Kerala PSC Staff Nurse Gr II Mock 003

Q1.A nurse is assessing a patient with a history of heart failure. Which of the following parameters, if decreased, would directly indicate a reduction in the heart's ability to pump blood effectively to the systemic circulation?

Q2.During gas exchange in the alveoli, oxygen moves from the alveoli into the blood, and carbon dioxide moves from the blood into the alveoli. This process is primarily driven by which of the following mechanisms?

Q3.A patient experiences sudden bradycardia, pupillary constriction, and increased salivation after accidental exposure to a potent cholinergic agent. Which part of the autonomic nervous system is primarily being stimulated?

Q4.A patient presents with symptoms including weight gain, cold intolerance, fatigue, and bradycardia. Blood tests reveal elevated TSH and low T3/T4 levels. Which endocrine gland is primarily dysfunctional, and what type of feedback mechanism is illustrated?

Q5.A nurse is educating a patient newly diagnosed with pancreatic insufficiency about their medication regimen. Which of the following digestive enzymes, primarily secreted by the pancreas, would be crucial for the digestion of fats?

Q6.Which part of the nephron is primarily responsible for the reabsorption of most filtered water, electrolytes, and nutrients back into the bloodstream?

Q7.A nursing student is reviewing the process of skeletal muscle contraction. Which ion is essential for initiating the cross-bridge cycle by binding to troponin, leading to the exposure of actin-binding sites?

Q8.A nurse is preparing to collect a urine specimen for a culture and sensitivity test from an ambulatory patient. Which of the following instructions is most crucial to ensure an accurate result?

Q9.A patient in the medical ward develops Clostridium difficile infection (CDI). What is the primary mode of transmission for C. difficile in a healthcare setting?

Q10.A 6-month-old infant receives antibodies from their mother through breastfeeding. This type of immunity is known as:

Q11.Which of the following bacterial structures is primarily responsible for adherence to host cells and surfaces, playing a crucial role in initiating infection?

Q12.A nurse is caring for a patient diagnosed with Methicillin-resistant Staphylococcus aureus (MRSA) in a private room. What is the most appropriate personal protective equipment (PPE) for the nurse to wear when entering the patient's room for routine care?

Q13.Bacterial resistance to antibiotics is a growing concern. Which of the following mechanisms is a common way bacteria develop resistance to penicillin-type antibiotics?

Q14.Endotoxins are a significant virulence factor produced by certain bacteria. Which type of bacteria are primarily associated with the production of endotoxins?

Q15.A community health nurse is establishing a support group for new mothers. Which characteristic best defines this type of group in a sociological context?

Q16.The increasing prevalence of nuclear families and geographical mobility in Kerala is a significant social change. How might this trend primarily impact the health and well-being of the elderly population?

Q17.A community health nurse identifies a high rate of adolescent substance abuse in a local urban slum. What is the most effective long-term strategy for the nurse to implement at the community level to address this social problem?

Q18.In the context of community health, what is the primary objective of health education initiatives regarding non-communicable diseases (NCDs) like diabetes and hypertension?

Q19.A community health nurse observes that a specific slum area has a significantly higher incidence of diarrheal diseases compared to other parts of the city. Which social determinant of health is most directly implicated in this observation?

Q20.During a routine home visit, a community health nurse identifies that an elderly patient living alone is struggling with medication adherence, social isolation, and poor nutrition. What is the most comprehensive nursing intervention in this scenario?

Q21.A patient diagnosed with a terminal illness insists that their doctor has made a mistake and refuses to believe the diagnosis, demanding more tests. Which defense mechanism is this patient primarily exhibiting?

Q22.A staff nurse wants to encourage a pediatric patient to take their oral medication regularly. The nurse decides to give the child a small sticker every time they successfully take the medicine without fuss. This approach is an example of which learning principle?

Q23.A nurse is caring for a patient who has recently lost their job, is experiencing homelessness, and has been admitted with severe malnutrition. According to Maslow's Hierarchy of Needs, which need should the nurse prioritize first for this patient?

