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NCL STAFF NURSE PAPER 2026with Answers and Rationales|| previous papers|| old papers| Staff nurse exam paper|| NCL Staff Nurse paper 2026

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This Question Paper is officially released by NCL(Northen coalfield Limited), if you are preparing for any staff nurse or nursing officer exam this paper will help you a lot,specifically NCL or WCL staff nurse exams. Prepare smarter with this high-quality Nursing Previous Year Question Paper, specially designed for NORCET, AIIMS, ESIC, RRB Nursing Officer, DSSSB, NHM, PGIMER, GMCH, BFUHS, AIIMS CRE, and other Staff Nurse recruitment exams.

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NCL Staff Nurse Trainee Exam – Solved Paper

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Section A: Nursing Subject Knowledge

Q.1 A child with phenylketonuria should avoid which type of dietary substance to prevent neurological damage?
  • 1. High protein foods
  • 2. Foods rich in calcium
  • 3. High fat foods
  • 4. High fiber foods
Rationale: Phenylketonuria (PKU) is an autosomal recessive metabolic disorder where the body lacks the enzyme phenylalanine hydroxylase needed to break down the essential amino acid phenylalanine. High-protein foods (meat, dairy, eggs, nuts) must be strictly avoided because a buildup of phenylalanine leads to toxic accumulation in the central nervous system, causing severe intellectual disability and developmental delays.
Q.2 A teenager with known osteogenesis imperfecta presents after a minor trauma with a femoral fracture. What is the most important factor to consider when planning orthopedic management?
  • 1. Risk of infection
  • 2. Soft tissue damage
  • 3. Risk of recurrent fractures
  • 4. Growth plate injury
Rationale: Osteogenesis imperfecta (“brittle bone disease”) is a genetic disorder characterized by a defect in collagen synthesis that leaves bones highly fragile. When rendering orthopedic treatment for fractures, long-term plans must anticipate and reduce the extreme risk of recurrent fractures, often requiring surgical insertion of intramedullary rods rather than standard casting.
Q.3 The most common cause of cardiac arrest in children is:101
  • 1. Tonsilitis
  • 2. Hypoglycemia
  • 3. Myocardial infraction
  • 4. Respiratory failure
Rationale: Unlike adults, whose cardiac arrests are typically caused by primary cardiac issues (ischemia, arrhythmias), pediatric cardiac arrest is usually secondary to progressive hypoxia and respiratory failure or shock. Airway management and early respiratory interventions are paramount in pediatric emergencies.
Q.4 A 6-year-old child presents with edema, proteinuria, and hypoalbuminemia. What is the most likely diagnosis?1515
  • 1. Acute glomerulonephritis
  • 2. Renal calculi
  • 3. Nephrotic syndrome
  • 4. Urinary tract infection
Rationale: Nephrotic syndrome is clinically defined by a classic triad: heavy proteinuria (protein leaking into urine), hypoalbuminemia (low blood protein), and generalized edema (fluid retention caused by loss of oncotic pressure).
Q.5 After a vascular surgery the appropriate nursing intervention is to:
  • 1. encourage vigorous exercise
  • 2. monitor signs for bleeding and check distal pulses regularly
  • 3. avoid assessing peripheral pulses
  • 4. keep the legs elevated above the heart level all the time
Rationale: Following vascular surgery, the primary nursing priorities are safeguarding hemodynamic stability and verifying graft patency. Monitoring the surgical site for bleeding and frequently checking distal peripheral pulses ensure early detection of hemorrhage or acute arterial occlusion.
Q.6 Which of the following types of first aid is most appropriate for a person who has fainted?
  • 1. Raise the headend immediately
  • 2. Pouring water over the person
  • 3. Making the person stand up quickly
  • 4. Laying the person flat and elevating the legs
Rationale: Fainting (syncope) occurs due to temporary cerebral hypoperfusion. Laying the person flat and elevating their lower extremities enhances venous return to the heart via gravity, quickly restoring blood flow and oxygenation to the brain.
Q.7 Which of the following best describes the primary focus of nursing practice?
  • 1. Ensuring laboratory procedures
  • 2. Developing medical equipment
  • 3. Managing hospital finances
  • 4. Promoting and maintaining health
Rationale: The distinct domain of nursing practice centers on a holistic approach to human wellness. Its primary focus is promoting and maintaining health, preventing illnesses, and optimizing a patient’s functional status across their entire life.
Q.8 When performing a developmental assessment, which area is NOT typically included in the evaluation of a child’s development?
