Exame Nacional da Ordem dos Enfermeiros de Angola (ORDENFA)

In the professional practice of nursing, what is the correct chronological sequence of the five interrelated phases of the Nursing Process (Sistematização da Assistência de Enfermagem - SAE)?

• ANursing Diagnosis, Medical Prescription, Implementation, Assessment, and Discharge
• BPlanning, Nursing Assessment, Intervention, Evaluation, and Prognosis
• CNursing Assessment (Investigação), Nursing Diagnosis, Planning, Implementation, and Evalu…
• DNursing Assessment, Planning, Medical Diagnosis, Execution, and Outcome Review

According to standard clinical guidelines for adult vital signs, what are the normal reference parameters for resting blood pressure in a healthy adult?

• ASystolic blood pressure between 140 and 159 mmHg and diastolic blood pressure between 90…
• BSystolic blood pressure below 120 mmHg and diastolic blood pressure below 80 mmHg
• CSystolic blood pressure between 130 and 139 mmHg and diastolic blood pressure between 85…
• DSystolic blood pressure below 90 mmHg and diastolic blood pressure below 60 mmHg

What is the standard methodological sequence for conducting a general physical examination on an adult patient?

• APalpation, Inspection, Auscultation, and Percussion
• BAuscultation, Percussion, Inspection, and Palpation
• CPercussion, Palpation, Auscultation, and Inspection
• DInspection, Palpation, Percussion, and Auscultation

Why is the sequence of physical examination modified specifically during abdominal assessment to Inspection, Auscultation, Percussion, and Palpation?

• APalpation and percussion can stimulate peristalsis and artificially alter bowel sounds pr…
• BAuscultation must always be performed when the abdominal musculature is completely tensed…
• CInspection and percussion provide all diagnostic data without the need for manual palpati…
• DBowel motility ceases permanently if deep palpation is performed before percussion

Which bed elevation angle corresponds to the High-Fowler position, and in which clinical situation is it most urgently indicated?

• AHead of bed elevated 15 to 30 degrees; indicated for pelvic surgery recovery
• BBed completely horizontal with feet elevated 45 degrees; indicated for severe hypoxemia
• CHead of bed elevated 60 to 90 degrees; indicated for acute respiratory distress and sever…
• DHead of bed elevated 30 to 45 degrees; indicated exclusively for spinal cord shock

What is the primary hemodynamic purpose and risk of placing a patient in the Trendelenburg position (bed tilted with feet higher than head)?

• AIt decreases central venous pressure while permanently curing cardiogenic pulmonary edema
• BIt prevents aspiration of gastric contents during general anesthesia induction without af…
• CIt accelerates renal filtration while completely eliminating the risk of cerebral edema
• DIt promotes venous return from lower extremities in acute hypotension, but increases intr…

Where is the precise anatomical landmark located for auscultating the apical pulse (point of maximal impulse - PMI) in an adult?

• ASecond intercostal space at the right sternal border
• BFifth intercostal space at the left midclavicular line
• CSecond intercostal space at the left sternal border
• DFourth intercostal space at the right midclavicular line

What are the three behavioral assessment components and the minimum/maximum score range of the Glasgow Coma Scale (GCS)?

• AEye opening (1-4), Verbal response (1-5), and Motor response (1-6); total score ranges fr…
• BPupillary reflex (1-5), Respiration (1-5), and Mobility (1-5); total score ranges from 0…
• CEye opening (1-3), Speech (1-3), and Reflexes (1-4); total score ranges from 1 to 10
• DBlood pressure (1-4), Pulse (1-4), and Temperature (1-4); total score ranges from 3 to 12

According to the international National Pressure Injury Advisory Panel (NPIAP) staging system, which clinical finding characterizes a Stage 2 pressure ulcer (lesão por pressão de estágio 2)?

• ANon-blanchable erythema of intact skin over a bony prominence
• BFull-thickness skin loss with visible subcutaneous adipose tissue, slough, and epibole
• CFull-thickness skin and tissue loss with directly palpable exposed muscle, tendon, ligame…
• DPartial-thickness skin loss with exposed dermis, presenting as a shallow open ulcer with…

Which six clinical subscales constitute the Braden Scale used by nurses to predict pressure injury risk in hospitalized patients?

