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Fundamentals of Nursing Master Quiz
26. Which of the following you identify as a risk factor for otitis media in an infant?
- (A) Preterm birth
- (B) Low birth weight
- (C) Bottle feeding
- (D) Formula feeding
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Bottle feeding
💡 Explanation: Bottle feeding (especially propping the bottle while the infant is supine) allows milk to easily pool in the back of the throat and enter the short, horizontal Eustachian tube, leading to middle ear infections.
27. Which of the following threats to internal validity is best controlled by using random assignment in experimental studies?
- (A) History
- (B) Maturation
- (C) Selection bias
- (D) Testing effect
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Selection bias
💡 Explanation: Random assignment ensures that individual differences (age, health status, etc.) are evenly distributed across both the control and experimental groups, eliminating selection bias.
28. Which of the following patient brought to emergency require the involvement of a forensic nurse?
- (A) An old woman with signs of abuse
- (B) A college student with signs of rape
- (C) A victim of violence
- (D) A victim of assault while doing robbery
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) A college student with signs of rape
💡 Explanation: Sexual assault cases strictly require the specialized skills of a forensic nurse (SANE) to meticulously collect, document, and preserve biological evidence for legal prosecution.
29. A nurse researcher is studying the effect of a new wound care protocol on healing time. She randomly assigns patients to intervention and control groups and measures wound healing over 3 weeks. Which research design is most appropriate?
- (A) Descriptive design
- (B) Quasi-experimental design
- (C) True experimental design
- (D) Correlational design
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) True experimental design
💡 Explanation: The presence of an intervention, a control group, AND random assignment are the three hallmark requirements of a True Experimental design (RCT).
30. Which electrolyte imbalance is most life-threatening in a patient with acute kidney injury (AKI)?
- (A) Hyperphosphatemia
- (B) Hypocalcemia
- (C) Hyperkalemia
- (D) Hypernatremia
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Hyperkalemia
💡 Explanation: The kidneys are responsible for excreting 90% of the body's potassium. In AKI, potassium builds up rapidly, which can cause sudden ventricular fibrillation and cardiac arrest.
31. Which of the following rightly describes the changes happening in a cadaver?
- (A) Rigor, cooling, marbling, mummification
- (B) Marbling, Cooling, rigor, mummification
- (C) Cooling, marbling, rigor, mummification
- (D) Cooling, rigor, marbling, mummification
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Cooling, rigor, marbling, mummification
💡 Explanation: The standard post-mortem sequence is Algor mortis (cooling of the body) -> Rigor mortis (stiffening of muscles) -> Marbling (putrefaction/vein discoloration) -> Mummification/Skeletonization.
32. Calculate the drop per minute if a nurse wants to administer intravenous (IV) fluid at a rate of 60ml/hour using a micro drip set.
- (A) 15 drops/ minute
- (B) 20 drops/ minute
- (C) 30 drops/ minute
- (D) 60 drops/ minute
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) 60 drops/ minute
💡 Explanation: A microdrip set delivers 60 drops per 1 mL. Therefore, the drop rate per minute is always exactly equal to the volume ordered per hour. 60 ml/hr = 60 drops/min.
33. While preparing a disinfection protocol for reusable surgical instruments, a nurse chooses glutaraldehyde. Which of the following instruments is most appropriately disinfected using high-level disinfection with glutaraldehyde?
- (A) Vaginal speculum
- (B) Laryngoscope blade
- (C) Surgical scalpel
- (D) IV infusion set
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Laryngoscope blade
💡 Explanation: A laryngoscope blade touches intact mucous membranes, making it a "semi-critical" item that requires High-Level Disinfection (HLD) like Glutaraldehyde. Scalpels (critical) need total sterilization.
34. A patient develops a catheter-associated urinary tract infection (CAUTI) despite adherence to aseptic insertion technique. Which of the following best explains this infection from an epidemiological standpoint?
- (A) Endogenous transmission via ascending colonization
- (B) Cross-transmission by health workers
- (C) Contaminated catheter tip during insertion
- (D) Improper urinary bag positioning
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Endogenous transmission via ascending colonization
💡 Explanation: Even with perfect insertion, over time, the patient's own (endogenous) bowel or perineal flora will crawl up the outside (extraluminal) or inside of the catheter tubing into the bladder, causing an infection.
35. During the sterilization audit of an autoclave, it is found that biological indicators test positive but chemical indicators are normal. What is the most appropriate conclusion?
- (A) The autoclave cycle was successful
- (B) The sterilization process was incomplete
- (C) Chemical indicators are more reliable than biological ones
- (D) It indicates only packaging failure
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) The sterilization process was incomplete
💡 Explanation: A positive biological indicator means that highly resistant bacterial spores survived the cycle. Biological indicators are the absolute gold standard; if they test positive, sterilization failed, even if the chemical tape changed color.
