accredited Abu Dhabi facilities?

Self-reporting by nurses only
Annual compliance survey
Hand hygiene is only monitored during accreditation visits
Regular covert observation by trained auditors with feedback and public display of compliance rates (Correct answer)

Correct answer: Regular covert observation by trained auditors with feedback and public display of compliance rates

Evidence-based hand hygiene programs (WHO's SAVE LIVES: Clean Your Hands) require continuous covert observation-based auditing by trained monitors, real-time feedback to staff, and display of compliance data to drive improvement. Compliance monitoring is year-round, not only during accreditation.

Question 63: When monitoring a patient with a pulmonary artery catheter (Swan-Ganz), which measurement BEST reflects left ventricular preload?

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

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

Position the patient flat to maximise cerebral blood flow
Encourage vigorous coughing to clear airway secretions
Elevate the head of bed to 30–45 degrees (Correct answer)
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 65: What are the DOH Abu Dhabi continuing professional development requirements for nurses?

Only attend one conference per year
Nurses must accumulate specified CPD hours during each license renewal cycle covering clinical and professional topics (Correct answer)
CPD is optional but recommended
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 66: A patient with suspected myocardial infarction presents with chest pain. Which ECG finding is most indicative of STEMI?

Prolonged PR interval greater than 0.20 seconds
Peaked T waves in precordial leads
ST-segment depression in all leads
ST-segment elevation in two or more contiguous leads (Correct answer)

Correct answer: ST-segment elevation in two or more contiguous leads

STEMI (ST-elevation MI) is diagnosed when ST elevation ≥1 mm is present in two or more contiguous leads (or ≥2 mm in V1–V3). This indicates complete coronary occlusion requiring immediate reperfusion therapy.

Question 67: 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
Do not administer; notify the physician immediately, as TMP-SMX contains a sulfonamide (Correct answer)
Administer with diphenhydramine premedication
Administer and monitor for mild rash only

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

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

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 69: What is the normal resting heart rate for a 2-year-old child?

140–160 beats per minute
80–130 beats per minute (Correct answer)
50–70 beats per minute
60–100 beats per minute

Correct answer: 80–130 beats per minute

Normal heart rate ranges vary by age. Toddlers (1–3 years) have a resting HR of 80–130 bpm. This is higher than adult normal (60–100 bpm) due to higher metabolic demands and smaller stroke volume. Knowing age-specific normals prevents false alarms.

Question 70: A nurse in Abu Dhabi is caring for a patient from a non-Arabic-speaking background who does not understand English. What is required before obtaining informed consent?

Proceed with consent in English and document interpreter was unavailable
Arrange for a trained medical interpreter (not family member) to facilitate communication (Correct answer)
Ask a bilingual family member to translate informally
Delay the procedure indefinitely until the patient learns Arabic or English

Correct answer: Arrange for a trained medical interpreter (not family member) to facilitate communication

DOH standards and international ethics require that patients understand information before consenting. Trained medical interpreters ensure accuracy, neutrality, and confidentiality. Family interpreters may omit, add, or alter information and create conflicts of interest. Language barriers must not delay emergency care but must be addressed for informed consent.

Question 71: According to the Surviving Sepsis Campaign guidelines, what is the recommended initial IV fluid bolus for septic shock?

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

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

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

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 73: 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?

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

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 74: A child with nephrotic syndrome has massive edema and low serum albumin. What dietary modification is indicated?

Unrestricted diet with high fluid intake
Protein restriction and high-potassium diet
Moderate protein intake and sodium restriction (Correct answer)
High-protein, high-sodium diet to replace losses

Correct answer: Moderate protein intake and sodium restriction

In nephrotic syndrome, protein is lost in urine, causing hypoalbuminemia. Sodium restriction reduces edema by limiting water retention. Moderate protein intake replaces losses without overburdening the kidneys. High sodium worsens edema.

Question 75: What is the correct procedure for documenting a medication administration error?

Only complete an internal incident report; do not document in the chart
Document 'medication error occurred' prominently in the nurses' notes
Complete an incident report and document objectively in the patient's chart; do not write 'error' in the chart (Correct answer)
Inform the family first before any documentation

Correct answer: Complete an incident report and document objectively in the patient's chart; do not write 'error' in the chart

The incident report is an internal quality improvement tool separate from the medical record. The chart should reflect objective clinical facts (what was given, patient response, physician notification) without the word 'error,' which is a legal term.

