115) NORCET 2023 Paper

NORCET/AIIMS
Memory Based Solved Question Paper-2023
Part - A
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M. L. Saini Sir L. R. Solanki Sir

Nursing Officer, JIPMER Nursing Officer, CGHS
www.missionhighnurses.com MISSION
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1. A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant
twice before, the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy
produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the GTPAL system
to record her obstetrical history, the nurse should record?
a. 3-2-0-0-2 b. 2-2-0-2-2 c. 3-1-1-0-2 d. 2-1-1-0-2
• The client is currently pregnant for the third time (G = 3)
• Her first pregnancy ended at term at 37 weeks (T = 1)
• Her second pregnancy ended preterm (36 weeks) (P = 1)
• She has no history of abortion (A = 0)
• She has two living children (L = 2)
• So score of GTPAL is 3, 1, 1, 0, 2
2. A client is admitted to the hospital for an induction of labor owing to a gestation of 42 weeks confirmed by dates
and ultrasound. When she is dilated 3 cm, she has a contraction of 70 seconds. She is receiving oxytocin. The
nurse's first intervention should be to?
a. Check FHR b. Notify the attending physician
c. Turn off the IV Oxytocin d. Prepare for the delivery because the client is probably in transition phase
• The standard of care for an induction according to guidelines that contractions should not exceed 60 seconds in an
induction. Inductions should simulate normal labor, 70-second contractions during the latent phase (3 cm) are not the
normal. The next contractions can be longer and increase risks to the mother and fetus. So IV Oxytocin should be turned
off is a priority action.
3. Which of the following step is not included in surgical safety checklist?
a. Time in b. Time out c. Sign in d. Sign out
Phases of WHO Surgical safety checklist
(Trick-SITOSO) Take bold words only)
Sign In- (NORCET-2021, S-l)
- The period begins before induction of anaesthesia.
- This phase should be assessed between nurse & anaesthetist.
Time Out-
- The period begins after induction of anaesthesia and before skin incision.
- This phase should be assessed b/w nurse, anaesthetist & surgeon
- Ensure antibiotic prophylaxis has been given prior to 60 minutes or not given. (AIMS Delhi-2018)
Sign Out-
- The period during or immediately after wound closure but before leaving the client from the operation room.
- This phase should be assessed b/w nurse, anaesthetist & surgeon.
Note :
- In WHO surgical safety checklist, Time in phase is not included. (NORCET-2021, S-Il, NORCET-2023)
4. All of the following are correct about WHO 5 hand hygiene movement, EXCEPT?
a. After touching the patient b. Before touching the patient
c. Before touching patient surrounding d. Before do any procedure
WHO 5 Moments for hand washing:
- Moment 1 : Before touching a patient
- Moment 2 : Before a clean/aseptic procedure
- Moment 3 : After a procedure or body fluid exposure risk
1.C 2.C 3.A 4.C
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- Moment 4 : After touching a patient
- Moment 5 : After touching patient surroundings
5. After liver biopsy, the patient should be placed in?
a. Supine position b. Prone position
c. Right lateral position d. High fowler position
Client's Position in Liver Biopsy
- During procedure- Supine or left lateral to expose the right side of the upper abdomen. (AIIMS Manglagiri-2018)
- After procedure- Right lateral with a pillow or sandbag under the puncture site to decrease the risk of haemorrhage or
bleeding.
- All other positions do not help to prevent bleeding.
6. What is the best position to keep a 12-year-old child after a lumbar puncture to assess CSF?
a. Semi-fowlers so that the child can watch TV and be entertained
b. Supine position for several hours so as to prevent a headache
c. On her right side to prevent leak of CSF
d. Prone for two hours to prevent vomiting and aspiration
Recommended position in lumber puncture
During procedure-
- Lateral recommended position or C-shaped position near edge of the bed (first choice)
- Sitting position in that patient sit on bed, leaning on cardiac table, feet supported on a flat surface
Post-Procedure-
- Prevent post lumber puncture headache by place the client in Supine position for 2 hours
- After that place the client in side lying or flat position for 2 to 3 hours.
- Post-procedure, head end of the bed should not be elevated for 6 hours to prevent post lumber puncture headache.
(AIIMS Delhi, PGI, JIPMER, ESIC 2018,19)
7. When teaching a mother of a 4-month-old with diarrhoea about the importance of preventing dehydration, the
nurse would inform the mother about the importance of feeding her child?
a. Fruit juices b. Diluted carbonated drinks
c. Soy-based, lactose-free formula d. Regular formulas mixed with electrolyte solutions
- Diluted fruit juices are not recommended for rehydration because they tend to aggravate the diarrhoea (they are act as
hypertonic property).
- Diluted soft drinks have a high-carbohydrate content, which aggravates the diarrhoea.
- Soy-based, lactose-free formula reduces stool output and duration of diarrhea in most infants.
- Regular formulas contain lactose, which can increase diarrhea.
8. Prior to administration of antibiotics there is need to sensitivity test. Which of the following antibiotic is not
required sensitivity test?
a. Metronidazole b. Meropenem c. Cefperazone d. Amoxicillin
9. A client with a cervical spine fracture at C4 level has just arrived in the emergency room. The primary nursing
intervention would be?
a. Stabilization of the cervical spine
b. Airway assessment and stabilization
c. Confirmation of spinal cord injury
d. Normalization of intravascular volume all
5.C 6.B 7.C 8.A 9.B

