Ethiopian Nursing Competency Exam Practice Questions (50 – Q)

Q51. A nurse is caring for an 8-year-old child diagnosed with Acute Rheumatic Fever. Which of the following historical findings is most directly related to the etiology of this disease? A) A severe bout of watery diarrhea 1 month ago B) An untreated or inadequately treated streptococcal pharyngitis (sore throat) 2 to 3 weeks ago C) A recent family history of bronchial asthma D) Exposure to contaminated water in a swimming pool

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• Correct Answer: B
• Rationale: Acute Rheumatic Fever is an autoimmune inflammatory reaction caused by cross-reactive antibodies produced against Group A beta-hemolytic streptococci following an untreated pharyngeal infection.

Q52. A pediatric nurse is assessing a 6-month-old infant’s neurodevelopmental milestones. Which of the following skills should the nurse normally expect an infant of this age to demonstrate? A) Walking independently without support B) Sitting alone without any physical support C) Transferring objects from one hand to the other and sitting with support D) Speaking 3 to 4 complete sentences

• Correct Answer: C
• Rationale: At 6 months of age, normal developmental milestones include sitting with support, rolling from back to stomach, transferring small objects from one hand to another, and babbling. Independent sitting usually matures around 7-8 months, and walking occurs around 12 months.

Q53. A 3-year-old child is brought to the emergency department after a brief generalized tonic-clonic seizure that lasted 2 minutes. The child has an acute upper respiratory infection with an axillary temperature of 39.2°C. Neurological examination reveals no focal deficits and no signs of meningeal irritation. What is the most likely diagnosis? A) Idiopathic Epilepsy B) Simple Febrile Seizure C) Acute Bacterial Meningitis D) Viral Encephalitis

• Correct Answer: B
• Rationale: A brief (<15 minutes), single generalized seizure occurring during a spike in fever in a child between 6 months and 5 years old, without central nervous system infection or metabolic imbalance, is classified as a simple febrile seizure.

Q54. A nurse is providing dietary counseling to the mother of a 7-month-old infant. The mother asks about starting complementary feeding. Which instruction should the nurse include? A) Completely discontinue breastfeeding and transition exclusively to solid foods B) Introduce new single-ingredient foods one at a time over 3 to 5 days to monitor for potential allergies while continuing frequent breastfeeding C) Add honey and cow’s milk generously to all foods to increase caloric intake D) Delay introducing any solid foods until the child reaches 12 months of age

• Correct Answer: B
• Rationale: Complementary feeding should begin at 6 months alongside continued breastfeeding. New foods should be introduced individually to help identify food allergies or intolerances. Honey should be avoided in children under 1 year due to the risk of infant botulism.

Q55. A 4-year-old child is brought to the pediatric ward with an acute asthma attack. The child has audible expiratory wheezing, tachypnea, and intercostal retractions. Which medication is the first choice for administration via inhalation to cause rapid bronchodilation? A) Inhaled Fluticasone propionate (Corticosteroid) B) Inhaled Salbutamol (Albuterol – Short-acting beta2 agonist) C) Oral Prednisolone syrup D) Intravenous Gentamicin

• Correct Answer: B
• Rationale: Salbutamol is a short-acting beta2-adrenergic agonist that relaxes bronchial smooth muscle rapidly, making it the first-line choice to relieve acute bronchospasm during an asthma exacerbation. Corticosteroids are used for long-term control.

Q56. A nurse is evaluating a 12-month-old infant with a history of poor growth and skeletal deformities. On examination, the nurse notes frontal bossing of the skull, widening of the wrists and ankles, and a noticeable bowing of the lower legs. What condition is most consistent with these clinical findings? A) Osteogenesis imperfecta B) Congenital hip dysplasia C) Nutritional Vitamin D deficiency Rickets D) Severe pituitary dwarfism

• Correct Answer: C
• Rationale: Frontal bossing, epiphyseal widening at the wrists and ankles, and bowing of the weight-bearing long bones are classic signs of active nutritional rickets, which is caused by a deficiency of Vitamin D and inadequate calcium mineralization in growing bones.

