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MSN MCQ Questions

  1. A 30-year-old patient with acute kidney injury is detected to have serum potassium of 7.5 meq/L. Which of the following is the most effective intervention to lower elevated serum potassium?
    1. 10 units of regular insulin in 50 ml of 50% dextrose infusion
    2. Salbutamol 5 mg nebulization diluted in 5 ml normal saline
    3. 10 ml of 10% calcium gluconate IV over 10 minutes with cardiac monitoring
    4. 4 g of Patiromer diluted in 100 ml DW via NG tube

 

  1. Following is   a   graphic   representation   of   a   farmer admitted to the medicine ward with fever with Jaundice. What could be the possible diagnosis?
    1. Cerebral malaria
    2. Brucellosis
    3. Leptospirosis
    4. Typhoid

 

  1. 60-year-old smoker with COPD GOLD stage II is started long term oxygen therapy at 6L/min. The nurse notes pulse 90/min, BP 140 / 100 mm Hg, RR 16/min, sp02= 98%. What should be the priority nursing action?
    1. Ask technician to urgently procure BiPAP machine for NIV
    2. Reduce oxygen flow to 2L/min
    3. Give iv Hydrocortisone 100 mg and nebulization with Formoterol on physician orders
    4. Encourage patient do deep diaphragmatic breathing

 

  1. Elevated jugular venous pressure is most commonly caused by which of the following?
    1. Hypervolemia
    2. Fluid overload
    3. Hypovolemia
    4. Dehydration

 

  1. A nurse is caring for a GBS patient on a mechanical ventilator. Mode selected is Assisted controlled mechanical ventilation. ABG shows pH = 7.50, pCO2 = 30 mmHg and HCO3 = 20 meq/L. Which laboratory value is most likely to be observed in this condition?
    1. Magnesium level = 1.8 mg/dL
    2. Sodium level = 145 mEq/L
    3. Potassium level = 3.0 mEq/L
    4. Phosphate level = 3.0 mg/dL

 

  1. A patient is prescribed nitroglycerine infusion at 15 mcg/ min. The solution available is 50 mg nitroglycerine in 500 mL D5W. What should be correct infusion rate in mL/ hr?
    1. 99 mL/hr
    2. 19 mL/hr
    3. 90 mL/hr
    4. 9 mL/hr

 

  1. 26-year-old female on paroxetine presents with inability to breath during a panic attack. Her ABG report shows:
    pH = 7.55
    PaCO2 = 25 mmHg
    HCO3- = 22 mEq/L
    Which of the following is correct about this patient
    1. Respiratory alkalosis, partially compensated
    2. Respiratory alkalosis, uncompensated
    3. Respiratory alkalosis, fully compensated
    4. Respiratory alkalosis with metabolic alkalosis

 

  1. A patient is suspected to have tuberculosis and the physician orders a Mantoux test. The nurse prepares 0.1 mL of purified protein derivative. By which route should it be administered?
    1. Intradermal
    2. Subcutaneous
    3. Intramuscular
    4. Intravenous

 

  1. Cushing’s triad, a late sign of increased intracranial pressure, includes which of the following?
    1. Widened pulse pressure, tachycardia, irregular respirations
    2. Hypertension, bradycardia, irregular respirations
    3. Hypotension, tachypnea, bounding pulse
    4. Hypertension, tachycardia, rapid respirations

 

  1. A patient has a fever of 101°F and is prescribed IV Meropenem. What should be the nurse’s priority action before administration?
    1. Administer antibiotics immediately
    2. Give antipyretic before starting antibiotics
    3. Obtain culture samples before giving the first dose of Meropenem
    4. Start IV fluids and observe the patient’s response of antibiotics

 

  1. A patient   undergoing   chemotherapy   presents   with Haemoglobin 8.6  g/dL and platelet  count  18 × 10³/µL. Which parameter requires immediate monitoring and intervention?
    1. Thrombocytopenia with platelet count 18 × 10³/µL
    2. Hemoglobin 8.6 g/dL
    3. White blood cell counts within normal limits
    4. Serum electrolytes

