1. Mrs. Bhavya Amin is on Coumadin for atrial fibrillation. She is admitted with ischemic bowel and requires
urgent surgery. Her INR is 10.4 and aPTT 52. Which one of the following interventions is the priority?
a. Protamine sulphate
b. Octaplex
c. Cryoprecipitate
d. Vitamin K infusion

2.. Mr. Amal Mathew is awaiting a bed on the ward and is no longer on the bedside monitor. The nurse
enters his room to assess him, and finds him cyanotic, apneic and pulseless. ECG leads are
connected and reveal ventricular fibrillation. Which one of the following is the priority?
a. Intubation and ventilation
b. Compressions X 2 minutes at 100/minute
c. Epinephrine 1 mg IV
d. Defibrillation with 3 quick shocks

3. Mrs. Anu Jose becomes agitated and is at risk for self-exubation. Which one of the following
interventions is the priority?
a. Apply restraints
b. Assess cause of agitation
c. Increase dose of sedatives
d. Have family sit with Mrs. Anu Jose

4. Mr. Binu Mon Jose experiences full thickness circumferential burns to his chest, abdomen and back. Which
one of the following interventions is the priority?
a. Silver sulfadiazine
b. Wound debridement
c. Escarotomies
d. Topical analgesia

5. Mrs. Dakshayani is admitted with urosepsis. Her blood pressure increases to 110/70 following 4 L of
normal saline, however, she remains oliguric with a urine output of < 10 ml/hr. Her oxygenation
deteriorates despite BiPAP, and she requires intubation. Labs reveal: Hb 101 Platelets 62,000 INR
1.9 aPTT 57. Her lactate has increased to 6 from 4. Which one of the following interventions is
a. Steroids
b. Vasopressin
c. Drotrecogin Alfa Activated (Xigris)
d. Dobutamine

6. Six hours following a motor vehicle collision, Mr. Anoop has a 10 fold increase in his CK and
myoglobin. Which one of the following interventions is the priority?
a. Fluid
b. Lasix
c. Tissue plasminogen activator (tPA)
d. Insulin and glucose

7. Following open repair of a ruptured aneurysm, Mr. Ahmad Anwar bladder pressure is 45 mmHg. Which
one of the following interventions is the priority?
a. Continuous bladder irrigation
b. Fluid administration
c. Decrease the amount of PEEP
d. Continuous renal replacement therapy

8. Interpret the following blood gas.
PaO2 78
PaCO2 29
pH 7.29
HCO3 14
BE - 10
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic acidosis
d. Metabolic alkalosis

9. Six hours following a traumatic brain injury due to a fall from a ladder, Mr. Anish P Varugese develops hypotension and a 4 gram drop in hemoglobin. Which one of the following problems would be consistent with these findings?
a. Diabetes insipidus
b. Intracranial hemorrhage
c. Intra-abdominal bleeding
d. Fat embolism

10. Ms. Deepa Jose is admitted with septic shock. She presents following a 12 hour history of sore throat,
decreasing level of consciousness and purpura. Which one of the following interventions should be
a. Airborn precautions
b. Contact precautions
c. Droplet precautions
d. No precautions while on closed circuit ventilation



1. Calculate Cerebral Perfusion Pressure (CPP) based on the following data:
HR 75
BP 120/80 (MAP 65)
CVP 12
ICP 15
RR 25
Minute Volume 10.5 L/min

a. 60
b. 50
c. 105
d. 52

2. Mr. Alberta is declared neurologically dead and his family consents to organ donation. Which one of
the following interventions is the priority?
a. Antibiotics, vasopressin and intensive insulin
b. Vasopressin, methylprednisolone (Solumedrol) and levothyroxine
c. Desmopressin (DDAVP), Epinephrine and dexamethasone (Decadron)
d. Antibiotics, Immunoglobulin and Vasopressin

3. Mr. Smith is admitted with pulmonary edema requiring intubation. His cardiac troponin and CK
increase 5 fold, 2 hours after admission and he develops ST segment depression in his lateral leads.
He has a history of diabetes, COPD and renal insufficiency. Which one of the following interventions
is the priority?
a. Tenectaplase
b. IV Heparin
c. Drotrecogin alfa activated
d. Digitalis