Q57. A newborn infant is suspected of having Congenital Hypothyroidism. Which of the following screening results is most definitive for confirming this diagnosis within the first weeks of life? A) Low serum TSH and high Free T4 levels B) High serum TSH and low Free T4 levels C) Normal serum calcium and low parathyroid hormone levels D) Elevated blood glucose and positive ketones

• Correct Answer: B
• Rationale: In primary congenital hypothyroidism, the malfunctioning thyroid gland produces insufficient thyroxine (T4), which removes negative feedback on the pituitary and leads to a compensatory elevation in thyroid-stimulating hormone (TSH).

Q58. A nurse is caring for an infant who has returned to the surgical ward following the repair of a cleft lip. Which position is most appropriate to place the infant in to protect the integrity of the suture line and prevent aspiration of secretions? A) Prone position flat on the abdomen B) Supine or side-lying position with the head of the bed slightly elevated C) High Fowler’s position with the neck hyperextended D) Trendelenburg position

• Correct Answer: B
• Rationale: Placing the infant in a supine or side-lying position prevents the child from rubbing or pressing the face against the mattress, which protects the cleft lip suture line from trauma and tension.

Q59. A 3-year-old child is brought to the clinic with a high fever, bilateral non-purulent conjunctivitis, cracked red lips, an erythematous rash on the trunk, and hard swelling of the hands and feet. The nurse recognizes this as Kawasaki Disease. What is the most critical long-term complication that must be monitored using echocardiography? A) Acute Glomerulonephritis B) Coronary artery aneurysms C) Persistent pulmonary hypertension D) Permanent hearing loss

• Correct Answer: B
• Rationale: Kawasaki disease is an acute systemic vasculitis. Its most serious complication is the development of coronary artery aneurysms, which can lead to myocardial infarction or sudden death in children if left untreated.

Q60. A nurse is assessing a child with severe acute malnutrition who is undergoing inpatient stabilization. The child is receiving the standard F-75 therapeutic formula. The nurse must monitor closely for signs of “Refeeding Syndrome,” which is driven by rapid intracellular shifts of which key electrolytes? A) Sodium and Calcium B) Potassium, Phosphate, and Magnesium C) Bicarbonate and Chloride D) Iron and Zinc

• Correct Answer: B
• Rationale: Refeeding syndrome occurs when nutrition is reintroduced too rapidly in severely malnourished individuals. This stimulates insulin secretion, causing carbohydrates to enter cells and carrying potassium, phosphate, and magnesium with them, resulting in dangerous drops in serum levels of these electrolytes.

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Part 4: Community Health Nursing and Communicable Diseases

Q61. A community health nurse is investigating a sudden increase in Malaria cases in a rural village. Which of the following environmental interventions is most effective for long-term primary prevention of vector-borne disease transmission in the community? A) Distributing oral Chloroquine prophylactically to all villagers B) Eliminating stagnant water pools, clearing micro-vegetation, and ensuring universal use of Long-Lasting Insecticidal Nets (LLINs) C) Fumigating the inside of health centers only D) Advising community members to stay indoors during the daytime

• Correct Answer: B
• Rationale: Malaria is transmitted by the female Anopheles mosquito, which breeds in stagnant water and bites primarily at night. Source reduction (draining breeding sites) and using LLINs break the transmission chain effectively at the community level.

Q62. A public health nurse is calculating the vital statistics for a specific district in Ethiopia. The number of deaths of infants under 1 year of age per 1,000 live births in a given year is known as which indicator? A) Neonatal Mortality Rate B) Maternal Mortality Ratio C) Infant Mortality Rate (IMR) D) Crude Death Rate

• Correct Answer: C
• Rationale: The Infant Mortality Rate is defined as the total number of deaths among infants under 1 year of age per 1,000 live births within a specific year, serving as a key indicator of overall community health and socioeconomic conditions.

Q63. During a community health campaign, a nurse provides education on the prevention of Schistosomiasis (Bilharzia). The nurse instructs the community that the primary mode of transmission involves which risk behavior? A) Eating undercooked or contaminated beef products B) Inhaling respiratory droplets from an infected individual C) Swimming or wading in fresh water contaminated with cercariae larvae released from infected snails D) Receiving an injection with an unsterile needle

• Correct Answer: C
• Rationale: Schistosoma parasites infect humans by penetrating the skin during direct contact with fresh water contaminated with free-swimming cercariae larvae, which rely on specific freshwater snails as intermediate hosts.

