Kerala PSC Staff Nurse Gr II Mock 009

Q1.A patient presents with unilateral pitting edema in the left arm following a mastectomy. Which anatomical system is most likely impaired, leading to this condition?

Q2.During normal inspiration, which of the following physiological changes primarily occurs to facilitate air entry into the lungs?

Q3.A nurse is educating a patient with chronic kidney disease about the importance of fluid restriction. Which hormone plays a crucial role in regulating water reabsorption in the collecting ducts of the kidneys, thus impacting fluid balance?

Q4.A patient experiences difficulty with balance, coordination, and fine motor skills after a traumatic head injury. Which part of the brain is most likely affected?

Q5.A patient presents with symptoms including unexplained weight loss, heat intolerance, tachycardia, and exophthalmos. These findings are most indicative of an overactivity of which endocrine gland?

Q6.Which of the following digestive enzymes, primarily secreted by the pancreas, is responsible for the breakdown of fats (triglycerides) into fatty acids and glycerol in the small intestine?

Q7.When a nurse assists a patient with passive range of motion exercises, which type of synovial joint allows for the widest range of movement, including flexion, extension, abduction, adduction, circumduction, and rotation?

Q8.A patient presents with fever, severe headache, neck stiffness, and photophobia. A lumbar puncture is performed, and the CSF analysis shows increased protein, decreased glucose, and a high white blood cell count predominantly neutrophils. Which bacterial pathogen is most likely responsible for these symptoms?

Q9.A nurse is caring for a patient diagnosed with active pulmonary tuberculosis. What is the primary mode of transmission for Mycobacterium tuberculosis, and what personal protective equipment (PPE) should the nurse prioritize?

Q10.A 6-month-old infant receives routine vaccinations as per the national immunization schedule. This type of immunity, where the body actively produces antibodies in response to an antigen, is known as:

Q11.A nurse is preparing to collect a midstream urine specimen for culture and sensitivity from an adult female patient. Which instruction is most crucial for ensuring an accurate result?

Q12.In a hospital setting, hand hygiene is considered the single most effective measure to prevent hospital-acquired infections (HAIs). According to WHO guidelines, when should a nurse perform hand hygiene using an alcohol-based hand rub or soap and water?

Q13.A microbiology lab technician is preparing to culture a bacterial specimen that is suspected to be an obligate anaerobe. What specific condition is essential for the successful growth of this type of microorganism?

Q14.A patient with a catheter-associated urinary tract infection (CAUTI) develops a fever, chills, and flank pain. The urine culture report shows a significant growth of Pseudomonas aeruginosa. Considering the characteristics of this bacterium, what is a key concern for the nurse regarding treatment and infection control?

Q15.A community health nurse facilitates a weekly meeting for new mothers to share experiences, offer advice, and provide mutual support regarding infant care. This group primarily serves as a source of emotional and practical assistance. From a sociological perspective, what kind of group is this, and how does it contribute to community health?

Q16.Rapid urbanization in developing countries often leads to significant social changes, including shifts in lifestyle and environment. From a community health perspective, which of the following health issues is most likely to show a marked increase as a direct consequence of these changes?

Q17.A community health nurse identifies a family experiencing multiple social problems, including chronic unemployment, domestic violence, and substance abuse by one parent. The children in the family show signs of neglect. What is the most appropriate initial and primary role of the community health nurse in addressing this complex situation?

Q18.A community health nurse is planning a health education program to reduce the incidence of non-communicable diseases (NCDs) in a rural village. Before implementing the program, the nurse spends significant time engaging with local leaders, understanding community beliefs about health and illness, and involving villagers in the planning process. Which core principle of community health nursing is the nurse primarily demonstrating?

Q19.A community health nurse observes a rising trend of non-communicable diseases (NCDs) such as obesity, diabetes, and cardiovascular diseases among residents of an urban slum community. Despite the availability of public health clinics, adherence to healthy lifestyle advice is low. Which social determinant of health is most likely playing a significant role in this specific community's health challenges?

Q20.A community health nurse is introducing a new national immunization program for adolescent girls in a rural community where traditional beliefs about health and gender roles are strong. The nurse notices significant resistance and low uptake, despite clear scientific evidence of the vaccine's benefits. What is the most effective approach for the nurse to increase the successful adoption of the vaccination program in this context?

