Free MOH Kuwait RN Exam Flashcards

Normal adult respiratory rate is 12-20 breaths/min. A rate below 10 or above 24 breaths/min, or visible use of accessory muscles, signals distress and requires immediate provider notification, not just re-measurement.

This is a hypertensive crisis (systolic 180 mmHg or higher, or diastolic 120 mmHg or higher). Priority is to recheck the reading, assess for end-organ symptoms (headache, vision changes, chest pain), and notify the provider immediately.

An N95 (or higher) fit-tested respirator, plus care in a negative-pressure room. Airborne precautions guard against pathogens on small droplet nuclei (TB, measles, varicella) that stay suspended in air, unlike droplet precautions, which only need a surgical mask.

Gloves first, then goggles/face shield, then gown, then mask/respirator last. Gloves come off first because they are usually the most contaminated item; the mask stays on until last to protect the nurse's airway while removing the other contaminated items.

Right documentation (chart immediately after giving, never before) and right to refuse (respect and document the patient's autonomy to decline a medication, then notify the provider).

Room number is never an acceptable identifier because patients can be moved or share rooms. The 'right patient' check requires two identifiers, such as full name plus date of birth or medical record number, matched against the order.

The patient's most current, accurately measured weight in kilograms, not an estimate. The ordered mg/kg is then multiplied by that weight; using an outdated or estimated weight is a leading cause of dosing errors, especially in pediatric and critical care patients.

mL/hr = total volume (mL) divided by total time (hours); 1,000 mL over 8 hours equals 125 mL/hr. For gravity infusions, the drip rate further multiplies this by the tubing's drop factor and divides by 60 minutes.

An INR of 5.2 is well above the typical therapeutic range of 2-3 and indicates a high bleeding risk. The nurse holds the next dose, notifies the provider, and monitors closely for bleeding signs such as gums, urine, stool, or bruising.

Stop or slow the feeding, assess bowel sounds, and reassess the residual before resuming per protocol, rather than increasing the feeding rate. High residuals raise the risk of aspiration and feeding intolerance.

Obtain a 12-lead ECG within minutes and assess for ST-segment elevation, which helps distinguish an acute MI from stable angina. Angina typically eases with rest or nitroglycerin; MI pain does not.

Muffled heart sounds, jugular venous distension, and hypotension. This triad indicates cardiac tamponade, in which fluid in the pericardial sac compresses the heart and impairs its filling.

This is acute pulmonary edema from fluid backing up into the lungs. High-Fowler's position (upright, legs dependent) reduces venous return and eases breathing while oxygen and diuretics are given.

Right-sided failure causes systemic congestion: peripheral or dependent edema, jugular venous distension, and hepatomegaly. Left-sided failure causes pulmonary congestion: crackles, dyspnea, and orthopnea.

It prolongs exhalation and creates back-pressure that keeps small airways open longer, reducing air trapping and CO2 retention, which relieves the dyspnea characteristic of COPD.

Pulmonary embolism. Immobility is a major risk factor for DVT that can embolize to the lungs; the nurse notifies the provider immediately, applies oxygen, and prepares for anticoagulation or thrombolytic therapy.

Continuous bubbling in the water-seal chamber signals an air leak in the system and needs investigation. Tidaling (fluid rising with inspiration, falling with expiration) is expected and confirms the tube is patent and connected to a functioning lung.

Diabetic ketoacidosis (DKA). The key distinguishing finding versus HHS is the presence of ketones in blood and urine along with a low serum pH/bicarbonate, reflecting metabolic acidosis from fat breakdown.

This is hypoglycemia (glucose below 70 mg/dL). Because the patient is alert and can swallow, give 15-20 g of fast-acting oral carbohydrate, recheck glucose in 15 minutes, and repeat if still low, following the 'rule of 15'.

Potassium. Failing kidneys cannot excrete potassium normally, so hyperkalemia can develop and cause life-threatening cardiac dysrhythmias; the nurse monitors serum potassium and ECG changes such as peaked T waves closely.

Stop and notify the surgeon or provider before proceeding; do not witness or move forward with the consent. Informed consent requires the physician to explain the procedure, and the patient must demonstrate understanding before signing.

Airway, breathing, and level of consciousness. Anesthesia effects can compromise the airway and respiratory drive first, so ABCs are assessed before pain or other comfort needs.

A dusky or purple stoma indicates poor perfusion or ischemia and is a surgical emergency. The nurse notifies the surgeon immediately rather than waiting for the next scheduled assessment.

Hypovolemic shock, caused by fluid or blood volume loss. Priority treatment is rapid volume replacement with IV fluids and/or blood products, along with controlling the source of loss.

Epinephrine, given first in anaphylactic shock. It is first-line because it reverses bronchospasm and vasodilation faster than antihistamines or steroids, which are adjunct treatments.