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- Primary intervention is protection of the airway and adequate ventilation. (first priority action)
- If cervical spine injury is suspected, the airway should be maintained using the jaw thrust method that also protects the
cervical spine.
- All other interventions are secondary to adequate ventilation.
10. A client is being discharged with albuterol and beclomethasone dipropionate to be administered via
inhalation three times a day and at bedtime. Client teaching regarding the sequential order in which the drugs
should be administered includes?
a. Glucocorticoids followed by the bronchodilator b. Bronchodilator followed by the glucocorticoids
c. Alternate successive administrations d. According to the client's preference
- Bronchodilators (albuterol) can dilate the airways first allow for the glucocorticoid (beclomethasone) to be inhaled
through open airways and increase the penetration of the steroid for maximum effectiveness of the drug.
- Rest of options are distracters.
11. A client with a diagnosis of C-4 injury has been stabilized and is ready for discharge. Because this client is at
risk for autonomic dysreflexia, he and his family should be instructed to assess for and report about?
a. Dizziness and tachypnea b. Circumoral pallor and light-headedness
c. Headache and facial flushing d. Pallor and itching of the face and neck
Autonomic Dysreflexia
- It is an uninhibited and exaggerated reflex of the autonomic nervous system
to stimulation, which results in vasoconstriction and elevated blood
pressure.
- It is a neurogenic emergency and should be treated immediately to prevent
a hypertensive stroke.
- Cause- injury at or above T6 level
- Most severe complication- Malignant Hypertension. (FAQs)
- DOC for treating hypertensive crisis is sodium nitroprusside. (Delhi AIIMS-2015)
- Clinical features includes: Distended bowel & bladder (cardinal sign)(AIIMS,
PGI), Hypertension, Bradycardia, Headache, Diaphoresis and Nasal
congestion
12. Which of the following is an indication of phototherapy in a new born with hyperbilirubinemia?
a. Bilirubin level 12.5 mg/dl b. Bilirubin level 15 mg/dl
c. Bilirubin level 20 mg/dl d. Bilirubin level 22 mg/dl
Indication of Phototherapy
- In Term new born: >15 mg/dl serum Bilirubin level
- In Pre-Term New born: >5 mg/dl serum bilirubin level, to prevent need for blood transfusion.
- Phototherapy should be discontinued when serum bilirubin level return to less than 10 mg/dl for 2 times.
13. A 35-weeks-pregnant client is undergoing a non-stress test (NST). During the 20-minute examination, the
nurse notes three foetal movements accompanied by accelerations of the foetal heart rate, each 15 bpm, and
lasting for 15 seconds. The nurse interprets this test to be?
a. Nonreactive b. Reactive c. Positive d. Negative
Result Interpretation of Non-Stress Test (NST)
Reactive/negative/normal:
- Presence of two or more fetal heart rate accelerations within a 20-minute period.
- Each acceleration must increase the heart rate 15 beats per minute above the baseline rate, and last for at least 15
seconds when the fetus is above 32 weeks' gestation, or 10 beats per minute over 10 seconds when the fetus is at or
10.B 11.C 12.B 13.B
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below 32 weeks' gestation.
- It indicates a healthy/normal fetus.
Non-reactive/positive/abnormal:
- Fewer than two adequate accelerations during a prolonged period, which may be over an hour
- It indicates fetal distress, in which no accelerations noted in FHR.
Also Remember:
- NST test is performed after 32 weeks of gestation.
- During NST Test the client is placed in lateral or side lying
position to avoid supine vena cava syndrome.
14. Which of the following electrolytes should monitor in a
patient with congestive heart failure receiving digoxin and
furosemide?
a. Sodium b. Calcium c. Potassium d. Zink
15. During CPR, the rescuers should change their position?
a. Every three minutes or after two cycles of CPR
b. Every two minutes or five cycles of CPR
c. Every five minutes or two cycles of CPR
d. Every one minute or two cycles of CPR
16. The chest compression and ventilation ratio should maintain in neonatal resuscitation?
a. 3:1 ratio of 90 chest compression and ventilation every 30 seconds
b. 1:1 ratio of 90 chest compression and ventilation every 90 seconds
c. 3:1 ratio of 60 chest compression and ventilation every 20 seconds
d. 2:1 ratio of 90 chest compression and ventilation every 45 seconds
17. Intra muscular injections in neonates should give in?
a. Dosrogluteal muscle b. Vastus lateralis muscle c. Gluteus maximum muscle d. Deltoid muscle
18. What is the normal plasma osmolality ranges in adult?
a. 260-270 mOsm/L b. 280-290 mOsm/L c. 320-330 mOsm/L d. 300-310 mOsm/L
19. Which of the following clinical features would not be seen in a client with dengue haemorrhagic fever, EXCEPT?
a. Thrombocytopenia b. Leucocytosis c. Lymphadenopathy d. Fever
20. A paediatric patient would receive 500 ml DNS through burette infusion set in 5 hours. Calculate the correct
fluid drops per minute?
a. 100 macro drops per minute b. 100 micro drops per minute
c. 80 macro drops per minute d. 80 micro drops per minute
Volume: 500 ml
Time: 5 hours, for per minute multiply with 60 minute
Drop factor: 60 micro drops (burette set considered as micro drip set)
Formula: Volume × Drop factor /Time
= 500 × 60/5 × 60 micro drops/minute = 100 micro drops/minute
21. Which of the following ECG finding would be seen in a patient with kidney failure with potassium level 6.3
mg/dl?
a. Flattened T wave b. Peaked T wave c. ST segment elevation d. ST segment depression
- ECG changes in Hyperkalemia: Tall, peaked T wave, flattened P wave, prolonged PR interval and wide QRS complex.
- ECG changes in hypokalemia: peaked P wave, prominent U wave, T wave inversion or shallow and ST depression.
14.C 15.B 16.A 17.B 18.B 19.B 20.B 21.B
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22. An 8-year-old child comes to the physician's office complaining of swelling and pain in the knees. His mother
says, “The swelling occurred for no reason, and it keeps getting worse.” The initial diagnosis is Lyme disease.
When talking to the mother and child, questions related to which of the following would be important to
include in the initial history?
a. A decreased urinary output and flank pain
b. A fever of over 1030F occurring over the last 2-3 weeks
c. Rashes covering the palms of the hands and the soles of the feet
d. Headaches, malaise, or sore throat
- Lyme disease is a tick-borne illness caused by the bacterium Borrelia burgdorferi.
- It is transmitted to humans through the bite of infected blacklegged ticks.
- Typical symptoms include fever, headache, fatigue, malaise, joint pain, weakness in lower limbs and a characteristic
skin rash called erythema migrans, which often occurs in a bull's-eye pattern.
23. While doing Weber test by tuning fork assessment and checking for vibration sense. Which one of the following
frequency tuning fork is commonly used for screening of hearing impairment?
a. 128 Hz b. 2056 Hz c. 512 Hz d. 1028 Hz
TUNING FORKS
- It is a metal instrument, consist of a stem (handle) and two prongs that form a U-shaped fork.
- The three commonly performed tuning fork tests include: Rinne test, weber test and Absolute bone conduction
test.
- Tuning forks are used to check a patient's hearing loss or to differentiate between conductive and sensorineural
hearing loss.
24. A 30 years old male patient comes in the surgical OPD with pain, discomfort and swelling around the anus and
bleeding per rectum. History is suggestive haemorrhoids. What will be the confirmatory test in OPD?
a. USG whole abdomen b. Sigmoidoscopy c. Proctoscopy d. Digital rectal examination
- Proctoscopy is considered confirmatory test for haemarroids which is allow to examiner to assess anus, rectum or
lower part of colon.
- Digital examination test (DET) is not a standard test to diagnose haemorrhoids either external or internal.
25. A 38 years old patient has comes in emergency department with ruptured gall bladder, cholecystectomy has
done. The patient is discharged with follow up instructions. After 2-3 weeks the patient comes for follow up in
surgical OPD with complain of pain abdomen, generalized tenderness in abdomen, fever etc. What would be
the possible complication?
a. Peritonitis b. Gastritis c. Evisceration d. Dehiscence
Clinical features include peritonitis:
- Rebound tenderness or Blumberg sign (most common sign),
- Abdominal pain, rigidity and guarding, intense while coughing & sneezing,
- Malaise, nausea & vomiting,
- Increased temperature and neutrophils
26. To enhance the percutaneous absorption of nitroglycerin patches, it would be MOST important for the nurse to
select a site that is which of the following?
a. Near the heart b. Non hairy area c. Muscular d. Over a bony prominence
• Skin site free of hair will increase absorption and also avoid distal part of extremities due to less than maximal
absorption. All other options can not affect absorption of NTG patches.
22.D 23.C 24.C 25.A 26.B

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27. A patient in 28-week gestation is receiving labetalol and magnesium sulfate for her pre-eclampsia treatment.
On checking her BP you find that it is 86/56. The most likely cause of this finding is?
a. False reading b. Accidental overdose of labetalol
c. Magnesium sulphate toxicity d. Patient is anxious
- Labetalol is an anti-hypertensive, a class of medications called beta blockers.
- It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.
- If blood pressure decreased below the baselines then it may due to overdose of labetalol.
28. What would be the correct steps to follow in female catheterization?
a. Clean with betadine - apply lignocaine on tip of catheter - Insert catheter - check for urine - inflate the balloon
b. Apply lignocaine on tip of catheter - clean with betadine - insert catheter - inflate the balloon - check for urine
c. Clean with betadin - apply lignocaine on tip of catheter - insert catheter - inflate the balloon - check for urine
d. Clean with betadin - apply lignocaine on tip of catheter - check for urine - insert catheter - inflate the balloon
Priority Nursing Action in Female Catheterisation Procedure
1. Expose external genitalia and meatus in the patient.
2. Separate labia minora with thumbs and forefingers then
3. Clean the vulva or urinary meatus with sterile gauze piece with betadine from anterior to posterior or up to down
technique (less contaminated to more contaminated) using one gauze piece for each time.
4. Keep the labia separating during cleaning.
5. Then insert smoothly lubricated catheter with water soluble gel about 3 inches or 6-8 cm or slightly past points at
which urine returns.
6. After that inflate the balloon usually by 10 to 15 ml sterile water
7. Then fix the catheter on inner thigh of the patient for prevention of accidental pull out.
29. Up to which age height of the child is measured in lying down posture?
a. 12 months b. 18 months c. 24 months d. 9 months
- For children less than 24 months old (or for height less than 85 cms), length should be measured in lying down
position by infantometer.
- For children more than 24 months old, the height should be measured in standing position by stadiometer.
30. Which of the following is an example of basal insulin?
a. Regular insulin b. NPH insulin c. Glulisine insulin d. Degludec insulin
31. In an adult, the normal blood pressure ranges is?
a. 130/90 mm hg b. 110/65 mm hg c. 120/80 mm hg d. 140/90 mm hg
Basal Insulin Bolus Insulin

