National NORCET Test-2

MEDICAL SURGICAL NURSING

1. A Registered nurse kept the resuscitation equipment available at the bedside of her assigned patient who is receiving
tissue plasminogen activator (t-PA), because reperfusion of the cardiac tissue can result in which of the following?
a. Hypertension b. Seizure
c. Hypothermia d. Cardiac arrhythmias.

Ans. d. Cardiac arrhythmias

• Option d: Cardiac arrhythmias are commonly observed with administration of t-PA. Cardiac arrhythmias are associated with
reperfusion of the cardiac tissue.
• Option a: Hypotension is commonly observed with administration of t-PA.
• Option b & c: Seizures and hypothermia are not generally associated with reperfusion of the cardiac tissue.

2. The doctor order for the application of Knee-high sequential compression devices to the newly admitted patient
in ICU. When the nurse visited at the patient bedside to perform initial assessment the patient report of new pain
localized in the right calf area that is noted to be slightly reddened and warm to touch upon initial assessment. select
the best possible intervention to be applied by the nurse?
a. Administer analgesics and then apply the compression device
b. Do not apply the compression device and contact to physician
c. Massage the area before applying the compression devices.
d. Apply the compression devices as it will help the patient.

Ans. b. Do not apply the compression device and contact to physician

option b: Localized pain, tenderness, redness, and warmth may be symptoms of deep vein thrombosis (DVT), in this scenario the nurse
should report to the physician and the compression devices should not be applied as intermittent compression may dislodge a thrombus.
option a: Analgesics may be administered as per the physician order only but the compression devices should not be applied until
further evaluation is completed.
option c: Massaging the area may dislodge a thrombus and is not recommended.
option d: DVT can become life threatening if a thrombus travels to the lung and becomes a pulmonary embolus and application of the
compression device may result into a thrombus dislodgement.

3. You have received a 50 years- old client in emergency unit and documented the following assessment findings: Severe
back pain, presence of grey turner’s sign, nausea, Blood pressure 90/40 mmHg, respiration 30 breath/min, Heart rate
128 beats/min. Based on the above assessment findings select the priority nursing intervention?
a. Insert the Foley’s catheter for I& O monitoring
b. Place a large-bore IV
c. Insert a nasogastric tube
d. Place the client in left lateral position

Ans. b. Place a large-bore IV

Option b: There are several conditions commonly associated with Grey Turner’s sign such as: Acute pancreatitis, perforated duodenal
ulcer, ruptured abdominal aortic aneurysm and all the presented assessment findings in the questions suggest a ruptured abdominal
aortic aneurysm. The priority nursing intervention in this situation to establish an IV line for immediate volume replacement.
14 National NORCET Test-2

Option a: With hypovolemia, the urine output will be diminished and monitoring intake and output will also be done but the priority is
to administer the IV fluids to prevent hypovolemia.
option c: Repositioning may potentiate the problem.
Option d: A nasogastric tube may be considered with severe nausea and vomiting to decompress the stomach.

4. You are posted in male medicine ward and assigned to provide care to a patient admitted with pernicious anemia.
Which of the following lab values should be report to the physician?
a. Schilling test result, elevated. b. Intrinsic factor, absent.
c. Sedimentation rate, 16 mm/h. d. Red blood cells (RBCs) within normal range

Ans. b. Intrinsic factor, absent

Option b: The defining characteristic of pernicious anemia, a megaloblastic anemia, is absence of the intrinsic factor.
Intrinsic Factor is needed for vitamin B12 absorption in the small intestine folic acid needs vitamin B12 for deoxyribonucleic acid
synthesis of RBCs.
Option a: An elevated result of Schilling test, indicates that the client has the intrinsic factor and can absorb vitamin B12 in the intestinal
tract.
Option c: A sedimentation rate of 16 mm/h is normal for both men and women and is a nonspecific test to detect the presence of
inflammation; it is not specific to anemias.
Option d: An RBC value within the normal range does not indicate an anemia.

5. While treating an elderly client with severe nose bleed, the physician has inserted posterior packing to control bleeding.
After insertion of the packing, the nurse will closely monitor the client for which of the following complications?
a. Vertigo. b. Bell’s palsy.
c. Hypoventilation. d. Loss of gag reflex.

Ans. c. Hypoventilation
option c: Nostril Packing can alter the respiratory status especially in elder client which can results into hypoventilation. The nurse
should closely monitor the client for changes in level of consciousness, respiratory rate, and heart rate and rhythm after the insertion of
the packing.
Option a: Vertigo does not occur as a result of the insertion of posterior packing.
Option b: Bell’s palsy, a disorder of the seventh cranial nerve, is not associated with epistaxis or nasal packing.
Option d: Loss of gag reflex does not occur as a result of the insertion of posterior packing.

6. The nurse is performing an endotracheal tube suctioning. Before suctioning the nurse has pre-oxygenated the client.
In order to avoid hypoxemia what is the maximum amount of time the nurse should suction the client at a time?
a. 10 seconds. b. 15 seconds.
c. 25 seconds. d. 30 seconds

Ans. a. 10 seconds
A client should be suctioned for no longer than 10 seconds at a time. Suctioning for longer than 10 seconds may reduce the client’s
oxygen level so much that he becomes hypoxic.
 National NORCET Test-2 15

7. A nurse should interpret which of the following as an early sign of a tension pneumothorax in a client with chest
trauma?
a. Diminished bilateral breath sounds
b. Muffled heart sounds
c. Respiratory distress
d. Tracheal deviation

Ans. c. Respiratory distress

• Respiratory distress or arrest is a universal finding of a tension pneumothorax. Unilateral, diminished, or absent breath sounds is
a common finding.
• Tracheal deviation is an inconsistent and late finding.
• Muffled heart sounds are suggestive of pericardial tamponade.

8. While performing the physical assessment, the nurse observed that the client is taking small breaths at first, then
bigger breaths, then a couple of small breaths, then 10 to 20 seconds of no breaths. The nurse should document the
assessment finding as:
a. Cheyne-Stokes respiration. b. Hyperventilation.
c. Obstructive sleep apnea. d. Biot’s respiration

Ans. a. Cheyne-Stokes respiration

• Option a: Cheyne-Stokes respiration is defined as a regular cycle that starts with normal breaths, which increase and then decrease
followed by a period of apnea. It can be related to heart failure or a dysfunction of the respiratory center of the brain.
• Option b: Hyperventilation is the increased rate and depth of respirations.
• Option c: Obstructive sleep apnea is recurring episodes of upper airway obstruction and reduced ventilation.
• Option d: Biot’s respiration, also known as “cluster breathing,” is periods of normal respirations followed by varying periods of
apnea

9. A patient admitted with Crohn’s disease with the presenting complaints of fever, diarrhea, cramping, abdominal
pain, and weight loss. The nurse should monitor the patient for which of the following?
a. Hyperalbuminemia b. Thrombocytopenia
c. Hypokalemia d. Hypercalcemia

Ans. c. Hypokalemia
option c: Hypokalemia is the most expected laboratory finding owing to the diarrhea.
Option a: Hypoalbuminemia is also associated with Crohn’s disease; Option b: Anemia is an expected development, but thrombocytopenia
is not.
Option d: Calcium levels are not affected

10. As per the doctor order you have started the infusion of TPN solution. While making a round you noticed that the
TPN solution was running at an incorrect rate and is now 2 hours behind schedule. Which action is most appropriate
for the nurse to take to correct the problem?
a. Readjust the solution to infuse the desired amount.
b. Continue the infusion at the current rate, but run the next bottle at an increased rate.
c. Double the infusion rate for 2 hours.
d. Notify the physician.

Ans. d. Notify the physician

• TPN solutions must be carefully and accurately infused. When TPN fluids are infused too rapidly or too slowly, the physician
should be notified.
• Rate adjustments should not be made without a written prescription from the physician. Alteration in the infusion rate can lead to
increase or decrease in blood glucose level.
16 National NORCET Test-2

11. A nurse has to administer an eye drop and an eye ointment to a client in right eye. How should the nurse best
administer the medications?
a. Administer the eye drop first, followed by the eye ointment.
b. Administer the eye ointment first, followed by the eye drop.
c. Administer the eye drop, wait 15 minutes, and administer the eye ointment.
d. Administer the eye ointment, wait 15 minutes, and administer the eye drop.

Ans. a. Administer the eye drop first, followed by the eye ointment.
When an eye drop and an eye ointment are scheduled to be administered at the same time, the eye drop is administered first. The
instillation of two medications are separated by 3 to 5 minutes.

12. Post-Operative nurse received a patient following open cholecystectomy with T tube drainage bag. After 6 hours of
admission the patient T-tube drainage bag is empty, and the nurse notice slight jaundice of the sclera. Which action
by the nurse is most important?
a. Repositioning the patient to promote T-tube drainage
b. Notifying the surgeon about these findings
c. Check the patient blood pressure immediately
d. Recording the findings and continuing to monitor the patient

Ans. b. Notifying the surgeon about these findings

Option b: The T-tube is usually placed in the common bile duct to ensure patency of the duct. Lack of bile draining into the T-tube and
presence of jaundice in sclera indicates bile flow obstruction which should be reported to the surgeon.
option a: Repositioning might promote bile flow if the catheter is obstructed or having kink. However, the jaundice indicates that the
bile duct obstructed not the T tube drain.
Option c: Checking Blood Pressure will not resolve the condition
Option d: Recording the findings and continuing to monitor the client is inappropriate because the client is experiencing signs of a
complication

13. The female patient is admitted with a new diagnosis of Cushing syndrome with elevated serum and urine cortisol
levels. Which assessment findings should the nurse expect to see in this patient?
a. Hair loss and moon face
b. Decreased weight and hirsutism
c. Decreased muscle mass and thick skin
d. Elevated blood pressure and blood glucose

Ans. d. Elevated blood pressure and blood glucose

Rationale:
• The elevated cortisol of Cushing syndrome manifests in elevated blood pressure and blood glucose. Also seen are moon face,
hirsutism, decreased muscle mass from protein wasting, increased weight and fragile skin with striae across the abdomen.

14. You have received an ABG report of your assigned patient admitted with Chronic COPD. ABG report shows:
• pH 7.35
• PCO2 62
• PO2 70
• HCO3 34
Based on the above findings which of the following intervention the nurse should perform?
a. Assess the vital signs. b. Reposition the client.
c. Prepare for intubation d. Apply a 100% nonrebreather mask.

Ans. a. Assess the vital signs

Patient with chronic COPD have CO2 retention and the respiratory drive is stimulated when the PO2 decreases.
The patient needs to be evaluated to assess hemodynamically stability by checking the heart rate, respiratory rate, and blood pressure
Option b: Repositioning will not help in this situation
option c: There is no indication that the client is experiencing respiratory distress requiring intubation.
Option d: Oxygen supplementation, if indicated, should be titrated upward in small increments.
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18 National NORCET Test-2

15. Which of the following complications is associated with prolonged mechanical ventilation?
a. Immunosuppression. b. Increased cardiac output.
c. Gastrointestinal hemorrhage. d. Pulmonary emboli.

Ans. c. Gastrointestinal hemorrhage

Prolonged mechanical ventilation can lead to gastrointestinal haemorrhage because of the development of stress ulcers.
If the patient is receiving steroid therapy or having any previous history of ulcers are more prone for GI haemorrhage.
Other possible complications include
• Incorrect ventilation,
• Oxygen toxicity,
• Fluid imbalance,
• Decreased cardiac output,
• Pneumothorax,
• Infection,
• Atelectasis.

16. You have received a new admission with the provisional diagnosis of ulcerative colitis. Initial assessment findings
include persistent diarrhea, and has lost 11 lb since the exacerbation of the disease. Which of the following is an
effective way to meet the patient nutritional needs?
a. Provide Continuous enteral feedings.
b. Provide total parenteral nutrition (TPN).
c. Provide intermittent enteral feeding
d. a&c

Ans. b. Provide total parenteral nutrition (TPN).

In case of ulcerative colitis with severe symptoms the management include to rest the bowel. To maintain the patient’s nutritional status,
the client will be started on TPN.
option a & c: Continuous Enteral feedings or intermediate feeding does not allow the bowel to rest.

17. Which of the following indicates that total parenteral nutrition is having an expected outcome?
a. Increased cell nutrition. b. Does not result to metabolic acidosis.
c. Provide hydration d. Result into negative nitrogen balance.

Ans. a. Increased cell nutrition

• The TPN is provided through the parenteral route to meet the nutritional need of the patient. TPN is a hypertonic solution
containing carbohydrates, amino acids, electrolytes, trace elements, and vitamins.
• TPN is not used to treat metabolic acidosis; ketoacidosis can actually develop as a result of administering TPN.
• It is not used to meet the hydration needs.
• TPN is administered to provide a positive nitrogen balance.

18. A patient has received multiple antibiotics and now is experiencing diarrhea. The doctor has prescribed a transmission-
based precaution. Which of the following types of precautions would be most appropriate in this case?
a. Airborne precautions. b. Contact precautions.
c. Droplet precautions. d. Standard Precaution

Ans. b. Contact precautions.

• Airborne precautions are required for clients with presumed or proven pulmonary tuberculosis (TB), chickenpox, or other airborne
pathogens.
• Contact precautions are used for organisms that are spread by skin-to-skin contact, such as antibiotic-resistant organisms or
Clostridium difficile.
• Droplet precautions are used for organisms such as influenza or meningococcus that can be transmitted by close respiratory or
mucous membrane contact with respiratory secretions.
• Transmission based precaution include: Contact, Airborne and Droplet precaution where standard precaution is to be applied to
all the patient regardless of their infection condition.
 National NORCET Test-2 19

19. You are formulating a nursing care plan for a patient with an arterial line (A-line). The nurse is well aware that this
line can be used for which of the following?
a. Monitoring blood pressure and heart rate, and infusing medications
b. Monitoring blood pressure and heart rate, and obtaining blood gases and other laboratory samples
c. Monitoring heart rate, obtaining blood gases and other laboratory samples, and infusing medications
d. Obtaining blood gases and other laboratory samples, and infusing medications

Ans. b. Monitoring blood pressure and heart rate, and obtaining blood gases and other laboratory samples
Medications should never be infused through an arterial line. Arterial lines are used for monitoring blood pressure and heart rate, or
ABG sampling.

20. You have received a client with emphysema in emergency becomes restless and confused. Which of the following
actions should the nurse take next?
a. Measure the body temperature b. Instruct to perform pursed lip breathing
c. Assess serum potassium level d. Increase the oxygen flow rate to 6 L/min.

Ans. b. Instruct to perform pursed lip breathing

Encourage the client to perform pursed-lip breathing—prevents collapse of lung unit and helps client control rate and depth of breathing
option a: Monitoring the temperature will not help as confusion is probably due to decreased oxygenation
option c: potassium level assessment will not help in identifying the confusion
option d: client should receive low flow rate of oxygen to prevent carbon dioxide narcosis.

21. Select the correct intervention from the following for the plan of care for a patient with severe liver disease?
a. Administer Kayexelate enemas.
b. Provide a low-protein, high-carbohydrate diet.
c. Insert a Sengsteken-Blakemore tube.
d. All of the above

Ans. b. Provide a low-protein, high-carbohydrate diet.

Severe liver diseases can lead to hepatic coma caused by increased levels of ammonia from breakdown of protein. Due to which it is
recommended to provide low-protein, high-carbohydrate diet to such patients.
option a: Kayexelate enemas is used in case of hyperkalemia to decreases serum potassium levels
option c: Sengsteken-Blakemore tube is usually used in case of upper GI bleeding to applies pressure against bleeding esophageal varices.

22. A patient present with jaundice due to pancreatic cancer. While prioritizing the patient needs which of the following
nursing diagnosis the nurse should give the HIGHEST priority?
a. Imbalanced Nutrition b. Disturb Self-image
c. Impaired Skin integrity d. Impaired gas exchange

Ans. a. Imbalanced Nutrition

• Pancreatic cancer is associated with profound weight loss and anorexia due to which nutritional needs become the highest priority
for this patient.
• Disturb self-image can be a concern due to the presence of jaundice but physiological needs take priority
• Impaired skin integrity can be placed for second highest priority as jaundice causes dry skin and pruritis; scratching can lead to
skin breakdown
• Impaired gas exchange is not a definitive nursing diagnosis for the patient with pancreatic cancer

23. Identify the ECG rhythm as demonstrated in the given video link? https://vimeo.com/440573811/339d18b7f7
a. Sinus tachycardia b. Paroxysmal supraventricular tachycardia
c. Sinus rhythm d. All of the above

Ans. b. Paroxysmal supraventricular tachycardia

20 National NORCET Test-2

RATIONALE:
• The correct answer is Paroxysmal supra ventricular tachycardia. Supraventricular tachycardia is a series of rapid heartbeats that
begin in or involve the upper chambers (atria) of the heart. Types of SVT are Atrial Fibrillation (A fib), Paroxysmal Supraventricular
Tachycardia (PSVT) and Atrial Flutter (A Flutter).
• Recognizing PSVT on an EKG
Ĕ The EKG will show a fast heart rate anywhere from 100 to up to 300 bpm.
Ĕ The QRS is narrow at a regular rhythm.
Ĕ Sometimes the P waves are inverted, this is referred to as retrograde P waves.
Ĕ It can also be drug induced; Digoxin and Theophylline can cause PSVT.
• Signs and symptoms:
Ĕ Anxiety
Ĕ Shortness of breath
Ĕ Tachycardia
Ĕ Palpitations
Ĕ Dizziness
Ĕ Syncope
• Sinus tachycardia is a sinus rhythm with a heart rate greater than 100 beats per minute in an adult. Note that the p waves are still
present.
Rhythm = Regular

Figure 1: Sinus Tachycardia

• Sinus rhythm
P wave PR Interval QRS Rate Rhythm
Before each QRS complex Constant, regular Rate 60 - 100 Regular
interval (0.12 - 0.20) Interval =/< 0.10

Figure 2: Sinus rhythm

 National NORCET Test-2 21

24. Identify the image given below:

a. Laminar flow hood b. C coil machine

c. C arm machine d. USG machine

Ans. c. C arm machine

RATIONALE:
• The correct answer is C arm machine. A C arm machine categorizes itself as an advanced medical imaging device that works on
the basic premise of the X-ray technology. They are fluoroscopy machines and are colloquially called image intensifiers. C arm gets
its name from the C-shaped arm present in the device, which is used to connect the X-ray source and the detector. These C arm
machines are widely used during orthopedic, complicated surgical, pain management (Anesthetics) and emergency procedures.
• A laminar flow cabinet or tissue culture hood is a carefully enclosed bench designed to prevent contamination of semiconductor
wafers, biological samples, or any particle sensitive materials. Air is drawn through a HEPA filter and blown in a very smooth,
laminar flow towards the user. Due to the direction of air flow, the sample is protected from the user, but the user is not protected
from the sample.

