Answer: A) The nurse asked, “Have you taken your medication?”
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.
Answer: B) to
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.”
Answer: B) The IV antibiotics were administered by the charge nurse.
Explanation: Simple past tense active voice (“administered”) converts to simple past passive voice (“were administered” for plural subject).
Q4. Choose the antonym of “BENIGN”.
Answer: C) Malignant
Explanation: “Benign” means non-cancerous/harmless, whereas “malignant” means dangerous or cancerous.
Q5. Choose the synonym of “PROPHYLACTIC”.
Answer: B) Preventive
Explanation: Prophylactic interventions or treatments are designed to prevent disease.
Q6. Select the correctly spelled medical term.
Answer: A) Anaphylaxis
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.”
Answer: C) was available
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.
Answer: B) at
Explanation: The idiom is “at all costs”.
Q9. Select the word nearest in meaning to “EXACERBATE”.
Answer: B) Aggravate
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.”
Answer: B) had
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”.
Answer: C) Improving in health
Explanation: “On the mend” signifies recovering or getting better after an illness.
Q12. Choose the correct option: “The patient is susceptible _____ nosocomial infections.”
Answer: B) to
Explanation: The adjective “susceptible” takes the preposition “to”.
Q13. Choose the sentence with correct verb agreement.
Answer: C) Either the physician or the charge nurse is responsible.
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.”
Answer: D) Vicissitude
Explanation: “Vicissitude” refers to a change or alteration in circumstances or conditions.
Q15. Select the antonym of “LETHARGIC”.
Answer: A) Energetic
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.”
Answer: A) The doctor ordered the nurse to check the blood pressure then.
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.”
Answer: C) swift
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.”
Answer: A) for
Explanation: One is “commended for” an action or achievement.
Q19. Select the correctly spelled word.
Answer: A) Auscultation
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”.
Answer: B) Soothing
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?
Answer: A) CN IX (Glossopharyngeal) and CN X (Vagus)
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:
Answer: B) Respiratory Acidosis
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?
Answer: B) Sinoatrial (SA) node
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?
Answer: C) Nephron
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?
Answer: C) Oxytocin
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:
Answer: B) Hypocalcemia
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?
Answer: C) Calcium
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?
Answer: B) Neurogenic shock
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)?
Answer: C) 120 days
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:
Answer: B) Myocardium
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?
Answer: B) Parietal cells
Explanation: Parietal (oxyntic) cells produce HCl and intrinsic factor (necessary for Vitamin B12 absorption).
Q32. In cerebrospinal fluid (CSF) analysis, bacterial meningitis typically demonstrates:
Answer: B) Low glucose, high protein, elevated neutrophils
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?
Answer: B) Medulla oblongata and Pons
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?
Answer: B) Beta cells
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:
Answer: B) Type II pneumocytes
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?
Answer: A) TPN contains high concentrations of dextrose.
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?
Answer: C) Severe head injury / Coma
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?
Answer: B) High-Fowler’s position with feet dangling
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?
Answer: C) 90 degrees
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:
Answer: B) 60 bpm in an adult
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:
Answer: A) Stage I
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?
Answer: C) Glycated Hemoglobin (HbA1c)
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:
Answer: B) Prevent leakage of irritating medication into subcutaneous tissue
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?
Answer: C) Continuous, vigorous bubbling in the water seal chamber
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:
Answer: B) 10–15 seconds
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?
Answer: B) 0.9% Normal Saline
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:
Answer: C) Stop the blood transfusion completely
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?
Answer: B) Low protein, restricted potassium and sodium
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?
Answer: B) Meninges
Explanation: Positive Kernig’s and Brudzinski’s signs indicate meningeal irritation (meningitis).
Q50. What is the correct priority sequence in the Nursing Process?
Answer: B) Assessment, Diagnosis, Planning, Implementation, Evaluation
Q51. A patient with asthma presents with severe wheezing. Suddenly, breath sounds become completely silent. This finding indicates:
Answer: B) Severe airway constriction and respiratory failure
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:
Answer: B) 3.5–5.0 mEq/L
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?
Answer: A) Tracheostomy tray and calcium gluconate
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)?
Answer: C) Airborne precautions
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?
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?
Answer: B) Autocratic
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:
Answer: A) Staffing and Delegation
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?
Answer: B) To document adverse events for quality improvement and risk management
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:
Answer: B) Non-maleficence
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?
Answer: B) Primary Nursing
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)?