• AAge, Blood pressure, Oxygen saturation, Capillary refill, Consciousness, and Edema
• BSensory perception, Moisture, Activity, Mobility, Nutrition, and Friction & Shear
• CBody mass index, Pain score, Serum albumin, Hemoglobin, Temperature, and Hygiene
• DPhysical condition, Mental state, Incontinence, Hydration, Sleep quality, and Pulse rate

In clinical thermometry, what core body temperature threshold defines clinical fever (pyrexia / febre) when measured orally or tympanically in an adult?

• ABody temperature equal to or greater than 38.0 °C (100.4 °F)
• BBody temperature between 36.5 °C and 37.2 °C (97.7 - 99.0 °F)
• CBody temperature equal to or greater than 42.0 °C (107.6 °F)
• DBody temperature below 35.0 °C (95.0 °F)

What does each letter represent in the widely utilized PQRST mnemonic for comprehensive nursing pain assessment?

• APain score, Quantity, Respiration, Temperature, and SpO2
• BPosition, Quickness, Relief, Sensation, and Treatment
• CProvocation/Palliation, Quality, Region/Radiation, Severity, and Timing/Duration
• DPathology, Questioning, Rest, Symptoms, and Therapy

In a hospitalized adult patient, what 24-hour urinary output threshold defines clinical oliguria (oligúria)?

• AUrine volume greater than 2,500 mL in 24 hours
• BUrine volume less than 400 mL in 24 hours (or less than 0.5 mL/kg/hour for 6 consecutive…
• CUrine volume between 1,000 mL and 1,500 mL in 24 hours
• DUrine volume strictly equal to 0 mL over 72 hours

What is the most reliable bedside method for a nurse to verify the correct gastric position of a newly inserted nasogastric tube (sonda nasogástrica) prior to initiating enteral feeding?

• AInjecting 30 mL of air through the tube while auscultating a 'whoosh' over the epigastriu…
• BImmersing the external end of the tube in a cup of water and observing for continuous bub…
• CAsking the patient if they feel the tube entering their stomach and inspecting their tong…
• DAspirating gastric fluid and testing its acidity with pH indicator paper (pH <= 5.5 in fa…

Which oxygen delivery system provides a precise, predictable fraction of inspired oxygen (FiO2) regardless of the patient's breathing pattern, making it the device of choice for acute COPD exacerbations?

• ASimple face mask (Máscara facial simples)
• BVenturi mask (Máscara de Venturi)
• CStandard nasal cannula (Óculos nasais)
• DNon-rebreather mask with reservoir bag (Máscara com reservatório não reinalante)

Which clinical condition represents a major absolute contraindication to performing chest percussion, vibration, and postural drainage in a hospitalized patient?

• AUnstable cervical spine injury, severe pulmonary hemorrhage/hemoptysis, or acute untreate…
• BChronic cystic fibrosis with retained viscous bronchial secretions
• CAtelectasis of the right middle lobe in a fully cooperative patient
• DBronchiectasis with daily productive sputum of 50 mL

What is the primary mechanism of action of sequential compression devices (intermittent pneumatic compression) in preventing deep vein thrombosis (DVT) in bedridden postoperative patients?

• AThey chemically lyse formed intravascular fibrin thrombi in the femoral vein
• BThey permanently paralyze arterial vascular smooth muscle to lower systemic vascular resi…
• CThey simulate the calf muscle pump to increase venous blood velocity and stimulate endoth…
• DThey restrict arterial inflow into the lower limbs to reduce peripheral edema

What are the four recognized biological phases of surgical wound healing, listed in their correct physiological order?

