PART I: ENGLISH (20 Marks)
Q1. Identify the correctly punctuated sentence.
A) The nurse asked, "Have you taken your medication?"
B) The nurse asked "Have you taken your medication"?
C) The nurse asked, "Have you taken your medication"?
D) The nurse asked "have you taken your medication?"
Answer: A
Explanation: Direct quotes are preceded by a comma, enclosed in quotation marks, and the question mark goes inside the closing quotation mark.
Q2. Choose the correct preposition: The patient was admitted _____ the intensive care unit.
A) on
B) to
C) at
D) into
Answer: B
Explanation: In clinical/medical contexts, patients are admitted to a ward or unit.
Q3. Select the correct passive voice: "The charge nurse administered the IV antibiotics."
A) The IV antibiotics are administered by the charge nurse.
B) The IV antibiotics were administered by the charge nurse.
C) The IV antibiotics had been administered by the charge nurse.
D) The IV antibiotics was administered by the charge nurse.
Answer: B
Explanation: Simple past tense active voice ("administered") converts to simple past passive voice ("were administered" for plural subject).
Q4. Choose the antonym of "BENIGN".
A) Mild
B) Harmless
C) Malignant
D) Inoculate
Answer: C
Explanation: "Benign" means non-cancerous/harmless, whereas "malignant" means dangerous or cancerous.
Q5. Choose the synonym of "PROPHYLACTIC".
A) Curative
B) Preventive
C) Therapeutic
D) Diagnostic
Answer: B
Explanation: Prophylactic interventions or treatments are designed to prevent disease.
Q6. Select the correctly spelled medical term.
A) Anaphylaxis
B) Annaphylaxis
C) Anaphylaxis
D) Anaphylaxis
(Options evaluation: A) Anaphylaxis B) Annaphylaxis C) Anaphylaxsis D) Anaphylaxis)
Answer: A
Explanation: The correct spelling is A-N-A-P-H-Y-L-A-X-I-S.
Q7. Identify the error in the sentence: "Neither the doctor nor the nurses was available during the emergency."
A) Neither
B) nor the nurses
C) was available
D) during the emergency
Answer: C
Explanation: When subjects are joined by "neither... nor", the verb agrees with the closer subject ("nurses" = plural, so it should be "were available").
Q8. Fill in the blank: The sterile technique must be maintained _____ all costs during central line insertion.
A) with
B) at
C) by
D) in
Answer: B
Explanation: The idiom is "at all costs".
Q9. Select the word nearest in meaning to "EXACERBATE".
A) Alleviate
B) Aggravate
C) Soften
D) Soothe
Answer: B
Explanation: "Exacerbate" means to make a problem or disease worse/more severe (aggravate).
Q10. Complete the sentence: "If the nurse _____ checked the vitals earlier, the complication could have been prevented."
A) has
B) had
C) would have
D) will have
Answer: B
Explanation: Third conditional structure requires "if + past perfect (had checked)" followed by "would/could have + past participle".
Q11. Select the correct meaning of the idiom: "On the mend".
A) Deteriorating rapidly
B) Undergoing surgery
C) Improving in health
D) On critical care support
Answer: C
Explanation: "On the mend" signifies recovering or getting better after an illness.
Q12. Choose the correct option: "The patient is susceptible _____ nosocomial infections."
A) for
B) to
C) from
D) with
Answer: B
Explanation: The adjective "susceptible" takes the preposition "to".
Q13. Choose the sentence with correct verb agreement.
A) Statistics shows that infection rates dropped.
B) The group of nurses are attending a seminar.
C) Either the physician or the charge nurse is responsible.
D) Ten milligrams are the required dose.
Answer: C
Explanation: When singular subjects are connected by "or", the verb remains singular ("is").
Q14. Identify the word that means "a sudden, unpredictable change in condition."
A) Chronicity
B) Recidivism
C) Caprice
D) Vicissitude
Answer: D
Explanation: "Vicissitude" refers to a change or alteration in circumstances or conditions.
Q15. Select the antonym of "LETHARGIC".
A) Energetic
B) Comatose
C) Somnolent
D) Sluggish
Answer: A
Explanation: "Lethargic" means drowsy or sluggish; its opposite is energetic.
Q16. Choose the correct indirect form: The doctor said to the nurse, "Check the blood pressure now."