Figure 1: Laminar flow hood

• An ultrasound machine makes images so that organs inside the body can be examined. The machine sends out high-frequency
sound waves, which reflect off body structures. A computer receives the waves and uses them to create a picture. Unlike with an
X-ray or CT scan, this test does not use ionizing radiation.
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 National NORCET Test-2 23

Figure 2: USG machine

• Other option is a distractor.

25. Identify the laparoscopic instrument in the given image?

a. Maryland dissector b. Maxigrip garsper

c. Fenestrated mediclinch grasper d. Harmonic ace

Ans. a. Maryland dissector

RATIONALE:
The correct answer is Maryland dissector is ideal for precise dissection.
Option2: Maxi-Grip Fundus Grasper

Figure 1: Maxi-Grip Fundus Grasper

Option 3: Fenestrated mediclinch grasper widely used on tissues of stomach wall and gall bladders

Figure 2: Fenestrated Mediclinch grasper

24 National NORCET Test-2

Option 4: The harmonic scalpel is a surgical instrument used to simultaneously cut and cauterize tissue.

Figure 3: Harmonic Ace

26. By using the surgical diathermy machine in operation theatre which of the following functions can be achieved?
a. cutting, coagulation, fulguration b. cutting, fulguration
c. cutting, coagulation d. coagulation, fulguration

Ans. a. cutting, coagulation, fulguration

• Cutting happens when the heat is given is so high frequency that the cell burns and is separated which is called as incision.
• Coagulation happens when the cytoplasm is heated so much and joins together.
• Fulguration is a process in which the heat is applied and it destroy the superficial layer of tissue by means of high-frequency.

27. Identify the name of the instrument given below?

a. Right angle forceps b. Cervical punch biopsy forceps

c. Tonsillar snare d. Yaunker tonsil tip

Ans. c. Tonsillar snare

RATIONALE:
option b: A biopsy punch is a circular hollow blade attached to a long, pencil-like handle. Commonly used in cervix biopsy.
 National NORCET Test-2 25

Figure: Cervical punch biopsy forceps

Option a: Right Angle Forceps are ratcheted, finger ring forceps commonly used for working in obscured surgical sites. They are most
frequently used for clamping, dissection, or grasping tissue.

Figure: Right angle forceps

Option c: Tonsil Snare is a commonly used tool in tonsillectomy procedures. The wire loop snare is designed to encircle the affected
tonsil for removal.

Figure: Tonsillar snare

Option d: Yanker tonsil tip is an oral suctioning tool used in medical procedures. It is typically a firm plastic suction tip with a large
opening surrounded by a bulbous head and is designed to allow effective suction without damaging surrounding tissue. This tool is used
to suction oropharyngeal secretions in order to prevent aspiration. A Yankauer can also be used to clear operative sites during surgical
procedures.

Figure: Yanker Tonsil tip

26 National NORCET Test-2

28. Which of the following term describes a fungal infection in scalp?

a. Tinea capitis
b. Tinea corporis
c. Tinea cruris
d. Tinea pedis

Ans. a. Tinea capitis

Rationale:
• Tinea capitis is a superficial fungal infection of the skin of the scalp, eyebrows, and eyelashes, with a propensity for attacking hair
shafts and follicles. Commonly seen in 3-7 yrs. old children. Caused by Trichophyton and Microsporum
• Tinea corporis, is a superficial fungal infection of the arms and legs, especially on glabrous skin; however, it may occur on any part
of the body.
• Tinea cruris is a fungal infection of the groin.
• Athlete’s foot (tinea pedis) is a fungal infection that usually begins between the toes.

29. Catgut is preserved in:

a. Glutaraldehyde b. Isopropyl alcohol
c. Iodine d. Formaldehyde

Ans. b. Isopropyl alcohol

Catgut sutures are packaged in alcohol solution (ethanol or isopropanol or Isopropyl alcohol) to retain their flexibility and the packages
are sterilized by either Co60 gamma-irradiation or ethylene oxide.

30. The nurse should use which of the following technique test to assess peripheral response to pain of an unconscious
patient during the motor and sensory function test?
a. Nail bed pressure
b. Squeezing of the sternocleidomastoid muscle
c. Sternal rub
d. Pressure on the orbital rim

Ans. a. Nail bed pressure

Rationale:
• Nail bed pressure tests a basic motor and sensory peripheral response.
• Cerebral responses to pain are tested using a sternal rib, placing upward pressure in the orbital rim, or squeezing the clavicle or
sternocleidomastoid muscle.

MIDWIFERY AND OBSTETRICAL NURSING

31. A pregnant female at 22 weeks of come for antenatal visit. On routine checkup her hemoglobin is 11.6 gm% &
her pre-pregnancy hemoglobin was 12.6gm%. The nurse advices her the following as per “Anemia Mukt Bharat
Programme”:-
a. 1 tab of 60mg iron and 500 mcg of folic acid
b. 2 tabs of 60 mg iron and 500 mcg folic acid
c. 1 tab 100 mg iron and 500 mcg folic acid
d. 2 tabs of 100 mg iron and 500 mcg folic acid

Ans. a. 1 tab of 60mg iron and 500 mcg of folic acid

If a female hemoglobin drops but remains above 11 gms percent- it means she has physiological anemia of pregnancy. For physiological
anemia she should be given 1 iron and folic acid tablet per day starting from 4th month of pregnancy for 180 days, i.e. throughout
pregnancy and for 180 days after that . Each tablet contains 60 mg elemental iron and 500 mcg folic acid.
If a pregnant female has pathological anemia – i.e. Hb is less than 11 gms percent – then she should be given 2 tabs per day .
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28 National NORCET Test-2

32. Identify the Leopold maneuver shown in figure?

a. 1st Maneuver b. 2nd Maneuver

c. 3rd Maneuver d. 4th Manouver

Ans. c. i.e 3rd Maneuver

The maneuver shown in image is being done at the pelvic are with one hand and while facing the face of patient – hence it is leopold
third maneuver

33. Which of the following is true statement about screening for diabetes in pregnancy?
a. It is done between 20 -24 weeks of pregnancy b. Fasting is needed by patient
c. Done with 100 g of glucose d. Done in first antenatal visit

Ans. d. done in first antenatal visit.

 National NORCET Test-2 29

A universal screening which is simple, feasible, acceptable and a single step procedure is applicable in Indian scenario as Indian women
have an eleven-fold increased risk of developing glucose intolerance during pregnancy.

Criteria In Pregnancy
2hours ≥ 200 mg/dl Diabetes Mellitus
2hours ≤ 140 mgdl GDM

Hence in Indian scenario - DIPSI recommended a single step procedure irrespective of the last meal. Pregnant women attending the
antenatal OPD are given 75g anhydrous glucose in 250-300ml of water and plasma glucose is estimated after 2 hour. A 2-hours plasma
glucose ≥ 140 mg/dl is taken as GDM

34. All of the following are normal during pregnancy except

a. Increased viscosity
b. Increased globulin level
c. Decreased hemoglobin concentration
d. Decreased peripheral vascular resistance

Ans. a. increased viscosity

• During pregnancy – both plasma volume and blood volume increase- but increase in plasma volume is more than blood volume
so during pregnancy there is hemodilution and blood viscosity decreases.
• Plasma protein mass increases in pregnancy, but plasma protein concentration decreases.
• Globulin increases in pregnancy and albumin decreases
• WBC count increases in pregnancy – platelet count decreases
• Hb mass increases in pregnancy but Hb concentration decreases in pregnancy
• Cardiac output, heart rate and stroke volume increases in pregnancy but peripheral vascular resistance decreases

35. A 12 weeks pregnant female whose BP was 140/90 mmHg suddenly at 22 weeks of pregnancy has BP increases to
160/110 mmHg with +1 proteinuria. What can be the diagnosis?
a. Severe Pre-eclampsia
b. Chronic Hypertension with superimposed pre-eclampsia
c. Gestational hypertension
d. Mild pre-eclampsia

Ans. b. chronic hypertension with superimposed pre-eclampsia

This female had high BP -140/90 mm of hg at 12 weeks of pregnancy – means she has chronic hypertension of pregnancy .Suddenly
after 20 weeks if BP becomes uncontrollable or if proteinuria u develops or she develops end organ damage – means she has chronic
hypertension with superimposed pre eclampsia .
In pre eclampsia and gestational hypertension – the increase in BP is seen after 20 weeks of pregnancy . In pre eclampsia there is
associated proteinuria or signs of end organ damage may be present . In gestational hypertension – neither proteinuria nor signs of end
organ damage are seen

36. A 26 years old female came with complains of scanty curdy white vaginal discharge. She also complains of itching and
dysuria. Most probable diagnosis is
a. Trichomonas vaginitis b. Bacterial vaginosis
c. Candidiasis d. Leukorrhea

Ans. c. candidiasis
Curdy white, scanty discharge with lot of itching indicates candidiasis . In bacterial vaginosis female complains of greyish white
discharge , with no itching . In trichomonas – discharge is yellowish green in colour.
30 National NORCET Test-2

37. Identify the maneuver?

a. Pinard maneuver b. Loveset maneuver

c. Burn-Marshall maneuver d. Prague maneuver

Ans. c. burn Marshall maneuver

Burn Marshall technique is for delivery of after coming had of breech where the baby’s body is allowed to hang by its own weight and
then when occipital protuberance is visible- feet of the baby are held and taken towards mother’s abdomen.

38. The plotting of partogram should begin from:-

a. left of alert line b. right of alert line
c. left of action line d. right of action line

Ans. a. left of alert line

The partogram used these days is Modified WHO partogram – where plotting begins from active phase I.e 4cms dilatation of cervix.
Ideally plotting should begin on alert line. Now since in options- on alert line is not given we will mark the answer as – left of alert line

39. What is the position of fetus in the following image?

a. Right occipito-posterior b. Left occipito-posterior

c. Left occipito-anterior d. Right occipito-anterior

Ans. b. left occipito-posterior position

In questions like these – identify the posterior fontanelle first. To identify posterior fontanelle remember- it is a triangular shaped
fontanelle whereas anterior fontanelle is quadrangular fontanelle.
 National NORCET Test-2 31

Now see whether post fontanelle is near the pubic symphysis or sacral promontory
1. If it is near pubic symphysis – it means occipito-anterior
2. If it is near sacral promontory – it means occipito-posterior
3. 3. If midway between pubic symphysis and sacral promontory – occipito-transverse
Now see whether – post-fontanelle is facing your right hand side or your left hand side
1. If post fontanelle/occiput is towards your left- its mothers right
2. If post fontanelle/occiput is towards your right – its mothers left
In the image – posterior fontanelle is towards sacral promontory i.e. its occipito-posterior position and because it’s towards your right
so it will be mothers left
Hence left occipito-posterior position

40. Which of the following is true regarding cephalhematoma?

a. Collection of blood above the periosteum
b. Can cross suture lines
c. Pits on applying pressure
d. Collection of blood below the periosteum

Ans. d. collection of blood below periosteum

Caput Succedaneum Cephalohematoma

Condition marked by localized soft tissue edema with poorly defined • Condition marked by soft, fluctuant, localized swelling with well-
outline defined outline
Caused by pressure of the fetal head against the cervix during labor, • Caused by subperiosteal hemorrhage
which decreases blood flow to the area and results in edema • Appears after birth; increases in size for 2-3 days
Present at birth; does not increase in size Swelling crosses suture lines • Swelling does not cross suture lines
Disappears within a few hours to several days Complications are rare • Disappears in several weeks to even months
• Complications include defective blood clotting, underlying skull
fracture
• or intracranial bleeding, and jaundice

41. Identify the type of fibroid given in the image :-

a. Sub-serosal fibroid b. Intra-mural fibroid

c. Sub-mucosal fibroid d. Sub-peritoneal fibroid

Ans. c. submucosal fibroid

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Fibroids/ leiomyoma are smooth muscle tumours of uterus. They arise from myometrium of uterus and are called intramural variety.
Some of them then grow towards uterine cavity- called as Submucous type and some grow towards uterine serous and are called as
subserosal. M/c type is – intramural
M/c fibroid leading to symptoms/ menorrhagia – submucosal fibroid
M/c fibroid causing abortions- submucosal fibroid

42. During Pap smear following instrument takes biopsy from -

a. Internal Os b. Vagina
c. Endocervix d. Transformation zone

Ans. c. Endocervix
The instrument shown in image is endocervical brush. It is used to take sample from endocervix.
Ayers spatula- takes sample from transformation zone. If TZ is not given in options – answer should be marked as squamous columnar
junction and if that is also not given then- external os.
First sample taken using Ayers spatula from TZ and then using endocervical brush from endocervix and both sample as are put on same
slide. The preservative used is – 95% ethyl alcohol and 5% ether

43. All of the following Vaccines can be given in pregnancy except:-

a. COVID 19 b. HPV
c. Rabies d. Flu vaccine

Ans. b. HPV
All live vaccines and HPV vaccine( which is not live )– are contraindicated in pregnancy
List of vaccines absolutely contraindicated in pregnancy
1. Mumps vaccine 2. Measeles vaccine
3. Rubella vaccine 4. Small pox
5. Chicken pox 6. Bcg
7. HPV

44. A 29-year-old multigravida at 37 weeks’ gestation is being treated for severe preeclampsia and has magnesium sulfate
infusing at 3 g/hour. The nurse has determined the priority nursing diagnosis to be: risk for central nervous system
injury related to hypertension, edema of cerebrum. To maintain safety for this client, the nurse should:
a. Maintain continuous fetal monitoring.
b. Encourage family members to remain at bedside.
c. Assess reflexes, clonus, visual disturbances, and headache.
d. Monitor maternal liver studies every 4 hours

Ans. c. Assess reflexes, clonus, visual disturbances, and headache.

34 National NORCET Test-2

option c: If the mother suffers CNS injury related to hypertension or stroke, oxygenation status is compromised and the well-being of
both mother and infant are at risk. In preeclampsia, frequent assessment of maternal reflexes, clonus, visual disturbances, and headache
give clear evidence of the condition of the maternal CNS system.
option a: Continuous fetal monitoring is an assessment strategy for the infant only and would be of secondary importance to maternal
CNS assessment because maternal oxygenation will dictate fetal oxygenation and well-being.
Option b: Psychosocial care plays an important role but physiological needs should be the priority.
option d: Monitoring the liver studies does give an indication of the status of the maternal system but the less invasive and highly
correlated condition of the maternal CNS system in assessing reflexes, maternal headache, visual disturbances, and clonus is the highest
priority.

45. The nurse should do which of the following actions first when admitting a multigravida client at 36 weeks’ gestation
with a probable diagnosis of abruptio placentae?
a. Prepare the client for a vaginal examination.
b. Obtain a brief history from the client.
c. Insert a large-gauge intravenous catheter.
d. Prepare the client for an ultrasound scan

Ans. c. Insert a large-gauge intravenous catheter.

option c: Abruptio placentae is a medical emergency because of the degree of hypovolemic shock. On admission, the nurse should plan
to first insert a large-gauge intravenous catheter for fluid replacement and provide oxygen by mask to decrease fetal anoxia.
option a: Vaginal examination usually is not performed on pregnant clients who are experiencing third-trimester bleeding due to
abruptio placentae because it can result in damage to the placenta and further fetal anoxia.
option b: The client’s history can be obtained once the client has been admitted and the intravenous line has been started. The nurse
should also plan to monitor the client’s vital signs and the fetal heart rate.
option d: Ultrasound is of limited use in the diagnosis of abruptio placentae.

46. The plane of engagement in the following image is:

a. Biparietal-Suboccipitobregmatic b. Biparietal-mento-vertical
c. Biparietal-Occipitofrontal d. Biparietal-Submentobregmatic

Ans. a. Biparietal-Suboccipitobregmatic

Rationale:
• The plane of engagement in the image is biparietal-suboccipito-bregmatic.
• It is seen in the vertex presentation with complete flexion attitude of head.
• Its circumference is 27.5 cm.
• Biparietal-mento-vertical: is seen in incomplete extension of head in vertex presentation with circumference of 37.5 cm.
• Biparietal-Occipitofrontal: is seen in deflexed head in vertex presentation with circumference of 34 cm.
• Biparietal-Submentobregmatic: is seen in complete extension of head vertex presentation with circumference of 27.5 cm.
 National NORCET Test-2 35

47. The nurse is assessing fetal position for a 32-year-old client in her eighth month of pregnancy. As shown below, the
fetal position can be described as which of the following?

a. Left occipital transverse. b. Left occipital anterior.

c. Right occipital transverse. d. Right occipital anterior

Ans. a. Left occipital transverse.

option a: In left occipital transverse lie, the occiput faces the woman’s left hip.
option b: In left occipital anterior lie, the occiput faces the left anterior segment of the woman’s pelvis.
option c: In right occipital transverse lie, the occiput faces the woman’s right hip.
option d: In right occipital anterior lie, the occiput faces the right anterior segment of the woman’s pelvis.

