Medical MCQs
1. A lumbar puncture is performed on a child suspected of having bacterial meningitis and CSF is obtained for analysis. The nurse can confirm the diagnosis with which of the following result?
(a) Clear CSF, elevated protein and decreased glucose levels
(b) Clear CSF, decreased pressure and elevated protein levels
(c) Cloudy CSF, elevated protein and decreased glucose levels
(d) Cloudy CSF, decreased protein and decreased glucose levels
C. Cloudy CSF, elevated protein and decreased glucose levels
Rationale & Concept Explanation:
Bacterial meningitis is an acute, life-threatening inflammation of the meninges (the protective membranes surrounding the brain and spinal cord) caused by a bacterial infection. When a lumbar puncture (spinal tap) is performed, the cerebrospinal fluid (CSF) analysis reveals a classic pattern indicative of a bacterial process:
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Cloudy or Turbid Appearance: Normal CSF is clear and colorless. In bacterial meningitis, a massive influx of white blood cells (specifically neutrophils) rushes into the subarachnoid space to fight the infection. The high concentration of these cells, dead tissue, and bacteria turns the fluid cloudy or purulent.
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Decreased Glucose (Hypoglycorrhachia): Both the rapidly multiplying bacteria and the active white blood cells consume significant amounts of glucose for cellular energy, leading to a marked drop in CSF glucose levels (typically less than two-thirds of the patient’s blood glucose level).
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Elevated Protein: The severe inflammatory response damages and increases the permeability of the blood-brain barrier. This allows large proteins from the blood plasma to leak into the CSF, causing protein levels to spike.
Why the other options are wrong:
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(a) Clear CSF, elevated protein and decreased glucose levels: Clear CSF is generally characteristic of viral (aseptic) meningitis. In viral meningitis, glucose levels usually remain normal, and the fluid does not become cloudy because there is no purulent bacterial exudate.
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(b) Clear CSF, decreased pressure and elevated protein levels: Bacterial meningitis typically causes an increase in CSF opening pressure due to brain swelling (cerebral edema) and inflammation, not a decrease. Also, the fluid would not be clear.
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(d) Cloudy CSF, decreased protein and decreased glucose levels: While the cloudy appearance and decreased glucose are accurate for a bacterial infection, the protein levels are characteristically elevated, never decreased. The inflammatory exudate guarantees a high protein count.
2. Furosemide is administered intravenously to a client with heart failure. How noon after administration should the nurse begin to monitor the evidence of the drug’s effect?
(a) 5-10 minutes
(b) 30-60 minutes
(c) 2-4 hours
(d) 6-8 hours
A. 5-10 minutes
3. A 40 year old man is diagnosed with essential hypertension whose blood pressure levels are consistently at or above which of the following
(a) 120/90 mm Hg
(b) 130/90 mm Hg
(c) 140/90 mm Hg
(d) 140/70 mm Hg
C. 140/90 mm Hg
4. A client with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life. What is the nurse’s best response?
(a) “The reason for your vitamin deficiency is inability to absorb vitamin because stomach is not producing sufficient acid”.
(b) “The reason for your vitamin deficiency is inability to absorb vitamin because stomach is not producing sufficient intrinsic factor”.
(c) “The reason for your vitamin deficiency is inability to absorb vitamin because of excessive excretion by kidney”.
(d) “The reason for your vitamins deficiency is increased requirement for the vitamins due to rapid RBC production”.
B. “The reason for your vitamin deficiency is inability to absorb vitamin because stomach is not producing sufficient intrinsic factor”.
5. Aspirin is administered to a client experiencing MI because of its
(a) Antipyretic action
(b) Antithrombotic action
(c) Antiplatelet action
(d) Analgesic action
B. Antithrombotic action
6. The most significant thing observed for a client admitted immediately after fract ure of femur.
(a) Compartment syndrome
(b) PO2 level
(c) Risk of infection
(d) Associated nerve injuries
B. PO2 level
7. A client with pneumonia has a temperature ranging between 101o and 102o F and periods of diaphoresis. Based on this information which of the following nursing interventions would be a priority?