36. Which of the following hand hygiene moments is most frequently missed in clinical settings, according to WHO compliance studies?
- (A) Before touching a patient
- (B) After body fluid exposure risk
- (C) After touching patient surroundings
- (D) After touching a patient
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) After touching patient surroundings
💡 Explanation: Healthcare workers often remember to wash hands after touching the patient directly, but frequently forget that touching the bedrails, monitors, or tables (patient surroundings) carries the exact same risk of pathogen transfer.
37. A nurse caring for an immunocompromised patient with neutropenia must:
- (A) Use only droplet precautions
- (B) Avoid fresh fruits and flowers in the patient’s room
- (C) Restrict all visitors regardless of symptoms
- (D) Apply airborne precautions for all procedures
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Avoid fresh fruits and flowers in the patient’s room
💡 Explanation: Fresh fruits, vegetables, plants, and soil harbor dangerous bacteria and fungal spores (like Aspergillus). Neutropenic patients have no white blood cells to fight these off, so they are strictly prohibited.
38. Which of the following combinations best meets the WHO criteria for a safe sharps container in a high-risk infectious disease ward?
- (A) Transparent, puncture-resistant, foot-operated
- (B) Rigid, colorless, autoclavable
- (C) Leak-proof, puncture-resistant, labeled with biohazard symbol
- (D) Plastic, sealed with lid, located near pharmacy
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Leak-proof, puncture-resistant, labeled with biohazard symbol
💡 Explanation: Safe sharps containers must be impenetrable to needles (puncture-resistant), contain any residual fluids (leak-proof), and be clearly marked with universal biohazard warnings.
39. What is the rationale for pre-treating microbiology laboratory waste before incineration or landfill disposal?
- (A) Prevent transmission of drug-resistant pathogens
- (B) Reduce plastic burden
- (C) Enhance combustion efficiency
- (D) Reduce color contamination in landfill soil
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Prevent transmission of drug-resistant pathogens
💡 Explanation: Microbiology waste contains highly concentrated, living cultures. Pre-treating (usually by autoclaving) kills these live pathogens, preventing massive outbreaks or environmental contamination during transport and disposal.
40. The primary hormone responsible for maintaining the pregnancy in the early stages is ______.
- (A) Estrogen
- (B) HCG
- (C) Progesterone
- (D) Oxytocin
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Progesterone
💡 Explanation: Progesterone (produced by the corpus luteum) relaxes the smooth muscle of the uterus, preventing contractions and maintaining the thick endometrial lining essential for the embryo's survival.
41. In behavioral therapy, which of the following is an example of negative reinforcement?
- (A) A patient receives praise for taking medication
- (B) A nurse ignores a patient's shouting to extinguish behavior
- (C) A patient's pain subsides after following an exercise regime
- (D) A patient is reprimanded for refusing physiotherapy
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) A patient's pain subsides after following an exercise regime
💡 Explanation: Negative reinforcement involves *removing* an unpleasant stimulus (pain) in response to a desired behavior (exercising), making the patient more likely to exercise again in the future.
42. The Glasgow Coma Scale assesses all the following parameters except?
- (A) Motor response
- (B) Verbal response
- (C) Eye opening
- (D) Memory
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Memory
💡 Explanation: The Glasgow Coma Scale (GCS) consists of three objective components: Eye Opening (E), Verbal Response (V), and Motor Response (M). It assesses level of consciousness, not memory.
43. Which micronutrient deficiency is most commonly seen in patients on long-term proton pump inhibitor (PPI) therapy?
- (A) Iron
- (B) Zinc
- (C) Magnesium
- (D) Vitamin C
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Magnesium
💡 Explanation: The FDA has issued specific warnings that long-term use of PPIs (like Pantoprazole or Omeprazole) alters intestinal absorption, leading to severe hypomagnesemia.
44. A renal patient on hemodialysis is prescribed a high-biological-value (HBV) protein diet. Which food would best meet this requirement?
- (A) Lentils
- (B) Tofu
- (C) Almonds
- (D) Egg whites
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Egg whites
💡 Explanation: Egg whites provide pure, high-biological-value protein (containing all essential amino acids) and are naturally very low in phosphorus, making them the perfect protein source for dialysis patients.
45. Which laboratory finding is most consistent with inhalation injury?
- (A) Decreased PaCO₂ with respiratory alkalosis
- (B) Elevated carboxyhemoglobin levels
- (C) Elevated serum amylase
- (D) Low hematocrit
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Elevated carboxyhemoglobin levels
💡 Explanation: Inhalation injury in fires involves inhaling carbon monoxide. CO binds to hemoglobin with 200x more affinity than oxygen, creating dangerous levels of carboxyhemoglobin in the blood.