 The basal insulin, also known as background insulin, is to keep  A bolus dose which isw also known as mealtime insulin, is
blood glucose levels at consistent levels during periods of fasting. insulin that is specifically taken at meal times to keep
 When fasting, the body steadily releases glucose into the blood to blood glucose levels under control following a meal.
our cells and keep blood glucose levels under control, and to  Bolus insulin needs to act quickly
allow the cells to take in glucose for energy.  Bolus insulin is often taken before meals but some people
 Basal insulin is usually taken once or twice a day depending on the may be advised to take their insulin during or just after
insulin. meal.
 Basal insulin is effective for 24 hours  bolus insulin is effective for 2-4 hours
 Examples:  Examples:
Intermediate acting: NPH, Lente Short-acting: Human actrapid (Regular)
Long-lasting: Glargine, detemir, and degludec Rapid acting: Glulusine, aspart, Lispro
27.B 28.A 29.C 30.D 31.C
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32. All of the following are true about ANTRA contraceptive, except?
a. It is injectable contraceptive b. It is irreversible
c. Can be used in 15 to 45 years of age group d. It is available all govt Hospital with free of cost
ANTRA Contraceptive Injection
- ANTRA contraceptive injection is an injectable, reversible progestin-only contraceptive method.
- Components of ANTRA: Depot medroxyprogesterone acetate (DMPA)
- Any women of 15-45 years of age can use this.
- It is available free of cost in government run health centre and hospital.
- Delay in return to fertility (7-10 months from last injection)
- Provide MPA card with due date of injection
- Key Highlights:
- Highly effective, three-month-long, reversible contraception.
- Reversible method of contraception with no effect on fertility
- Effective and safe option for breast-feeding women (after 6 weeks of delivery)
- Each injection (150 mg/ml) gives protection for 90 days (3 months).
- Reduces menstrual cramps and improves anemia by reducing blood loss
- Easily be administered in the arm, thighs or buttocks
- Contraindication of ANTRA:
- Unexplained vaginal bleeding
- Stroke and uncontrolled diabetes
- Breast cancer (past & present)
- Active hepatitis or liver tumor
- Desire for rapid return to fertility
33. A 1 year old toddler develops symptoms like mild tenderness at injection site, malaise,mild fever and
discomfort following DPT immunization. What would be the teaching plan for his parents?
a. This is appropriate reaction
b. Delayed for Next Immunizations process
c. All the features are enough to take the baby in emergency department
d. This is mild reaction and teach the parents how to manage at home
34. When inspecting a cardiovascular client, the nurse notes that he needs to sit upright to breathe. This behaviour
is most indicative for?
a. Pericarditis b. Anxiety c. Congestive heart failure d. Angina
35. On psychiatric interview, a patient had the following thought sample" Hay ! May ! pay ! ray ! day is a sample for?
a. Neologism b. Clang association
c. Derailment d. Loosening of association
36. A patient has sudden cardiac arrest. What would be the first line management of the patient?
a. Check consciousness b. Check breathing
c. Check pulse d. Chest compression
Priority Nursing Action In Cardiac Arrest
1. Assess level of consciousness if found unconscious, then shake the victim's shoulder and shout “Are you OK” (first
action of the CPR), if no response, then call for help or activate emergency medical service EMS system. (second action)
2. Then assess circulation within 10 seconds (FAQs, AIIMS, PGI, JIPMER)
3. If there is pulse not felt than put the victim on firm surface or mattress and in the supine position.
32.B 33.A 34.C 35.B 36.A
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4. Interlock the hands and put on lower half of sternum between nipples and compress chest, complete recoil will be
occurred. (AIIMS BPL- 2018)
5. Allow complete recoil of the chest after each compression to allow the heart refill completely before the next
compression.
6. After initial 30 compressions, assess and establish an airway (less than 10 sec.), use head tilt- chin lift maneuver. (If
cervical injury is suspected than use jaw thrust maneuver without hyperextension of the neck.) (AIIMS, PGI, JIPMER)
7. If two rescues are present then rescuers may changes positions after 2 minute or after 5 cycles of compression and
ventilation at a ratio of 30:2 to prevent fatigue. (Delhi AIIMS & RRB 2019)
8. The adult chest is compressed to a depth of at least 2 inches and compression should be hard and fast at a rate of at least
100 compressions per minutes. (UPNHM-CHO-2018)
9. According to old guidelines of the CPR compression to ventilation ratio is in adults & children 5:1 and in neonate 3:1
(JIPMER, AIIMS, ESIC- 2018)
10. Recommended dose of epinephrine during CPR in infants- 0.1-0.3 ml/kg in dilution 1:10000. (FAQs)
11. Recommended dose of sodium bicarbonate or NaOHCO3 in infants during CPR is 1-2 mEq/kg
37. Which of the following child has low risk for Sudden Infant Death Syndrome (SIDS)?
a. Child lying on back b. Has history of previous child has sudden infant death syndrome
c. Child lying on abdomen d. Child sleeping in side lying
Risk Factors of SIDS:
- Hypothermia, low birth weight and apgar score, prematurity
- Higher percentage of males than females
- Prone position, most common (FAQs), so it is contraindicated for infant less than 1 year age.
- Sleeping on abdomen and on soft mattress
- Exposure to environmental tobacco smoke
- Respiratory disorders like broncho-pulmonary dysplasia
- Has history of previous child has sudden infant death syndrome
- Suddenly pressure on the baby by adults during sleeping.
- Maternal: very young, smoking during pregnancy, drug abused
Note: The best position during sleeping for infant is supine position, positioning on back on firm surface for sleep.
(FAQs)
38. According to World health organization, severe stunning for low height for age is best described in standard
deviation is?
a. Stunted height for age below two standard deviation
b. Stunted height for age below three standard deviation
c. Stunted height for age below four standard deviation
d. Stunted height for age below one standard deviation
WHO Classification for Malnutrition
Classification Index used Moderate Severe
Underweight Weight for age <-2 Z scores <-3 Z score
Wasting Weight for height/length <-2 Z scores <-3 Z score
MUAC 6-59 months <12.5 cm (125 mm) <11.5 cm (115 mm)
Stunting Height for age <-2 Z scores <-3 Z score
37.A 38.B
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- Moderate Stunting is defined as height-for-age z score <−2.0 standard deviation
- Severe Stunting is defined as height-for-age z score <−3.0 standard deviation
39. Human development index components includes, EXCEPT?
a. Life expectancy at birth, schooling and good standard of living
b. Life expectancy at 1 year, schooling and income
c. Life expectancy at 1 year, infant mortality rate and income
d. Life expectancy at 5 year, infant mortality rate and income
40. A nurse taking care of a patient's with chest tube
drainage suddenly notices that there is no fluctuation in
the water seal tube. Which of the following action should
the nurse take first?
a. Turn the patient to the unaffected side
b. Inform the physician
c. Check the tubing to ensure there is no kinking d. Start milking the chest tube
FACTS ABOUT CHEST TUBE DRAINAGE SYSTEM
In water seal chamber:
- Intermittent bubbling may indicate suction level is maintained or normal finding.
- Continuous or excessive bubbling may indicate air leaking or abnormal finding, it should be report to the duty doctor
immediately. (AIIMS)
In suction chamber:
- Steady or constant bubbling may indicates suction level is maintained or normal finding. (PGI-2020)
- Vigorous bubbling in suction chamber indicate abnormal finding and should be inform to duty doctor. (AIISM, PGI, ,
JIPMER, ESIC, GMCH-2019)
Conditions where fluctuation in water seal chamber stopped:
- If tube is obstructed
- If any depended loops exists or resolved.
- If the suction is not working properly or
- If the lungs have re-expanded.
41. Which of the following is a first priority assessment in Cardiac Arrest ?
a. Chest compression b. Check breathing c. Check airway d. Check consciousness
42. Which of the following finding is suggestive an abnormal reading in a 4 hours old new born ?
a. Platelets count 200,000 b. WBC count 17000 c. Haemoglobin 18 gm/dl d. Blood glucose 30 mg/dl
43. A patient is developed mild urticaria and breathlessness. Which of the following medicine would not be
prescribed for this patient at this time?
a. Chlorpromazine b. Hydrocortisone c. Chlorpheniramine d. Dexamethasone
44. In a 28 year old patient Adrenaline to be infused at the rate of 0.2 mcg/kg/minutes. The weight of the patient is
40 kg. The medicine available in ampule is 4 mg (2mg/ml) and 2 ampule to be added in 46 ml Normal saline.
How many ml per minute dose would be administered?
a. 1 ml b. 2 ml c. 3 ml d. None of the above
45. In a patient left femoral popliteal bypass grafting surgery has been done. After 6 hours of the procedure, the
dorsal pedis pulse of the left leg is not palpable. After further assessment reveals that the leg is feel like cool and
pale. What would be the priority nursing action?
a. Notify the doctor b. Reposition and reassess the leg c. Start IV fluid d. It is normal & documentation
39.A 40.C 41.D 42.D 43.A 44.C 45.B