Question 76: What is the DOH Abu Dhabi protocol for managing aggressive or violent patients?

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

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 77: Which electrolyte disturbance is most dangerous in a patient receiving digoxin therapy?

Hypercalcemia
Hypernatremia
Hypermagnesemia
Hypokalemia (Correct answer)

Correct answer: Hypokalemia

Hypokalemia potentiates digoxin toxicity because potassium and digoxin compete for the same binding site on Na+/K+-ATPase. Low potassium means digoxin has less competition, increasing its effect and causing toxicity even at therapeutic levels.

Question 78: A patient on heparin infusion develops a platelet count drop from 250,000 to 60,000 over 5 days with a new clot. What condition is most likely?

Idiopathic thrombocytopenic purpura (ITP)
Drug-induced thrombocytopenia from a different medication
Disseminated intravascular coagulation (DIC)
Heparin-induced thrombocytopenia type 2 (HIT) (Correct answer)

Correct answer: Heparin-induced thrombocytopenia type 2 (HIT)

HIT type 2 is an immune-mediated reaction to heparin-platelet factor 4 complexes, causing platelet destruction and paradoxical thrombosis. The 4T score (Thrombocytopenia, Timing, Thrombosis, oTher causes) aids diagnosis. Stop all heparin immediately.

Question 79: What disaster and emergency preparedness role do DOH Abu Dhabi nurses have?

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)
Only follow physician instructions during disasters
Nurses have no role in disaster preparedness

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

Unequal pupils (anisocoria) with altered level of consciousness (Correct answer)
Mild pedal edema in both feet
Blood pressure of 118/76 mmHg
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 81: What discharge planning requirements does DOH Abu Dhabi mandate for nurses?

Discharge planning begins on the day of discharge
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

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

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

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

Chronic disease management does not involve nurses
Patient education, self-management support, medication adherence monitoring, lifestyle counseling, and coordination of multidisciplinary care (Correct answer)
Chronic disease management is physician-only
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 84: What is the primary purpose of a Root Cause Analysis (RCA) following a sentinel event in a DOH-licensed facility?

Determine which staff member should face disciplinary action
Create legal documentation for the patient's litigation case
Satisfy accreditation documentation requirements only
Identify system and process failures contributing to the event, not to assign individual blame (Correct answer)

Correct answer: Identify system and process failures contributing to the event, not to assign individual blame

RCA is a structured, non-punitive, systems-focused investigation that identifies contributing causes and root causes of serious events. The goal is to design system improvements that prevent recurrence. A just culture separates human error (system design issues) from reckless behavior (individual accountability).

Question 85: A patient prescribed fluoxetine (SSRI) and tramadol concurrently is at risk for which condition?

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

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 86: A nurse in Abu Dhabi discovers a medication dispensing error that reached the patient but caused no harm. Should this be reported?

Report only if the physician asks
Report anonymously to the DOH directly without notifying the facility
Yes — near misses and no-harm events must still be reported through the incident management system (Correct answer)
No — only errors causing patient harm require reporting

Correct answer: Yes — near misses and no-harm events must still be reported through the incident management system

A just culture of patient safety requires reporting all adverse events, near misses, and no-harm events. Near-miss reporting is especially valuable as it identifies system vulnerabilities before serious harm occurs. DOH standards mandate a non-punitive reporting environment to encourage disclosure.

Question 87: Which over-the-counter medication is most dangerous for patients with liver failure?

Aspirin
Ibuprofen
Paracetamol (acetaminophen) (Correct answer)
Loratadine

Correct answer: Paracetamol (acetaminophen)

Paracetamol is metabolized in the liver and its toxic metabolite (NAPQI) is normally conjugated by glutathione. In liver failure, glutathione is depleted and normal doses can cause hepatotoxicity. Maximum dose in liver disease is significantly reduced. Even therapeutic doses can cause harm.

Question 88: What cultural competency standards does DOH Abu Dhabi establish for nursing practice?

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

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 89: Which statement by a patient with major depressive disorder (MDD) indicates the most immediate safety risk?