Q21.A staff nurse is teaching a patient with a recent colostomy how to change their ostomy bag independently. The nurse breaks down the task into small steps, provides immediate positive feedback for correct actions, and corrects errors constructively. Which learning theory is the nurse primarily applying in this teaching approach?

Q22.A patient recovering from a stroke expresses profound doubt about their ability to regain strength and walk again, despite showing progress in physical therapy. The nurse wants to boost the patient's motivation for rehabilitation. Which motivational concept should the nurse primarily target?

Q23.A newly graduated nurse consistently makes negative remarks about patients with chronic pain, often stating they are 'attention-seeking' or 'exaggerating.' The nursing supervisor observes this behavior during team rounds. What is the most appropriate initial action for the supervisor to address this situation?

Q24.A patient diagnosed with a terminal illness, despite receiving clear medical information about their prognosis, continuously talks about planning a world tour for next year and refuses to discuss end-of-life care options. Which defense mechanism is this patient primarily exhibiting?

Q25.A nurse is educating a patient newly diagnosed with type 2 diabetes on dietary changes. The patient expresses difficulty giving up sugary drinks, which has been a daily habit for years. To best support the patient in changing this habit, the nurse should recommend:

Q26.A patient with a history of anxiety disorder is admitted for a non-cardiac procedure. The nurse observes the patient frequently checking their pulse, expressing disproportionate fear about minor bodily sensations, and repeatedly asking for reassurance from staff. Which nursing assessment is most crucial to conduct first?

Q27.A 2-year-old child presents with generalized edema, a distended abdomen, and apathy, despite having some subcutaneous fat. The nurse suspects a severe form of malnutrition. Which condition and primary nutrient deficiency is most likely?

Q28.A nurse is advising a pregnant woman diagnosed with iron deficiency anemia on dietary changes. Which of the following foods or beverages should she be advised to consume *separately* from iron-rich meals to maximize iron absorption?

Q29.A nurse is counseling a patient on increasing their intake of dietary fiber. Which of the following food items would be the *best* recommendation to achieve this goal?

Q30.A nurse is providing dietary education to a patient with Type 2 Diabetes Mellitus. Which of the following dietary strategies would be *least* beneficial for managing blood glucose levels?

Q31.A patient with chronic kidney disease (CKD) is on a renal diet. Which of the following is often a concern and may require supplementation in CKD patients due to impaired kidney function or dietary restrictions?

Q32.A nurse is educating a patient about the importance of nutrition for optimal immune function. Which of the following micronutrients is essential for maintaining skin integrity and vision, and plays a role in immune response, making it important in preventing infections?

Q33.A nurse is caring for a patient experiencing acute hypoglycemia. From a biochemical perspective, which immediate compensatory mechanism in the liver is primarily responsible for releasing glucose into the bloodstream to raise blood sugar levels?

Q34.A patient is admitted with severe burns and requires extensive wound care. From a biochemical standpoint, which class of macromolecules is most critically needed in increased amounts for tissue repair and regeneration during the healing process?

Q35.A blood sample is drawn for serum enzyme analysis, such as AST and ALT, to assess liver function. To ensure the accuracy of the results, the nurse understands that maintaining an optimal environment for enzyme activity is crucial. Which condition is most important to control for reliable enzyme assay results?

Q36.A nurse is educating a patient about the importance of a balanced diet for overall health, particularly focusing on cell membrane integrity and hormone production. Which essential dietary component, when deficient, would primarily impair the structural integrity of cell membranes and the synthesis of steroid hormones?

Q37.A patient with diabetic ketoacidosis (DKA) presents with severe metabolic acidosis. The nurse knows that the body's primary immediate buffering system in the extracellular fluid will attempt to neutralize the excess acid. Which biochemical system is most active in this initial compensatory effort?

Q38.A nurse is assessing a malnourished patient, a chronic alcoholic, who exhibits symptoms of Wernicke-Korsakoff syndrome, including confusion and ataxia. This condition is related to a deficiency of a specific vitamin that acts as a coenzyme in crucial carbohydrate metabolism pathways in the brain. Which vitamin deficiency is the nurse most likely observing?