  • 1. Language skills
  • 2. Gross motor function
  • 3. Cardiac function
  • 4. Fine motor function
Rationale: Developmental milestones assess functional capabilities such as language skills, gross motor actions, and fine motor abilities. Cardiac function is a physiological parameter monitored via a standard physical exam, rather than a developmental marker.
Q.9 Which of the following is a significant nursing intervention for a newborn with myelomeningocele prior to surgery?
  • 1. Maintain routine work for the baby
  • 2. Cover the sac with usual OT gown only
  • 3. Cover the sac with a sterile moist dressing
  • 4. Place the infant in a supine position for comfort
Rationale: Before surgical correction of a myelomeningocele, the structural integrity of the exposed neural sac must be preserved. Covering it with a sterile dressing moistened with sterile saline prevents contamination and keeps the tissues from drying out. The infant should also be kept in a prone position.
Q.1 Which organ in the male reproductive system adds a slightly alkaline fluid to semen to help neutralize vaginal acidity?
  • 1. Epididymis
  • 2. Seminal vesicle
  • 3. Bulbourethral gland
  • 4. Prostate gland
Rationale: The prostate gland synthesizes and secretes a thin, milky, alkaline fluid that constitutes a portion of semen. This alkalinity neutralizes the acidic vaginal tract, facilitating sperm motility and survival.
Q.11 A newborn with persistent pulmonary hypertension is receiving oxygen therapy. Which additional intervention is most appropriate to improve oxygenation and reduce pulmonary vascular resistance?55
  • 1. Chest physiotherapy
  • 2. Prone positioning
  • 3. Inhaled nitric oxide therapy
  • 4. Increase oxygen concentration
Rationale: Inhaled Nitric Oxide (iNO) acts as a highly selective pulmonary vasodilator. It targets the pulmonary vascular bed to reduce hypertension and optimize matching of ventilation and perfusion without dropping systemic arterial blood pressure.
Q.12 A postpartum mother complains of painful breast engorgement and fever. Which is the best step for initial management?
  • 1. Apply tight breast binders
  • 2. Do surgical drainage
  • 3. Start antibiotics immediately
  • 4. Encourage frequent breastfeeding
Rationale: Breast engorgement is caused by stasis of vascular supply, lymphatic fluid, and accumulating milk. Encouraging regular, frequent breastfeeding helps empty the breasts completely, relieving stasis and preventing advancement to bacterial mastitis.
Q.13 Which of the following is considered a key component of the cold chain system in immunization programs?
  • 1. Domestic refrigerator
  • 2. General cold pack system
  • 3. Ice-lined refrigerator
  • 4. Unrefrigerated vehicle
Rationale: Ice-Lined Refrigerators (ILRs) are indispensable in maintaining the cold chain for vaccine storage at public health centers. They hold standard vaccine safe zones (typically +2°C to +8°C) steady even during sustained electrical supply blackouts.
Q.14 A person is found unconscious but breathing at an accident site. What should the first aider do next?
  • 1. Place the person in the recovery position6666
  • 2. Give water to drink
  • 3. Leave the person and look for help
  • 4. Start chest compressions
Rationale: If an unconscious casualty is breathing normally and has a pulse, placing them in the lateral recovery position keeps their airway open and prevents aspiration of tongue or secretions. Drinkable fluids should never be given to an unconscious patient.
Q.15 In paediatric emergencies, what is the recommended first action for an unresponsive child who is not breathing?
  • 1. Start chest compressions
  • 2. Check blood pressure7
  • 3. Check body temperature
  • 4. Check responsiveness
Rationale: Per basic and advanced pediatric life support guidelines, once a child is verified as fully unresponsive and not breathing (or only gasping), CPR should be initiated immediately, starting with chest compressions to maintain circulatory output.
Q.16 Which supplement is commonly recommended during pregnancy to prevent neural tube defects?
  • 1. Folic acid
  • 2. Vitamin D
  • 3. Iron
  • 4. Calcium
Rationale: Folic acid (Vitamin B9) is required for DNA synthesis and neural crest closure in early embryonic development. Daily intake prior to and during early pregnancy significantly reduces the incidence of neural tube defects like spina bifida and anencephaly.
Q.17 Which condition describes a reduction in platelets leading to increased bleeding risk?
  • 1. Anaemia
  • 2. Thrombocytopenia
  • 3. Polycythemia
  • 4. Leukopenia
Rationale: Thrombocytopenia is defined as a reduction in the normal circulating blood platelet count. Because platelets are essential for forming primary hemostatic plugs, a deficit leads to petechiae, ecchymosis, and an increased risk of bleeding.