'I sometimes think life is not worth living'
'I feel very sad and have no energy'
'I used to think about suicide but not anymore'
'I have a plan to kill myself tonight with the pills I saved' (Correct answer)

Correct answer: 'I have a plan to kill myself tonight with the pills I saved'

A specific plan with identified method and timeline (tonight, saved pills) constitutes high-risk suicidal ideation requiring immediate intervention (psychiatric hold, removing means, constant observation). Passive death wish and ideation without plan carry lower immediate risk.

Question 90: 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 91: Which cardiac rhythm requires immediate unsynchronised defibrillation?

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

Correct answer: Ventricular fibrillation

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

Question 92: A patient with asthma is prescribed a short-acting beta-2 agonist (SABA) and an inhaled corticosteroid (ICS). What is the correct order of inhalation?

ICS only; SABA is not recommended with corticosteroids
Both simultaneously using a spacer
SABA first to bronchodilate, then ICS for inflammation control (Correct answer)
ICS first, then SABA after 5 minutes

Correct answer: SABA first to bronchodilate, then ICS for inflammation control

SABA (e.g., salbutamol) is inhaled first because it bronchodilates the airways within minutes, allowing the subsequently inhaled ICS (e.g., budesonide) to penetrate deeper into the bronchial tree for better therapeutic effect.

Question 93: A nurse is preparing to administer insulin. The order reads: 'Insulin glargine 20 units subcutaneously at bedtime.' What is the key safety check?

Administer IV if subcutaneous route is unavailable
Draw it up with regular insulin in the same syringe for convenience
Verify it is glargine (long-acting) and NEVER mix with any other insulin (Correct answer)
Verify the dose with only the ordering physician present

Correct answer: Verify it is glargine (long-acting) and NEVER mix with any other insulin

Insulin glargine (Lantus) is a long-acting basal insulin with a peakless profile. It must NEVER be mixed with other insulins because mixing alters its pH-dependent precipitation mechanism, changing its pharmacokinetics and making glucose control unpredictable. It is a subcutaneous-only insulin.

Question 94: 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?

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

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

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

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 96: What telehealth nursing standards does DOH Abu Dhabi establish?

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

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 97: What is the most common cause of postpartum hemorrhage?

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

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 98: What ethical guidelines does DOH Abu Dhabi establish for nursing practice?

Ethics are not regulated in Abu Dhabi
Ethics only apply to private hospitals
Only confidentiality is regulated
Professional ethics including patient autonomy, confidentiality, beneficence, non-maleficence, justice, informed consent, and cultural sensitivity (Correct answer)

Correct answer: Professional ethics including patient autonomy, confidentiality, beneficence, non-maleficence, justice, informed consent, and cultural sensitivity

DOH establishes comprehensive nursing ethics covering patient autonomy and informed consent, confidentiality and data protection, beneficence and non-maleficence, justice in care delivery, and cultural/religious sensitivity.

Question 99: A 3-year-old child is brought to the clinic. According to normal developmental milestones, which skill should the child have already mastered?

Tying shoelaces independently
Reading simple words
Drawing a person with 6 body parts
Riding a tricycle and speaking in 3-word sentences (Correct answer)

Correct answer: Riding a tricycle and speaking in 3-word sentences

By age 3, children typically ride a tricycle (gross motor) and speak in 3-word or longer sentences (language). Reading and tying shoes develop later. Drawing a person with 6 parts is a milestone for age 4–5 years.

Question 100: What is the recommended frequency for repositioning an immobile patient to prevent pressure injuries?

Every 2 hours (Correct answer)
Every 8 hours
Every hour only at night
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 101: A patient with dementia is agitated and repeatedly asks to go home. What is the best therapeutic response?

Restrain the patient to prevent elopement without any verbal interaction
Tell the patient their home was sold and they must stay
Repeatedly orient the patient to the fact they cannot go home
Use validation therapy: acknowledge the emotion and redirect with a calm, meaningful activity (Correct answer)

Correct answer: Use validation therapy: acknowledge the emotion and redirect with a calm, meaningful activity

Validation therapy acknowledges the patient's emotional reality (desire for safety, familiarity) without reinforcing delusion or causing distress through repeated reality orientation. Redirection to a comforting activity uses the patient's preserved emotional memory. Reality orientation in advanced dementia causes distress.

Question 102: Norepinephrine is the first-line vasopressor for septic shock. What is its primary mechanism of action?

