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Saudi Nursing Licensure Examination (SNLE): free practice test

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Practice test questions with answers and explanations

Try the questions in the test above first, then open each one here to see the correct answer and why every other option is wrong.

01Mr. Fahad has diarrhea caused by Clostridioides difficile. After removing gloves in his room, which hand hygiene action is best?

Practice question Unit: Nursing Fundamentals

  1. ARub hands with an alcohol-based product for 30 seconds

    Alcohol is ineffective against spores, however long it is applied.

  2. BWash hands with soap and water ✓ Correct answer

    C. difficile forms spores that alcohol does not kill; washing removes spores mechanically.

  3. CRub hands with alcohol, then put on a second pair of gloves

    Extra gloves do not fix the missing spore removal on the hands.

  4. DWipe hands with a damp cloth and air dry

    A damp cloth only spreads spores and does not clean hands.

Reference: SCFHS SNLE Applicant Guide (2025), Nursing Fundamentals: Fundamentals of nursing, p. 3; Centers for Disease Control and Prevention, Guideline for Isolation Precautions

02Mr. Saleh, 68 years old, has dyspnea, ankle swelling and difficulty breathing when lying flat. At the apex the nurse hears an extra sound in early diastole after S2. Which interpretation is most appropriate?

Practice question Unit: Nursing Fundamentals

  1. AAtrial contraction against a stiff, hypertrophied ventricle (an S4 sound)

    S4 occurs late in diastole just before S1, not after S2.

  2. BClosure of the aortic and pulmonic valves, which is the normal second sound

    Closure of the semilunar valves is S2 itself, and the extra sound comes after it.

  3. CAn S3 gallop indicating ventricular volume overload, as in heart failure ✓ Correct answer

    A third sound after S2 comes from rapid filling of an overloaded ventricle and is an important sign of heart failure in adults.

  4. DA normal variant seen only in people older than 60

    S3 can be normal in children and young adults, but in an older adult with these symptoms it is pathological.

Reference: SCFHS SNLE Applicant Guide (2025), Nursing Fundamentals: Physical assessment, p. 3; Hogan-Quigley, Palm & Bickley, Bates' Nursing Guide to Physical Examination and History Taking, 2nd ed.; Hinkle & Cheever, Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.

03Mr. Fahad, 70 years old, has heart failure. He suddenly develops severe dyspnea, pink frothy sputum, SpO2 84% on room air, and a respiratory rate of 34/min. What should the nurse do first?

Practice question Unit: Adult Nursing

  1. ALay him flat to measure blood pressure

    Lying flat increases venous return to the heart and worsens pulmonary congestion and breathing.

  2. BStart a 500 mL normal saline bolus

    Giving fluid to a client in pulmonary edema adds volume to an overloaded circulation and can be fatal.

  3. CCollect a sputum sample for culture

    A culture is not urgent; the client is hypoxic, and airway and breathing take priority over diagnostic specimens.

  4. DPlace him in high Fowler's position ✓ Correct answer

    Sitting upright lowers venous return and lets the lungs expand more easily, which relieves pulmonary edema; oxygen and IV diuretic follow immediately.

Reference: SCFHS SNLE Applicant Guide (2025), Adult Nursing: Medical nursing, p. 3; Hinkle & Cheever, Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.

04During the time-out for a left knee arthroscopy, the nurse notices that the consent form states "left knee" but no site marking is visible on the patient's leg. What should the nurse do?

Practice question Unit: Adult Nursing

  1. ASpeak up to stop the procedure until the site is verified and marked by the surgeon ✓ Correct answer

    Any discrepancy at time-out is a stop-point; the procedure waits until the surgeon confirms the site with the patient and records, and marks it as required.

  2. BMark the left knee herself and continue since consent is clear because the left side is already written in the chart

    The surgeon, not the nurse, marks the site, ideally with the awake patient involved.

  3. CProceed and plan to confirm the site once the incision is made because the team is waiting and the patient is already asleep

    Verification after incision is too late and risks wrong-site surgery.

  4. DAsk the circulating staff to check the schedule board instead and proceed if the board shows the left knee

    A schedule board is not an adequate source; the patient, consent, and surgeon's marking must agree.

Reference: SCFHS SNLE Applicant Guide (2025), Adult Nursing: Surgical nursing, p. 3; Hinkle & Cheever, Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.; World Health Organization, WHO Surgical Safety Checklist

05A 70 kg patient has septic shock with hypotension. According to the sepsis bundle, what initial crystalloid volume (30 mL/kg) is required?

Practice question Unit: Adult Nursing

  1. A1400 mL

    1400 mL equals 20 mL/kg, below the recommended amount.

  2. B700 mL

    700 mL equals only 10 mL/kg.

  3. C3500 mL

    3500 mL equals 50 mL/kg, more than recommended and a fluid-overload risk.

  4. D2100 mL ✓ Correct answer

    30 × 70 = 2100 mL of crystalloid, given within the first 3 hours.