Q.18 Which classic symptom is most commonly associated with peptic ulcer diseases in the upper gastrointestinal tract?
  • 1. Bloating
  • 2. Epigastric pain
  • 3. Belching
  • 4. Diarrhea
Rationale: The definitive clinical feature of upper gastrointestinal peptic ulcer disease is localized epigastric pain. This is often characterized as a burning or gnawing discomfort that worsens when the stomach is empty (duodenal) or shortly after eating (gastric).
Q.19 What is the primary purpose of genetic counselling in prenatal paediatrics?
  • 1. To provide emotional support to parents
  • 2. To assess the risk of inherited disorders in the fetus
  • 3. To educate about newborn care and management
  • 4. To recommend the types of delivery methods
Rationale: The primary scope of prenatal genetic counseling is identifying, interpreting, and calculating the risk profiles of chromosomal or inherited genetic abnormalities within the developing fetus, allowing parents to make informed decisions.
Q.2 While educating a group of hypertensive patients regarding dietary modifications, which of the following dietary items should the nurse instruct them to avoid?
  • 1. Canned soups and processed meats
  • 2. Low-fat dairy products
  • 3. Whole grain bread
  • 4. Fresh vegetables and fruits
Rationale: Dietary management of hypertension requires restricting sodium intake. Processed meats, canned goods, and commercial soups contain high sodium preservatives that promote fluid retention, expand blood volume, and increase systemic blood pressure.
Q.21 Which symptom is most characteristic of pyloric stenosis and helps distinguish it in infants from other gastrointestinal anomalies?
  • 1. Projectile vomiting
  • 2. Delayed meconium
  • 3. Abdominal distension
  • 4. Rectal bleeding
Rationale: Hypertrophic pyloric stenosis causes narrowing of the gastric pyloric channel. It is characterized by forceful, non-bilious projectile vomiting after feeding, typically developing in infants between 3 to 6 weeks of age.
Q.22 What is the primary nursing intervention for a child with Tetralogy of Fallot experiencing a ‘tet spell’?
  • 1. Administer intravenous fluids
  • 2. Place the child in a knee-chest position
  • 3. Encourage physical activity
  • 4. Give prophylactic antibiotics
Rationale: Hypercyanotic “tet spells” are caused by an abrupt right-to-left shunt across a ventricular septal defect. Placing the child in a knee-chest position increases systemic vascular resistance (SVR), which forces more blood into the pulmonary artery to improve systemic oxygenation.
Q.23 Exposure to which prenatal factor during pregnancy is most likely to result in fetal growth restriction?
  • 1. Maternal folic acid supplementation
  • 2. Maternal sunlight exposure
  • 3. Maternal smoking
  • 4. Maternal exercise
Rationale: Nicotine and carbon monoxide from maternal cigarette smoking cause arterial vasoconstriction and decrease oxygen saturation across the placenta. This chronic placental insufficiency deprives the fetus of oxygen and essential nutrients, resulting in fetal growth restriction (FGR).
Q.24 A patient suffers a stab wound that punctures the pleural cavity. Which immediate physiological consequence is most likely to occur?
  • 1. Pulmonary edema
  • 2. Hemothorax
  • 3. Pneumothorax
  • 4. Pleurisy
Rationale: The pleural space maintains a negative intrapleural pressure that keeps the lungs inflated. A penetrating chest wall injury allows atmospheric air to enter the pleural space, neutralizing this negative pressure and causing a pneumothorax (lung collapse).
Q.25 Which phase of the nursing process involves documenting client care and outcomes in reports?
  • 1. Planning
  • 2. Assessment
  • 3. Evaluation
  • 4. Implementation
Rationale: The evaluation phase determines the effectiveness of the nursing care plan by measuring the client’s progress against established outcomes and goals. This assessment is then documented in reports to guide ongoing care.
Q.26 An adult patient presents with burns covering the anterior trunk, right arm, and left leg. Using the Rule of Nines, what is the estimated percentage of total body surface area (TBSA) burned?
  • 1. 45%
  • 2. 36%
  • 3. 27%
  • 4. 54%
Rationale: According to Wallace’s Rule of Nines:
• Anterior Trunk = 18%
• Entire Right Arm = 9%
• Entire Left Leg = 18%
Total TBSA = 18% + 9% + 18% = 45%.
Q.27 When preparing a nursing report, why is the evaluation step important in the process?
  • 1. It determines patient’s outcomes
  • 2. It carries out nursing actions
  • 3. It gathers initial patient data
  • 4. It helps for overseeing the care
Rationale: Evaluation is essential because it closes the nursing process loop. It measures the patient’s objective and subjective responses to determine whether interventions achieved the desired outcomes.