Q24.A new staff nurse frequently expresses negative opinions about a particular patient's lifestyle choices to colleagues, even though it does not directly impact the patient's medical care. This behavior indicates a potential issue with the nurse's:

Q25.A patient with obsessive-compulsive disorder (OCD) experiences intense anxiety if they do not perform their rituals, believing that something terrible will happen if they don't. From a Freudian perspective, which component of the mind is primarily responsible for generating these feelings of guilt and anxiety related to not following internalized rules?

Q26.A nurse is educating a patient with newly diagnosed hypertension on the importance of regular exercise. To help the patient establish a new habit of daily walking, which strategy would be most effective?

Q27.A 5-year-old child presents with difficulty seeing in dim light, especially during dusk. On examination, the conjunctiva appears dry and wrinkled. Which of the following nutritional deficiencies is most likely causing these symptoms?

Q28.A nurse is educating a client about a balanced diet. If a food item contains 10 grams of protein, 15 grams of carbohydrates, and 5 grams of fat, what is the approximate total caloric value of this food item?

Q29.A nurse is teaching a patient with chronic kidney disease (CKD) about dietary management. Which of the following nutrients requires careful restriction to prevent hyperkalemia?

Q30.A patient is on long-term antibiotic therapy. The nurse should monitor for potential deficiency of which vitamin, primarily synthesized by gut bacteria, that is essential for blood clotting?

Q31.A nurse is counseling a patient with Type 2 Diabetes Mellitus on dietary management. Which of the following recommendations is most important for maintaining stable blood glucose levels throughout the day?

Q32.As per national guidelines, exclusive breastfeeding is recommended for infants for the first six months of life. What is the primary nutritional benefit of this practice?

Q33.A 55-year-old patient with Type 2 Diabetes Mellitus presents with consistently high blood glucose levels despite dietary modifications. From a biochemical perspective, the primary underlying issue leading to this hyperglycemia in Type 2 Diabetes is often related to impaired cellular response to insulin. Which biochemical process is *primarily* affected by this impaired insulin sensitivity, leading to elevated blood glucose?

Q34.A 68-year-old patient is recovering from a major abdominal surgery and the nurse observes slow wound healing and poor tissue granulation. From a nutritional biochemistry standpoint, the nurse would prioritize assessing the patient's intake of which macronutrient, crucial for collagen synthesis and tissue repair?

Q35.A patient presents to the emergency department with acute chest pain radiating to the left arm. Blood tests are ordered to assess for myocardial injury. Which of the following cardiac biomarkers, specifically an isoenzyme, is considered highly specific for myocardial cell damage and is commonly used in the diagnosis of acute myocardial infarction?

Q36.During a patient education session, a nurse is explaining the diverse roles of dietary fats in the human body. Besides serving as a concentrated energy source and aiding in vitamin absorption, what crucial structural component of all human cells is primarily composed of lipids?

Q37.A nurse reviews the arterial blood gas (ABG) results of a patient with severe pneumonia: pH 7.28, PaCO2 58 mmHg, HCO3- 25 mEq/L. Based on these values, what acid-base imbalance is the patient experiencing?

Q38.A 45-year-old chronic alcoholic patient presents with symptoms including nystagmus, ataxia (impaired coordination), and confusion. The nurse recognizes these neurological signs as characteristic of Wernicke-Korsakoff syndrome, which is primarily caused by the deficiency of which specific vitamin?

Q39.A patient receiving intravenous morphine for severe pain reports intense itching and develops a rash. The nurse assesses the patient and notes no signs of respiratory distress or angioedema. What is the most likely explanation for these symptoms?

Q40.A physician orders 500 mL of 0.9% Normal Saline to be infused over 4 hours. The IV administration set delivers 15 drops/mL. What is the correct infusion rate in drops per minute (gtts/min)?

Q41.A nurse is educating a patient newly prescribed Lisinopril for hypertension. Which of the following adverse effects should the nurse specifically instruct the patient to report immediately due to its potential severity?