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46. While preparing the medicine, a nurse by mistakenly had needle stuck injury. For which disease post exposure
prophylaxis measure is not required?
a. Hepatitis B b. Hepatitis C c. Tetanus d. HIV
47. Which of the following is correct sequence of hand washing?
a. Wet the hands with water, put the soap, scrub the hands, rins with water, dry the hands with tissue paper
b. Put the soap, wet the hands with water, scrub the hands, rins the hands with water and dry the hands with tissue
paper
c. Wet the hands with water, put the soap, scrub the hands, rins with water, dry the hands with dryer
d. Wet the hands, scrub the hands, put the soap and rins with water
48. A 34 weeks woman admitted in labour room with compliant of abdominal pain and fluid is leaking, after
assessment reveals that the BP 100/70 mg, PR-86 pbm and membrane has ruptured. What would be the
priority nursing action?
a. Assess FHR b. Quality of amniotic fluid
c. Check colour and odour of amniotic fluid d. Begin the labor process immediately
49. A new nurse is caring for an adolescent in the trauma unit who has injuries secondary to a motor vehicle
accident. The nurse has started a blood transfusion. After 30 minutes, the client complains of nausea,
headache, chills and muscle stiffness. An observing nurse should determine that the new nurse intervened
appropriately when the new nurse took which action first?
a. Obtained a set of vital signs b. Called the primary health-care provider
c. Flushed the infusion tubing with normal saline and restarted the blood d. Stopped the transfusion
Transfusion Reactions
Haemolytic Reaction Febrile Reaction Allergic Reaction
 Usually occurs within first 10-15 minutes.  Usually occurs within 30 minutes  Usually occurs during transfusion till
 Signs & symptoms - Shivering, headache,  Clinical features of febrile reaction the end.
flank pain, increase pulse and respiratory are chills, fever, and muscles  Signs & symptoms - Hives, wheezing,
rate, haemoglobinuria, oliguria, sign of stiffness. flushing, pruritis and joint pain.
shock and renal failure.
Priority Nursing Actions If Any Reactions Occurred
 Stop infusion immediately (First priority), then Inform to on duty doctor (Second priority)
 Replace all IV tubing with IV canula that containing blood,
 Maintains patency of IV tubing with only Normal Saline (do not administer other fluids except NS during transfusion)
 Monitor vital signs and Intake/output frequently, strictly first 15 minutes.
 Usually transfusion reaction is occurred within 50 ml of transfusion.
 Stay with the client for the first 15 minutes of the infusion of blood & monitor the client for signs and symptoms of a transfusion
reaction, the first 15 minutes of the transfusion are the most critical, so assigned nurse should be stay with the client.
 Resend the blood to the laboratory.
 Send urine specimen to the laboratory if a haemolytic reaction is suspected.
50. Recommended dose of adrenaline (epinephrine) during neonatal resuscitation is?
a. 1 mg/kg body weight (1 ml in 1:1,000 dilution) b. 0.1 mg/kg body weight (0.1 ml in 1:10,000)
c. 0.01 mg/kg body weight (0.1 ml in 1:10,000) d. 0.5 mg/kg body weight (0.1 ml in 1:1,000)
51. In a patient neck of the femur fractured. Position of the leg should maintain in?
a. External rotation less than 45 degree b. External rotation more than 45 degree
c. Internal rotation less than 45 degree d. Internal rotation more than 45 degree
52. A client is brought to the emergency department reporting chest pain. Assessment shows vital signs that
include a blood pressure (BP) of 155/88 mm Hg, pulse 88 beats per minute (BPM), and respirations 20 breaths
per minute. The nurse administers nitroglycerin 0.4 mg sublingually. The treatment is found to be effective
46.B 47.C 48.A 49.D 50.C 51.C 52.D
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when the reassessment of vital signs shows which data?
a. BP 160/70 mm Hg, Pulse-98 BPM, RR-20 breaths per minute
b. BP 90/60 mm Hg, Pulse-48 BPM, RR-24 breaths per minute
c. BP 170/82 mm Hg, Pulse-60 BPM, RR-24 breaths per minute
d. BP 88/56 mm Hg, Pulse-92 BPM, RR-20 breaths per minute
- NTG works as dilate the blood vessels like arteries and veins, causing blood to pool in the periphery. This causes a
reduced preload and therefore a drop in cardiac output. This vasodilatation causes the blood pressure to fall.
53. Which of the following is the correct height velocity in children aged 2-10 years?
a. 8-18 cm/year b. 4-6 cm/year c. 2-4 cm/ year d. 6-8 cm/year
54. A nurse, assessing a client hospitalized following a road traffic accident (RTA), obtains the following vital signs:
blood pressure (BP) 80/55 mm Hg, heart rate (HR) 128, respiratory rate (RR) 24 and cool clammy skin and
rapid breathing. For which life-threatening complication should the nurse carefully monitor the client?
a. Hypovolemic shock b. Neurogenic shock c. Septic shock d. Cardiogenic shock
TYPES OF SHOCK
Types Clinical manifestations Remarks
Hypovolemic Hypotension, tachycardia, weak thready pulse, cool, pale, moist skin, U/O decreased Decreased CO. Increased SVR
Cardiogenic Hypotension, tachycardia, weak thready pulse, cool, pale, moist skin U/O <30 ml/hr, crackles, Decreased CO, Increased SVR
tachypnea
Neurogenic Hypotension, bradycardia, warm dry skin (AIIMS & SJH-2019) Decreased CO, Venous & arterial
vasodilation, loss sympathetic tone
Anaphylactic Hypotension, tachycardia, cough, dyspnea pruritus, urticaria, restlessness, decreased LOC Decreased Co Decreased SVR
Septic Hypotension, tachycardia, full bounding pulse, tachypnea pink, warm, flushed skin, decreased U/O, Decreased CO, Decreased SVR
Fever
55. Nurse Jeremy is evaluating a client's fluid intake and output record. Fluid intake and urine output should relate
in which way?
a. Fluid intake should be double the urine output
b. Fluid intake should be approximately equal to the urine output
c. Fluid intake should be half the urine output
d. Fluid intake should be inversely proportional to the urine output
- Normally, fluid intake is approximately equal to the urine output. Any other relationship signals an abnormality.
- Fluid intake that is double the urine output indicates fluid retention
- Fluid intake that is half the urine output indicates dehydration.
- Normally, fluid intake isn't inversely proportional to the urine output
56. Under five mortality rate is calculated based on?
a. The number of deaths of children under 5 years per 1,000 live births
b. The number of births of children under 5 years per 1,000 live births
c. The number of deaths of children under 1 years per 1,000 live births
d. The number of births of children under 5 years per 1,0000 live births
57. Which of the following statement is correct about puberty?
a. Onset of secondary sexual characteristics before 10 years of age is defined as precocious puberty
b. Cessation of menstrual cycle is known as menarche
c. Onset of secondary sexual characteristics before 16 years of age is defined as precocious puberty
d. Onset of puberty is known as menopause
53.D 54.A 55.B 56.A 57.A

