← Combined Technical (NG)
Past Questions — 2026
Which of the following medication will be prescribed for reducing high intracranial pressure?
A)
Osmotic diuretic
B)
Dilantin sodium
C)
Lorazepam
D)
Syndopa
The correct option is 'Osmotic diuretic' (such as Mannitol). These medications work by increasing the osmotic pressure of the blood, which draws excess water out of the brain tissue and into the bloodstream to be excreted by the kidneys, thereby reducing cerebral edema and lowering intracranial pressure (ICP).
Incorrect options:
- Syndopa (Levodopa/Carbidopa): Used primarily for the treatment of Parkinson's disease.
- Dilantin sodium (Phenytoin): An anticonvulsant used to prevent and treat seizures.
- Lorazepam: A benzodiazepine used for anxiety, insomnia, or as an acute treatment for status epilepticus, but not specifically for reducing ICP.
An old woman was hit by motor cycle while crossing the road. As a nurse who was the witness there, the first intervention that she will do is:
A)
Immobilize the leg
B)
Call for help
C)
Reduce the fracture manually
D)
Move the person to a safer place
In any emergency situation, the first priority according to standard First Aid and Basic Life Support (BLS) protocols is 'Scene Safety.' Before providing care, the rescuer must ensure that the environment is safe for both the victim and the provider to prevent further injuries (e.g., preventing the victim from being hit by other vehicles).
- Option (d) is correct because moving the person to a safer place ensures the scene is secure before medical interventions begin.
- Option (b) is a priority, but scene safety always precedes calling for help or treating the patient.
- Option (a) is a secondary intervention that occurs after the scene is safe and the primary survey is complete.
- Option (c) is contraindicated; manual reduction of a fracture should only be performed by qualified professionals in a controlled setting to avoid nerve or vascular damage.
What is PRN order for medication?
A)
Immediately
B)
At bed time
C)
Whenever necessary
D)
Early morning
PRN is an abbreviation for the Latin phrase 'pro re nata', which translates to 'as the thing is needed' or 'whenever necessary'. In medical prescriptions, a PRN order indicates that a medication should be administered only when the patient experiences specific symptoms (e.g., pain or fever), rather than on a fixed schedule.
Incorrect options:
- Option (a) 'Immediately' is denoted by the term 'STAT'.
- Option (b) 'At bed time' is denoted by the abbreviation 'hs' (hora somni).
- Option (d) 'Early morning' is not a standard single-abbreviation order, though medications may be scheduled for 'AM'.
The strength of Iron and folic acid for pregnant women as per Anaemia Mukt Bharat is:
A)
60 mg elemental iron and 0.5mg folic acid
B)
100 mg elemental iron and 0.5 mg folic acid
C)
60 mg elemental iron and 0.1 mg of folic acid
D)
100 mg of elemental iron and 0.1 mg of folic acid
According to the Anaemia Mukt Bharat (AMB) strategy, the prophylactic dose of Iron and Folic Acid (IFA) for pregnant women is 100 mg of elemental iron and 0.5 mg (500 mcg) of folic acid daily for 180 days.
- Option (b) is correct as it aligns with the AMB guidelines for pregnancy.
- Option (a) is incorrect; 60 mg elemental iron and 0.5 mg folic acid is the dose prescribed for women of reproductive age (15-49 years) and adolescent girls.
- Options (c) and (d) are incorrect because the folic acid dosage is listed as 0.1 mg, which is below the recommended prophylactic dose of 0.5 mg for pregnant women.
Death occurring in the period between 28 weeks of gestation and 7 days after delivery is termed as:
A)
Still birth
B)
Perinatal mortality
C)
Post-natal mortality
D)
Early neonatal mortality
Perinatal mortality is defined as the sum of late fetal deaths (stillbirths after 28 weeks of gestation) and early neonatal deaths (deaths within the first 7 completed days of life). This period covers the critical window from viability (28 weeks) to the first week of postnatal life.
Why other options are incorrect:
- a) Still birth: Refers only to fetal death occurring after 28 weeks of gestation but before birth.
- c) Post-natal mortality: A general term for deaths occurring after birth, which is too broad and does not specify the 28-week gestation starting point.
- d) Early neonatal mortality: Refers specifically to deaths occurring from birth up to 7 completed days of life, excluding fetal deaths.
Which of the following drug in DOTS therapy can cause hearing and balance problem?
A)
Ethambutol
B)
Isoniazid
C)
Rifampicin
D)
Streptomycin
Streptomycin is an aminoglycoside antibiotic used in the treatment of tuberculosis (DOTS). It is known to be ototoxic, meaning it can damage the eighth cranial nerve (vestibulocochlear nerve), leading to hearing loss (auditory toxicity) and balance problems/vertigo (vestibular toxicity).