Q42.A nurse is preparing to administer a subcutaneous injection of insulin. Which of the following actions is most appropriate to ensure proper absorption and minimize discomfort?

Q43.A patient is prescribed Furosemide (Lasix) for fluid overload. The nurse should closely monitor the patient for which of the following electrolyte imbalances, a common side effect of loop diuretics?

Q44.A nurse is preparing to administer a medication that requires refrigeration. Upon retrieving the vial, the nurse notices it has been left at room temperature for an extended period. What is the most appropriate action for the nurse to take?

Q45.A patient reports severe pain (8/10) after surgery. The nurse observes grimacing, guarding of the surgical site, and an increased heart rate. Which step of the nursing process is the nurse primarily engaged in when collecting this information and identifying these signs?

Q46.A nurse is preparing to administer an intramuscular injection. According to standard infection control guidelines, when is the MOST appropriate time for the nurse to perform hand hygiene using an alcohol-based hand rub?

Q47.A nurse is preparing to administer a new medication to a patient. To ensure patient safety and prevent medication errors, which of the following is the MOST critical action for the nurse to perform *before* administering the medication?

Q48.Which method is considered the MOST effective for sterilizing heat-sensitive medical equipment that cannot withstand high temperatures, such as certain endoscopes?

Q49.A nurse implemented a plan to improve a patient's mobility after a hip replacement surgery, including regular ambulation and pain management. During the evaluation phase of the nursing process, what is the primary action the nurse should take?

Q50.A patient with chronic low back pain is prescribed a new oral analgesic. The nurse is preparing to assess the effectiveness of the medication. To accurately assess the effectiveness of the analgesic, which of the following actions is MOST appropriate for the nurse to take?

Q51.A 65-year-old male presents to the emergency department with severe crushing chest pain radiating to his left arm, diaphoresis, and shortness of breath. His vital signs are BP 140/90 mmHg, HR 105 bpm, RR 24 bpm, SpO2 90% on room air. Which of the following is the most immediate priority nursing intervention?

Q52.A nurse is caring for a patient with an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) who is experiencing severe dyspnea. Which of the following positions would be most beneficial for this patient to facilitate breathing?

Q53.A patient with Chronic Kidney Disease (CKD) on hemodialysis is receiving dietary teaching. The nurse emphasizes the importance of restricting certain electrolytes to prevent complications. Which electrolyte, if consumed excessively, is most likely to cause life-threatening cardiac arrhythmias in CKD patients?

Q54.A 72-year-old patient is brought to the emergency department by their family with sudden onset of left-sided weakness, facial drooping, and slurred speech. What is the priority initial nursing assessment in this suspected stroke case?

Q55.A nurse is providing discharge education to a patient diagnosed with Peptic Ulcer Disease (PUD). Which of the following instructions is most crucial for preventing recurrence and promoting healing?

Q56.A patient has sustained full-thickness burns over 30% of their total body surface area (TBSA). The nurse is monitoring the effectiveness of fluid resuscitation during the first 24 hours. Which of the following parameters is the most reliable indicator of adequate fluid resuscitation in an adult burn patient?

Q57.A primigravida at 32 weeks gestation reports sudden onset of severe headache, blurred vision, and epigastric pain. Her blood pressure is 150/100 mmHg. What is the immediate nursing priority?

Q58.During active labor, a nurse notes recurrent late decelerations on the fetal heart rate monitor. The client is receiving oxytocin for augmentation. What is the most appropriate initial nursing action?

Q59.A new mother expresses concern that her 3-day-old infant is not getting enough milk, stating the baby feeds frequently and seems unsatisfied. What is the most appropriate advice a nurse should provide regarding breastfeeding?

Q60.A newborn infant at 1 minute of life has a heart rate of 90 bpm, weak cry, some flexion of extremities, grimaces to stimulation, and a pink body with blue extremities. What is the APGAR score for this infant?