 

  1. A patient undergoing haemodialysis develops drop in blood pressure from 150/100 mmHg to 90/60 mmHg, accompanied by tachycardia. What should be the nurse’s first immediate action?
    1. Administer IV dopamine
    2. Inform physician
    3. Reduce ultrafiltration and place patient in Trendelenburg position
    4. Administer IV fluids (normal saline/albumin)

 

  1. A 65-year-old patient with a history of diabetes mellitus and coronary artery disease presents with dizziness and near syncope. ECG shows the following, what is the most appropriate management?
    1. Amiodarone
    2. Transcutaneous pacemaker insertion
    3. Anticoagulant therapy with continuous observation
    4. Atropine

 

  1. A patient with rheumatoid arthritis is presented with a history of gastric ulcer. Which of the following drugs is most appropriate for this patient?
    1. Etoricoxib
    2. Naloxone
    3. Acetaminophen
    4. Ibuprofen

 

  1. Which of the following is not typically seen in a construction worker with heat stroke?
    1. Sweating
    2. Mydriasis
    3. Rapid pulse
    4. Hot dry skin

 

  1. A patient is prescribed an inhaler with 200 puffs. The order is 2 puffs every 6 hours, for how many days will one inhaler last?
    1. 20 days
    2. 25 days
    3. 28 days
    4. 30 days

 

  1. Which of the following is not correct about Diabetes insipidus?
    1. Orthostatic hypotension
    2. Polydipsia with polyuria
    3. Relative hypernatremia
    4. Isosthenuria

 

  1. Nurse notices that a DVT patient receiving heparin has an aPTT of 95 seconds. What is the most appropriate next action?
    1. Hold the next dose of heparin
    2. Check for evidence of blood loss from nose, in urine and in stool
    3. Continue the same heparin dose
    4. Administer vitamin K on physician orders

 

  1. A COPD patient develops an exacerbation due to poor AQI. ABG shows pH=7.2, pCO2 = 60 mm Hg and HCO3= 28 meq/L. Which intervention is the most appropriate for this case?
    1. Start NIV
    2. Administer high flow oxygen with CPAP
    3. Administer high flow oxygen with Venti mask
    4. Start IV hydrocortisone with nebulization with Foracort

 

  1. Before starting dialysis a patient in AKI is found to have a potassium level rises to 6.8 meq/L. What is the immediate management?
    1. Administer calcium gluconate IV
    2. Start insulin drip in 25-50% dextrose
    3. Administer 40 mg furosemide
    4. Restrict IV fluids

 

  1. Which of the following is the most common side effect of nitroglycerin?
    1. Bradycardia
    2. Headache
    3. Nausea
    4. Palpitations

 

  1. A patient is suspected of having acute pancreatitis, which laboratory values are most commonly elevated?
    1. Amylase and lipase
    2. Serum bilirubin
    3. ALT and AST
    4. Creatinine

 

  1. A patient’s arterial blood gas shows pH 7.50, PaCO2 28 mmHg, HCO3– 24 mEq/L. Which of the following is the most likely cause?
    1. Acute exacerbation of COPD
    2. Pulmonary embolism
    3. Status asthmaticus
    4. Obesity hypoventilation syndrome

 

  1. A patient with CKD presents with hyponatremia. What is   the   most   appropriate   initial nursing intervention?
    1. Administer 0.9% NS
    2. Restrict fluids
    3. Administer 3% hypertonic saline
    4. Start diuretics

 

  1. A patient   with   central    diabetes   insipidus   receives vasopressin. What is the expected effect on urine?
    1. Urine volume remains high
    2. Urine specific gravity rises
    3. Urine volume does not change
    4. Urine specific gravity lowers

 

