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GMCH Nursing Officer exam Previous Year Paper
GMCH Nursing Officer question paper of Jan 2019
1. Arrange the following five events in the correct order of occurrence:
I. Stimulation of the anterior pituitary
II. Stimulation of ovaries
III. Stimulation of neurosecretory cells
IV. Release of Gonadotropic hormone
V. Release of Gonadotropin-releasing hormone
Codes:
(A) III, V, I, IV, II
(B) II, IV, I, V, III
(C) I, V, III, II, IV
(D) IV, V, III, II, I
Answer: (A) III, V, I, IV, II
Explanation: This describes the hypothalamic-pituitary-gonadal axis. Neurosecretory cells in the hypothalamus release Gonadotropin-releasing hormone (GnRH), which stimulates the anterior pituitary to release Gonadotropic hormones (LH and FSH), which then stimulate the ovaries.
2. Arrange the following events in the order of their occurrence in the Panic circle:
I. Apprehension or worry
II. Body sensations
III. Perceived threat
IV. Interpretation of sensations as catastrophic
V. Trigger stimulus
Codes:
(A) I, III, II, V, IV
(B) V, II, III, I, IV
(C) V, III, I, II, IV
(D) III, V, I, II, IV
Answer: (C) V, III, I, II, IV
Explanation: The panic circle typically starts with a trigger, leading to a perceived threat. This causes apprehension, which in turn leads to body sensations that are then interpreted catastrophically.
3. While receiving a blood transfusion, the patient develops chills and a headache. What should be the nurse's initial action?
(A) Notify the physician STAT
(B) Stop the transfusion immediately
(C) Cover the patient with a blanket and administer the ordered acetaminophen.
(D) Slow the blood flow to keep the vein open.
Answer: (B) Stop the transfusion immediately
Explanation: Chills and headache during a blood transfusion can indicate a transfusion reaction, which requires immediate cessation of the transfusion to prevent further complications.
4. Choose the most therapeutic response to Mr. Shyam's question: "Am I going to die?"
(A) "We all are going to die one day."
(B) "What has your doctor told you?"
(C) "You really don't want to talk about death, do you?"
(D) "Would you like to talk about your condition and prognosis?"
Answer: (D) "Would you like to talk about your condition and prognosis?"
Explanation: This response acknowledges the patient's fear, offers an opportunity for open communication, and focuses on their specific situation and future outlook.
5. Which of the following would be a common indication of infiltration of a peripheral intravenous infusion?
(A) Redness and swelling around the insertion site
(B) Blood return in the cannula
(C) Difficulty regulating the flow with gravity
(D) Cool skin distal to the insertion site
Answer: (A) Redness and swelling around the insertion site
Explanation: Infiltration occurs when IV fluid leaks into the surrounding tissue, causing redness, swelling, and coolness at the insertion site.
6. Ms. Babita is in the emergency room after being involved in a traffic accident. What would be an early sign of hemorrhagic shock?
(A) Increased blood pressure
(B) Pallor
(C) Increased pulse
(D) Deep breathing
Answer: (C) Increased pulse
Explanation: In hemorrhagic shock, the body attempts to compensate for blood loss by increasing the heart rate (tachycardia) to maintain cardiac output.
7. Ms. Anita asks the nurse when she can start eating after surgery. What is the most appropriate response by the nurse?
(A) "You'll have to ask the doctor."
(B) "Tell me about your appetite."
(C) "You'll likely start on clear fluids once bowel sounds can be heard."
(D) "I'll have the dietitian consult with you about the most nutritious post-surgery menus."
Answer: (C) "You'll likely start on clear fluids once bowel sounds can be heard."
Explanation: Return of bowel sounds indicates the digestive system is beginning to recover, and clear fluids are typically the first step in post-surgical dietary advancement.
8. When caring for an infant during cardiac arrest, which pulse must be palpated to determine cardiac function?
(A) Carotid
(B) Brachial
(C) Pedal
(D) Radial
Answer: (B) Brachial
Explanation: The brachial pulse is the most accessible and reliable pulse to check in infants during cardiac arrest.
