MOHAP Nursing Exam cheat sheet

Normal adult vital signs: temperature 36.5–37.5°C oral, pulse 60–100 beats/min, respirations 12–20/min, blood pressure <120/80 mmHg, oxygen saturation ≥95% on room air.

Stages of pressure injury: Stage 1 = non-blanchable erythema; Stage 2 = partial-thickness loss (shallow open ulcer or blister); Stage 3 = full-thickness loss with visible subcutaneous fat; Stage 4 = full-thickness loss with exposed muscle, tendon, or bone.

Intake and output: 1 mL = 1 g; 1 cup = 240 mL; 1 oz = 30 mL; 1 L = 1000 mL. Normal adult urine output is 0.5–1 mL/kg/hr (about 30–60 mL/hr).

Body mass index (BMI) = weight (kg) / height (m²). Underweight <18.5; normal 18.5–24.9; overweight 25–29.9; obese ≥30.

Fowler position: head of bed 45–60°; Semi-Fowler 30–45°; High-Fowler 60–90°. Used for dyspnea and to improve lung expansion.

Maslow hierarchy (physiologic first): airway, breathing, circulation, then safety, love/belonging, esteem, self-actualization. Prioritize ABCs in any client scenario.

Signs of hypoxia: restlessness, confusion, tachycardia, tachypnea, cyanosis (late sign), decreased SpO2. Early intervention = apply oxygen and reposition.

Hand hygiene: use alcohol-based rub for visibly clean hands; use soap and water when hands are visibly soiled or after caring for a client with C. difficile.

Normal urine specific gravity: 1.010–1.025. Below 1.010 = dilute (diabetes insipidus, excessive fluid intake); above 1.025 = concentrated (dehydration).

Acute myocardial infarction: MONA – morphine, oxygen (if SpO2 <90%), nitroglycerin, aspirin. Troponin rises within 3–6 hours and peaks at 12–24 hours.

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

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

Diabetes: HbA1c <7% for most adults; fasting glucose 70–99 mg/dL; hypoglycemia <70 mg/dL treated with 15 g fast-acting carbohydrate, recheck in 15 minutes.

Acute pancreatitis: severe epigastric pain radiating to back, elevated amylase/lipase, NPO, IV fluids, pain control. Avoid alcohol.

Dumping syndrome after gastric surgery: occurs 15–30 minutes after eating; symptoms include tachycardia, sweating, diarrhea. Eat small low-carb meals and lie down after eating.

Fracture care: 5 Ps = pain, pallor, paresthesia, paralysis, pulselessness. Compartment syndrome is an emergency requiring fasciotomy.

Renal failure: normal BUN 7–20 mg/dL, creatinine 0.6–1.2 mg/dL. Hyperkalemia (>5.0 mEq/L) is life-threatening; treat with calcium gluconate, insulin + glucose, and dialysis.

Stroke: time is brain. IV thrombolytic (alteplase) window is up to 4.5 hours from symptom onset. Check blood glucose immediately (hypoglycemia mimics stroke).

Estimated date of delivery (EDD) by Naegele's rule: first day of last menstrual period + 7 days − 3 months + 1 year (or + 9 months).

Stages of labor: 1st = dilation 0–10 cm; 2nd = full dilation to birth; 3rd = birth to placenta delivery; 4th = first 1–2 hours postpartum (risk of hemorrhage).

Normal fetal heart rate: 110–160 beats/min. Late decelerations = uteroplacental insufficiency (reposition left lateral, give oxygen, stop oxytocin). Variable decelerations = cord compression.

Postpartum hemorrhage: >500 mL after vaginal birth or >1000 mL after cesarean. Most common cause = uterine atony; massage fundus and give oxytocin.

APGAR score at 1 and 5 minutes: Appearance, Pulse, Grimace, Activity, Respiration. Score 0–3 = severely depressed; 7–10 = normal.

Preeclampsia: BP ≥140/90 mmHg after 20 weeks plus proteinuria or end-organ damage. Severe features: BP ≥160/110, platelets <100,000, elevated liver enzymes, pulmonary edema. Treatment = magnesium sulfate for seizure prophylaxis.

