Mixed Deck — All SNLE Topics Flashcards

A patient is started on fluoxetine for depression. When should the nurse tell them to expect improvement in mood?

Answer: 2–4 weeks for full antidepressant effect

SSRIs and other antidepressants have a delayed onset of action. Mood improvement typically takes 2–4 weeks, though sleep, appetite, and energy may improve earlier. Patients must be warned to continue the medication even if they do not feel better immediately.

What does 'therapeutic milieu' mean in a psychiatric setting?

Answer: A safe, structured environment designed to promote therapeutic change through social interactions

Therapeutic milieu refers to the planned, structured, safe environment of a psychiatric unit where all aspects — physical layout, rules, staff interactions, group activities — are used as therapeutic tools to promote healing and behavioral change.

A postpartum patient develops a fever of 38.5°C on day 3 with a tender, red area on her right breast. What condition is this?

Answer: Mastitis

Mastitis is breast infection (most commonly Staphylococcus aureus) presenting with localized redness, warmth, tenderness, fever, and flu-like symptoms, typically on days 3–4 postpartum. Treatment includes antibiotics and continued breastfeeding or pumping.

What does the nurse assess using the Richmond Agitation-Sedation Scale (RASS)?

Answer: Level of sedation or agitation in critically ill patients, ranging from -5 (unarousable) to +4 (combative)

RASS rates sedation/agitation: +4 combative, +3 very agitated, +2 agitated, +1 restless, 0 alert and calm, -1 drowsy, -2 light sedation, -3 moderate sedation, -4 deep sedation, -5 unarousable. Target is typically 0 to -2 in ICU patients, adjusted to clinical needs.

Adequate postoperative protein intake is most critical for which physiological purpose?

Answer: Supporting wound healing and maintaining immune function

Protein is the primary substrate for collagen synthesis during wound healing and for immunoglobulin production, both essential for postoperative recovery.

What are a nurse's legal obligations regarding a patient who refuses a life-saving treatment?

Answer: Ensure the patient is competent, document their informed refusal, continue supportive care, notify the physician, and escalate if patient capacity is in question

Competent adult patients have the legal right to refuse any treatment in Saudi Arabia, consistent with Islamic principles of personal autonomy. The nurse's obligations are: assess competence, provide complete information, document the refusal clearly (preferably signed), notify the physician, and ensure ongoing supportive care continues.

A community health nurse is conducting a needs assessment. Which data source provides the most comprehensive population health information?

Answer: National health surveys, vital statistics, and census data combined

Comprehensive needs assessments combine multiple data sources: national health surveys (burden of disease, risk factors), vital statistics (birth/death rates, mortality causes), census data (demographics, socioeconomic factors), and community input for a complete picture.

A patient is prescribed erythromycin. What should the nurse teach about administration?

Answer: Take with food to reduce gastrointestinal side effects; avoid macrolide-drug interactions

Erythromycin frequently causes GI side effects (nausea, vomiting, abdominal cramping) due to its motilin agonist properties accelerating gut motility. Taking with food reduces GI irritation. Erythromycin inhibits CYP3A4 — important drug-drug interaction to check.

What is the purpose of an autoclave in healthcare?

Answer: To sterilize heat-resistant instruments using pressurized steam at high temperature

Autoclaves use pressurized saturated steam (typically 121°C at 15 psi for 15–20 minutes, or 134°C for faster cycles) to achieve sterilization by denaturation of microbial proteins. It is the gold standard for sterilizing heat/moisture-stable instruments.

What is the normal respiratory rate for a newborn?

Answer: 30-60 breaths/minute

Normal newborn respiratory rate is 30-60 breaths per minute. Rates above 60 (tachypnea) may indicate respiratory distress, while periodic breathing (brief pauses <10 seconds) is normal in newborns. Always count for a full 60 seconds in infants.

What concentration of alcohol-based handrub is effective against most healthcare pathogens?

