DOH Abu Dhabi Nursing Exam cheat sheet

Nursing process: Assessment (collect data), Diagnosis (NANDA-I), Planning (SMART goals), Implementation, Evaluation (compare outcomes to goals).

Subjective data = patient's verbal report; Objective data = measurable/observable signs (vitals, labs, physical exam).

Maslow's hierarchy guides prioritization: physiological > safety > love/belonging > esteem > self-actualization.

ABCDE priority: Airway, Breathing, Circulation, Disability (neuro), Exposure.

Normal adult vital signs: HR 60-100 bpm, RR 12-20/min, BP <120/80 mmHg, SpO2 ≥95%, temp 36.5-37.5°C.

Stages of infection: incubation, prodromal, illness, decline, convalescence.

Wound healing phases: hemostasis, inflammatory, proliferative, maturation (remodeling).

Hand hygiene is the single most effective measure to prevent healthcare-associated infections.

Heart failure: left-sided → pulmonary congestion (dyspnea, crackles, orthopnea); right-sided → systemic congestion (JVD, edema, hepatomegaly).

MI: MONA (Morphine, Oxygen if SpO2<90%, Nitroglycerin, Aspirin) plus reperfusion; troponin rises 3-6 h after onset.

COPD: oxygen target SpO2 88-92% to avoid hypercapnia; pursed-lip breathing and tripod position reduce dyspnea.

DKA: hyperglycemia >250 mg/dL, pH <7.3, bicarbonate <18, ketones, Kussmaul respirations; treat with IV fluids, insulin, potassium replacement.

Hypoglycemia <70 mg/dL: 15 g fast-acting carbohydrate, recheck in 15 min (rule of 15).

Acute kidney injury: pre-renal (hypovolemia), intra-renal (ATN), post-renal (obstruction); monitor urine output ≥0.5 mL/kg/h.

Stroke: thrombolytic (alteplase) window ≤4.5 h from symptom onset; check glucose and CT first.

Cirrhosis: ascites, varices, hepatic encephalopathy (lactulose to reduce ammonia).

Stages of labor: 1st (latent 0-6 cm, active 6-10 cm), 2nd (full dilation to birth), 3rd (birth to placenta), 4th (first 1-2 h postpartum).

Fetal heart rate baseline 110-160 bpm; early decelerations = head compression; variable = cord compression; late = uteroplacental insufficiency.

Postpartum hemorrhage: >500 mL vaginal or >1000 mL cesarean; uterine atony is most common cause; massage fundus, oxytocin.

Preeclampsia: BP ≥140/90 after 20 weeks plus proteinuria or end-organ damage; severe features ≥160/110, platelets <100k, liver enzymes elevated.

Magnesium sulfate for eclampsia prophylaxis: monitor reflexes, respirations ≥12, urine output ≥30 mL/h; antidote calcium gluconate.

APGAR at 1 and 5 min: Appearance, Pulse, Grimace, Activity, Respiration; score 0-10.

Newborn transitional circulation: ductus arteriosus closes functionally within 24-72 h; foramen ovale closes functionally after birth.

Breastfeeding: colostrum first 2-3 days; feed on demand 8-12 times/24 h.

Pediatric vital signs vary by age: infant HR 100-160, RR 30-60; adolescent HR 60-100, RR 12-20.

Weight-based dosing: verify mg/kg and maximum dose; use a second nurse for high-alert drugs.

Dehydration: mild <5%, moderate 5-10%, severe >10% weight loss; use ORS for mild-moderate.

Kawasaki disease: fever ≥5 days, conjunctivitis, rash, lymphadenopathy, mucositis, extremity changes; risk of coronary aneurysms; treat with IVIG + aspirin.

Croup: barking cough, stridor, hoarseness; treat with dexamethasone and nebulized epinephrine for severe cases.

Epiglottitis: drooling, tripod position, muffled voice; do not inspect throat; prepare for airway.

Pyloric stenosis: projectile nonbilious vomiting at 3-6 weeks, olive-shaped mass, hypochloremic hypokalemic metabolic alkalosis.