  1. A   patient   is   on continuous   ECG monitoring while receiving   treatment for NSTEMI. Based on the rhythm displayed on the ECG monitor, which   dysrhythmia is the patient experiencing?
    1. Ventricular fibrillation
    2. Torsades de pointes
    3. Polymorphic Ventricular tachycardia
    4. Monomorphic Ventricular tachycardia

 

  1. Name the device shown below and medical condition used for?
    1. CPAP for OSA
    2. Bi-PAP for OSA
    3. CPAP for high altitude pulmonary oedema
    4. Bi-PAP for high altitude pulmonary oedema

 

  1. A patient with jaundice and tremors presents with the following finding in the eye. What will be nursing diagnosis?
    1. Huntington’s chorea
    2. Wilson’s disease
    3. Heavy metal poisoning
    4. Sydenham’s chorea

 

  1. Three days after being initiated on a certain drug, a patient developed the following lesions. Which of the following drugs was likely started for this patient?
    1. Warfarin
    2. Aspirin
    3. Atorvastatin
    4. Levofloxacin

 

  1. What does I.P in the following indicate?
    1. Intellectual property
    2. Indian pharmacopoeia
    3. Industrial production
    4. International pharmaceuticals

 

  1. A 20-year-old man is brought to the emergency following an episode of syncope during his morning walk. His blood pressure is 80/60 mmHg. His present ECG is given below. Which is the most appropriate treatment for the patient?
    1. Lignocaine
    2. Diazoxide
    3. DC cardioversion
    4. Radiofrequency ablation

 

  1. A 20-year-old woman has complaints of reduced hearing on her right side. You perform a diagnostic test using the following instrument. What is the name of this instrument?
    1. Digital audiometer
    2. Tympanometer
    3. Rhinomanometer
    4. BERA

 

  1. What is the most likely diagnosis for the below given ECG image?
    1. Atrial Flutter
    2. Atrial Fibrillation
    3. Ventricular Fibrillation
    4. None of the above

     

  1. What is the name of the osteoarthritis deformity seen in the image?
    1. Dupuytren’s contracture
    2. Swan neck deformity
    3. Heberden’s nodes
    4. Boutonniere deformity

 

  1. Patient with cardiomyopathy and heart failure findings is on digoxin. He latest ECG is shown below. Physician is likely to order which drug for this patient?
    1. Lignocaine
    2. Sotalol
    3. Quinidine
    4. Amiodarone

 

  1. What is the likely diagnosis of this case?
    1. Cushing syndrome
    2. PCOD
    3. Acromegaly
    4. Conn Syndrome

 

  1. The four dysrhythmias ECGs are given below. Which of the following can lead to development of embolic stroke?

 

  1. A nursing student is using coffee and energy drinks to stay awake. He comes to the ER with fluttering feeling in the chest. What is the ECG rhythm shown
    1. Atrial flutter
    2. PSVT
    3. Sinus rhythm with premature ventricular contractions
    4. Ventricular tachycardia

 

  1. You   are   evaluating   a   patient   post   a   neurosurgical procedure.  The patient opens her eyes in response to a loud voice, localizes pain and is confused and disoriented. What is the GCS score of this patient?
    1. E3 M5 V4
    2. E3 M6 V5
    3. E4 M4 V5
    4. E3 M5 V5

 

  1. Match the following:
    1. 1-a, 2-c, 3-b, 4-d
    2. 1-c, 2-a, 3-d, 4-b
    3. 1-b, 2-d, 3-c, 4-a
    4. 1-d, 2-b, 3-a, 4-c

 

  1. In a normal ECG obtained from a patient, a biphasic P wave maybe seen in which of the following lead (s)?
    1. Leads II and V2
    2. Leads II and V1
    3. Lead V1
    4. Lead V5

 

  1. Based on the provided ECG readings, for which patient is likely to be on digoxin?
    1. Patient A
    2. Patient B
    3. Patient C
    4. Patient D

