1.
Which is the most common reaction seen in Rationale: The red Venturi mask is color-coded
patients undergoing blood transfusion? and calibrated to deliver 40% oxygen at a flow
A) Anaphylactic reaction rate of 10 liters per minute. Venturi masks
B) Febrile non-hemolytic provide precise oxygen concentrations, useful
C) Hemolytic transfusion reaction for COPD patients who need controlled oxygen
D) Allergic rash delivery.
Answer: B) Febrile non-hemolytic
Rationale: Febrile non-hemolytic transfusion 4. Which preservative solution allows blood
reaction (FNHTR) is the most commonly storage up to 35 days?
observed transfusion reaction. It occurs due to A) Heparin
recipient antibodies reacting against donor B) Sodium citrate
leukocytes or cytokines released during C) CPD
storage. It typically presents with fever and D) CPDA-1
chills, and although not life-threatening, it can Answer: D) CPDA-1
be uncomfortable and alarming. Rationale: CPDA-1 (Citrate Phosphate
Dextrose Adenine) is a blood preservative
2. A patient is to be started on enteral solution that allows storage of whole blood for
nutrition. All of the following routes can be up to 35 days. The addition of adenine helps
used except: maintain ATP levels in red blood cells,
A) Nasojejunal tube enhancing their survival during storage.
B) Nasogastric tube
C) PEG tube 5. What is the correct depth for inserting a
D) PICC rectal suppository in an adult?
Answer: D) PICC A) 2 inches
Rationale: Peripherally Inserted Central B) 4 inches
Catheter (PICC) is used for parenteral C) 1 inch
nutrition, where nutrients are delivered D) 3 inches
intravenously. Enteral routes—like nasogastric, Answer: B) 4 inches
nasojejunal, or PEG (Percutaneous Endoscopic Rationale: In adults, rectal suppositories
Gastrostomy) tubes—deliver nutrition directly should be inserted approximately 4 inches (10
to the digestive tract. cm) into the rectum to ensure they bypass the
anal sphincter and reach the rectal mucosa for
3. Red venturi mask delivers oxygen at what optimal absorption.
percentage and flow rate?
A) 24% at 2 L/min 6. What is the immediate management of
B) 28% at 4 L/min dopamine extravasation?
C) 40% at 10 L/min A) Apply cold compress and elevate limb
D) 60% at 15 L/min B) Elevate limb, apply warm compress, give
Answer: C) 40% at 10 L/min phentolamine
C) Massage site and inject lidocaine C) Paul Bert effect
D) Elevate and inject atropine D) Lorrain Smith effect
Answer: B) Elevate limb, apply warm Answer: C) Paul Bert effect
compress, give phentolamine Rationale: The Paul Bert effect refers to CNS
Rationale: Dopamine is a vasoconstrictor, and toxicity due to breathing high partial pressures
if it leaks into surrounding tissues of oxygen. Symptoms include seizures, nausea,
(extravasation), it can cause necrosis. and visual disturbances. Commonly seen in
Immediate treatment includes warm compress hyperbaric or deep-sea divers.
to dilate vessels and phentolamine, a
vasodilator that counteracts the effects locally. 10. After how many minutes of absent bowel
sounds should a nurse notify the physician?
7. Preferred blood component in von A) After 1 minute
Willebrand disease: B) After 2 minutes
A) Platelet concentrate C) After 5 minutes
B) Whole blood D) After 10 minutes
C) Cryoprecipitate Answer: C) After 5 minutes
D) Fresh frozen plasma Rationale: Bowel sounds should be
Answer: C) Cryoprecipitate auscultated for at least 5 minutes in each
Rationale: Cryoprecipitate contains von quadrant before declaring them absent. No
Willebrand factor (vWF), factor VIII, and sounds after this period may indicate paralytic
fibrinogen, making it effective in treating von ileus or bowel obstruction.
Willebrand disease and hemophilia A.
11. Which link in the chain of infection is
8. Ideal tip position for a peripherally inserted broken by maintaining skin integrity?
central catheter (PICC): A) Infectious agent
A) Subclavian vein B) Reservoir
B) Internal jugular vein C) Portal of entry
C) Cephalic vein D) Mode of transmission
D) Superior vena cava Answer: C) Portal of entry
Answer: D) Superior vena cava Rationale: The skin acts as a natural barrier
Rationale: The optimal placement of the PICC against pathogens. When it's intact, it prevents
line tip is in the lower third of the superior vena microorganisms from entering the body,
cava near the cavoatrial junction. This ensures effectively breaking the "portal of entry" link in
safe infusion of hyperosmolar solutions and the chain of infection.
reduces risk of thrombosis or complications.