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58. An adult client arrives in the emergency department with burns to both entire legs and the perineal area.
Which of the following fluid would be started by on duty nurses?
a. Ringer lactate b. Normal saline 0.9% c. DNS d. Normal saline 0.45% with dextrose 10%
- Ringers lactate is considered as fluid of choice for fluid resuscitation in burn cases.
59. A nurse's client, who is in post-operative phase, during assessment obtains the information chills, high grade
fever, significantly drop in blood pressure and rapid breathing. Patient may develop septicaemia. Based on the
above assessment, which result is abnormal and should be reported to the physician?
a. White blood cells (WBCs): 18,000/mm3 b. Glucose: 78 gm/dl
c. Haemoglobin: 13.2 g/dl d. Platelets: 1,50,000/mm3
60. The nurse is inserting nasogastric tube to a client, tube is inserting gently downwards and it reached
nasopharynx and there is slightly resistance occurs. What would be the nurse's next action?
a. Withdraw the tube b. Wait for 5 minutes and further insert the tube
c. Instruct the patient to swallow or engulf d. Notify the physician
61. Which of the following manifestation commonly seen in a patient with thiamine deficiency?
a. Memory loss b. Gums bleeding c. Emotion changes d. Rectal bleeding
62. A nurse is preparing a newborn with a myelomeningocele sac for surgery. The most appropriate intervention
to keep the site sterile and protected is to?
a. Leave the sac as it is, exposing it to air b. Apply petroleum as a protective covering for the sac
c. Cover the sac with moist, saline dressings d. Apply dry dressing over the sac
- The sac should be kept moist before surgery to maintain its integrity.
- Exposing the sac to open air, especially in an incubator, can cause drying. Prolonged use of ointments can cause the
breakdown of the tissue while dry dressings are irritating to the sac.
63. A client is bleeding excessively after the birth of a neonate. The health care provider orders fundal massage and
pre-scribes an IV infusion containing 10 units of oxytocin (Pitocin) at 100 ml/hr. A nurse's evaluation of the
client's responses to these interventions is BP: 135/90 mm Hg; uterus: boggy at 3 cm above the umbilicus and
displaced to the right, perineal pad: saturated with bright red lochia. What is the nurse's next action?
a. Increase the infusion rate b. Assess for a distended bladder
c. Continue to perform fundal massage d. Continue to assess the blood pressure
64. Which of the following assessment finding after an amniotomy needs to be conducted first?
a. Cervical dilation b. Bladder distension c. Fetal heart rate pattern d. Maternal blood pressure
65. In the operation theatre, OT in-charge is instructing about scrubbing to the staff nurse. Which is the correct
order in preference-1 Gloves
2 Gown 3 Scrub
4 Check Instrument 5 Gauze count
a. a. 1, 2, 3, 4, 5, b. 3, 2, 1, 5, 4 c. 3, 2, 1, 4, 5 d. 4, 3, 2, 1, 5
66. Which of the following needle type used for fix the surgical drain?
a. Cutting b. Reverse cutting c. Round body d. Tapper point
67. Which statement is true, except?
a. FFP can be stored up to 42 days b. PRBC infused within 4-6 hours
0
c. Platelets can be stored 20 C d. ?
68. A patient develops type 2 respiratory failure. Which is a probable cause of this?
a. Interstitial lung disease b. Flail chest c. Pulmonary oedema d. ARDS
58.A 59.A 60.C 61.A 62.C 63.B 64.C 65.B 66.B 67.A 68.B
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RESPIRATORY FAILURE
Type-01 Type-02
Type 1 respiratory failure occurs when the respiratory system cannot Type 2 respiratory failure occurs when the respiratory system cannot
adequately provide oxygen to the body, leading to hypoxemia. sufficiently remove carbon dioxide from the body, leading to hypercapnia.
it is also known as hypoxic RF. It is also known as hypercapnic RF.
Examples: Examples:
Emphysemia, Interstitial lung disease, ARDS Drug overdose: opioids, alcohol, benzodiazepines
Congestive heart failure Neuromuscular diseases: Mysthenia gravis, GBS, botulism
Pulmonary embolism Obstructive diseases: COPD, Asthma
Arteriovenous malformation Chest wall deformity: flail chest, kyphoscoliosis,
Complete atelectasis Other: obesity, bronchitis,
Severe pneumonia
Severe pulmonary edema
69. In infant/newborn baby, standardised oxygen saturation target range of?
a. 91-95% b. 95-97% c. 97-99% d. 87-90%
70. All of the following given in a patient with potassium toxicity, EXCEPT?
a. Calcium gluconate b. Ipratropium Nebulization c. Insulin dextrose d. Soda bicarbonate
71. A patient may report hearing voice criticizing him every time, he hears the sound of a rotating fan and which
stop when the fan is not running. There is which types of hallucination occur?
a. Functional hallucination b. Pseudo hallucination c. Visual hallucination d. Olfactory hallucination
72. A 6 year old baby is kept 4 hours NPO before endoscopy procedure. Which of the following fluid would be
prescribed for the baby?
a. Isolyte-P b. 10% Dextrose c. 0.9 % NS with 10 % Dextrose d. Ringer lactate
73. The nurse is caring for a child with sickle cell anemia. To prevent thrombus formation in capillaries, as well as
other problems from stasis and clotting of blood in the sickling process. The nurse should take which action on priority?
a. Administer oxygen b. Increase fluids and hydration level
c. Encourage the child to maintain bed rest d. Administer prescribed anticoagulants
Complications of Sickle Cell Crisis
Vaso- Occlusive crisis Sequestration Crisis Aplastic Crisis
 Cauuse- Stasis of blood with clubbin g of cells in the micro -  Large amount of Blood pulling in  It is severe anaemic condition caused by
circulation due to sickle cells. spleen, causing suddenly drop in blood diminished production and increased
 It is a painful episode, not life threatening. pressure and shock, resulted multiple destruction of RBC’s.
 Vaso-occlusive crisis is most common type of sickle cell crisis. splenic infractions.  Destruction of RBC’s precipitate by viral
(IGIMS-2015)  Signs & Symptoms- infection or depletion of folic acid.
 Signs & Symptoms- 1. Profound anaemia  Signs & Symptoms-
1. Sickles cells obstructs blood flow causing, occlusio n, ischemia 2. Hypovolemia, hypotension, shock. 1. Profound anaemia and pallor
and necrosis.  Priority actions- to give more IV fluids  Priority Actions- Conservative
2. Fever, acute abdominal pain, painful swelling of hands, feet to restore fluid volume.
and joints or arthralgia (joint pain)
3. Hand-foot syndrome - It is also known as palmar-plantar
erythrodysesthesia, it is also complication of Chemotherapy.
(AIIMS BPL-2018)
 Priority actions- to give oxygen to prevent sickling cells
Hyper-Haemolytic Crisis Acute Chest Syndrome Brain Attack or CVA
 Increased destruction of red blood cells or RBC’s.  It is a pulmonary infiltrate due to obstruction of  It is Cerebral Vascular Accident due to
 Clinical features - Anaemia, jaundice and sickling cells in the microstructure of lungs. And sickled cells block major blood vessels in
Reticulocytosis. pneumonia like symptoms occurred. the brain.
 Priority Actions- Conservative  Signs & Symptoms includes chest pain, fever ,  Sign & Symptom - depends on involved
cough, tachypnoea, wheezing and hypoxia. part of the brain.
 Priority Actions - semi to fowler position, oxygen  Priority Actions- oxgen administration
and IV fluids.
69.A 70.B 71.A 72.A 73.A
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ANEMIA MUKT BHARAT: Prophylactic Dose and Regime for IFA supplementation
Age group Elemental Iron Folic Acid Frequency Colour code
Children 6-59 months of age 20 mg 100 mcg Biweekly 1 ml Syrup
Children 5-9 years of age 45 mg 400 mcg Weekly Pink colour tab.
School-going adolescent girls and boys, 10-19 years of age 60 mg 500 mcg Weekly Blue colour tab.
Out-of-school adolescent girls, 10-19 years of age 60 mg 500 mcg Weekly Blue colour tab.
Women of reproductive age 20-49 years (non-pregnant, non-lactating) 60 mg 500 mcg Weekly Red colour tab.
Pregnant women 60 mg 500 mcg Daily Red colour tab.
Lactating mothers (of 0-6 months child)
 Starting from the 4th month of pregnancy or from the 2nd trimester
 Continued throughout pregnancy (minimum 180 days during pregnancy) and to be continued for 180 days, post-partum
 Total 360 days (perinatal 180 days +postnatal 180 days)
74. A pregnant woman at 28 weeks of gestation visited ante-natal clinic at a primary health centre for the first
time. Her hemoglobin level was found to be 9 gm%. The therapeutic management will include?
a. 1 IFA tablet (60 mg elemental iron and 500 mcg folic acid) daily
b. 1 IFA tablet (60 mg elemental iron and 500 mcg folic acid) weekly
c. 2 IFA tablet (60 mg elemental iron and 500 mcg folic acid) daily
d. Daily blood transfusion
According to Anaemia Mukht Bharat Program:
- Therapeutic dose of IFA for treatment of Anaemia during pregnancy: 2 IFA tablet containing 60 mg elemental iron
and 500 mcg folic acid for 1 month
- Prophylactic dose of IFA for treatment of Anaemia during pregnancy: 1 IFA tablet containing 60 mg elemental iron
and 500 mcg folic acid starting from 2nd trimester (4 month of pregnancy) for 180 days.
75. Which solution causes the shifting of fluid from the cell to intravascular compartment?
a. Isotonic b. Hypertonic
c. Hypotonic d. Diffusion
76. Which of the following method is used to clean the insertion site of a surgical drain?
a. Inner to outer following in circular motion
b. Outer to inner following in circular motion
c. Central to peripheral
d. Botton to top
77. In the following clinical condition “honey like crusts are seen around the mouth in a baby. Identify the following
skin disease?
a. Scabies b. Impetigo c. Atopic dermatitis d. Rashes
Impetigo
- It is a highly contagious skin infection (due to poor hygiene) caused by bacteria
Staphylococcus aureus. (most common)
- The most commonly affected body part- face around the mouth region and neck region
- Cardinal sign: honey coloured crusts
78. By the instruction of Government of India, the Maharashtra Government, which city has renamed as Chhatrpati
Sambhaji Nagar?
a. Dharashiv b. Aurangabad c. Ahemadnagar d. Ahmadabad
74.C 75.B 76.A 77.B 78.B

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79. Following denote instrument is used in which of the procedure?
a. Throidectomy b. Matoidectomy c. Mastectomy d. Craniotomy