(a) Maintain complete bed rest
(b) Administer oxygen
(c) Provide frequent lines changes
(d) Provide fluid intake adequately
D. Provide fluid intake adequately
8. A 40 year old woman with history of asthma is admitted to emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/minute, nasal flaring and use of accessory muscles. Auscultation of lungs reveals greatly diminished breath sounds. Based on there findings which should be a priority action?
(a) Initiate O2 therapy and reassess after 10 minutes
(b) Draw blood for ABG analysis and obtain chest X-ray
(c) Administer bronchodilators
(d) Encourage the client to relax and breath through mouth.
C. Administer bronchodilators
9. The nurse interprets which of the following as an early sign of ARDS in a client at risk?
(a) Elevated PCO2
(b) Hypoxia not responsive to oxygen therapy
(c) Severe electrolyte imbalance
(d) Metabolic acidosis
B. Hypoxia not responsive to oxygen therapy
Acute Respiratory Distress Syndrome (ARDS) is a
- Severe restrictive pulmonary disease
- Characterized by stiff, non-compliant lung tissue
- That prevents full expansion.
It involves acute inflammatory damage to the alveolar-capillary membrane, causing the alveoli to fill with fluid.
This flooding creates a massive intrapulmonary shunt where blood flows through the lungs without engaging in gas exchange.
As a result, the classic early clinical hallmark is refractory hypoxemia, meaning the patient’s oxygen levels remain dangerously low despite the administration of high-flow supplemental oxygen.
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Elevated PCO2: Early in ARDS, patients hyperventilate to compensate for their hypoxemia. This rapid breathing blows off carbon dioxide, resulting in a low PCO2 (respiratory alkalosis). Elevated PCO2 is a late sign of respiratory muscle fatigue and impending failure.
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Severe electrolyte imbalance: This is not a direct pulmonary sign of ARDS, though it may independently present if the patient has a severe underlying systemic infection or renal issue.
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Metabolic acidosis: This is a late-stage complication. It occurs when prolonged, unresolved tissue hypoxia forces the body into anaerobic metabolism, producing lactic acid. In the early stages, the primary acid-base disturbance is respiratory alkalosis.
10. The nurse teaches the client how to instill nasal drops. Which of the following techniques are correct?
(a) The client uses sterile techniques while handling the dropper
(b) The client blows the nose gently before instilling drops
(c) The client uses a new dropper for each instillation
(d) The client sits in a semi-flower’s position for instillation
B. The client blows the nose gently before instilling drops
11. Which of the following symptom is most common in tuberculosis?
(a) Weight loss
(b) Increased appetite
(c) Dyspnoea on exertion
(d) Skin rashes
A. Weight loss
12. Prednisolone is usually not used along with
(a) Omeprazole
(b) Ranitidine
(c) Aspirin
(d) Dicnil
C. Aspirin
13. A client is admitted to the hospital after vomiting blood and is diagnosed with a bleeding duodenal ulcer. Later, client develops a sudden, sharp pain in the midepigastric region along with a rigid abdomen. There clinical manifestations most likely indicates
(a) An intestinal obstruction has developed
(b) Additional ulcers have developed
(c) The esophagus has became inflamed
(d) The ulcer has perforated
D. The ulcer has perforated
14. For caring a client with ileostomy, which of the following has the highest priority?
(a) Providing relief from constipation
(b) Assisting client with self care activities
(c) Maintaining fluid and electrolyte balance
(d) Minimizing odour formation
C. Maintaining fluid and electrolyte balance
15. A client with chronic pancreatitis should be monitored closely for the development of which of the following disorder?