9. The evidence to assert whether or not experimental treatment/condition has made a difference refers to:
(A) External validity
(B) Internal Validity
(C) Criterion validity
(D) Construct validity
Answer: (B) Internal Validity
Explanation: Internal validity refers to the degree to which a study accurately determines that the independent variable caused the observed changes in the dependent variable.
(A) Dorothea Orem
(B) Madeleine Leininger
(C) Martha Rogers
(D) Sister Callista Roy
Answer: (A) Dorothea Orem
Explanation: Dorothea Orem is known for her Self-Care Deficit Nursing Theory, which posits that individuals have the ability to care for themselves.
11. What is the term used for normal respiratory rhythm and depth in a client?
(A) Eupnea
(B) Apnea
(C) Bradypnea
(D) Tachypnea
Answer: (A) Eupnea
Explanation: Eupnea refers to normal, quiet breathing.
12. Alarm, resistance, and exhaustion are concepts related to
(A) Health Belief Model
(B) The Trans Theoretical Model
(C) Health Promotion Model
(D) General Adaptation Syndrome
Answer: (D) General Adaptation Syndrome
Explanation: The General Adaptation Syndrome (GAS), proposed by Hans Selye, describes the body's physiological response to stress, consisting of alarm, resistance, and exhaustion stages.
13. A client is in the late active phase of labour. Suddenly, she tells the nurse she feels weak and dizzy. The nurse notes the drop in maternal B.P. and late decelerations of fetal heart rate. The initial action the nurse should take to
(A) Increase the I.V. drip rate and notify the provider
(B) Turn the client on their side and administer oxygen
(C) Assess for cord prolapse or vaginal bleeding
(D) Prepare for immediate delivery
Answer: (B) Turn the client on their side and administer oxygen
Explanation: Late decelerations and maternal hypotension can indicate uteroplacental insufficiency. Turning the client to her side (often left lateral) and administering oxygen improves uterine blood flow and fetal oxygenation.
14. During which war did the United States ask for Florence Nightingale's assistance in setting up military hospitals?
(A) Crimean War
(B) World War I
(C) World War II
(D) Civil War
Answer: (D) Civil War
Explanation: While Florence Nightingale is famously associated with the Crimean War, the question specifically asks when the United States asked for her assistance, which was during the Civil War.
15. Birth rate is-
(A) Live birth/1000 mid-year population
(B) Birth/1000 mid-year population
(C) Live birth/10000 mid-year population
(D) Live birth/10000 population of reproductive age Group (15-45 years)
Answer: (A) Live birth/1000 mid-year population
Explanation: Birth rate is typically defined as the number of live births per 1,000 people in a population per year.
16. As per the latest census sex ratio (the number of females per 1000 of males) of Chandigarh is reported to be....
((A) 718
(B) 818
(C) 918
(D) 1000
Answer: (B) 818
Explanation: This is a factual recall question about the sex ratio in Chandigarh based on the latest census.
17. This step of the nursing process includes the systematic collection of all subjective and objective data about the client, in which the nurse focuses holistically on the client- physical, psychological, emotional, sociocultural, and spiritual aspects.
(A) Assessment
(B) Planning
(C) Implementation
(D) Diagnosis
Answer: (A) Assessment
Explanation: Assessment is the first step of the nursing process and involves gathering comprehensive data about the patient's health status.
18. There are a number of risk factors associated with coronary artery disease. Which of the following is a modifiable risk factor?
(A) Obesity
(B) Heredity
(C) Gender
(D) Age
Answer: (A) Obesity
Explanation: Modifiable risk factors are those that can be changed or controlled, such as obesity, diet, exercise, and smoking. Heredity, gender, and age are non-modifiable.
19. When administering single-rescuer adult CPR, what is the breaths-to-compressions ratio?
(A) 2 breaths every 30 compressions
(B) 1 breath every 30 compressions
(C) 1 breath every 15 compressions
(D) 2 breaths every 5 compressions
Answer: (A) 2 breaths every 30 compressions
Explanation: For single-rescuer adult CPR, the recommended ratio is 30 compressions followed by 2 breaths.