Q61.A 30-year-old woman with a history of deep vein thrombosis (DVT) is seeking a highly effective contraceptive method. Which of the following methods would be contraindicated for her?

Q62.A nurse is caring for a client in the immediate postpartum period. Which of the following factors in the client's history or current condition would place her at highest risk for postpartum hemorrhage?

Q63.A mother brings her 6-month-old infant for a routine check-up. Which of the following developmental milestones would the nurse expect to observe in a typically developing infant of this age?

Q64.A 1-year-old child is brought to the clinic with acute watery diarrhea for 2 days. The nurse assesses the child and notes the child is irritable, has sunken eyes, drinks eagerly, and has decreased urine output. Based on IMNCI guidelines, how would the nurse classify this child's dehydration?

Q65.A 9-month-old infant is classified under IMNCI as having 'Severe Pneumonia'. Which of the following is the most appropriate initial management step for this child?

Q66.At what age would a typically developing infant be expected to pick up a small object like a raisin using a pincer grasp (thumb and forefinger)?

Q67.A 2-year-old child is diagnosed with iron deficiency anemia. Which of the following clinical findings is most indicative of this condition?

Q68.A nurse is assessing a 4-month-old infant using IMNCI guidelines. Which of the following findings would be classified as a 'General Danger Sign' requiring urgent action?

Q69.A Staff Nurse is newly posted to a rural Primary Health Centre (PHC). In line with the principles of Primary Health Care as outlined in the Alma-Ata Declaration, what should be the primary focus of her role?

Q70.A Staff Nurse working at a sub-centre observes a significant increase in cases of fever with chills, rigors, and headache in her service area during the monsoon season. Which National Health Program should she primarily engage with for surveillance, diagnosis, and control measures?

Q71.The National Health Mission (NHM) aims to achieve universal access to equitable, affordable, and quality healthcare services. As a Staff Nurse involved in NHM activities, which of the following represents a key strategy to strengthen primary healthcare under this mission?

Q72.A Staff Nurse at a sub-centre is conducting a home visit for a pregnant woman in her third trimester. What is a crucial health education topic she should prioritize during this visit, aligning with antenatal care guidelines?

Q73.A Staff Nurse is supervising an ASHA worker in a remote village. The ASHA reports challenges in ensuring complete immunization coverage for children due to parental misconceptions. What is the most effective guidance the Staff Nurse can provide to the ASHA?

Q74.During a village health and nutrition day at the Anganwadi Centre, a Staff Nurse observes several children with signs of severe acute malnutrition (SAM). What immediate action should she prioritize as part of the community health nursing role?

Q75.A client diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. The nurse should prioritize monitoring the client for which of the following common side effects?

Q76.A nurse is interacting with a client who expresses feelings of sadness and hopelessness. Which of the following statements by the nurse is an example of a non-therapeutic communication technique?

Q77.A client with severe depression is admitted to the psychiatric unit and expresses suicidal ideation. What is the priority nursing intervention for this client?

Q78.A client in the psychiatric unit suddenly experiences symptoms including palpitations, shortness of breath, dizziness, and intense fear, indicative of a panic attack. What is the nurse's priority action?

Q79.A client admitted with bipolar disorder in a manic phase is observed pacing rapidly, talking loudly, and making grandiose statements. Which nursing intervention is most appropriate for this client?

Q80.A patient tells the nurse, "I feel like I'm just floating through life, nothing matters anymore." Which response by the nurse best demonstrates the therapeutic communication technique of clarification?

Q81.A charge nurse on a medical-surgical unit needs to delegate tasks. Which of the following tasks is most appropriate for the charge nurse to delegate to an experienced Licensed Practical Nurse (LPN) for a stable patient?

Q82.A newly appointed nurse manager aims to empower staff nurses, encourage shared decision-making, and foster a strong sense of team ownership over patient outcomes. Which leadership style would best align with these goals?

Q83.A nurse educator is preparing a session for a group of final-year nursing students on managing a complex obstetric emergency, such as shoulder dystocia. Which teaching strategy would be most effective in allowing students to practice critical thinking, decision-making, and teamwork in a safe environment?