80. In the following image, identify the clinical condition?
a. Tinea pedis b. Tinea corporis c. Tinea capitus d. Tinea unguis

Tinea Fungal Infection
- Tinea capitis- Fungal infection of scalp.
- Tinea Pedis- Fungal infection of foot, it also known as 'Athlete's Foot” (AIIMS BPL- 2016)
- Tinea Corporis- Fungal infection of generalised body
- Tinea cruris- Fungal infection of Groin area.
- Candidiasis- It is also fungal infection, it affects mouth then it called Oral thrush. Cardinal sign of oral thrush is white
patches in the mouth.
81. A pregnant female at 40 weeks of gestation is undergoing for non-stress test (NST). During the examination,
the nurse notes three fetal movements accompanied by accelerations of the fetal heart rate for 15 beats per
minutes from base line for at least in lasting 15 seconds. The nurse interprets this test to be?
a. Non-reactive b. Reactive c. Positive d. Negative
Explanation:
- A reactive NST shows at least two accelerations of FHR with fetal movements, each 15 bpm, lasting 15 seconds or more,
over 20 minutes.
82. Aspirin is used in all of the following conditions, EXCEPT?
a. MI b. Colorectal cancer c. Liver cancer d. Stroke
83. Which of the following medicine is used for fetal lung maturity?
a. Betamethasone b. Indomethasin c. Terbutaline d. IFA
84. A diagnosis of meningitis is made through the analysis of CSF. Which of the following results would be expected
with a diagnosis of bacterial meningitis?
a. Cloudy CSF, elevated WBC, elevated protein and decreased glucose
b. Clear CSF, decreased WBC, elevated protein and elevated glucose
c. Cloudy CSF, decreased WBC, decreased protein and elevated glucose
d. Clear CSF, elevated WBC, decreased protein and decreased glucose
- In the case of bacterial meningitis, findings usually include an elevated pressure, turbid or cloudy CSF, elevated
leukocytes, elevated protein, and decreased glucose levels. This is attributed to the inflammatory response and the
breaching of the blood brain barrier by bacteria.
85. Which is a 30-point questionnaire scale that is used extensively in clinical and research settings to measure
cognitive impairment at bed side in psychiatry?
a. ASRS b. MMSE c. BPRS d. FAST
79.A 80.B 81.B 82.C 83.A 84.A 85.B

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86. Which is the best location of apical pulse assessment in an adult patient?
a. Fourth intercostals space at the right mid axillary line
b. Fourth and Fifth intercostals space at the left mid-clavicular line
c. Fourth intercostals space at the right mid axillary line
d. Fifth intercostals space at the left mid-clavicular line
87. An emergency room nurse is assessing a 22 years old male who has been using opioids. What symptoms
indicate that the client has overdose?
a. Constricted pupils and hypotension b. Vomiting and tachycardia
c. Pupillary dilation and hypertensive crisis d. Tremors and ataxia
88. Identify the following method of oxygenation which is denoting in image?
a. Partial re-breather mask b. Simple oxygen mask

c. Non re-breather mask (NRBM) d. Venturi mask
89. Identify the following radiological finding which is denoting in image?
a. COPD b. Pleural effusion c. Tension Pneumothorax d. ARDS

90. Identify the correct cleaning process of urethral meatus for female catheterization
a. Libia minora front to back b. Labia majora back to front
c. Whole perineum d. ?
91. Identify the following ECG finding which is denoting in photograph?
a. Atrial fibrillation b. Ventricular tachycardia

c. Atrial flutter d. SVT
92. According to Elisabeth Kübler-Ross model for grief, a patient experience with unsurprising symptoms such as
sadness and loss of something which is commonly seen during which stage of kubber model?
a. Denial b. Depression c. Anger d. Acceptance
DABDA is a proper sequence of stage of grief resolution, which is as follow
- I stage (denial) This cannot happen to me.
- II stage (anger) Why is this happening.
- III stage (bargaining) If this avoided I will worship daily.
86.B 87.A 88.C 89.B 90.A 91.C 92.B
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- IV stage (depression)- I do not like anything.
- V stage (acceptance) - Deaths are natural.
93. Which of the following number of surgical blade is used for incision and drainage for a wound abscess?
a. 11 b. 15 c. 22 d. 10
94. An older male patient receiving normal saline 0.9% through IV line complaining shortness of breath and
palpitation. The patient's assessment finding reveals that central venous pressure (CVP) is 18 cm H2O. What
would be the priority nursing intervention?
a. Continue the IV fluid b. Increase the flow rate of IV fluid
c. Discontinue the fluid d. Notify to the physician
FACTS ABOUT CVP
- The central venous pressure (CVP) is the pressure measured in the central veins close to the heart. It indicates mean
right atrial pressure and is frequently used as an estimate of right ventricular preload.
- The normal CVP in Cm H2O- 5 to 10 cm H2O
- The normal CVP in mm hg- 2 to 6 mm hg
- If CVP reading is lower side then client may suspect for hypovolaemia, IV fluid should be increased and if CVP reading is
lower side then IV fluid should be stopped (if going)
- Position of CVP line is Just inferior superior vena cava.
95. A new born baby had delivered with lumbo-sacral meningocoele. Till the period of surgery, the sac should be
well protected by covering it with a sterile gauze piece soaked in?
a. Spirit b. Normal saline c. Methylene blue d. Betadine
96. A nurse includes the nursing diagnosis of Disturbed thought processes secondary to paranoia in the care plan
for a newly admitted client diagnosed with schizophrenia. Which approach is most appropriate for this client?
a. Avoid laughing or whispering in front of the client
b. Begin to identify social supports in the community
c. Encourage the client to interact with others on the unit
d. Have the client sign a written release of information form
- The client is experiencing paranoia and is distrustful and suspicious of others. Laughing or whispering in front of the
client would only serve to increase the client's suspicions. The client is not ready to identify information concerning
community support. Asking the client to trust and to share personal information with strangers is unachievable at this
time. Having the client sign a release may not be appropriate due to the client's current level of awareness.
97. Which of the following is TRUE about disinfection in a surgical unit using Glutaraldehyde?
a. Once prepared can be used for a maximum duration of 7 days
b. 1% glutaraldehyde is used commonly
c. Dilute with water in 1:5 ratio before every use
d. Minimum contact period for disinfection is 20 min
98. A patient presented with swelling in front of neck in midline which moves on deglutition. Which among the
following will be the LESS likely diagnosis?
a. Thyroglossal Cyst b. Solitary thyroid nodule in isthmus
c. Subhyoid bursitis d. Lipoma
99. You witness a 5 years old child who is admitted with you having a seizure. Which is an immediate nursing care
with most appropriate?
a. Maintain in lying position, flat surface; turn head to side during seizure activity, give IV midazolam in
appropriate dose and begin infusion of IV anticonvulsant
93.A 94.C 95.B 96.A 97.D 98.D 99.C

