Kerala PSC Staff Nurse Gr II Mock 013

Q1.A 65-year-old male patient presents with dyspnea, fatigue, and bilateral pitting edema of the lower limbs. On examination, the jugular venous pressure is elevated, and auscultation reveals a third heart sound (S3 gallop). Which of the following is the MOST likely diagnosis?

Q2.During a routine health check-up, a 40-year-old female is found to have a fasting blood glucose level of 145 mg/dL. Which of the following endocrine glands is primarily responsible for regulating blood glucose levels?

Q3.A patient with chronic kidney disease (CKD) presents with muscle cramps and weakness. Which of the following electrolytes is MOST likely to be imbalanced in this scenario?

Q4.A 30-year-old woman complains of irregular menstrual cycles and difficulty conceiving. On examination, her BMI is 32, and she has hirsutism. Which of the following hormones is MOST likely elevated in her condition?

Q5.A patient with a history of hypertension is prescribed a diuretic to manage fluid overload. Which of the following is the PRIMARY site of action of loop diuretics in the nephron?

Q6.During a physical examination, a nurse notes that a patient has a positive Babinski sign (dorsiflexion of the big toe with fanning of other toes). Which of the following pathways in the nervous system is MOST likely affected?

Q7.A patient with a history of alcohol abuse presents with confusion, nystagmus, and ataxia. Which of the following vitamins is MOST likely deficient in this scenario?

Q8.A 25-year-old male presents with a fever of 102°F, productive cough, and rusty sputum. Chest X-ray shows consolidation in the right middle lobe. Which of the following bacteria is the MOST likely causative organism?

Q9.Which of the following is the PRIMARY mode of transmission of Mycobacterium tuberculosis?

Q10.A nurse is collecting a throat swab specimen from a patient with suspected streptococcal pharyngitis. Which of the following steps is MOST critical to ensure accurate culture results?

Q11.Which of the following immune responses provides the FIRST line of defense against bacterial infections?

Q12.A patient with a suspected urinary tract infection is instructed to provide a mid-stream clean-catch urine sample. What is the PRIMARY purpose of this method?

Q13.Which of the following bacteria is MOST commonly associated with healthcare-associated infections (HAIs) such as catheter-associated urinary tract infections?

Q14.A nurse is caring for a patient with a draining wound infected by Staphylococcus aureus. Which of the following precautions is MOST appropriate to prevent the spread of infection to other patients?

Q15.Which among the following is a primary social group?

Q16.Which of the following is NOT a characteristic of social change?

Q17.In community health nursing, which social problem is directly linked to poor sanitation and lack of clean water?

Q18.Which social group is most likely to experience social exclusion in Kerala?

Q19.A community health nurse notices a high prevalence of anemia among adolescent girls in a rural area. Which social factor is most likely contributing to this health problem?

Q20.Which of the following is an example of social stratification in Kerala society?

Q21.A 45-year-old male patient with hypertension is advised to reduce stress to prevent further complications. Which mental mechanism is the patient MOST likely using if he starts exercising regularly and practices mindfulness meditation?

Q22.During a mental status examination, a nurse observes that a patient frequently shifts topics and speaks in a tangential manner, making it difficult to follow the conversation. Which mental mechanism is MOST likely contributing to this behavior?

Q23.A nurse is educating a group of adolescents about the dangers of substance abuse. Which type of learning is MOST directly involved when the nurse explains how peer pressure can influence decisions to use drugs?

Q24.A patient with anxiety disorder reports that they avoid crowded places due to fear of having a panic attack. Which motivational factor BEST explains this avoidance behavior?

Q25.A 30-year-old female patient with a history of childhood trauma suddenly becomes emotionally detached during a therapy session when discussing her past. Which mental mechanism is MOST likely responsible for this behavior?

Q26.A nurse is assessing a patient who exhibits persistent handwashing despite knowing it is excessive and causing skin damage. Which psychological concept BEST explains this behavior?

Q27.A 35-year-old male patient with hypertension is advised to follow a DASH (Dietary Approaches to Stop Hypertension) diet. Which of the following food items should he be encouraged to consume more of?

