50 Advanced-Level MCQs for TU IOM Staff Nurse Exam (with Answers)
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| MCQs for TU IOM Staff Nurse Exam (with Answers) |
🫀 1. Which of the following ECG findings is most specific for myocardial infarction?
A. ST depression
B. T wave inversion
C. ST elevation in contiguous leads
D. Prolonged QT interval
✅ Answer: C. ST elevation in contiguous leads
🧠 2. A client with schizophrenia says, “The sky is full of flying monkeys.” This is an example of:
A. Hallucination
B. Delusion
C. Neologism
D. Flight of ideas
✅ Answer: B. Delusion
👶 3. A newborn is born with a cleft palate. What is the nurse’s priority intervention during feeding?
A. Allow the baby to cry between feeds
B. Use a standard nipple
C. Position upright and use a special nipple
D. Encourage breastfeeding
✅ Answer: C. Position upright and use a special nipple
💉 4. A patient develops urticaria and shortness of breath after IV penicillin. What is the nurse’s first action?
A. Stop the infusion
B. Administer antihistamine
C. Start oxygen therapy
D. Notify physician
✅ Answer: A. Stop the infusion
🧬 5. Which drug requires monitoring of absolute neutrophil count (ANC)?
A. Haloperidol
B. Clozapine
C. Fluoxetine
D. Diazepam
✅ Answer: B. Clozapine
🧫 6. In a case-control study, the measure of association is:
A. Relative risk
B. Attributable risk
C. Odds ratio
D. Incidence rate
✅ Answer: C. Odds ratio
🩸 7. Heparin acts by:
A. Inhibiting vitamin K
B. Inhibiting thrombin and factor Xa
C. Activating platelets
D. Decreasing fibrinogen production
✅ Answer: B. Inhibiting thrombin and factor Xa
🧠 8. Which of the following indicates increased intracranial pressure (ICP) in a child?
A. High-pitched cry
B. Sunken fontanelle
C. Increased appetite
D. Slow breathing
✅ Answer: A. High-pitched cry
🫁 9. What is the hallmark sign of a tension pneumothorax?
A. Bradycardia
B. Tracheal deviation
C. Rales
D. Hemoptysis
✅ Answer: B. Tracheal deviation
💊 10. Which anti-tubercular drug causes optic neuritis?
A. Isoniazid
B. Rifampicin
C. Ethambutol
D. Pyrazinamide
✅ Answer: C. Ethambutol
👩⚕️ 11. What is the nurse’s role during informed consent?
A. Explain the procedure
B. Assess client’s understanding and witness the signature
C. Sign the consent form on behalf of the patient
D. Guarantee the success of the procedure
✅ Answer: B. Assess client’s understanding and witness the signature
👶 12. The most common cause of neonatal sepsis in Nepal is:
A. E. coli
B. Staphylococcus aureus
C. Group B streptococcus
D. Klebsiella pneumoniae
✅ Answer: C. Group B streptococcus
💉 13. Which insulin has no peak and lasts up to 24 hours?
A. Regular insulin
B. NPH insulin
C. Lispro
D. Glargine
✅ Answer: D. Glargine
🧬 14. The presence of HBsAg for more than 6 months indicates:
A. Immunity
B. Acute infection
C. Chronic carrier state
D. Past exposure
✅ Answer: C. Chronic carrier state
💊 15. Lithium toxicity may occur when used with:
A. ACE inhibitors
B. NSAIDs
C. Diuretics
D. All of the above
✅ Answer: D. All of the above
🩺 16. During postural drainage, the nurse should be cautious in:
A. Bronchial asthma
B. Heart failure
C. Pneumonia
D. Cystic fibrosis
✅ Answer: B. Heart failure
🧠 17. Which neurotransmitter is primarily involved in Parkinson’s disease?
A. Serotonin
B. Acetylcholine
C. Dopamine
D. Norepinephrine
✅ Answer: C. Dopamine
🩸 18. Which IV fluid is isotonic?
A. 0.45% Normal saline
B. 5% Dextrose in water
C. 0.9% Normal saline
D. Dextrose in 0.45% saline
✅ Answer: C. 0.9% Normal saline
🧪 19. A nurse is evaluating fundal height at 28 weeks. Where should the fundus be palpated?
A. At the symphysis pubis
B. Below umbilicus
C. At the umbilicus
D. Above umbilicus
✅ Answer: D. Above umbilicus
💉 20. The correct needle size for intradermal injection is:
A. 16G
B. 22G
C. 26G
D. 20G
✅ Answer: C. 26G
🧠 21. The first sign of hypoxia is usually:
A. Cyanosis
B. Restlessness
C. Bradycardia
D. Hypotension
✅ Answer: B. Restlessness
🧬 22. Which stage of labor is from full dilation to delivery of baby?
A. First stage
B. Second stage
C. Third stage
D. Latent phase
✅ Answer: B. Second stage
📊 23. The best research design to establish cause-effect is:
A. Case-control study
B. Cross-sectional study
C. Randomized controlled trial
D. Descriptive study
✅ Answer: C. Randomized controlled trial
💉 24. Which antipsychotic has the highest risk of extrapyramidal symptoms (EPS)?