Q64. A community health nurse is implementing “Directly Observed Therapy, Short-course” (DOTS) for patients diagnosed with Pulmonary Tuberculosis. What is the primary purpose of utilizing the DOTS strategy in public health? A) To isolate tuberculosis patients from their families to prevent transmission B) To ensure strict patient adherence to the anti-TB medication regimen, preventing treatment failure and the development of drug-resistant TB strains C) To provide free nutritional food supplements to all community members D) To reduce the financial cost of purchasing diagnostic X-ray machines

• Correct Answer: B
• Rationale: DOTS requires a designated health worker or community supervisor to watch the patient swallow every dose of anti-TB medication. This ensures treatment compliance, maximizes cure rates, and prevents the emergence of multi-drug resistant tuberculosis (MDR-TB).

Q65. A public health officer wants to evaluate the proportion of existing cases of HIV in a town at a specific point in time, including both old and newly diagnosed cases. Which epidemiological measure should be used? A) Incidence rate B) Attack rate C) Point Prevalence D) Crude Birth Rate

• Correct Answer: C
• Rationale: Point prevalence measures the total proportion of individuals in a specified population who have a disease or condition at a single, defined point in time, capturing both pre-existing and new cases. Incidence measures only new cases over a period.

Q66. A community nurse is conducting a water, sanitation, and hygiene (WASH) workshop. The nurse explains the “F-diagram” of fecal-oral disease transmission. Which of the following represent the key vectors in this transmission path? A) Food, Fingers, Flies, Fields, and Fluids B) Fever, Fracture, Friction, and Fluidity C) Families, Factories, Farms, and Forests D) Feces, Fungi, Formulations, and Fixtures

• Correct Answer: A
• Rationale: The “5 Fs” of fecal-oral transmission describe how pathogens from feces reach a new human host: through contaminated Fluids (water), Fingers, Flies, Fields (soil/crops), and Food.

Q67. A nurse is organizing a community intervention to address Podoconiosis (endemic non-filarial elephantiasis) in a rural agricultural area. Which primary preventive measure should the nurse advocate for most strongly? A) Mass administration of systemic antifungal medications B) Wearing protective shoes consistently from early childhood and practicing daily foot hygiene with soap and water C) Spraying powerful insecticides over all agricultural fields D) Boiling all local drinking water before consumption

• Correct Answer: B
• Rationale: Podoconiosis is an inflammatory skin disease caused by prolonged, barefoot exposure to irritant volcanic clay soils. Consistent use of protective footwear and regular foot hygiene are the most effective ways to prevent its development.

Q68. A public health nurse is investigating an outbreak of acute food poisoning following a community feast. To evaluate the relationship between exposure to a specific food item and the development of illness, the nurse compares a group of sick individuals to a group of well individuals. What type of epidemiological study design is this? A) Randomized Controlled Trial B) Case-Control Study C) Longitudinal Cohort Study D) Experimental Laboratory Study

• Correct Answer: B
• Rationale: A case-control study begins with the disease outcome status (cases who are sick vs. controls who are well) and looks backward retrospectively to evaluate and compare exposure histories (e.g., foods consumed).

Q69. A nurse is conducting a health education session on the prevention of Trachoma in a drought-prone district. Which of the following interventions targets the primary vector of this infection? A) Boiling milk to eliminate bacteria B) Improving facial cleanliness and hygiene to reduce eye-seeking flies (Musca sorbens) C) Eradicating rats and mice from grain storage areas D) Avoiding walking barefoot in mud

• Correct Answer: B
• Rationale: Trachoma, caused by Chlamydia trachomatis, is spread through direct contact with eye and nose discharge from infected individuals, often carried by eye-seeking flies. Regular face washing reduces fly attraction and interrupts transmission.

Q70. An epidemiological survey is conducted to evaluate a new screening test for a disease. The ability of the screening test to correctly identify individuals who truly do not have the disease is known as what parameter? A) Sensitivity B) Positive Predictive Value C) Specificity D) Reliability

• Correct Answer: C
• Rationale: Specificity is the proportion of true negatives that are correctly identified by a diagnostic or screening test (the ability to correctly identify healthy individuals). Sensitivity is the ability to correctly identify those with the disease (true positives).

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Part 5: Mental Health Psychiatric Nursing

Q71. A 26-year-old male is admitted with a diagnosis of Schizophrenia. During the interview, he states, “The radio is broadcasting secret codes meant only for me to control the movements of the police forces.” The nurse identifies this belief as which symptom? A) Auditory hallucination B) Delusion of reference C) Looseness of association D) Illusion

• Correct Answer: B
• Rationale: A delusion of reference is a fixed, false belief that random external events, objects, or statements by others (such as radio or TV broadcasts) have a highly specific, personal meaning or hidden message directed specifically at oneself.

