Question 1:-Heamoglobin is a coordination compound in which the central metal atom is
 Correct Answer:- Option-B
Question 2:-Anterior interosseous nerve supplies
 A:-Flexor pollicis longus
 B:-Abductor pollicis longus
 C:-Flexor pollicis brevis
 D:-Flexor carpi radialis
 Correct Answer:- Option-A

Question 3:-A condition characterized by a prolonged PR interval more than 0.2 secs in ECG is called
 A:-Second degree AV block
 B:-Mobiz type II AV block
 C:-First degree AV block
 D:-Complete block
 Correct Answer:- Option-C

Question 4:-Vitamin A is mostly stored in which type of cells in the liver
 B:-Stellate/Ito cells
 C:-Kupffer cells
 D:-All the above
 Correct Answer:- Option-B

Question 5:-Which of the following anti-tuberculosis drug can damage the 8th cranial nerve?
 B:-Paraoamino Salicylic Acid (PAS)
 C:-Ethambutol hydrochloride (myambutol)
 Correct Answer:- Option-A

Question 6:-Earliest symptom of carcinoma vocal cord is
 Correct Answer:- Option-A

Question 7:-Culture media sterilised by
 B:-Hot air oven
 C:-Ethylene oxide
 Correct Answer:- Option-A

Question 8:-Korsakoff's psychosis is due to intake of
 Correct Answer:- Option-D

Question 9 :-Which of the following is not a use of dexamethasone ?
 A:-Nephrotic syndrome
 B:-Addison's disease
 C:-Cushing's disease
 D:-Hodgkin's lymphoma
 Correct Answer:- Option-C

Question 10:-Condition associated with autoimmune hepatitis
 B:-Ulcerative colitis
 D:-All of the above
 Correct Answer:- Option-D


Question # 1:-Peptic ulcer of the esophagus is also called as
 A:-Barrett's ulcer
 B:-Reiter's syndrome
 C:-Reflux esophagitis
 Correct Answer:- Option-A
Question# 2:-Drug used to treat H1N1 infection
 Correct Answer:- Option-D

Question # 3:-Convert `104 Degree F` to celsius
 A:- `C = 37 Degree C `
 B:-`C = 38  Degree C`
 C:-`C = 40  Degree C`
 D:-`C = 48 Degree C`
 Correct Answer:- Option-C

Question #4:-Intra-aortic balloon pump therapy is most often used in the management of
 A:-Congestive cardiac failure
 B:-Cardiogenic shock
 C:-Pulmonary edema
 D:-Aortic insufficiency
 Correct Answer:- Option-B

Question#5:-A 40 year old female patient presents in the casualty department with history of acute onset of severe epigastric pain radiating towards the back. The patient has no significant medical history and previous surgery. On examination, the patient has marked epigastric tenderness with guarding and diminished bowel sounds. The patients' amylase level is 2500 units. What is the most likely cause of this patients pain ?
 A:-Peptic ulcer disease
 B:-Gall stone
 C:-Alcohol abuse
 D:-Intestinal colic
 Correct Answer:- Option-B

Question #6:-The positive diagnosis for HIV infection is made based on
 A:-A history of high risk sexual behaviors
 B:-Positive ELISA and Western blot tests
 C:-Identification of an associated opportunistic infection
 D:-Evidence of extreme weight loss and high fever
 Correct Answer:- Option-B

Question #7:-The water testing apparatus used to find out the quantity of chlorine required to disinfect
100 gallons (455 litres) of water.
 A:-Horrock's Apparatus
 B:-Berkefeld Apparatus
 Correct Answer:- Option-A

Question #8:-Spina ventosa
 A:-Tuberculous dactilitis
 B:-Tuberculous infection of ventricles of brain
 C:-Fungal affection of spinal cord
 D:-Crystal deposition disorder in spine
 Correct Answer:- Option-A

Question #9:-Hormone responsible for ovulation and development of corpus luteum is
 Correct Answer:- Option-B

Question #10-Chylomicrons are synthesized by
 A:-Small intestine
 B:-Large intestine
 D:-All the above
 Correct Answer:- Option-A


Question #1:-Bicuspid valve is present between
 A:-Left atrium and left ventricle
 B:-Right atrium and right ventricle
 C:-Left atrium and right atrium
 D:-Right ventricle and left ventricle
 Correct Answer:- Option-A
Question #2:-Enrichment medium for vibrio cholerae
 A:-Alkaline Peptone Water
 B:-Cary Blair Medium
 C:-Selenite Fbroth
 D:-Stuart's medium
 Correct Answer:- Option-A

Question #3:-Koplik's spots are seen in
 Correct Answer:- Option-B

Question #4:-Which of the following tissue is most sensitive to blockade by Atropine ?
 A:-Gastric glands
 B:-Salivary glands
 C:-Circular muscle of iris
 D:-Urinary bladder
 Correct Answer:- Option-B

Question #5:-Chromosomal translocation in acute myeloid leukemia (AML-M3)
 Correct Answer:- Option-C

Question #6:-Oxidation pond is a method used for
 A:-Solid waste disposal
 B:-Sewage treatment
 C:-Water purification
 D:-Sullage disposal
 Correct Answer:- Option-B