20. Rashtriya Bal Swasthya Karyakram (RBSK) is a new initiative aiming at early identification and early intervention for children from birth to 18 years to cover 4 'D's viz.
(A) Defects at birth, Deficiencies, Diseases, Development delays, including disability.
(B) Drug Abuse, Deficiencies, Development delays, including disability, and Defects at birth.
(C) Deformities, Development delays including disability, deficiencies, and drug abuse
(D) Diseases, Development delays including disability, defects at birth, and diarrhoeal diseases
Answer: (A) Defects at birth, Deficiencies, Diseases, Development delays, including disability.
Explanation: RBSK focuses on screening children for these four categories to ensure early intervention.
21. A positive over-the-counter pregnancy test is considered a:
(A) Possible sign of pregnancy
(C) Probable sign of pregnancy
(B) Presumptive sign of pregnancy
(D) Positive sign of pregnancy
Answer: (C) Probable sign of pregnancy
Explanation: Probable signs of pregnancy are those that are objective and detected by an examiner, but could have other causes. A positive pregnancy test (due to hCG) is considered probable because, in rare cases, other conditions can cause false positives. Positive signs (e.g., fetal heartbeat) are definitive.
22. You are working in a paediatric unit of the hospital and caring for a six-year-old boy who is hospitalized with cystic fibrosis and respiratory compromise. Which developmental task is the challenge for this boy at his age?
(A) To cough, deep breathe, and improve respiratory status
(B) To establish industry and self-confidence
(C) To develop autonomy and self-control
(D) To develop initiative and a sense of purpose
Answer: (B) To establish industry and self-confidence
Explanation: According to Erik Erikson's stages of psychosocial development, children aged 6-12 are in the "Industry vs. Inferiority" stage, where they focus on developing competence and confidence in their abilities.
23. During which week does the fetal heart begin pumping its own blood?
(A) 3rd week
(B) 4th week
(C) 5th week
(D) 6th week
Answer: (B) 4th week
Explanation: The fetal heart begins to beat and pump blood around the 4th week of gestation.
24. Which type of cancer has the poorest prognosis?
(A) Squamous cell carcinoma
(B) Breast cancer
(C) Pancreatic cancer
(D) Gastric cancer
Answer: (C) Pancreatic cancer
Explanation: Pancreatic cancer is notoriously difficult to treat and has one of the lowest survival rates among common cancers.
25. The stages of infection in correct sequential order are:
(A) The prodromal, incubation, illness, and convalescence stages
(B) The incubation, prodromal, illness, and convalescence stages
(C) The prodromal, primary infection, secondary infection, and tertiary infection
(D) The inflammation, infection, and disease
Answer: (B) The incubation, prodromal, illness, and convalescence stages
Explanation: This is the typical progression of an infectious disease:
○ Incubation: Time from exposure to onset of symptoms.
○ Prodromal: Early, non-specific symptoms.
○ Illness: Full-blown symptoms of the disease.
○ Convalescence: Recovery period.
26. Match List - I with List - II and give your answer using the codes given below:
Codes:
(P) | Q | R | S
(A) 1 | 2 | 3 | 4
(B) 3 | 1 | 4 | 2
(C) 4 | 3 | 1 | 2
(D) 3 | 4 | 1 | 2
Answer: (D) 3, 4, 1, 2
Explanation:
The acetylcholinergic system is primarily associated with the Pons and basal forebrain (3).
Noradrenergic system nuclei are mainly found in the Locus coeruleus (4).
Serotonergic system nuclei are primarily in the Raphe nuclei (1).
Hypocretinergic system (orexinergic) nuclei are located in the Lateral hypothalamus (2).
27. Which of the following is the best method to relieve constipation during pregnancy?
(A) Lying flat on the back while sleeping
(B) Increasing the intake of vegetables and fruits
(C) Reduction of iron intake by half
(D) Taking a mild over-the-counter laxative
Answer: (B) Increasing the intake of vegetables and fruits
Explanation: Increasing dietary fiber through vegetables and fruits, along with adequate fluid intake, is the safest and most effective non-pharmacological approach to prevent and relieve constipation during pregnancy.