Q72. A 34-year-old female patient is admitted with severe Major Depressive Disorder. She appears lethargic, responds in monosyllables, and expresses feelings of worthlessness. Which of the following assessments is the absolute priority for the nurse to conduct? A) Evaluating the patient’s dietary intake and weight patterns over the past month B) Assessing the patient’s risk for suicide and presence of specific self-harm plans C) Assessing the patient’s short-term memory and cognitive orientation D) Checking the patient’s adherence to outpatient sleep schedules

• Correct Answer: B
• Rationale: Safety is always the highest priority in psychiatric nursing. Patients with severe major depression are at significant risk for suicide, so a direct, compassionate assessment of suicidal ideation and plans is mandatory.

Q73. A patient is brought to the psychiatric emergency unit exhibiting extreme grandiosity, a decreased need for sleep (sleeping only 1 hour per night), rapid and pressured speech, and reckless financial spending. The nurse recognizes that these behaviors indicate which clinical state? A) Acute panic attack B) Catatonic schizophrenia C) Manic episode D) Major depressive episode

• Correct Answer: C
• Rationale: A manic episode, characteristic of Bipolar I Disorder, is defined by an abnormally elevated, expansive, or irritable mood, paired with grandiosity, hyper-talkativeness, pressured speech, racing thoughts, and impulsive behavior.

Q74. A 45-year-old male with a long history of chronic alcohol dependence is admitted to the medical ward for an unrelated injury. Forty-eight hours after admission, he becomes severely agitated, disoriented, tremulous, tachycardic, and reports seeing terrifying insects crawling on the ceiling. What acute condition is this patient experiencing? A) Wernicke-Korsakoff syndrome B) Hepatic encephalopathy C) Delirium Tremens (Severe Alcohol Withdrawal) D) Acute schizophrenic psychosis

• Correct Answer: C
• Rationale: Delirium tremens is a severe, life-threatening manifestation of alcohol withdrawal that occurs 48 to 96 hours after cessation of drinking. It is characterized by altered consciousness, autonomic hyperactivity (tachycardia, fever), severe tremors, and vivid visual hallucinations.

Q75. A patient is admitted to the psychiatric ward with a diagnosis of Obsessive-Compulsive Disorder (OCD). The nurse observes the patient washing her hands repeatedly, up to 30 times an hour, causing skin breakdown. What is the primary psychological purpose behind these compulsive rituals? A) To gain attention and sympathy from the nursing staff B) To temporarily reduce severe internal anxiety triggered by obsessive thoughts C) To consciously manipulate the ward schedule D) To exercise and strengthen upper extremity muscles

• Correct Answer: B
• Rationale: Compulsions are repetitive, purposeful behaviors performed in response to an obsession. Their primary psychological function is to temporarily reduce the intense anxiety or distress caused by those persistent, unwanted thoughts.

Q76. A nurse is caring for a patient who has been newly prescribed Haloperidol (a typical antipsychotic). Two days after starting the medication, the patient develops a rigid neck deviated to one side, a locked jaw, and upward rolling of the eyes. The nurse recognizes these symptoms as which adverse effect? A) Tardive dyskinesia B) Neuroleptic Malignant Syndrome (NMS) C) Acute Dystonia D) Akathisia

• Correct Answer: C
• Rationale: Acute dystonia is an extrapyramidal side effect (EPS) characterized by sudden, painful muscle spasms of the neck (torticollis), jaw, or eyes (oculogyric crisis), occurring within days of starting high-potency first-generation antipsychotics. It is treated with anticholinergic medications like Benztropine.

Q77. A 22-year-old university student presents to the clinic complaining of sudden, unprovoked episodes of intense fear, accompanied by a pounding heart, shortness of breath, dizziness, sweating, and a fear of dying or losing control. These episodes peak within 10 minutes. What condition should the nurse suspect? A) Generalized Anxiety Disorder B) Panic Disorder C) Post-Traumatic Stress Disorder (PTSD) D) Schizoid Personality Disorder

• Correct Answer: B
• Rationale: Panic disorder is characterized by recurrent, unexpected panic attacks that present with sudden, intense physical symptoms (tachycardia, dyspnea, dizziness) and severe cognitive apprehension that peaks rapidly.