Question #7:-The recommended maximum noise level is
 A:-75 decibels
 B:-85 decibels
 C:-130 decibels
 D:-140 decibels
 Correct Answer:- Option-B

Question #8:-Christmas tree stains are used in the detection of
 A:-Vaginal epithelial cells
 B:-Chorionic villi
 C:-Red blood cells
 Correct Answer:- Option-D

Question #9:-The lower end of spinal cord in a neonate end s at the level of
 A:-S3 vertebra
 B:-S1 vertebra
 C:-L2 vertebra
 D:-L3 vertebra
 Correct Answer:- Option-D

Question #10:-An early sign of Hodgkin' disease is
 A:-Difficulty in breathing
 B:-Swollen cervical lymph nodes
 C:-Difficulty in swallowing
 D:-Feeling of fullness over the liver
 Correct Answer:- Option-B


Question #1. The nurse has just received shift report and is preparing to make rounds. Which client should be seen first?
A. The client who has a history of a cerebral aneurysm with an oxygen saturation rate of 99%
B. The client who was admitted 1 hour ago with shortness of breath
C. The client who is three days post–coronary artery bypass graft with a temperature of 100.2°F
D. The client who is being prepared for discharge following a femoral popliteal bypass graft

Answer B is correct. The client admitted 1 hour ago with shortness of breath should be seen first because this client might require oxygen therapy. The client in answer A with a low-grade temperature can be assessed after the client with shortness of breath. The client in answer C can also be seen later. This client will have some

Question #2. The client has an order for heparin to prevent post-surgical thrombi.
Immediately following a heparin injection, the nurse should:
A. Aspirate for blood
B. Check the pulse rate
C. Massage the site
D. Check the site for bleeding

Answer D is correct. After administering any subcutaneous anticoagulant, the nurse should check the site for bleeding. Answers A and C are incorrect because aspirating and massaging the site are not done. Checking the pulse is not necessary, as in answer B.

Question #3. The nurse is assisting in the care of a patient with diverticulosis. Which of the following assessment findings would necessitate a report to the doctor?
A. Bowel sounds of 5–20 seconds
B. Intermittent left lower-quadrant pain
C. Constipation alternating with diarrhea
D. Hemoglobin 26% and hematocrit 32

Answer D is correct. Low hemoglobin and hematocrit might indicate intestinal bleeding. Answers A, B, and C are normal lab values.

Question #4. The nurse is assessing the abdomen. The nurse knows the best sequence to perform the assessment is:
A. Palpation, inspection, auscultation
B. Auscultation, palpation, inspection
C. Inspection, auscultation, palpation
D. Inspection, palpation, auscultation

Answer C is correct. The nurse should inspect first, then auscultate, and finally palpate. If the nurse palpates first the assessment might be unreliable. Therefore, answers A, B, and D are incorrect.

Question #5. The nurse is making assignments for the day. Which client should be assigned to the nursing assistant?
A. The 18-year-old with a fracture to two cervical vertebrae
B. The infant with meningitis
C. The elderly client with a thyroidectomy 4 days ago
D. The client with a thoracotomy 2 days ago

Answer C is correct. The most stable client is the client with the thyroidectomy 4 days ago. Answers A, B, and D are incorrect because the other clients are less stable and require a registered nurse.

Question #6. The client is admitted to the postpartum unit with an order to continue the infusion of Pitocin. Which finding indicates that the Pitocin is having the desired effect?
A. The fundus is deviated to the left.
B. The fundus is firm and in the midline.
C. The fundus is boggy.
D. The fundus is two finger breadths below the umbilicus.

Answer B is correct. Pitocin is used to cause the uterus to contract and decrease
bleeding. A uterus deviated to the left, as stated in answer A, indicates a full bladder. It is not desirable to have a boggy uterus, making answer C incorrect. This lack of muscle tone will increase bleeding. Answer D is incorrect because the position of the uterus is not related to the use of Pitocin.

Question #7. A 70-year-old male who is recovering from a stroke exhibits signs of unilateral neglect. Which behavior is suggestive of unilateral neglect?
A. The client is observed shaving only one side of his face.
B. The client is unable to distinguish between two tactile stimuli presented simultaneously.
C. The client is unable to complete a range of vision without turning his head side to side.
D. The client is unable to carry out cognitive and motor activity at the same time.

Answer A is correct. The client with unilateral neglect will neglect one side of the body. Answers B, C, and D are not associated with unilateral neglect.

Question #8. The nurse is assigned to care for an infant with physiologic jaundice. Which action by the nurse would facilitate elimination of the bilirubin?
A. Decreasing caloric intake
B. Maintaining the infant’s body temperature at 98.6°F
C. Minimizing tactile stimulation
D. Increasing the infant’s fluid intake

Answer D is correct. Bilirubin is excreted through the kidneys, thus the need for increased fluids. Maintaining the body temperature is important but will not assist in eliminating bilirubin; therefore, answer B is incorrect. Answers A and C are incorrect because they do not relate to the question.