(a) Cholelithiasis
(b) Hepatitis
(c) Irritable bowel syndrome
(d) Diabetes mellitus
D. Diabetes mellitus
16. Assessment of the diabetic client for common complications should always include examination of
(a) Abdomen
(b) Lymph nodes
(c) Pharynx
(d) Eyes
D. Eyes
17. The nurse should recognize that fluid shift in a client with burn injury results from an increase in the
(a) Permeability of capillary walls
(b) Total volume of intravascular plasma
(c) Permeability of kidney tubules
(d) Total volume of circulating whole blood
A. Permeability of capillary walls
18. The nurse should teach the diabetic client that which of the following is the most common symptom of hypoglycemia
(a) Nervousness
(b) Anorexia
(c) Kassmaul’s respiration
(d) Brady cardia
A. Nervousness
19. A client is admitted to the hospital with diagnosis of renal calculi. He is experiencing severe flank pain and nausea. His temperature is 100.6o F. Which of the following would be a priority action?
(a) Prevention of urinary tract infection
(b) Alleviation of pain
(c) Alleviation of nausea
(d) Maintenance of fluid and electrolyte balance
B. Alleviation of pain
20. Hypophysectomy means
(a) Removal of parathyroids
(b) Removal of ovaries
(c) Removal of pituitary gland
(d) Removal of adrenal gland
C. Removal of pituitary gland
21. 0.9% normal saline is a
(a) Isotonic solution
(b) Hypotonic solution
(c) Hypertonic solution
(d) Colloid
A. Isotonic solution
22. A client complains pain at the site of an intervenous infusion. The nurse assess the site and determines that the client has developed phlebitis. The nurse avoids which action in care of this client?
(a) Notifies the physician
(b) Applies warm moist pack to the site
(c) Discontineus the IV catheter at the site
(d) Starts a new IV line in the proximal portion of some vein
D. Starts a new IV line in the proximal portion of some vein
23. A nurse walks into a client’s room and finds the client is unresponsive. The client is not breathing and does not have a pulse, and the nurse immediately calls out for help. The next nursing action is which of the following?
(a) Open the airway
(b) Administer oxygen
(c) Start chest compression
(d) Ventilate with a mouth to mask device
A. Open the airway
24. A nurse assesses a client’s surgical incision for signs of infection. Which finding by the nurse would be interpreted as normal finding at the surgical site?
(a) Red, hard skin
(b) Serous drainage
(c) Purulent drainage
(d) Warm, tender skin
B. Serous drainage
25. What is the backbone of infection control practices
(a) Proper disposal
(b) Hand washing
(c) Tepid sponge
(d) Mouth care
B. Hand washing
26. Which of the following is the most reliable method of temperature measurement?
(a) Oral method
(b) Axillary method
(c) Rectal method
(d) All of these
A. Oral method
27. “Step ladder” pattern of fever is observed in
(a) TB
(b) Typhoid fever
(c) Malaria
(d) UTI
B. Typhoid fever
28. Which of the following pattern of respiration is seen in patient admitted with injury to medulla oblongata?
(a) Biot’s respiration
(b) Cheyne stokes respiration
(c) Kussmaul’s respiration
(d) Apneostic respiration
A. Biot’s respiration
29. 14 G IV canula can be identified with the colour code of
(a) Orange
(b) Grey
(c) Green
(d) Yellow
A. Orange
30. When the nurse performs mouth care for an unconscious patient, which nursing intervention is the priority?
(a) Keep a suction machine available
(b) Place the client in supine position
(c) Wear sterile gloves while brushing the patient’s teeth
(d) Use gauze wrapped around the fingers to clean patient’s gum
A. Keep a suction machine available
31. Which of the following is an example for non absorbable suture?
(a) Nylon
(b) Vicryl
(c) Cat gut
(d) All of the above
A. Nylon
32. A nurse is preparing a preoperative client for transfer to operating room. The nurse should take which action in the care of this client at this time?