28. Of the following, which disease causes the most deaths worldwide?
(A) Cardiovascular disease
(B) HIV/AIDS
(C) Malaria
(D) Tuberculosis
Answer: (A) Cardiovascular disease
Explanation: Cardiovascular diseases, including heart attacks and strokes, are globally the leading causes of death.
29. Which of the following is a vector of infection?
(A) An infectious fly
(B) A contaminated thermometer
(C) A contaminated ball
(D) An infected person
Answer: (A) An infectious fly
Explanation: A vector is an organism (like an insect) that transmits a pathogen from one host to another. Contaminated inanimate objects are called fomites. An infected person is a reservoir.
30. An infant born with non-communicating hydrocephalus has just had a ventriculo-peritoneal shunt inserted. In addition to neuromuscular assessments, what measures should the nurse use in a child's care plan?
(A) Reinforce wet dressings every 2 hours
(B) Position the infant on the operative side
(C) Place the infant in a semi-Fowler's position
(D) Measure head and abdominal circumference
Answer: (D) Measure head and abdominal circumference
Explanation: Monitoring head circumference is crucial for hydrocephalus to assess shunt effectiveness and potential malfunction. Abdominal circumference is also monitored because the shunt drains into the peritoneal cavity.
31. Select the anatomic malformations associated with the Tetralogy of Fallot.
(A) Ventricular septal defect, an overriding aorta, right ventricular hypertrophy, pulmonary stenosis
(B) Atrial septal defect, an overriding aorta, right ventricular hypertrophy, pulmonary stenosis
(C) Ventricular septal defect, an overriding aorta, left ventricular hypertrophy, and right ventricular outflow
(D) Atrial septal defect, an overriding aorta, pulmonary atresia, and right ventricular outflow
Answer: (A) Ventricular septal defect, an overriding aorta, right ventricular hypertrophy, pulmonary stenosis
Explanation: These are the four classic defects that constitute Tetralogy of Fallot.
32. Which of the following conditions is related to the development of renal calculi?
(A) Pancreatitis
(B) Fractured femur
(C) Gout
(D) Disc disease
Answer: (C) Gout
Explanation: Gout is associated with elevated uric acid levels, which can lead to the formation of uric acid kidney stones (renal calculi).
33. Select the cranial nerve paired with its name correctly.
(A) The twelfth cranial nerve: The hypoglossal nerve
(B) The fifth cranial nerve: The auditory nerve
(C) The second cranial nerve: The olfactory nerve
(D) The tenth cranial nerve: The trigeminal nerve
Answer: (A) The twelfth cranial nerve: The hypoglossal nerve
Explanation:
○ (B) The fifth cranial nerve is the Trigeminal nerve. The Auditory nerve is the eighth cranial nerve.
○ (C) The second cranial nerve is the Optic nerve. The Olfactory nerve is the first cranial nerve.
○ (D) The tenth cranial nerve is the Vagus nerve. The Trigeminal nerve is the fifth cranial nerve.
34. What could be the expected delivery date for the woman who got her last menstrual cycle on 20th April,2018?
(A) January 27th, 2019
(C) January 31st, 2019
(B) February 20th, 2019
(D) February 27th, 2019
Answer: (A) January 27th, 2019
Explanation: Using Naegele's Rule:
○ Add 7 days to the first day of the last menstrual period: April 20 + 7 days = April 27.
○ Subtract 3 months from that date: April 27 - 3 months = January 27.
○ Add 1 year: January 27, 2019.
35. A 4-year-old female child suffered severe burns in a house fire. How will you examine the extent of her burns?
(A) By using the Parkland Formula
(B) By using the Lund and Browder chart
(C) By using Hartman's formula
(D) By using the Rule of Tens
Answer: (B) By using the Lund and Browder chart
Explanation: The Lund-Browder chart is specifically designed for estimating burn surface area in children, as their body proportions change with age, making the Rule of Nines (used for adults) inaccurate.
