← Combined Technical (NG)
Past Questions — 2026
Screening for hypertension in adults is considered:
A)
Health promotion
B)
Primary prevention
C)
Secondary prevention
D)
Tertiary prevention
Screening for hypertension is a classic example of secondary prevention.
1. Why 'c' is correct: Secondary prevention focuses on the early detection of a disease (asymptomatic stage) through screening tests to allow for early intervention and prevent the progression of the condition or its complications. Since hypertension is often 'silent' (asymptomatic), screening identifies it early to prevent outcomes like stroke or heart failure.
2. Why other options are incorrect:
- Health promotion (a): This involves general actions to improve overall well-being (e.g., encouraging a healthy diet for the general population), not targeting a specific disease through screening.
- Primary prevention (b): This aims to prevent the onset of disease entirely (e.g., reducing salt intake to prevent hypertension from developing).
- Tertiary prevention (d): This focuses on managing established disease to prevent further deterioration or disability (e.g., cardiac rehabilitation after a heart attack).
Which of the following signs indicates the need for sputum examination for AFB?
A)
Hematemasis
B)
Fever for 1 week
C)
Cough for 3 weeks
D)
Chest pain for 1 week
The correct option is 'c' because a cough lasting for 3 weeks or more is the classic clinical indicator for a suspected case of Pulmonary Tuberculosis (TB). AFB (Acid-Fast Bacilli) sputum examination is the primary diagnostic tool used to detect Mycobacterium tuberculosis. According to global health guidelines (such as WHO and national TB programs), any patient presenting with a chronic cough of 3 weeks or more is considered a 'TB suspect' and must undergo sputum microscopy.
Other options are incorrect because:
- 'a' Hematemasis (vomiting blood) typically indicates upper gastrointestinal bleeding, not a primary respiratory infection.
- 'b' and 'd' Fever and chest pain for 1 week are acute symptoms that are non-specific and can be caused by various conditions such as common cold, acute bronchitis, or pneumonia, and do not meet the duration threshold for chronic TB screening.
Which massage technique involves using long, sweeping strokes with the hands or fingers to create a soothing and relaxing effect on the muscles?
A)
Petrissage
B)
Friction
C)
Effleurage
D)
Tapotement
Effleurage is the correct answer because it is defined as a massage technique characterized by long, gliding, sweeping strokes applied with the palms or fingers, primarily used to soothe the nervous system and warm up the muscles.
Other options are incorrect because:
- Petrissage (a) involves kneading, squeezing, or rolling the muscles to release tension.
- Friction (b) involves deep, circular, or transverse rubbing to break down adhesions.
- Tapotement (d) consists of rhythmic tapping, cupping, or hacking movements to stimulate the muscles.
The solution used to disinfect the bed linen of HIV positive patient is:
A)
Dettol
B)
Lysol
C)
Savlon
D)
Sodium Hypochlorite
1. Why Sodium Hypochlorite is correct: Sodium Hypochlorite (bleach) is a powerful oxidizing agent and a broad-spectrum disinfectant. It is the gold standard recommended by health organizations (like the WHO and CDC) for disinfecting surfaces and linens contaminated with blood or body fluids from HIV-positive patients because it effectively inactivates the HIV virus and other blood-borne pathogens.
2. Why other options are incorrect: Dettol, Savlon, and Lysol are general-purpose antiseptics or disinfectants. While they are useful for skin disinfection or general household cleaning, they do not possess the same level of high-level virucidal efficacy as sodium hypochlorite for neutralizing blood-borne viruses like HIV in a clinical or high-risk setting.
Which of the following clients is at the greatest risk for developing pressure ulcers?
A)
An obese client who relies on a wheelchair.
B)
An 80-year-old ambulatory client with diabetes.
C)
A 79-year-old malnourished client who is on bed rest.
D)
An incontinent client who has experienced three episodes of diarrhea.
The correct option is 'c' because this client possesses three major risk factors for pressure ulcers: advanced age (thinning skin), malnutrition (lack of protein and vitamins for skin integrity), and immobility (bed rest). The combination of poor nutritional status and complete immobility creates the highest risk for tissue breakdown.
Other options are less critical:
- Option 'a': While wheelchair use increases risk, obesity can sometimes provide a cushion, and the client is not noted as malnourished.
- Option 'b': Being ambulatory significantly reduces the risk of pressure ulcers, despite age and diabetes.
- Option 'd': Incontinence and diarrhea cause moisture-associated skin damage (MASD), which increases risk, but it is generally less severe than the systemic failure of nutrition combined with total immobility seen in option 'c'.