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

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 103: Which position is recommended for a patient in labor with a prolapsed umbilical cord while awaiting emergency delivery?

Knee-chest position or Trendelenburg with manual elevation of presenting part (Correct answer)
Left lateral decubitus without manual cord elevation
Upright sitting position to use gravity
Lithotomy position to facilitate emergency delivery

Correct answer: Knee-chest position or Trendelenburg with manual elevation of presenting part

Knee-chest or steep Trendelenburg position, combined with manual elevation of the fetal presenting part off the cord, relieves compression of the umbilical cord and preserves oxygenated blood flow to the fetus until emergency cesarean can be performed.

Question 104: What is the recommended chest compression-to-ventilation ratio for single-rescuer adult CPR per AHA/ERC guidelines?

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

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 105: A postoperative patient develops sudden onset chest pain and dyspnea. Which complication is most likely?

Pulmonary embolism (Correct answer)
Atelectasis
Pneumonia
Pleural effusion

Correct answer: Pulmonary embolism

Sudden onset pleuritic chest pain with dyspnea in a postoperative patient is the classic presentation of pulmonary embolism, often caused by dislodgment of a DVT. This is a life-threatening emergency requiring immediate action.

Question 106: A high peak airway pressure alarm sounds on a mechanically ventilated patient. What should the nurse do FIRST?

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

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.

Question 107: A patient with a fractured femur develops sudden respiratory distress, petechiae on the chest, and confusion 24 hours post-injury. What complication has occurred?

Pulmonary embolism from DVT
Fat embolism syndrome (Correct answer)
Hypovolemic shock
Compartment syndrome

Correct answer: Fat embolism syndrome

Fat embolism syndrome classically presents 24–72 hours after a long bone fracture with the triad of respiratory distress, neurological changes, and petechiae (fat droplets occlude capillaries). It is differentiated from DVT-related PE by the petechiae and timing.

Question 108: What is the purpose of a nursing diagnosis (as defined by NANDA)?

To identify a medical disease or pathological condition
To describe a clinical judgment about a human response to health conditions (Correct answer)
To assign a patient to a specific nursing care unit
To create a billing code for insurance purposes

Correct answer: To describe a clinical judgment about a human response to health conditions

A NANDA nursing diagnosis is a clinical judgment about a patient's, family's, or community's response to actual or potential health problems. It differs from a medical diagnosis, which identifies disease. Nursing diagnoses guide nursing interventions.

Question 109: What is the DOH Abu Dhabi requirement for nutritional assessment and management in nursing?

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

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

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

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

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

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 112: 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
Ensure correct latch-on technique: baby's mouth covers the areola, not just the nipple (Correct answer)
Feed for no longer than 5 minutes per side

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 113: Which intervention is priority when a patient with anorexia nervosa is medically hospitalized?

Encourage unlimited exercise to manage anxiety
Nutritional rehabilitation and medical stabilization (electrolyte monitoring, refeeding protocol) (Correct answer)
Initiate cognitive behavioral therapy sessions immediately
Weigh the patient multiple times daily and share results

Correct answer: Nutritional rehabilitation and medical stabilization (electrolyte monitoring, refeeding protocol)

Medical priorities in anorexia include correcting electrolyte imbalances (especially hypokalemia, hypophosphatemia — refeeding syndrome), cardiac monitoring, and gradual nutritional rehabilitation. Refeeding syndrome (dangerous phosphate drop) can occur when feeding resumes too rapidly.

Question 114: 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 115: What is the antidote for benzodiazepine overdose?

N-acetylcysteine
Naloxone
Flumazenil (Correct answer)
Protamine sulfate

Correct answer: Flumazenil

Flumazenil is a competitive benzodiazepine receptor antagonist that rapidly reverses sedation and respiratory depression from benzodiazepine overdose. It has a shorter half-life than most benzodiazepines, so re-sedation can occur and repeat dosing or infusion may be needed. Naloxone reverses opioids.

Question 116: What is the DOH Abu Dhabi nursing protocol for preventing healthcare-associated infections?

Only use antibiotics prophylactically
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 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 117: Which pain assessment tool is appropriate for a 3-year-old child?