48. A 31-year-old multigravida client at 39 weeks’ gestation admitted to the hospital in active labor is receiving intravenous
lactated Ringer’s solution and a continuous epidural anesthetic. During the first hour after administration of the
anesthetic, the nurse should monitor the client for:
a. Hypotension. b. Diaphoresis.
c. Headache. d. Tremors.

Ans. a. Hypotension.
• When a client receives an epidural anesthetic, sympathetic nerves are blocked along with the pain nerves, possibly resulting in
vasodilation and hypotension.
• Other adverse effects include bladder distention, prolonged second stage of labor, nausea and vomiting, pruritus, and delayed
respiratory depression for up to 24 hours after administration.
• Diaphoresis and tremors are not usually associated with the administration of epidural anesthesia.
• Headache, a common adverse effect of many drugs, also is not associated with administration of epidural anesthesia.

49. Feature of diabetes mellitus in pregnancy:

i. Hydramnios ii. ↑ congenital defect
iii. PPH iv. Neonatal hyperglycemia
a. If i, ii, iii are correct b. If i and iii are correct
c. If ii and iv are correct d. If all four (i, ii, iii, & iv) are correct

Ans. a. If i, ii, iii are correct

Rationale:
• Maternal hyperglycemia leads to fetal hyperglycemia, which in turn causes polyuria and thus causes polyhydramnios.
• Polyhydramnios leads to preterm delivery and not postdatism.
• Excessive uterine enlargement because of polyhydramnios and macrosomia causes increased incidence of atonic PPH.
• Diabetes leads to increased incidence of congenital defects in fetus.
• Maternal hyperglycemia → to fetal hyperglycemia → hyperinsulinemia → to neonatal hypoglycemia at birth.
36 National NORCET Test-2

Remember:
In Diabetes
• Maternal and fetal – hyperglycemia
• Neonatal – hypoglycemia

50. Uterine tachysystole is defined as:

a. More than 5 contraction in a 5 min period
b. More than 5 contraction in a 10 min period
c. More than 10 contraction in a 5 min period
d. More than 10 contraction in a 10 min period

Ans. b. More than 5 contractions in a 10-min period

Rationale:
• Uterine tachysystole is defined as ≥ 5 contractions in a 10 min period. It should always be qualified by the presence or absence of
fetal heart rate abnormalities.
• It is caused by pharmacological agents used for cervical ripening and induction such as misoprostol (both oral and vaginal),
dinoprostone.
• It can also be associated with placental abruption.

NURSING FOUNDATIONS

51. The nurse is completing a client’s preoperative checklist prior to an early morning surgery. The nurse obtains the
client’s vital signs: temperature 97.4° F (36° C), radial pulse 84 strong and regular, respirations 16 and unlabored, and
blood pressure 132/74. Which of the following actions should the nurse take FIRST?
a. Notify the physician of the client’s vital signs.
b. Obtain orthostatic blood pressures lying and standing.
c. Lower the side rails and place the bed in its lowest position.
d. Record the data on the client’s preoperative checklist.

Ans. d. Record the data on the client’s preoperative checklist.

All the parameters are within the normal range and should be properly documented in the client’s preoperative checklist.
other options are distracters.

52. A day care nurse is assigned to administer an IM injection to a client with pernicious anemia. The nurse selects which
of the following muscles to administer this injection?
a. Gluteus maximus b. Deltoid
c. Vastus lateralis d. Dorsogluteal

Ans. c. Vastus lateralis

option a: Administration of IM injection in Gluteus maximus is associated with possible injury to sciatic nerve
Option b: Deltoid can only use for small amount of medications and doesn’t have enough muscle mass to support the absorption.
option c: Vastus lateralis is best for the administration of IM injection as no major nerves or blood vessels
option d: Administration of IM injection in Dorsolateral is associated to possible injury to sciatic nerve

53. Suction of drainage in chest drain should be maintained at pressure:

a. -10 to -20 cm of H2O
b. -6 cm of H2O
c. 10 to 20 cm of H2O
d. 60 cm of H2O

Ans. a. -10 to -20 cm of H2O

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38 National NORCET Test-2

Rationale:
Suction drainage system
• Chest drains also known as under water sealed drains (UWSD) are inserted to allow draining of the pleural spaces of air, blood or
fluid, allowing expansion of the lungs and restoration of negative pressure in the thoracic cavity.
• Chest tube is connected to active suction drain usually with a pressure of -20 cm of H2O.
• If the lung expands well the chest tube is left under suction drainage for a period of 5 - 7 days or until the space is permanently
obliterated.
• ICD is removed when output is less than 100 mL.

54. Which of the following is the proper sequence for examination of the lungs?
a. Inspection, auscultation, percussion, and palpation
b. Inspection, percussion, palpation, and auscultation
c. Inspection, palpation, auscultation, and percussion
d. Inspection, palpation, percussion, and auscultation

Ans. d. Inspection, palpation, percussion, and auscultation

Rationale:
The proper sequence for examination of the lungs is:
• Inspection for chest wall abnormalities, symmetry, and retractions
• Palpation for fremitus and crepitus (“crinkly” sensation)
• Percussion for dullness and diaphragmatic excursion
• Auscultation of breath sounds

55. Nurse Reena is ICU 1 head nurse and during her morning shift she received a handover report from the emergency
nurse who will be transferring a patient to ICU. The patient has a Sengstaken-Blackmore Tube. While taking the
handover about the Sengstaken-Blackmore tube which among the following is incorrect? (MSN)
a. It is a three-lumen gastric tube
b. one lumen to inflate gastric balloon
c. second lumen to inflate esophageal balloon
d. third lumen is for esophageal suction port

Ans. d. third lumen is for esophageal suction port

RATIONALE:
• The correct answer is option d.
• Sengstaken-Blakemore tube is a 3 lumen tube, one lumen to inflate gastric balloon, a second lumen to inflate esophageal balloon
and a third lumen to aspirate gastric contents. There is no esophageal suction port. This causes saliva to pool in the esophagus and
thus put patients at risk of aspiration.

Figure: Sengstaken-Blakemore tube

 National NORCET Test-2 39

56. The nurse understands that lumbar Puncture is useful to diagnose which of following condition?
a. Tuberculosis meningitis
b. Multiple sclerosis
c. subarachnoid Hematoma
d. All of the above

Ans. d. All of the above

• In Tuberculosis meningitis, Cerebrospinal fluid protein level increased.
• Presence of oligoclonal immunoglobulin (antibodies) bands in the CSF is considered as the single most useful laboratory marker
to diagnose multiple sclerosis.
• Subarachnoid Hematoma can be detected with CSF sample anticipated with blood.

57. You are posted in burn unit and assigned to provide care to a newly admitted 13 years old patient with total body
burn surface area 30% and body weight is 20 kg. While administering the initial fluid, the nurse will set flow rate of
infusion at how many ml/hr?
a. 2400 ml/hr
b. 100 ml/hr
c. 150 ml/hr
d. 210 ml/hr

Ans. c. 150 ml/hr

Here, in the given scenario we already have
TBSA (total body surface area) = 30%
Body weight in kg =20 kg
Now we need to identify the total amount of fluid need to administered in 24 hours by using the parkland formula
The Parkland formula for the total fiuid requirement in 24 hours is as follows: =4ml/kg × TBSA (%) × body weight (kg)
(50% given in first eight hours; 50% × given in next 16 hours.)
Total amount of fluid need to administered in 24 hours
= 4 X 20kg X 30%
Total amount of fluid need to administered in 24 hours =2400 ml
As we know in burn patient fluid need to administered initially in the first 8 hour.
So now next step will be to identify the volume of fluid need to be administered in first 8 hours.
volume of fluid need to be administered in first 8 hours= TOTAL VOLUME OF FLUID ADMINISTERED IN 24 HOURS ÷ 2
volume of fluid need to be administered in first 8 hours=2400÷ 2
volume of fluid need to be administered in first 8 hours = 1200
Now we need to figure out at what ml/hr the nurse will set the flow rate while administering the initial fluid for the first 8 hours to burn
patient.
Flow rate = total volume in ml/ time in hours
Flow rate = 1200 ml/8 hours
Flow rate = 150 ml/hrs

58. What purpose does the pilot balloon of an endotracheal or tracheostomy tube used in airway management?
a. To minimize mucosal trauma during insertion
b. To protect the airway against aspiration
c. To monitor cuff integrity and pressure
d. All of the above

Ans. b. To monitor cuff integrity and pressure

40 National NORCET Test-2

The cuff is designed to provide a seal within the airway, allowing airflow through the ETT but preventing passage of air or fluids around
the ETT.

59. Who has given the theory of interpersonal relationship?

a. Hildegard peplau b. Florence Nightingale
c. Dorothea Elizabeth d. Imogene M king

Ans. a. Hildegard peplau

Hildegard Elizabeth Peplau has given the theory of Interpersonal Relations Theory

Phases of IPR theory

1. Orientation
2. Working phase includes Identification & Exploitation
3. Resolution /Termination
Dorothea Elizabeth Orem developed Self-Care Theory. Focuses on each individual’s ability to perform self-care. Composed of three
interrelated theories: (1) the theory of self-care, (2) the self-care deficit theory, and (3) the theory of nursing systems, which is further
classified into wholly compensatory, partially compensatory, and supportive-educative.
Imogene M. King: Theory of Goal Attainment. Explains that the nurse and patient go hand-in-hand in communicating information, set
goals together, and then take actions to achieve those goals.
Florence Nightingale founder of Modern Nursing and Pioneer of the Environmental Theory. Identified the act of utilizing the patient’s
environment to assist him in his recovery.”

60. The trainee nurse is helping the assigned nurse who is providing care to the kidney transplant patient. The trainee
nurse asks about the type of isolation to be used for such patients:
a. Positive pressure room b. Negative pressure room
c. General room d. Droplet precaution

Ans. a. Positive pressure room

Rationale:
• Positive pressure isolation rooms are used to isolate immunocompromised patients, for example like oncology and some transplant
patients to reduce the risk of airborne transmission of infection to a susceptible patient. Here, the concept of reverse barrier nursing
is applied where the patient needs to be protected from the risk of infections.
• In Positive pressure room, the air pressure is higher than outside, in order to keep the microorganism outside the room. This is
done by the following the principle of the exhaust air to run at 10–15 percent lower than the supply air. The pressure differential is
more than 2.5 Pa and ideally should be 8 Pa.
• In Negative pressure room, the air pressure is lower than outside in order to avoid the flow of contaminated air inside out. Exhaust
air is run 10–15 per cent higher than the supply air. The patient who requires airborne precaution needs to be kept in negative
pressure room. The air exiting a negative pressure environment has to be filtered with a high-efficiency particulate air (HEPA) filter.

61. Doctor prescribed colloid solution to the patient. Identify which of the following is the example of colloid solution.
a. 25 % albumin b. Dextran
c. Haemaccel d. All of the above

Ans. d. All of the above

 National NORCET Test-2 41

RATIONALE:
The correct answer is option 4.
Colloids are gelatinous solutions that maintain a high osmotic pressure in the blood. Particles in the colloids are too large to pass semi-
permeable membranes such as capillary membranes, so colloids stay in the intravascular spaces longer than crystalloids. Examples of
colloids are albumin, dextran, hydroxyethyl starch (or hetastarch), Haemaccel and Gelofusine.

62. You are assigned to provide care to a ventilated patient. While charting the baseline vital data nurse noticed that
the low-exhaled volume alarm sounds on a mechanical ventilator. The nurse determines that the cause for alarm
activation may be which of the following complication?
a. Excessive secretions
b. Kinks in the ventilator tubing
c. Displacement of the endotracheal tube
d. All of the above

Ans. a. Displacement of the endotracheal tube

RATIONALE:
The correct answer is option 3.
The low-exhaled volume alarm will sound if the patient does not receive the preset tidal volume. Possible causes of inadequate tidal
volume include disconnection of the ventilator tubing from the artificial airway, a leak in the endotracheal or tracheostomy cuff,
displacement of the endotracheal tube or tracheostomy tube, and disconnection at any location of the ventilator parts.
Whereas high-pressure ventilator alarm is in case of Water or a kink in the tubing and Increased secretions in the airway.

63. The nurse informs the Occupational therapy department that the patient is too weak to use a walker and needs to be
transported by wheelchair. Which step of the nursing process is the nurse engaged in at this time?
a. Assessment
b. Planning
c. Implementation
d. Evaluation

Ans. b. Planning

RATIONALE:
The correct answer is option b
The nurse is responsible for coordinating the plan of care with other disciplines to ensure the patient safety. This action represents the
implementation phase of the nursing process.
• Data gathering occurs during assessment
• Goal setting occurs during planning.
• Determining attainment of client goals occurs as part of evaluation.\

64. To assess for the sign of phlebitis over the intravenous site which among the following score to be used by the nurse?
a. VIP score
b. FLACC scale
c. Braden risk assessment scale
d. NIPS

Ans. a. VIP score

RATIONALE:
The correct answer is option 1
VIP Score is visual infusion phlebitis score. The tool helps the nurses to determine appropriate assessment, discontinuation of peripheral
intravenous catheters based on the presence and severity of symptoms.
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VIP Score

65. Which among the following practice is implemented by the nurse as the Reverse barrier nursing
a. The nurse has placed a renal transplant patient into a positive pressure room
b. The nurse has provided surgical mask to the patient who is immune-compromised while shifting to the diagnostic department
c. The nurse uses appropriate personal protective equipment’s to prevent the transmission of infection.
d. Both a & b

Ans. d. Both a & b

RATIONALE:
The correct answer is option 4.
Protective isolation or reverse isolation denotes the practices used for protecting vulnerable patient for contracting an infection. When
patient with weakened immune systems are exposed to organisms, it could lead to infection and serious complications.
Both option 1 & 2 are considered as Reverse barrier nursing techniques where the patient is protected from the infection.
While in option 3 use of PPE by the nurse is considered as an example of barrier nursing.

ANATOMY & PHYSIOLOGY

66. Compression of nerve within the carpel tunnel produces inability to:
a. Abduct the thumb b. Adduct the thumb
c. Flex the distal phalanx of thumb d. Oppose the thumb

Ans. d. Oppose the thumb

Rationale:
• Flexion of the distal phalanx of thumb is by flexor pollicis longus and supplied by anterior interosseous nerve
• Adduction of thumb is by adductor pollicis supplied by deep branch of ulnar nerve
• Abduction of thumb by abductor pollicis longus and supplied by radial nerve
• Oppose the thumb by opponents pollicis and supplied by median nerve

67. Abduction and adduction of foot occurs at which joints?

a. Ankle b. Subtalar
c. Tarsometatarsal d. Transverse tarsal

Ans. d. Transverse tarsal

44 National NORCET Test-2

Rationale:
• Adduction is movement of the foot towards the middle in the transverse plane; abduction is movement away from the midline.
• This movement occurs at the transverse tarsal joints (a compound joint made up of calcaneocuboid and talonavicular joints) and
also by the first tarsometatarsal and metatarsophalangeal joints.

68. Incretins causes:

a. Decrease in insulin secretion
b. Increase in blood glucose levels
c. Increase in glucagon levels
d. Increase in insulin secretion

Ans. d. Increase in insulin secretion

Rationale:
Oral glucose stimulates the release of certain hormones that acts on beta cells of pancreas to increase insulin secretion. Such GI hormones
are termed as Incretins
• Incretin hormones are:
Ĕ Glucagon-like peptide-1 (GLP1) – most potent incretin
Ĕ Gastric inhibitory peptide (GIP) or Glucose dependent insulinotropic peptide

69. When a person is standing, blood flow in the lungs is:

a. Lowest at the base because that is where alveolar pressure is greater than arterial pressure
b. Equal at the apex and the base
c. Highest at the apex owing to the effects of gravity on arterial pressure
d. Highest at the base because that is where the difference between arterial and venous pressure is greatest

Ans. d. Highest at the base because that is where the difference between arterial and venous pressure is greatest

Rationale:
The distribution of blood flow in the lungs is affected by gravitational effects on arterial hydrostatic pressure. Thus, blood flow is highest
at the base, where arterial hydrostatic pressure is greatest and the difference between arterial and venous pressure is also greatest. This
pressure difference drives the blood flow.

70. If the lungs get punctured, which of the following would happen?
a. The lung would collapse on the side of the puncture
b. Both the lung and the chest wall would collapse on the side of the puncture
c. The relaxation pressure of the chest wall would increase until it surpassed the atmospheric
d. The relaxation pressure of the chest wall would increase, but stop before it reached atmospheric pressure

Ans. a. The lung would collapse on the side of the puncture

Rationale:
• When the muscles of the chest and diaphragm contract they expand the chest, causing the lungs to inflate. Like a balloon, the lungs
stretch as they inflate.
• When you exhale, the muscles relax, and like a balloon that’s been released, the lungs spring back. But if the air escapes from the
lung and into the chest around the lung, the lung can collapse inside the chest.
• This can occur from the bursting of a weak spot of the lung, either from another medical condition, infection, or cancer. Or it could
be caused by a puncture of the lung such as from a fractured rib.

71. Burning pain is carried by which type of fibers?

a. Aδ fiber b. Aβ fiber
c. Aα fiber d. C fibers

Ans. d. C fibers

Rationale:
• Pain is transmitted via two fibers types:
Ĕ Thinly myelinated A delta fiber (2 - 5 m in diameter) which conduct at rates 2 - 3 m/s.
 National NORCET Test-2 45

Ĕ Unmyelinated C fibers (0.4 - 1.2 m in diameter) which conduct at low rates of 0.5 - 2 m/s.
• Thermoreceptors also span these two fiber types. Cold receptors are on dendrite ending of A delta fibers and C fibers, whereas
warmth (heat) receptors are on C fibers.