Q28.A patient with type 2 diabetes mellitus is prescribed a carbohydrate-controlled diet. As a staff nurse, you need to educate the patient about the glycemic index (GI). Which statement best reflects the correct understanding of GI?

Q29.A postpartum mother is breastfeeding her newborn and asks for dietary advice to improve lactation. Which nutrient is most critical for enhancing breast milk production?

Q30.A patient with chronic kidney disease (CKD) stage 4 is prescribed a renal diet. Which dietary modification is most appropriate to reduce the risk of hyperkalemia?

Q31.A 15-year-old adolescent with iron-deficiency anemia is advised to include iron-rich foods in their diet. Which combination of foods would provide the best bioavailability of iron?

Q32.A patient recovering from surgery is prescribed a high-protein, high-calorie diet to promote wound healing. Which food item would be the least suitable for this therapeutic diet?

Q33.Which of the following is the primary function of albumin in blood plasma?

Q34.A patient presents with symptoms of confusion and muscle weakness. Blood tests reveal low serum calcium levels. Which biochemical abnormality is most likely responsible?

Q35.Which of the following enzymes is commonly measured in serum to assess liver function in a patient with suspected hepatitis?

Q36.A nurse is administering insulin to a diabetic patient. Which of the following biochemical processes is insulin primarily regulating in the body?

Q37.Which of the following is a key function of Vitamin D in the body?

Q38.A patient with chronic renal failure develops metabolic acidosis. Which of the following compensatory mechanisms will the body primarily employ to restore pH balance?

Q39.A 65-year-old patient with hypertension, diabetes, and chronic kidney disease is prescribed an antihypertensive medication. Which class of drugs should be AVOIDED due to its potential to worsen renal function and hyperkalemia?

Q40.A nurse is preparing to administer 0.9% Normal Saline (1000 mL) over 8 hours using an IV set with a drop factor of 15 drops/mL. What is the correct drip rate (drops per minute)?

Q41.Which of the following adverse drug reactions (ADRs) is MOST commonly associated with the use of broad-spectrum antibiotics like Amoxicillin-Clavulanic acid?

Q42.A patient is prescribed 500 mg of Paracetamol orally. The available tablets are 250 mg each. How many tablets should the nurse administer?

Q43.Which of the following drug classes is primarily used to manage type 2 diabetes by increasing insulin sensitivity in peripheral tissues?

Q44.A patient develops a severe allergic reaction (anaphylaxis) after administration of Penicillin. Which of the following medications should be administered IMMEDIATELY as part of the emergency management?

Q45.A 65-year-old male patient with diabetes mellitus is admitted for a foot ulcer. Which of the following nursing interventions is MOST critical to prevent infection in this patient?

Q46.During the assessment phase of the nursing process, which of the following actions BEST demonstrates a nurse's use of critical thinking?

Q47.A patient on bed rest develops a pressure ulcer over the sacrum. Which of the following nursing actions is PRIORITY to promote healing and prevent further deterioration?

Q48.A nurse is preparing to administer an intramuscular injection to a 5-year-old child. Which site is MOST appropriate to minimize risk of injury and ensure proper absorption?

Q49.A nurse observes that a colleague did not perform hand hygiene before assisting a patient with eating. What is the BEST immediate action for the nurse to take?

Q50.A patient with a urinary catheter develops a fever and cloudy urine. Which of the following actions should the nurse take FIRST?

Q51.A 65-year-old male with a history of hypertension and type 2 diabetes mellitus presents with sudden onset of severe chest pain radiating to the left arm, diaphoresis, and nausea. The nurse suspects acute myocardial infarction (MI). Which of the following is the MOST appropriate immediate nursing intervention?

Q52.A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2 L/min via nasal cannula. The nurse notes that the patient has become increasingly lethargic and confused. Arterial blood gas (ABG) results show PaO2 70 mmHg, PaCO2 60 mmHg, and pH 7.32. Which of the following is the MOST likely cause of this clinical deterioration?

Q53.A 45-year-old female is admitted with acute pancreatitis. The nurse notes that her urine output has decreased to 20 mL/hour over the past 2 hours, and her serum creatinine level has risen from 0.8 mg/dL to 1.5 mg/dL. Which of the following is the MOST appropriate nursing intervention at this stage?