46. During acute management, which electrolyte imbalance is most expected in the first 24 hours post-burn?
- (A) Hyperkalemia
- (B) Hypernatremia
- (C) Hypokalemia
- (D) Hypercalcemia
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Hyperkalemia
💡 Explanation: Severe burn injuries destroy millions of cells. Because potassium is primarily located *inside* the cell, massive cell death dumps huge amounts of potassium directly into the bloodstream.
47. A psychiatric nurse observes a patient sitting still, staring at the wall, and resisting all attempts at interaction. What is the most appropriate nursing diagnosis?
- (A) Risk for Violence
- (B) Disturbed Sensory Perception
- (C) Social Isolation
- (D) Catatonia related to Schizophrenia
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Catatonia related to Schizophrenia
💡 Explanation: Immobility, staring, mutism, and rigid resistance to being moved or engaged are textbook clinical hallmarks of catatonia.
48. In the milieu therapy setting, which principle most effectively fosters autonomy in hospitalized psychiatric patients?
- (A) Minimizing patient choices to reduce stress
- (B) Encouraging patient participation in decision-making
- (C) Enforcing rigid ward routines to maintain safety
- (D) Limiting peer interaction to reduce triggers
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Encouraging patient participation in decision-making
💡 Explanation: Milieu therapy relies on using the environment as a therapeutic tool. Giving patients a voice in ward rules and daily schedules fosters self-worth, independence, and autonomy.
49. A patient on lithium therapy presents with diarrhea, muscle weakness, and coarse tremors. What should the nurse suspect?
- (A) Lithium non-compliance
- (B) Lithium toxicity
- (C) Dehydration
- (D) Serotonin syndrome
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Lithium toxicity
💡 Explanation: Lithium has a very narrow therapeutic index. Coarse tremors, severe GI distress (diarrhea/vomiting), and muscle weakness are classic manifestations that lithium levels have reached toxic ranges (>1.5 mEq/L).
50. According to the Indian Public Health Standards (IPHS), what is the population norm for a PHC in hilly/tribal areas?
- (A) 10,000
- (B) 20,000
- (C) 30,000
- (D) 50,000
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) 20,000
💡 Explanation: In India, a Primary Health Centre (PHC) covers a population of 30,000 in plain areas, but the standard is reduced to 20,000 in hilly, tribal, or difficult-to-reach areas.
51. During evaluation of student nurses’ clinical performance, which of the following best ensures objectivity?
- (A) Anecdotal records by clinical instructors
- (B) Use of standardized checklists and rating scales
- (C) Peer assessment and feedback
- (D) Faculty group discussion post-clinical posting
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Use of standardized checklists and rating scales
💡 Explanation: Standardized checklists and rating scales provide clear, predefined criteria for evaluation. This removes the instructor's personal bias, ensuring the assessment is completely objective, fair, and consistent across all students.
52. While teaching pharmacology to intern nurses at bedside, the nurse educator asks them to explain the rationale for the drug regimen of a cardiac patient. Which teaching principle is being applied?
- (A) Repetition
- (B) Motivation
- (C) Correlation with clinical experience
- (D) Evaluation
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Correlation with clinical experience
💡 Explanation: Asking interns to explain the rationale of a specific real-world patient's drug regimen beautifully bridges the gap between theoretical classroom knowledge and practical clinical application (correlation).
53. A nurse educator observes that students lack confidence during patient interaction. Which approach best addresses this issue?
- (A) Increasing classroom lectures on communication skills
- (B) Assigning individual assignments on patient rights
- (C) Organizing structured role-playing of patient scenarios
- (D) Providing detailed manuals on nurse-patient communication
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Organizing structured role-playing of patient scenarios
💡 Explanation: Role-playing allows students to practice communication skills, make mistakes, and receive feedback in a safe, controlled environment. This active practice builds self-confidence prior to actual patient encounters.
54. Which leadership style is most appropriate in a high-acuity critical care unit during a code blue emergency?
- (A) Transformational
- (B) Democratic
- (C) Autocratic
- (D) Laissez-faire
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Autocratic
💡 Explanation: In a critical emergency like a Code Blue (cardiac arrest), there is no time for debate or consensus. An autocratic (directive) leadership style is highly effective because one leader quickly delegates tasks to save a life.
55. A nursing superintendent decides to decentralize decision-making. Which benefit is most likely to result from this strategy?
- (A) Faster decision-making at the point of care
- (B) Reduced communication between departments
- (C) Increased control at the executive level
- (D) Homogenization of staff policies
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Faster decision-making at the point of care
💡 Explanation: Decentralization pushes authority down the chain of command, empowering frontline charge nurses and staff to make quick, relevant decisions without waiting for approval from top administration.