Question #9. A 24-year-old female client is scheduled for surgery in the morning. Which of the following is the primary responsibility of the nurse?
A. Taking the vital signs
B. Obtaining the permit
C. Explaining the procedure
D. Checking the lab work

Answer A is correct. The primary responsibility of the nurse is to take the vital signs before any surgery. The actions in answers B, C, and D are the responsibility of the doctor and, therefore, are incorrect for this question.

Question #10. The doctor orders 2% nitroglycerin ointment in a 1-inch dose every 12 hours. Proper application of nitroglycerin ointment includes:
A. Rotating application sites
B. Limiting applications to the chest
C. Rubbing it into the skin
D. Covering it with a gauze dressing

Answer A is correct. Sites for the application of nitroglycerin should be rotated, to prevent skin irritation. It can be applied to the back and upper arms, not to the lower extremities, making answer B incorrect. Answer C is contraindicated to the question, and answer D is incorrect because the medication should be covered with a prepared dressing made of a thin paper substance, not gauze.


Question #1:-The stain using to visnalise separated DNA by gel electrophoresis is
 A:-Ethidium bromide
 D:-Feulgen dye
 Correct Answer:- Option-A

Question #2:-All of the following are characteristics of teratomas except
 A:-A malignant component should be present
 B:-They arise from totipotential germ cells
 C:-They can arise in the ovary
 D:-Tissues resembling those from an embryo can be seen
 Correct Answer:- Option-A

Question #3:-The most common content of hernia-en glissade
 A:-Sigmoid colon
 D:-Urinary bladder
 Correct Answer:- Option-A

Question #4:-Dagger sign in X-ray is seen in
 A:-Rheumatoid arthritis
 C:-Ankylosing spondylitis
 D:-Metaphyseal dysplasia
 Correct Answer:- Option-C

Question #5:-Which microorganism is associated with cervical cancer?
 A:-Human papilloma virus
 C:-Mycobacterium avium
 D:-Pneumocystis carinii
 Correct Answer:- Option-D

Question #6:-Fibres carried by greater splanchnic nerve
 A:-Preganglionic sympathetic
 B:-Postganglionic sympathetic
 C:-Preganglionic parasympathetic
 D:-Postganglionic parasympathetic
 Correct Answer:- Option-A

Question #7:-Neural tube defects can be prevented by
 A:-Supplementation with Vitamin B complex
 B:-Supplementation with hydantoin
 C:-Maternal folate supplementation
 D:-Prophylaxis with valproic acid
 Correct Answer:- Option-C

Question #8:-What is the commonest cause for neonatal mortality in India ?
 A:-Congenitial anomalies
 B:-Birth asphyxia
 Correct Answer:- Option-D

Question #9:-The intravenous anaesthetic agent used for treating clinical depression is
 C:-Thiopentone sodium
 Correct Answer:- Option-A

Question #10:- Contraindications for using oral contraceptives
 B:-Urinary tract infections
 C:-Ulcerative colitis
 Correct Answer:- Option-A


Question #1:-The antidote for heparin is
 A:-Vitamin K
 B:-Warfarin (Coumadin)
 D:-Protamine sulphate
 Correct Answer:- Option-D

Question #2:-The most sensitive basic screening technique for early detection of breast cancer is
 A:-Breast self examination
 C:-Chest X-ray
 Correct Answer:- Option-D

Question #3:-Total number of bones in human body
 Correct Answer:- Option-B

Question #4:-The amount of aqueous humor in the anterior chamber of the eye is
 A:-0.25 ml
 B:-0.025 ml
 C:-2.5 ml
 D:-0.5 ml
 Correct Answer:- Option-A

Question #5:-The Biomedical Waste (Management and Handling) Rule came in to enforcement in India in
 Correct Answer:- Option-C

Question #6:-Which of the following stage the carcinogen is irreversible?
 A:-Progression stage
 B:-Initiation stage
 C:-Regression stage
 D:-Promotion stage
 Correct Answer:- Option-A

Question #7:-The Pulse Polio Immunization Programme was started on
 A:-9th) December 1994
 B:-9th) December 1995
 C:-9th) December 1996
 D:-9th) December 1997
 Correct Answer:- Option-B

Question #8:-Biochemical findings of low serum iron, low total iron binding capacity and serum ferritin above 100 ng/ml
suggest a diagnosis of
 A:-Anemia of chronic disease
 C:-Iron deficiency
 D:-Sideroblastic anemia
 Correct Answer:- Option-A

Question #9:-Four H's of scurvy are haemorrhagic signs, hypochondriasis, haematologic abnormalities and
 B:-Hyperkeratosis of hair follicles
 Correct Answer:- Option-B

Question #10:-What is the likely cause of blood urea nitrogen concentration elevated in acute renal failure?
 A:-Fluid retention
 B:-Hemolysis of red blood cells
 C:-Below normal metabolic rate
 D:-Reduced renal blood flow
 Correct Answer:- Option-D


Question #1:-Largest gland in the body
 D:-Parotid gland
 Correct Answer:- Option-B

Question #2:-The drug used to reduce fever
 Correct Answer:- Option-A

Question #3:-Assessment of gestational age at birth is done using
 A:-New Ballard score
 B:-APGAR score
 C:-Bhakoo score
 D:-Downe score
 Correct Answer:- Option-A

Question #4:-Which is the preferred Glucocorticoid used in the treatment of raised intracranial tension ?