Q54.A 30-year-old male with a spinal cord injury at the C4 level is admitted for rehabilitation. The nurse notes that the patient has developed a sudden onset of headache, flushing, and bradycardia. Which of the following is the MOST likely cause of these symptoms?

Q55.A patient with a deep partial-thickness burn covering 30% of the total body surface area (TBSA) is receiving fluid resuscitation according to the Parkland formula. Four hours after the burn injury, the nurse notes that the patient's urine output has dropped to 10 mL/hour. Which of the following is the MOST appropriate nursing action?

Q56.A 55-year-old male with a history of chronic kidney disease (CKD) Stage 4 is admitted with hyperkalemia (serum potassium 6.8 mEq/L). The nurse notes peaked T waves on the ECG. Which of the following medications should the nurse prepare to administer FIRST?

Q57.A 28-year-old primigravida at 32 weeks gestation presents with BP 150/100 mmHg, proteinuria (3+) and generalized edema. She reports headache and visual disturbances. Which of the following is the MOST appropriate IMMEDIATE nursing intervention?

Q58.During a postnatal visit, a mother reports persistent perineal pain 7 days after normal delivery. On examination, the nurse notes a foul-smelling discharge and redness at the episiotomy site. Which complication should the nurse SUSPECT first?

Q59.A newborn at 1 minute of life has a heart rate of 90 bpm, weak cry, some flexion of extremities, and a pink body with blue extremities. What is the APGAR score for this newborn?

Q60.A 35-year-old woman, gravida 3 para 2, requests permanent contraception after her second cesarean section. Which is the MOST suitable method for her?

Q61.During the third stage of labor, the nurse notices that the uterus is not contracting well and there is a gush of blood from the vagina. What is the FIRST nursing action?

Q62.A 24-year-old woman in her first trimester has a hemoglobin level of 9.5 g/dL. She complains of fatigue and pallor. Which dietary advice should the nurse prioritize?

Q63.A 2-year-old child presents with high fever, irritability, and a petechial rash. The mother reports the child has not received any vaccinations. Which of the following is the MOST likely diagnosis?

Q64.During an IMNCI assessment, a 4-month-old infant is found to have fast breathing (>60 breaths/min) with chest indrawing. What is the FIRST priority action according to IMNCI guidelines?

Q65.A 5-year-old child with a history of recurrent respiratory infections is brought to the clinic with a productive cough and fever. On auscultation, crackles are heard in the right lower lung zone. Which of the following is the MOST appropriate nursing intervention?

Q66.According to the IMNCI protocol, a child aged 12 months presents with diarrhea for 4 days, sunken eyes, and very slow skin pinch. What is the classification and recommended treatment?

Q67.A 6-month-old infant is brought to the clinic with a history of poor weight gain, irritability, and a distended abdomen. On examination, the nurse notes hepatomegaly and edema. Which of the following conditions is MOST likely?

Q68.A 3-year-old child with a history of fever and rash is diagnosed with chickenpox. The mother asks about the infectious period. Which of the following is the CORRECT response?

Q69.Which of the following is the primary responsibility of a Staff Nurse at a Primary Health Centre (PHC) under the National Health Mission (NHM)?

Q70.A 35-year-old woman presents to a Sub-Centre with complaints of fatigue and breathlessness. She reports a history of heavy menstrual bleeding for the past 6 months. As a Staff Nurse, which national health programme initiative should you prioritize in her care?

Q71.During a community health survey, a Staff Nurse identifies a cluster of cases of acute watery diarrhea in a village. Which of the following actions aligns with the Integrated Disease Surveillance Programme (IDSP)?

Q72.A Sub-Centre Staff Nurse is conducting an antenatal check-up for a primigravida at 28 weeks of gestation. Which national health programme component should be emphasized during this visit?

Q73.Which of the following is a key objective of the Ayushman Bharat - Health and Wellness Centres (AB-HWCs) initiative?

Q74.A Staff Nurse at a PHC is reviewing the immunization records of children under 5 years. Which vaccine is administered at birth under the Universal Immunization Programme (UIP)?