4. Mr. Viato had an open repair of an abdominal aneurysm involving his renal arteries. His fluid balance
from the operating room is 3 litres positive and he is on FiO2 .5 PEEP 10 and AC 14. Three hours


1. Mr. Sing has a massive GI bleed from a gastric ulcer. Following 12 units of packed cells and 4 units of
fresh frozen plasma, he has the following labs: Hb 80 Platelets 82,000 INR 1.9 aPTT 58 and fibrinogen 0.4 g/L (normal 2-4 g/L). Which one of the following interventions is the priority?
a. Potassium bolus
b. Octoplex
c. Cryoprecipitate
d. Protamine sulphate
2. Ms. Tirani is on FiO2 0.5 PEEP 5 and PS 15. She has a total minute volume of 12 L and her RR has
increased to 36 from 22. She is restless and agitated. Blood gases are:
PaO2 69
PCO2 49
pH 7.36
HCO3 30

Which one of the following interventions is most appropriate?
a. Increase her FiO2
b. Convert to AC
c. Increase her Pressure Support
d. Increase her sedation

3.. Calculate Cerebral Perfusion Pressure (CPP) based on the following data:
HR 75
BP 120/80 (MAP 65)
CVP 12
ICP 15
RR 25
Minute Volume 10.5 L/min

 a. 60
 b. 50
c. 105
d. 52
4. Mrs. Butovsky develops sepsis due to an infected prosthetic hip joint. She is started on antibiotic
therapy. Which lab test can be used to evaluate her response to antibiotic therapy?
a. Eosinophil Sedemenation Rate (ESR)
b. Protein C levels


Mr. Jackle, 68 yrs old, is admitted with hypotension and respiratory distress requiring intubation following a large ST elevation anterior-lateral wall myocardial infarction.

1. Shortly after insertion of a rights subclavian catheter, he develops worsening shortness of breath and
bibasilar crackles. Blood is noted to be backing up from the central venous catheter and his oxygen
saturation decreases with supine positioning. Which one of the following problems is consistent with
these findings?
a. Pulmonary embolus
b. Right heart failure
c. Cardiac pulmonary edema
d. Hemopneumothorax

2. Mr. Jackle’s will be monitored for signs of reinfarction. Which one of the following lab tests would best
indicate reinfarction?
a. Creatinine kinase
b. Cardiac troponin
c. Lactate dehydrogenase
d. Venous oxygen saturation

3. Mr. Jackle develops cardiogenic shock, respiratory failure and acute kidney injury. He is receiving
epinephrine at 2 ug/min and is fully ventilated on an FiO2 .6 with PEEP 10. His SpO2 is 95%, HR 93
(sinus rhythm), BP 110/72 (MAP 66), CVP 14 mmHg, Hb 82 and central venous oxygen saturation
(ScvO2) 42%. Which one of the following interventions is most appropriate?
a. Metoprolol
b. Captopril
c. Increased FiO2
d. Packed cells

4. Mr. Jackle has a right chest tube inserted for a large pneumothorax. Immediately following insertion, the nurse notes that there is no fluctuation or bubbling in the underwater seal. Which one of the following interventions is the priority?
a. Increase the level of suction
b. Increase the volume in the water seal


1. Which of the following hormones increases the force of contraction of the heart chambers?
  • Aldosterone
  • Luteinising hormone
  • Somatostatin
  • Thyroxine
 Answer: Thyroxine

2. Which valve prevents the backwards flow of blood in to the left atrium?

  • Mitral valve
  • Aortic valve
  • Pulmonary valve
  • Tricuspid valve
Answer: Mitral valve

3.What sort of space exists between the parietal and visceral pericardium?

  • Absolute
  • Virtual 
  • Essential
  • Virtuous

Answer: Virtual

4. The ‘p’ wave on the electrocardiogram corresponds to:

  • Ventricular depolarisation
  • Atrial depolarisation
  • Atrial repolarisation
  • Ventricular repolarisation

Answer: Atrial depolarisation

5. The Frank-Starling Law states:

  • The greater the heart rate the higher the blood pressure.
  • The amount of stretch the ventricle is subject to affects the force of contraction
  • The amount of afterload affects the force of ventricular contraction
  • Cardiac output equals stroke volume times heart rate.

Answer: The greater the heart rate the higher the blood pressure.