A) The doctor ordered the nurse to check the blood pressure then.
B) The doctor asked the nurse that check blood pressure now.
C) The doctor told the nurse for checking blood pressure then.
D) The doctor says to the nurse to check blood pressure now.
Answer: A
Explanation: Imperative sentences change to infinitive ("to check") and time adverbs change ("now" to "then").
Q17. Which word is an adjective in: "The post-operative recovery was remarkably swift."
A) recovery
B) remarkably
C) swift
D) was
Answer: C
Explanation: "Swift" describes the noun "recovery", making it an adjective ("remarkably" is an adverb).
Q18. Fill in the blank: "The team was commended _____ their diligent outbreak response."
A) for
B) on
C) about
D) with
Answer: A
Explanation: One is "commended for" an action or achievement.
Q19. Select the correctly spelled word.
A) Auscultation
B) Oscultation
C) Auscultasion
D) Oscultasion
Answer: A
Explanation: Auscultation (listening to bodily sounds) is spelled A-U-S-C-U-L-T-A-T-I-O-N.
Q20. Choose the word closest in meaning to "PALLIATIVE".
A) Curative
B) Soothing
C) Surgical
D) Diagnostic
Answer: B
Explanation: Palliative care focuses on relieving pain and providing comfort (soothing) rather than curing.
PART II: PROFESSIONAL TEST (80 Marks)
A. Basic Medical Sciences & Pathophysiology (Q21–35)
Q21. Which cranial nerve is responsible for the gag reflex?
A) CN IX (Glossopharyngeal) and CN X (Vagus)
B) CN V (Trigeminal) and CN VII (Facial)
C) CN XI (Accessory) and CN XII (Hypoglossal)
D) CN VIII (Vestibulocochlear)
Answer: A
Explanation: CN IX provides the sensory limb and CN X provides the motor limb of the gag reflex.
Q22. In arterial blood gas (ABG) analysis, a pH of 7.28, PaCO₂ of 52 mmHg, and HCO₃⁻ of 24 mEq/L indicates:
A) Metabolic Acidosis
B) Respiratory Acidosis
C) Respiratory Alkalosis
D) Metabolic Alkalosis
Answer: B
Explanation: Low pH (<7.35) with elevated PaCO₂ (>45 mmHg) and normal bicarbonate indicates uncompensated respiratory acidosis.
Q23. Which cardiac pacemaker node has an intrinsic firing rate of 60–100 beats per minute?
A) Atrioventricular (AV) node
B) Sinoatrial (SA) node
C) Bundle of His
D) Purkinje fibers
Answer: B
Explanation: The SA node is the primary pacemaker of the heart with a normal baseline rate of 60–100 bpm.
Q24. What is the primary functional unit of the human kidney?
A) Glomerulus
B) Calyx
C) Nephron
D) Loop of Henle
Answer: C
Explanation: The nephron is the structural and functional unit responsible for urine formation and filtration.
Q25. Which hormone is secreted by the posterior pituitary gland?
A) Growth Hormone (GH)
B) Thyroid Stimulating Hormone (TSH)
C) Oxytocin
D) Adrenocorticotropic Hormone (ACTH)
Answer: C
Explanation: Oxytocin and Antidiuretic Hormone (ADH) are synthesized in the hypothalamus and stored/released by the posterior pituitary.
Q26. Trousseau’s sign and Chvostek’s sign are classic clinical indicators of:
A) Hyperkalemia
B) Hypocalcemia
C) Hyponatremia
D) Hypermagnesemia
Answer: B
Explanation: Neuromuscular excitability manifesting as carpopedal spasm (Trousseau) and facial twitching (Chvostek) indicates low serum calcium.
Q27. During muscle contraction, which ion binds to troponin to expose myosin-binding sites on actin?
A) Sodium
B) Potassium
C) Calcium
D) Chloride
Answer: C
Explanation: Calcium release from the sarcoplasmic reticulum binds to troponin, causing a conformational change that moves tropomyosin.
Q28. Which type of shock is characterized by loss of sympathetic tone causing vasodilation below the level of spinal injury?
A) Hypovolemic shock
B) Neurogenic shock
C) Cardiogenic shock
D) Anaphylactic shock
Answer: B
Explanation: Neurogenic shock occurs due to disruption of autonomic pathways following spinal cord injury, leading to hypotension and bradycardia.