Q39.A nurse needs to administer 0.25 mg of digoxin orally. The available stock is digoxin 125 mcg tablets. How many tablets should the nurse administer?

Q40.A patient is prescribed Furosemide (Lasix) for fluid overload. Which electrolyte imbalance is a nurse most concerned about monitoring in this patient?

Q41.A nurse is preparing to administer medication to an elderly patient. Which of the following is the most crucial step a nurse should take *before* administering any medication?

Q42.A patient with hypertension is started on an ACE inhibitor (e.g., Ramipril). Which adverse effect should the nurse specifically educate the patient about and monitor for, as it can be persistent and lead to medication non-adherence?

Q43.A patient is prescribed Metformin for Type 2 Diabetes Mellitus. Which common adverse effect should the nurse primarily advise the patient about, especially during the initial phase of treatment, and suggest strategies to manage it?

Q44.A physician orders 500 mg of a drug to be administered intravenously. The drug is supplied in a vial containing 1 gram of powder, which needs to be reconstituted with 10 mL of sterile water. What volume (in mL) should the nurse draw from the reconstituted solution to administer the ordered dose?

Q45.A patient is admitted to the hospital with acute abdominal pain. According to the nursing process, what is the nurse's *initial* priority action?

Q46.A nurse is preparing to insert an intravenous (IV) catheter for a patient. According to standard infection control guidelines, when is it essential for the nurse to perform hand hygiene?

Q47.A nurse is caring for an unconscious patient who is at high risk for aspiration due to impaired gag reflex. Which position would be most appropriate for this patient?

Q48.A nurse is preparing a sterile field for a central line dressing change. Which action by the nurse would indicate a breach in sterile technique?

Q49.A nurse needs to monitor the core body temperature of an adult patient frequently and non-invasively. Which method is generally preferred for this purpose in an acute care setting?

Q50.A nurse has completed the assessment and formulated nursing diagnoses for a patient experiencing acute pain. What is the *next* logical step in the nursing process?

Q51.A nurse is caring for a patient admitted with an acute myocardial infarction (MI). Which of the following findings would be the MOST critical to report immediately to the physician?

Q52.A patient with Chronic Obstructive Pulmonary Disease (COPD) is admitted to the hospital with acute exacerbation. The nurse observes the patient is anxious, using accessory muscles to breathe, and has an oxygen saturation of 88% on room air. What is the PRIORITY nursing intervention?

Q53.A nurse is educating a patient with Chronic Kidney Disease (CKD) about dietary restrictions. To manage hyperkalemia, which food item should the nurse advise the patient to consume in moderation or avoid?

Q54.A nurse is assessing a patient with a severe head injury. Which of the following assessment findings is an EARLY and critical indicator of increasing intracranial pressure (ICP)?

Q55.A patient is admitted to the emergency department with suspected upper gastrointestinal (GI) bleeding, reporting black, tarry stools and feeling dizzy. The nurse's PRIORITY intervention upon admission should be to:

Q56.A patient receiving chemotherapy develops neutropenia. Which instruction is MOST important for the nurse to provide to the patient and family?

Q57.A 28-year-old primigravida at 16 weeks gestation reports experiencing occasional, painless, irregular uterine contractions. She is concerned and asks the nurse if this is normal. What is the most appropriate response by the nurse?

Q58.During active labor, a nurse notes late decelerations on the fetal monitor strip for a client. The client is receiving oxytocin infusion. What is the immediate priority nursing intervention?

Q59.A nurse is assessing a postpartum client 24 hours after a vaginal delivery. The nurse palpates the fundus at the level of the umbilicus, firm, and midline. The lochia is moderate rubra with small clots. What is the most appropriate interpretation of these findings?

Q60.A newborn is delivered and at 1 minute of age, the nurse observes the following: heart rate 90 bpm, weak cry, some flexion of extremities, blue extremities but pink body, and irregular respirations. What is the APGAR score for this infant?

Q61.A 30-year-old woman with a history of deep vein thrombosis (DVT) 2 years ago is seeking a contraceptive method. Which of the following methods would be contraindicated for her?

Q62.A pregnant client at 36 weeks gestation presents to the emergency department with a blood pressure of 160/100 mmHg, 3+ proteinuria, and reports a severe headache and blurred vision. The nurse suspects preeclampsia with severe features. What is the most critical nursing intervention to anticipate and prepare for?

