Mixed Deck — All DOH NURSING Topics Flashcards

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

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.

What is the most common cause of postpartum hemorrhage?

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.

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

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.

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

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.

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

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.

Which complication is of greatest concern when a child has a tracheostomy?

Answer: Accidental decannulation (tube dislodgement)

Accidental decannulation is life-threatening because the child cannot breathe without the tracheostomy tube (or cannot breathe adequately). A replacement tube of the same size and a size smaller must always be at the bedside. This is the highest-priority safety concern.

A patient on opioid analgesia has a respiratory rate of 8 breaths/min and is difficult to arouse. What is the priority intervention?

Answer: Administer naloxone (Narcan) IV/IM/IN, stimulate the patient, apply oxygen, and call for help

Respiratory rate <12/min with decreased level of consciousness indicates opioid-induced respiratory depression, a life-threatening emergency. Naloxone (opioid antagonist) must be given immediately. Oxygen supports ventilation while naloxone takes effect (1–2 minutes IV). Respiratory support may be needed.

What medication management considerations does DOH Abu Dhabi identify for elderly patients?

Answer: Age-related pharmacokinetic changes requiring dose adjustments, polypharmacy screening using tools like STOPP/START, and monitoring for adverse effects

DOH identifies age-related pharmacokinetic changes (reduced renal clearance, altered distribution), requires polypharmacy review using criteria like STOPP/START, and mandates enhanced monitoring for adverse drug reactions in elderly patients.

What community health nursing services does DOH Abu Dhabi provide?

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.

Which finding is a classic sign of deep vein thrombosis (DVT) in the lower extremity?

Answer: Unilateral calf pain, warmth, redness, and swelling

DVT classically presents with unilateral signs because the clot forms in one leg's vein. The triad of pain, warmth, and swelling results from venous obstruction and inflammation. Homan's sign is unreliable; Doppler ultrasound confirms diagnosis.

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

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.

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

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.

What is the primary mechanism of action of heparin?

Answer: Activates antithrombin III, which inhibits thrombin and factor Xa

Unfractionated heparin binds antithrombin III, dramatically enhancing its ability to inhibit thrombin (factor IIa) and factor Xa, preventing fibrin formation. It does not dissolve existing clots. Warfarin inhibits vitamin K-dependent factors; alteplase is a thrombolytic.

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

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.

Which site is preferred for intramuscular injection in adults to avoid the sciatic nerve?

Answer: Ventrogluteal site

The ventrogluteal site is the preferred IM injection site in adults because it is free of major nerves and blood vessels, has a thick muscle mass, and is easy to locate. The dorsogluteal site carries risk of sciatic nerve injury.

A nurse is preparing to administer a blood transfusion. Which action is the highest priority before starting?

Answer: Verify patient identity and blood product compatibility at the bedside with two nurses

Two-nurse verification of patient identity (using two identifiers) and blood product compatibility (ABO/Rh type, unit number, expiration) is mandatory before any transfusion to prevent potentially fatal hemolytic transfusion reactions.

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

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.

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?

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.

A patient with COPD has a PaO2 of 55 mmHg and PaCO2 of 58 mmHg. What oxygen delivery device should the nurse use?

Answer: Venturi mask at 24–28% FiO2

COPD patients may rely on hypoxic drive for respiration. Controlled low-flow oxygen via Venturi mask (24–28%) raises PaO2 to a safe level (55–65 mmHg) without eliminating the hypoxic drive. High-flow oxygen can cause CO2 retention.

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

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.