72. Antibodies are formed from which white blood cell?

a. Neutrophil b. Basophil
c. B-lymphocyte d. Monocyte

Ans. c. B-lymphocyte

Rationale:
• There are two types of lymphocyte – T-lymphocyte (T-cell) and B-lymphocyte (B-cell). The type of lymphocyte is determined by
the location of cell maturation. All lymphocytes are formed from stem cells in either the thymus gland or lymphoid tissue.
• B-lymphocytes complete their development in the spleen or lymph nodes.
• Lymphocytes that mature in the thymus are referred to as T-lymphocytes (or T-cells). Within a few months of birth, the T-cells are
fully mature and leave the thymus to circulate in the blood and body fluids.

73. The blood filtering capacity of the renal corpuscles is enhanced by:
a. The thin porous endothelial-capsular membrane
b. A large capillary surface area
c. High capillary pressure
d. All of the above

Ans. d. All of the above

Rationale:
• Glomerular capillaries are the most permeable in the body, being about 50 times more porous than other types of capillary. The
presence of relatively large pores in the glomerular capillaries prevents the filtration of blood cells but allows all components of
plasma through.
• Large proteins are prevented from filtering into the glomerular fluid by the basement membrane.
• Within the glomerulus, the capillary network is extensive, providing a large surface area for filtration. This is complemented by the
relatively high glomerular capillary blood pressure.

74. Occlusion of the LAD will lead to infarction of which area:

a. Posterior part of the interventicular septum
b. Anterior wall of the left ventricle
c. Lateral part of the heart
d. Inferior surface of right ventricle

Ans. b. Anterior wall of the left ventricle

Rationale:
LAD (Left anterior descending) artery is also known as anterior interventricular artery and runs in the same named groove, supplying
anterior 2/3 of interventricular septum lying deep to it and also the adjacent anterior wall of the left ventricle.

75. All of the following are true about cavernous sinus thrombosis, except:
a. Spreads through ethmoidal sinus
b. Loss of sensation around orbit
c. Loss of jaw jerk
d. Infection spreads to cavernous sinus from danger area of face via superior ophthalmic vein muscles of mastication and
temporomandibular joint

Ans. c. Loss of jaw jerk

Rationale:
Routes of spread:
• From the infection of sphenoid sinus, ethmoid sinus and frontal sinus
• Through facial vein draining danger area of face via superior ophthalmic vein and angular vein
• Clinical features of cavernous sinus thrombosis:
46 National NORCET Test-2

Ĕ Headache
Ĕ Involvement of 3, 4, 5, 6 cranial nerve
Ĕ Papilledema – increase of intra cranial tension
Ĕ Loss of vision – involvement of optic nerve
Ĕ Proptosis – protrusion of eyeball
Ĕ Ophthalmoplegia – paralysis of eyeball muscles
Ĕ Chemosis – swelling of conjunctiva

Microbiology:

76. HEPA filter is used to disinfect:

a. Water b. Air
c. Culture d. Blood

Ans. b. Air
Rationale:
• HEPA is High efficiency particulate air filter
• Used in operation theatres and laboratories
• It removes >95% particles with a diameter of more than 0.3um

77. Blood spill in operation theatre is cleaned with:

a. Chlorine compound
b. Phenolic compound
c. Quartnery ammounium compounds
d. Alcoholic compounds

Ans. a. Chlorine compound

Rationale:
• Chlorine is mainly used for disinfection of water – swimming pools, tanks
• Its compound sodium hypochlorite is the best disinfectant for surface blood spills Concentration used is 0.5 to 5% depend upon
the contamination
• Immediately seeing a blood spill, cover the area with tissue paper and pour 1% sodium hypochlorite over it for 15-30 minutes and
then discard with universal precautions

78. Blood culture is positive in which infection of Staphlococcus aureus-

a. TSS b. SSSS
c. Infective endocarditis d. Impetigo

Ans. c. Infective endocarditis

Rationale:
TSS and SSSS are toxin mediated diseases and impetigo is localized infection of skin and subcutaneous tissue. So the infecting organism
is not cultivable from blood.
Infective endocarditis due to Staphylococcus aureus is an endovascular infection and so is blood culture positive.

79. The “string of pearl” colonies on nutrient agar is produced by-

a. Klebsiella b. Proteus
c. Bacillus d. Salmonella

Ans. c. Bacillus

Rationale:
• When Bacillus anthracis is grown on solid medium containing 0.05 – 0.5 U of penicillin/mL, the cells become large and spherical
and occur in chains on the surface of the agar, resembling a string of pearls.
• This string of pearls reaction clearly differentiates B.anthracis from B.cereus and other aerobic spore bearers.
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48 National NORCET Test-2

80. A 6-month-old infant presents with painless verrucous growths on the laryngeal folds. What is the most likely causal
agent?
a. Cytomegalovirus b. Human papilloma virus
c. B19 virus d. Herpes simplex virus

Ans. b. Human papilloma virus

• Perinatal infection with human papilloma virus can cause infantile laryngeal warts

Human Papilloma Virus (HPV)

• Distinguishing Characteristics:
Ĕ Over 100 serotypes
Ĕ Different serotypes are associated with different clinical presentations
• Reservoir: human skin and genitals
• Transmission: direct contact, fomites
• Pathogenesis
Ĕ Virus infects basal layer of the skin and mucous membranes
Ĕ Hyperkeratosis leads to the formation of the “wart”
Ĕ Malignancy may result: E6 and E7 inhibit tumor-suppressor genes p53 and Rb, respectively.
• Diseases:
Ĕ Cutaneous warts
ƒ Common warts (serotypes 2 and 4) are predominantly found on hands and fingers
ƒ Plantar warts (serotype 1) are predominantly found on soles of feet; tend to be deeper and more painful
Ĕ Anogenital warts (Condylomata acuminata)
ƒ Over 90% are serotypes 6 and 11 (benign)
ƒ Also cause laryngeal papillomas in infants and sexually active adults
ƒ Serotypes 16 and 18 are preneoplastic (cervical intraepithelial neoplasia or CIN), 31, 33, 35, 45, 52, 58 (16 and 18 >70%
of cases)

81. Trismus and Ophisthotonus are caused by

a. Clostridium botulinum b. Clostridium tetani
c. Clostridium perfringens d. Clostridium sporogenes

Ans. b. Clostridium tetani

Toxin of tetani causes presynaptic block of glycine and GABA leads to loss of spinal inhibition
Clinically patient present as Trismus – lock jaw, muscle pain, laryngeal obstruction and in severe form it leads to ophisthotonus position

82. At a birthday party, oysters, hamburger and potato salad were served. After 24 hours, 50 people had diarrhea. Which
is the most likely organism causing this type of clinical presentation?
a. Salmonella enteritidis b. Vibrio parahemolyticus
c. Yersinia enterocolitica d. Staphylococcus aureus

Ans. b. Vibrio parahemolyticus

Rationale:
Whenever a case of food poisoning is given: two findings are important: (1) Food type (2) Incubation period; Here sea food clearly gives
a clue that halophilic vibrios (saltloving) – Vibrio parahemolyticus is the answer;
Vibrio parahaemolyticus is a halophilic bacterium that causes acute gastroenteritis after ingestion of contaminated seafood such as raw
fish or shellfish.
After an incubation period of 12–24 hours, nausea and vomiting, abdominal cramps, fever, and watery to bloody diarrhea occur

83. Test done for Mycobacterium tuberculosis by whole blood is:

a. IGRA b. BACTEC
c. Culture d. GenXpert

Ans. a. IGRA
 National NORCET Test-2 49

Rationale:
• Interferon-Gamma Release Assays (IGRAs) are whole blood tests that can aid in diagnosing Mycobacterium tuberculosis infection.
• They do not help differentiate latent tuberculosis infection from tuberculosis disease.
• Two IGRAs that have been approved by FDA are
Ĕ QuantiFERON®-TB Gold In-Tube test (QFT-GIT);
Ĕ T-SPOT®.TB test (T-Spot)

84. Acid fastness of tubercle bacilli is attributed to:

a. Presence of mycolic acid b. Integrity of cell wall
c. Both of the above d. None of the above

Ans. a. Presence of mycolic acid

Rationale:
M. tuberculosis resists decolorization with 20% sulphuric acid when stained with carbolfuchsin by Ziehl-Neelsen method or by
fluorescent dyes like auramine O or rhodamine.
Acid fastness has been ascribed to the presence of an unsaponifiable lipid-rich (mycolic acid) wax material in the cell wall or to a
semipermeable membrane around the cell.

85. A 52-year-old man has undergone lung transplantation. Two months after transplantation, he developed pulmonary
symptoms and diagnosed as having bilateral diffuse interstitial pulmonary pneumonitis and bronchiolitis.
Which of the following etiological agent is responsible in this condition?
a. Cytomegalovirus b. Herpes Simplex virus
c. Epstein Barr virus d. Varicella zoster virus

Ans. a. Cytomegalovirus
Rationale:
• Cytomegalovirus, a type of herpes group of virus is the most common cause of congenital infections.
• It has the largest genetic content among the herpes group of viruses
• It has a cell surface glycoprotein, which acts as an Fc receptor that can bind non specifically with the Fc portion of the immunoglobulin
• CMV infection forms a characteristic cytopathic effect – perinuclear cytoplasmic inclusions in addition to intranuclear inclusions
• Normal hosts – infectious mononucleosis like illness immunosuppressed, post transplantation patients – pneumonia, bronchiolitis,
hepatitis, colitis, disseminated infection
• Congenital infection: IUGR, hepatomegaly, splenomegaly, chorioretinitis, thrombocytopenia, microcephaly, calcifications.
• Diagnosis: CMV: Owl eye shaped inclusion bodies; serological tests, molecular diagnosis
• Treatment: Ganciclovir

BIOCHEMISTRY & NUTRITION

86. Preferred fuel for body in fasting state?

a. Carbohydrates b. Fats
c. Proteins d. Amino acids

Ans. b. Fats
Rationale:
• In fasting state, preferred fuel is Fats and Adipose tissues are broken down to give energy.
• Preferred fuel for body in fed state is carbohydrates, i.e. Glucose.

87. Which of the following has highest glycemic index?

a. Glucose b. Fructose
c. Sucrose d. Sorbitol

Ans. a. Glucose
50 National NORCET Test-2

Rationale:
• Glycemic Index (GI)- This is the increase in blood glucose after the test dose of a carbohydrate compared with that of an equivalent
amount of glucose.
• GI is a value assigned to foods based on how slowly or how quickly those foods cause an increase in blood glucose levels.
• The highest glycemic index is for glucose and galactose (also lactose, maltose, trehalose and isomaltose get converted to glucose,
so they also have high GI).
• GI of fructose is less than that of glucose.
• Fructose and sugar alcohols have less glycemic index because they are not absorbed completely.
• Sucrose also has low glycemic index than glucose as it gets split to glucose and fructose

88. Heparin is a:
a. Glycosaminoglycan b. Carbohydrate
c. Proteoglycan d. None of the above

Ans. a. Glycosaminoglycan (GAG)

Rationale:
Heparin, an anticoagulant is a Glycosaminoglycan (GAG). This is sulfated, negatively charged GAG, released from mast cells and liver
cells.

89. Which of the following does not depend on insulin for Glucose uptake?
a. Brain b. Cardiac muscles
c. Skeletal muscles d. Adipose tissue

Ans. a. Brain

Rationale:
Glucose uptake occurs in muscles (Cardiac and Skeletal) and Adipose tissue via GLUT-4, which is
Insulin dependent. In Brain, GLUT-1 and GLUT-3 are present which are not dependent on Insulin.

90. Which of the following foods should the patient eat to obtain the best supply of vitamin B12?
a. Diary products b. Vegetables
c. Grains d. Broccoli

Ans. a. Diary products

Vitamin B12 (cobalamin)

FUNCTION
• Cofactor for methionine synthase (transfers CH3 groups as methylcobalamin) and methylmalonyl-CoA mutase.
• Important for DNA synthesis.
• Found in animal products.
• Synthesized only by microorganisms. Very large reserve pool (several years) stored primarily in the liver.
DEFICIENCY
• Macrocytic, megaloblastic anemia; hyper segmented PMNs; paresthesias and subacute combined degeneration (degeneration of
dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts) due to abnormal myelin. Associated with increases serum
homocysteine and methylmalonic acid levels, along with 2° folate deficiency.
• Prolonged deficiency → irreversible nerve damage
• Deficiency caused by malabsorption (eg, sprue, enteritis, Diphyllobothrium latum), lack of intrinsic factor (pernicious anemia,
gastric bypass surgery), absence of terminal ileum (surgical resection, e.g., for Crohn disease), or insufficient intake (eg, veganism).
• Anti-intrinsic factor antibodies diagnostic for pernicious anemia.

91. A patient has a stage 4 pressure ulcer on their sacral area. What type of foods would the patient most benefit from?
a. Dried beans, eggs, meats b. Liver, spinach, corn
c. Oats, fruits, and juices d. None of the above

Ans. a. Dried beans, eggs, meats

 National NORCET Test-2 51

Rationale:
• A patient with a stage 4 pressure ulcer needs a high protein diet to promote wound healing. Dried beans, eggs, and meats are the
highest protein foods of the selection.

92. A patient had a stroke and has garbled speech. What type of diet do you expect the patient to be prescribed after a
speech evaluation?
a. Soft diet
b. Full liquid diet
c. Mechanically altered diet with thin liquids
d. Mechanically altered diet with nectar thick liquids

Ans. d. Mechanically altered diet with nectar thick liquids

Rationale:
• When a patient has a stroke they are at risk for aspiration due to the decrease ability to swallow. Many times a stroke with affect
speech as well the patient‘s ability to utilize the swallowing muscles.
• Generally, when garbled speech is noted in a stroke victim this is a sign there is a problem with the patient’s ability to use their
swallowing muscles.
• A mechanically altered diet with nectar thick liquid will usually be prescribed. However, a speech evaluation will determine what
is needed.

93. Two in one salt is common salt fortified with:

a. Iron and iodine b. Zinc and iodine
c. Vitamin A and iodine d. Vitamin B12 and calcium

Ans. a. Iron and iodine

Rationale:
• “Two-in-one” salt developed by NIN Hyderabad is common salt fortified with iron and iodine.
• It contains 40 mcg iodine and 1 mg Iron per gram of salt.
Also Know…..
• Iodization of salt is the most widely used prophylactic public health measure against endemic goiter.
• In India under the Prevention of Food Adulteration (PEA) Act the level of iodization is fixed at:
Ĕ Not less than 30 ppm at the production point
Ĕ Not less than 15 ppm of iodine at the consumer level.

94. The technique used for most routine protein and nucleic acid separation is:
a. Evaporation b. Chromatography
c. Electrophoresis d. Filtration

Ans. c. Electrophoresis

Rationale:
• Option c is correct response as separation of proteins and nucleic acid depends on the fact that charged molecules migrate through
matrix called polyacrylamide.
• Option b is incorrect response as in chromatography separation of a mixture occur.
• Options a and d are also incorrect as in evaporation liquid evaporates from a solution and in filtration separates solid particles.

95. Alpha-Keratin is a protein present in:

a. Wool b. Eggs
c. Blood d. Skin

Ans. d. Skin

RATIONALE: -
• Alpha-keratin, or α-keratin, is a type of keratin found in vertebrates. This protein is the primary component in hairs, nails and the
epidermis layer of the skin.
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 National NORCET Test-2 53

• Eggs contain Ovalbumin protein.

• Blood contains albumin and globulin protein.
• Wool contains hard α-keratins.

PHARMACOLOGY

96. Hepatic First pass metabolism will be encountered by which of the following routes of drug administration?
a. Oral b. Intravenous
c. Sublingual d. Subcutaneous

Ans. a. Oral
Rationale:
• Hepatic first pass metabolism is encountered by oral and rectal routes of administration. The reason being by these routes drug is
absorbed into enteric circulation and then it goes via portal vein into liver, which is responsible for first pass metabolism.
• Though by rectal route only 50% drug flows through portal vein and hence only 50% of drug undergoes first pass metabolism. Rest
50% is directly absorbed into inferior vena cava.

97. Efficacy of a drug means:

a. Maximum absorption of a drug
b. Maximum metabolism of a drug
c. Maximum response that can be elicited by the drug
d. Maximum binding to its receptor

Ans. c. Maximum response that can be elicited by the drug

Rationale:
• The tendency of the drug to activate the receptor and produce maximal effect is known as efficacy.
• Affinity of the drug to bind the receptor is called potency. In other words potency is the minimal dose required to produce a
particular effect.

98. Which of the following drug interact with Warfarin:

a. ACE inhibitor b. Fluconazole
c. Aspirin d. both b and c

Ans. d. both b and c

• Fluconazole is an enzyme inhibitor and hence can increase effect of warfarin.
• Aspiring being an antiaggregant can cause excessive bleeding if given with anticoagulants like warfarin

99. Heparin and protamine sulfate is an example of:

a. Physical antagonism b. Chemical antagonism
c. Competitive antagonism d. Noncompetitive antagonism

Ans. b. Chemical antagonism

Rationale:
Chemical Antagonism:
One drug prevents another drug’s action by chemically combining with it in a solution. Examples are given below.
• Binding of dimercaprol to heavy metals.
• Binding of protamine sulfate to heparin
• Binding of monoclonal antibodies to protein targets.