 

  1. An elderly woman is rushed to the ER following an episode of syncope. Her caretaker reports that the patient had multiple episodes of loose stools and vomiting for the past 2 days. Work up is shown below. What is the next best step in the management of this patient?
    Serum sodium: 130 mEq/L
    Serum potassium: 2.8mEq/L
    Serum chloride: 100 mEq/L
    Blood urea nitrogen creatinine ratio: 30
    1. Asses BP, give NS with KCL 40 meq/L
    2. Asses ECG and give KCL via central line 20meq/ hr
    3. Asses BP and give 3% saline bolus over 30 minutes
    4. Asses ECG and give KCL via peripheral line 40 meq/Hr

 

  1. A 37-year-old man, with no known medical illness, came for a routine medical check-up. His chest radiograph is presented to you. Identify the incorrect statement with respect to the X-ray shown below.
    1. The structure marked as number 2 is right ventricular border
    2. The structure marked as 1 is the trachea
    3. The structure marked as 3 is the left ventricular border
    4. The structure marked as 4 is the aortic arch

 

  1. A nurse is caring for a patient diagnosed with rheumatoid arthritis. Which assessment finding does the nurse expect to assess?
    1. Asymmetrical pain in the large weight bearing joints
    2. Low back pain and stiffness that is worse in the morning
    3. Pain, swelling and redness of the great toe
    4. Symmetrical pain and swelling in the small joints of the hands

 

  1. A 48-year-old female patient with history of T2DM presents to the clinic with complaints of polyuria, polydipsia and weight- loss over the past month.   On   physical   examination, she   is   alert   and oriented but appears dehydrated. Her blood pressure is 140/90 mmHg, heart rate is 110 bpm, respiratory rate is 16/min and temperature 37.8°C (100°F).  Labs show elevated fasting blood glucose levels and HbA1c levels. The nurse suspects diabetic ketoacidosis (DKA). What is the priority nursing intervention?
    1. Administer intravenous insulin infusion
    2. Start an intravenous line and obtain blood for laboratory tests
    3. Assess the patient’s urine output and ketone levels
    4. Administer intravenous fluids to correct dehydration

 

  1. Which of the following is not seen in cystic fibrosis?
    1. Meconium ileus
    2. Biliary atresia
    3. Bleeding diathesis
    4. Nasal polyposis

 

  1. A 45-year-old female patient has stiffness in the joints of the hands for the past 6 years. On examination, the following deformity is noted.  Serology is positive for anti-CCP antibodies. Which of the following are associated with this condition?

    1) Pleural effusion

    2) Anaemia of chronic disease

    3) Swan neck deformity and Boutonniere deformity

    4) Uveitis

    5) Seizures

    1. 1, 2, 5
    2. 1, 3, 4, 5
    3. 1, 2, 3
    4. 4, 5

 

  1. What is the most common neurological manifestation seen in patients with systemic lupus erythematosus?
    1. Seizures
    2. Depression
    3. Cognitive impairment
    4. Polyneuropathy

 

  1. Which of   the   following   statements   is   false   about Raynaud’s phenomenon?
    1. Secondary Raynaud’s is associated with more severe symptoms
    2. Secondary Raynaud’s develops predominantly after the age of 30 years
    3. Primary Raynaud’s is usually ANA negative
    4. Primary Raynaud’s is associated with digital tissue necrosis and ulcers

 

  1. A    23-year-old   woman    presents    to   the    emergency department with seizures. Her parents said this started 15   minutes   back   and   has   been      Initial resuscitative   measures   are   taken   and   she   is   given lorazepam. However, her seizures didn’t subside. Which antiepileptic drug is indicated now?
    1. Propofol
    2. Phenytoin
    3. Phenobarbitone
    4. Pregabalin

 