(a) Ensure that the client has voided
(b) Administer all the daily medications
(c) Practice post operative breathing exercises
(d) Verify that he client has not eaten for the last 24 hrs
A. Ensure that the client has voided
33. A nurse understands that which of the following is a correct guideline for adult CPR?
(a) One breath should be given for every five compressions
(b) Two breaths should be given for every 15 compressions
(c) Initially, two quick breaths should be given as rapidly as possible
(d) Each rescue breath should be given over 1 second and should produce visible chest rise
D. Each rescue breath should be given over 1 second and should produce visible chest rise
34. For a client with Gastro exphageal reflux disease (GERD), the recommended position is
(a) Fowler’s position
(b) Trendelenburg’’s position
(c) Reverse trendelenburg’s position
(d) Right lateral position
C. Reverse trendelenburg’s position
35. A nurse is assessing for correct placement of a narogastric tube. The nurse aspirates the contents and checks for pH. The nurse verifies correct tube placement if pH value is
(a) 3.5
(b) 7.0
(c) 7.35
(d) 7.5
A. 3.5
36. 1 gm of Hb contains mg of iron.
(a) 1.34 mg
(b) 3.4 mg
(c) 34 mg
(d) 4.3 mg
B. 3.4 mg
37. Which of the following is not a mandatory vaccine?
(a) Measles vaccine
(b) Varicella vaccine
(c) DPT
(d) OPV
B. Varicella vaccine
38. Which of the following is not a live attenuated vaccine?
(a) OPV
(b) BCG
(c) TT
(d) MMR
C. TT
39. Percentage of available chlorine in bleaching powder is
(a) 23%
(b) 33%
(c) 35%
(d) 43%
B. 33%
40. Which of the following electrolyte imbalance is expected after blood transfusion?
(a) Hyper calcemia
(b) Hyper kalemia
(c) Hypo kalemia
(d) Hyper magneremia
B. Hyper kalemia
41. RNTCP was started in the year
(a) 1972
(b) 1982
(c) 1992
(d) 1962
C. 1992
42. Health survey and planning committee is named as
(a) Bhore committee
(b) Mudaliar committee
(c) Kartar Singh committee
(d) Jungalwalla committee
B. Mudaliar committee
43. Diseases occurring in an area from a common source on a large scale is called
(a) Epidemic
(b) Endemic
(c) Pandemic
(d) Sporadic
A. Epidemic
44. Koplik’s spots are seen in
(a) Mamps
(b) Measles
(c) Rubella
(d) Varicella
B. Measles
45. Primary level of disease prevention includes
(a) Early diagnosis and treatment
(b) Disability limitation and rehabilitation
(c) Health promotion and specific protection
(d) All the above
C. Health promotion and specific protection
46. Which of the following is not a method of spacing?
(a) Condom
(b) IUD
(c) Diaphragm
(d) Vasectomy
D. Vasectomy
47. According to psychosexual stages of development by Sigmand Freud, the phallic stage is the period of
(a) 0-1 years
(b) 1-3 years
(c) 3-6 years
(d) 6-12 years
C. 3-6 years
48. The mother of a 4 year old child calls the clinic nurse and expresses concern because the child has been masturbating. Using Erikson’s Psychosocial development theory the appropriate response by the nurse is
(a) “This is a normal behavior at this age”
(b) “Children usually begins this behavior at the age of 8 years”
(c) “This is not a normal behavior”
(d) “This child is very young to begin this behavior, and should be consulted by the physician”
A. “This is a normal behavior at this age”
49. A nurse assesses the vital signs of a 12 month old infant with respiratory infection and notes that the respiratory rate is 35 breaths/minute. Based on this finding, which action is appropriate?
(a) Administer oxygen
(b) Notify the physician
(c) Document the findings
(d) Reassess after 15 minutes
C. Document the findings
50. Public health centre is meant for a population of
(a) 20,000 – 30,000
(b) 30,000 – 50,000
(c) 10,000 – 20,000
(d) 3,000 – 5,000
A. 20,000 – 30,000
51. Surgical Management of BPH
A. ORIF
B. CABG
C. TURP
D. PAMI
C. TURP