Magnesium sulfate toxicity: loss of deep tendon reflexes, respiratory depression, oliguria. Antidote = calcium gluconate 10%.

Breastfeeding: colostrum first 2–3 days; mature milk by 2 weeks. Newborn should feed 8–12 times per 24 hours and have 6+ wet diapers/day by day 5.

Pediatric vital signs vary by age: newborn HR 100–160, RR 30–60; infant HR 90–160, RR 25–40; toddler HR 80–140, RR 20–30; school-age HR 70–120, RR 18–25.

Weight-based dosing: verify safe dose range (mg/kg/day). Example: acetaminophen 10–15 mg/kg/dose every 4–6 hours, max 75 mg/kg/day.

Dehydration in children: mild = 3–5% weight loss; moderate = 6–9%; severe = ≥10%. Signs: sunken fontanel, decreased tears, dry mucous membranes, tachycardia.

Maintenance IV fluids (Holliday-Segar): 100 mL/kg/day for first 10 kg + 50 mL/kg/day for next 10 kg + 20 mL/kg/day for each kg above 20.

Kawasaki disease: fever ≥5 days, conjunctivitis, rash, cervical lymphadenopathy, strawberry tongue, desquamation. Risk = coronary aneurysms; treat with IVIG and aspirin.

Epiglottitis vs croup: epiglottitis = drooling, tripod position, high fever, do NOT inspect throat; croup = barking cough, inspiratory stridor, treat with dexamethasone and nebulized epinephrine.

Intussusception: colicky abdominal pain, currant-jelly stools, sausage-shaped mass. Treat with air or barium enema.

Pediatric pain scales: FLACC (Face, Legs, Activity, Cry, Consolability) for ages 2 months–7 years; Wong-Baker FACES for ≥3 years; numeric scale for ≥8 years.

Therapeutic communication techniques: open-ended questions, reflection, restating, clarification, silence. Avoid advice, false reassurance, and why questions.

Serotonin syndrome: triad of mental status changes, autonomic instability, and neuromuscular hyperactivity (clonus, hyperreflexia). Caused by SSRIs, MAOIs, and other serotonergic drugs.

Neuroleptic malignant syndrome: fever, muscle rigidity, autonomic instability, elevated CK. Caused by antipsychotics; treat by stopping drug, dantrolene, bromocriptine.

Lithium therapeutic range 0.6–1.2 mEq/L; toxicity >1.5 mEq/L (tremor, vomiting, ataxia, seizures). Maintain sodium and fluid intake.

Alcohol withdrawal: monitor CIWA score; treat with benzodiazepines. Risk of seizures 6–48 hours after last drink; delirium tremens 48–96 hours.

Suicide risk assessment: direct asking is appropriate. Highest risk = previous attempt, plan, access to means, male, older adult, substance use.

Eating disorders: anorexia nervosa = low BMI, fear of weight gain, lanugo, amenorrhea; bulimia = binge-purge, normal weight, dental enamel erosion, hypokalemia.

Mental Health Act principles: least restrictive care, informed consent, confidentiality, and duty to warn if a client threatens a specific person.

Levels of prevention: primary = before disease (immunization, health education); secondary = early detection (screening, Pap smear); tertiary = rehabilitation and limiting disability.

Herd immunity threshold depends on R0: for measles R0 ≈ 12–18, need ~92–95% coverage; for polio ~80–85%.

UAE immunization schedule includes BCG at birth, hepatitis B at birth, and routine DTaP, IPV, Hib, MMR, and varicella according to the national schedule.

Notifiable diseases in the UAE include cholera, plague, yellow fever, measles, rubella, tuberculosis, hepatitis A/B/C, and HIV; report to the local health authority.

Epidemiology measures: incidence = new cases / population at risk over time; prevalence = all existing cases / total population. Attack rate = cases / exposed population.

Sensitivity = true positives / (true positives + false negatives); specificity = true negatives / (true negatives + false positives).

Home visit priority: assess safety first, then perform physical assessment, then health education. Keep visits time-limited and document.

Screening criteria (Wilson-Jungner): important health problem, accepted treatment, early detection benefit, acceptable test, and cost-effective.