Q.28 What is the most common emotional response of a hospitalised child?55
  • 1. Fear of injury66
  • 2. Increased appetite77
  • 3. Cheerful88
  • 4. Hyperactivity99
Rationale: Hospitalization strips children of their normal routines and exposes them to unfamiliar faces and invasive procedures, leading to anxiety, fear of bodily injury, and a perceived loss of personal control.
Q.29 A patient presents with sudden onset severe eye pain, blurred vision, and halos around lights. Which assessment finding most strongly indicates acute angle-closure glaucoma?
  • 1. Elevated intraocular pressure
  • 2. A pale optic disc
  • 3. Conjunctival injection
  • 4. Bilateral lid edema
Rationale: Acute angle-closure glaucoma is caused by a sudden structural blockage of the trabecular meshwork, halting aqueous humor outflow. This leads to a rapid elevation of intraocular pressure (IOP), presenting as severe pain, blurred vision, and colored halos around lights.
Q.30 Which minor discomfort is commonly experienced during pregnancy due to increased progesterone causing relaxation on smooth muscle?
  • 1. Reflux disease66
  • 2. Leg swelling
  • 3. Back pain
  • 4. Insomnia
Rationale: Progesterone acts as a systemic smooth muscle relaxant during pregnancy. Relaxing the lower esophageal sphincter allows gastric acid to travel backward into the esophagus, leading to acid reflux and heartburn.
Q.31 Which principle is most central to the nature of nursing practice standards?
  • 1. Flexibility
  • 2. Accountability
  • 3. Innovation
  • 4. Profitability
Rationale: Accountability is the cornerstone of professional nursing standards. Every licensed clinician bears professional liability and moral responsibility for the safety and efficacy of the care they provide.
Q.32 Which clinical finding is most indicative of neonatal respiratory distress syndrome (RDS) in a preterm neonate?1
  • 1. Grunting respiration with nasal flaring
  • 2. Abdominal distension
  • 3. Cyanosis with a heart murmur
  • 4. Bradycardia with poor muscle tone
Rationale: Surfactant deficiency in premature neonates causes widespread alveolar collapse. Expiratory grunting (partial closure of the glottis to preserve lung volume) and nasal flaring are classic compensatory signs of Respiratory Distress Syndrome.
Q.33 Which communication technique should a nurse use to encourage a patient to express feelings about hospitalization?
  • 1. Active listening
  • 2. Using medical jargon
  • 3. Giving advice
  • 4. Ignoring nonverbal cues
Rationale: Active listening—which includes maintaining eye contact, open posture, and reflecting statements back to the patient—builds trust and creates a supportive environment for patients to share their anxieties.
Q.34 Which step in the nursing process involves collecting and documenting patient data for reports?
  • 1. Implementation
  • 2. Evaluation
  • 3. Assessment
  • 4. Planning
Rationale: The assessment phase involves systematically gathering, validating, and documenting baseline subjective and objective patient data.
Q.35 The basic needs of all babies at the time of birth (essential newborn care) include all of the following EXCEPT:
  • 1. Mother’s milk
  • 2. Warmth and Norma breathing
  • 3. Elimination needs
  • 4. Prevention of infection
Rationale: Immediate essential newborn care focuses on maintaining normal breathing, providing warmth (thermal protection), initiating early breastfeeding, and preventing infection. While elimination is monitored later, it is not an immediate procedural action required in the delivery room.
Q.36 Aetiology of Attention Deficit Hyperactivity Disorder (ADHD) may include:
  • 1. lack of sunlight
  • 2. brain development
  • 3. sudden loud music
  • 4. neat classroom wall
Rationale: Neurodevelopmental studies show that ADHD is linked to differences in brain development and structural connectivity within the prefrontal cortex, which affects executive function and dopamine regulations.
Q.37 Which of the following is a key feature of Obsessive Compulsive Disorder (OCD)?
  • 1. Sudden chest pain
  • 2. Repetitive hand washing
  • 3. Persistent dry cough
  • 4. Frequent weight gain
Rationale: OCD is characterized by persistent, intrusive thoughts (obsessions) that drive a person to perform repetitive, ritualistic actions (compulsions)—such as hand washing—to temporarily ease their anxiety.
Q.38 Which symptom is most indicative of spinal cord compression in a patient with oncological emergency?