36. A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response?
(A) "You may have eaten contaminated restaurant food."
(B) "You could have gotten it by using IV drugs."
(C) "You must have received an infected blood transfusion."
(D) "You probably got it by engaging in unprotected sex."
Answer: (A) "You may have eaten contaminated restaurant food."
Explanation: Hepatitis A is primarily transmitted through the fecal-oral route, often by consuming contaminated food or water.
37. Select the criterion that is coupled with its indication of gestational age or birth weight.
(A) Small for gestational age: The neonate's weight is less than the 20th percentile
(B) Large for gestational age: The infant's weight is above the 99th percentile
(C) Low birth weight: The infant's weight is less than 1,500g at the time of delivery
(D) Appropriate for gestational age: The neonate's weight lies in the range of the 10th to 90th percentile
Answer: (D) Appropriate for gestational age: The neonate's weight lies in the range of 10th to 90th percentile
Explanation:
○ Small for gestational age (SGA) is typically defined as below the 10th percentile.
○ Large for gestational age (LGA) is typically defined as above the 90th percentile.
○ Low birth weight (LBW) is defined as less than 2,500g, while very low birth weight (VLBW) is less than 1,500g.
38. Which of the following is paired correctly with its description about skeletal fracture?
(A) An avulsion fracture: A fracture that extracts a part of the bone from the ligament or tendon
(B) A greenstick fracture: This bends the bone but does not lead to a fracture
(C) A complete fracture: The fractured bone pierces to the skin surface through the skin
(D) A pathological fracture: A fracture that occurs due to some physical trauma
Answer: (A) An avulsion fracture: A fracture that extracts a part of bone from the ligament or tendon
Explanation:
○ (B) A greenstick fracture is an incomplete fracture where the bone bends and cracks but doesn't break completely.
○ (C) A complete fracture involves a full break in the bone, and if it pierces the skin, it's an open or compound fracture.
○ (D) A pathological fracture occurs due to a disease that weakens the bone, not necessarily physical trauma.
39. Which of the following signs and symptoms indicates salicylate toxicity?
(A) Chest pain
(B) Pink coloured urine
(C) Slow pulse rate
(D) Ringing in the ears
Answer: (D) Ringing in the ears
Explanation: Tinnitus (ringing in the ears) is a classic symptom of salicylate (aspirin) toxicity.
40. The Urinary bladder is lined with?
(A) Simple epithelium
(B) Stratified epithelium
(C) Transitional epithelium
(D) Pseudostratified epithelium
Answer: (C) Transitional epithelium
Explanation: Transitional epithelium (urothelium) is specialized to stretch and accommodate changes in the volume of urine in the bladder.
41. An emergency room nurse is assessing a 22-year-old male who has been using opioids. What symptoms indicate that the client has overdosed?
(A) Constricted pupils and hypotension
(B) Vomiting and tachypnoea.
(C) Pupillary dilatation and hypertensive crisis
(D) Tremors and ataxia.
Answer: (A) Constricted pupils and hypotension
Explanation: Opioid overdose typically causes respiratory depression, pinpoint (constricted) pupils, and decreased blood pressure (hypotension).
42. Which of the following pairs is not a negative symptom of Schizophrenia?
(A) Emotional flattening and Asociality
(B) Anhedonia and amotivation
(C) Poverty of speech and apathy
(D) Hallucinations and Bizarre behaviour
Answer: (D) Hallucinations and Bizarre behaviour
Explanation: Hallucinations and bizarre behavior are considered positive symptoms of schizophrenia, meaning they are an excess or distortion of normal functions. Negative symptoms (like emotional flattening, asociality, anhedonia, poverty of speech, and apathy) represent a deficit in normal functions.
43. The nurse is providing a teaching session to a client who has ulcerative colitis. The nurse will instruct the client on which diet?
(A) Carbohydrate-consistent diet
(B) High-calorie, high-protein diet
(C) High-calcium and high-potassium diet
(D) Low-residue, low-fiber diet
Answer: (D) Low-residue, low-fiber diet
Explanation: A low-residue, low-fiber diet is often recommended during acute flares of ulcerative colitis to reduce bowel stimulation and irritation.