1. Mr. Jockim underwent coronary bypass surgery. Four hours following admission to the critical care
unit, his BP begins to fall, his HR rises to 130 and his urine output decreases to 35 ml/hr. His CVP
increases to 22 and his PWP 18. The critical care nurse notifies the cardiovascular surgeon. Pending
the surgeons arrival, which intervention is the priority?
a. Milrinone
b. Dobutamine
c. Lasix
d. Fluid

2. Mr. Swetty is admitted with hypoxemic and hypercarbic respiratory arrest requiring intubation and ventilation. He has a RLL consolidation on xray, with copious purulent secretions. WBC is 24,000 T 39.2. BP 88/55 HR 136 and CVP 18 after 6 L of 0.9% normal saline. Urine output is 10 ml/hr. Which one of the following interventions is a priority?
a. Levophed
b. Dopamine
c. Dobutamine
d. Labetolol

3. When using a Passy-Muir Valve (PMV), which one of the following interventions is appropriate?
a. Ensure the cuff is always inflated
b. Monitor for adequacy of exhalation
c. Introduce the PMV as soon as the tracheostomy is performed
d. Suction prn by passing the catheter through the centre of the PMV

4. Mrs. Prasad has advanced cancer. She has been extubated for two days, with orders for no
reintubation. She develops increasing dyspnea. Which one of the following agents would best
manage these symptoms?
a. Propofol (Diprovan)
b. Fentanyl
c. Midazolam (Versed)
d. Gabapentin

5. Mrs. Savitha Lobo is admitted with cardiogenic shock following a myocardial infarction. She has the
following findings:
HR 68 BP 80/55 CVP 24 SpO2 88%
Which one of the following interventions is the priority?
a. Levophed
b. Epinephrine
c. Lasix
d. Metoprolol

6. Mr. Param Singh has been on home ventilation for several years with severe COPD. He was admitted for exacerbation of COPD due to pneumonia. At home, he varies his support between Pressure Control ventilation and spontaneous breathing. His pneumonia has now resolved and the plan is to return him to his baseline ventilation. He calls you to his bedside and asks you what his ventilator is set to because he feels short of breath. You tell him he is on Pressure Support, and he becomes very angry. He tells you that he told the respiratory therapist that he has tried Pressure Support in the past and he does not like it. When you speak to the respiratory therapist, she had placed the patient on PS to see if he noticed the difference. Which one of the following is an appropriate response?
a. Encourage Mr. Param Singh to stay on the Pressure Support and give it a chance to work
b. Have the respiratory therapists speak to Mr. Ferriere to explain her interventions
c. Facilitate a meeting between you, the respiratory therapist and Mr. Ferriere to develop a plan for weaning
d. Tell Mr. Param Singhthat his lungs have changed and the previous mode might not work the same way

7. Identify the formula for minute volume.
a. Tidal volume X respiratory rate
b. Functional residual capacity – tidal volume
c. Forced vital capacity X respiratory rate
d. Cardiac Output X respiratory rate

8. Following an inferior wall infarction, Mrs. Kunal develops a sinus rhythm with Wenkebach
phenomena. She develops episodes of symptomatic bradycardia. Which one of the following
interventions would be the priority?
a. Epinephrine
b. Cardioversion
c. Atropine
d. Dopamine
9. Ms. Arungiri is recovery from a prolonged critical illness. She is having tracheostomy-mask trials each day. She is withdrawn and sad, and tells the nurse she no longer has any control of her life. Which one of the following interventions would best meet her needs?
a. Initiate antidepressant therapy
b. Administer sedation at bedtime
c. Develop a collaborative plan of care
d. Refer Mrs. Tam to a psychiatrist

10. After successful completion of a spontaneous breathing trial, extubation is considered. Which one of
the following findings would be a contraindication to extubation?
a. FiO2 0.4
b. PEEP 5
c. GCS 4
d. Minute volume 10 L/min


Question# 1:-Name the area where optic nerve leaves the eyeball
 A:-Hyaloid fossa
 C:-Blind spot
Correct Answer:- Option-C
Question#  2:-Give an example for insitu biodiversity conservation?
 A:-Zoological parks
 B:-Botanical gardens
 C:-National parks
Correct Answer:- Option-C

Question# 3:-Pel-Ebstein type of fever is seen in
 C:-Hodgkin's disease
Correct Answer:- Option-C

Question# 4:-In which part of the fallopian tube fertilisation occurs ?
 D:-Interstitial portion
Correct Answer:- Option-B

Question# 5:-The measurement of obstetrical conjugate
Correct Answer:- Option-C

Question# 6:-A disabled friendly toilet should have
 A:-Wide entrance for wheelchair to pass
 B:-Grab bars inside for support
 C:-Ramp (not steps) at the entrance
 D:-All of the above
Correct Answer:- Option-D