100. A known case of TB is now resistant to Rifampicin and Isoniazid. Which of the following would be most appropriate
in treating this patient?
a. 6 drugs for 4 months; 4 drugs for 12 months b. 6 drugs for 6 months; 4 drugs for 18 months
c. 4 drugs for 4 months; 6 drugs for 12 months d. 5 drugs 2 months; 4 drugs 1 month; 3 drug 5 months

Ans. b. 6 drugs for 6 months; 4 drugs for 18 months

54 National NORCET Test-2

Rationale:
• Resistance to rifampicin and isoniazid is termed as multiple drug resistance TB (MDR TB).
• In such case 6 drugs are used for 6–9 months in intensive phase followed by 4 drugs for 18 months in continuous phase.
• Hence, option 2 is the answer.
Type of TB Number of drugs used
Non-drug resistant – New 4 drugs for 2 months + 3
Case drugs for 4 months
Non-drug resistant – 5 drugs for 2 months +
Previously treated 4 drugs for 1 month + 3
drugs for 5 months
Rifampicin resistance + 7 drugs for 6–9 months + 5
Isoniazid sensitive drugs for 18 months
MDR TB 6 drugs for 6–9 months + 4
drugs for 18 months
XDR TB 7 drugs for 6–12 months +
6 drugs for 18 months
• Other options are distractors.

101. Which among the following is an orally acting anti-thrombin drug?

a. Hirudin b. Lepirudin
c. Bevalirudin d. Dabigatran

Ans. d. Dabigatran

Rationale:
• Dabigatran is an oral direct thrombin inhibitor (DTI).
• Used for treatment of acute venous thromboembolism also, in lower limb surgeries.
Parenteral DTI Oral DTI

• Hirudin
• Lepirudin
• Bivalirudin • Dabigatran
• Argatroban • Ximelagatran

102. Discoloration of teeth is caused by antibiotics called:

a. Streptomycin b. Neomycin
c. Tetracycline d. Penicillin

Ans. c. Tetracycline

Rationale:
• Antibiotics such as tetracycline and doxycycline are well known for effects of teeth discoloration which is mainly common among
children with developing teeth. Apart from above said antibiotics, mouth washing using chlorhexidine and cetylpyridinium
chloride are also causative agents of teeth discoloration.
• Neomycin and penicillin are also antibiotics with multiple side effects, but no teeth discoloration so far has been reported.

103. It is recommended to administer diuretics early in the morning because:

a. Prevent drug-food interaction b. Prevent nausea and vomiting
c. To avoid nocturia d. To promote absorption

Ans. c. To avoid nocturia

Rationale:
Nocturia is a condition in which the patient need to get up many times during the night to urinate
Diuretics increases the urine excretion. If the drug is administered in the evening/night, it may result in nocturia
So it is advised to administer diuretics early in the morning.
 National NORCET Test-2 55

104. Which of the following drugs might have produced the effect in the picture?

a. Nicotinic acid b. Retinoic acid

c. Folic acid d. Pantothenic acid

Ans. b. Retinoic acid

Rationale:
Teratogenic effects of retinoic acid:
• Bilateral microtia
• Anotia with stenosis of external ear canal
• Flat, depressed nasal bridge and ocular hypertelorism
• Cleft lip and palate

105. Pigmentation of nail can be seen with all except:

a. Chloroquine b. Cyclophosphamide
c. Chlorpromazine d. Amiodarone

Ans. d. Amiodarone

Rationale:
Drugs causing pigmentation of nails:
• Melphalan
• Hydroxyurea
• Doxorubicin
• Busulfan
• 5-FU
• Methotrexate
• Cyclophosphamide
• Bleomycin
• Tetracyclines
• Antimalarials
• Sulfonamides
• Phenothiazines
• Mercury
• Gold
• Phenytoin
• Timolol

106. The most convenient, common and safe route of administration for most of the drugs is:
a. Topical administration b. Intramuscular and subcutaneous
c. Oral d. All of the above

Ans. c. Oral
56 National NORCET Test-2

Rationale:
• Oral administration is the most convenient, economical and common route of administration; it is generally safe for most drugs.
• Topical administration is used widely when a local effect is desired or to minimize systemic effects, especially in dermatology and
ophthalmology. Note that drugs administered topically may sometimes produce systemic effects.
• Intramuscular and Subcutaneous route cause irritation and pain.

107. The teratogenic effect given in the picture is associated with:

a. Lenalidomide b. Warfarin
c. Cyclosporine d. Thalidomide

Ans. d. Thalidomide
Rationale:
• Teratogens are any substances that may result into physical or functional defects in the fetus when the pregnant woman is exposed
to the substance. Alcohol and cocaine are examples of such substances.
• The teratogenic defect given in the picture is limb bud defects, i.e. Phocomelia.
• It has been classically associated with thalidomide.

108. Which of the following barbiturate is useful in the procedure given in the picture?

a. Phenobarbital b. Secobarbital
c. Thiopental d. Methohexital

Ans. d. Methohexital
Rationale:
• The procedure given in the picture is ECT (Electro convulsive therapy)
• Methohexital is a barbiturate anesthetic agent that paradoxically causes seizure.
• Hence it is the anesthetic agent of choice in ECT.
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58 National NORCET Test-2

109. A child accidentally consumed a fruit shown in the picture? Which of the following drug is used for management?

a. Atropine b. Neostigmine
c. Pyridostigmine d. Physostigmine

0Ans. d. Physostigmine
Rationale:
• The plant in the picture is Datura Stramonium, which contains atropine.
• The child thus has anticholinergic toxicity, for which physostigmine is the drug of choice.

110. Atropine is not given in which of the following case of poisoning:

a. Baygon b. Parathion
c. Endrin d. TIK 20

Ans. c. Endrin
Rationale:
• Endrin is an organochloride pesticide which causes neurotoxicity. There is no antidote available and hence only symptomatic
treatment is done.
• Parathion and TIK-20 are organophosphates, and Baygon is a combination of organophosphate and carbamate; for all of these,
atropine is the drug of choice for poisoning.

111. Drug used to differentiate between myasthenia gravis and cholinergic crisis is
a. Neostigmine b. Edrophonium
c. Methacholine d. Bethanechol

Ans. b. Edrophonium
Rationale:
• Edrophonium is the drug of choice for diagnosis of myasthenia gravis. As soon as it is given there is an improvement in muscle
weakness.
• Cholinergic crisis is due to excessive Ach in the synapse (ACHE inhibitor overdosing), which downregulates the postsynaptic NM
receptors and causes muscle weakness.
• If edrophonium is given in this case there will be further worsening of muscle weakness due to increase in Ach.

112. A child comes to you with ADHD. He has a family h/o drug addiction. Which is the DOC in this patient?
a. Methylphenidate b. Atomoxetine
c. Amphetamine d. Clonidine

Ans. b. Atomoxetine
Rationale:
• Stimulants like amphetamine and methylphenidate have potential for abuse and patients of ADHD are at increased risk of substance
abuse. Hence both should not be used in patients of ADHD with a family history of ADHD.
• Thus in these patients atomoxetine is preferred
 National NORCET Test-2 59

113. In a diabetic patient with autonomic neuropathy early morning hypotension and dizziness is seen; the drug of choice
is:
a. Dobutamine b. Isoproterenol
c. Clonidine d. Midodrine

Ans. d. Midodrine

Rationale:
• Hypotension in early morning period i.e. when patient gets up from bed indicates towards postural hypotension.
• Midodrine and alpha 1 agonist is the vasopressor of choice for treatment of postural hypotension.
• The drug preferred for long term management however is fludrocortisone and is the drug of choice for same.

114. A diabetic, obese patient on metformin presents with uncontrolled sugar level even after increasing dosage. He is
allergic to sulphonylureas, has pancreatitis and family history of bladder cancer. He does not want to take injections,
so what will you give next?
a. Sitagliptin b. Liraglutide
c. Pioglitazone d. Canagliflozin

Ans. d. Canagliflozin
Rationale:
• Sitagliptin causes pancreatitis and hence cannot be given to this patient.
• Liraglutide is a parenteral drug given by subcutaneous route but the patient does not want injectable drugs.
• Pioglitazone causes bladder cancer and as patient has family history of bladder cancer it cannot be given as well.
• Hence, canagliflozin will be given to the patient.
• Canagliflozin
Ĕ It is a SGLT-2 inhibitor and used in the treatment of type II diabetes associated with an upregulation of SGLT-2.
Ĕ Used for treatment of type II diabetes mellitus only along with other oral hypoglycemic agents or insulin at once a day dosing
(long-acting).
Ĕ Used with metformin in fixed dose combinations.
Ĕ Not used in type I diabetes mellitus due to increased risk of diabetic ketoacidosis.
Ĕ Side-effects: Leg amputation (commonly associated), urinary tract infection and vaginal infections.

115. The given X-ray film is showing the presence of ICD which is considered as a first line treatment of the following,
except:

a. Congenital long QT syndrome b. Ventricular fibrillation

c. Ventricular tachycardia d. Atrial fibrillation

Ans. d. Atrial fibrillation

60 National NORCET Test-2

Rationale:
The patient has been implanted an ICD (Implanted cardiovert defibrillator) device, which is used for long-term management to prevent:
• Congenital long QT syndrome
• Ventricular tachycardia associated with MI
• Ventricular fibrillation

Figure: Treatment and prophylaxis of atrial fibrillation

116. True about fibrates is all except:

a. Drug of choice for type III hyperlipoproteinemia and hypertriglyceridemia
b. Activates PPAR to stimulate LPL
c. Absorbed good on empty stomach and absorption is delayed by fatty meals
d. Side effects are rash, urticarial, myalgia and impotence

Ans. c. Absorbed good on empty stomach and absorption is delayed by fatty meals
Rationale:
Fibrates are better absorbed with food and lesser on empty stomach.
They activate PPAR alpha and increase LPL synthesis.
Rash, urticarial, myalgia, impotence, alopecia, headache, anemia can be associated.

PATHOLOGY & GENETICS

117. Most common cause of nephritic syndrome in adults is:

a. Rapidly progressive glomerulonephritis
b. Focal segmental glomerulosclerosis
c. Membranous glomerulonephritis
d. Minimal change disease

Ans. a. Rapidly progressive glomerulonephritis

Rationale:
• Nephritic syndrome is characterized by glomerular capillary damage leading to hematuria, pyuria, water retention and subsequent
hypertension and edema
• It can be caused by a variety of conditions including autoimmune, hereditary and infectious diseases.
• Nephritic diseases can manifest with varying degrees of severity, ranging from asymptomatic hematuria to systemic involvement,
as in rapidly progressive glomerulonephritis.
• The urine sediment is typically characterized by red blood cell casts, mild to moderate proteinuria (< 3.5 g/day) and sterile pyuria.
• Diagnosis of the underlying disease is often based on presentation and laboratory values, although renal biopsy may be indicated
for confirmation.
• Except option “a”; all other options “b”, “c” and “d”” are associated with nephrotic syndrome.
 National NORCET Test-2 61

Point to Remember:
• IgA nephropathy is a frequent cause of recurrent gross or microscopic hematuria and is probably the most common type of
primary glomerulonephritis worldwide.
• MC primary cause of nephritic syndrome in children: post streptococcal glomerulonephritis
• MC primary cause of nephrotic syndrome in children: minimal change disease
• MC primary cause of nephrotic syndrome in adults: focal segmental glomerulosclerosis
• MC overall/ secondary cause of nephrotic syndrome in adults: diabetes mellitus

118. The process of division of a somatic cell’s nucleus into two daughter nuclei is:
a. Prophase b. Cytokinesis
c. Mitosis d. Meiosis

Ans. c. Mitosis
Rationale:
• Mitosis involves somatic cells. Meiosis refers to the production of the sex cells.
• Meiosis is a process where a single cell divides twice to produce four cells containing half the original amount of genetic information.
These cells are our sex cells – sperm in males, eggs in females.
• During meiosis one cell divides twice to form four daughter cells.
• These four daughter cells only have half the number of chromosomes of the parent cell – they are haploid.
• Meiosis produces eggs in females and sperm in males.

119. Male to male transmission is seen in:

a. Autosomal dominant disease b. X-linked recessive
c. X-linked dominant d. Mitochondrial disease

Ans. a. Autosomal dominant disease

Rationale:
• Male to male transmission cannot occur in X-linked disease and mitochondrial disease.
• Mitochondrial Inheritance: Mother transmits disorder (maternal inheritance) to all her children but females may show signs of
disease
• X linked Dominant:
Ĕ Rare pattern of inheritance
Ĕ Affected male will transmit it to 100% of their daughters and none of their sons.
Ĕ Affected (diseased) female will transmit the disease 50% of their sons and daughters.
• X linked Recessive (XLR)
Ĕ Most common pattern of sex-linked disorders are X-linked recessive.
Ĕ Commonly males are affected; because mutant genes on the X-chromosome do not have a Y-chromosome counterpart
(affected males are hemizygous for the X-linked mutant gene).
Ĕ Female can be affected when there is random X inactivation in cells population.
• Autosomal dominant disease
Ĕ Most common pattern of Mendelian inheritance.
Ĕ They manifest disease in the heterozygous state, so at least one parent of index case is usually affected.
Ĕ Most commonly due to defects in structural genes.
Ĕ Many generations, both males and females are affected.

PEDIATRICS

120. A mother of a school going child is anxious about the recurrent respiratory infection of her child. The nurse tells
her that these infections will decrease as the child grows older. Which of the following statement by the nurse best
describes why children have fewer respiratory tract infections as they grow older?
a. The amount of lymphoid tissue decreases. b. Repeated exposure to organisms causes increased immunity.
c. Viral organisms are less prevalent in the population. d. Secondary infections rarely occur after viral illnesses.

Ans. b. Repeated exposure to organisms causes increased immunity.

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 National NORCET Test-2 63

Rationale:
The statement that best describes the decrease in the occurrence of infection with growing age is that repeated exposure to organisms
causes increased immunity. This occurs due to a unique feature of the immune system known as the “Immunological memory”. It is the
ability of the immune system to respond more quickly and effectively to pathogens that have been encountered previously, and redirects
the preexistence of a clonally expanded population of antigen-specific lymphocytes.
Other options are incorrect as the amount of lymphoid tissues does not decrease with age, neither the viral organisms are less prevalent
in the population nor the occurrence of secondary infections is rare.

121. A 4-year-old has been toilet-trained becomes incontinent when hospitalized for surgery. What is the most appropriate
nursing diagnosis based on this assessment finding?
a. Growth and development, altered r/t incontinence
b. Ineffective individual coping r/t hospitalization
c. Urinary elimination, altered r/t incontinence
d. oping, defensive r/t stress of hospitalization

Ans. d. Coping, defensive r/t stress of hospitalization

Rationale:
The child here in this case is hospitalized for surgery and because of stress related to hospitalization he is using regression as a coping
mechanism. According to Sigmund Freud, regression is an unconscious defense mechanism, which causes the temporary or long-term
reversion of the ego to an earlier stage of development (instead of handling unacceptable impulses in a more adult manner). Therefore,
the most appropriate nursing diagnosis for this child will be Coping, defensive r/t stress of hospitalization.
Option “a” is incorrect as in this case altered growth & development is not a concern
Option “b” is incorrect as here the child is trying to cope
Option “c” is incorrect as there is no physiological cause of altered urinary elimination

122. A pediatric health nurse observes a 10-month-old child who is using the pincer grasp. Which option below best
describes this milestone?
a. The infant is able to grasp large objects with the palm and forefingers.
b. The infant is able to grasp small objects with the index finger and thumb.
c. The infant is able to grasp small and large objects with the middle finger and thumb.
d. The infant is able to grasp large objects with the palm and thumb.

Ans. b. The infant is able to grasp small objects with the index finger and thumb.
Rationale:
The pincer grasp is the ability to hold/grasp objects between the thumb and index/first finger. This generally develops in infants around
9 to 10 months of age. The pincer grasp is considered as a crucial fine-motor milestone. This reflex helps in assessing the co-ordination
of brain and muscles. Immature pincer grasp can be achieved by 9 months while the mature pincer grasp is achieved by 12 months.

Reference: https://www.facebook.com/OTMatters/photos/the-pincer-grasp-typically-develops-at-9-12-months-of-age-by-using-the-
index-fin/1043965448980523/
Other options are distractors
64 National NORCET Test-2

123. Nurse Nisha was assessing a 2-month-old infant. Which finding below is a normal milestone that should be reached
by this infant at this age?
a. The infant can sit up with support.
b. The infant holds a rattle.
c. The infant smiles at its parent.
d. The infant is afraid of strangers.

Ans. c. The infant smiles at its parent.

Rationale:
The normal milestone for a 2-month-old infant is to smile at his/her parents. This is called social smile that the baby gives in response
to other individuals. A social smile signifies that the vision and social parts of his brain are developing. If the babies do not achieve this
maximum by three to four months, it could be related to a problem in vision or a problem in getting attached to parents or significant
others.
• The infant can sit up with support by 4–6 months of age
• The infant holds a rattle by 3.5 months of age
• The infant is afraid of strangers at 4-5 months of age and it becomes more extreme at 7-10 months of age.

124. The nurse cares for a 2-year-old boy whose mother is worried that he is not fully toilet trained yet. The mother is
worried because he is not yet able to hold his urine for more than a couple hours, but is proud that he can use the toilet
for bowel movements. How should the nurse reply to the mother?
a. “Bladder control is usually achieved after bowel control, so toilet training can take anywhere from 2 to 3 years to fully achieve.”
b. “You should tell your son ‘no’ every time he wets himself. That is the only way he will learn that his behavior is not acceptable.”
c. “Bladder control is usually achieved before bowel control, but he is on track to become fully potty trained.”
d. “Your child could be developmentally delayed and should have achieved full toilet training by now. Let me refer you to a pediatric
psychologist.”

Ans. a. “Bladder control is usually achieved after bowel control, so toilet training can take anywhere from 2 to 3 years to fully achieve.”