44. Which of the following categories would a 70-year-old adult be placed in?
(A) Intimacy vs. Isolation
(B) Generativity vs. Stagnation
(C) Integrity vs. Despair
(D) Longevity vs. Guilt
Answer: (C) Integrity vs. Despair
Explanation: According to Erik Erikson's stages of psychosocial development, individuals in late adulthood (typically 65 and older) are in the "Integrity vs. Despair" stage, reflecting on their lives and finding meaning.
45. Furosemide acts on which part of the nephron?
(A) Proximal tubule
(B) Descending limb of the loop of Henle
(C) Ascending limb of the loop of Henle
(D) Distal tubule
Answer: (C) Ascending limb of the loop of Henle
Explanation: Furosemide is a loop diuretic that primarily acts on the thick ascending limb of the loop of Henle to inhibit sodium and chloride reabsorption.
46. A person with Schizophrenia was found to repeat whatever words the psychiatric nurse was speaking. This behaviour can be labelled as:
(A) Echopraxia
(B) Neologism
(C) Word Salad
(D) Echolalia
Answer: (D) Echolalia
Explanation: Echolalia is the involuntary, senseless repetition of a word or phrase just spoken by another person.
47. After falling from a 10-feet ladder, a patient is brought to the emergency department. The patient is alert, reports back pain, and difficulty moving the lower extremities. Which additional observation is an indication that the patient may be experiencing neurogenic shock?
(A) Cool and pale skin
(B) Bradycardia
(C) Poor skin turgor
(D) Increased systolic blood pressure
Answer: (B) Bradycardia
Explanation: Neurogenic shock, often caused by spinal cord injury, leads to a loss of sympathetic tone, resulting in vasodilation, hypotension, and bradycardia (slow heart rate), which differentiates it from other forms of shock that typically cause tachycardia.
48. The nurse should instruct a patient who is to receive digoxin (Lanoxin) to report the development of which of the following side effects?
(A) Ringing in the ears
(B) Alopecia
(C) Signs of bruising
(D) Sensitivity to sunlight
Answer: (A) Ringing in the ears
Explanation: Tinnitus (ringing in the ears) is a possible sign of digoxin toxicity. Other signs include nausea, vomiting, visual disturbances (e.g., yellow-green halos), and cardiac arrhythmias.
49. Match List - I with List - II and indicate your answer with the help of the codes given below:
Codes:
P | Q | R | S
(A) 2 | 1 | 3 | 4
(B) 4 | 2 | 1 | 3
(C) 3 | 1 | 4 | 2
(D) 1 | 4 | 3 | 2
Answer: (C) 3, 1, 4, 2
Explanation:
Incidence (P) refers to the number of new cases over a period of time.
Epidemiology (Q) is the study of the distribution and determinants of health-related states or events in specified populations.
Prevalence (R) refers to the total number of cases (new and existing) in a population at a given time or over a period.
Syndrome (S) is a group of symptoms that consistently occur together, or a condition characterized by a set of associated symptoms.
50. Which of the following does not describe an obsession?
1. Continually reliving a traumatic event.
2. An unwanted thought that a person finds intrusive and distressing.
3. A behaviour that a person feels compelled to perform.
4. Something a person enjoys doing and talking about constantly.
Codes:
(A) 1, 2, and 4
(B) 2 and 4
(C) 2, 3, and 4
(D) 1, 3, and 4
Answer: (D) 1, 3, and 4
Explanation:
○ An obsession is an unwanted, intrusive, and distressing thought (2).
○ "Continually reliving a traumatic event" (1) describes a symptom of PTSD, not typically an obsession in the context of OCD.
○ "A behaviour that a person feels compelled to perform" (3) describes a compulsion, which is distinct from an obsession (though often linked in OCD).
○ "Something a person enjoys doing and talking about constantly" (4) does not describe an obsession, which is inherently unwanted and distressing.
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