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b. Maintain in supine position, give supplemental oxygen, and start IV midazolam in an appropriate dose
c. Maintain in lying position, flat surface; turn head to side during seizure activity: loosen clothing from neck or chest
and abdominal areas; suction as needed; supervise supplemental oxygen or bag ventilation
d. Maintain in supine position, flat surface; turn head to side during seizure activity, provide
supplemental oxygen and inform the doctor on duty
100. Which of the following medications have robust evidence for having anti-suicidal properties?
a. Valproate & Lithium b. Fluoxetine & Escitalopram
c. Olanzapine & Fluoxetine d. Lithium & Clozapine
101. As per the gazetted guidelines for assessment of persons with disability, which tool is used to assess mental
disability for purpose of certification?
a. Indian Schedule for Disability Assessment b. Indian Disability and Emotional Assessment Schedule
c. Indian Disability Evaluation and Assessment Scale d. Indian Scale for Assessment of Mental Illness & Disability
102. Which of the following is not a sign of dehydration in an infant?
a. Perineal excoriation b. Delayed skin pinch c. Dry mouth d. Drying of tears
103. A 35 year old farmer brought to emergency with history of multiple time vomiting, loose stool &
breathlessness for two hours while he was fumigating his crops. On examination he was drowsy & had
excessive salivation, involuntary defecation, pulse rate 46/minute, BP-90/60 mmHg, respiratory rate-
14/minute, pupils- bilaterally constricted, twitching in bilateral calf muscles. Chest auscultation revealed
bilateral crackles. What is the likely poisoning?
a. Opioid b. Almunium phosphide c. Arsenic d. Organophosphorus
- Organophosphorus poisoning symptoms may include increased saliva and tear production, diarrhoea, nausea,
vomiting, small pupils, sweating, muscle tremors, and confusion. The onset of symptoms is often within minutes, and it
can take weeks to disappear.
104. A patient presenting the signs and symptoms of persecution, suspiciousness, lack of insight may be having?
a. Paranoid Schizophrenia b. Simple Schizophrenia
c. Hebephrenic Schizophrenia d. Undifferentiated Schizophrenia
FACTS ABOUT SCHIZOPHRENIA
 Most common type of schizophrenia- Paranoid schizophrenia, in this type of schizophrenia prognosis is good compare to other type because
paranoid schizophrenia has less negative symptoms, it has more positive symptoms.
 Second most common type of schizophrenia-Disorganized schizophrenia, previously known as Hebephrenic schizophrenia, it usually occurred in
early age < 25 year.
 Chlorpromazine was the 1st antipsychotic to be used by Delay & Deniker in 1953.
 Agranulocytosis (neutropenia and thrombocytopenia): It is most common side effect of Clozapine. Risk is highest in the first year of treatment, so do
CBC count every week for first 6 month and then bi weekly for next 6 months.
 Clozapine is contraindicated if TLC count is < 3500/cumm, it should be discontinued if TLC count become < 3000/cumm or ANC (absolute neutrophil
count) become < 1500/cumm.
105. A client with chronic undifferentiated schizophrenia is receiving an antipsychotic medication haloperidol.
The client is not sitting still and moving inside and outside the ward. For which potentially extra-pyramidal
side effect should a nurse monitor the client?
a. Akathisia b. Oculogyric crisis c. Tardive dyskinesia d. Pseudo parkinsonism
106. Kalloo, a 24-year-old occasional alcoholic shows a change in behaviours. He suspects that people are
conspiring in behaviors; he suspects that people are aspiring against him though his father states that there is
no reason for his fears. He also gets hallucinations of voice commenting on his actions. What is the most
probable diagnosis as per ICD-10?
a. F20-F29 b. F30-F39 c. F40-F49 d. F50-F59
100.B 101.C 102.A 103.D 104.A 105.A 106.A

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WHO ICD-10 Classification of Mental Disorders

International Classification of Mental Disorders (ICD- 10) developed by
WHO in 1992-
 F00-F09: Organic mental disorder.
 F10-F19: Mental and behavioral disorder due to psychoactive
substance use
 F20-F29: Schizophrenia, Delusional and Schizotypal disorder
 F30-F39: Mood (Affective) disorders
 F40-F49: Neurotic and somatoform disorder
 F50-F59: Behavioral syndrome due to physical and physiological factor
 F60-F69: Personality disorders
 F70-F79: Mental retardation
 F99: Unspecified mental disorder
107. A nurse is caring for a client who is diagnosed with severe diarrhoea with dehydration and is receiving 500 ml
dextrose 10% intravenously (IV). How much calorie will get patient from 500 ml dextrose 10% IV fluid?
a. 200 b. 100 c. 300 d. 400
108. A nurse is caring an older patient with congestive heart failure. The nurse can anticipate which medicine will
prescribe by the health care provider?
a. Amiodrone b. Clopidogrel c. Aspirin d. Digoxin
109. A nurse giving dietary instructions to a patient who is at risk of coronary artery disease. Which oil should
avoid?
a. Coconut oil b. Sunflower oil c. Olive oil d. Safflower Oil
110. Most common symptoms of alcohol withdrawal?
a. Tremors b. Bodyache c. Diarrhoea d. Rhinorrhoea
111. The nurse knows that in which of the following poisoning case gastric lavage is not recommended?
a. Arsenic poisoning b. Kerosine poisoning
c. Organophosphorus poisoning d. Dhatura poisoning
112. Best diagnostic measure for the enteric fever in second week of onset of the disease?
a. Urine b. Stool c. Widal d. Blood
113. Which of the following statement is TRUE about Kangaroo Mother Care (KMC)?
a. Exclusive breastfeeding, early discharge, prevention of hypothermia
b. Early initiation of breastfeeding, early discharge, prevention of hypothermia
c. Exclusive breastfeeding, late discharge, prevention of hypothermia
d. Exclusive breastfeeding, early discharge, prevention of hypoglycaemia
114. Which of the following drug would be prescribed for a patient who had barium enema?
a. Laxative b. Neomycin c. Antacid d. Zink
115. A client is admitted with diabetic ketoacidosis (DKA) associated with type 1 diabetes mellitus. The client's
blood sugar is 520 mg/dL. The respiratory assessment finding reveals respiratory rate of 32, with a deep,
regular respiratory effort. Which insulin will prescribe by the health care provider?
a. NPH insulin SC b. Regular insulin infusion c. 5% Dextrose IV d. Sweet juice
116. A new born with 15.3 mg/dl Bilirubin level is admitted in the nursery (NICU) for the management of
hyperbilirubinaemia. The baby need for phototherapy. Which of the following nursing intervention is correct?
a. Change position every 2 hourly b. Check activity every 4 hourly
c. Remove eye shields twice in a day d. Provide breast feeding every 4 hourly
107.A 108.D 109.A 110.A 111.B 112.C 113.A 114.A 115.B 116.A
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Nursing care during Phototherapy
- Cover the eyes and genitals to prevent damage
- Ensure minimum body parts exposing during therapy
- Patient's activity including position, temperature and any other activity should be checked every 2 hourly and eye
shields should be removed at least once per shift for assessment.
- Breastfeeding should offer more frequently usually every 2 hourly
- Body weight should be checked once a day.
- Maintain hydration level, give more fluid by IV infusion.
- Serum Bilirubin level: every 12 hourly
- Provide additional fluid 20-40 ml/kg/day during therapy to prevent dehydration.
- Phototherapy should be discountined when serum Bilirubin level return to <10 mg/dl for 2 times.
117. In a patient an IV cannula is inserted in external jugular vein (EJV) and administered a drug. Which is a correct
pathway of the drug to reach up to the heart?
a. EJV - Subclavian vein Brachiocephalic vein - Heart b. EJV - IJV - Brachiocephalic vein - Heart
c. EJV - Brachiocephalic vein - Heart d. EJV - IJV - Subclavian vein - Brachiocephalic vein Heart
118. What would be the appropriate teaching to a mother in post-partum period about breast feeding for her child?
a. Every 3 hour breast feed b. When baby cry c. Every 6 hour d. When baby Sleep
119. Which of the following is a early symptom of meningitis seen in neonates?
a. Poor feeding b. Bulging fontanel c. Headache d. High pitch cry
120. Identify the level of jaundice correlates in below depicted photograph with TSB level at 3 point (as per
Kramer's zones)?
a. 4-8 mg/dl b. 8-16 mg/dl c. 5-12 mg/dl d. 11-20 mg/dl
121. A patient brought into the emergency department with chest injury. After assessment finding reveals that ribs
are fractured, active bleeding, SpO2 98%, BP 120/77 mm hg. What would be the priority action?
a. Control of bleeding b. Treat rib fracture? c. Administer O2 d. Stabilization of the spine
122. Which of the following test used to differentiate inguinal hernia and Hydrocele?
a. Three finger test b. Ring test c. Deep ring occlusion test d. Transillumination test
123. Identify the correct cleaning process of urethral meatus for female catheterization
a. Libia minora front to back b. Labia majora back to front c. Whole perineum d. Libia minora back to front
124. Which of the following drug should not be used in a patient with renal failure?
a. Spironolactone b. Furosemide c. Sodium Bicarbonate d. Chlorthiazide
117.A 118.A 119.A 120.B 121.A 122.D 123.A 124.A