Rationale:
The nurse should reply to the mother that “Bladder control is usually achieved after bowel control, so toilet training can take anywhere
from 2 to 3 years to fully achieve.” She should further add that as the size of the urinary bladder is small in this age, it is difficult to hold
urine properly. It is considered normal if the child takes full 36 months to learn toilet training. If it is extended beyond 3 years of age,
that could be because of some underline psychological issue, but it does not necessitate a visit to a child psychologist.
Option “b” is incorrect as force or negative statements should not be used with child and also this is won’t be of help
Option “c” is incorrect as bowel control occurs before bladder control
Option “d” is incorrect as this does not indicate any developmental delay

125. Alex has been diagnosed with Hirschsprung’s disease and presents with fever and watery explosive diarrhea. Which
of the following would Nurse Trisha do first?
a. Administer an antidiarrheal.
b. Notify the physician immediately.
c. Monitor the child every 30 minutes.
d. Document the findings as normal

Ans. b. Notify the physician immediately.

Rationale:
The first action taken in this case by Nurse Trisha will be to notify the physician immediately as these symptoms indicate the occurrence
of enterocolitis which is a life-threatening situation and should be dealt promptly by the doctor. In this condition, the intestine gets
inflamed which is associated with the majority of morbidity and mortality in such patients.
Option “a” is incorrect as antidiarrheal are not used in Hirschsprung’s disease as there is intestinal obstruction and inadequate
propulsive intestinal movement.
Option “c” is incorrect as the child is facing a life threatening condition, therefore immediate action has to be taken and he should be
assessed more frequently.
Option “d” is incorrect as these are not normal finding.
 National NORCET Test-2 65

126. The nurse Alvia is caring for a child immediately after removal of the endotracheal tube. The nurse should report
which sign immediately if experienced by the client?
a. Stridor
b. Occasional pink-tinged sputum
c. Respiratory rate of 24 breaths/minute
d. A few basilar lung crackles on the right

Ans. a. Stridor
Rationale:
The sign that nurse Alvia should report immediately is “Stridor” as it is a sign of respiratory distress that could endanger the life of the
client and hence it should immediately be reported. Stridor is a high-pitched, coarse sound heard on auscultation over the trachea that
indicates airway edema and places the client at risk for airway obstruction.
Other options are incorrect as they are not life threatening and does not require immediate reporting.

127. The nurse Celina is preparing to administer medication using a child’s nasogastric tube. Which actions should the
nurse take before administering the medication?
a. Check the residual volume.
b. Aspirate the stomach contents.
c. Turn off the suction to the nasogastric tube.
d. All of the above

Ans. d. All of the above

Rationale:
All of the above actions must be considered by the nurse Celina before administering the medication through the nasogastric tube as the
prerequisites for administering medication includes:
• Checking the residual volume.
• Aspirating the stomach contents.
• Turning off the suction to the nasogastric tube.
• Testing the stomach contents for a pH indicating acidity
The nurse can aspirate the stomach contents and can check the residual volume along with the pH checked which has to be less than
3.5 that will help in identifying the gastric placement.
Moreover, the suction should be turned off before the tubing is disconnected to analyze the residual volume. Make sure to let the suction
remain off for 30 to 60 minutes after the medication has been administered in order to allow for proper absorption of medication.

128. The nurse in the clinical area is preparing to explain the concepts of Kohlberg’s theory of moral development with
a parent. The nurse should tell the parent that which factor motivates good and bad actions for the child at the pre-
conventional level?
a. Peer pressure b. Social pressure
c. Parents’ behavior d. Punishment and reward

Ans. d. Punishment and reward

Rationale:
According to the Kohlberg’s theory, punishment and reward are the motivating factors for the moral development. The child considers
actions as good or bad accordingly like if he does something good, he is praised and if not, he is punished. In other words, if the child
is obedient, he is not punished.
Other options are incorrect as they are not associated factors for this stage of moral development.

129. A 4-year-old child diagnosed with leukemia is hospitalized for chemotherapy. The child is fearful of the hospitalization.
Which nursing intervention should be implemented to alleviate the child’s fears?
a. Encourage the child’s parents to stay with the child.
b. Encourage play with other children of the same age.
c. Advise the family to visit only during the scheduled visiting hours.
d. Provide a private room, allowing the child to bring favorite toys from home.

Ans. a. Encourage the child’s parents to stay with the child.

66 National NORCET Test-2

Rationale:
The main concern at this time for the child is separation anxiety. Although, the child may be visiting the playpen and may handle
separation from parents but the hospital environment can increase the level of stress and interfere in the coping of the child related to
the separation from the parents. Hence, the nurse should arrange and encourage the child’s parents to stay with the child.
Option “b” is incorrect as the child of this age is more prone to separation anxiety.
Option “c” is incorrect as it may enhance the level of separation anxiety.
Option “d” is incorrect as this will make the child feel lonelier.

130. The nurse assesses the vital signs of a 12-month-old infant with a respiratory infection and notes that the respiratory
rate is 35 breaths/minute. On the basis of this finding, which action is most appropriate?
a. Administer oxygen. b. Document the findings.
c. Notify the health care provider. d. Reassess the respiratory rate in 15 minutes.

Ans. b. Document the findings.

Rationale:
The most appropriate action according to this age is to document the findings as the normal respiratory rate in a 12-month-old infant
is 20 to 40 breaths/minute.
Other options are incorrect as nothing has to be done in this case as the findings are normal.

131. The pediatric nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle
cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction?
a. Stress b. Trauma
c. Infection d. Fluid overload

Ans. d. Fluid overload

Rationale:
If the parents identifies fluid overload as a precipitating factor for sickle cell anemia, this would indicate the need for further instructions
as fluid overload is not a precipitating factor for sickle cell anemia rather dehydration is for which the child should be offered fluid intake
of 1½ to 2 times the daily requirement. The precipitating factors for sickle cell anemia are:
• Infection
• Dehydration
• Hypoxia
• Trauma
• Physical stress
• Emotional stress
Also, sickle cell disease is associated with diseases like Vaso-occlusive crisis, Splenic sequestration, Hyper hemolytic crisis, Aplastic crisis
etc.

132. The charge nurse on a pediatric ward is making assignments for the shift. One of the clients admitted to the ward is a
five-year-old with severe neutropenia and a fever. Which of the following clients would be most appropriate to assign
with this client?
a. 15-year-old with an uncomplicated appendectomy
b. Two-week-old with suspected meningitis
c. Three-year-old with cellulitis
d. Four-year-old admitted with respiratory distress

Ans. a. 15-year-old with an uncomplicated appendectomy

Rationale:
The client which is most appropriate to assign with this client will be a 15-year-old with an uncomplicated appendectomy as this patient
is less likely to have any infectious disease that can compromise the health of the five-year-old client.
Other options are incorrect as a child with suspected meningitis, cellulitis and respiratory distress will increase the risk of infection in
the patient with neutropenia (low number of neutrophils).
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68 National NORCET Test-2

133. A nurse analyzes the lab values of a child with leukemia who is receiving chemotherapy. The nurse notices that the
platelet count is 19,500 cell/mm3. Based on this lab value which intervention would the nurse document in her plan
of care.
a. Monitor closely for signs of infection.
b. Temperature every four hours.
c. Isolation precautions
d. Use a small toothbrush for mouth care

Ans. d. Use a small toothbrush for mouth care

Rationale:
The nurse should include the use of a small toothbrush for mouth care of child in the plan of care as if the platelet count in this child
is less than 20,000 than bleeding precautions need to be taken. Basically, in Leukemia, there is a malignant increase in the number
of leukocytes, usually at an immature stage, in the bone marrow. This primarily leads to risk of infection due to neutropenia, risk of
anemia due to decreased erythrocytes & risk for bleeding due to decreased platelet count. In this case as only platelet count is mentioned,
therefore, the most appropriate reply is option “d”.

134. A child with cancer has the following lab result: WBC 10,000, RBC 5, and platelets of 20,000. When planning this
child’s care, which risk should the nurse consider most significant?
a. Hemorrhage
b. Anemia
c. Infection
d. Pain

Ans. a. Hemorrhage

Rationale:
The correct answer is hemorrhage because when we review the normal lab values of WBCs, RBC, and platelets, we can clearly see that
all are within the normal range, except the platelet count. A normal platelet counts in adult ranges from 150,000 to 450,000 platelets per
microliter of blood. A platelet counts of less than 150,000 platelets per microliter is lower than normal. The platelets play an active role
in clotting, so if the platelet count is low, it will lead to excessive bleeding i.e: hemorrhage

135. A child in the pediatric ward is being taken care by Nurse Reena who is diagnosed with aplastic anemia. The nurse
monitors for changes in which of the following physiological functions?
a. Bleeding tendencies b. Intake and output
c. Peripheral sensation d. Bowel function

Ans. a. Bleeding tendencies

Rationale:
The correct answer is Bleeding tendencies because Aplastic anemia leads to decrease in the bone marrow production of RBCs, WBCs,
and Platelets. In the above case, the child is at risk for bruising and bleeding tendencies.
• Intake output will be impaired if the child suffers from any circulatory problem or renal disease
• Peripheral sensation is a concern in case of diseases of neurological origin
• Bowel functions are primary altered in gastrointestinal diseases

136. A teenage, Mohit was admitted with iron deficiency anemia and blood-streaked emesis. Which question is most
appropriate for the nurse Tiara to ask in determining the extent of the client’s activity intolerance?
a. “What activities were you able to do 6 months ago compared with present?”
b. “How long have you had this problem?”
c. “Have you been able to keep up with all your usual activities?”
d. “Are you more tired now than you used to be?”

Ans. a. “What activities were you able to do 6 months ago compared with present?”

Rationale:
The correct answer is option “a”. To check the level of activity intolerance, one must have the baseline values, therefore the nurse must
collect history related to the patient’s tolerance level 6 months ago so that a comparison can be made. Moreover, in clients with iron
 National NORCET Test-2 69

deficiency anemia individual endurance varies over a period of time as it is a gradual process. Therefore, knowledge about last 6 months’
activities will be the most crucial aspect.
Other options are incorrect as they just provide data related to the problem but not the extent of the problem.

137. As the nurse Rita takes a history of a 3 year-old with neuroblastoma, what comments by the parents require follow-up
and are consistent with the diagnosis?
a. “We notice muscle weakness and some unsteadiness.”
b. “Clothes are becoming tighter across her abdomen.”
c. “Her urine is dark yellow and small in amounts.”
d. “The child has been listless and has lost weight.”

Ans. b. “Clothes are becoming tighter across her abdomen.”

Rationale:
The correct answer is option “b” i.e: “Clothes are becoming tighter across her abdomen.” as it is a common sign of neuroblastoma that
can lead to the development of Wilms tumor. Therefore, it has to be followed up timely to prevent fatal complications.
Other options are incorrect as they are not the alarming signs that could lead to complications like Wilms tumor.

138. A child is admitted in the oncology department for the management of brain stem glioma. The child is receiving
vincristine sulfate (Oncovin). The nurse should monitor the child for which of the following adverse reactions?
a. Typhlitis b. Diarrhea
c. Appendicitis d. Constipation

Ans. d. Constipation

Rationale:
The correct answer is “d”: Constipation. The child is receiving Vincristine sulfate (Oncovin) which is an antineoplastic drug that inhibits
mitosis at metaphase. Neuropathies are common with this drug, especially that of the gut which results in constipation. This can also
lead to paralytic ileus if not treated timely.
• Appendicitis and typhlitis are infectious in nature and occurs in those with decreased WBC count.
• Diarrhea cannot occur as an adverse effect as there is neuropathy of gut causing decreased and not increased gut movements.

139. A child presents to the eye clinic with chief complaints of lazy eye, rapid involuntary movement, redness and blurred
vision. The ophthalmologist diagnosed it to be retinoblastoma. Apart from the above symptoms, which of the
following does the nurse assess as a major presenting clinical manifestation in the child with a retinoblastoma?
a. Aniridia b. Icteric sclera
c. Cat’s eye reflex d. Chronic conjunctivitis

Ans. c. Cat’s eye reflex

Rationale:
The correct answer is option “c”: Cat’s eye reflex. It is considered as the most common first sign of retinoblastoma. This can be seen as a
visible whiteness in the pupil, also referred to as “leukocoria” that is mainly noticeable in dim light or in photographs taken with a flash.

Figure: Cat’s eye reflex in retinoblastoma

• In hepatic dysfunction an icteric sclera is seen.
• In Chronic conjunctivitis is not related to retinoblastoma.
• Aniridia is associated with Wilms’ tumor.
70 National NORCET Test-2

140. A baby delivered in the labor room is being taken care by the on duty nurse. The nurse administers erythromycin
ointment to the newborn’s eyes, and the mother asks the nurse why this is done. the nurse should give which response
to the client?
a. Prevents cataracts in the neonate born to a woman who is susceptible to rubella
b. Protects the neonate’s eyes from possible infection acquired while hospitalized
c. Minimizes the spread of microorganisms to the neonate from invasive procedures during labor
d. Prevents ophthalmia neonatorum from occurring after delivery to a neonate born to a woman with an untreated gonococcal
infection

Ans. d. Prevents ophthalmia neonatorum from occurring after delivery to a neonate born to a woman with an untreated gonococcal infection

Rationale:
The correct answer is option “d”. The reason for administering erythromycin ointment is to prevent the occurance of ophthalmia
neonatorum that occurs in neonate born to a woman with an untreated gonococcal/chlamydial or viral infection within 30 days of
life. It is acute in nature and is manifested as mucopurulent discharge. The only available drug approved by the US Food and Drug
Administration for the prevention of gonococcal ophthalmia neonatorum is 0.5% erythromycin ophthalmic ointment.
• Erythromycin is not a drug of choice for the prevention of cataract, nosocomial infections or iatrogenic infections in neonates.

141. A 2-year-old boy is brought to the emergency department because of shortness of breath and left-sided abdominal
pain for 3 hours. He appears pale. Physical examination shows hypotension and tachycardia. There is splenomegaly
with the spleen tip palpated 8 cm below the left costal margin. Laboratory studies show: Hemoglobin – 5.1 g/dL
(N=12.1–14.9) Hematocrit – 16% (N=37%–44.4%) Leukocyte count – 4500/mm3 (N=4000–11,500) Platelet count
– 87,000/mm3 (N=150,000–400,000) A photomicrograph of a Wright-stained peripheral blood smear is shown as:
Which of the following is the most likely cause of this patient’s current condition?

a. Aplastic crisis b. Salmonella sepsis

c. Congestive heart failure d. Splenic sequestration

Ans. d. Splenic sequestration

Rationale:
The correct answer is “d. Splenic sequestration” as in the peripheral blood smear sickle cells can be seen. Splenic sequestration is a
serious complication of sickle cell anemia mostly affecting the young children. In this there is drop of hemoglobin level along with
splenomegaly. As spleen helps in filtering the blood, sickle cell anemia affects spleen and causes splenomegaly. Also, the clinical pictures
reveal the symptoms like shortness of breath and left-sided abdominal pain, hypotension and tachycardia those are suggestive of sickle
cell anemia.
These symptoms are not suggestive of Aplastic crisis, salmonella sepsis or congestive heart failure.

142. The nurse prepares to give a one-year-old child an intramuscular injection for an oncology disorders The BEST site
for this injection would be:
a. Deltoid muscle b. Dorsogluteal muscle
c. Vastus lateralis muscle d. Ventrogluteal muscle

Ans. c. Vastus lateralis muscle

 National NORCET Test-2 71

Rationale:
The correct answer is “c” as the best site for giving I/M injection is vastus lateralis muscle. The muscle lies along the lateral aspect of the
thigh and is known to tolerate larger volumes of medicine without causing injury to any nerve or blood vessels.
Other options are incorrect as these site our not safe and can cause skin irritation or injury to nerve or blood vessels.

143. A 2-year-old has just been diagnosed with cystic fibrosis (CF). The parents ask the nurse what early respiratory
symptoms they should expect to see in their child. Which is the nurse’s best response?
a. “You can expect your child to develop a barrel-shaped chest.”
b. “You can expect your child to develop a chronic productive cough.”
c. “You can expect your child to develop bronchiectasis.”
d. “You can expect your child to develop wheezing respirations.”

Ans. d. “You can expect your child to develop wheezing respirations.”

Rationale:
The correct answer is “d” as early respiratory symptoms the parents should expect to see is wheezing. In addition to this, a dry, non-
productive cough can be seen in the early phases of cystic fibrosis. Cystic fibrosis is a disorder that affects lungs, digestive tract and
other organs. Apart from this, other symptoms of Cystic fibrosis include coughing with thick mucus, bulky, greasy bowel movements,
constipation or diarrhea, trouble gaining weight or poor height growth and very salty sweat.
• Barrel-shaped chest, chronic productive cough and Bronchiectasis are late respiratory symptoms of cystic fibrosis

COMMUNITY HEALTH NURSING

144. The school nurse has provided an instructional session about impetigo to parents of the children attending the school.
Which statement, if made by a parent, indicates a need for further instruction?
a. “It is extremely contagious.”
b. “It is most common in humid weather.”
c. “Lesions most often are located on the arms and chest.”
d. “It might show up in an area of broken skin, such as an insect bite.”