Q78. A patient is admitted to the psychiatric hospital after surviving a catastrophic factory fire 3 months ago. The patient reports experiencing vivid, distressing flashbacks of the event, persistent nightmares, emotional numbing, and avoids any location that resembles the factory. How should the nurse classify these symptoms? A) Post-Traumatic Stress Disorder (PTSD) B) Conversion Disorder C) Body Dismorphic Disorder D) Borderline Personality Disorder

• Correct Answer: A
• Rationale: PTSD develops following exposure to a traumatic event. It is characterized by symptoms of intrusion (flashbacks, nightmares), avoidance of trauma-related stimuli, negative alterations in cognition/mood, and hyperarousal lasting for more than 1 month.

Q79. A nurse is establishing a therapeutic relationship with a newly admitted psychiatric patient. During the orientation phase, which nursing action is most critical to ensure a successful therapeutic outcome? A) Discussing long-term termination and discharge summaries explicitly B) Establishing clear boundaries, building trust, and setting mutual goals for the relationship C) Confronting the patient immediately about their defense mechanisms D) Administering scheduled psychotropic medications without explanation

• Correct Answer: B
• Rationale: The orientation phase focuses on building trust, rapport, establishing boundaries, exploring the patient’s reasons for seeking help, and setting mutually agreed-upon goals.

Q80. A 19-year-old female patient is admitted with a diagnosis of Anorexia Nervosa. On physical assessment, the nurse notes severe emaciation, bradycardia, hypotension, and the presence of fine, downy hair growth on her back and arms. How should the nurse document this specific hair growth, and what is its purpose? A) Alopecia; caused by high stress levels B) Lanugo; a physiological compensatory mechanism to provide insulation and retain body heat in response to severe starvation C) Hirsutism; driven by excessive estrogen production D) Trichotillomania; a behavioral habit of pulling out hair strands

• Correct Answer: B
• Rationale: Lanugo is fine, downy hair that grows on the bodies of severely malnourished individuals, such as those with anorexia nervosa. It serves as a compensatory physiological response to help insulate the body due to a loss of subcutaneous fat.

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Part 6: Nursing Leadership, Management, Ethics, and Professional Development

Q81. A nurse manager is preparing the annual budget for the surgical ward. The cost of nursing salaries, medical supplies, and standard patient care materials are classified under which specific budget category? A) Capital Budget B) Operating Budget C) Cash Budget D) Strategic Long-term Allocation

• Correct Answer: B
• Rationale: The operating budget reflects the day-to-day expenses of running a unit, including personnel costs (salaries), routine supplies, utilities, and repairs. The capital budget is reserved for high-cost, long-term purchases (e.g., major medical equipment).

Q82. A charge nurse observes that a staff nurse consistently arrives late for shifts and leaves patient documentation incomplete. The charge nurse decides to meet with the staff nurse privately to address this behavior. Which management function is the charge nurse performing? A) Planning B) Organizing C) Directing / Controlling D) Budgeting

• Correct Answer: C
• Rationale: Controlling involves monitoring performance, comparing it against established standards, and taking corrective actions when necessary to ensure organizational goals and quality standards are met.

Q83. A nurse is caring for an elderly patient who requires an emergency surgical procedure to save his life. The patient is conscious but refuses to sign the informed consent form due to personal beliefs. The nurse respects the patient’s decision and notifies the surgical team. Which ethical principle is the nurse upholding? A) Beneficence B) Non-maleficence C) Autonomy D) Justice

• Correct Answer: C
• Rationale: The principle of autonomy asserts that individual patients have the moral and legal right to self-determination and can make independent decisions about their own medical treatment, including refusing life-saving care if they are competent.

Q84. A nurse manager utilizes a leadership style characterized by encouraging open communication, involving staff nurses in decision-making processes regarding ward policies, and seeking consensus before implementing changes. Which type of leadership style is this? A) Autocratic leadership B) Bureaucratic leadership C) Democratic leadership D) Laissez-faire leadership

• Correct Answer: C
• Rationale: Democratic (or participative) leadership encourages staff involvement in decision-making, promotes collaboration, values open communication, and seeks consensus, which typically increases staff satisfaction and morale.