  1. A 50-year-old woman complains of numbness of her hands, generalized weakness and easy fatigability. She is a vegetarian. She looks very pale and her peripheral smear reveals    macrocytic    hypochromic      If untreated, she is at risk of developing which of the following conditions?
    1. Proprioceptive loss
    2. Stabbing pain
    3. Temperature loss
    4. Burning pain

 

  1. A patient with SIADH is being treated with water restriction. Which findings indicate that the treatment is effective?
    1. Increased urine   output, decreased   serum   sodium levels and elevated urine specific gravity
    2. Increased urine output, increased serum sodium levels and reduced urine specific gravity
    3. Reduced urine output, increased serum sodium levels and reduced urine specific gravity
    4. Reduced urine output, decreased serum sodium levels and elevated urine specific gravity

 

  1. Which patient is at the highest risk for   developing aspiration pneumonia?
    1. An infant   who   recently   underwent   repair   of   a tracheoesophageal defect
    2. An alert 10-year-old with cystic fibrosis
    3. A 50-year-old with fractured ribs and a broken leg from a motor vehicle accident (MVA)
    4. A confused 75-year-old with history of a cerebrovascular accident VA)

 

  1. How should the nurse interpret the finding that a patient with bronchiectasis has expectorated three cupfuls of foul-smelling, mucopurulent secretions in the past 24 hours?
    1. A secondary infection has developed
    2. The disease process is improving
    3. The patient is displaying typical symptoms of the condition
    4. Chest physical therapy requires adjustment to meet the patient’s needs

 

  1. Acute Respiratory    Distress   Syndrome    can develop due to direct lung injury or indirectly through systemic   inflammatory   response    syndrome (SIRS). The nurse understands that ARDS is most commonly associated with which of the following conditions?
    1. Sepsis
    2. Oxygen toxicity
    3. Prolonged hypotension
    4. Cardiopulmonary bypass

 

  1. Which positioning is recommended for management of patients with paO2 / Fio2 ratio of 300 with CXR showing bilateral infiltrates?
    1. Supine
    2. Reverse-Trendelenburg
    3. Trendelenburg
    4. Prone

 

  1. AKIN and RIFLE criteria are used to classify:
    1. Acute kidney injury
    2. Chronic renal failure
    3. Acute glomerulonephritis
    4. Nephrotic syndrome

 

  1. What causes the glomerular damage seen in glomerulonephritis?
    1. Proliferation of microorganisms within the glomeruli
    2. Toxins produced by bacteria damaging the glomeruli
    3. Deposition of immune complexes in the glomeruli
    4. Breakdown of red blood cells circulating through the glomeruli

 

  1. A patient with GBS is receiving plasmapheresis. What is the purpose of this treatment?
    1. Reduce inflammation
    2. Remove autoantibodies
    3. Increase blood volume
    4. Correct electrolyte imbalances

 

  1. A patient develops dyspnea during a blood transfusion. What complication should the nurse suspect?
    1. Hypoglycemia
    2. Transfusion-related acute lung injury (TRALI)
    3. Hypokalemia
    4. Wound infection

 

  1. A 70-year-old   lady with   Parkinsonism suffers from aspiration pneumonia, with 3 episodes for the past 6 months. X ray shows bibasilar bronchiectasis. Moderate oropharyngeal dysphagia is present and had   a poor cough reflex. What is the best appropriate step for long- term prevention of recurrent aspiration pneumonia?
    1. High frequency oscillatory chest therapy
    2. PEG gastrostomy tube insertion
    3. Nebulization with    N-acetyl    cysteine    to    reduce secretions
    4. Azithromycin for    antibacterial    prophylaxis    and prokinetic effect

 

  1. A patient with low-grade fever and weight loss has poor excursion on the right side of the chest with decreased fremitus, flatness to percussion and decreased breath sounds all on the right. The trachea is deviated to the left. Which of the following is the most likely diagnosis?
    1. Pleural effusion
    2. Pneumothorax
    3. Chronic obstructive lung disease
    4. Consolidated pneumonia