Question# 7:-The amount of amniotic fluid at term
 A:-1500 ml
 B:-1200 ml
 C:-1000 ml
 D:-800 ml
Correct Answer:- Option-D

Question# 8:-The acceptable range of normal adult body mass index
 A:-15.3-21.6 kg/m2
 B:-18.5-24.9 kg/m2
 C:-23.2-28.5 kg/m2
Correct Answer:- Option-B

Question# 9:-Typical finding in anaphylactic shock
Correct Answer:- Option-C

Question# 10:-Which of the following is a water soluble vitamin
 A:-Vitamin A
 B:-Vitamin B
 C:-Vitamin D
 D:-Vitamin K
Correct Answer:- Option-B


Question # 1:-The following arteries are branches of internal carotid artery except
 A:-Anterior cerebral
 B:-Anterior choroidal
 C:-Posterior choroidal
 D:-Posterior communicating
 Correct Answer:- Option-C
Question# 2:-Ascorbic acid is the chemical name of
 A:-Vitamin A
 B:-Vitamin B
 C:-Vitamin C
 D:-Vitamin D
 Correct Answer:- Option-C

Question# 3:-Declaration of HELSINKI deals with

 A:-Human organ transplantation
 B:-Rights of medical practitioners
 C:-Codes of medical ethics
 D:-Human experimentation
 Correct Answer:- Option-D

Question# 4:-Which is more elastic?

 Correct Answer:- Option-C

Question# 5:-Active form of Vitamin D

 A:-Vitamin `D_(3)`
 C:-7 - Dehydrocholesterol
 D:-Vitamin `D_(2)`
 Correct Answer:- Option-B

Question# 6:-A 2 year old child with moderate to severe pain due to bone metastasis from neuroblastoma should be treated

 A:-Codeine + Paracetamol + Bisacodyl
 B:-Morphine + Paracetamol + Bisacodyl
 C:-Ibuprofen + Paracetamol + Lansoprazole
 D:-Tramadol + Paracetamol + Lansoprazole
 Correct Answer:- Option-B

Question # 7:-Minimum percentage of disability needed to claim the benefits of a physically handicapped is
 Correct Answer:- Option-B

Question# 8:-The type of personality where the person has alternating periods of elation and depression
 D:- Cyclothymic
 Correct Answer:- Option-D

Question# 9:-Bronchial breath sound heard in all except
 B:-Just above the upper level of pleural effusion
 C:-Over the trachea
 Correct Answer:- Option-A

Question 10:-The shape of ammonia molecule is
 Correct Answer:- Option-C


1. Ms. Pushparaj suddenly develops a decrease in her level of consciousness, even though she has not received any additional sedatives or analgesics. She is on broad spectrum antibiotics, levophed, vasopressin, steroids and intensive insulin. She is being fed via a nasal gastric feeding tube. She develops gastric distention with residual volumes equal to 6 hours feeding volume. Which one of the following interventions is a priority?
a. Change feeding tube to small bowel placement
b. Obtain a blood glucose measurement
c. Initiate a prokinetic agent
d. Change feeds to elemental solution

2. Mr. Padmanavha is admitted with decreased level of consciousness. His admission labs are: Blood glucose 56 mmol/L, Na 149 K 4.8 Cl 105 HCO3 22, ABGs PaO2 72 PCO2 45 pH 7.39 HCO3 23. Which one of the problems is indicated by these findings?
a. Diabetic ketoacidosis
b. Glucagon overdose
c. Non-ketotic hyperosmolar coma
d. Adrenal crisis

3. Mr. Lijosh Kuriyakose is admitted with alcoholic pancreatitis. He has a T 38.2 WBC 14,000 (with left shift and increased neutrophils). Following 4 litres of normal saline, his BP increases to 117/80 from 70/50, HR decreases from 144 to 92 and urine output increases from 10 to 60 ml/hr. He requires intubation for worsening hypoxemia. Which one of the following best explains these findings?
a. Sepsis
b. Severe sepsis
c. Septic shock
d. Systemic Inflammatory Response Syndrome

4. Mr. Nikhil George is admitted following a motor vehicle collision. Her past medical history includes daily prednisone for the treatment of systemic lupus. Despite fluid replacement therapy and initiation of levophed, her blood pressure remains low. Which one of the following interventions is the priority?
a. Cosyntropinin
b. Epinephrine
c. Hydrocortisone
d. Vasopressin

5. Which one of the following pharmacological agents should be administered with levothyroxine for the
treatment of myxedema coma?
a. Insulin
b. Glucagon
c. Epinephrine
d. Steroids

6. Which one of the following factors increases the risk for central line infection?
a. Subclavian venous access
b. Chorhexidine skin prep
c. Tunneled catheters
d. TPN

7. Ms. Sandriya, 80 kg, drops her platelet count by >50% 10 days after starting subcutaneous heparin.
She develops a swollen right calf and positive Homan’s sign. Which one of the following interventions would you anticipate?
a. Change anticoagulant to dalteparin 15,000 units SC daily
b. Administer protamine sulphate and discontinue heparin
c. Initiate anticoagulation with fondaparinux
d. Stop all anticoagulation and initiate pneumatic compression stockings