Answer: 60–80% alcohol (ethanol or isopropanol)

WHO and CDC recommend alcohol concentrations of 60–80% for maximal antimicrobial activity. Concentrations below 60% are less effective; above 80%, the evaporation is too rapid for adequate denaturing time, and the formulation becomes less effective. The sweet spot is 60–80%.

Which method is used to test whether an autoclave has achieved sterilization?

Answer: Biological indicators (Geobacillus stearothermophilus spore strips)

Biological indicators using Geobacillus stearothermophilus spore strips are the gold standard for autoclave validation. These are the most heat-resistant organisms; if they are killed, sterilization was achieved. Chemical indicators (Bowie-Dick test, color-change tape) confirm exposure to steam/heat but do not confirm sterilization.

What is the recommended approach for tuberculosis contact investigation?

Answer: Screen all close contacts with TST or IGRA and treat latent TB infection in high-risk individuals

TB contact investigation identifies recently infected individuals who can progress to active TB. All close contacts receive tuberculin skin test (TST) or interferon-gamma release assay (IGRA). Positive test with no active disease = latent TB treated with isoniazid to prevent activation.

What is the recommended minimum ventilation requirement for airborne infection isolation rooms?

Answer: Negative pressure with ≥12 air changes per hour, exhausted directly outside or through HEPA filtration

Airborne infection isolation rooms must maintain negative pressure (to prevent contaminated air from escaping), achieve ≥12 air changes per hour (to dilute and remove airborne particles), and exhaust air directly outside or through HEPA filters to prevent circulation of airborne pathogens.

What is the normal fetal heart rate range?

Answer: 110–160 beats per minute

Normal fetal heart rate is 110–160 bpm. Bradycardia (160 bpm) may suggest maternal fever, fetal infection, or fetal distress.

What are the signs of dehydration in an infant?

Answer: Sunken fontanelle, dry mucous membranes, decreased tears, decreased urine output, and poor skin turgor

Infant dehydration signs: sunken anterior fontanelle, dry mucous membranes, absent tears when crying, decreased urine output (<6 wet diapers/day), poor skin turgor (tenting), tachycardia, lethargy, and sunken eyes. Severe dehydration is a medical emergency in infants.

What is the correct process for a Saudi nurse to report a near-miss incident?

Answer: Complete an incident report and submit to the quality or risk management department for learning and prevention

Near-miss reporting is a critical safety culture practice. Near-miss events (unsafe conditions that nearly caused harm) are reported through the hospital's incident reporting system to the quality/risk management department for root cause analysis and system improvement — preventing future actual harm.

What is the legal status of a nurse practicing in Saudi Arabia without a valid SCFHS license?

Answer: It is illegal — practicing without a valid license exposes the nurse and employer to criminal and professional sanctions

Practicing healthcare in Saudi Arabia without a valid SCFHS license is illegal under Saudi health law. Sanctions include criminal prosecution, deportation for expatriate workers, employer fines, and permanent ban from practicing in the Kingdom. License verification is mandatory before employment.

What is the primary nursing concern when oxytocin (Pitocin) is being used for labor induction?

Answer: Monitor for uterine hyperstimulation and fetal heart rate changes

Oxytocin can cause uterine hyperstimulation (more than 5 contractions in 10 minutes or contractions >90 seconds), which reduces uteroplacental blood flow and causes fetal hypoxia. Continuous fetal monitoring is mandatory during induction.

What is the nursing management for a patient with acute respiratory distress syndrome (ARDS)?

Answer: Low tidal volume ventilation (6 mL/kg), prone positioning, PEEP optimization, and conservative fluid management

ARDS management: lung-protective ventilation (low tidal volume 6 mL/kg ideal body weight), appropriate PEEP to maintain oxygenation, prone positioning (12-16 hours/day improves oxygenation), conservative fluid management, sedation management, and monitoring for barotrauma.