The Nurse giving oxygen therapy should know that it has to be humidified because:
A)
Oxygen gets warmed by humidification
B)
Oxygen is a dry gas and thickens the mucus
C)
Oxygen gets cleaned of pathogens by humidification
D)
Oxygen gets easily absorbed because humidification adds H-ion to it
The correct option is 'b' because medical oxygen is stored as a compressed gas, which is inherently dry. When administered to a patient, especially at higher flow rates, this dry gas evaporates moisture from the respiratory mucosa. This leads to the drying of secretions, making the mucus thick and tenacious, which can obstruct the airways and impair the mucociliary escalator's ability to clear debris. Humidification prevents this drying effect.
Other options are incorrect because:
- Option 'a': While humidification may slightly affect temperature, the primary clinical reason for humidifying oxygen is to prevent mucosal drying, not simply to warm the gas.
- Option 'c': Humidification is not a sterilization process; it does not 'clean' the oxygen of pathogens.
- Option 'd': Humidification does not add H-ions to oxygen to facilitate absorption; oxygen absorption occurs via passive diffusion across the alveolar-capillary membrane regardless of humidification.
The sudden return to the normal temperature from very high fever is called:
A)
Lysis
B)
Crisis
C)
Thermostasis
D)
Homeostasis
In medical terminology, the termination of a fever occurs in two primary ways:
1. **Crisis (Correct):** This is the sudden and rapid drop of body temperature back to normal, often accompanied by profuse sweating.
2. **Lysis (Incorrect):** This refers to a gradual decline in temperature over several days until it reaches normal levels.
3. **Homeostasis (Incorrect):** This is the general physiological process by which an organism maintains a stable internal environment despite external changes; it is not a specific term for the resolution of a fever.
4. **Thermostasis (Incorrect):** This is a general term for the maintenance of a constant body temperature, similar to homeostasis but specifically focused on heat.
The type of fluid which causes water to shift from cells into blood stream?
A)
Hypotonic
B)
Hypertonic
C)
Isotonic
D)
Albumin
The movement of water between cells and the bloodstream is governed by osmosis, where water moves from an area of lower solute concentration to an area of higher solute concentration.
1. **Why Hypertonic is correct**: A hypertonic fluid has a higher concentration of solutes compared to the intracellular fluid (inside the cell). This creates an osmotic gradient that pulls water out of the cells and into the bloodstream to balance the concentration, causing the cells to shrink.
2. **Why other options are incorrect**:
- **Hypotonic (a)**: These fluids have a lower solute concentration than the cell. Water moves from the bloodstream into the cells, causing them to swell or burst.
- **Isotonic (c)**: These fluids have an equal solute concentration to the cell, resulting in no net movement of water.
- **Albumin (d)**: While albumin is a protein that helps maintain oncotic pressure in the blood, it is a specific protein/solute, not a 'type of fluid' in the context of tonicity classifications.
Which of the following represents the essential components of palliative care?
A)
Rehabilitation, continuity of care, treatment
B)
Effective communication, terminal care, bereavement planning
C)
Terminal care, symptom control, rehabilitation
D)
Education, research, grief planning
Palliative care is a holistic approach designed to improve the quality of life for patients with life-limiting illnesses. The essential components include: 1) Effective communication to manage expectations and goals of care, 2) Terminal care (end-of-life care) to ensure dignity and comfort, and 3) Bereavement planning to support the family after the patient's death.
Other options are incorrect because:
- Option 'a' focuses on 'Rehabilitation' and 'Treatment', which are primary goals of curative care rather than palliative care.
- Option 'c' includes 'Rehabilitation', which is generally not a core component of palliative care (which focuses on comfort over functional restoration).
- Option 'd' lists 'Education' and 'Research', which are academic or systemic supports rather than the direct clinical components of patient care.
The nurse taking care of a patient with chest tube drainage suddenly notices that there is no fluctuation in the water seal tube. Which of the following action should the nurse take first?
A)
Turn the patient to the unaffected side
B)
Inform the physician
C)
Check the tubing to ensure there is no kinking
D)
Start milking the chest tube
In a chest tube drainage system, 'tidaling' (fluctuation) in the water seal chamber indicates that the system is patent and communicating with the pleural space. When fluctuation stops, it typically means one of two things: either the lung has fully re-expanded (a positive outcome) or there is an obstruction in the tubing. The nurse's first action should always be the least invasive assessment to identify the cause. Checking for kinks or obstructions in the tubing is the immediate priority to ensure the system is functioning correctly.
Why other options are incorrect:
- Option a: Turning the patient to the unaffected side is not a standard intervention for a lack of tidaling and does not address the potential cause of the issue.