Q29. What is the normal physiological lifespan of a human erythrocyte (red blood cell)?
A) 30 days
B) 60 days
C) 120 days
D) 180 days
Answer: C
Explanation: Red blood cells circulate in the peripheral vascular system for approximately 120 days before being destroyed in the spleen.
Q30. The middle layer of the heart wall composed primarily of cardiac muscle fibers is the:
A) Endocardium
B) Myocardium
C) Epicardium
D) Pericardium
Answer: B
Explanation: The myocardium is the thick muscular middle layer responsible for cardiac contraction.
Q31. Which cell type in the gastric mucosa secretes Hydrochloric Acid (HCl) and Intrinsic Factor?
A) Chief cells
B) Parietal cells
C) G cells
D) Mucous neck cells
Answer: B
Explanation: Parietal (oxyntic) cells produce HCl and intrinsic factor (necessary for Vitamin B12 absorption).
Q32. In cerebrospinal fluid (CSF) analysis, bacterial meningitis typically demonstrates:
A) High glucose, low protein, elevated lymphocytes
B) Low glucose, high protein, elevated neutrophils
C) Normal glucose, normal protein, high eosinophils
D) Elevated glucose, low protein, high RBCs
Answer: B
Explanation: Bacteria consume glucose (low CSF glucose), release proteins/debris (high protein), and trigger a neutrophilic immune response.
Q33. Which part of the brain controls primary respiratory centers regulating breathing rate and rhythm?
A) Cerebellum
B) Medulla oblongata and Pons
C) Hypothalamus
D) Thalamus
Answer: B
Explanation: The respiratory rhythmicity centers are located in the medulla oblongata and pons within the brainstem.
Q34. Insulin is synthesized and secreted by which specific pancreatic cells?
A) Alpha cells
B) Beta cells
C) Delta cells
D) F cells
Answer: B
Explanation: Beta cells of the islets of Langerhans produce insulin; Alpha cells produce glucagon.
Q35. Surfactant in alveoli reduces surface tension to prevent alveolar collapse. Surfactant is produced by:
A) Type I pneumocytes
B) Type II pneumocytes
C) Alveolar macrophages
D) Goblet cells
Answer: B
Explanation: Type II alveolar cells (pneumocytes) synthesize and secrete pulmonary surfactant.
B. General Nursing & Clinical Interventions (Q36–55)
Q36. When administering total parenteral nutrition (TPN) via a central line, what is the primary reason for strictly monitoring blood glucose levels?
A) TPN contains high concentrations of dextrose.
B) TPN impairs renal glucose excretion.
C) TPN induces destruction of pancreatic beta cells.
D) TPN causes rapid liver glycogen storage loss.
Answer: A
Explanation: Hypertonic TPN solutions contain 20%–50% dextrose, requiring frequent monitoring to prevent severe hyperglycemia.
Q37. A patient with a head injury exhibits a Glasgow Coma Scale (GCS) score of 7. How is this score classified?
A) Mild head injury
B) Moderate head injury
C) Severe head injury / Coma
D) Normal neurological status
Answer: C
Explanation: A GCS score of 8 or lower indicates severe brain injury and deep unconsciousness/coma ("GCS of 8, intubate").
Q38. Which position is most therapeutic for a patient experiencing acute pulmonary edema?
A) Supine with legs elevated
B) High-Fowler's position with feet dangling
C) Trendelenburg position
D) Left lateral Sims position
Answer: B
Explanation: High-Fowler's with feet dangling decreases venous return to the heart (preload) and improves pulmonary expansion.
Q39. What is the standard angle of needle insertion for an Intramuscular (IM) injection?
A) 15 degrees
B) 45 degrees
C) 90 degrees
D) 30 degrees
Answer: C
Explanation: IM injections penetrate deep muscular tissue at a 90-degree angle.
Q40. Before administering digoxin, the nurse must assess the apical pulse for 1 full minute. Digoxin should be withheld if the pulse rate is below:
A) 50 bpm in an adult
B) 60 bpm in an adult
C) 70 bpm in an adult
D) 80 bpm in an adult
Answer: B
Explanation: Digoxin is a negative chronotrope; withholding the drug when adult heart rate is <60 bpm prevents severe bradycardia.