Q63.A staff nurse is assessing the developmental milestones of an 8-month-old infant during a well-baby clinic visit. Which of the following milestones would the nurse most likely expect to observe in a healthy 8-month-old?

Q64.A 1-year-old child presents to the emergency department with a 2-day history of acute watery diarrhea. The nurse assesses the child and notes the following: lethargy, sunken eyes, skin pinch goes back slowly (more than 2 seconds), and the child is unable to drink. According to IMNCI guidelines, how would the nurse classify this child's dehydration status?

Q65.A 3-month-old infant is admitted to the pediatric ward with a diagnosis of viral bronchiolitis. The nurse observes signs of respiratory distress including tachypnea (RR 70/min), nasal flaring, and intercostal retractions. What is the most appropriate initial nursing action to improve the infant's respiratory status?

Q66.A community health nurse is assessing a 15-month-old child at home using IMNCI guidelines. The child has had a fever for 2 days. Which of the following findings observed by the nurse would be classified as a "general danger sign" requiring urgent referral to a hospital?

Q67.According to IMNCI guidelines, a 6-month-old infant is assessed and classified as having "Pneumonia" (yellow classification). What is the recommended management plan for this infant?

Q68.A staff nurse is preparing to administer routine immunizations to a 9-month-old infant during a well-baby check-up. Which of the following vaccines is typically administered at 9 months of age according to the National Immunization Schedule (NIS) in India?

Q69.A Staff Nurse posted at a Sub-centre is conducting a routine home visit for a pregnant woman in her second trimester. Which of the following is the *most crucial* action for the nurse to perform during this visit, considering her role in primary health care?

Q70.The National Health Mission (NHM) emphasizes a comprehensive approach to improve health outcomes. Which of the following core components is a *primary focus* under the NHM's strategy for maternal and child health, including adolescence?

Q71.A Staff Nurse working in a community observes a significant increase in fever cases with chills, suspected to be malaria, during the monsoon season. As part of the National Vector Borne Disease Control Programme (NVBDCP), which intervention would be *most appropriate* to implement or reinforce in the affected community?

Q72.A Staff Nurse is tasked with identifying the priority health needs of a rural community before initiating a new health intervention program. Which of the following data sources would provide the *most comprehensive* and relevant information for this purpose?

Q73.An Auxiliary Nurse Midwife (ANM) at a Sub-centre is planning an immunisation drive for infants and pregnant women in her service area. Which of the following roles is *primarily* carried out by an ASHA worker to ensure the success of this drive?

Q74.A Staff Nurse reviews the health statistics for her block and notes a consistently high Infant Mortality Rate (IMR) over the past three years. This finding *most strongly* indicates a need for intensified interventions in which of the following areas?

Q75.A nurse responds to a patient who states, "I just want to end it all, there's no hope for me." by saying, "You shouldn't talk like that; things will get better if you just try." Which communication technique is the nurse using, and is it therapeutic?

Q76.A patient diagnosed with schizophrenia believes that the television newscaster is sending him direct, personal messages specifically meant for him. This type of thought disturbance is best described as:

Q77.A patient in the emergency department presents with severe anxiety, hyperventilation, and reports feeling a sense of impending doom. What is the nurse's priority initial intervention?

Q78.A nurse is assessing a patient receiving haloperidol. The patient suddenly develops severe muscle rigidity, high fever, altered mental status, and autonomic dysfunction (e.g., profuse sweating, tachycardia). The nurse recognizes these symptoms as indicative of which life-threatening condition?

Q79.A patient tells the nurse, "I feel like I'm walking on eggshells all the time, and everyone is judging me." Which of the following responses by the nurse best demonstrates the therapeutic communication technique of 'reflecting'?

Q80.A patient firmly believes that the hospital staff are poisoning his food, despite evidence to the contrary. This fixed, false belief is best described as a:

Q81.A newly appointed Charge Nurse on a busy medical-surgical unit observes high staff turnover and frequent conflicts among team members. To address these issues and foster a more positive work environment, she decides to implement a leadership style that encourages shared decision-making and empowers staff. Which leadership style is she most likely adopting?