- Option b: Informing the physician is necessary if the lung has re-expanded or if a complication is found, but the nurse must first assess the equipment to provide an accurate report.
- Option d: 'Milking' or 'stripping' chest tubes is generally contraindicated in modern nursing practice as it can create excessive negative pressure and cause tissue damage.
In Parkland formula for: Ringer’s Lactate = ?
A)
2 mL × kg × % TBSA
B)
3 mL × kg × % TBSA
C)
4 mL × kg × % TBSA
D)
5 mL × kg × % TBSA
The Parkland formula is the gold standard for calculating fluid resuscitation in burn patients during the first 24 hours. The formula is: 4 mL × body weight (kg) × percentage of Total Body Surface Area (% TBSA) burned. This total volume of Ringer's Lactate is administered as follows: half in the first 8 hours from the time of injury, and the remaining half over the next 16 hours.
Options a, b, and d are incorrect because they use different multipliers (2 mL, 3 mL, and 5 mL). While some modern guidelines (like the ABA) may suggest starting at 2 mL/kg for adults to avoid 'fluid creep,' the classic 'Parkland Formula' specifically refers to the 4 mL constant.
Which of the following is a first-line conservations management for stress incontinence?
A)
Anticholinergic drugs
B)
Pelvic floor muscle training
C)
Botulinum toxin injection
D)
Indwelling catheter
Stress incontinence occurs when physical movement or activity (coughing, sneezing, exercising) puts pressure on the bladder, causing urine leakage.
1. Why 'b' is correct: Pelvic floor muscle training (PFMT), including Kegel exercises, is the gold-standard first-line conservative management. It strengthens the levator ani muscles and the urethral sphincter, increasing the support of the bladder neck and reducing leakage.
2. Why other options are incorrect:
- Anticholinergic drugs (a): These are used for 'urge incontinence' (overactive bladder) to relax the detrusor muscle; they are not effective for stress incontinence.
- Botulinum toxin injection (c): This is typically a third-line or refractory treatment for neurogenic detrusor overactivity or severe urge incontinence, not a first-line conservative measure for stress incontinence.
- Indwelling catheter (d): This is an invasive measure used for urinary retention or end-of-life care, not a management strategy for stress incontinence.
In cold chain process, the walk-in coolers stores vaccine upto:
A)
1 month
B)
3 months
C)
6 months
D)
9 months
In the cold chain management system for vaccines, different storage facilities are used based on the duration of storage. Walk-in Coolers (WICs) are designed for regional or district-level storage and are typically used to store vaccines for a period of up to 6 months.
- Option (c) is correct as per standard cold chain guidelines for WICs.
- Options (a) and (b) are incorrect because they refer to shorter durations typically associated with lower-level storage like ILRs (Ice-Lined Refrigerators) at PHCs or outreach sites.
- Option (d) is incorrect as storage beyond 6 months usually requires larger, centralized Walk-in Freezer/Cooler systems at the national or state level, or is limited by the vaccine's own expiry date.
How much floor space area should be available per person according to housing standards to prevent overcrowding?
A)
50-70 sq.ft
B)
70-90 sq.ft
C)
90-110 sq.ft
D)
>100 sq.ft
According to standard public health and housing guidelines (often cited in community health and urban planning manuals), the minimum floor space required to prevent overcrowding is generally considered to be between 70 to 90 square feet per person. This range ensures adequate ventilation, movement, and hygiene within a living space.
- Option (a) 50-70 sq.ft is considered insufficient and may lead to overcrowding and health risks.
- Option (c) 90-110 sq.ft and Option (d) >100 sq.ft represent higher comfort levels or luxury standards, but they are not the minimum baseline threshold defined in standard housing regulations to 'prevent' overcrowding.
A male patient enquires about the effectiveness of vasectomy compared to female tubectomy. Which statement is MOST accurate?
A)
Tubectomy is more effective than vasectomy
B)
Vasectomy is safer, simpler, and equally effective
C)
Vasectomy requires general anaesthesia
D)
Fertility returns faster after vasectomy
The correct option is 'b' because vasectomy is widely recognized as a safer, simpler, and more cost-effective procedure compared to tubectomy. It is a minor surgical procedure that can be performed under local anesthesia, whereas tubectomy is a more invasive abdominal surgery. In terms of efficacy, both are highly effective methods of permanent sterilization.
Incorrect options:
- Option 'a': Tubectomy is not more effective; both methods provide high levels of permanent contraception.
- Option 'c': Vasectomy does NOT require general anesthesia; it is typically performed under local anesthesia.