Q85. In a hospital ward, the nurse manager assigns tasks to team members based on their specific functional expertise: one nurse administers all intravenous medications, another performs all wound dressings, and an assistant checks all vital signs. Which nursing care delivery model does this represent? A) Functional Nursing B) Team Nursing C) Primary Nursing D) Total Patient Care

• Correct Answer: A
• Rationale: Functional nursing is a task-oriented model where distinct care responsibilities are assigned to specific staff members based on efficiency and function, rather than assigning a nurse to provide total care for an individual patient.

Q86. A nurse accidentally administers the wrong medication dosage to a patient. Upon realizing the error, the nurse immediately checks the patient’s vital signs, ensures safety, notifies the physician, and completes an incident report. Which ethical professional value does this demonstrate? A) Paternalism B) Accountability C) Veracity D) Fidelity

• Correct Answer: B
• Rationale: Accountability means taking responsibility for one’s own professional actions, including admitting errors, implementing immediate corrective steps, and reporting variances transparently.

Q87. A hospital is implementing a new electronic medical record system. The nurse manager anticipates resistance from the staff and uses Kurt Lewin’s Change Theory to guide the transition. The first phase, which involves preparing the staff for change by breaking down old habits and creating awareness of the need for change, is known as what? A) Moving phase B) Refreezing phase C) Unfreezing phase D) Stabilizing phase

• Correct Answer: C
• Rationale: According to Kurt Lewin’s theory, the three stages of change are: Unfreezing (preparing the group for change and overcoming resistance), Moving (implementing the actual change), and Refreezing (stabilizing and integrating the new change into long-term habits).

Q88. A nurse is participating in a clinical audit to evaluate the quality of nursing documentation in the intensive care unit. This process of reviewing records after patient discharge to ensure quality standards were met represents which type of evaluation? A) Prospective audit B) Concurrent audit C) Retrospective audit D) Predictive analysis

• Correct Answer: C
• Rationale: A retrospective audit is a quality review conducted after the patient has been discharged and care is completed, using medical records and documentation to evaluate compliance with care standards.

Q89. A nurse researcher is planning a study to explore the lived experiences of mothers caring for children with chronic disabilities. The researcher intends to conduct in-depth interviews with a small group of participants. Which research methodology is most appropriate for this study? A) Quantitative experimental design B) Qualitative phenomenological design C) Retrospective cohort design D) Randomized controlled trial

• Correct Answer: B
• Rationale: Qualitative phenomenology is a research approach designed to explore, understand, and describe the deep “lived experiences” and perspectives of individuals regarding a specific phenomenon.

Q90. A charge nurse is resolving a interpersonal conflict between two staff nurses who disagree on shift scheduling. The charge nurse encourages both sides to give up some demands to reach a mutually acceptable agreement. What conflict resolution strategy is being applied? A) Avoiding B) Collaborating C) Compromising D) Competing

• Correct Answer: C
• Rationale: Compromising is a conflict resolution strategy where each party yields or gives up something of value to reach a middle-ground solution, resolving the issue through mutual concessions.

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Part 7: Fundamentals of Nursing, Basic Skills, and Safety

Q91. A nurse is preparing to insert an indwelling urinary catheter for a female patient. To minimize the risk of introducing micro-organisms into the urinary tract, which level of asepsis is mandatory for this procedure? A) Medical asepsis (clean technique) B) Surgical asepsis (sterile technique) C) Basic localized disinfection D) Concurrent sanitation

• Correct Answer: B
• Rationale: Catheterization enters a normally sterile body cavity (the bladder). Therefore, strict surgical asepsis (sterile technique), including sterile gloves and drapes, is required to prevent catheter-associated urinary tract infections (CAUTIs).

Q92. While checking a patient’s vital signs, the nurse notes that the pulse rate is 112 beats per minute. How should the nurse document this finding? A) Bradycardia B) Tachypnea C) Tachycardia D) Arrhythmia

• Correct Answer: C
• Rationale: In adults, a normal resting heart rate ranges from 60 to 100 beats per minute. A rate exceeding 100 beats per minute is classified as tachycardia, while a rate below 60 is bradycardia.

Q93. A nurse is preparing to administer an intramuscular (IM) injection of an antibiotic to an adult patient. Which site is preferred and considered the safest choice for large volume IM injections due to the absence of major blood vessels and nerves? A) Deltoid muscle B) Ventrogluteal site C) Dorsogluteal site D) Rectus femoris

• Correct Answer: B
• Rationale: The ventrogluteal site is the preferred and safest injection site for adults because it features a thick muscle mass, lacks major nerves or blood vessels, and is associated with a lower risk of accidental subcutaneous injection.