56. Which intervention is the priority for a patient with a GCS score of 7?
- (A) Insert a nasogastric tube
- (B) Administer IV fluids
- (C) Prepare for intubation
- (D) Provide family counseling
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Prepare for intubation
💡 Explanation: The golden rule of trauma and critical care is: "Less than 8, Intubate!" A GCS of 7 indicates severe coma; the patient has lost their gag reflex and cannot protect their airway. Intubation is the immediate priority.
57. Herd immunity protects the population by:
- (A) Treating infected individuals
- (B) Vaccinating children only
- (C) Reducing the number of susceptible hosts
- (D) Isolating infected persons
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Reducing the number of susceptible hosts
💡 Explanation: When a high percentage of a community becomes immune to a disease (via vaccination or prior illness), the chain of transmission is broken, thereby indirectly protecting those who are not immune.
58. Which management theory focuses on workers’ motivation through self-direction & autonomy?
- (A) Scientific Management Theory
- (B) Theory X
- (C) Bureaucratic Theory
- (D) Theory Y
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Theory Y
💡 Explanation: Douglas McGregor's Theory Y posits that employees are naturally self-motivated, seek responsibility, and thrive on autonomy. This contrasts directly with Theory X, which assumes workers are lazy and need strict supervision.
59. A community assessment reveals high infant mortality despite high antenatal coverage. What should the nurse evaluate next?
- (A) Nutritional practices of mothers
- (B) Sanitation facilities
- (C) Quality of intranatal and postnatal services
- (D) Immunization records
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Quality of intranatal and postnatal services
💡 Explanation: If mothers are receiving good care during pregnancy (antenatal), but babies are still dying shortly after birth, the gap in care lies during the actual delivery (intranatal) and the days immediately following birth (postnatal).
60. A nurse is caring for a patient on warfarin therapy with an INR (International Normalized Ratio) of 5.6. Which medication should be administered?
- (A) Vitamin K
- (B) Protamine sulfate
- (C) Fresh frozen plasma
- (D) Heparin
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Vitamin K
💡 Explanation: A therapeutic INR for Warfarin is typically 2.0-3.0. An INR of 5.6 indicates severe toxicity and high bleeding risk. Vitamin K (Phytonadione) is the specific pharmacological antidote for Warfarin toxicity.
61. Which statement accurately describes the mechanism of Rh isoimmunization?
- (A) Rh-negative mother produces IgM antibodies that cross the placenta
- (B) Rh-positive fetus destroys maternal red blood cells
- (C) Rh-positive mother develops antibodies against Rh-negative fetal cells
- (D) Rh-negative mother develops IgG antibodies after exposure to Rh-positive fetal cells
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Rh-negative mother develops IgG antibodies after exposure to Rh-positive fetal cells
💡 Explanation: When an Rh-negative mother is exposed to an Rh-positive baby's blood (usually during delivery), her immune system creates permanent IgG antibodies. These IgG antibodies can cross the placenta in future pregnancies and attack the next Rh-positive fetus.
62. A patient with preeclampsia is on magnesium sulfate. Which sign indicates magnesium toxicity?
- (A) Positive ankle clonus
- (B) Respiratory rate of 10/min
- (C) Blood pressure of 160/110 mmHg
- (D) Hyperreflexia
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Respiratory rate of 10/min
💡 Explanation: Magnesium Sulfate is a central nervous system depressant used to prevent seizures in preeclampsia. Toxicity is characterized by a loss of deep tendon reflexes, oliguria, and life-threatening respiratory depression (RR < 12 breaths/min).
63. A patient with septic shock is being treated with norepinephrine. Which is the primary goal of this therapy?
- (A) Increase systemic vascular resistance and MAP
- (B) Reduce heart rate
- (C) Decrease myocardial oxygen demand
- (D) Improve urine output directly
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Increase systemic vascular resistance and MAP
💡 Explanation: Septic shock causes massive, systemic vasodilation, resulting in severe hypotension. Norepinephrine is a potent alpha-1 agonist vasopressor that constricts blood vessels to increase Systemic Vascular Resistance (SVR) and maintain Mean Arterial Pressure (MAP) > 65 mmHg.
64. Which hemodynamic parameter is most indicative of left ventricular preload?
- (A) Central venous pressure (CVP)
- (B) Mean arterial pressure (MAP)
- (C) Pulmonary capillary wedge pressure (PCWP)
- (D) Systemic vascular resistance (SVR)
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Pulmonary capillary wedge pressure (PCWP)
💡 Explanation: PCWP, obtained via a Swan-Ganz catheter, measures the pressure in the pulmonary capillary bed. This pressure closely reflects the pressure in the left atrium and left ventricle at the end of diastole, which is Left Ventricular Preload.