Q41. A patient on bed rest develops a non-blanchable erythema over an intact skin area on the sacrum. This stage of pressure ulcer is:
A) Stage I
B) Stage II
C) Stage III
D) Stage IV
Answer: A
Explanation: Stage I pressure injury presents as localized, non-blanchable redness over intact skin.
Q42. Which laboratory test provides the most accurate indicator of long-term glycemic control over the preceding 2–3 months?
A) Fasting Blood Glucose
B) Oral Glucose Tolerance Test
C) Glycated Hemoglobin (HbA1c)
D) Postprandial Blood Sugar
Answer: C
Explanation: HbA1c measures glucose binding to hemoglobin over the lifespan of red blood cells (~120 days).
Q43. The primary purpose of performing the Z-track technique during IM injection is to:
A) Reduce pain during needle entry
B) Prevent leakage of irritating medication into subcutaneous tissue
C) Accelerate drug absorption into the vascular system
D) Avoid striking blood vessels
Answer: B
Explanation: Z-track seals the medication in muscular tissue and prevents back-seepage into sensitive subcutaneous layers.
Q44. Which assessment finding indicates a potential complication of a chest tube drainage system?
A) Gentle bubbling in the suction control chamber
B) Fluctuations (tidaling) in the water seal chamber during respiration
C) Continuous, vigorous bubbling in the water seal chamber
D) Dark red drainage of 30 mL over 4 hours
Answer: C
Explanation: Continuous bubbling in the water seal chamber indicates an unintended air leak in the system or patient's chest.
Q45. When suctioning an endotracheal tube, the maximum duration for a single suction pass should not exceed:
A) 5–10 seconds
B) 10–15 seconds
C) 20–25 seconds
D) 30 seconds
Answer: B
Explanation: Suctioning should be limited to 10–15 seconds to prevent profound hypoxia and vagal bradycardia.
Q46. Which fluid is an isotonic intravenous solution used for fluid resuscitation in hypovolemia?
A) 0.45% Normal Saline
B) 0.9% Normal Saline
C) 5% Dextrose in 0.9% Normal Saline (D5NS)
D) 3% Hypertonic Saline
Answer: B
Explanation: 0.9% Sodium Chloride (and Lactated Ringer's) are isotonic fluids that expand intravascular volume without shifting cell fluids.
Q47. During blood transfusion, the patient complains of chills, back pain, and dyspnea 10 minutes after start. The FIRST nursing action is to:
A) Slow down the rate of transfusion
B) Administer diphenhydramine immediately
C) Stop the blood transfusion completely
D) Notify the physician while blood runs
Answer: C
Explanation: Immediate cessation of transfusion prevents further infusion of incompatible antigens during a reaction.
Q48. Which dietary recommendation is essential for a patient diagnosed with chronic kidney disease (CKD) on non-dialysis management?
A) High protein, high sodium
B) Low protein, restricted potassium and sodium
C) High potassium, low carbohydrate
D) High protein, high phosphorus
Answer: B
Explanation: Restricting protein reduces nitrogenous waste production; restricting potassium and sodium prevents hyperkalemia and fluid overload.
Q49. Brudzinski’s sign and Kernig’s sign are indicative of inflammation in which system?
A) Peritoneum
B) Meninges
C) Pleura
D) Pericardium
Answer: B
Explanation: Positive Kernig’s and Brudzinski’s signs indicate meningeal irritation (meningitis).
Q50. What is the correct priority sequence in the Nursing Process?
A) Planning, Assessment, Diagnosis, Implementation, Evaluation
B) Assessment, Diagnosis, Planning, Implementation, Evaluation
C) Diagnosis, Assessment, Implementation, Planning, Evaluation
D) Assessment, Planning, Diagnosis, Implementation, Evaluation
Answer: B
Explanation: ADPIE: Assessment → Diagnosis → Planning → Implementation → Evaluation.
Q51. A patient with asthma presents with severe wheezing. Suddenly, breath sounds become completely silent. This finding indicates:
A) Spontaneous resolution of asthma attack
B) Severe airway constriction and respiratory failure
C) Conversion to chronic bronchitis
D) Mucus clearance from bronchioles
Answer: B
Explanation: The "silent chest" is a medical emergency indicating minimal air movement due to near-total airway obstruction.