Other options are incorrect because:
- Ethambutol (a) is primarily associated with optic neuritis (visual disturbances).
- Isoniazid (b) is primarily associated with peripheral neuropathy and hepatotoxicity.
- Rifampicin (c) is primarily associated with hepatotoxicity and orange-colored discoloration of body fluids.
A child presents with diarrhoea and on examination his eyes are sunken, skin pinch goes back slowly and drinks eagerly. How will you classify the dehydration as per IMNCI?
A)
Some dehydration
B)
Over-hydration
C)
Severe dehydration
D)
No dehydration
According to the Integrated Management of Neonatal and Childhood Illness (IMNCI) guidelines, dehydration is classified based on specific clinical signs.
1. **Why 'Some dehydration' is correct**: A child is classified as having 'Some dehydration' if two or more of the following signs are present: restless/irritable, sunken eyes, drinks eagerly/thirsty, or skin pinch goes back slowly. In this case, the child has three signs: sunken eyes, skin pinch goes back slowly, and drinks eagerly.
2. **Why other options are incorrect**:
- **No dehydration**: This classification is used when the child does not exhibit any of the signs of dehydration (e.g., eyes are not sunken, skin pinch goes back immediately).
- **Severe dehydration**: This requires two or more of the following: lethargic or unconscious, sunken eyes, unable to drink or drinks poorly, or skin pinch goes back very slowly (≥2 seconds). The child in the question is drinking eagerly, which rules out severe dehydration.
- **Over-hydration**: This is not a classification used within the IMNCI dehydration assessment framework for diarrhea.
In a balanced diet, protein contributes to how much percentage of the daily energy requirement?
A)
50-60%
B)
20-30%
C)
10-15%
D)
10%
In a balanced diet, the recommended distribution of daily energy (calories) is typically divided among macronutrients: Carbohydrates (50-60%), Fats (20-30%), and Proteins (10-15%).
1. Why Option 'c' is correct: Proteins are essential for growth and repair, but they are not the primary energy source. A contribution of 10-15% of total daily calories is sufficient to meet the body's amino acid requirements for most healthy adults.
2. Why other options are incorrect:
- Option 'a' (50-60%) is the typical range for Carbohydrates.
- Option 'b' (20-30%) is the typical range for Fats.
- Option 'd' (10%) is too narrow and represents the lower limit rather than the standard balanced range.
The hemodialysis access that is surgically created by anastomosing an artery to vein either side to side or end to side is known as:
A)
AV graft
B)
AV fistula
C)
AV shunt
D)
Catheter
An AV (arteriovenous) fistula is the gold standard for hemodialysis access. It is created by surgically connecting (anastomosing) a native artery directly to a native vein, either side-to-side or end-to-side, to increase blood flow to the vein and thicken its wall to withstand repeated needle punctures.
Other options are incorrect because:
- AV graft (a): Uses a synthetic tube (prosthetic graft) to connect the artery and vein, rather than a direct anastomosis of native vessels.
- AV shunt (c): A shunt is typically used to divert blood flow away from an organ or to treat specific conditions (like a PDA), not as a standard term for a dialysis access point.
- Catheter (d): A plastic tube inserted into a large vein (e.g., internal jugular) for temporary or permanent access; it does not involve an anastomosis of an artery to a vein.
A client who is unconscious needs frequent mouth care. When performing a mouth care, the best position of a client is:
A)
Fowler’s position
B)
Side lying
C)
Supine
D)
Trendelenburg
The correct position for an unconscious client receiving mouth care is the side-lying (lateral) position.
1. Why Side-lying is correct: Unconscious patients lack a gag reflex and cannot swallow or cough effectively. Positioning them on their side allows secretions and fluids used during mouth care to drain by gravity out of the mouth, significantly reducing the risk of aspiration pneumonia and choking.
2. Why other options are incorrect:
- Fowler's position (a): While used for conscious patients to prevent aspiration, it is not as safe as side-lying for a completely unconscious patient who cannot manage secretions.
- Supine (c): This is the most dangerous position as fluids can easily flow back into the trachea, leading to aspiration.
- Trendelenburg (d): This position (head lower than feet) would cause fluids to pool in the back of the throat and increase the risk of aspiration and intracranial pressure.
What are the long-term effects of iodine deficiency in pregnant women and their children?