• AProliferation, Hemostasis, Epithelialization, and Necrosis
• BInflammation, Fibrosis, Hemostasis, and Exudation
• CMaceration, Debridement, Collagenolysis, and Hypertrophy
• DHemostasis, Inflammation, Proliferation (granulation), and Maturation (remodeling)

When performing endotracheal or tracheostomy suctioning on an adult patient, what are the maximum recommended suction duration, catheter size rule, and suction pressure to prevent hypoxemia and mucosal trauma?

• ASuction applied for no more than 10 to 15 seconds per pass, catheter diameter <= 1/2 of a…
• BSuction applied continuously for 45 seconds, catheter diameter equal to airway diameter,…
• CSuction applied for 30 seconds on insertion only, with negative pressure set at 40 mmHg
• DSuction applied for 60 seconds with hyperventilation omitted to preserve carbon dioxide

A nurse calculates the 24-hour fluid balance (Balanço Hídrico) for a patient. Total intake includes: 1,500 mL IV fluids, 500 mL enteral feed, and 200 mL IV antibiotic flushes. Total output includes: 1,200 mL urine, 400 mL nasogastric drainage, and 100 mL surgical wound drainage. What is the net 24-hour fluid balance?

• A-500 mL (negative balance)
• B+1,200 mL (positive balance)
• C+500 mL (positive balance)
• D+2,200 mL (positive balance)

Which scenario corresponds to Moment 3 of the World Health Organization (WHO) '5 Moments for Hand Hygiene' in clinical nursing care?

• ABefore touching a patient when entering the examination cubicle
• BBefore performing a clean/aseptic procedure such as inserting an intravenous cannula
• CAfter touching patient surroundings such as adjusting the bed railing when leaving the ro…
• DAfter body fluid exposure risk (após risco de exposição a fluidos corporais), such as aft…

What are the recommended durations for performing hand hygiene with an alcohol-based handrub (fricção anti-séptica) versus washing with soap and running water (lavagem com água e sabão)?

• AAlcohol-based handrub: 20 to 30 seconds; Soap and water handwashing: 40 to 60 seconds
• BAlcohol-based handrub: 5 seconds; Soap and water handwashing: 15 seconds
• CAlcohol-based handrub: 2 minutes; Soap and water handwashing: 5 minutes
• DAlcohol-based handrub: 10 seconds; Soap and water handwashing: 20 seconds

To which patient population do Standard Precautions (Precauções Padrão) apply in healthcare facilities?

• AExclusively to patients with confirmed seropositive HIV or Hepatitis B virus infections
• BOnly to patients admitted to intensive care units and isolation wards
• CTo all patients receiving care in healthcare facilities, regardless of their presumed or…
• DExclusively to surgical patients during invasive intraoperative procedures

Which combination of personal protective equipment and environmental engineering controls is mandatory when caring for a patient on Airborne Precautions (Precauções para Via Aérea / Aerossóis), such as active pulmonary tuberculosis?

• AStandard surgical paper mask and positive pressure room with windows opened to the hallway
• BN95/FFP2 particulate respirator, negative pressure isolation room with >= 12 air changes…
• CSimple cloth mask and placement in a general open multi-bed ward at least 1 meter away fr…
• DGloves and apron only, with no respiratory protection required if visiting for less than…

Which infectious disease requires Droplet Precautions (Precauções para Gotículas), and what is the primary personal protective equipment required within 1 to 2 meters of the patient?

• ANeisseria meningitidis (Meningococcal meningitis); surgical mask worn when working within…
• BVaricella zoster (Chickenpox); sterile latex gloves alone
• CClostridioides difficile colitis; FFP3 respirator alone
• DHepatitis A; eye goggles without a mask

For a patient colonized with Methicillin-Resistant Staphylococcus aureus (MRSA) in an open wound, what are the essential Contact Precautions required?

• AN95 particulate respirator and full positive-pressure spacesuit
• BPlacement in an open ward without gloves provided the nurse washes hands once at the end…
• CProhibiting any direct nursing assessment and administering all care through an intercom
• DClean non-sterile gloves and isolation gown upon entering the room, dedicated patient-car…

When doffing Personal Protective Equipment after caring for a patient on Airborne Precautions (e.g., pulmonary tuberculosis), why must the particulate respirator (N95/FFP2) be removed last, and only after leaving the isolation room?