65. Which is the correct match regarding Indian health committees and their contributions?
- (A) Bhore Committee – Introduced CHC concept
- (B) Kartar Singh Committee – Laid foundation of multipurpose worker scheme
- (C) Shrivastava Committee – Focused on medical education reform
- (D) Mudaliar Committee – Introduced primary health care
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Kartar Singh Committee – Laid foundation of multipurpose worker scheme
💡 Explanation: The Kartar Singh Committee (1973) famously recommended the concept of the "Multipurpose Health Worker" (Male and Female) to replace unipurpose workers in India's rural health services.
66. In a patient with increased intracranial pressure (ICP), which intervention should be avoided?
- (A) Head midline and elevated 30°
- (B) Frequent suctioning
- (C) Osmotic diuretics
- (D) Hypertonic saline
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Frequent suctioning
💡 Explanation: Endotracheal suctioning violently stimulates coughing and the gag reflex, which causes a dangerous, transient spike in intracranial pressure. Therefore, routine or "frequent" suctioning should be strictly avoided in high ICP patients.
67. A nurse notes narrow pulse pressure, muffled heart sounds, and jugular vein distention in a trauma patient. What condition is suspected?
- (A) Tension pneumothorax
- (B) Cardiac tamponade
- (C) Myocardial infarction
- (D) Pulmonary embolism
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Cardiac tamponade
💡 Explanation: This exact triad of symptoms (narrow pulse pressure/hypotension, distant/muffled heart sounds, and JVD) is known as Beck's Triad. It is the hallmark clinical presentation of Cardiac Tamponade.
68. During weaning from mechanical ventilation, which sign indicates that the patient is not tolerating the trial?
- (A) Respiratory rate of 18/min
- (B) SpO₂ of 96%
- (C) Use of accessory muscles & paradoxical abdominal movement
- (D) Tidal volume of 450 mL
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Use of accessory muscles & paradoxical abdominal movement
💡 Explanation: Using accessory muscles (neck/shoulder muscles) and paradoxical breathing are clear signs of extreme respiratory fatigue and an unacceptably high work of breathing, meaning the patient is failing the weaning trial.
69. What is the most critical nursing assessment after administering IV thrombolytics for myocardial infarction?
- (A) Assess respiratory effort
- (B) Monitor for chest pain
- (C) Check for signs of bleeding
- (D) Monitor ECG for ST elevation
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Check for signs of bleeding
💡 Explanation: Thrombolytic drugs ("clot busters" like Alteplase) dissolve all clots in the body. The most dangerous, life-threatening adverse effect is massive bleeding, particularly Intracranial Hemorrhage (ICH).
70. Which of the following indicators is not used to measure the effectiveness of the Janani Suraksha Yojana (JSY)?
- (A) Institutional delivery rate
- (B) Maternal mortality ratio
- (C) Neonatal mortality rate
- (D) Total fertility rate
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Total fertility rate
💡 Explanation: The JSY is a safe motherhood intervention aimed at reducing Maternal and Neonatal Mortality by promoting Institutional Deliveries. Total Fertility Rate (TFR) pertains to family planning and population control, not the direct outcome of JSY.
71. A student got chemical burn while working in the lab. As a school nurse, which of the following intervention you will do to reduce the severity of the burn?
- (A) Immediately cover the area
- (B) Apply antidote solution
- (C) Remove skin from burned area
- (D) Flush the area with water
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Flush the area with water
💡 Explanation: The most crucial, immediate first-aid step for chemical burns is continuous flushing of the affected skin with copious amounts of running water for 15-20 minutes to dilute and remove the chemical completely.
72. Which of the following intervention is considered right while providing first aid to a victim of snake bite?
- (A) Applying tourniquet above the bite wound
- (B) Attempting to suck out venom
- (C) Removing jewelry from the affected limb
- (D) Cut a bite wound
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Removing jewelry from the affected limb
💡 Explanation: Snake bites induce rapid and severe tissue swelling. Removing rings, watches, and tight clothing immediately prevents the items from acting as a tourniquet and causing ischemic tissue death. (Sucking venom and cutting are outdated, harmful practices).
73. Mr X, 45 years is admitted with loss of balance while walking. A nurse performs the Romberg’s sign to evaluate the function of ________.
- (A) Cerebellum
- (B) Acoustic nerve
- (C) Posterior spinal column
- (D) Facial nerve
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Posterior spinal column
💡 Explanation: A positive Romberg test (loss of balance when eyes are closed) indicates a sensory ataxia related to a deficit in proprioception. Proprioception is transmitted via the posterior (dorsal) columns of the spinal cord.