Ans. c. “Lesions most often are located on the arms and chest.”
Rationale:
The correct answer is option “c” as the lesions in impetigo are not located on the arms and chest, rather they are located around the
mouth and nose, although, they may be present on the hands and extremities. Impetigo is a highly contagious bacterial infection of the
skin that is caused by β-hemolytic streptococci or staphylococci, or both usually seen in hot and humid summers.
All other options are true regarding impetigo and does not require a need for further instructions

145. The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin
continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse
bases this suspicion on which finding noted on assessment of the child’s skin?
a. Fine grayish red lines b. Purple-colored lesions
c. Thick, honey-colored crusts d. Clusters of fluid-filled vesicles

Ans. a. Fine grayish red lines

Rationale
The correct answer is option “a”: Fine grayish red lines. Scabies is a parasitic skin disorder which occurs due to the infestation of
Sarcoptes scabiei (itch mite) that characteristically appears as burrows or fine, grayish red, threadlike lines those are challenging to see
if they are masked by excoriation and inflammation.
• Purple-colored lesions are seen in different types of disorders, including systemic conditions but not scabies.
• Thick, honey-colored crusts are commonly seen in impetigo or secondary infection in eczema.
• Clusters of fluid-filled vesicles are common manifestations seen in herpesvirus infection.
 What Our opper’s (NORCET 2021)
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The REVISION NOTES strives to lift the haze of all contradiction in the mind and heart of all readers or nursing officer Strategically prepared, REVISION NOTES will help you
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NOTES are just not the notes only, it's a Ramvaan Aushadhi (Panacea). The Notes, you have to read throughout your important role in our preparation. These notes are to be
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 National NORCET Test-2 73

146. The parent of a 12-month-old child who has received the MMR, Varivax, and hepatitis A vaccine calls the clinic to
report redness and swelling at the vaccine injection sites and a temperature of 100.3° F. The nurse will perform which
action?
a. Recommend aspirin or an NSAID for pain and fever
b. Recommend acetaminophen and cold compresses
c. Report these adverse effects to the Vaccine Adverse Event Reporting System (VAERS)
d. Schedule an appointment in clinic so the provider can evaluate the child

Ans. b. Recommend acetaminophen and cold compresses

Rationale:
The correct answer is “b” as these manifestations are commonly seen as minor side effects of Hepatitis A vaccine that can easily be
managed through symptomatic treatment. Therefore, acetaminophen and cold compresses are the best treatment strategies in this case.
• Aspirin is contraindicated in children because of the risk of the development of Reye’s syndrome.
• Redness and swelling at injection site with fever are not serious adverse effects, they do not need to be reported to VAERS.
• Evaluation is not required in this case so there is no need to schedule a clinic visit.

147. A group of college students visited sub-Saharan Africa for an educational trip where most of the children became
sick and were diagnosed with Ascaris lumbricoides What is the common specimen source required to detect Ascaris
lumbricoides?
a. Urine sample b. Sputum
c. Feces d. Both b and c are correct

Ans. d. Both b and c are correct

Rationale:
The correct answer is option “d” i.e. both sputum and feces. The sputum analysis reveals larvae or Charcot-Leyden crystals and the
stool examination reveals characteristic eggs of Ascaris lumbricoides who inhabits in the small intestine of more frequently children
than adults. Ascariasis is caused by ingestion of the worm eggs through contaminated hands or fingers with dirt, or by eating vegetables
or fruits that have not peeled, washed, or cooked properly. They are commonly found in tropical and subtropical regions, including
Latin America and sub-Saharan Africa.
• Urine samples are not used to diagnose ascariasis.

148. A patient with suspected influenza is being kept in a separate room at home. Which nursing intervention is most
important for the home care nurse and other family members to follow when providing care to this patient at home?
a. Wearing PPE while providing care to the patient
b. Donning a facemask upon entering the room
c. Maintaining meticulous hand hygiene before and after patient care
d. All of the above

Ans. d. All of the above

Rationale:
The correct answer is “all of the above” as droplet infection precautions include all the strategies displayed in option a, b and c.
Droplet precautions are required to prevent the spread of a patient’s infection to family members, visitors, staff members, and other
patients through speaking, sneezing, or coughing. Diseases requiring droplet precautions include influenza (flu), pertussis (whooping
cough), mumps, and respiratory illnesses, such as those caused by coronavirus infections including COVID-19. In addition to this, it is
mandatory for everyone who goes into the room to wear a surgical mask

149. A young adult patient is in the clinic to receive a tetanus vaccine after sustaining a laceration injury. The nurse learns
that the patient, who works in a day care center, has not had any vaccines for more than 10 years. Which vaccine will
the nurse expect to administer?
a. DT b. DTaP
c. Td d. Tdap

Ans. d. Tdap
74 National NORCET Test-2

Rationale:
The nurse expects to administer Tdap as people who are working with children in any form should get acellular pertussis vaccine. Tdap
is advisable for adult patients.
• DTaP is given to children up to age 6.
• DT and Td does not contain pertussis.

150. While on a regular home visit, the community health nurse observes a patient who is diagnosed with Hepatitis A and
is incontinent of stool. What type of precautions the CHN advices in this case?
a. Contact b. Standard
c. Droplet d. Contact and Droplet

Ans. a. Contact

Rationale:
In this case the community health nurse will advise “Contact precaution”. Contact precautions are essential to protect against either
direct or indirect transmission. Contact precautions are indicated for patients with gastrointestinal (diarrheal) illness, and incontinent
persons including those who use incontinent products.
Other precautions are of no use in this case.

151. While giving health education to a group of students on droplet precautions, the student nurse emphasizes its
importance in the pandemic. Which among the following patients would be placed in droplet precautions?
a. A 36-year-old patient with Pertussis.
b. A 25-year-old patient with Scarlet Fever.
c. A 69-year-old patient with Streptococcal Pharyngitis.
d. All of the above

Ans. d. All of the above

Rationale:
The correct answer is “all of the above”. Diseases requiring droplet precautions include influenza (flu), pertussis (whooping cough),
mumps, and respiratory illnesses (Streptococcal pharyngitis), such as those caused by coronavirus infections including COVID-19.
Therefore, in all the above cases droplet precautions are required.

152. Which statement MOST accurately describes the pharmacodynamics of vaccines?

a. Vaccines work by stimulating the humoral immune system.
b. Vaccines provide IgG antibodies to protect against infection.
c. Vaccines prevent the formation of antibodies against a specific antigen.
d. Vaccines work by suppressing the amino acid immunoglobulin sequence.

Ans. a. Vaccines work by stimulating the humoral immune system.

Rationale:
The statement that most accurately describes the pharmacodynamics of vaccine is that “a. Vaccines work by stimulating the humoral
immune system”. Vaccine stimulates the production of antibodies in response to the specific antigen that provides active immunity.
Vaccine-mediated immunity is often multifactorial and the best protection is likely to be produced by the combination of strong
humoral and cell-mediated immune responses.
Other options are incorrect as they are not the mechanism by which vaccines work.

153. Some members of a group are displaying symptoms like fever with chills, sore throat and small blisters. Doctor has
advised Anthrax vaccine to the rest of the group. The anthrax vaccine is recommended for which groups of people?
a. Military personnel
b. Veterinarians
c. Workers who process imported animal hair
d. All of the above

Ans. d. All of the above

 National NORCET Test-2 75

Rationale:
The correct answer is “d” i.e. All of the above as people who are at risk for exposure to the anthrax bacterium include military
personnel, veterinarians, and workers who process imported animal hair.

154. The nurse is reviewing the Centers for Disease Control recommendations for vaccines. The pneumococcal vaccine
(Pneumovax 23) is recommend for which group?
a. Newborn infants
b. Patients who are immunosuppressed
c. Patients who are transplant candidates
d. Smokers between 19 and 64 years’ old

Ans. d. Smokers between 19 and 64 years’ old

Rationale:
According to Centers for Disease Control recommendations pneumococcal vaccine (Pneumovax 23) is recommend for Smokers
between 19 and 64 years old as they are at higher risk of infection. In general, CDC recommends pneumococcal vaccination for all
adults 65 years or older. PNEUMOVAX 23 vaccine is useful in preventing infections caused by certain types of germs or bacteria called
pneumococcus.
Other options are incorrect as CDC does not recommend this vaccine for them.

155. A 4-year-old child is receiving amoxicillin (Amoxil) to treat otitis media and is in the clinic for a well-child checkup
on the last day of antibiotic therapy. The provider orders varicella (Varivax); mumps, measles, and rubella (MMR);
inactivated polio (IPV); and diphtheria, tetanus, and acellular pertussis (DTaP) vaccines to be given. Which action
by the nurse is correct?
a. Administer the vaccines as ordered.
b. Discuss giving the MMR vaccine in 4 weeks.
c. Hold all vaccines until 2 weeks after antibiotic therapy
d. Recommend aspirin for fever and discomfort

Ans. a. Administer the vaccines as ordered.

Rationale:
The correct action by the nurse will be “Administering the vaccines as ordered” as there is no contraindications as such to administer
vaccine with ongoing antibiotic therapy. Vaccines may be administered during mild acute illness or during the convalescent phase of
an illness.
Option “b” and “c” are incorrect as all four vaccines may be administered. Moreover, If the MMR or other live virus vaccine is not
given the same day as the varicella vaccine, always prefer maintaining a gap of at least four weeks between the administration of the two
vaccines
Option “d” is incorrect as aspirin should not be given to children because of the increased risk of Reye’s syndrome.

156. A teenager has arrived at a clinic to receive a shot of tetanus toxoid. What teaching would the nurse provide
to a client receiving the tetanus toxoid?
a. “You will have lifetime immunity from this injection.”
b. “Soreness at the injection site is a common reaction.”
c. “This medication must be repeated weekly for 4 weeks.”
d. “Increase fluid and fiber in your diet to prevent constipation.”

Ans. d. “Soreness at the injection site is a common reaction.”

Rationale:
The correct answer is option “b” i.e: “soreness at injection site is a common reaction”. The nurse should teach the client that after
receiving tetanus toxoid it is normal to have minor side effects like soreness at injection site.
Option “a” is incorrect as tetanus toxoid provides immunity for 6 months only and not for lifetime.
Option “b” is incorrect as it is not repeated weekly for 4 weeks
Option “c” is incorrect as tetanus toxoid does not cause constipation
76 National NORCET Test-2

157. A patient is diagnosed with Hepatitis A. The patient asks how a person can become infected with this condition. You
know the most common route of transmission is?
a. Blood b. Percutaneous
c. Mucosal d. Fecal-oral

Ans. d. Fecal-oral

Rationale:
The common route of transmission of Hepatitis A infection is through fecal-oral route. Hepatitis A can be transmitted when a person
ingests the virus from food, drinks, or other objects contaminated with stool from an infected person.
• Hepatitis B and C are transmitted through infected blood
• Hepatitis B is transmitted through percutaneous exposure
• HBV and HCV infection transmits through mucosal-cutaneous exposure (eyes or mouth mucosa or skin)

158. Nurses in community health often use epidemiology because in the community it is often difficult to control the
environment. Which of the following statements demonstrates an epidemiologic strategy for monitoring disease
trends?
a. A nurse in community health conducts an education class for clients newly diagnosed with diabetes.
b. A nurse in community health investigates a breakout of whooping cough in a local middle school.
c. A nurse in community health organizes a health fair at the community health center.
d. A nurse in community health participates on a county school board that addresses student health issues.

Ans. b. A
 nurse in community health investigates a breakout of whooping cough in a local middle school.

Rationale:
The statement that demonstrates an epidemiologic strategy for monitoring disease trends is that given in option “b”: A nurse in
community health investigates a breakout of whooping cough in a local middle school because in this the nurse uses her knowledge of
epidemiology to find out the agent, host and environment responsible for causing pertussis.
Other options are incorrect as in these the community health nurse is more concerned about the implementation of the preventive
health strategies.

159. One of the basic concepts in epidemiology is the concept of risk. Risk refers to the:
a. the probability that a member of the population has a given condition at a point in time.
b. probability that an event will occur within a specified time period.
c. measure of the frequency of a health event in a defined population.
d. study of the occurrence and distribution of health-related states.

Ans. b. probability that an event will occur within a specified time period.

Rationale: Risk
refers to the probability that an event will occur within a specified time period.
• Prevalence is the probability that a member of the population has a given condition at a point in time.
• Rate is a measure of the frequency of a health event in a defined population, usually in a specified period of time.
• Epidemiology is the study of the occurrence and distribution of health-related states or events in specified populations, including
the study of the determinants influencing such states, and the application of this knowledge to control the health problems.

160. A nurse in community health who teaches a client with asthma to recognize and avoid exposure to asthma triggers
and assists the family in implementing specific protection strategies such as removing carpets and avoiding pets is
intervening at the level of:
a. Assessment. b. Primary prevention.
c. Secondary prevention. d. Tertiary prevention.

Ans. b. Primary prevention.

Rationale:
In this case the nurse is intervening at primary level of prevention as:
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78 National NORCET Test-2

Levels of Prevention and Modes of Intervention

Levels of prevention Modes of intervention Examples
Primordial Individual and mass • Discourage adoption of high-risk behavior in a specific population where it does not exist.
education E.g., smoking, drinking in societies where it is not prevalent yet.
Primary Health promotion • Health education
• Environment modification, e.g., provision of safe water, sanitary latrines, control of insects
and rodents
• Lifestyle and behavioral changes, e.g., exercise and medication
• Improvement in overall socio-economic status of the population
• Promotion of breastfeeding
• Promotion of small family norms
• Marriage counseling
Specific protection • Immunization
• Chemoprophylaxis
• Nutrition supplement, e.g., IFA, vitamin A, iodine
• Avoidance of allergens
• Protection against occupational hazards, accidents, carcinogen
• Control of air pollution, noise control, chlorination of water
• Use of helmets and seat belts to protect against head injuries
• Use of mosquito net
• Contraception
Secondary Early diagnosis • Screening (Pap smear, breast self- examination, mammography), active case search,
medical examination of school children, infants and young children, industrial workers
Treatment • DOTS
• MDT for leprosy
• Dental filling and tooth extraction
Tertiary Disability limitation • Resting affected limb in a neutral position to prevent stress on the paralyzed muscle
• Plaster cast to a patient with Colles fracture
• Provide rest, morphine, oxygen and streptokinase to a patient of acute myocardial
infarction (MI).
Rehabilitation • School for blind
• Reconstructive surgery
• Arranging for the schooling of child suffering from postpolio residual paralysis (PPRP)
• Provision of hearing aids, artificial limb and calipers
• Restoration of capacity to earn livelihood (Vocational)
• Restoration of family and social relations (Social)
• Restoration of personal dignity and confidence (Psychological)

161. You’re providing education to a patient with an active Hepatitis B infection. What will you include in their discharge
instructions?
a. “Take acetaminophen as needed for pain.”
b. “Follow a diet low in fat and high in carbs.”
c. “Do not share toothbrushes, razors, utensils, drinking cups, or any other type of personal hygiene product.”
d. Both “b” and “c”

Ans. d.Both “b” and “c”

Rationale:
The correct answer is “d” as it is generally recommendations for people with severe liver disease to eat large amounts of carbohydrate
foods and make it the major source of calories in this diet along with moderate intake of fat as they prove to be healing factors for liver.
Option “a” is incorrect as the patient should NOT take acetaminophen (Tylenol) due to its adverse effect on the liver.

162. A patient visits the community health center with the complaint of diarrhea and has bilateral edema of legs. The
community health nurse came to know from the dietary history of the patient that mustard oil is used for cooking in
his family. The nurse anticipates it to be:
a. Elephantiasis b. Epidemic dropsy
c. Cellulitis d. Nephrotic syndrome

Ans. b. Epidemic dropsy

 National NORCET Test-2 79

Rationale:
The nurse anticipates that this is epidemic dropsy as epidemic dropsy is caused by ingestion of mustard oil contaminated with Argemone
mexicana oil. The disease is characterized by bilateral swelling of legs often associated with erythema, diarrhea, dyspnoea, glaucoma.
The two major toxins that can cause this disease include Sanguinarine and dehydrosanguinarine (alkaloids of Argemone oil). These
toxins cause capillary dilatation, proliferation and increased capillary permeability.
Elephantiasis, also known as lymphatic filariasis is incorrect as in it is the infection that occurs because of a parasites classified as
nematodes (roundworms) of the family Filariodidea, transmitted through the bite of the mosquitos where there is unilateral edema of
leg and is not associated with ingestion of mustard oil.
Cellulitis is bacterial infection that causes erythema, edema and warmth but not edema
Nephrotic syndrome is a renal disease characterized by proteinuria swelling around the eyes and in the feet and ankles, foamy urine and
weight gain due to excess fluid retention. In the above scenario, there is diarrhea accompanied by edema, hence this is also incorrect.

163. A mother has reached a well-baby clinic for getting her child immunized against. Haemophilus influenzae. Which
vaccination was developed to prevent bacterial meningitis caused by Haemophilus influenzae?
a. Preener
b. Gardasil
c. Hepatitis B vaccine
d. Hib conjugate vaccine

Ans. d. Hib conjugate vaccine

Rationale:
Hib conjugate vaccine was developed to prevent bacterial meningitis caused by Haemophilus influenzae. It is a bacteria driven vaccine
that decreased the mortality rate of children from 3months to 5 years to a great extent. The Hib vaccine dose is 0.5 mL IM. A primary
childhood series is given in 3 doses at age 2, 4, and 6 months or in 2 doses at age 2 and 4 months, depending on the formulation. In either
case, a booster is recommended at age 12 to 15 months.
Other options are distractors

MENTAL HEALTH NURSING

164. Which of the following is correctly arranged related to memory?

a. Encoding—retrieval—storage
b. Encoding—storage—retrieval
c. Storage—encoding—retrieval
d. Retrieval—encoding—storage

Ans. b. Encoding—storage—retrieval

Rationale:
• Memory is a single term that reflects a number of different abilities: holding information briefly while working with it (working
memory), remembering episodes of one’s life (episodic memory), and our general knowledge of facts of the world (semantic
memory).
• Remembering episodes involves three processes: encoding information (learning it, by perceiving it and relating it to past
knowledge), storing it (maintaining it over time), and then retrieving it (accessing the information when needed).
• Failures can occur at any stage, leading to forgetting or to having false memories.