• ABecause the respirator is the least contaminated piece of equipment and can therefore be…
• BBecause removing the respirator inside the room would expose the nurse's unprotected airw…
• CBecause keeping the respirator on longest reduces the nurse's oxygen consumption during t…
• DBecause the respirator must be removed at the same time as the gloves to prevent hand con…

What are the standard operational physical parameters (temperature, pressure, and exposure time) for steam sterilization in a hospital autoclave?

• A100 °C at 0.5 atm for 5 minutes
• B180 °C at 5.0 atm for 24 hours
• C121 °C at 1.0 atm (15 psi) for 15 to 30 minutes, or 134 °C at 2.0 atm (30 psi) for 3 to 5…
• D80 °C at ambient pressure for 60 minutes

A nurse is reprocessing a flexible gastrointestinal endoscope that contacted intact mucous membranes during a procedure. Under the Spaulding classification, what is the minimum required level of reprocessing before the device can be reused?

• ALow-level disinfection with 70% alcohol alone, since the device only contacted the patien…
• BHigh-level disinfection (HLD) with an approved agent such as ortho-phthalaldehyde or pera…
• CSimple rinsing with sterile water followed by air drying, since all visible soil was remo…
• DTerminal steam sterilization in an autoclave at 134 °C, which is mandatory for every reus…

In the hospital waste management system (Gestão de Resíduos Hospitalares) applied in Angolan health units, what type of waste belongs to Grupo IV (perfurocortantes), and how must it be discarded?

• ANon-infectious general administrative paper and cardboard; discarded in ordinary black pl…
• BAnatomical pathology body parts and placentas; discarded in transparent domestic trash ca…
• CRadioactive isotopes and heavy metals; poured directly into the municipal sanitary sewer
• DSharps waste (needles, scalpel blades, glass ampoules); discarded immediately in rigid, p…

If a nurse sustains an accidental needlestick injury (picada de agulha) from a hollow-bore needle used on an HIV/HBV-positive patient, what are the immediate first-aid action and recommended timeframe for initiating Post-Exposure Prophylaxis (PEP)?

• ASqueeze the puncture site vigorously until it bleeds profusely, immerse the finger in 100…
• BApply a tight tourniquet above the wrist, cauterize the skin with flame, and withhold ant…
• CWash the puncture site immediately with soap and copious running water (without forcefull…
• DDo nothing because hollow-bore needles carry zero risk of viral transmission

Which evidence-based bundle of interventions has been proven to significantly reduce Central Line-Associated Bloodstream Infections (CLABSI / Infecções da Corrente Sanguínea)?

• ARoutine femoral vein insertion, dry gauze without antiseptic, and keeping lines in place…
• BChanging the central venous catheter every 48 hours over a guidewire through infected skin
• CApplying topical antibiotic ointment to the catheter insertion site at every nursing shift
• DStrict hand hygiene, maximal sterile barrier precautions during insertion, 2% chlorhexidi…

What is the key nursing measure to prevent Catheter-Associated Urinary Tract Infections (CAUTI / ITU associada a sonda vesical) in a patient with an indwelling Foley catheter?

• AMaintain an unobstructed closed drainage system, keep the collection bag below the level…
• BDisconnect the drainage bag twice daily to flush the catheter with non-sterile tap water
• CKeep the drainage collection bag placed on the patient's chest during bed transfers
• DRoutinely replace the urinary catheter every 3 days regardless of clinical necessity

In preoperative preparation to prevent Surgical Site Infections (SSI / Infecção do Sítio Cirúrgico), why is electric clipping preferred over shaving with a razor blade for hair removal?

• ARazor shaving permanently prevents hair follicles from ever regrowing after surgery
• BRazor shaving causes microscopic cutaneous abrasions and epidermal microtrauma that harbo…
• CClipping sterilizes the subcutaneous fat layer through magnetic radiation
• DClipping eliminates the need for intraoperative skin antiseptic preparation

What is the recommended procedure and disinfectant concentration for managing a substantial hospital spill of blood or bodily fluids on the floor?