A)
Increased risk of infections
B)
Developmental delays and mental impairment
C)
Osteoporosis
D)
Higher rates of obesity
Iodine is essential for the synthesis of thyroid hormones, which are critical for the development of the fetal brain and nervous system. Severe iodine deficiency during pregnancy can lead to congenital hypothyroidism and cretinism, characterized by irreversible developmental delays, stunted physical growth, and severe mental impairment.
Other options are incorrect because:
- (a) Increased risk of infections is typically associated with immunodeficiency or malnutrition, not specifically iodine deficiency.
- (c) Osteoporosis is related to calcium, vitamin D, or hormonal imbalances (like estrogen), not iodine.
- (d) While hypothyroidism can slow metabolism, the primary and most devastating long-term effect of prenatal iodine deficiency is neurological impairment rather than obesity.
Which of the following vitamin deficiencies will cause pernicious anemia?
A)
Vitamin B12
B)
Folic acid deficiency
C)
Serum iron deficiency
D)
Calcium deficiency
Pernicious anemia is a specific type of megaloblastic anemia caused by the deficiency of Vitamin B12. It occurs when the body cannot absorb B12 due to a lack of 'intrinsic factor,' a glycoprotein produced by the parietal cells of the stomach lining. Without B12, DNA synthesis in red blood cells is impaired, leading to large, immature, and dysfunctional erythrocytes.
Incorrect options:
- b) Folic acid deficiency: While it also causes megaloblastic anemia, it is not termed 'pernicious anemia,' which specifically refers to the B12/intrinsic factor mechanism.
- c) Serum iron deficiency: This leads to microcytic hypochromic anemia (small, pale red blood cells), not pernicious anemia.
- d) Calcium deficiency: This affects bone density (osteoporosis/osteomalacia) and neuromuscular function, but does not cause anemia.
Cardiac enzyme levels are monitored in the patient with chest pain because:
A)
Serial measurement of enzyme level reveals the extent of cardiac damage and helps to monitor healing progress
B)
Help to identify area of myocardial injury
C)
It reveals if the patient is truly having chest pain
D)
Decreasing enzyme level helps to estimate the recovery time for the patient with MI
Cardiac enzymes (such as Troponin and CK-MB) are released into the bloodstream when myocardial cells are damaged or necrotic.
1. Why 'a' is correct: Serial measurements (testing at multiple time intervals) are crucial because enzymes rise and fall at different rates. The peak level often correlates with the extent of the myocardial infarction (MI), and the return to baseline helps clinicians monitor the healing process and ensure no re-infarction has occurred.
2. Why others are incorrect:
- Option 'b': Enzymes indicate that damage has occurred, but they cannot localize the specific anatomical area of the heart (e.g., anterior vs. inferior wall); this is done via a 12-lead ECG.
- Option 'c': Chest pain is a subjective symptom; enzymes detect objective tissue damage, not the 'truthfulness' of the patient's reported pain.
- Option 'd': While decreasing levels indicate the acute phase is passing, they are not used as a primary tool to 'estimate recovery time' (which depends on ejection fraction and clinical stability) but rather to confirm the timeline of the injury.
Myopia is defined as:
A)
Light focuses behind the retina
B)
Light focuses in front of the retina
C)
Equal focusing on retina and lens
D)
Absence of lens curvature
Myopia, commonly known as nearsightedness, occurs when the eyeball is too long or the cornea is too curved. This causes light rays to converge and focus at a point in front of the retina rather than directly on it, making distant objects appear blurry.
Incorrect options:
- Option (a) describes Hyperopia (farsightedness), where light focuses behind the retina.
- Option (c) is physiologically incorrect as the lens and retina are different structures; light must focus specifically on the retina for clear vision.
- Option (d) is incorrect because the lens must have curvature to refract light; an absence of curvature would result in an inability to focus light at all.
What are the ‘5 Keys to Safer Food’ promoted by the WHO?
A)
Keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, and use safe water and raw materials
B)
Wash your hands, cook food, refrigerate food, avoid cross-contamination, and wash produce
C)
Shop smart, cook well, handle leftovers properly, store food correctly and use safe water
D)
Read labels, cook food to the recommended temperature, serve food immediately, throw left over and dont waste.
The '5 Keys to Safer Food' is a global initiative by the World Health Organization (WHO) designed to ensure food safety and reduce foodborne illnesses. The correct keys are: 1. Keep clean, 2. Separate raw and cooked, 3. Cook thoroughly, 4. Keep food at safe temperatures, and 5. Use safe water and raw materials. Option 'a' lists these five pillars exactly as defined by the WHO. Options 'b', 'c', and 'd' are incorrect because they list general food hygiene tips or shopping advice that do not align with the specific, standardized framework established by the WHO.