Reference: SCFHS SNLE Applicant Guide (2025), Adult Nursing: Critical care nursing, p. 3; Hinkle & Cheever, Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.; Surviving Sepsis Campaign, International Guidelines for Management of Sepsis and Septic Shock 2021

06In a town of 10,000 people, 200 already have a chronic disease on January 1. During the year, 49 new cases are diagnosed. What is the incidence rate for the year?

Practice question Unit: Adult Nursing

  1. A5 per 1,000 persons at risk ✓ Correct answer

    Incidence counts only new cases among people at risk: 10,000 - 200 = 9,800, and 49 / 9,800 = 0.005, or 5 per 1,000.

  2. B4.9 per 1,000 total population

    Using the total population as the denominator includes people who already have the disease and cannot become new cases.

  3. C24.9 per 1,000 total population

    This adds existing and new cases (249) over the total population, which is a prevalence-style figure, not incidence.

  4. D25 per 1,000 persons at risk

    This is 249 / 9,800 rather than new cases only; existing cases are not counted in incidence.

Reference: SCFHS SNLE Applicant Guide (2025), Adult Nursing: Community nursing, p. 3; Rector, Community & Public Health Nursing: Promoting the Public's Health, 7th ed.

07The first day of Mrs. Sara's last menstrual period was November 10, 2025. Using Naegele's rule, what is her estimated date of delivery?

Practice question Unit: Maternal-Child Nursing

  1. AAugust 3, 2026

    This answer subtracts 7 days instead of adding them. The rule adds 7 days to the first day of the last period.

  2. BAugust 17, 2026 ✓ Correct answer

    Add 7 days to November 10 to get November 17, subtract 3 months to get August 17, then add 1 year. The EDD is August 17, 2026.

  3. CSeptember 17, 2026

    Only 2 months were subtracted. The rule subtracts a full 3 months.

  4. DAugust 17, 2025

    This answer omits adding the year, producing a date before the pregnancy even began.

Reference: SCFHS SNLE Applicant Guide (2025), Maternal-Child: Maternity nursing, p. 3; Ricci, Essentials of Maternity, Newborn, and Women's Health Nursing, 5th ed.

08Mrs. Noura has regular menstrual cycles of 32 days. Counting the first day of menses as day 1, on about which day does she most likely ovulate?

Practice question Unit: Maternal-Child Nursing

  1. ADay 12

    Day 12 would leave a luteal phase of 20 days, far longer than normal.

  2. BDay 18 ✓ Correct answer

    The luteal phase is fairly constant at about 14 days, and the follicular phase varies. Cycle length 32 minus 14 gives ovulation around day 18.

  3. CDay 14

    Day 14 applies only to a 28-day cycle. Her cycle is longer, so the follicular phase is longer.

  4. DDay 16

    Day 16 would give a luteal phase of 16 days, longer than the usual 14.

Reference: SCFHS SNLE Applicant Guide (2025), Maternal-Child: Gynecology, p. 3; Ricci, Essentials of Maternity, Newborn, and Women's Health Nursing, 5th ed.

09At 1 minute after birth, a nurse records for a newborn: heart rate 130 beats/min, weak cry with slow irregular respirations, some flexion of the extremities, grimace on suctioning, and a pink body with blue hands and feet. What is the 1-minute Apgar score?

Practice question Unit: Maternal-Child Nursing

  1. A7

    A total of 7 would require 2 points for respirations or tone. Slow irregular breathing with a weak cry scores only 1, and some flexion scores only 1.

  2. B5

    This total undercounts one sign. A heart rate of 130 is above 100 beats/min and earns the full 2 points.

  3. C8

    This score assumes a fully pink color and a strong cry. Blue extremities with weak cry and breathing lower the score to 6.

  4. D6 ✓ Correct answer

    Heart rate above 100 scores 2; weak slow respirations 1; some flexion 1; grimace on suction 1; pink body with blue extremities 1. Total 2+1+1+1+1 = 6.

Reference: SCFHS SNLE Applicant Guide (2025), Maternal-Child Nursing: Neonatal nursing, p. 3; Ricci, Essentials of Maternity, Newborn, and Women's Health Nursing, 5th ed.

10A nurse is caring for four patients. Which patient requires the nurse's attention first?

Practice question Unit: Nursing Management and Leadership

  1. AMrs. Huda, 45, with pneumonia, temperature 38.5 C, waiting for her next scheduled antibiotic dose

    She is stable and the antibiotic is not yet overdue.

  2. BAhmed, 8 years old, with a casted fractured arm, pain 5/10 and an analgesic due now

    Moderate pain is addressed soon, but it is not life-threatening.

  3. CMr. Khalid, 72, with COPD, SpO2 91% on 2 L/min, which is his baseline

    The saturation matches his baseline, so he is stable.

  4. DMr. Salem, 68, 30 minutes after cardiac catheterization, with a bleeding groin and BP 84/50 mm Hg ✓ Correct answer

    Signs of hemorrhage and shock make him unstable; bleeding and circulation take priority over the other needs.

Reference: SCFHS SNLE Applicant Guide (2025), Nursing Management and Leadership: Resources to support and coordinate patient care, p. 3; Marquis & Huston, Leadership Roles and Management Functions in Nursing: Theory and Application, 10th ed.

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