Numeric rating scale (0–10)
McGill Pain Questionnaire
FLACC scale (Faces, Legs, Activity, Cry, Consolability) (Correct answer)
Visual Analog Scale (0–10 line)

Correct answer: FLACC scale (Faces, Legs, Activity, Cry, Consolability)

The FLACC scale is used for pre-verbal children and those who cannot self-report (typically 2 months–7 years). It assesses behavioral indicators. The numeric and VAS scales require cognitive ability typically present by age 7+. Wong-Baker Faces is valid from age 3+.

Question 118: Which assessment finding in a breastfeeding newborn on day 3 of life indicates adequate milk intake?

Persistent yellow jaundice intensifying after day 5
6–8 wet diapers and 3–4 stools per day, steady weight, alert baby (Correct answer)
Weight loss of 15% from birth weight
Only 2 wet diapers in 24 hours

Correct answer: 6–8 wet diapers and 3–4 stools per day, steady weight, alert baby

Adequate intake signs: 6+ wet diapers by day 4–5, 3+ stools per day initially (may change after week 1), weight loss <7–10% of birth weight in first week, and the baby appearing satisfied after feeds. Fewer wet diapers and excessive weight loss indicate inadequate intake.

Question 119: In the ABCDE primary trauma survey, what does 'D' assess?

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

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 120: What is the primary purpose of a nursing care plan?

To assign nursing staff to patient care areas
To provide individualized, goal-directed care and ensure continuity (Correct answer)
To document billing information for hospital accounting
To satisfy accreditation requirements only

Correct answer: To provide individualized, goal-directed care and ensure continuity

A nursing care plan individualizes care based on each patient's specific diagnoses, goals, and interventions. It promotes continuity across shifts and disciplines, guides decision-making, and provides a legal record of care.

Question 121: A patient post-anterior MI develops hypotension, tachycardia, raised JVP, and cool clammy skin. Which type of shock is most consistent with these findings?

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

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

White = allergy, orange = fall risk, black = DNAR
Blue = allergy, red = DNAR, green = fall risk
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 123: According to DOH Abu Dhabi standards, what is the correct procedure for patient handover between nursing shifts?

Handover only when the patient's condition changes significantly
Quick verbal summary in the nurses' station hallway
Written note in the patient chart only, no verbal communication required
Structured bedside handover using SBAR or equivalent, with direct patient involvement where possible (Correct answer)

Correct answer: Structured bedside handover using SBAR or equivalent, with direct patient involvement where possible

DOH and JCI standards require structured, standardized handover at the bedside using a framework (SBAR) that includes the patient, promotes patient engagement, and ensures critical information is communicated. Bedside handover also allows visual patient verification and reduces error.

Question 124: What is the normal blood pressure range for a healthy 5-year-old child?

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

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

Publishing all hospital infection rates online
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
Sharing patient data with the government for research purposes

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

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

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 127: A patient with bipolar disorder is experiencing a manic episode. Which behavior is most consistent with this phase?

Profound sadness, hypersomnia, and psychomotor retardation
Grandiosity, decreased need for sleep, pressured speech, and reckless behavior (Correct answer)
Flat affect, social withdrawal, and poverty of thought
Paranoid delusions with auditory hallucinations only

Correct answer: Grandiosity, decreased need for sleep, pressured speech, and reckless behavior

Manic episodes feature elevated/expansive or irritable mood, grandiosity, decreased need for sleep (not insomnia — they feel rested with 3 hours of sleep), pressured speech, racing thoughts, distractibility, goal-directed activity, and risky behavior. Psychotic features may occur in severe mania.

Question 128: When providing oral hygiene to an unconscious patient, what is the most important safety measure?

Position the patient on their side to prevent aspiration (Correct answer)
Use a soft toothbrush with fluoride toothpaste
Wear sterile gloves throughout the procedure
Perform oral care every 8 hours only

Correct answer: Position the patient on their side to prevent aspiration

Positioning the unconscious patient on their side (lateral position) allows fluid and secretions to drain out rather than into the airway, preventing aspiration pneumonia — the primary risk during oral care for unconscious patients.

Question 129: Which nursing diagnosis is the highest priority for a patient with severe depression who is refusing to eat or drink?