Diet recommended for a patient with glomerulonephritis:
A)
High protein, low calorie
B)
Low protein, high calorie
C)
Low protein, high sodium and potassium
D)
High calorie, high protein
Glomerulonephritis involves inflammation of the glomeruli, leading to a decrease in the glomerular filtration rate (GFR).
1. Why 'Low protein, high calorie' is correct:
- Low Protein: When kidneys are damaged, they cannot effectively excrete nitrogenous waste products (like urea and creatinine) from protein metabolism. Reducing protein intake minimizes the accumulation of these toxins (azotemia) and reduces the workload on the kidneys.
- High Calorie: To prevent the body from breaking down its own muscle proteins for energy (catabolism), which would further increase urea levels in the blood, a high-calorie diet (primarily from carbohydrates and fats) is essential.
2. Why other options are incorrect:
- Options 'a' and 'd' (High protein): High protein intake increases the production of nitrogenous waste, worsening uremia and putting excessive strain on the inflamed glomeruli.
- Option 'c' (High sodium and potassium): Patients with glomerulonephritis often suffer from edema and hypertension due to sodium and water retention, and potential hyperkalemia due to impaired excretion. Therefore, sodium and potassium must be restricted, not increased.
What is the recommended energy dose for the first shock when using a biphasic defibrillator in adult VF/pulseless VT?
A)
50 joules
B)
120–200 joules
C)
360 joules
D)
720 joules
According to the American Heart Association (AHA) and Advanced Cardiovascular Life Support (ACLS) guidelines, the recommended initial energy dose for a biphasic defibrillator in adult Ventricular Fibrillation (VF) or pulseless Ventricular Tachycardia (pVT) is 120 to 200 joules. If the specific manufacturer's recommended dose is unknown, 200 joules is typically used.
Incorrect options:
- Option a (50 joules): This is too low for an initial adult shock.
- Option c (360 joules): This is the standard dose for monophasic defibrillators, not biphasic.
- Option d (720 joules): This dose is dangerously high and not used in standard ACLS protocols.
For malaria elimination, states are divided into how many categories based on API, ABER and SPR?
A)
2
B)
3
C)
4
D)
none of the above
Under the National Framework for Malaria Elimination (NFME) in India, states and districts are categorized into 4 distinct categories to tailor intervention strategies based on the disease burden. These categories are determined by the Annual Parasite Incidence (API), Annual Blood Examination Rate (ABER), and Slide Positivity Rate (SPR). The categories are: 1. High Endemicity, 2. Moderate Endemicity, 3. Low Endemicity, and 4. PF-free/Elimination phase. Options a, b, and d are incorrect because they do not align with the standardized four-tier classification system used by the National Vector Borne Disease Control Programme (NVBDCP) for strategic planning.
Key component of Orem’s theory is:
A)
Self care
B)
Self perception
C)
Love and belonging
D)
Physiologic needs
Dorothea Orem's theory is known as the 'Self-Care Deficit Nursing Theory.' The central concept is 'Self-care,' which refers to the practice of activities that individuals initiate and perform on their own behalf to maintain life, health, and well-being. Nursing intervention is required when a 'self-care deficit' occurs—meaning the patient's self-care agency is insufficient to meet their therapeutic self-care demands.
Incorrect options:
- 'Physiologic needs' and 'Love and belonging' (Options d and c) are components of Maslow's Hierarchy of Needs, not Orem's theory.
- 'Self perception' (Option b) is a general psychological concept and not a defining key component of Orem's nursing framework.
Which of the following is an absolute contraindication for isotretinoin therapy?
A)
Diabetes
B)
Hypertension
C)
Pregnancy
D)
Hypothyroidism
Isotretinoin is highly teratogenic, meaning it causes severe birth defects (craniofacial, cardiac, and CNS anomalies) if taken during pregnancy. Therefore, pregnancy is an absolute contraindication. Strict protocols (like iPLEDGE) are implemented to ensure patients are not pregnant before and during therapy. Options a, b, and d (Diabetes, Hypertension, and Hypothyroidism) are not absolute contraindications; while some may require monitoring or caution, they do not prohibit the use of the medication.
Which level of prevention aims to reduce the number and/or impact of complication?
A)
Primordial level of prevention
B)
Primary level of prevention
C)
Secondary level of prevention
D)
Tertiary level of prevention
The correct option is Tertiary prevention.
1. **Why Tertiary is correct**: Tertiary prevention occurs after a disease has already been diagnosed and treated. Its primary goal is to soften the impact of an ongoing illness or injury that has lasting effects. This is achieved through rehabilitation, optimal management of the condition, and preventing further complications or disability to improve the patient's quality of life.