 

  1. Which electrolyte imbalance increases the risk of digoxin toxicity?
    1. Hyperkalemia
    2. Hypokalemia
    3. Hypernatremia
    4. Hypocalcemia

 

  1. The murmur of mitral stenosis corresponds to which part of the ECG?
    1. P wave
    2. ST segment
    3. QRS complex
    4. T wave

 

  1. Which of these tumor markers is elevated in carcinoma breast?
    1. CA-125
    2. CA-19-9
    3. CA-15-3
    4. CA-72-4

 

  1. An adult patient undergoing dialysis asks if he can take insulin before the dialysis treatment. Which statement about insulin and dialysis should the nurse include in the response?
    1. Insulin levels are not reduced by hemodialysis.
    2. Insulin enhances the effects of dialysis.
    3. Dialysis destroys insulin.
    4. Dialysis stimulates the production of insulin.

 

  1. A 47-year-old patient has Addison’s disease; the nurse would expect to find which of the following during the nursing assessment?
    1. A supraclavicular fat pad
    2. A puffy face
    3. Low blood pressure
    4. Ecchymotic areas

 

  1. An elderly   patient   on   a vegetarian   diet   presenting with   easy   fatigability   and   pallor   was   Peripheral smear showed findings of macrocytic anemia. Investigations   reveal    elevated   serum    homocysteine levels and normal   serum methylmalonic   acid levels. What is the probable cause of anemia in this patient?
    1. Vitamin B9 deficiency
    2. Vitamin B12 deficiency
    3. Vitamin B1 deficiency
    4. Vitamin B6 deficiency

 

  1. A nurse   is   supervising   a   student   nurse   providing tracheostomy care to a patient.  Which action by the student should prompt supervising nurse to intervene?
    1. The student nurse cuts the dressing to fit around the tracheostomy tube
    2. The student   nurse   uses   sterile   technique   while cleaning around the stoma
    3. The student   nurse   applies   a   new   tracheostomy dressing under the flange
    4. The student nurse removes the inner cannula for cleaning

 

  1. During the recording of the EEG, a resting and awake person was instructed to close his eyes and then open them. The dominant wave which decreases on opening the eyes is:
    1. Alpha
    2. Beta
    3. Theta
    4. Delta

 

  1. A resident doctor ordered procalcitonin for a patient with suspected ventilator-associated pneumonia and was on empirical antibiotic therapy. What is the role of procalcitonin?
    1. Differentiate fungal and bacterial causes
    2. Diagnose VAP
    3. To decide duration of antibiotics
    4. To decide the empirical therapy

 

  1. A 46-year-old man with a history of type 2 Diabetes Mellitus presents with a complicated UTI, urinalysis shows more than 40 WBCs. He is hypotensive and not responding to IV fluids. What would be the treatment of choice?
    1. Meropenem
    2. Amoxicillin-Clavulanate
    3. Ceftriaxone
    4. Nitrofurantoin

 

  1. Which of the following is the drug of choice for management of digoxin induced toxicity. Heart rate is 38/min with BP 70/50 mmHg with altered mentation?
    1. Atropine
    2. Digiband
    3. Digitoxin
    4. Lignocaine

 

  1. A 52-year-old man presents with acute onset of severe pain, redness, and swelling in the first metatarsophalangeal joint. Which of the following is the drug of choice for the management of this acute gout attack?
    1. Xanthine oxidase inhibitor
    2. Microtubule polymerization inhibitor
    3. COX -1 inhibitor
    4. Uricosuric drug

 

  1. Which of the following drugs can cause black discoloration of the tongue?
    1. Phenytoin
    2. Sucralfate
    3. Valproate
    4. Lithium

 

  1. A 55-year-old man with type 2 diabetes mellitus is started on an SGLT2 inhibitor for improved glycemic control. Which of the following adverse effects is least likely to be associated with this drug class?
    1. Euglycemic ketoacidosis
    2. Increased risk of genital mycotic infections
    3. Hypoglycaemia when used as monotherapy
    4. Increased risk of urinary tract infections