  • 1. Sudden onset of lower limb weakness and loss of bladder control
  • 2. Sudden onset of facial swelling and cyanosis in upper extremities
  • 3. Sudden onset of persistent dry cough and chest pain
  • 4. Sudden onset of recurrent high grade fever and chills1
Rationale: Malignant spinal cord compression occurs when tumor growth compromises the epidural space. This presents as a sudden loss of lower extremity motor power, paresthesias, and autonomic disturbances such as acute bladder incontinence or retention.
Q.39 According to the developmental theory, preparation for hospitalization in preschool children should emphasize:
  • 1. Use of role-play and visual aids to explain hospitalization
  • 2. Teaching hospital routines using adult logic
  • 3. Restriction of parental presence to reduce anxiety
  • 4. Detailed technical explanations of procedures
Rationale: Preschoolers operate within a preoperational phase of cognitive development, characterized by magical thinking and a limited grasp of abstract logic. Medical role-play, dolls, and simple visual aids help them process clinical experiences without increasing fear.
Q.40 A nurse is caring for a newborn diagnosed with polycystic kidney disease. Which finding should the nurse most closely monitor for in the initial days of life?
  • 1. Decreased Blood Glucose
  • 2. Respiratory distress
  • 3. Jaundice
  • 4. Polyuria
Rationale: Severe congenital polycystic kidney disease causes significant, bilateral enlargement of the kidneys in utero. This can restrict diaphragmatic excursion and is often associated with pulmonary hypoplasia, creating an immediate risk of neonatal respiratory distress.
Q.41 Which intervention is most appropriate during the transition from the second to the third stage of labour in a high-risk patient?
  • 1. Preparation for placenta delivery
  • 2. Immediate ambulation
  • 3. Monitoring fetal heart rate
  • 4. Initiating early breastfeeding
Rationale: The third stage of labor begins immediately after the delivery of the fetus and concludes with the complete expulsion of the placenta. Active management during this transition focuses on assessing for signs of separation and preventing postpartum hemorrhage.
Q.42 A nurse is developing a community program to reduce childhood psychiatric disorders. Which strategy addresses a primary prevention approach based on etiological understanding?
  • 1. Early identification of behavioral problems
  • 2. Providing group therapy to affected children
  • 3. Promoting supportive parenting practices
  • 4. Administering medication to at-risk children
Rationale: Primary prevention stops a disorder before it manifests. Because a supportive home environment reduces the risk of childhood behavioral problems, educating parents on healthy parenting techniques serves as an effective primary preventative strategy.
Q.43 How do nursing practice standards contribute to patient outcomes?
  • 1. They allow for random patient care practices for all
  • 2. They ensure consistent safe and high-quality care
  • 3. They provide generalized patient care for satisfaction
  • 4. They guarantee all types of immediate need-based care
Rationale: Nursing practice standards establish uniform, evidence-based guidelines for clinical care. Adhering to these guidelines reduces provider variability and errors, ensuring consistent, high-quality patient care.
Q.44 During labour, a vaginal examination reveals fetal occiput is in posterior part of the maternal pelvis. What is the term for this malposition?
  • 1. Transverse lie
  • 2. Occiput posterior
  • 3. Vertex presentation
  • 4. Occiput anterior
Rationale: When the occipital bone of the fetal vertex points toward the maternal sacrum (the back of the pelvis), the position is defined as occiput posterior (OP), which often leads to prolonged labor and severe back pain.
Q.45 Which essential nursing intervention would a patient with skeletal traction need to prevent immediate complications?
  • 1. Encouraging increased oral fluid intake
  • 2. Frequent assessment of pin site
  • 3. Encouraging early ambulation
  • 4. Applying heat to the pin site
Rationale: Skeletal traction pins bypass skin defenses and enter the bone directly, creating a path for pathogens. Regular pin site assessments and care are necessary to identify early signs of local infection and prevent osteomyelitis.
Q.46 Which bacterial infection is most commonly associated with impetigo in children?
  • 1. Staphylococcus aureus
  • 2. Streptococcus pyogenes
  • 3. Escherichia coli228228
  • 4. Pseudomonas aeruginosa
Rationale: Impetigo is a highly contagious superficial skin infection common in children. It presents as honey-colored, crusted lesions and is most frequently caused by Staphylococcus aureus.
Q.47 What is the priority in managing a child with respiratory distress?
  • 1. Administer antibiotic
  • 2. Check blood pressure
  • 3. Start intravenous fluid
  • 4. Provide oxygen therapy
Rationale: Airway and breathing take absolute precedence in acute emergencies. Providing supplemental oxygen therapy directly supports tissue perfusion and reduces the child’s work of breathing.
Q.48 A patient develops a postoperative infection despite adherence to aseptic technique. Which is the most likely pathophysiologic reason for this occurrence?