8. Mrs. Kamala has been on steroids for the past 6 years to treat severe rheumatoid arthritis. Which one of the following problems would you anticipate?
a. Hypercalcemia
b. Hyperkalemia
c. Hyperlipidemia
d. Hypoglycemia

9. Ms. Yakshitha is admitted with coma. She has a BP of 158/75 HR 52 (sinus) and requires intubation for level of consciousness and pulmonary edema. Her temperature is 34 (oral). Which of the following lab tests is the priority?
a. TSH, T3, T4
b. Serum and urine osmolalities
c. Cosyntropinin stimulation test
d. Serum renin and angiotensin levels

10. Mr. Jayaraj is admitted with hypoxemic and hypercarbic respiratory arrest requiring intubation and ventilation. He has a RLL consolidation on xray, with copious purulent secretions. WBC is 24,000 T 39.2. BP 88/55 HR 136 and CVP 18 after 6 L of 0.9% normal saline. Urine output is 10 ml/hr. Which one of the following interventions is a priority?
a. Levophed
b. Dopamine
c. Dobutamine
d. Labetolol


1. Mrs. Hajeeja Sail is on Continuous Renal Replacement and is receiving hemodiafiltration. Which one of the following interventions would increase clearance?
a. Increased fluid removal
b. Use of citrate anticoagulation
c. Use of a larger filter
d. Reduction in the blood flow rate

2. Mrs. Fathima develops a leak of gastric contents around her new gastrostomy tube site. She is placed NPO and started on a medication to decrease gastroenteropancreatic secretions. Which medication has been ordered to produce this effect?
a. Pantoprozole (Pantoloc)
b. Octreotide (Sandostatin)
c. Metoclopramide (Maxeran)
d. Vasopressin

3. Ms. Febina  is in a positive fluid balance with urine output < 30 ml/hr and significant peripheral edmea.
Labs are as follows:
Na 148 K 4.9 Cl 105 HCO3 23 Urea 16 mmol/L Creatinine 85 umol/L. Urine sodium is low, and
serum and urine osmolality increased. Which one of the following interventions would you anticipate?
a. Furosemide (Lasix)
b. 0.45% normal saline
c. 0.9 % normal saline
d. Fluid restriction

4. Mr. Abdul Aziz is admitted with a diagnosis of hepatic encephalopathy secondary to cirrhosis. His ammonia level dropped to normal in the first 24 hours and he has had 2 spontaneous bowel movements. He remains in coma. Which one of the following interventions is a priority?
a. Lactulose
b. N-acetylcysteine (Mucomyst)
c. Sodium Polystyrene (Kayexalate)
d. Glutamine supplements

5. the following problems is suggested by these findings?
a. Hyperthyroidism
b. Hypothyroidism
c. Sick euthyroid of critical illness
d. Pituitary dysfunction

6. Mr. Abubakkar, 75 yrs old, has a history of Type II diabetes and chronic renal insufficiency. He is scheduled for a CT abdomen with contrast. Which one of the following interventions should be anticipated?
a. Furosemide (Lasix)
b. N-acetylcysteine (Mucomyst)
c. Mannitol
d. Low dose dopamine

7. Following a severe traumatic brain injury, Jamie’s urine output increases to 300 ml/hr, BP decreases
to 90/60 and HR increases to 144. His serum sodium is 155 mmol/L. Which one of the following interventions is the priority?
a. Obtain urine and serum osmolalities
b. Change IV fluid to 0.45 % NaCl
c. Administer desmopressin (DDAVP)
d. Initiate levophed infusion

8. Mr. Yathif is admitted with cardiogenic shock and oliguric acute kidney injury. Hemodynamics reveal
the following: BP 105/60 (~70) Sinus rhythm (108) CI 1.8 (CO 2.4) CVP 23 PWP 25 SVRI 2088 (SVR
1566). Which one of the following interventions would you anticipate?
a. Dopamine at 2 mcg/kg/min
b. Captopril 6.5 mg q6h
c. Metoprolol 25 mg BID
d. Dobutamine at 5 mcg/kg/min

9. Mr. Ismail is admitted with bleeding from esophageal varicies. He is intubated and ventilated for airway protection and to maintain sedation, and has a Minnesota Tube inserted to tamponade his varicies. Which of the following should be included in the care of a patient with a Minnesota tube?
a. The esophageal balloon must be inflated if the gastric balloon is deflated
b. The esophageal balloon should be inflated at all times
c. Traction is maintained through the use of weights on an overbed pully
d. Airway obstruction can occur if the gastric balloon is inflated

10. Mr. Mohammed Ul Sha undergoes an open repair of an abdominal aortic aneurysm. In the first 24 hours following surgery, his creatinine doubles and his urine output decreases to < 10 ml/hr. Which one of the
following is the most likely cause of his acute kidney injury
a. Postrenal
b. Intrarenal
c. Prerenal
d. Aneurysmal