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- Spironolactone is a diuretics, which is used in the treatment of cardiovascular disease, but is contraindicated in renal
failure due to the risk of hyperkalemia, because in RF potassium level usually remained elevated.
125. The clinical finding polyuria would not be seen in?
a. Diabetes insipidus b. Diabetes mellitus c. Glomerolnephritis d. Pyelonephritis
126. All of the following options are true related to bed sore, EXCEPT?
a. Early bed sore can treat with care b. Most common site for bed sore is sacrum
c. Air mattress cannot reduce the chance of bed sore d. Change the client position every 2 hourly
127. Clinical manifestations of bed sore includes skin breaks, abrasion, blister, or shallow crater, oedema, and
infection are characteristics of? (SCTIMST 2015)
a. Stage I pressure ulcer b. Stage IV pressure ulcer c. Stage III pressure ulcer d. Stage II pressure ulcer
STAGEOF PRESSURE SORE
Stage-1  Non-blanchable area of erythema
 Skin is intact
 Usually over on bony prominence.
 Usually painful
Stage-2  Partial thickness ulceration of epidermis or dermis
 Present as abrasion, blister or shallow open ulcer with a red/pink wound bed without tissue sloughing.
 Skin is not intact
 Open or ruptured serum filled blister (Delhi AIIMS-2019)
 Usually pain is present.
Stage-3  Full thickness ulceration involving epidermis, dermis and subcutaneous tissues.
 Sloughing may be present
 Subcutaneous tissues may be visible
 Undermining or tunnelling may or may not be present.
 In this stage-3 bone, tendon and muscles not exposed.
 Nerve ending damaged so pain is absent
 May require graft.
Stage-4  Extensive tissue damage with involved or exposed bone, tendon or muscles.
 Slough or eschar may be present
 Undermining and Tunneling may develop.
 Nerve ending may be damaged so Pain is absent
 It may require a graft
Unstageable  It is full thickness type wound is covered by eschar and slough
pressure  The true depth or stage of the wound cannot be determined until the slough or eschar is removed to visualize the
ulcer wound bed.
 The true depth or stage of the wound cannot be determined until the slough or eschar is removed to visualize the
wound bed.
128. The inferior epigastric artery is the branch of?

a. External iliac artery b. Internal iliac artery c. Obstructer artery d. Cealiac trunk
129. Recommended disinfectant used for handling spills is?
a. 10% sodium hypochlorite b. 1% sodium hypochlorite
c. 5% Bleach solution d. 2% Bleach solution
- Small volumes (few drops) of Spills: Wipe the spill with a newspaper moistened with hypochlorite solution (1%
dilution containing minimum 500 ppm chlorine). Dis-card the paper as infected waste. Repeat until all visible soiling is
removed.
- Large volumes (>10 ml) of spills: Flood the spill with 10% hypochlorite solution. Remove and discard the paper as
infected waste.
125.C 126.C 127.D 128.A 129.B
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130. When evaluating a client with symptoms of shock, it is important for the nurse to differentiate between
neurogenic and Hypovolemic shock. The symptoms of neurogenic shock differ from hypovolemic shock in
that?
a. In neurogenic shock, the skin is warm and dry
b. In hypovolemic shock, there is a bradycardia
c. In hypovolemic shock, capillary refill is less than 2 seconds
d. In neurogenic shock, there is delayed capillary refill
TYPES OF SHOCK
Types Clinical manifestations Remarks
Hypovolemic Hypotension, tachycardia, weak thready pulse, cool, pale, moist skin, U/O decreased Decreased CO. Increased SVR
Cardiogenic Hypotension, tachycardia, weak thready pulse, cool, pale, moist skin U/O <30 ml/hr, Decreased CO, Increased SVR
crackles, Tachypnea
Neurogenic Hypotension, bradycardia, warm dry skin (AIIMS & SJH-2019) Decreased CO, Venous & arterial
vasodilation, loss sympathetic tone
Anaphylactic Hypotension, tachycardia, cough, dyspnea pruritus, urticaria, restlessness, decreased LOC Decreased Co Decreased SVR
Septic Hypotension, tachycardia, full bounding pulse, tachypnea pink, warm, flushed skin, Decreased CO, Decreased SVR
decreased U/O, Fever
131. Split thickness grafting is
a. Epidermis and part of dermis b. Epidermis and whole of dermis
c. Epidermis and part of dermis underlying structure d. Epidermis
- Split thickness skin grafts (SSG's) consist of the epidermis and a partial thickness of the dermis
132. The nurse is caring a patient with tracheoesopgeal fistula. Which of the following position given to the patient?
a. Head elevation 300 b. Prone position c. Side line d. Supine position
133. All of the following symptoms would be seen in a client with respiratory distress syndrome (RDS), EXCEPT?
a. Nasal flaring b. Tachypnea c. Grunting sound d. Sub costal retraction
134. A 2 years old child brought to an emergency department with complains of frequently episodes of lose stool,
lethargy, weakness. The physical assessment findings reveals poor skin turgor, dry and dull mucous
membrane and rapid heartbeat. The child is having severe dehydration. Which is the best management of fluid
resuscitation for the child?
a. 30 ml/kg/body weight initial 60 minutes then 70 ml /kg/body weight in 5 hr
b. 50 ml/kg /body weight initial 30 minute then 70 ml/kg/body weight in 2.30 hr
c. 30 ml/kg /body weight initial 30 minute then 70 ml/kg/body weight in 2.30 hr
d. 20 ml/kg/body weight bolus and then 70 ml/kg/body weight in 5 hours
135. In the below depicted pedigree of genetic disorders, Identify the disorder?
a. Autosomal dominant b. Autosomal recessive c. X-Linked disorder d. X-Linked dominant
130.A 131.A 132.A 133.D 134.A 135.A

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SECTION-B Non-Tech MCQs

136. Which of the following planet is known as “blue planet”?
a. Saturn b. Earth c. Neptune d. Jupiter
137. Fill in the blank with the relevant preposition-
The cake was cut ___ a knife.
a. By b. Upon c. With d. At
138. Which of the following country is not included in G-20?
a. Brazil b. Canada c. Pakistan d. China
KEY FACTS ABOUT G20
- India is set to take over the G20 presidency from December 1, 2022, till November 30, 2023.
- The 2023 G20 New Delhi summit is the upcoming 18th meeting of Group of Twenty (G20), a summit scheduled to take
place in International Exhibition-Convention Centre (IECC), Pragati Maidan, in New Delhi in 2023.
- It is the first ever G20 summit to be hosted in India and also in South Asia.
- The G20 New Delhi Summit will be chaired by the Indian Prime Minister, Narendra Modi.
- Date: 910 September 2023,
- Motto: One Earth, One Family, One Future
- Location: International Exhibition-Convention Centre (IECC), Pragati Maidan, New Delhi
- City: New Delhi, India (host)
- The 2024 G20 Brazil summit is the upcoming 19th meeting of Group of Twenty (G20), a summit scheduled to take place
in Brazil in 2024.
- The 2022 G20 summit was held in Bali, Indonesia.
139. The clinical finding polyuria would not be seen in?
a. Diabetes insipidus b. Diabetes mellitus c. Glomerolnephritis d. Acute pylonephritis
140. Which state hosted Snow Festival (Winter Carnival) in 2023?
a. Jammu & Kashmir b. Ladhak c. Himachal Pradesh d. Sikkim
141. What is the Synonym of ESSENTIAL?
a. Indispensable b. Necessary c. Needed d. Imperative
142. Select the most appropriate ANTONYM of the given word. PRECISE
a. Actual b. Correct c. Definite d. Inaccurate
143. Select the set in which the numbers are related in the same way as are the numbers of the following set. 8, 9, 145
a. 10, 11, 121 b. 7, 8, 117 c. 6, 8, 104 d. 6, 7, 85
144. Star' is related to 'Galaxy' in the same way as 'Flower' is related to
a. Jasmine b. Blossom c. Bouquet d. Petal
145. Find out that word where the spelling is correct?
a. Puncture b. Punchure c. Punture d. Punctur
136.C 137.C 138.C 139.D 140.A 141.B 142.D 143.D 144.C 145.A
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Memory Based Solved Question Paper-2023

Mission High Nursing Classes

Call / What's app : 7984176768 / 9079000426

M. L. Saini Sir L. R. Solanki Sir

5.C 6.B 7.C 8.A 9.B

22.D 23.C 24.C 25.A 26.B

Basal Insulin Bolus Insulin

39.A 40.C 41.D 42.D 43.A 44.C 45.B

53.D 54.A 55.B 56.A 57.A

74.C 75.B 76.A 77.B 78.B

a. Throidectomy b. Matoidectomy c. Mastectomy d. Craniotomy

a. Tinea pedis b. Tinea corporis c. Tinea capitus d. Tinea unguis

79.A 80.B 81.B 82.C 83.A 84.A 85.B

a. Partial re-breather mask b. Simple oxygen mask

a. COPD b. Pleural effusion c. Tension Pneumothorax d. ARDS

a. Atrial fibrillation b. Ventricular tachycardia

93.A 94.C 95.B 96.A 97.D 98.D 99.C

100.B 101.C 102.A 103.D 104.A 105.A 106.A

WHO ICD-10 Classification of Mental Disorders

a. 4-8 mg/dl b. 8-16 mg/dl c. 5-12 mg/dl d. 11-20 mg/dl

117.A 118.A 119.A 120.B 121.A 122.D 123.A 124.A

128. The inferior epigastric artery is the branch of?

130.A 131.A 132.A 133.D 134.A 135.A

SECTION-B Non-Tech MCQs

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