Disturbed sleep pattern
Risk for self-harm and imbalanced nutrition: less than body requirements (Correct answer)
Ineffective coping
Impaired social interaction

Correct answer: Risk for self-harm and imbalanced nutrition: less than body requirements

Severe depression with refusal to eat and drink presents immediate physical safety risks (dehydration, malnutrition, medical deterioration) alongside the psychiatric risk of self-harm. Both must be addressed urgently. Physical safety and nutrition take priority over social or sleep-related diagnoses.

Question 130: What is the mechanism of action of aspirin as an antiplatelet agent?

Irreversible inhibition of COX-1 and COX-2, preventing thromboxane A2 synthesis and platelet aggregation (Correct answer)
Reversible inhibition of COX-2 only
Enhancing antithrombin III activity
Blocking ADP receptors on platelets

Correct answer: Irreversible inhibition of COX-1 and COX-2, preventing thromboxane A2 synthesis and platelet aggregation

Aspirin irreversibly acetylates and inhibits cyclooxygenase (COX-1 predominantly), blocking thromboxane A2 synthesis. Thromboxane A2 promotes platelet aggregation and vasoconstriction. Because platelets lack a nucleus and cannot synthesize new COX, the effect lasts the platelet's lifespan (7–10 days).

Question 131: What is the normal newborn blood glucose level?

110–140 mg/dL
≥45 mg/dL (2.5 mmol/L) (Correct answer)
<30 mg/dL
70–100 mg/dL

Correct answer: ≥45 mg/dL (2.5 mmol/L)

Neonatal hypoglycemia is defined as blood glucose <45 mg/dL in the first 24 hours. Normal glucose in a neonate is ≥45 mg/dL. Levels of 70–100 mg/dL are normal adult values; neonates normally run slightly lower due to ongoing adaptation.

Question 132: 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
Frequency depends on clinical condition and physician orders; minimum typically every 4–8 hours for stable patients (Correct answer)
Every hour regardless of clinical condition
Once daily for all ward patients

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

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

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 134: A pregnant woman at 36 weeks has a blood pressure of 152/98 mmHg on two readings 4 hours apart with +2 proteinuria. What condition does this indicate?

HELLP syndrome
Gestational hypertension without proteinuria
Chronic hypertension
Preeclampsia (Correct answer)

Correct answer: Preeclampsia

Preeclampsia is defined as new-onset hypertension (≥140/90 mmHg on two occasions) plus proteinuria (≥300 mg/24 hours or ≥+1 on dipstick) after 20 weeks. The patient meets both criteria.

Question 135: 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?

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

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

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

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 137: What is the nurse's appropriate response when a depressed patient says 'I'll never get better. Things will always be bad'?

Gently challenge cognitive distortion: 'You're describing things as permanent — what evidence do you have that this is always true?' (Correct answer)
Immediately change the subject
Agree: 'Yes, depression can be very difficult to treat'
Give false reassurance: 'You'll be fine in no time'

Correct answer: Gently challenge cognitive distortion: 'You're describing things as permanent — what evidence do you have that this is always true?'

The statement reflects cognitive distortions (permanence and pervasiveness) consistent with Beck's cognitive triad. A therapeutic response gently challenges the distortion using Socratic questioning while acknowledging the patient's pain. Agreeing reinforces hopelessness; false reassurance dismisses feelings.

Question 138: A breastfeeding mother asks why her colostrum is yellow-orange in color. What should the nurse explain?

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
Yellow colostrum is a sign of jaundice in the mother and should not be fed to the infant

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 139: 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)
Decline verbal/phone orders entirely under DOH policy
Immediately carry out the verbal order without documentation
Ask the physician to fax the order before acting

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 140: Which DOH Abu Dhabi standard addresses the safe use of look-alike/sound-alike (LASA) medications?

DOH medication safety standards require LASA drugs to be stored separately, clearly labeled with tall-man lettering, and listed in a facility LASA registry (Correct answer)
LASA errors are inevitable and cannot be systemically prevented
Only the pharmacy is responsible for LASA medication management
LASA drugs should be stored alphabetically with no special labeling

Correct answer: DOH medication safety standards require LASA drugs to be stored separately, clearly labeled with tall-man lettering, and listed in a facility LASA registry

LASA medication errors are a significant cause of adverse drug events. DOH/JCI standards require: a facility-specific LASA list, separate storage, tall-man lettering (e.g., hydrOXYzine vs. hydrALAzine), warning labels, and staff education. These are measurable elements of JCI medication safety standards.