Intussusception: colicky pain, currant-jelly stools, sausage-shaped mass; air enema is diagnostic and therapeutic.

Therapeutic communication: open-ended questions, reflection, silence; avoid advice, false reassurance, why-questions.

Suicide risk: ask directly; highest risk with plan, means, prior attempt, male, older, substance use, hopelessness.

Serotonin syndrome: clonus, hyperreflexia, hyperthermia, agitation; caused by SSRIs + MAOIs, tramadol, triptans.

Neuroleptic malignant syndrome: rigidity, fever, autonomic instability, elevated CK; stop antipsychotic, give dantrolene/bromocriptine.

Lithium therapeutic range 0.6-1.2 mEq/L; toxicity signs tremor, vomiting, ataxia; monitor levels and renal/thyroid function.

Alcohol withdrawal: CIWA-Ar; benzodiazepines first-line; risk of seizures and delirium tremens 48-96 h after last drink.

Anorexia nervosa: refeeding syndrome risk (hypophosphatemia); start low-calorie and monitor electrolytes.

Involuntary admission criteria: danger to self/others, grave disability; least restrictive environment.

Levels of prevention: primary (immunization, education), secondary (screening, early detection), tertiary (rehabilitation, chronic care).

Epidemiology measures: incidence = new cases/population at risk/time; prevalence = all cases/population at a point.

Herd immunity threshold depends on R0; for measles R0 12-18, need ~92-95% coverage.

Notifiable diseases in UAE include measles, rubella, polio, tuberculosis, hepatitis, HIV, and foodborne outbreaks.

Screening criteria: disease must be important, have detectable early stage, acceptable test, and effective treatment.

Outbreak investigation steps: verify diagnosis, define cases, find source, implement control, communicate.

Vaccine cold chain: +2 to +8 °C for most vaccines; avoid freezing; monitor with data loggers.

Social determinants of health: income, education, housing, food security, environment, healthcare access.

ACLS: compressions 100-120/min, depth 5-6 cm, ratio 30:2, minimize interruptions <10 s; defibrillate VF/pVT immediately.

Shock signs: hypotension (SBP <90), tachycardia, tachypnea, altered mental status, oliguria, cool extremities; lactate >2 mmol/L.

Sepsis bundle: measure lactate, blood cultures before antibiotics, broad-spectrum antibiotics within 1 h, 30 mL/kg crystalloid for hypotension/lactate ≥4.

Anaphylaxis: IM epinephrine 0.3-0.5 mg (1:1000) into anterolateral thigh; repeat every 5-15 min; adjuncts H1/H2 blockers, steroids.

Ventilator alarms: high pressure = secretions, biting, bronchospasm, pneumothorax; low pressure = disconnect, leak.

Increased ICP: head of bed 30°, avoid hypoxia/hypercapnia, maintain CPP = MAP − ICP (goal 60-70 mmHg).

Tension pneumothorax: tracheal deviation, absent breath sounds, hypotension; immediate needle decompression.

Mass casualty triage: prioritize immediate (red) over delayed (yellow), minor (green), expectant (black).

Six rights: right patient, drug, dose, route, time, documentation (plus reason and response).

High-alert medications: insulin, heparin, opioids, chemotherapy, concentrated electrolytes; require independent double-check.

Narrow therapeutic index drugs: digoxin (0.5-2 ng/mL), lithium (0.6-1.2 mEq/L), warfarin (INR 2-3), phenytoin (10-20 mcg/mL), vancomycin (trough 10-20 mcg/mL).

Warfarin antidote vitamin K; heparin antidote protamine sulfate; opioid antidote naloxone; benzodiazepine antidote flumazenil.

Digoxin toxicity: nausea, visual changes (yellow-green halos), bradycardia; check potassium (hypokalemia increases risk).

MAOIs + tyramine → hypertensive crisis; avoid aged cheese, wine, fermented foods.

IV push rates: verify per drug; e.g., furosemide ≤20 mg/min; potassium never IV push.

Medication reconciliation at admission, transfer, discharge; report adverse drug events through incident system.