Q84.A staff nurse on a critical care unit identifies a recurring problem of central line-associated bloodstream infections (CLABSIs) and wishes to implement an evidence-based intervention. What should be the initial step in the process of integrating evidence into practice?

Q85.A nurse researcher is conducting a study on the effectiveness of a new pain management protocol in a group of post-operative patients. The principle of ensuring that participants fully understand the nature of the study, potential risks, benefits, and their right to withdraw at any time, before agreeing to participate, primarily upholds which ethical principle?

Q86.Following an audit, a hospital unit identifies an increase in patient falls over the last quarter. The nursing management team wants to systematically investigate the underlying causes and implement sustainable solutions to reduce fall rates. Which quality improvement tool or methodology is most appropriate for a deep, systematic analysis of the root causes of a problem?

Q87.A 45-year-old patient with persistent cough, low-grade fever, night sweats, and weight loss is suspected of having pulmonary tuberculosis. Which nursing intervention is crucial to prevent further spread of the disease within the hospital setting?

Q88.A nurse is educating a patient with newly diagnosed Type 2 Diabetes Mellitus about self-management. Which statement by the patient indicates a need for further teaching regarding glycemic control?

Q89.A child accidentally spills hot tea on their arm, resulting in a superficial partial thickness burn (redness, blistering, pain). What is the immediate first aid action a nurse should advise the parent to take?

Q90.A nurse is assigned to care for a celebrity patient admitted to a private ward. A journalist approaches the nurse, offering a substantial sum of money for details about the patient's condition. What is the most ethically appropriate response from the nurse?

Q91.A nurse is counseling a patient newly diagnosed with HIV. The patient expresses fear about disclosing their status to their partner. Which nursing action aligns best with ethical principles and patient-centered care?

Q92.A 55-year-old patient with newly diagnosed essential hypertension asks the nurse, "What lifestyle changes are most important for me to manage my blood pressure?" Which of the following recommendations should the nurse prioritize?

Q93.Under the 'Aardram Mission' in Kerala, Family Health Centres (FHCs) are being strengthened to provide comprehensive primary healthcare. Which of the following new or enhanced services would a Staff Nurse typically be involved in at an FHC transformed by this mission?

Q94.A patient from a low-income household in Kerala is admitted to a government hospital requiring a costly surgical procedure. The patient expresses concern about the financial burden. As a Staff Nurse, what is the most appropriate action to guide the patient regarding available health schemes?

Q95.A community health nurse is educating mothers about key interventions to improve child survival rates, aligning with global initiatives. Which of the following is a primary component emphasized by the UNICEF-supported GOBI-FFF strategy?

Q96.A Staff Nurse is tasked with organizing a public health awareness campaign focusing on the prevention, early diagnosis, and access to treatment for viral hepatitis. Which of the following national health observances is most directly aligned with this objective and would be the most opportune time for such a campaign?

Q97.A patient presents to a government hospital in Kerala requiring admission for a surgical procedure and expresses intent to avail cashless benefits under a major national health insurance scheme. As a staff nurse, which key feature of the Pradhan Mantri Jan Arogya Yojana (PM-JAY) is essential to confirm for guiding the patient's eligibility and benefits?

Q98.The Ayushman Bharat Digital Mission (ABDM) aims to establish a nationwide digital health ecosystem. From a staff nurse's perspective, what is the most significant practical implication of the ABDM for improving patient care and healthcare delivery?

Q99.A Staff Nurse working in a rural primary health center observes a sudden increase in patients reporting with acute febrile illness, severe myalgia, and skin rash from a specific geographical area within a week. What is the most appropriate initial action for the nurse?

Q100.A staff nurse working in a primary health center in Kerala is counseling a patient from an economically weaker section regarding access to cashless treatment for a chronic illness. Which of the following state-level health initiatives primarily provides comprehensive health insurance coverage for such patients in Kerala?