12. Common pulmonary complication in
9. CNS oxygen toxicity is referred to as: immobilized, recumbent patients:
A) Nitrogen narcosis A) Pulmonary embolism
B) Decompression sickness
B) Hypostatic pneumonia, atelectasis, Rationale: A sitz bath uses warm water to
respiratory acidosis promote local circulation, reduce inflammation
C) Bronchial asthma and pain, and support healing of the surgical
D) Pneumothorax site after procedures like hemorrhoidectomy.
Answer: B) Hypostatic pneumonia, atelectasis,
respiratory acidosis 15. Where should K-wire be discarded after
Rationale: Immobilized patients often have removal?
shallow breathing and impaired clearance of A) Yellow bin
secretions. This leads to mucus stasis, B) Blue cardboard box
collapse of alveoli (atelectasis), and infections C) Red container
(hypostatic pneumonia) resulting in poor gas D) Black bin
exchange and respiratory acidosis. Answer: B) Blue cardboard box
Rationale: Blue boxes are designated for
metallic sharps like K-wires and orthopedic
13. What happens to the water seal chamber pins. They help prevent injury and ensure safe
in chest drainage during mechanical biomedical waste management.
ventilation?
A) No fluctuation 16. How long can a long-term urinary catheter
B) Bubbles continuously stay in place?
C) Water increases during inspiration A) 12 weeks
D) Water decreases during inspiration & B) 4 weeks
increases during expiration C) 6 weeks
Answer: D) Water decreases during D) 2 weeks
inspiration & increases during expiration Answer: A) 12 weeks
Rationale: During mechanical ventilation, the Rationale: Long-term urinary catheters, usually
normal respiratory pressure pattern is made of silicone, can remain in place for up to
reversed. So, unlike spontaneous breathing, 12 weeks, provided there are no complications
water in the seal chamber falls during like infection or blockage.
inspiration (due to positive pressure) and rises
during expiration. 17. Uvula pulsation is a sign of:
A) Mitral stenosis
B) Aortic stenosis
14. Why is sitz bath given after
C) Mitral regurgitation
hemorrhoidectomy?
D) Aortic regurgitation
A) Control bleeding
Answer: D) Aortic regurgitation
B) Reduce fever
Rationale: Pulsation of the uvula (known as
C) Promote healing
Müller’s sign) is a classic finding in aortic
D) Prevent constipation
regurgitation, caused by the high stroke
Answer: C) Promote healing
volume and wide pulse pressure due to blood
leaking back into the left ventricle during D) 1/16 inch
diastole. Answer: D) 1/16 inch
Rationale: An ideal 1/16 inch gap between the
18. Target fasting glucose and HbA1c in stoma and the appliance ring helps prevent
gestational diabetes: leakage of stool onto the surrounding skin
A) <110 mg/dl, HbA1c <7 while allowing enough room for stoma
B) <105 mg/dl, HbA1c <6.5 movement without causing irritation or
C) <95 mg/dl, HbA1c <6 pressure.
D) <100 mg/dl, HbA1c <7
Answer: C) <95 mg/dl, HbA1c <6
Rationale: Tight glycemic control in
gestational diabetes is essential to prevent
fetal complications like macrosomia and
neonatal hypoglycemia. The recommended
fasting blood sugar target is <95 mg/dl, and
HbA1c <6%.
19. Signs and symptoms of cystitis in children
include:
A) Nocturnal enuresis only
B) Urinary retention
C) Dysuria, hematuria, suprapubic pain, cloudy
urine
D) Polyuria only
Answer: C) Dysuria, hematuria, suprapubic
pain, cloudy urine
Rationale: Cystitis, or inflammation of the
bladder (usually from infection), typically
presents in children as painful urination
(dysuria), hematuria, lower abdominal
discomfort, and sometimes cloudy or
foul-smelling urine.
20. Ideal space between stoma and appliance
ring:
A) ½ inch
B) ¼ inch
C) ⅛ inch