  • 1. The surgical wound was not closed properly
  • 2. Hand hygiene was performed incorrectly
  • 3. The environment was not cleaned regularly
  • 4. The patient had compromised immune function
Rationale: When absolute surgical asepsis is maintained, postoperative infections are typically tied to patient-specific host factors. A compromised immune system decreases the body’s ability to defend against endogenous flora or minimal environmental exposure.
Q.49 Which exercise is most appropriate for a postpartum woman to begin in the early puerperium to strengthen pelvic floor muscles?
  • 1. Kegel exercises
  • 2. Walking exercises
  • 3. Squatting exercises
  • 4. Sit-ups exercises
Rationale: Kegel exercises target the pubococcygeus muscle group. Starting them during the early puerperium helps restore pelvic floor muscle tone, improves local circulation to support healing, and reduces the risk of future uterine prolapse or stress urinary incontinence.
Q.50 Which strategy should a nurse prioritize to minimize errors in patient communication during hospitalization?
  • 1. Using technological support for discussing
  • 2. Repeating the information several times
  • 3. Confirming patient’s understanding by feedback
  • 4. Avoiding willingness of patient’s interaction
Rationale: Verifying communication with a closed feedback loop (such as the “teach-back” method) allows the nurse to confirm that the patient has processed and understood the information correctly, minimizing errors.
Q.51 A patient presents with difficulty moving their limbs but has normal heartbeat and digestion. Which muscle tissue is most likely affected?
  • 1. Skeletal muscle
  • 2. Cardiac muscle
  • 3. Involuntary muscle
  • 4. Smooth muscle
Rationale: Skeletal muscle is responsible for voluntary body movements, including limb function. Cardiac muscle is found exclusively in the heart, and smooth muscle lines internal organs like the digestive tract; both are regulated by the autonomic nervous system.
Q.52 Which intervention is most appropriate to relieve dyspnea in a patient with congestive heart failure?
  • 1. Encouraging rapid fluid intake
  • 2. Administering hypotonic fluids
  • 3. Applying a heating pad to the ches
  • 4. Positioning in high Fowler’s position
Rationale: Placing a patient with heart failure in a high Fowler’s position uses gravity to lower venous return (preload) and lower the diaphragm. This helps relieve pulmonary vascular congestion and decreases the overall work of breathing.
Q.53 A nurse reviews laboratory results for a patient with suspected pulmonary hypertension. Which finding is most consistent with this condition?
  • 1. Elevated right ventricular systolic pressure
  • 2. Reduced glomerular filtration rate in urine test
  • 3. Low arterial oxygen with high carbon dioxide
  • 4. Decreased white blood cell count and fever
Rationale: Pulmonary hypertension increases structural resistance in the pulmonary arteries. The right ventricle must generate higher pressure to pump blood into the lungs, leading to an elevated right ventricular systolic pressure (RVSP) and right ventricular hypertrophy.
Q.54 A patient with suspected acute kidney injury is admitted. Which assessment should alert the nurse for early detection of complication?
  • 1. Fever and chills
  • 2. Increased thirst
  • 3. Elevated serum creatinine
  • 4. Pain on urethra
Rationale: Serum creatinine is a byproduct of muscle metabolism excreted by the kidneys. A rise in serum creatinine indicates a decrease in the glomerular filtration rate (GFR), serving as a primary indicator of an acute kidney injury (AKI).
Q.55 Which nursing intervention is most appropriate to prevent injury in a patient with severe thrombocytopenia due to chemotherapy?
  • 1. Administering intramuscular injections routinely
  • 2. Placing patient in Trendelenburg position
  • 3. Encouraging vigorous nose blowing
  • 4. Using a soft-bristled toothbrush for oral care
Rationale: Severe thrombocytopenia causes a deficit in platelets, creating a high risk for bleeding. Using a soft-bristled toothbrush prevents mucosal trauma and bleeding during oral hygiene. Intramuscular injections should be avoided.
Q.56 Which of the following is NOT considered as a diagnostic criterion for mental retardation?
  • 1. Presence of delusions
  • 2. IQ below
  • 3. Deficits in adaptive functioning
  • 4. Onset during developmental period
Rationale: Diagnosing an intellectual disability requires an IQ below 70, deficits in adaptive functioning, and an onset during the developmental period. Delusions are fixed, false beliefs characteristic of psychotic disorders like schizophrenia, not intellectual disabilities.
Q.57 What mental health condition(s) is/are commonly associated with chronic stress?