Answer: B) Puncture-proof yellow/red container
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:
Answer: B) Cumulative financial value and consumption volume
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)?
Answer: B) Priority to patients with greatest chance of survival with immediate care (Red tag)
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:
Answer: C) Deceased or expectant (un-salvageable)
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?
Answer: C) Planning
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:
Answer: A) Situation, Background, Assessment, Recommendation
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?
Answer: B) Autonomy
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:
Answer: B) Highly experienced, highly motivated autonomous professional staff are involved
Explanation: Laissez-faire works effectively with highly specialized, self-directed professionals requiring minimal supervision.
Q69. In ward management, benchmarking is defined as:
Answer: B) Comparing organizational processes and performance metrics to industry best practice standards
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?
Answer: A) Yellow bag
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?
Answer: B) Protamine Sulfate
Explanation: Protamine sulfate neutralizes heparin through an acid-base ionic interaction.
Q72. What is the specific antidote for opioid-induced respiratory depression?
Answer: B) Naloxone
Explanation: Naloxone is a competitive opioid receptor antagonist that reverses respiratory depression.
Q73. Aminoglycoside toxicity (e.g., Gentamicin) primarily damages which two organ systems?
Answer: B) Otic (Hearing/Balance) and Renal (Nephrotoxicity)
Explanation: Major adverse effects of aminoglycosides are ototoxicity and nephrotoxicity.
Q74. Which drug is preferred for immediate relief of acute asthma attack (rescue inhaler)?
Answer: B) Albuterol (Salbutamol)
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:
Answer: D) After eating lunch in the cafeteria
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” is defined as the time required for:
Answer: B) The plasma drug concentration to decrease by 50%
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)?
Answer: A) Persistent dry cough
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?
Q79. Minimum effective personal protective equipment (PPE) for entering a Droplet Precaution room includes:
Answer: B) Surgical mask within 3 feet of patient
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)?
Answer: B) Escherichia coli
Explanation: E. coli (often introduced via catheterization) is the leading pathogen responsible for nosocomial urinary tract infections.
Q81. High-level disinfection (HLD) destroys all microorganisms EXCEPT large numbers of:
Answer: C) Bacterial endospores
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:
Answer: A) Solvent or Diluent
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?
Answer: B) INR / Prothrombin Time (PT)
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)?
Answer: B) Antiemetic (5-HT3 receptor antagonist)
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:
Answer: B) 121°C (250°F) at 15 psi for 15–20 mins
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?
Answer: B) Care focuses on holistic well-being, comfort, and coping; Cure focuses on disease eradication and biological recovery.
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:
Answer: B) Patient satisfaction, comfort, and positive healthcare experiences
Explanation: Patient hospitality combines clinical safety with empathy, dignity, clean environment, and respectful communication.
Q88. Which strategy best exemplifies patient-centered care during admission?
Answer: B) Orienting the patient to the ward environment, staff, call bell, and addressing immediate concerns
Explanation: Proper orientation reduces anxiety and establishes a collaborative nurse-patient therapeutic relationship.
Q89. Active listening by a charge nurse involves:
Answer: B) Maintaining eye contact, nodding, and reflecting feelings without judging
Explanation: Active listening requires non-verbal presence, non-judgmental attention, and empathetic validation.
Q90. Palliative care differs from Hospice care in that Palliative care:
Answer: B) Can be initiated at any stage of a serious illness alongside curative treatment
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?
Answer: B) Maintaining noise reduction controls during night shifts
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:
Answer: B) Accommodate the cultural dietary preference if clinically non-contraindicated
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:
Answer: B) Treating family members as essential partners in patient emotional support and recovery
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:
Answer: B) The fifth vital sign
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?
Answer: B) Providing clear, age-appropriate explanations of what to expect before, during, and after
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?
Answer: B) Empathy
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:
Answer: B) Optimize functional independence and self-management capabilities
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:
Answer: B) Expose only the body part being washed while keeping other areas covered
Explanation: Draping exposed areas respects body privacy and preserves dignity.
Q99. What constitutes a breach of patient confidentiality?
Answer: A) Discussing patient case details in a public hospital elevator
Explanation: Discussing protected health information in public areas violates privacy regulations (e.g., HIPAA).
Q100. Holistic nursing assessment encompasses which of the following dimensions?
Answer: B) Physical, psychological, social, and spiritual health
Explanation: Holistic care integrates physical, mental, social, and spiritual dimensions of human health.