• AMop the blood directly across the ward floor using hot water only
• BSpray 70% alcohol directly onto pool of blood without cleaning up the blood first
• CCover the spill with dry sand and leave it in place for 48 hours to dry
• DDon PPE, absorb gross blood with disposable absorbent towels, clean with detergent and wa…

What are the fundamental 'Rights' of safe medication administration (Certos da Administração de Medicamentos) that a nurse must verify before administering any drug?

• ARight physician, Right pharmacy, Right hospital, Right insurance, and Right bed number
• BRight room, Right nurse, Right syringe brand, Right needle gauge, and Right day
• CRight patient, Right medication, Right dose, Right route, Right time, and Right documenta…
• DRight diagnosis, Right cost, Right manufacturer, Right expiration code, and Right storage…

Why is the ventrogluteal muscle (glúteo ventral) considered the preferred, safest anatomical site for deep intramuscular (IM) injections in adults?

• AIt provides a deep, thick muscle mass free of major blood vessels and the sciatic nerve,…
• BIt contains the main trunk of the sciatic nerve which accelerates drug absorption into th…
• CIt has no sensory pain receptors, rendering intramuscular injections completely painless
• DIt is the only site where medications can be injected directly into the peritoneal cavity

What is the maximum safe medication volume that can be administered via intramuscular injection into the deltoid muscle in an adult, and what anatomical landmark identifies the site?

• AMaximum 5 to 7 mL; landmarked at the posterior axillary fold
• BMaximum 1 to 2 mL; landmarked 2 to 3 fingerbreadths (3 to 5 cm) below the lower edge of t…
• CMaximum 10 mL; landmarked directly over the lateral clavicle bone
• DMaximum 0.1 mL; landmarked 10 cm above the olecranon process

What is the correct needle insertion angle and technique for administering a subcutaneous injection (e.g., low-molecular-weight heparin or insulin)?

• AInsert at a 10-degree angle with bevel facing downwards, and vigorously rub the site for…
• BInsert at a 90-degree angle into the periosteum, aspirate vigorously until bone marrow ap…
• CInsert at a 45-degree angle (or 90-degree angle if grasping a 2-inch skinfold), do not as…
• DInsert parallel to the skin at 0 degrees, aspirate 5 mL of blood, and massage deeply

What is the proper technique and expected immediate physical outcome when administering an intradermal (ID) injection for a Mantoux tuberculin skin test (PPD / Prova Tuberculínica)?

• AInsert 26-27 gauge needle at a 10 to 15-degree angle with bevel facing upward into the de…
• BInsert 18 gauge needle at a 90-degree angle deep into muscle to create a large intramuscu…
• CInsert at 45 degrees into subcutaneous fat without forming any visible surface elevation
• DApply the solution topically on intact skin with a cotton swab without penetrating the st…

A physician prescribes 500 mL of 0.9% Normal Saline (Soro Fisiológico) to be infused intravenously over 6 hours. The infusion administration set has a standard macrodrip drop factor of 20 drops/mL. What is the calculated flow rate in drops per minute (gotas/min)?

• A17 drops/minute
• B28 drops/minute
• C42 drops/minute
• D56 drops/minute

A pediatric patient is prescribed 250 mL of 5% Dextrose in Water to be infused over 4 hours using a microdrip infusion set (drop factor: 60 microdrops/mL). What is the calculated flow rate in microdrops per minute (microgotas/min)?

• A63 microdrops/minute (62.5 mL/hr)
• B21 microdrops/minute
• C125 microdrops/minute
• D40 microdrops/minute

A 24 kg child with acute bacterial sinusitis is prescribed Amoxicillin oral suspension at 50 mg/kg/day divided into 3 equal doses every 8 hours. The available suspension concentration is 250 mg / 5 mL. How many milliliters (mL) should the nurse administer per single dose?

• A24.0 mL per dose
• B4.0 mL per dose
• C16.0 mL per dose
• D8.0 mL per dose