 

  1. The following patch is used for which of the following patients?
    1. 10- year- old scheduled for bone marrow biopsy
    2. 40 -year old with breast cancer with spine metastasis
    3. 65 – year old undergone total knee replacement
    4. 85 – year old man with chronic severe osteoarthritis knee pain, already on high – dose oral opioids

 

  1. The 5 – year old child consumed two bottles of strawberry flavoured paracetamol and became unconscious. Which of the following is toxic product responsible?
    1. N- acetyl – p benzoquinone imine
    2. N – acetyl – cysteine
    3. Glutathione
    4. Glutathione sulphate

 

  1. You are managing a patient with reversible airway disease and have prescribed the following pressurized metered dose inhaler for management of acute exacerbations due to poor AQI. Which of the following is not a side effect of this drug?
    1. Hypoglycaemia
    2. Tachyphylaxis
    3. Hypokalemia
    4. Throat pain

 

  1. 30-year-old patient had a fall from entire flight of stairs and MRI spine shows burst fracture of T6 vertebra. Which will be seen in this case?
    1. Spastic weakness of legs and urge incontinence
    2. Flaccid weakness of legs and overflow incontinence
    3. Impaired diaphragmatic function and CO2 retention
    4. Low BP and high Heart rate

 

  1. Marathon runner presents with acute onset hyponatremia (Serum Na= 122 meq/L) with dehydration and disorientation. He develops one episode that was managed with iv lorazepam. Which is correct management of this case?
    1. Slow correction of hyponatremia with 3% saline at 6 meq/day
    2. Fast correction of hyponatremia with 0.45% saline
    3. Slow correction of hyponatremia with 0.45% saline at 6 meq/day
    4. Fast correction of hyponatremia with 3% saline bolus

 

  1. 30-year-old man presents with headache and nuchal rigidity. On examination nuchal rigidity and Brudzinski sign is present. NCCT head shows small hydrocephalus with no evidence of bleeding. Nurse will anticipate which condition
    1. Pyogenic Meningitis
    2. Viral meningitis
    3. Subdural haemorrhage
    4. Subarachnoid hemorrhage

 

  1. Patient had spinal cord injury at T4. Which of the following is seen?
    1. Flaccidity of upper limb
    2. Hyperreflexia and spasticity of upper limbs
    3. Reduced diaphragmatic paralysis and requirement of ventilator support
    4. Efficient cough and independent use of upper limbs

 

  1. A 30-year-old patient in the ICU has been receiving large volumes of 0.9% Normal Saline for resuscitation. After 48 hours, the nurse notices rising chloride levels on the lab report. Which complication should the nurse most closely monitor for?
    1. Metabolic alkalosis due to excess bicarbonate
    2. Hyperchloremic metabolic acidosis
    3. Respiratory alkalosis due to hypoventilation
    4. Hyponatremia with cerebral oedema

 

  1. 60-year-old smoker comes with central chest pain radiating to left shoulder. ECG is shown below. Troponin I shows rise with value > 99th centile of upper reference limit of normal. On examination pulse is 80/min, BP 90/60 mm Hg and neck veins appear full. Which of the following will not be kept ready for this by the nursing officer?
    1. Normal saline
    2. NTG
    3. Enoxaparin
    4. Streptokinase

 

  1. 60-year-old alcoholic man admitted with diagnosis of Pyelonephritis is having protracted vomiting and epigastric abdominal pain. ABG shows pH=7.3, pC02= 30 mm Hg and HCO3 =15 meq/L, Ketostix is 4+, RBS is 200 mg/dl. Which of the following is not to be used in this patient
    1. Insulin infusion @0.5 ml/kg/hour in normal saline
    2. 5% D in 0.45% normal saline
    3. Soda bicarbonate
    4. Potassium chloride 40meq/L in normal saline