Question 141: A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which finding is expected?

Normal serum sodium with high urine sodium only
Hypernatremia, dilute urine, and severe dehydration
Hyperkalemia, low urine osmolality, and polyuria
Hyponatremia, concentrated urine, and euvolemia or mild fluid excess (Correct answer)

Correct answer: Hyponatremia, concentrated urine, and euvolemia or mild fluid excess

SIADH involves excessive ADH causing water retention and dilutional hyponatremia. Urine is concentrated (high urine osmolality/sodium) despite low serum sodium. The patient is euvolemic or slightly hypervolemic, not dehydrated.

Question 142: 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 is at the xiphoid process
Fundal height measures 20 cm at the umbilicus (Correct answer)
Fundal height measures 10 cm below the umbilicus

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

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

Correct answer: Apply supplemental oxygen via non-rebreather mask

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

Question 144: What postpartum assessment does DOH Abu Dhabi require nurses to perform?

Only assess breastfeeding
Postpartum assessment is physician responsibility only
Systematic assessment of uterine involution, lochia, perineal healing, breastfeeding, vital signs, and mental health screening for postpartum depression (Correct answer)
Only check vital signs once

Correct answer: Systematic assessment of uterine involution, lochia, perineal healing, breastfeeding, vital signs, and mental health screening for postpartum depression

DOH postpartum assessment includes uterine fundal height and tone, lochia assessment (color, amount, odor), perineal/surgical wound evaluation, breastfeeding assessment, vital signs, and Edinburgh Postnatal Depression Screen.

Question 145: A patient deteriorates rapidly on a general ward. A nurse believes the treating team is not acting urgently enough. What is the appropriate escalation mechanism in Abu Dhabi hospitals?

Only the charge nurse can escalate clinical concerns
Wait for the next scheduled physician round
Activate the Rapid Response Team (RRT) or Medical Emergency Team (MET) according to calling criteria (Correct answer)
Contact the patient's family to request a different doctor

Correct answer: Activate the Rapid Response Team (RRT) or Medical Emergency Team (MET) according to calling criteria

Rapid Response Teams or Medical Emergency Teams exist specifically to prevent ICU admissions and cardiac arrests by responding early to clinical deterioration. Any nurse, patient, or family member can activate the RRT when clinical concern exists. Early escalation is encouraged and consistent with DOH patient safety culture.

Question 146: What is the purpose of administering vitamin K to a newborn immediately after birth?

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

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

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

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 148: What scope of practice guidelines does DOH Abu Dhabi establish for registered nurses?

Scope of practice is not defined in Abu Dhabi
All nurses have the same scope of practice
Nurses can perform any medical procedure
Scope is defined by qualification level, license category, competency assessment, and facility-specific privileging (Correct answer)

Correct answer: Scope is defined by qualification level, license category, competency assessment, and facility-specific privileging

DOH defines nursing scope of practice based on the nurse's qualification level (enrolled, registered, specialist), license category, individual competency assessment, and the facility's credentialing process.

Question 149: A patient rates pain as 8/10. Which nursing action takes priority?

Apply a cold compress and wait for the physician
Notify the physician immediately without intervening
Document the pain score and continue routine care
Administer prescribed analgesic and reassess in 30–60 minutes (Correct answer)

Correct answer: Administer prescribed analgesic and reassess in 30–60 minutes

A pain score of 8/10 indicates severe pain requiring prompt intervention. The nurse should administer prescribed analgesia, then reassess effectiveness within 30–60 minutes per pain management standards.

Question 150: Which procedure is used in Abu Dhabi healthcare facilities to safely handle chemotherapy waste?

No special handling required if the drug is diluted sufficiently
Place in regular clinical waste bin with biohazard label
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 151: A nurse is administering an intramuscular injection to a 6-month-old infant. Which muscle is preferred?

Dorsogluteal
Deltoid
Vastus lateralis (anterolateral thigh) (Correct answer)
Rectus femoris

Correct answer: Vastus lateralis (anterolateral thigh)

The vastus lateralis is the preferred IM injection site for infants <1 year because the deltoid is too small and the dorsogluteal carries sciatic nerve risk. The anterolateral thigh has well-developed muscle mass in infants.

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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