- Option 'd': Neither procedure is designed for the return of fertility; both are intended to be permanent. While reversals exist, they are complex and not guaranteed, and 'speed of return' is not a standard clinical comparison for effectiveness.
The vector of Dengue is:
A)
Aedes aegypti
B)
Culex fatigans
C)
Mansonia uniformis
D)
Anopheles culifacies
The correct option is (a) Aedes aegypti. Dengue fever is caused by the Dengue virus (DENV) and is primarily transmitted to humans through the bite of an infected female Aedes aegypti mosquito.
Reasons why other options are incorrect:
- (b) Culex fatigans: Primarily known as a vector for Japanese Encephalitis and Filariasis.
- (c) Mansonia uniformis: Primarily associated with the transmission of Brugian Filariasis.
- (d) Anopheles culifacies: The primary vector for Malaria in many regions.
Which of the following is a positive mortality indicator?
A)
Child mortality rate
B)
Life expectancy
C)
Duration of hospital stay
D)
Maternal mortality rate
In public health and epidemiology, mortality indicators are categorized as either 'negative' or 'positive'.
1. **Why 'Life expectancy' is correct:** A positive mortality indicator is one where a higher value represents a better health outcome or a higher quality of life. Life expectancy measures the average number of years a person is expected to live; therefore, an increase in this value indicates improved health and survival rates.
2. **Why other options are incorrect:**
- **Child mortality rate (a)** and **Maternal mortality rate (d)** are negative indicators because a higher value indicates a worse health outcome (more deaths).
- **Duration of hospital stay (c)** is a measure of morbidity or healthcare efficiency/utilization, not a mortality indicator.
Allen’s test checks the patency of the:
A)
Jugular vein
B)
Radial artery & Ulnar artery
C)
Carotid artery
D)
Brachial artery
Allen's test is a clinical bedside test used to assess the arterial blood supply to the hand. It specifically checks the patency of the radial and ulnar arteries and the adequacy of the palmar arch (collateral circulation). The test is typically performed before performing an arterial blood gas (ABG) draw or radial artery cannulation to ensure that if the radial artery is damaged or occluded, the ulnar artery can provide sufficient blood flow to the hand.
Incorrect options:
- Option a (Jugular vein): This is a vein, not an artery; patency is checked via different methods (e.g., ultrasound or observing pulsations).
- Option c (Carotid artery): Located in the neck; its patency is checked via palpation of the carotid pulse or Doppler ultrasound.
- Option d (Brachial artery): Located in the upper arm; while it supplies the arm, Allen's test specifically focuses on the distal distribution at the wrist.
Which method of health communication involves 4-8 qualified persons to sit and discuss topics in front of a large group of audience?
A)
Symposium
B)
Focussed group discussion
C)
Panel discussion
D)
Workshop
A Panel Discussion is a health communication method where a small group of experts (typically 4-8 people) engage in a conversational discussion about a specific topic in front of an audience. The goal is to provide different perspectives on the subject through an interactive dialogue.
Why other options are incorrect:
- Symposium (a): In a symposium, experts give a series of short, formal individual presentations/lectures rather than a conversational discussion.
- Focussed group discussion (b): This is a qualitative research tool involving a small group to gather data; it is not conducted 'in front of a large group of audience'.
- Workshop (d): A workshop is a hands-on, participatory session focused on skill-building and practical application, rather than a discussion panel for an audience.
Open vial policy allows reuse of partially used multi dose vials of applicable vaccines under UIP in subsequent session. Which of the following vaccine follow this policy?
A)
MR
B)
BCG
C)
RVV
D)
IPV
The Open Vial Policy (OVP) allows the reuse of partially used multi-dose vials of certain vaccines in subsequent sessions to reduce wastage.
1. **Correct Option (a) MR:** The Measles-Rubella (MR) vaccine, along with others like DPT, HepB, TT, and Pentavalent, follows the OVP. These vaccines can be used for up to 28 days after opening, provided they are stored at the correct temperature and the vial is not expired.
2. **Incorrect Options (b, c, d):**
- **BCG (b):** This is a freeze-dried vaccine that becomes unstable once reconstituted; it must be discarded after 6 hours.
- **RVV (c):** Rotavirus Vaccine is an oral liquid vaccine that does not follow the OVP; it must be discarded after the session.
- **IPV (d):** While some guidelines vary by region, under the standard UIP OVP, reconstituted or specific live/fragile vaccines are excluded. In the context of this specific set of options, MR is the definitive OVP-compliant vaccine.
The best indicator of adequate fluid balance in a client with burn, especially in the first 48 hours of care is:
A)
Change in the level of consciousness
B)
Elevated hematocrit levels.