1. Mr. Albu Ainstin is a 66 year old man who had an intraventricular hemorrhage. He has an external
ventricular drain (EVD) that is open to drainage at 5 cmH20 above the reference level. It has been
draining ~20 ml per hour for the past 24 hours. The waveform suddenly becomes dampened with a
pressure reading of 8 mmHg, and there has been no CSF drainage during the past hour. How should
these findings be interpreted?
a. Lack of drainage is an expected finding
b. Clotting of the catheter should be suspected
c. The hydrocephalus has resolved
d. The drainage chamber should be raised

2. Mr. Mohammed Iqbal had an ischemic bowel requiring urgent total colectomy and ileostomy and TPN. One week
following admission to ICU, his Alanine Aminotransferase (ALT) and his Aspartate Aminotransferase
(AST) double, and his alkaline phosphatase and direct bilirubin increase 4 fold. His lipase and
pancreatic amylase are mildly elevated and his ammonia is normal. These findings are most
consistent with which complication?
a. Hepatic ischemia
b. Biliary track disease
c. Pancreatitis
d. Hemolysis

3. Mrs. Jibi Chakocha develops a sudden facial droop with dysphagia. Which diagnostic test is best for
identification of an acute cerebral infarction?
a. MRI
b. EEG
c. CT scan
d. Cerebral angiogram

4. Mrs. Simran Mathew is started on neuromuscular blocking agents. Which one of the following interventions is
a priority?
a. Titrate sedation using a sedation scoring tool
b. Maintain eyes in a closed position
c. Use of oral hydration solutions
d. Administration of prn analgesia

5. Following insertion of a nasogastric feeding tube, Mrs. Sindrella is started on continuous enteral
feeding infusion at 30 ml/hr. Three hours later, she has a residual volume of 100 ml. Which one of the
following interventions would be the priority?
a. Remove the feeding tube and replace with a nasal-jejunal tube
b. Position Mrs. Sindrella on her left side
c. Initiate metoclopramide (Maxeran)
d. Administer a dose of pantoprazole (Pantoloc)

6. Mr. Stalin is admitted with acute gallstone pancreatitis following ERCP. He develops ARDS and
requires intubation and mechanical ventilation, with fluid resuscitation for systemic inflammation. He
is experiencing nausea and vomiting. Which one of the following interventions would you anticipate?
a. Early initiation of TPN
b. NPO with gastric drainage
c. Nasal-jejunal enteral feeding
d. Avoidance of narcotics

7. Fernandis is a 18 year old who suffers from anorexia and bulimia. She is admitted with failure to thrive,
weighing 39 kg. Which one of the following interventions is a priority?
a. Initiate central TPN while encouraging oral intake
b. Initiate tube feeding at a rate that matches daily energy requirements
c. Monitor and replace phosphate, magnesium and potassium
d. Administer loperamide prn if diarrhea develops

8. Which one of the following interventions should be included in the care of a patient receiving Central
a. Change lipid tubing every 72 hours
b. Change central line every 7 days
c. Weekly blood cultures
d. Routine liver function tests

9. Mrs. Flossy Rodrigus is admitted with a diagnosis of septic shock NYD. She received aggressive fluid
resuscitation, is started on broad spectrum antibiotics and steroids, and is now on levophed at 15
mcg/min and vasopressin at 2.4 units/hr. Despite maintaining a MAP of 65 mmHg, her lactate rises
from 4.5 to 8.8 and she develops new onset diarrhea. Which one of the following interventions would
you anticipate?
a. Repeat blood cultures
b. Hepatic ultrasound
c. CT abdomen
d. Insertion of rectal tube

10. Mr. Binu Abraham is admitted following an overdose of beta blockers. Which one of the following antidotes
would you anticipate?
a. Levothyroxine
b. Glucagon
c. Levophed
d. N-aceylcysteine Mucomyst



1. Jomon is an 18 year old man admitted with pneumonia and exacerbation of his asthma. He complains of chest tightness and develops increased wheezes. Which one of the following interventions is the priority?
a. Ipratropium bromide (Atrovent)
b. Bethamethasone (QVAR)
c. Salmeterol/fluticasone (Advair)
d. Salbutamol (Ventolin)
2. During surgery, Mrs. Flossy develops malignant hyperthermia. Which one of the following is the
a. Aggressive cooling
b. Potassium boluses
c. Sodium citrate
d. Dantrolene

3. Mrs. Tejavani is recovering from septic shock. After failing several spontaneous breathing trials, she
received a percutaneous tracheostomy tube. Two days later, within 10 minutes of starting a
tracheostomy mask trial, she complains of shortness of breath and demands to return to the
ventilator. Her SpO2 remains > 95% during the trial. Which one of the following interventions pre
trachestomy mask trial is most likely to reduce her dyspnea and facilitate spontaneous breathing?
a. N-acetylsysteine (Mucomyst)
b. Lorazepam (Ativan)
c. Morphine
d. Aminophylline

4. Joshna is a 22 year old woman admitted with ARDS following H1N1. Her blood gases on .8 PEEP 10
PC 34 (tidal volumes ~500 cc) and AC 28 are as follows:
PaO2 52 PaCO2 46 pH 7.32 HCO3 17
Which one of the following interventions is the priority?
a. increase PEEP
b. increase FiO2
c. decrease PC
d. increase AC