Q94. A nurse is caring for an immobile bedridden patient. To prevent the development of pressure ulcers over bony prominences, how frequently should the nurse reposition the patient? A) At least once every 8 hours B) At least once every 2 hours C) Only during daily morning hygiene care D) Every 24 hours

• Correct Answer: B
• Rationale: Prolonged pressure over bony prominences restricts capillary blood flow, leading to tissue ischemia and necrosis. Turning and repositioning the patient at least every 2 hours relieves this pressure and prevents skin breakdown.

Q95. A patient is prescribed a continuous intravenous infusion of 0.9% Normal Saline. During assessment of the IV insertion site, the nurse notes that the skin is cool, pale, swollen, and the patient reports local discomfort. The infusion has slowed down. What complication does this indicate? A) Phlebitis B) Infiltration C) Systemic circulatory overload D) Thrombus formation

• Correct Answer: B
• Rationale: IV infiltration occurs when non-vesicant fluid leaks into the surrounding subcutaneous tissue, causing localized swelling, coolness, pallor, and discomfort. Phlebitis is characterized by localized warmth, erythema, and a palpable cord along the vein.

Q96. A nurse is preparing to administer an oral medication to a patient. To ensure patient safety and prevent errors, the nurse must verify the “Rights of Medication Administration.” What are the core traditional rights? A) Right Patient, Right Drug, Right Dose, Right Route, and Right Time B) Right Room, Right Cost, Right Volume, Right Physician, and Right Day C) Right Syringe, Right Needle, Right Hospital, Right Uniform, and Right Choice D) Right Diagnosis, Right Response, Right Assessment, Right Level, and Right Equipment

• Correct Answer: A
• Rationale: The 5 core rights of medication administration are: right patient, right drug, right dose, right route, and right time. Verifying these rights before administration is essential to prevent medication errors.

Q97. A nurse is evaluating a patient’s arterial blood gas (ABG) results. The values are: pH = 7.30, PaCO2​=55 mmHg, and HCO3−​=24 mEq/L. How should the nurse interpret these results? A) Respiratory Alkalosis B) Metabolic Acidosis C) Respiratory Acidosis D) Metabolic Alkalosis

• Correct Answer: C
• Rationale: A pH below 7.35 indicates acidosis. The PaCO2​ is elevated (>45 mmHg), which matches the acidotic pH trend, while the bicarbonate (HCO3−​) is within normal limits (22−26 mEq/L). This confirms uncompensated respiratory acidosis.

Q98. A nurse is performing an open suctioning procedure of a patient’s endotracheal tube. To prevent hypoxia and tissue damage, what is the maximum recommended duration for applying suction during a single pass? A) 5 seconds B) 10 to 15 seconds C) 30 seconds D) 1 minute

• Correct Answer: B
• Rationale: Suctioning removes oxygen along with secretions. To minimize the risk of hypoxia, vagal stimulation, and trauma to the tracheal mucosa, suction application should be limited to 10-15 seconds per pass, with pre-oxygenation provided beforehand.

Q99. A patient is admitted with severe, non-healing burns over his back. The nurse plans to change the dressings. Which type of exudate drainage is characterized by clear, watery fluid derived from plasma? A) Purulent drainage B) Sanguineous drainage C) Serous drainage D) Sero-sanguineous drainage

• Correct Answer: C
• Rationale: Serous exudate is clear and watery, composed primarily of the serum component of blood, and is common in mild inflammations or blister injuries. Purulent drainage contains pus, while sanguineous drainage contains fresh red blood.

Q100. A nurse is teaching a patient how to use a cane for assistance with ambulation following a left-sided stroke that resulted in right-sided leg weakness. On which side should the patient hold the cane, and how should they move? A) Hold the cane on the weak side (right side) to support the leg directly B) Hold the cane on the strong side (left side) and advance the cane simultaneously with the weak leg C) Hold the cane on either side and move backwards only D) Keep the cane in front with both hands holding it simultaneously

• Correct Answer: B
• Rationale: A cane should be held on the unaffected or strong side (opposite the injury). This shifts the body weight away from the weak side and provides optimal balance. The cane is advanced forward with the weak leg to provide stability.