74. Which of the following is a standardized scale that can be used by a nurse to best quantify the severity of post-operative pain in an adult patient?
- (A) Color analog scale
- (B) 11-point numerical rating scale
- (C) Descriptive rating scale
- (D) Faces pain scale
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) 11-point numerical rating scale
💡 Explanation: The 11-point Numerical Rating Scale (NRS) asking the patient to rate pain from 0 (no pain) to 10 (worst pain imaginable) is the most universally validated, standardized tool for cognitively intact adults.
75. The nurse is providing care to Mr X who is admitted in a palliative care unit. The main strategy used in palliative care to manage pain is ____.
- (A) Acetaminophen
- (B) Diazepam
- (C) Gabapentin
- (D) Morphine
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Morphine
💡 Explanation: According to the WHO analgesic ladder, strong opioids like Morphine are the gold standard and mainstay pharmacological strategy for managing moderate to severe pain in palliative care patients.
76. The nurse caring a patient with lung cancer in palliative care unit understands that the main goal of palliative care is to provide________.
- (A) Aggressive treatment
- (B) Plan surgery
- (C) Advanced diagnostic testing
- (D) Comfort and pain relief
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Comfort and pain relief
💡 Explanation: Palliative care explicitly shifts the focus away from curative or aggressive life-prolonging treatments to prioritizing symptom management, comfort, and improving the patient's quality of life.
77. The nurse providing care to a patient of carcinoma bladder explains rightly that myositis is a side effect of_____ drugs.
- (A) Antineoplastic agents
- (B) Anxiolytics
- (C) Antidepressants
- (D) Narcotic analgesics
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Antineoplastic agents
💡 Explanation: Certain antineoplastic (chemotherapy) agents are highly toxic and can cause widespread inflammatory side effects in the body, including myositis (muscle inflammation and pain).
78. The nurse is involved in managing a patient with cardiac arrest. Which of the following must be considered as a shockable rhythm while providing Advanced Cardiac Life Support (ACLS)?
- (A) Ventricular tachycardia
- (B) Atrial tachycardia
- (C) Atrial fibrillation
- (D) Ventricular fibrillation
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Ventricular fibrillation
💡 Explanation: In an ACLS pulseless arrest algorithm, the only two "shockable" rhythms are Ventricular Fibrillation (VFib) and Pulseless Ventricular Tachycardia (pVT). (Asystole and PEA are non-shockable).
79. The proper steps for operating AED?
- (A) Switch on AED, analyze the rhythm, apply pad, deliver shock
- (B) Switch on AED, apply pads, clear the victim, deliver shock
- (C) Apply pads, switch on AED, deliver shock, analyze rhythm
- (D) Apply pads, switch on AED, clear the victim, deliver shock
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Switch on AED, apply pads, clear the victim, deliver shock
💡 Explanation: The universal steps for using an AED are: 1) Turn it on, 2) Apply pads to bare chest, 3) Let AED analyze and "clear" everyone from touching the patient, 4) Deliver shock if advised.
80. How many compressions and breaths should you do for each cycle of CPR?
- (A) 15 compressions, 2 breaths
- (B) 30 compressions, 5 breaths
- (C) 30 compressions, 2 breaths
- (D) 15 compressions, 5 breaths
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) 30 compressions, 2 breaths
💡 Explanation: Current AHA guidelines dictate a universal ratio of 30 chest compressions followed by 2 rescue breaths for adult CPR.
81. The nurse who is a team member of neonatal resuscitation is rightly resuscitating the newborn when she provides a compression ventilation ratio of____.
- (A) 3:1
- (B) 5:1
- (C) 15:1
- (D) 30:2
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) 3:1
💡 Explanation: Neonatal resuscitation requires a 3:1 ratio (90 compressions and 30 breaths per minute). This is because cardiac arrest in neonates is almost exclusively caused by a respiratory event (asphyxia), requiring a higher emphasis on ventilation.
82. A child admitted after ventriculo-peritoneal shunt is receiving 60ml/hour normal saline via a micro-drip set. How much drop rate is required to meet the fluid requirement of the child?
- (A) 40 drops/minute
- (B) 60 drops/minute
- (C) 80 drops/minute
- (D) 10 drops/minute
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) 60 drops/minute
💡 Explanation: A microdrip set is calibrated to deliver exactly 60 drops per milliliter (drop factor = 60). Therefore, the prescribed rate in mL/hour will always equal the drop rate in drops/minute (60 mL/hr = 60 drops/min).
83. After delivery, a newborn infant is immediately assessed with a routine procedure as part of their care. Which of the following scale is used for this immediate newborn assessment?