5. Three days after insertion of a chest tube for pleural effusion/empyema, Mr. Bob Rol’s ventilator begins
to alarm for low exhaled tidal volume. Upon examination, increased bubbling is noted in the
underwater seal chamber of the chest drainage unit, and the set tidal volume is 200 cc > exhaled tidal
volume. Which one of the following problems do these findings suggest?
a. Chest tube obstruction
b. Bronchopleural fistula
c. Asynchrony with ventilator
d. Air trapping

6. Ms. Sanjana sustained a complete spinal cord injury at the level of C3 and underwent anterior
fixation 3 days ago. Which one of the following interventions should be included in her care plan?
a. Assisted cough during suctioning
b. Atropine pre suctioning
c. Mannitol x 24 hours post operatively
d. Early extubation

7. Which one of the goals for wound care should be included for a Stage II pressure ulcer?
a. Wet to dry dressings
b. Hydrocolloid dressings
c. Cleansing with chorhexidine
d. Tight packing of wound cavity

8. Mrs. Shamili is one day postoperative repair fractured hip. She develops a sudden onset of
hypoxemic respiratory failure and is diagnosed with an acute pulmonary embolus. Which one of the
following interventions is the priority?
a. Dalteparin (Fragmin) 5,000 units subcutaneous OD
b. Drotrecogin alfa activated (Xigris)
c. Coumadin (Warfarin) 10 mg loading dose
d. Heparin IV 80 units/kg bolus

9. Mrs. Rajini develops hypercarbia and hypoxemia following extubation. She is started on BiPAP in an
effort to avoid reintubation. Which one of the following interventions should be included in her plan of
a. Integumentary inspection of nose and face
b. Nasal-tracheal suctioning to facilitate secretion clearance
c. Oral intake of high calorie milk shakes.
d. Administer regular dose benzodiazepines

10. Which pair of cranial nerves is being evaluated when a corneal reflex test is performed on the L eye.
a. L CN V and VII
b. R CN V and VII
c. L CN III and VII
d. R CN III and VII



1. Mrs. Bhavya Amin is on Coumadin for atrial fibrillation. She is admitted with ischemic bowel and requires
urgent surgery. Her INR is 10.4 and aPTT 52. Which one of the following interventions is the priority?
a. Protamine sulphate
b. Octaplex
c. Cryoprecipitate
d. Vitamin K infusion

2.. Mr. Amal Mathew is awaiting a bed on the ward and is no longer on the bedside monitor. The nurse
enters his room to assess him, and finds him cyanotic, apneic and pulseless. ECG leads are
connected and reveal ventricular fibrillation. Which one of the following is the priority?
a. Intubation and ventilation
b. Compressions X 2 minutes at 100/minute
c. Epinephrine 1 mg IV
d. Defibrillation with 3 quick shocks

3. Mrs. Anu Jose becomes agitated and is at risk for self-exubation. Which one of the following
interventions is the priority?
a. Apply restraints
b. Assess cause of agitation
c. Increase dose of sedatives
d. Have family sit with Mrs. Anu Jose

4. Mr. Binu Mon Jose experiences full thickness circumferential burns to his chest, abdomen and back. Which
one of the following interventions is the priority?
a. Silver sulfadiazine
b. Wound debridement
c. Escarotomies
d. Topical analgesia

5. Mrs. Dakshayani is admitted with urosepsis. Her blood pressure increases to 110/70 following 4 L of
normal saline, however, she remains oliguric with a urine output of < 10 ml/hr. Her oxygenation
deteriorates despite BiPAP, and she requires intubation. Labs reveal: Hb 101 Platelets 62,000 INR
1.9 aPTT 57. Her lactate has increased to 6 from 4. Which one of the following interventions is
a. Steroids
b. Vasopressin
c. Drotrecogin Alfa Activated (Xigris)
d. Dobutamine

6. Six hours following a motor vehicle collision, Mr. Anoop has a 10 fold increase in his CK and
myoglobin. Which one of the following interventions is the priority?
a. Fluid
b. Lasix
c. Tissue plasminogen activator (tPA)
d. Insulin and glucose

7. Following open repair of a ruptured aneurysm, Mr. Ahmad Anwar bladder pressure is 45 mmHg. Which
one of the following interventions is the priority?
a. Continuous bladder irrigation
b. Fluid administration
c. Decrease the amount of PEEP
d. Continuous renal replacement therapy

8. Interpret the following blood gas.
PaO2 78
PaCO2 29
pH 7.29
HCO3 14
BE - 10
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic acidosis
d. Metabolic alkalosis

9. Six hours following a traumatic brain injury due to a fall from a ladder, Mr. Anish P Varugese develops hypotension and a 4 gram drop in hemoglobin. Which one of the following problems would be consistent with these findings?
a. Diabetes insipidus
b. Intracranial hemorrhage
c. Intra-abdominal bleeding
d. Fat embolism

10. Ms. Deepa Jose is admitted with septic shock. She presents following a 12 hour history of sore throat,
decreasing level of consciousness and purpura. Which one of the following interventions should be
a. Airborn precautions
b. Contact precautions
c. Droplet precautions
d. No precautions while on closed circuit ventilation