C)
Urine output of 30 – 50 ml / hour
D)
Weight of the patient
1. Why Option C is correct: In the first 48 hours after a major burn (the emergent/resuscitative phase), the primary goal is to maintain organ perfusion. Urine output is the most reliable, non-invasive, and real-time indicator of cardiac output and renal perfusion. For an average adult, a urine output of 30–50 ml/hour (or 0.5 ml/kg/hr) indicates that the kidneys are being adequately perfused and that fluid resuscitation is sufficient.
2. Why other options are incorrect:
- Option A: While consciousness can change due to shock or hypoxia, it is a late and non-specific indicator of fluid balance.
- Option B: Hematocrit levels typically increase (hemoconcentration) immediately after a burn due to fluid shifting from the intravascular to the interstitial space; however, it is not a precise tool for titration of hourly fluid replacement.
- Option D: Weight changes occur due to massive fluid shifts (edema) in burn patients, making daily weight an unreliable measure of immediate intravascular fluid balance during the acute 48-hour window.
Irregular respiration characterized by apnea and hyperventilation is known as:
A)
Cheyne stokes respiration
B)
Hyperventilation
C)
Kussmauls respiration
D)
Sighing
Cheyne-Stokes respiration is a specific pattern of periodic breathing characterized by a gradual increase in depth and rate of breathing (hyperventilation) followed by a gradual decrease that culminates in a period of apnea (cessation of breathing). This cycle then repeats. It is commonly seen in patients with heart failure or severe neurological injury.
Other options are incorrect because:
- Kussmaul's respiration (c) is characterized by deep, rapid, and labored breathing without periods of apnea, typically seen in diabetic ketoacidosis.
- Hyperventilation (b) is simply an increased rate or depth of breathing that lowers blood CO2 levels, but it does not inherently include alternating periods of apnea.
- Sighing (d) is an occasional deep breath that occurs normally or during emotional stress, not a pathological cycle of apnea and hyperventilation.
What is important for the nurse to include in the postoperative care of the patient following tympanoplasty?
A)
Avoid flight travel
B)
Encourage the patient to bathe next day after surgery
C)
Avoid changing the cotton padding
D)
Instruct the patient to forcefully blow the nose
The correct option is 'a' because flight travel involves significant changes in atmospheric pressure, which can cause pressure imbalances across the tympanic membrane. This can lead to the displacement of the graft or rupture of the newly repaired membrane, compromising the surgical outcome.
Incorrect options:
- b: Patients are typically instructed to keep the surgical area dry and avoid bathing or getting water in the ear for several days to prevent infection.
- c: Cotton padding is usually changed or removed by the healthcare provider or according to specific protocols to maintain cleanliness and monitor drainage; avoiding it entirely is not a standard postoperative rule.
- d: Forcefully blowing the nose creates positive pressure in the eustachian tube, which can push against the graft and cause it to fail or displace.
The addition of non-nutritious substances to food to improve its appearance, flavour, texture and storage properties is known as:
A)
Food fortification
B)
Food additives
C)
Food adulteration
D)
Food hygiene
The correct option is 'Food additives'.
1. **Why 'b' is correct:** Food additives are substances added to food to maintain or improve its safety, freshness, taste, texture, or appearance (e.g., preservatives, colorants, and emulsifiers). They are typically non-nutritious but serve functional purposes in food processing.
2. **Why other options are incorrect:**
- **Food fortification (a):** This is the process of adding *essential* micronutrients (vitamins and minerals) to food to improve its nutritional quality, not for appearance or texture.
- **Food adulteration (c):** This refers to the *illegal* or fraudulent addition of inferior or harmful substances to food to increase quantity or profit, which degrades the quality of the food.
- **Food hygiene (d):** This refers to the conditions and measures necessary to ensure the safety of food from contamination during production, handling, and storage.
The process of preparing families for impending death and continues immediately following death and up until patient deaths refer to:
A)
End of life care
B)
Bereavement care
C)
Crisis intervention
D)
Denial
Bereavement care is the correct answer because it specifically encompasses the support provided to families and loved ones both before the death (anticipatory grief) and after the death (post-death support) to help them cope with the loss.
Incorrect options:
- 'End of life care' (a) focuses primarily on the physical, emotional, and spiritual care of the dying patient themselves rather than the family's long-term grieving process.
- 'Crisis intervention' (c) is a short-term immediate response to a traumatic event to stabilize an individual, not a continuous process of death preparation and mourning.
- 'Denial' (d) is a psychological stage of grief (per the Kübler-Ross model), not a professional care process.