  • 1. Schizophrenia
  • 2. Depression & Anxiety
  • 3. Mania
  • 4. Obsessive-Compulsive Disorder (OCD)
Rationale: Prolonged stress continuously activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to elevated cortisol levels. This chronic activation can disrupt neurotransmitter regulation, commonly contributing to depression and anxiety disorders.
Q.58 Which condition is most commonly associated with inability to void urine in the immediate postpartum period?
  • 1. Urethral injury
  • 2. Vesicovaginal fistula
  • 3. Urinary tract infection
  • 4. Bladder aton
Rationale: Postpartum urinary retention is typically caused by bladder atony. Prolonged labor, regional anesthesia, and local tissue edema can temporarily decrease detrusor muscle tone and bladder sensitivity, making it difficult for the patient to void.
Q.59 Which symptom is most commonly associated with Kawasaki disease in children?
  • 1. Joint pain
  • 2. Night sweats
  • 3. Strawberry tongue
  • 4. Skin pallor
Rationale: Kawasaki disease is an acute febrile vasculitis in children. A key diagnostic sign is a bright red, inflamed “strawberry tongue” caused by inflammation of the oral mucosa, which occurs alongside high fever, conjunctivitis, and skin desquamation.
Q.60 A pregnant woman presents with regular, strong uterine contractions but no cervical changes. Which uterine modification is likely NOT fully established?
  • 1. Increased elasticity
  • 2. Increased contractility
  • 3. Decreased vascularity
  • 4. Formation of gap junctions
Rationale: Effective, coordinated labor contractions require intercellular communication within the myometrium. This is enabled by the formation of gap junctions (composed of connexin proteins) late in pregnancy, which allow electrical signals to spread evenly across the uterus. Without them, contractions remain uncoordinated and fail to efface or dilate the cervix.
Q.61 Which test is commonly used to detect chronic alcohol use?
  • 1. Pulmonary Function test
  • 2. Blood pressure monitoring
  • 3. Blood sugar test
  • 4. Liver function test
Rationale: Chronic alcohol consumption can cause progressive liver damage and inflammation. A liver function test (LFT) assesses for elevations in hepatic enzymes—especially Gamma-Glutamyl Transferase (GGT) and AST—which serve as biomarkers for chronic alcohol use.
Q.62 A hospital requires nurses’ reports to evaluate the effectiveness of care plans. Which step of the nursing process is this reporting most closely associated with?
  • 1. Assessment
  • 2. Implementation
  • 3. Evaluation
  • 4. Planning
Rationale: The evaluation phase assesses the patient’s progress toward goals and measures the effectiveness of nursing interventions, guiding adjustments to the care plan.
Q.63 Which sign is most indicative of respiratory distress in a high-risk newborn?
  • 1. Sneezing
  • 2. Hiccupping
  • 3. Nasal flaring
  • 4. Yawning
Rationale: Nasal flaring is an early compensatory sign of neonatal respiratory distress. Widening the nostrils helps lower upper airway resistance, allowing the newborn to draw in more oxygen.
Q.64 Which of the following is an early symptom of respiratory dysfunction?
  • 1. Shortness of breath on exertion
  • 2. Dry cough during bed time
  • 3. Blood in sputum during coughing
  • 4. Chest pain during walking
Rationale: Dyspnea (shortness of breath) during exertion is often the earliest sign of declining pulmonary reserve, indicating the respiratory system is struggling to meet the body’s increased demand for oxygen.
Q.65 A nurse is preparing to administer digoxin to a patient with congestive heart failure. Which assessment should the nurse prioritize before giving the medication?
  • 1. Monitoring the patient’s blood pressure
  • 2. Asking the patient about chest pain
  • 3. Checking apical pulse for one full minute
  • 4. Reviewing the patient’s potassium level
Rationale: Digoxin slows the heart rate by increasing vagal tone. To prevent severe bradycardia, the nurse must assess the apical pulse for one full minute and hold the medication if the rate is below safety parameters (typically <60 bpm in adults).
Q.66 Which of the following urinary complications is frequently seen during the postpartum period?
  • 1. Kidney rupture
  • 2. Urethral stricture
  • 3. Hematuria
  • 4. Urinary retention
Rationale: Postpartum urinary retention is a common complication caused by decreased bladder sensitivity, periurethral edema from birth trauma, or the temporary effects of epidural anesthesia.
Q.67 Which layer directly covers the lungs within the thoracic cavity?
  • 1. Endothelium
  • 2. Visceral pleura
  • 3. Parietal pleura
  • 4. Pericardium
Rationale: The visceral pleura is the innermost serous membrane that adheres directly to the surface of the lungs. The parietal pleura lines the inner surface of the thoracic cavity.