- (A) Infant Functionality Scale
- (B) Apgar scoring system
- (C) Neonatal Development Scale
- (D) Dubowitz-Ballard Scale
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Apgar scoring system
💡 Explanation: The APGAR score is the universal, rapid assessment tool used exactly at 1 minute and 5 minutes post-delivery to evaluate the newborn's physiological transition to extrauterine life.
84. A 3 months old child is noticed to have chest indrawing and difficulty in breast feeding. How would you classify the child using integrated management of childhood illness (IMCI)?
- (A) Bronchopneumonia
- (B) Pneumonia
- (C) Mild pneumonia
- (D) Severe pneumonia
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) Severe pneumonia
💡 Explanation: According to WHO IMCI guidelines, the combination of lower chest wall indrawing and general danger signs (such as inability to breastfeed or drink) classifies the condition as Severe Pneumonia, requiring immediate hospital referral and antibiotics.
85. The nurse is providing care to a patient with bipolar disorder. Which of the following lithium levels of the patient she understands as within the therapeutic range?
- (A) 0.4 mmol/L
- (B) 1.1 mmol/L
- (C) 1.8 mmol/L
- (D) 2.6 mmol/L
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) 1.1 mmol/L
💡 Explanation: The standard therapeutic range for Lithium during an acute manic episode is 0.8 to 1.2 mEq/L (mmol/L). Levels above 1.5 indicate toxicity.
86. The nurse is collecting history from the husband of Mrs. X brought to psychiatry OPD. Which of the following symptom reported by her husband leads the nurse towards the diagnosis of schizophrenia?
- (A) Hallucinations
- (B) Excessive worry
- (C) Delirium
- (D) Grandiosity
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Hallucinations
💡 Explanation: Hallucinations (perceiving things that aren't there, such as hearing voices) are one of the core, defining positive symptoms required for a clinical diagnosis of schizophrenia.
87. A community health nurse is assessing the neighborhood near the health agency. He drove around observing the condition of the buildings, facilities, and the people in the community. Which of the following best describes the action done by the nurse?
- (A) A phenomenological survey
- (B) A neighborhood observation
- (C) An ethnographic study
- (D) A windshield survey
👀 Click to Reveal Answer & Explanation
✅ Answer: (D) A windshield survey
💡 Explanation: A "windshield survey" is a formal community health nursing term for an observational assessment made by driving or walking through an area to gather initial, informal data on the environment and population.
88. A patient (weight: 60 kg) admitted to critical care unit is to be administered with Inj. methyl prednisolone 5.4mg/kg/hour. The nurse dilutes 2 g methyl prednisolone in 50 ml of normal saline. Calculate the rate of infusion.
- (A) 8.1ml/hour
- (B) 7.5ml/hour
- (C) 9.4ml/hour
- (D) 9ml/hour
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) 8.1ml/hour
💡 Explanation: 1) Find prescribed dose: 5.4 mg × 60 kg = 324 mg/hr.
2) Find concentration: 2g (2000 mg) in 50 mL = 40 mg/mL.
3) Find rate: 324 mg ÷ 40 mg/mL = 8.1 mL/hr.
89. Mrs. X is in active labor and is hyperventilating with a respiratory rate of 28. You are expecting that she will develop respiratory alkalosis. Which of the following presenting manifestations you would notice the patient to have?
- (A) Productive and persistent coughing
- (B) Dizziness
- (C) Cyanosis
- (D) Pallor
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Dizziness
💡 Explanation: Hyperventilation drops CO2 levels in the blood, leading to Respiratory Alkalosis. A low CO2 level causes cerebral vasoconstriction, meaning less blood flow to the brain, which presents as dizziness and lightheadedness.
90. Mrs. Y is a 24-year-old primigravida at 39 weeks gestation who presents to the labor and delivery room in active labor. On admission, the obstetrician notes that she has been pushing for 3 hours with no descent of the fetal head. What is the most likely cause of Mrs. Y's obstructed labor?
- (A) Fetal malpresentation
- (B) Maternal exhaustion
- (C) Pelvic contracture
- (D) Fetal macrosomia
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Pelvic contracture
💡 Explanation: An absolute lack of fetal descent despite 3 hours of adequate, active pushing in a primigravida points toward Cephalopelvic Disproportion (CPD), often caused by a physical narrowing of the maternal pelvis known as a pelvic contracture.
91. A woman who has been in labor for 36 hours is found to have a ruptured uterus. What is the most appropriate treatment in this scenario?
- (A) Emergency cesarean section
- (B) Vaginal delivery
- (C) Administration of antibiotics
- (D) Induction of labor
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Emergency cesarean section
💡 Explanation: A ruptured uterus is a catastrophic obstetric emergency resulting in massive internal bleeding. Immediate surgery via an emergency laparotomy/cesarean section is the only intervention that can save the lives of the mother and fetus.