A. Olanzapine
B. Risperidone
C. Haloperidol
D. Clozapine
✅ Answer: C. Haloperidol
🩸 25. What is the goal of primary health care?
A. Provide tertiary care
B. Provide high-tech services
C. Achieve health for all
D. Prevent rare diseases
✅ Answer: C. Achieve health for all
🧪 26. Which is the most sensitive indicator of renal function?
A. BUN
B. Urine output
C. Creatinine clearance
D. Serum creatinine
✅ Answer: C. Creatinine clearance
🧠 27. The best response to a depressed patient expressing hopelessness is:
A. “Everything will be fine.”
B. “Why do you feel that way?”
C. “You seem really down right now.”
D. “Let’s talk about something else.”
✅ Answer: C. “You seem really down right now.”
🩺 28. Which heart sound corresponds to the closure of mitral and tricuspid valves?
A. S1
B. S2
C. S3
D. S4
✅ Answer: A. S1
💊 29. Which electrolyte imbalance can potentiate digoxin toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
✅ Answer: B. Hypokalemia
🧠 30. Postpartum blues usually resolve within:
A. 24 hours
B. 3 days
C. 2 weeks
D. 2 months
✅ Answer: C. 2 weeks
🧬 31. Which is the most common site for deep vein thrombosis (DVT)?
A. Femoral vein
B. Popliteal vein
C. Posterior tibial vein
D. Saphenous vein
✅ Answer: B. Popliteal vein
📦 32. Inventory control system used in PHC is:
A. ABC analysis
B. VED analysis
C. FIFO
D. LIFO
✅ Answer: C. FIFO
🩺 33. The antidote for magnesium sulfate toxicity is:
A. Potassium chloride
B. Calcium gluconate
C. Vitamin K
D. Sodium bicarbonate
✅ Answer: B. Calcium gluconate
📉 34. The most appropriate nursing diagnosis for a patient with CHF is:
A. Risk for infection
B. Impaired gas exchange
C. Acute pain
D. Risk for falls
✅ Answer: B. Impaired gas exchange
💊 35. The half-life of a drug determines:
A. Route of excretion
B. Onset of action
C. Dosage interval
D. Peak effect
✅ Answer: C. Dosage interval
🧠 36. CAGE questionnaire is used to assess:
A. Anxiety
B. Schizophrenia
C. Alcohol abuse
D. Depression
✅ Answer: C. Alcohol abuse
🧪 37. A patient with SIADH will most likely present with:
A. Hypernatremia
B. Hyponatremia
C. Hypokalemia
D. Hyperkalemia
✅ Answer: B. Hyponatremia
🩺 38. Murphy’s sign is indicative of:
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Hepatitis
✅ Answer: C. Cholecystitis
💉 39. Which vaccine is contraindicated in pregnancy?
A. Tetanus toxoid
B. Hepatitis B
C. Influenza
D. MMR
✅ Answer: D. MMR
📊 40. Type I error in research refers to:
A. Failing to reject a false null hypothesis
B. Rejecting a true null hypothesis
C. Using wrong study design
D. Misinterpretation of results
✅ Answer: B. Rejecting a true null hypothesis
💊 41. Most nephrotoxic aminoglycoside is:
A. Gentamicin
B. Amikacin
C. Streptomycin
D. Tobramycin
✅ Answer: A. Gentamicin
👶 42. The most common congenital heart defect is:
A. Patent ductus arteriosus
B. Ventricular septal defect
C. Tetralogy of Fallot
D. Atrial septal defect
✅ Answer: B. Ventricular septal defect
🧪 43. Most common cause of postpartum hemorrhage is:
A. Cervical tear
B. Retained placenta
C. Uterine atony
D. Vaginal laceration
✅ Answer: C. Uterine atony
🩸 44. In management by objectives (MBO), the key principle is:
A. Autocratic leadership
B. Top-down hierarchy
C. Participatory goal setting
D. Group therapy
✅ Answer: C. Participatory goal setting
📚 45. A non-experimental research design is:
A. Quasi-experimental
B. RCT
C. Descriptive study
D. Controlled trial
✅ Answer: C. Descriptive study
🧬 46. The correct order of donning PPE is:
A. Gloves → Mask → Gown
B. Gown → Mask → Gloves
C. Mask → Gloves → Gown
D. Mask → Gown → Gloves
✅ Answer: B. Gown → Mask → Gloves
🧠 47. Most effective communication in therapeutic relationship is:
A. Giving advice
B. Active listening
C. Offering false reassurance
D. Changing the subject
✅ Answer: B. Active listening
💊 48. Which of the following is not a part of the nursing process?
A. Assessment
B. Planning
C. Implementation
D. Supervision
✅ Answer: D. Supervision
🩸 49. Which test is used to detect HIV in newborns?
A. ELISA
B. Rapid test
C. Western blot
D. PCR
✅ Answer: D. PCR
💡 50. When delegating a task to a nursing assistant, the RN is responsible for:
A. Performing the task
B. Supervising and evaluating the outcome
C. Delegating further
D. Ignoring errors
✅ Answer: B. Supervising and evaluating the outcome