6. Gap junctions in the intercalated discs of cardiac muscle cells allow the rapid passage of what?

  • Water
  • Oxygen
  • Calcium
  • Action potentials

Answer: Action potentials

7. The cells of the cardiac conduction system have the ability to create their own action potentials, this is known as:

  • Spontaneity
  • Reflexivity
  • Mechanicity
  • Automaticity

Answer: Automaticity

8.The effect of adrenaline on the heart includes:

  • Increased diastolic time
  • Increased heart rate
  • Increased systolic time
  • Increased relaxation period

Answer: Increased heart rate

9. What effect does increased activity in the parasympathetic nervous system have on the heart:

  • Increase force of contraction
  • Increase heart rate
  • Decrease heart rate
  • Decrease force of contraction

Answer: Decrease heart rate

10. The parasympathetic nervous system innervates the heart via which cranial nerve?

  • Cranial Nerve XII – Hypoglossal nerve
  • Cranial nerve IV – Trochlear nerve
  • Cranial nerve VI – Abducens nerve
  • Cranial nerve X – Vagus nerve

Answer: Cranial nerve X – Vagus nerve


1. Which of the following conditions is linked to more than 50% of clients with abdominal aortic aneurysms?
a. DM
b. Syphilis
c. PVD
d. HPN

Answer: d. HPN

2:-Which of the following communicable disease is eradicated in our country ?
 D:-Small pox

Answer:-  D:-Small pox

3. Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?
a. HPN
b. Aneurysm rupture
c. Cardiac arrythmias


1. Removing a neonate from an incubator for procedures without the use of an overhead warmer will result in heat loss by
A. convection
B. evaporation
C. radiation
Answer: A. convection

2. A normal finding of male genitalia in the term neonate is
A. retractable prepuce
B. rugated scrotum
C. testes in the inguinal canal
Answer: B. rugated scrotum

3. A preeclamptic woman in the immediate postpartumperiod needs to be monitored closely for elevated
blood pressure and
A. adult respiratory distress syndrome
B. onset of seizures
C. subdural hematoma
Answer: B. onset of seizures

4. A predisposing factor for assisted delivery (forceps or vacuum) is
A. post dates gestation
B. multiparity


1. Which type of computer is Cray T90?
A. Minicomputer
B. Microcomputer
C. Supercomputer
D. Mainframe

2. The four common types of files are documents files, presentation files, worksheet files and:
A. Program files
B. Database files
C. System files
D. Digital files

3. Which of the following is a malicious threat?
A. Hackers trying to flood a mail server with emails to freeze the service
B. Injection of queries in login text box to retrieve user password
C. Cracking of database passwords
D. All of the above

4. An application of voice and vision technology is in:
A. Database system
B. Photoshop
C. Video conferencing


1. What is the term used to describe an enlargement of the heart muscle?
a. Myocarditis
b. Cardiomyopathy
c. Cardiomegaly
d. Pericarditis

Answer: c. Cardiomegaly

2. A pulsating abdominal mass usually indicates which of the following conditions?
a. Enlarged spleen
b. Abdominal aortic aneurysm
c. Gastic distention
d. Gastritis

Answer: b. Abdominal aortic aneurysm

3. In which of the following disorders would the nurse expect to assess sacral eddema in bedridden client?
a. Right-sided heart failure
b. Pulmonary emboli


Answer for Question No. 1
Answer D is correct. Taking corticosteroids in the morning mimics the body’s natural release of cortisol. Answers A is not necessarily true, and answers B and C are not true.

Answer for Question No. 2
Answer B is correct. A persistent cough might be related to an adverse reaction to Captoten. Answers A and D are incorrect because tinnitus and diarrhea are not associated with the medication. Muscle weakness might occur when beginning the treatment but is not an adverse effect; thus, answer C is incorrect.

Answer for Question No. 3
Answer B is correct. The vital signs are abnormal and should be reported to the doctor immediately. Answer A, continuing to monitor the vital signs, can result in deterioration of the client’s condition. Answer C, asking the client how he feels, would supply only subjective data. Involving the LPN, in answer D, is not the best solution to help this client because he is unstable.