92. Breast milk can be stored at room temperature safely for _____ hours.
- (A) 2 hours
- (B) 4 hours
- (C) 6 hours
- (D) 8 hours
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) 4 hours
💡 Explanation: According to the CDC and pediatric guidelines, freshly expressed breast milk can be safely stored at normal room temperature (up to 77°F / 25°C) for a maximum of 4 hours.
93. The nurse identifies that the condition in which arterial blood gas analysis showing PH of 7.0 and plasma bicarbonate value of 19 mmol/L is _________ .
- (A) Respiratory acidosis
- (B) Respiratory alkalosis
- (C) Metabolic acidosis
- (D) Metabolic alkalosis
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Metabolic acidosis
💡 Explanation: A pH of 7.0 indicates severe Acidemia (normal 7.35-7.45). A bicarbonate (HCO3) of 19 is abnormally low (normal 22-26 mEq/L). Since the bicarbonate is moving in the same acidic direction as the pH, the primary problem is Metabolic Acidosis.
94. Mr. X is admitted with traumatic brain injury in critical care unit. On assessment, he opens eyes to pain, produces incomprehensible sound and localizes upper extremities to pain. What is his score on Glasgow Coma Scale?
- (A) E3V3M6
- (B) E3V2M4
- (C) E2V2M5
- (D) E2V3M5
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) E2V2M5
💡 Explanation: GCS scoring: Eye opening to pain = E2. Incomprehensible sounds (moaning) = V2. Localizes to pain (moves hand towards painful stimulus to stop it) = M5. Total Score = 9.
95. Which among the following is an inappropriate management for Mr.Y with serum potassium 6.2 mEq/L?
- (A) Administration of spironolactone
- (B) Calcium gluconate infusion
- (C) 5% dextrose with insulin
- (D) Infusion of sodium bicarbonate
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Administration of spironolactone
💡 Explanation: A potassium level of 6.2 is hyperkalemia. Spironolactone is a potassium-*sparing* diuretic. Giving it would cause the kidneys to retain even more potassium, worsening the life-threatening condition.
96. Which of the following maneuver you will use for a patient who is brought to emergency after a fall from ladder while doing electrical work on a street light?
- (A) Jaw thrust maneuver
- (B) Neck extension
- (C) Head tilt-chin lift
- (D) Modified head tilt-chin lift
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Jaw thrust maneuver
💡 Explanation: A traumatic fall indicates a high probability of a cervical spine (neck) injury. The jaw-thrust maneuver is the only safe way to open the airway without extending or rotating the neck.
97. The burned area on the right arm of a patient received in emergency room appears red, has blisters, and is very painful. The nurse correctly identifies it as:
- (A) Superficial burn
- (B) Partial thickness burn
- (C) Deep burn
- (D) Full thickness burn
👀 Click to Reveal Answer & Explanation
✅ Answer: (A) Superficial burn
💡 Explanation: *Note: As per the official GMCH Answer Key, this is marked A.* Generally, clinical texts define a burn with redness and blisters as a superficial partial-thickness (2nd degree) burn, as purely superficial (1st degree) burns usually lack blisters.
98. Which of the following advice given by nurse to a postoperative patient of extracapsular cataract extraction and lens implantation is inappropriate?
- (A) Use the eye patch for 24 hours
- (B) Use aspirin for pain
- (C) Minimize activity for 24 hours
- (D) Wear sunglasses
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Use aspirin for pain
💡 Explanation: Aspirin prevents platelet aggregation and prolongs bleeding time. It is highly contraindicated after delicate ocular surgery due to the severe risk of intraocular hemorrhage. Acetaminophen should be used instead.
99. Identify the type of fracture seen in the given X ray;
- (A) Transverse fracture
- (B) Green stick fracture
- (C) Comminuted fracture
- (D) Spiral fracture
👀 Click to Reveal Answer & Explanation
✅ Answer: (C) Comminuted fracture
💡 Explanation: While the image is missing here, a comminuted fracture (as per the answer key) is defined as a break where the bone is crushed, splintered, or shattered into three or more fragments.
100. Nurse is giving care to a teenage girl with Mullerian agenesis on first postoperative day of vaginoplasty. Which of the following instruction by the physician should alert the nurse?
- (A) Early ambulation
- (B) Removal of Foley’s catheter
- (C) Early resumption of feeding
- (D) Respiratory exercises
👀 Click to Reveal Answer & Explanation
✅ Answer: (B) Removal of Foley’s catheter
💡 Explanation: Post-vaginoplasty, the Foley catheter must remain in place for several days to act as a stent to maintain urethral patency and to prevent urine from contaminating the fresh surgical grafts. Removing it on day 1 is strongly contraindicated.
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