Early septic shock often presents with warm, flushed skin from vasodilation caused by the infectious/inflammatory response, while hypovolemic shock presents with cool, pale, clammy skin from peripheral vasoconstriction.

The newly discharged colostomy client, because they have an unmet learning need and higher risk of complications without teaching. Community nursing prioritizes clients with unstable conditions or unmet safety/education needs over stable, routine follow-ups.

Coordinating an individualized health plan, ensuring rescue medication such as a bronchodilator inhaler is accessible, and educating school staff to recognize and respond to an exacerbation, emphasizing primary and secondary prevention.

Ask directly about the plan and means, then ensure immediate safety by removing access to means, initiating close observation, and notifying the provider. Direct questioning does not increase risk and is required whenever suicidal ideation is suspected.

Reduce environmental stimuli such as dim lighting, low noise, and fewer people present; speak calmly and simply; and maintain a safe distance and exit path, rather than confronting or arguing with the patient's perceptions.

Preeclampsia is suspected, since it involves hypertension plus proteinuria after 20 weeks gestation. New-onset seizures indicate progression to eclampsia, a medical emergency treated with IV magnesium sulfate.

Magnesium sulfate prevents and treats seizures. The nurse monitors deep tendon reflexes, respiratory rate, and urine output closely, because magnesium toxicity causes loss of reflexes and respiratory depression; calcium gluconate is the antidote.

RhoGAM (Rh immune globulin) is given at approximately 28 weeks gestation, and again within 72 hours after delivery if the newborn is Rh-positive, to prevent maternal sensitization affecting future pregnancies.

Between 24 and 28 weeks gestation, using an oral glucose challenge test; earlier screening is done for patients with pre-existing risk factors such as obesity or a prior history of gestational diabetes.

Late decelerations, indicating uteroplacental insufficiency (reduced fetal oxygenation). First action is to reposition the mother onto her side, give oxygen, increase IV fluids, stop oxytocin if infusing, and notify the provider.

Blood loss over 500 mL after a vaginal delivery (over 1,000 mL after cesarean). For a boggy, soft fundus, the nurse performs fundal massage first, since uterine atony is the most common cause of postpartum hemorrhage.

The fundus should be firm and at or near the level of the umbilicus on day 1, then descend about 1 cm (one fingerbreadth) per day. A fundus that is boggy, higher than expected, or deviated from midline suggests atony or a full bladder.

Colostrum, the thick, antibody-rich first milk, is sufficient to meet the newborn's nutritional needs in the first days; supplementation is not routinely needed, and frequent early feeding stimulates milk production.

Appearance (color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration, each scored 0-2. It is assessed at 1 minute and 5 minutes after birth, and repeated at 10 minutes if the 5-minute score is low.

Yes. Normal newborn heart rate is 110-160 bpm and respiratory rate is 30-60 breaths/min, markedly different from adult norms, and should not be treated as tachycardia or tachypnea in isolation.

Phototherapy, which uses light to convert unconjugated bilirubin in the skin into water-soluble forms the newborn can excrete. The nurse protects the newborn's eyes, keeps skin exposed, and monitors temperature and hydration during treatment.

A sunken fontanelle, dry mucous membranes, and decreased urine output (fewer wet diapers) with poor skin turgor. These signs guide the priority of fluid resuscitation in pediatric patients.

Recognize this as significant respiratory distress consistent with an asthma exacerbation, and prioritize airway and oxygenation support with rapid bronchodilator administration, since this positioning signals the child is working hard to breathe.

Intussusception, where one segment of bowel telescopes into another. The colicky pain pattern and currant-jelly (bloody, mucous) stool are classic signs requiring urgent evaluation, often needing an air or contrast enema to reduce it.

Barrier methods, such as condoms or diaphragms, physically block sperm from reaching the egg and also reduce STI transmission risk. Hormonal methods, such as pills or hormonal IUDs, primarily prevent ovulation or thicken cervical mucus and do not protect against STIs.

Helping to the bathroom and routine vital signs on a stable patient can be delegated to UAP. The admission assessment must remain with the RN, since assessment, clinical judgment, and initial evaluation of a new patient cannot be delegated.

The patient with new-onset stridor, because airway takes priority over psychosocial needs under both the ABC framework (airway, breathing, circulation first) and Maslow's hierarchy (physiologic survival needs before higher-level needs).

Report the event through the facility's incident/occurrence reporting system immediately, regardless of whether harm occurred, and document only objective facts in the medical record without referencing the incident report itself, per just-culture and patient-safety principles.

Timely, accurate documentation supports continuity of care across shifts and providers, enables quality and safety data to be tracked and analyzed, and reduces the risk of medication or treatment errors caused by missing or delayed information.

Situation, Background, Assessment, Recommendation. It structures communication so critical clinical information is conveyed clearly and consistently, reducing the risk of missed information during handoffs or urgent provider notifications.