Q52. The normal therapeutic range for serum potassium is:
A) 1.5–2.5 mEq/L
B) 3.5–5.0 mEq/L
C) 5.5–7.0 mEq/L
D) 135–145 mEq/L
Answer: B
Explanation: Normal serum potassium levels range from 3.5 to 5.0 mEq/L.
Q53. When caring for a patient following a thyroidectomy, which emergency equipment MUST be kept at the bedside?
A) Tracheostomy tray and calcium gluconate
B) Chest tube kit and suction bottle
C) Lumbar puncture set
D) Cardiac defibrillator only
Answer: A
Explanation: Risk of airway collapse due to edema/hematoma requires a tracheostomy kit; risk of accidental parathyroid removal requires IV calcium gluconate for tetany.
Q54. What type of isolation precaution is mandatory for a patient diagnosed with pulmonary Tuberculosis (TB)?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Answer: C
Explanation: Mycobacterium tuberculosis is transmitted via droplet nuclei (<5 microns) requiring airborne precautions (negative pressure room, N95 respirator).
Q55. In the Glasgow Coma Scale, what score is assigned for a patient who opens eyes to speech, speaks confused words, and localizes pain?
A) 10
B) 11
C) 12
D) 9
Answer: C
Explanation: Eye opening to speech = 3; Confused speech = 4; Localizes pain = 5. Total = 3 + 4 + 5 = 12.
C. Ward Administration & Hospital Management (Q56–70)
Q56. Which leadership style is characterized by a charge nurse who makes decisions unilaterally without consulting ward staff?
A) Democratic
B) Autocratic
C) Laissez-faire
D) Transformational
Answer: B
Explanation: Autocratic (authoritarian) leadership involves centralized decision-making with strict control and minimal staff input.
Q57. In a hospital ward, the process of assigning duties based on staff skill level and patient acuity is known as:
A) Staffing and Delegation
B) Centralization
C) Quality Control
D) Accreditation
Answer: A
Explanation: Delegation and appropriate assignment match nursing competence with patient care demands.
Q58. What is the primary purpose of an Incident / Event Report in ward management?
A) To punish the nurse responsible for an error
B) To document adverse events for quality improvement and risk management
C) To inform the media regarding hospital safety
D) To serve as legal proof to fire employees
Answer: B
Explanation: Incident reports are non-punitive tool risk management logs used to identify system gaps and improve safety.
Q59. The principle of nursing ethics that obligates the nurse to "do no harm" to patients is known as:
A) Beneficence
B) Non-maleficence
C) Autonomy
D) Justice
Answer: B
Explanation: Non-maleficence means avoiding intentional or unintentional harm.
Q60. Which system of nursing care delivery assigns a nurse total responsibility for a group of patients during their entire shift?
A) Functional Nursing
B) Primary Nursing
C) Team Nursing
D) Case Management
Answer: B (or Total Patient Care / Primary Nursing model)
Explanation: Primary/Total patient care involves one nurse carrying out all nursing duties for assigned patients throughout the shift.
Q61. What color-coded bin or container is internationally recommended for the disposal of sharp instruments (needles, scalpels)?
A) Yellow plastic bag
B) Puncture-proof yellow/red container
C) Black general waste bag
D) Blue open bucket
Answer: B
Explanation: Sharps must be placed in rigid, puncture-proof containers to prevent needle-stick injuries.
Q62. In inventory management, the "ABC Analysis" technique categorizes hospital supplies based on:
A) Expiry date
B) Cumulative financial value and consumption volume
C) Weight and physical size
D) Country of manufacture
Answer: B
Explanation: ABC analysis divides inventory into Category A (high cost/low quantity), B (moderate cost/quantity), and C (low cost/high quantity).
Q63. What is the standard ratio or principle followed in triage during a Mass Casualty Incident (MCI)?
A) Treat the most critically ill first, regardless of survival chances
B) Priority to patients with greatest chance of survival with immediate care (Red tag)
C) Treat elderly patients first
D) Treat patients who arrive first at the emergency department
Answer: B
Explanation: Disaster triage allocates resources to save the greatest number of lives, prioritising salvageable critical patients (Red).
Q64. A triage tag of BLACK color during a disaster indicates:
A) Immediate / Life-threatening injury
B) Delayed / Non-life threatening
C) Deceased or expectant (un-salvageable)
D) Minimal / Walking wounded
Answer: C
Explanation: Black tags are assigned to deceased victims or those whose injuries are so severe that recovery is impossible with available resources.