Primary survey: A = airway with cervical spine protection, B = breathing, C = circulation with hemorrhage control, D = disability (GCS), E = exposure.

Glasgow Coma Scale: eye 1–4, verbal 1–5, motor 1–6; total 3–15. Score ≤8 = coma, consider intubation.

Anaphylaxis: IM epinephrine 0.3–0.5 mg (1:1000) in the anterolateral thigh, repeat every 5–15 minutes; then oxygen, IV fluids, antihistamines, corticosteroids.

Adult CPR: compression rate 100–120/min, depth 5–6 cm, ratio 30:2, minimize interruptions <10 seconds, early defibrillation.

Shock signs: tachycardia, hypotension (late), cool clammy skin, altered mental status, decreased urine output. Treat cause and give isotonic fluids.

Sepsis bundle: measure lactate, obtain blood cultures before antibiotics, give broad-spectrum antibiotics within 1 hour, and 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L.

Ventilator alarms: high-pressure alarm = secretions, coughing, biting, kinked tubing, pneumothorax; low-pressure alarm = disconnection or leak.

Mass casualty triage: red = immediate, yellow = delayed, green = minor, black = expectant. Prioritize airway and hemorrhage control.

Rights of medication administration: right client, right drug, right dose, right route, right time, right documentation, right reason, right to refuse.

Narrow therapeutic index drugs requiring monitoring: digoxin (0.5–2.0 ng/mL), lithium (0.6–1.2 mEq/L), warfarin (INR 2–3), phenytoin (10–20 mcg/mL), theophylline (10–20 mcg/mL).

Digoxin toxicity: nausea, vomiting, visual changes (yellow-green halos), bradycardia. Hold dose if apical pulse <60/min in adults.

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

Insulin onset: rapid-acting (lispro/aspart) 15 min; short-acting (regular) 30 min; intermediate (NPH) 1–2 hours; long-acting (glargine) 1–2 hours with no peak.

IV push rates: administer according to manufacturer and institutional policy; never exceed prescribed rate. Use a filter for amphotericin B and vancomycin.

High-alert medications (ISMP): insulin, heparin, opioids, chemotherapy, concentrated electrolytes. Use independent double-check.

Vancomycin: infuse over at least 60 minutes to prevent red man syndrome; monitor trough levels (10–20 mcg/mL).

Chain of infection: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host. Break any link to prevent infection.

Standard precautions apply to all clients: hand hygiene, gloves, gown, mask, eye protection, and safe sharps handling.

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

Airborne precautions require a negative-pressure room with ≥12 air exchanges per hour and N95 respirator for staff.

Needlestick injury: wash with soap and water, report immediately, test source and exposed person for HIV, HBV, HCV; HIV PEP within 2 hours if indicated.

Surgical asepsis: sterile field must be above waist level; sterile items touching non-sterile surfaces are contaminated; do not turn away from the field.

C. difficile: use soap and water (alcohol does not kill spores); contact precautions; private room.

Central line–associated bloodstream infection prevention: hand hygiene, maximal sterile barrier during insertion, chlorhexidine skin antisepsis, daily review of line necessity.

UAE Nursing Code of Ethics: practice with compassion, respect, dignity, and confidentiality; maintain competence; advocate for the patient.

Informed consent requires capacity, disclosure, understanding, and voluntariness. Minors and incapacitated adults require a legal guardian.

Confidentiality: patient information may be disclosed only with consent or as required by law (e.g., notifiable diseases, court order).

UAE Federal Law No. 4 of 2016 (Medical Liability Law): healthcare professionals must provide care according to approved standards; negligence may lead to compensation and disciplinary action.

Mandatory reporting: suspected child abuse, domestic violence, communicable diseases, and unsafe practice must be reported to the appropriate authority.

Scope of practice: nurses must perform only tasks within their licensure and training. Delegation to unlicensed assistive personnel requires supervision and appropriate task selection.

Do-not-resuscitate orders require valid documentation and physician order; nurses advocate for patient wishes and follow institutional policy.

Documentation: objective, timely, accurate, and legible; late entries labeled; never alter a record. The medical record is a legal document.