Q82.A nursing instructor is designing an assessment for final year students to evaluate their ability to integrate theoretical knowledge with practical skills in a simulated patient care scenario. Which evaluation method would be most appropriate for this purpose?

Q83.A staff nurse identifies that the current protocol for preventing hospital-acquired pressure injuries seems outdated and wants to explore implementing an evidence-based approach. According to the evidence-based practice (EBP) process, what is the crucial first step the nurse should undertake?

Q84.A Head Nurse is reviewing the annual budget for the nursing department. Which of the following is considered a 'fixed cost' in nursing management?

Q85.When developing a curriculum for a new nursing program, which of the following is the most important factor to consider to ensure the program's relevance and quality?

Q86.A nurse researcher is conducting a study on the effectiveness of a new wound care dressing. To ensure ethical conduct, which action is paramount before enrolling any patients in the study?

Q87.A 45-year-old patient is diagnosed with active pulmonary tuberculosis (TB) and is admitted to a general ward. As a staff nurse, what is the most appropriate infection control measure you should implement for this patient?

Q88.A 60-year-old male with a history of type 2 diabetes presents to the clinic for a routine check-up. His latest HbA1c is 8.5%. Which of the following lifestyle modifications should the nurse prioritize in patient education to help manage his condition and prevent complications?

Q89.While having lunch in the hospital cafeteria, a colleague suddenly clutches their throat, cannot speak, and appears distressed. What is the immediate first aid action a staff nurse should take?

Q90.A nurse is charting in the electronic health record when a colleague from another unit asks to see the medical history of a mutual friend who is a patient on a different ward, citing 'personal concern'. What is the most ethical response from the nurse?

Q91.A new staff nurse is preparing to administer an injection to a patient diagnosed with Hepatitis B. She accidentally sustains a needle stick injury with the contaminated needle. What is the immediate priority action for the staff nurse following this exposure?

Q92.A 65-year-old patient with newly diagnosed hypertension is prescribed medication and advised lifestyle modifications, including a low-sodium diet. During a follow-up visit, the patient expresses difficulty adhering to the diet due to traditional family meal preparations. How can the nurse best support the patient in adhering to the dietary recommendations?

Q93.A 45-year-old daily wage worker, identified as belonging to an economically weaker section, is diagnosed with a severe cardiac condition requiring expensive surgery. His family is unable to bear the treatment costs. As a Staff Nurse in a government hospital, which major Kerala government health scheme would you primarily advise them to explore for financial assistance for this life-saving treatment?

Q94.A Staff Nurse is actively involved in community outreach programs aimed at transforming Primary Health Centres (PHCs) into Family Health Centres (FHCs) across Kerala. This initiative emphasizes strengthening primary healthcare, improving infrastructure, and promoting preventive and promotive health activities at the grassroots level. Which of the following Kerala government missions is the driving force behind this transformation?

Q95.A community health nurse in a remote area of Kerala is organizing a mass immunization camp for children under five. To ensure the safety and efficacy of the vaccines, which international organization's guidelines would be most crucial for establishing proper cold chain management, vaccine storage, and administration protocols?

Q96.During National Nutrition Week (September 1-7), a Staff Nurse in a Primary Health Centre is tasked with developing educational materials for community outreach. Which of the following topics would be most central to promoting the observance's primary goal of improving public health through better dietary practices?

Q97.The Ayushman Bharat Digital Mission (ABDM) aims to establish a national digital health ecosystem. As a staff nurse, what is the most direct benefit of this mission for improving patient care coordination in your practice?

Q98.Recent health policy directives in India emphasize a strong focus on strengthening Primary Health Centres (PHCs) and expanding community-based screening for Non-Communicable Diseases (NCDs) like hypertension and diabetes. What is the most significant practical implication of this policy for a staff nurse working in a PHC setting?

Q99.A Staff Nurse working in a primary health centre observes an unusual increase in the number of patients presenting with fever, cough, and shortness of breath over the past three days. What is the most appropriate initial action for the nurse to take in this potential epidemic outbreak situation?

Q100.A Staff Nurse is explaining the key initiatives of the Kerala Government in public health to a newly joined colleague. When discussing the 'Aardram Mission', which of the following statements best encapsulates its primary objective relevant to patient care and institutional development in Kerala?