Q65. Which management function involves setting goals, establishing strategies, and developing plans to coordinate activities?
A) Directing
B) Organizing
C) Planning
D) Controlling
Answer: C
Explanation: Planning is the foundational administrative phase where objectives and strategic courses of action are defined.
Q66. Shift hand-over communication using the SBAR framework stands for:
A) Situation, Background, Assessment, Recommendation
B) Subjective, Body, Action, Review
C) Status, Breakdown, Analysis, Reaction
D) Safety, Bedside, Assessment, Response
Answer: A
Explanation: SBAR (Situation, Background, Assessment, Recommendation) provides a standardized structure for critical clinical handoffs.
Q67. A patient refuses surgery despite full explanation of risks. The nurse respects the decision based on which ethical principle?
A) Fidelity
B) Autonomy
C) Veracity
D) Justice
Answer: B
Explanation: Autonomy represents the patient's moral right to self-determination and decision-making regarding their body.
Q68. "Laissez-faire" leadership style is best suited when:
A) Emergency cardiac arrest situation occurs in ER
B) Highly experienced, highly motivated autonomous professional staff are involved
C) New nursing graduates are being trained
D) Strict policy adherence is audited
Answer: B
Explanation: Laissez-faire works effectively with highly specialized, self-directed professionals requiring minimal supervision.
Q69. In ward management, benchmarking is defined as:
A) Calculating nurse-to-patient staffing ratios daily
B) Comparing organizational processes and performance metrics to industry best practice standards
C) Counting hospital drug inventory monthly
D) Reporting nursing turnover rates to ministry
Answer: B
Explanation: Benchmarking measures clinical performance and outcome indicators against top-performing peer standards.
Q70. Bio-medical waste: Anatomical human tissue waste should be disposed of in which colored bag?
A) Yellow bag
B) Red bag
C) Blue bag
D) Black bag
Answer: A
Explanation: Human anatomical waste, tissues, and placenta are incinerated/autoclaved via yellow biohazard bags.
D. Pharmacology & Infection Control (Q71–85)
Q71. What is the antidote for heparin overdose?
A) Vitamin K
B) Protamine Sulfate
C) Naloxone
D) Flumazenil
Answer: B
Explanation: Protamine sulfate neutralizes heparin through an acid-base ionic interaction.
Q72. What is the specific antidote for opioid-induced respiratory depression?
A) Atropine
B) Naloxone
C) Acetylcysteine
D) Deferoxamine
Answer: B
Explanation: Naloxone is a competitive opioid receptor antagonist that reverses respiratory depression.
Q73. Aminoglycoside toxicity (e.g., Gentamicin) primarily damages which two organ systems?
A) Cardiac and Hepatic
B) Otic (Hearing/Balance) and Renal (Nephrotoxicity)
C) Ocular and Hematologic
D) Gastrointestinal and Pulmonary
Answer: B
Explanation: Major adverse effects of aminoglycosides are ototoxicity and nephrotoxicity.
Q74. Which drug is preferred for immediate relief of acute asthma attack (rescue inhaler)?
A) Salmeterol
B) Albuterol (Salbutamol)
C) Fluticasone
D) Montelukast
Answer: B
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) providing rapid bronchodilations.
Q75. The "Five Moments for Hand Hygiene" defined by WHO include all of the following EXCEPT:
A) Before touching a patient
B) Before clean/aseptic procedures
C) After touching patient surroundings
D) After eating lunch in the cafeteria
Answer: D
Explanation: The 5 moments are clinical patient-care focused (1. Before patient touch, 2. Before clean task, 3. After body fluid risk, 4. After patient touch, 5. After surroundings touch).
Q76. A drug's "half-life" ($t_{1/2}$) is defined as the time required for:
A) The body to absorb 50% of the oral dose
B) The plasma drug concentration to decrease by 50%
C) The drug to achieve peak therapeutic effect
D) The kidney to excrete 100% of drug metabolites
Answer: B
Explanation: Half-life is the time period in which total drug concentration in plasma is reduced to half.
Q77. What is the primary adverse effect associated with ACE inhibitors (e.g., Captopril, Enalapril)?