Q75.A 32-year-old male patient with schizophrenia is admitted with auditory hallucinations, disorganized speech, and delusions of grandeur. The nurse observes that the patient is laughing without any apparent reason and muttering to himself. Which of the following nursing interventions is the MOST appropriate at this stage?

Q76.A 24-year-old female patient diagnosed with bipolar disorder is experiencing a manic episode with elevated mood, decreased need for sleep, and reckless spending. The nurse notes that the patient is dominating group therapy sessions and is easily distracted. Which therapeutic communication approach is BEST to use with this patient?

Q77.A patient with major depressive disorder is prescribed fluoxetine 20 mg daily. The nurse explains that the therapeutic effect of this medication typically begins after:

Q78.During a mental status examination, a patient states, 'The doctors are putting thoughts in my head to control me.' This statement would be documented by the nurse as an example of:

Q79.A nurse is caring for a patient with borderline personality disorder who threatens to harm herself if a scheduled family visit is canceled. The nurse's BEST response would be to:

Q80.A 45-year-old male patient with generalized anxiety disorder is prescribed buspirone. Which statement by the patient indicates a NEED for further teaching?

Q81.A staff nurse is assigned to lead a team for a community health camp. Which leadership style is most effective for ensuring high participation and adherence to health education sessions?

Q82.During a ward round, a staff nurse notices that a patient’s medication schedule is not aligned with the hospital’s standard protocol. The most appropriate action is to:

Q83.A staff nurse is conducting a health education session on diabetes management. Which teaching method is most effective for ensuring long-term retention of information?

Q84.In a primary health center, a staff nurse identifies a recurrent issue of low immunization coverage in a particular community. The next step in addressing this problem should be:

Q85.A staff nurse is evaluating the effectiveness of a newly implemented nursing protocol for pressure ulcer prevention. Which research design is most appropriate for this evaluation?

Q86.During a training session for new staff nurses, the instructor emphasizes the importance of maintaining accurate patient records. The primary reason for this is to:

Q87.A 45-year-old male patient presents with a 3-day history of fever, headache, and a generalized maculopapular rash. On examination, he has posterior cervical lymphadenopathy. Which of the following is the MOST likely diagnosis?

Q88.A patient with Type 2 Diabetes Mellitus is brought to the emergency department with confusion, fruity odor on breath, and deep rapid breathing. The nurse suspects diabetic ketoacidosis (DKA). Which of the following is the FIRST priority nursing intervention?

Q89.A 6-year-old child is brought to the school health clinic with a sudden onset of high fever, sore throat, and difficulty swallowing. On examination, the nurse notes a bright red rash on the cheeks (slapped cheek appearance) and a maculopapular rash on the trunk. The child is otherwise alert and playful. Which of the following organisms is MOST likely responsible for this condition?

Q90.A nurse is providing first aid to a patient who has suffered a deep laceration on the forearm. After controlling the bleeding with direct pressure, the nurse notices a piece of glass embedded in the wound. Which of the following is the CORRECT next step?

Q91.A 50-year-old female patient with a history of hypertension is admitted with sudden onset of severe chest pain radiating to the left arm. The nurse recognizes the need for immediate action. Which of the following ethical principles is MOST relevant when prioritizing this patient's care?

Q92.A patient with chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea and purulent sputum. The nurse suspects an acute exacerbation and prepares to administer nebulized bronchodilators. Which of the following medications is MOST appropriate for immediate management?

Q93.Under the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the 'Health and Wellness Centres' (HWCs) are designed to provide comprehensive primary health care. Which of the following services is NOT primarily delivered through HWCs?

Q94.The 'Kudumbashree' initiative in Kerala integrates health with livelihood by promoting community-based health programs. Which of the following is a direct outcome of this integration under the 'Health & Nutrition' component of Kudumbashree?

Q95.According to the WHO/UNICEF initiative 'Baby-Friendly Hospital Initiative (BFHI)', which of the following practices is NOT a part of the 'Ten Steps to Successful Breastfeeding'?

Q96.The Kerala government recently launched the 'Aarogyam' initiative under the 'Health for All' mission. Which of the following is the PRIMARY objective of this initiative?

Q97.As per the recent Kerala Public Health Policy 2023, which of the following is a KEY focus area for reducing non-communicable diseases (NCDs) in the state?