WHO 5 Moments for Hand Hygiene: before patient contact, before aseptic task, after body fluid exposure, after patient contact, after touching surroundings.

Standard precautions apply to all patients: hand hygiene, gloves, gown, mask, eye protection, safe sharps disposal.

Transmission-based precautions: contact (MRSA, C. difficile, scabies), droplet (influenza, pertussis, meningococcal), airborne (TB, measles, varicella).

Airborne precautions: N95 respirator, negative-pressure room, door closed; for TB until effective therapy and smear negative.

C. difficile: soap and water handwashing (alcohol gel ineffective against spores); contact precautions; bleach cleaning.

Needlestick: wash with soap and water, report immediately, HIV PEP within 2 h (up to 72 h), hepatitis B immunoglobulin/vaccine if nonimmune.

Sterile field: 2.5 cm border is non-sterile; never turn back on field; keep field above waist.

Surgical site infection prevention: chlorhexidine skin prep, normothermia, glycemic control, antibiotic prophylaxis within 60 min of incision.

Fall risk tools: Morse Fall Scale; interventions include bed low, call light within reach, non-skid footwear, hourly rounding.

Pressure injury staging: Stage 1 non-blanchable erythema; Stage 2 partial thickness; Stage 3 full thickness; Stage 4 to bone/tendon; unstageable and deep tissue injury.

Braden Scale ≤18 indicates risk; reposition every 2 h; use pressure-redistribution surface.

Patient identification: two identifiers (full name + date of birth or MRN) before meds, blood, procedures.

Handoff: SBAR (Situation, Background, Assessment, Recommendation).

Restraints: use least restrictive, time-limited, physician order, frequent monitoring, release every 2 h.

Speak-up culture: use CUS (Concerned, Uncomfortable, Safety issue) to escalate.

Root cause analysis for sentinel events; disclose harm to patient/family per policy.

PDSA cycle: Plan, Do, Study, Act for iterative improvement.

Donabedian model: Structure, Process, Outcomes for quality assessment.

Nursing ethics principles: autonomy, beneficence, nonmaleficence, justice, veracity, fidelity.

Informed consent elements: competence, voluntariness, disclosure, understanding, consent.

Advocacy: nurse protects patient rights, privacy, and safety; report unsafe practice.

Quality indicators: falls with injury, CAUTI, CLABSI, VAP, medication errors, pressure injuries.

Incident reporting is non-punitive and mandatory for actual or near-miss events.

Evidence-based practice steps: ask, acquire, appraise, apply, assess.

Federal Ministry of Health and Prevention (MOHAP) regulates federal health services; DOH regulates Abu Dhabi; DHA regulates Dubai.

DOH (Department of Health – Abu Dhabi) licenses healthcare facilities and professionals in the Emirate of Abu Dhabi.

Mandatory health insurance in Abu Dhabi (Thiqa for nationals, basic for residents) under DOH regulation.

Emirates ID is used for patient identification and insurance eligibility.

UAE nursing workforce is multicultural; English is the professional language; Arabic for patient communication as needed.

Public health programs: mandatory childhood immunizations, premarital screening, cancer screening (breast, cervical, colorectal).

DOH reporting requirements: notifiable diseases, sentinel events, medication errors, and occupational exposures.

Continuing education (CPD) required for license renewal; DOH sets credit requirements.

DOH Nursing Scope of Practice defines RN, LPN, and nurse assistant roles; RNs assess, plan, implement, evaluate, and delegate.

Delegation: RN retains accountability; delegate tasks based on patient stability, complexity, and competency of delegatee.

Medication administration is a regulated act; nurses must have valid license and follow DOH medication safety standards.

Mandatory reporting: suspected abuse, neglect, communicable diseases, medication errors, and sentinel events.

Documentation must be contemporaneous, accurate, legible, signed, and retained per DOH record retention policy.

Consent and confidentiality governed by UAE law and DOH standards; breach may lead to license action.

Scope expansion (e.g., prescribing, advanced practice) requires specific DOH credentialing and approval.

License renewal requires CPD, valid BLS, and good standing; practice outside scope is a violation.