A) Persistent dry cough
B) Hypokalemia
C) Tachycardia
D) Constipation
Answer: A
Explanation: ACE inhibitors prevent bradykinin breakdown, leading to bradykinin accumulation in lungs causing a dry, persistent cough.
Q78. Which medication is an antiplatelet drug commonly administered during acute myocardial infarction?
A) Heparin
B) Aspirin
C) Warfarin
D) Alteplase
Answer: B
Explanation: Aspirin inhibits thromboxane A2 aggregation, slowing thrombus growth in acute coronary syndrome.
Q79. Minimum effective personal protective equipment (PPE) for entering a Droplet Precaution room includes:
A) N95 respirator and sterile gloves
B) Surgical mask within 3 feet of patient
C) Complete hazmat suit
D) Goggles only
Answer: B
Explanation: Respiratory droplets (>5 microns) travel short distances; a surgical mask worn when entering room provides barrier defense.
Q80. Which organism is the most common cause of hospital-acquired urinary tract infections (HAUTIs)?
A) Staphylococcus aureus
B) Escherichia coli
C) Pseudomonas aeruginosa
D) Candida albicans
Answer: B
Explanation: E. coli originating from colonic flora accounts for the majority of catheter-associated UTIs.
Q81. High-level disinfection (HLD) destroys all microorganisms EXCEPT large numbers of:
A) Vegetative bacteria
B) Fungi
C) Bacterial endospores
D) Enveloped viruses
Answer: C
Explanation: HLD kills all pathogens except high concentrations of resistant bacterial endospores (which require sterilization).
Q82. When reconstituting a powder vial drug, the liquid added to dissolve the powder is called a:
A) Solvent or Diluent
B) Solute
C) Precipitate
D) Emulsifier
Answer: A
Explanation: A diluent (e.g., sterile water, normal saline) is used to reconstitute powdered medication into solution.
Q83. Patient on Warfarin (Coumadin) therapy should have which lab value monitored regularly?
A) APTT
B) INR / Prothrombin Time (PT)
C) Serum Creatinine
D) Bleeding Time
Answer: B
Explanation: Warfarin inhibits Vitamin K-dependent factors evaluated by PT/INR (Target INR usually 2.0–3.0).
Q84. What is the therapeutic classification of Ondansetron (Zofran)?
A) Antihypertensive
B) Antiemetic (5-HT3 receptor antagonist)
C) Analgesic
D) Anticoagulant
Answer: B
Explanation: Ondansetron blocks serotonin 5-HT3 receptors centrally and peripherally to prevent nausea and vomiting.
Q85. Standard sterilization temperature and pressure in an autoclave are:
A) 100°C at 10 psi for 5 mins
B) 121°C (250°F) at 15 psi for 15–20 mins
C) 150°C at 30 psi for 60 mins
D) 90°C at 5 psi for 45 mins
Answer: B
Explanation: Saturated steam sterilization requires 121°C at 15 psi pressure to destroy bacterial spores.
E. Hospitality of Patients & Care vs. Cure Management (Q86–100)
Q86. What is the fundamental difference between the "Care" model and the "Cure" model in health management?
A) Care focuses on financial profits, while Cure focuses on community health.
B) Care focuses on holistic well-being, comfort, and coping; Cure focuses on disease eradication and biological recovery.
C) Care is performed only by doctors, while Cure is performed by nurses.
D) Care applies only to pediatric patients, while Cure applies to geriatric patients.
Answer: B
Explanation: Nursing essence centers on "Care" (holistic human response and quality of life), whereas medicine emphasizes "Cure" (pathology elimination).
Q87. Hospitality in patient care primarily aims to enhance:
A) Surgical accuracy
B) Patient satisfaction, comfort, and positive healthcare experiences
C) Diagnostic laboratory efficiency
D) Hospital billing speed
Answer: B
Explanation: Patient hospitality combines clinical safety with empathy, dignity, clean environment, and respectful communication.
Q88. Which strategy best exemplifies patient-centered care during admission?
A) Completing admission paperwork without looking at the patient
B) Orienting the patient to the ward environment, staff, call bell, and addressing immediate concerns
C) Restricting family visitors immediately
D) Administering sedatives to prevent patient inquiries
Answer: B
Explanation: Proper orientation reduces anxiety and establishes a collaborative nurse-patient therapeutic relationship.