2. **Why other options are incorrect**:
- **Primordial prevention (a)**: Aims to avoid the emergence and establishment of social, economic, and cultural patterns of living that contribute to an elevated risk of disease (e.g., national policies to discourage smoking).
- **Primary prevention (b)**: Aims to prevent the onset of disease entirely by controlling risk factors (e.g., vaccination or healthy diet).
- **Secondary prevention (c)**: Aims to detect a disease in its early stages (screening) to provide early treatment and prevent it from progressing (e.g., Pap smears or BP screening).
A patient has painless purulent exudate, along with nausea, vomiting and dizziness, the nurse suspects the following condition:
A)
Chronic otitis media
B)
Otorrhea
C)
Meniere’s disease
D)
Tympanic membrane
The correct option is Chronic Otitis Media (COM).
1. Why 'a' is correct: Chronic Otitis Media is characterized by a persistent perforation of the tympanic membrane with painless purulent discharge (exudate). When the infection spreads to the inner ear (labyrinthitis), it triggers vestibular symptoms such as nausea, vomiting, and dizziness (vertigo).
2. Why other options are incorrect:
- 'b' Otorrhea: This is a general medical term for discharge from the ear, not a specific disease or diagnosis.
- 'c' Meniere’s disease: While it causes dizziness, nausea, and vomiting, it is characterized by fluid buildup (endolymphatic hydrops) and hearing loss, not by purulent exudate (pus).
- 'd' Tympanic membrane: This is an anatomical structure (the eardrum), not a clinical condition.
The purpose of giving purgative enema is to:
A)
Clear the bowel
B)
Provide nutrition
C)
Provide anesthesia
D)
Destroy intestinal worms
A purgative enema is designed to stimulate peristalsis and evacuate the contents of the lower bowel. Its primary purpose is to clear the bowel, often in preparation for surgery, diagnostic procedures (like a colonoscopy), or to treat severe constipation.
Incorrect options:
- Option b: Nutrition is provided via enteral or parenteral routes, not via purgative enemas.
- Option c: Anesthesia is administered systemically or locally to numb pain, not through a purgative process.
- Option d: Intestinal worms are treated with anthelmintic medications, not by the mechanical action of a purgative enema.
Intradermal route is used for testing allergic reactions because:
A)
It is less painful
B)
It is easy to administer
C)
It diffuses rapidly
D)
It diffuses slowly
The intradermal route involves injecting a substance into the dermis, which has a very limited blood supply compared to the subcutaneous or intramuscular layers. This results in slow absorption and diffusion into the systemic circulation. This slow diffusion is critical for allergy testing (such as the Mantoux test) because it keeps the allergen localized, allowing the immune system to react locally and making it easier for clinicians to observe a localized inflammatory response (wheal and flare) without risking a sudden, systemic anaphylactic shock.
Incorrect options:
- (c) Rapid diffusion would cause the substance to enter the bloodstream too quickly, increasing the risk of systemic reactions and preventing localized observation.
- (a) and (b) are irrelevant to the pharmacological or diagnostic purpose of the route; intradermal injections are generally more painful than subcutaneous ones due to the tightness of the skin.
Upon evaluating the patient, the nurse identifies the following diagnoses. Arrange them in order of priority, with the most critical (categorized as high) appearing first: 1. Constipation 2. Expected grieving 3. Inadequate airway clearance 4. Insufficient tissue perfusion
A)
3, 2, 1, 4
B)
1, 4, 2, 3
C)
2, 4, 3, 1
D)
3, 4, 1, 2
The correct order of priority is determined using the ABC (Airway, Breathing, Circulation) framework and Maslow's Hierarchy of Needs.
1. **Inadequate airway clearance (3)**: This is the highest priority as it relates to 'Airway,' the most critical component of survival. Without a clear airway, oxygenation cannot occur.
2. **Insufficient tissue perfusion (4)**: This relates to 'Circulation,' the next priority in the ABC framework. Ensuring organs receive oxygenated blood is critical for life.
3. **Constipation (1)**: This is a physiological need (elimination), but it is not immediately life-threatening compared to airway or circulation issues.
4. **Expected grieving (2)**: This is a psychosocial need. According to Maslow's Hierarchy, physiological and safety needs must be met before addressing emotional or psychological needs.
Therefore, the sequence is 3, 4, 1, 2. Options a, b, and c are incorrect because they prioritize non-life-threatening issues (grieving or constipation) over critical airway and circulatory stability.