165. According to Wechsler intelligence scale scoring, average IQ of a normal child is:-
a. 50
b. 75
c. 90
d. 111

Ans. c. 90
80 National NORCET Test-2

Rationale:
• According to Wechsler intelligence scale scoring, the following is the classification:-
IQ Range IQ Classification
130 and above Very superior
120-129 Superior
110-119 High average
90-109 Average
80-89 Low average
70-79 Borderline
69 and below Extremely low

166. ADHD in childhood can lead to what in future?

1. Schizophrenia
2. Alcoholism
3. Intellectual change
4. Antisocial behaviour
a. If 1, 2, 3 are correct
b. If 1 and 3are correct
c. If 2 and 4 are correct
d. If all four (1, 2, 3, & 4) are correct

Ans. c. If 2 and 4 are correct

• Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders of childhood. It is usually
first diagnosed in childhood and often lasts into adulthood.
• Attention deficit hyperactivity disorder (ADHD) is a mental health disorder that can cause above-normal levels of hyperactive
and impulsive behaviors. People with ADHD may also have trouble focusing their attention on a single task or sitting still for long
periods of time. Both adults and children can have ADHD.
• Kindly note, the few books have also mentioned intellectual changes as an answer. This is not true. Though children with ADHD
tend to have lower educational achievements, however it is not because of any intellectual impairment but because of poor attention
and hyperactivity.

167. 15-year-old male is found to have mental age 9 years on IQ testing. He has: -
a. Mild Mental Retardation b. Moderate Mental Retardation
c. Severe Mental Retardation d. Profound Mental Retardation

Ans. a. Mild Mental Retardation

Rationale:
The formula for IQ is Mental age/Chronological age × 100. However, please remember that the maximum denominator can be 15.
• In this case 9/15× 100 = 60. Hence it will come under the category of mild mental retardation.

168. Which of the following is not a core symptoms of autistic spectrum disorders as per DSM-5:-
a. Persistent deficit in social communication and interaction
b. Restricted, repetitive pattern of behavior, interests and activities
c. Associated physical characteristics
d. Disturbances in Language Development and Usage

Ans. d. Disturbances in Language Development and Usage

• Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with
others, causing problems in social interaction and communication.
• The disorder also includes limited and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to
the wide range of symptoms and severity.
• DSM-5 Autism Diagnostic Criteria:-
Ĕ Persistent deficits in social communication and social interaction across multiple contexts.
Ĕ Restricted, repetitive patterns of behavior, interests, or activities
 National NORCET Test-2 81

Ĕ Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed
limited capacities or may be masked by learned strategies in later life).
Ĕ Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
Ĕ These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global
developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses
of autism spectrum disorder and intellectual disability, social communication should be below that expected for general
developmental level.

169. Identify the false statement:-

a. Separation anxiety is developed between 10 and 18 months of age
b. Stranger anxiety is developed by 8 months of age
c. Child starts moving autonomously, away from mother between the age of 10 and 18 months
d. Object consistency is developed by 18 months

Ans. d. Object consistency is developed by 18 months

• Separation anxiety is children’s common and normal fear of being away from their parents or carers. The behaviour you might see
when children are separated from parents is sometimes called separation protest. Separation anxiety can start at around 8 months
and reach its peak in babies aged 14-18 months.
• Stranger anxiety is a perfectly normal developmental stage that often begins around 6 to 8 months.
• Object constancy is the ability to maintain your positive feelings for someone while you are feeling hurt, angry, frustrated, or
disappointed with their behavior. Without object constancy, every fight becomes a potential breakup. This skill doesn’t develop
until a baby is about 8 months old.

170. In a child with IQ 50, All of the followings are true; except:-
a. Can look after himself independently
b. Can study up to 8th standard
c. Can follow simple verbal commands
d. Recognize family members

Ans. b. Can study up to 8th standard

• IQ of 50 corresponds to mild mental retardation. People with mild mental retardation, can have independent living, study till 6th
class.
• The level of functioning varies in different severity of mental retardation. The following table summarizes the same.
Category Class Mental age as adults Educational Life Work
achievements
Mild MR Educable 9-12 yrs Upto 6th class Independent living Unskilled or semi-skilled work
Moderate MR Trainable 6-8 yrs Upto 2nd class Needs some education Unskilled or semi-skilled work
Severe MR Dependent 3-6 yrs No formal education Needs attention Simple task-under supervision
Profound MR Needs life support < 3 yrs No formal education Needs continuous None
supervision

171. Pronoun reversal is classically seen in which childhood disorder:-

a. Autism spectrum disorder
b. Attention Deficit Hyperactivity Disorder
c. Specific Learning Disorder
d. Speech fluency disorder

Ans. a Autism spectrum disorder

• Personal pronoun reversal (PPR), characterized by inverse use of personal pronouns (typically first and second person) is a
hallmark of an autism spectrum disorder diagnosis.

172. Children experience nightmares with a peak frequency around the age of
a. 2or 3 years b. 5 or 6 years
c. 8 or 9 years d. > 12 years

Ans. b. 5 or 6 years
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 National NORCET Test-2 83

• Frequent nightmares in 1–2% of adults, higher prevalence in women.

• Peak prevalence in late adolescence or early adulthood.
• Children experience nightmares with a peak frequency around the age of 5 or 6 years.

173. Short term memory is also known as………………………….

a. Iconic Memory b. Echoic Memory
c. Working Memory d. Sensory Memory

Ans. c. Working Memory

• Short-term memory (STM) is the second stage of the multi-store memory model proposed by the Atkinson-Shiffrin. The duration
of STM seems to be between 15 and 30 seconds, and the capacity about 7 items. It is also known as “primary” or “active memory”.
• Long-term memory is usually divided into two types—explicit and implicit. Explicit memories, also known as declarative
memories, include all of the memories that are available in consciousness. Explicit memory can be further divided into episodic
memory (specific events) and semantic memory (knowledge about the world).

174. Problem solving comprises of four stages. Choose the correct sequence of stages
a. Incubation, preparation, verification, illumination b. Preparation, incubation, illumination, verification
c. Incubation, preparation, illumination, verification d. Preparation, illumination, incubation, verification

Ans. b. Preparation, incubation, illumination, verification

• The four stages of the creative process:
• Stage 1: Preparation- The creative process begins with preparation: gathering information and materials, identifying sources
of inspiration, and acquiring knowledge about the project or problem at hand. This is often an internal process (thinking deeply
to generate and engage with ideas) as well as an external one (going out into the world to gather the necessary data, resources,
materials, and expertise).
• Stage 2: Incubation- Next, the ideas and information gathered in stage 1 marinate in the mind. As ideas slowly simmer, the work
deepens and new connections are formed. During this period of germination, the artist takes their focus off the problem and allows
the mind to rest. While the conscious mind wanders, the unconscious engages in what Einstein called “combinatory play”: taking
diverse ideas and influences and finding new ways to bring them together.
• Stage 3: Illumination- Next comes the elusive aha moment. After a period of incubation, insights arise from the deeper layers of
the mind and break through to conscious awareness, often in a dramatic way. It’s the sudden Eureka! that comes when you’re in the
shower, taking a walk, or occupied with something completely unrelated. Seemingly out of nowhere, the solution presents itself.
• Stage 4: Verification-Following the aha moment, the words get written down, the vision is committed to paint or clay, the business
plan is developed. Whatever ideas and insights arose in stage 3 are fleshed out and developed. The artist uses critical thinking and
aesthetic judgment skills to hone and refine the work and then communicate its value to others.

175. A Psychologist employed in the school, at the instruction of school authorities, administered an IQ test to the school
children and displayed the scores on the notice board. This is an
a. Ethically incorrect practice since it violates confidentiality
b. Ethically incorrect practice since it violates informed consent
c. Ethically correct practice in view of the transparent policies of the school
d. Ethically correct practice provided the scores are not taken into consideration while giving grades

Ans. a. Ethically incorrect practice since it violates confidentiality

• An IQ test is an assessment that measures a range of cognitive abilities and provides a score that is intended to serve as a measure
of an individual’s intellectual abilities and potential. IQ tests are among the most commonly administered psychological tests.
• The result displayed on the notice board is ethically incorrect practice since it violates confidentiality.

NURSING RESEARCH

176. Identify which among the following is considered as building blocks of theories?
a. Concepts b. Research data
c. Hypotheses d. Numbers

Ans. a. Concepts
84 National NORCET Test-2

Rationale:
Option a: When concepts are linked together, they form propositions that provide the framework for a theory.
• Option b: Research data are used in constructing and testing a theory. Keep in mind that theories can also be started without data,
merely by logically linking concepts, perhaps based on a review of the literature.
• Option c: Hypotheses are tested in a research study. They may or may not have been formulated on the basis of a theory.
• Option d: Data in a quantitative study consist of numbers.

177. A statement of the expected relationship between two or more variables is known as:
a. Concept definition b. Hypothesis
c. Problem statement d. Research question

Ans. b. Hypothesis

Rationale:
• Hypothesis is a statement of the expected relationship between two or more variables. It is a testable prediction of the expected
outcome. The types of hypothesis include:
Ĕ Null hypothesis (i.e.: no relationship between the independent and dependent variable)
Ĕ Alternative hypothesis (i.e.: the relationship between two variables is significant)
• Other options are incorrect as none of them helps in describing the relationship between the variables.

ARITHMETIC

178. 15% of 45% of a number is 105.3. What is 24% of that number?

a. 374.4 b. 375
c. 385.5 d. 390

Ans. a. 374.4

Solution
Let the number b x. then, 15% of 45% of x = 105.3
 15 45 
⇒ × × x = 105.3
 100 100 
27 x
⇒ =105.3
400
 105.3 × 400 
=⇒x  =  1560
 27 
 24 
∴ 24% of 1560 = × 1560  =374.4
 100 

179. Sonal is 40 years old and Nitya is 60 years old. How many years ago was the ratio of their ages 3: 5?
a. 5 years b. 10 years
c. 20 years d. 37 years
e. None of these

Ans. b. 10 years

Solution
Let x years ago the ratio of their ages be 3: 5
40 – x 3
Then, = ⇒ 3 (60 – x) =
5 (40 – x)
60 – x 5
 National NORCET Test-2 85

⇒ 180 – 3x = 200 – 5x
⇒ 2x = 20
⇒ x = 10
∴ 10 years ago, their ages were in the ratio 3: 5

180. A sum of Rs 1600 gives a simple interest of Rs 252 in 2 years and 4 months. The rate of interest per annum is
a. 6 % b. 6¼%
c. 6½% d. 6¾%

Ans. d. 6¾%
Solution 1 7
= 2= years years
Time = 2 years 4 months 3 3
S. I. = Rs 252, p = Rs 1600
 100 × 252 ×3  3
Rate =  % = 6 %
 1600 × 7  4

181. A can complete a journey in 10 hours. He travels first half of the journey at the rate of 21 km/hr and second half at the
rate of 24 km/hr. find the total journey in km.
a. 220 km b. 224 km
c. 230 km d. 360 km

Ans. b. 224 km
Solution
Let the total distance be x km. Then,
1 1
x x
2 + 2 =10 ⇒ x + x = 20
21 24 21 24
 168 × 20 
⇒ 15 x= 168 × 20 ⇒ x=  = 224 km
 15 

182. A 120 metre long train is running at a speed of 90 km/hr. It will cross a railway platform 230 m long in
4
4 seconds
a. 5
b. 7 seconds
1
9 seconds
c. 5
d. 14 seconds

Ans. d. 14 seconds
Solution
 5
Speed =  60 ×  m / sec = 25 m/sec
 18 
Total distance covered = (120 + 230) m = 350 m.
 350 
∴ Required time =   sec =
14sec
 25 
National NORCET Test 2
GK/Eng/Arth
86 National NORCET Test-2

ENGLISH

183. Which of the following is the antonym of the word “Arrogant”

a. Humble b. Cowardly
c. Egotistic d. Gentlemanly

Ans. a. Humble

Rationale
Humble: Having or showing a modest or low estimate of one’s importance.
Cowardly: Lacking courage.
Egoistic: Having exaggerated self importance.
Gentlemanly: Chivalrous, courteous.
From the meaning it is clear that option a is the correct answer.

184. Which of the following is synonym of the word “August”

a. Common b. Ridiculous
c. Dignified d. Petty

Ans. c. Dignified

Rationale
Common: occurring, found, or done often; prevalent.
Ridiculous: funny; hilarious.
Dignified: having or showing a composed or serious manner that is worthy of respect.
Petty: of little importance; trivial.
From the meaning it is clear that the option c is the correct answer.

185. Fill in the blank with the word given in the option Look, a new missile _____________________
a. is launched b. is launch
c. is being launch d. is being launched

Ans. d. is being launched

Rationale
Rule :
Subject + is/am/are + being + V3 + other agents.
Look, a new missile is being launched.

186. Which of the following is the correctly spelt word

a. Skillful b. Skillfull
c. Skilfull d. Skilpull

Ans. a. Skillful
Rationale
The correct spelling is Skillful

187. Give one word for “Habitually silent or talking little

a. Servile b. Unequivocal
c. Taciturn d. Synoptic

Ans. c. Taciturn
Rationale
Taciturn: a person who is reserved or uncommunicative in speech; saying little.
 National NORCET Test-2 87

GENERAL KNOWLEDGE

188. Who won Wimbledon 2022 Men’s Singles Final?

a. Novak Djokovic b. Rafael Nadal
c. Cameron Norrie d. Nick Kyrgios

Ans. a. Novak Djokovic

Rationale
Novak Djokovic won his 7th Wimbledon title and 21st Grand Slam on July 10, 2022

189. Who won Wimbledon 2022 Women’s Singles Final?

a. Ons Jabeur b. Simona Halep
c. Elena Rybakina d. Tatjana Maria

Ans. c. Elena Rybakina

Rationale
Elena Rybakina created history by becoming the first Asian woman to win the Wimbledon title on July 9, 2022.

190. When is World Population Day observed?

a. July 9th b. July 10th
c. July 11th d. July 12th

Ans. c. July 11th

Rationale
World Population Day is observed every year on July 11, 2022.

191. When is National Doctor’s Day is observed in India?

a. July 15th b. July 1st
c. July 10th d. July 20th

Ans. b. July 1st

Rationale
National Doctor’s Day in India is celebrated every year on July 1st to mark the birth anniversary of an eminent physician Dr. BC Roy.

192. Olympic Champion Neeraj Chopra recently broke his own national record in which tournament?
a. Diamond League Meet
b. Asian Games
c. World Athletics Championships
d. World Indoor Championship

Ans. a. Diamond League Meet

Tokyo Olympic Gold Medalist Neeraj Chopra on June 30, 2022, gave another shining performance as he won a Silver Medal at the
prestigious Diamond League Meet in Stockholm and broke his own previous record by throwing the javelin 89.94 meters.

193. EVM stands for

a. Electric Vending Machine b. Electronic Vending Machine
c. Electronic Voting Machine d. None of the above

Ans. b. Electronic Vending Machine

Rationale
EVM stands for Electronic Vending Machine
88 National NORCET Test-2

194. In which Governor General’s reign railway lines in India were established
a. Lord William Bentick b. Lord Cornwallis
c. Lord Kenning d. Lord Dalhousie

Ans. d. Lord Dalhousie

Rationale
The country’s first passenger train, which ran between Bombay’s Bori Bunder station and Thane on 16 April 1853, was dedicated by
Lord Dalhousie.

195. The headquarter of the UNESCO is at

a. Rome b. Geneva
c. New York d. Paris

Ans. d. Paris

Rationale
The headquarter of UNESCO is at Paris

196. Which of the following is used in Pencil

a. Graphite b. Silicon
c. Charcoal d. Phosphorous

Ans. a. Graphite

Rationale
Graphite is used in pencils.

197. Who among the following authored the book ‘No Full Stop in India”
a. Raj Mohan Gandhi b. Shyam Lal
c. E. M. Forster d. Mark Tully

Ans. d. Mark Tully

Rationale
Mark Tully is the author of the book ‘No Full Stops in India’.

198. PM Modi has urged citizens to hoist the national flag at their homes on which day under Har Ghar Tiranga movement?
a. August 13-15 b. August 14-15
c. August 11-20 d. August 12-16

Ans. a. August 13-15

Rationale
Prime Minister Narendra Modi has urged citizens to hoist the national flag of India at their homes and offices between August 13 and
15 to strengthen the Har Ghar Tiranga Movement.
 National NORCET Test-2 89

199. Which of the following film awarded as the best feature film by the 68th National Film Award 2022
a. Soorarai Pottru b. Tanhaji
c. Toolsidas Junior d. Dollu

Ans. a. Soorarai Pottru

Rationale
Soorarai Pottruis a 2020 Indian Tamil-language drama film written and directed by Sudha Kongara and produced by Suriya, Jyothika
and Guneet Monga.

200. Ctrl + Page Up is Used to (COMP)

a. Moves the cursor one Page Up b. Moves the cursor one Paragraph Up
c. Moves the cursor one Screen Up d. Moves the cursor one Line Up

Ans. a.Moves the cursor one Page Up

Rationale
“Ctrl + PageUp” is used to move the cursor one Page Up.
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next live conducting national
NORCET Exam. Without NNL this Pavamveer Singh MM C plus more focused study.ST is really osm for
norcet test on 25th July,2022
test will be hard for me. This test our preparation. Thanks to all faculty of
and I attempted this test, which Ma’am this test was more difficult
is so helpful for me to know my nursing next live... I m biggest fan of Dr.
was a great initiative by them. than test-1 National norcet was a bit
Rank among various students from Shakshi ma'am, Dr. Aanand bhatiya sir,
The level of difficulty is moderate difficult, which I think good as it helped
different states.. I really appreciate and sabina ali mam.
for me... It increases the level of me to see where I’m lagging behind and
the test and hope a similar test will
competition at the national level where I’m standing on national level
be conducted by NNL…
which is good for me to know the
Now I m so pleased to say I had And I think its good mam the mock tests
pace of preparation and by this, I
choose the right path for my should be more difficult that's how they
can interpret my rank on the AIIMS
success... prepare for to deal with actual paper.
Norcet exam...
Thank u NNL faculty and team.