Q89. Active listening by a charge nurse involves:
A) Interrupting the patient to correct medical terms
B) Maintaining eye contact, nodding, and reflecting feelings without judging
C) Writing notes while ignoring non-verbal cues
D) Planning the next task while the patient speaks
Answer: B
Explanation: Active listening requires non-verbal presence, non-judgmental attention, and empathetic validation.
Q90. Palliative care differs from Hospice care in that Palliative care:
A) Is provided only in the final 2 weeks of life
B) Can be initiated at any stage of a serious illness alongside curative treatment
C) Forbids administration of pain medications
D) Is only delivered at home
Answer: B
Explanation: Palliative care optimizes quality of life at any disease stage, concurrent with curative therapy; hospice care is specifically for terminal prognosis (<6 months).
Q91. Which environment factor directly reduces patient stress and promotes sleep in hospital wards?
A) Continuous overhead fluorescent lighting
B) Maintaining noise reduction controls during night shifts
C) Keeping room temperature at 30°C
D) Loud alarms set on maximum volume
Answer: B
Explanation: Controlling noise pollution at night preserves circadian sleep architecture essential for healing.
Q92. When caring for a culturally diverse patient who requests a specific dietary practice, the nurse should:
A) Refuse the request to maintain ward standardization
B) Accommodate the cultural dietary preference if clinically non-contraindicated
C) Discharge the patient immediately
D) Force standard hospital meals
Answer: B
Explanation: Culturally competent care adapts health delivery to respect patient beliefs and dietary customs safely.
Q93. A key aspect of "Hospitality of Patients" regarding family involvement is:
A) Total exclusion of families from care planning
B) Treating family members as essential partners in patient emotional support and recovery
C) Charging visitors per hour spent in ward
D) Allowing families to administer prescription drugs unsupervised
Answer: B
Explanation: Family-centered care recognizes family support as critical to patient coping and healing.
Q94. Pain is officially recognized in nursing and clinical care as:
A) An objective laboratory finding
B) The fifth vital sign
C) A psychological defense mechanism only
D) An optional nursing assessment
Answer: B
Explanation: Pain assessment alongside BP, HR, RR, and Temperature is established as the 5th vital sign.
Q95. What is the most effective nursing action to alleviate patient anxiety prior to a invasive procedure?
A) Telling the patient "Do not worry, everything will be fine."
B) Providing clear, age-appropriate explanations of what to expect before, during, and after
C) Leaving the patient alone in a dark room
D) Giving general reassurance without details
Answer: B
Explanation: Providing factual, structured information reduces fear of the unknown far better than false reassurances.
Q96. Which core concept of therapeutic communication involves validating the patient’s emotional experience?
A) Sympathy
B) Empathy
C) Apathy
D) Antipathy
Answer: B
Explanation: Empathy is understanding and emotionally connecting with another's experience while maintaining professional objectivity.
Q97. In chronic disease management, the primary goal of the "Care" paradigm is to:
A) Achieve instant permanent cure
B) Optimize functional independence and self-management capabilities
C) Keep the patient continuously hospitalized
D) Suppress all immune responses
Answer: B
Explanation: Chronic illness management focuses on symptom optimization, self-care empowerment, and functional quality of life.
Q98. To maintain patient dignity during personal hygiene care (bed bath), the nurse MUST:
A) Leave the door wide open for ventilation
B) Expose only the body part being washed while keeping other areas covered
C) Allow visitors to remain in the room
D) Perform the bath as quickly as possible without speaking
Answer: B
Explanation: Draping exposed areas respects body privacy and preserves dignity.
Q99. What constitutes a breach of patient confidentiality?
A) Discussing patient case details in a public hospital elevator
B) Documenting patient vitals in the electronic health record
C) Reporting a communicable disease to public health authorities as mandated by law
D) Handing over patient details to the oncoming relief nurse
Answer: A
Explanation: Discussing protected health information in public areas violates privacy regulations (e.g., HIPAA).
Q100. Holistic nursing assessment encompasses which of the following dimensions?
A) Physical health only
B) Physical, psychological, social, and spiritual health
C) Laboratory and radiological data only
D) Financial status and insurance coverage only
Answer: B
Explanation: Holistic care integrates physical, mental, social, and spiritual dimensions of human health.
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