Answer for Question No. 4
Answer D is correct. Because the client is immune-suppressed, foods should be served in sealed containers, to avoid food contaminants. Answer B is incorrect because of possible infection from visitors. Answer A is not necessary, but the utensils should be cleaned thoroughly and rinsed in hot water. Answer C might be a good idea, but alcohol can be drying and can cause the skin to break down.

Answer for Question No. 5
Answer C is correct. Sodium warfarin is administered in the late afternoon, at approximately 1700 hours. This allows for accurate bleeding times to be drawn in the morning. Therefore, answers A, B, and D are incorrect.

Click here for the Questions for above answers


1. The client is taking prednisone 7.5mg po each morning to treat his systemic lupus errythymatosis. Which statement best explains the reason for taking the prednisone in the morning?
❍ A. There is less chance of forgetting the medication if taken in the morning.
❍ B. There will be less fluid retention if taken in the morning.
❍ C. Prednisone is absorbed best with the breakfast meal.
❍ D. Morning administration mimics the body’s natural secretion of corticosteroid.

Click here for Answer

2. The physician prescribes captopril (Capoten) 25mg po tid for the client with hypertension. Which of the following adverse reactions can occur with administration of Capoten?
❍ A. Tinnitus
❍ B. Persistent cough
❍ C. Muscle weakness
❍ D. Diarrhea

Click here for Answer

3. The client returns to the unit from surgery with a blood pressure of 90/50, pulse 132, respirations 30. Which action by the nurse should receive priority?
❍ A. Continue to monitor the vital signs
❍ B. Contact the physician


1. Gynecomastia is a term used for :
(1) male breast infection
(3) hypertrophy of male breast
(2) family history
(4) women over 40 years

2. When an individual expresses his failures and difficulties by blaming others is known as :
(1) repression
(2) projection
(3) sublimation
(4) denial

3. ADEID stands for :
(1) Attention Deficit Hypoactive Disorder
(2) Activity Deficit Hypoactive Disorder
(3) Attention Deficit Hyperactive Disorder
(4) Activity Deficit Hyperactive Disorder

4. Largectile in high doses is mostly given in one of the following conditions
(1) Schizophrenia


Question 1. The nurse understands that the diagnosis of oral cancer is confirmed with:
❍ A. Biopsy
❍ B. Gram Stain
❍ C. Scrape cytology
❍ D. Oral washings for cytology
Click here for Answer with Rationale

Question 2. The physician has prescribed tranylcypromine sulfate (Parnate) 10mg bid. The nurse should teach the client to refrain from eating foods containing tyramine because it may cause:
❍ A. Hypertension
❍ B. Hyperthermia
❍ C. Melanoma
❍ D. Urinary retention
Click here for Answer with Rationale

Question 3. A home health nurse is making preparations for morning visits. Which one of the following clients should the nurse visit first?
❍ A. A client with brain attack (stroke) with tube feedings
❍ B. A client with congestive heart failure complaining of nighttime dyspnea
❍ C. A client with a thoracotomy 6 months ago


The Answers with Rationale published here are for the questions published on 28/11/2016- Click here to view Questions

Question 1. -Answer A is correct. The best diagnostic tool for cancer is the biopsy. Other assessment includes checking the lymph nodes. Answers B, C, and D will not confirm a diagnosis of oral cancer.

Question 2-Answer A is correct. If the client eats foods high in tyramine, he might experience malignant hypertension. Tyramine is found in cheese, sour cream, Chianti wine, sherry, beer, pickled herring, liver, canned figs, raisins, bananas, avocados, chocolate, soy sauce, fava beans, and yeast. These episodes are treated with Regitine, an alphaadrenergic blocking agent. Answers B, C, and D are not related to the question.

Question 3- Answer B is correct. The client with congestive heart failure who is complaining of nighttime dyspnea should be seen first because airway is no. 1 in nursing care. In answers A, C, and D, the clients are more stable.


1. Which of the following sounds is distinctly heard on auscultation over the abdominal region of an abdominal aortic aneurysm client?
a. Friction rubs
b. Crackles
c. Dullness
d. Bruit

Answer: d. Bruit

2. Which of the following blood vessel layers may be damaged in a client with an aneurysm?
a. Media
b. Interna
c. Externa
d. Interna and Media

Answer: a. Media

3. Toxicity from which of the following medications may cause a client to see a green halo around lights?
a. Digoxin
b. Furosemide