 

  1. 70-year-old patient who has ROSC after CPR for 2 minutes and Defibrillation of 200 J biphasic. ABG shows pH=7.3, pCO2= 30 mm Hg and HCO3=10 meq/L. Diagnosis is?
    1. Metabolic acidosis uncompensated
    2. Partially compensated metabolic acidosis
    3. Metabolic acidosis with respiratory acidosis
    4. Fully compensated metabolic acidosis
  2. Which of the following steps can lead to errors while drawing blood sample for serum calcium?
    1. Make a tight fist and maintain arm tension during the draw
    2. Use of wide bore needle on 20 ml syringe
    3. Swabbing with isopropyl alcohol and not letting it dry
    4. Use of antecubital vein

 

  1. Normal anion gap metabolic acidosis is seen in which of the following
    1. Acute renal failure
    2. Chronic renal failure
    3. Acute gastroenteritis
    4. Glue sniffing

 

  1. During ABG sampling which of the following is a good nursing practise?
    1. Air bubbles from the syringe are not to be expelled
    2. Use of EDTA/ Citrated in syringe
    3. Place hand of client at an angle of 45 degrees of wrist flexion
    4. Sample processing within 1 hour in ice slurry

 

  1. A 3-year-old child is brought to the emergency department after accidentally ingesting kerosene at home. The child is coughing and has mild respiratory distress. As the nurse caring for this child, which of the following actions is contraindicated?
    1. Keep the child in upright position and monitor airway, breathing, circulation
    2. Prepare for gastric lavage using a wide-bore Ryle’s tube
    3. Administer humidified oxygen and monitor for aspiration pneumonia
    4. Keep suction equipment ready at the bedside

 

  1. q-SOFA (sequential organ failure assessment score) is used for assessment of which of the following?
    1. Sepsis
    2. SIRS
    3. Septic shock
    4. Multi organ failure

 

  1. Which of the following complications can occur immediately after multiple blood transfusions? 
    1. Hypokalemia
    2. Hyperkalemia 
    3. Hypocalcemia 
    4. Metabolic acidosis 

    1. 1,3
    2. 2,3
    3. 1,2,3
    4. 1,3,4  

 

  1. 28-year-old mountaineer develops cough, breathlessness at rest, and pink frothy sputum after rapid ascent to 3,800 meters. On examination: SpO₂ is 70% on room air, pulse 120/min, and bilateral crackles are heard. Which of the following is the priority nursing intervention at your high-altitude nursing station?
    1. Encourage deep breathing exercises and ambulation
    2. Administer furosemide IV to reduce pulmonary oedema
    3. Use Gammow bag for resuscitation
    4. Restrict fluids strictly and give acetazolamide( Diamox)

 

  1. Elevated PCWP is seen in which of the following conditions
    1. ARDS
    2. Cor pulmonale
    3. Mitral stenosis
    4. Pulmonary artery hypertension

 

  1. Which of the following reflexes is not assessed for the diagnosis of brain death?
    1. Pupillary light reflex
    2. Corneal reflex
    3. Doll’s eye reflex (oculocephalic reflex)
    4. Cremasteric reflex

 

  1. Child of RHD with Mitral regurgitation is put on drug X. Which of the following drug X based on ECG findings?
    1. Digoxin
    2. Furosemide
    3. ACEi
    4. Spirinolactone

 

  1. Osborn waves on ECG are seen in which of the following case scenarios
    1. Soldier in Thar desert due to heat exhaustion
    2. Lung cancer patient with hypercalcaemic crisis
    3. Post operative patient with extensive vomiting due to anaesthesia drugs
    4. Cold compresses used in bilateral ankle strain

 

  1. Which of the following is seen in patients with hypothyroidism
    1. Hypokalemia
    2. Hyperkalemia
    3. Hyponatremia
    4. Hypernatremia