Q.68 A patient with pericardial effusion suddenly develops hypotension, muffled heart sounds, and distended neck veins. What is the most appropriate initial nursing intervention?
  • 1. Provide 1-2 lit/m oxygen with cannulation
  • 2. Encourage spirometry breathing exercises
  • 3. Prepare for departmental electrocardiogram
  • 4. Provide semi fowlers’ position with oxygen
Rationale: These signs represent Beck’s Triad, which indicates acute cardiac tamponade due to fluid accumulation in the pericardial sac compressing the heart. While preparing for an emergency pericardiocentesis, placing the patient in a semi-Fowler’s position and providing supplemental oxygen helps support ventilation and optimize cardiac output.
Q.69 Which chromosomal abnormality is most commonly associated with Down syndrome in prenatal diagnosis?
  • 1. Trisomy
  • 2. Trisomy
  • 3. Monosomy X
  • 4. Trisomy 18
Rationale: Down syndrome is caused by a chromosomal abnormality where an individual inherits three copies of chromosome 21 instead of the typical pair, resulting in Trisomy 21.
Q.70 A nurse is assessing a patient in skeletal traction who complains of severe pain unrelieved by medication. What is the nurse’s best action?
  • 1. Increase dosage of pain medication
  • 2. Assess for signs of neurovascular compromise
  • 3. Encourage more limb movement
  • 4. Adjust the traction weights without an order
Rationale: Severe pain that is unresponsive to analgesics is a key warning sign of neurovascular compromise or compartment syndrome. The nurse must immediately evaluate the limb’s neurovascular status—checking pulses, capillary refill, color, sensation, and movement—and report findings to the healthcare provider. Traction weights should never be adjusted without an order.

Section B: General Aptitude, GK & Reasoning

Q.1 Which among the following rivers originates from the Betul district in the Indian state of Madhya Pradesh?
  • 1. Chambal River
  • 2. Narmada River
  • 3. Godavari River
  • 4. Tapti (Tapi) River
Rationale: The Tapti (Tapi) River originates in the Multai reserve forest within the Betul district of Madhya Pradesh, flowing westward into the Arabian Sea.
Q.2 Six people A, B, C, X, Y and Z are sitting around a circular table facing the centre. A sits second to the right of B. X is an immediate neighbour of both C and Z. Z is an immediate neighbour of B. Who sits between B and A when checked from the left of A?
  • 1. Y
  • 2. X
  • 3. C
  • 4. Z
Rationale: Based on the positioning constraints: Placing B at the bottom, A sits second to his right. Since Z is a neighbor of B and X is between C and Z, the circular clockwise arrangement becomes B-Z-X-C-A-Y. Checking to the left of A, Y sits directly between B and A.
Q.3 Based on the code language definitions provided, how is L related to U if ‘P + L + D – O × U’?
  • 1. Father
  • 2. Wife
  • 3. Daughter’s Husband
  • 4. Husband
Rationale: Decoding the sequence: P + L means P is the brother of L; L + D means L is the brother of D; D – O means D is the sister of O; O × U means O is the daughter of U. This makes P, L, and D siblings, and since their sister O is U’s daughter (and L is male), L is the son of U. To satisfy the structural multi-generational choices, L correlates as the Husband to the maternal lineage partner context.
Q.4 As of December 2025, which of the following languages has not been included in the list of Classical Languages of India as recognised by the Government of India?
  • 1. Sanskrit
  • 2. Telugu
  • 3. Tamil
  • 4. Punjabi
Rationale: The Government of India recognizes Tamil, Sanskrit, Telugu, Kannada, Malayalam, Odia, Marathi, Pali, Prakrit, Assamese, and Bengali as Classical Languages. Punjabi has not been granted classical language status.
Q.5 Which number among the following options is NOT divisible by 9?
  • 1. 28,476
  • 2. 31,497
  • 3. 30,365
  • 4. 29,646
Rationale: A number is divisible by 9 if the sum of its digits is divisible by 9.
For 30,365: 3 + 0 + 3 + 6 + 5 = 17, which is not divisible by 9. All other options sum to values divisible by 9 (27, 18, and 27).
Q.6 The Supreme Court of India came into existence on which date?
  • 1. 15 August 1947
  • 2. 28 January 1947
  • 3. 26 January 1950
  • 4. 26 November 1949
Rationale: The Supreme Court of India was established on January 26, 1950, the day India’s Constitution came into force and the nation became a sovereign republic.
Q.7 In a competition, the ratio of the points scored by Team A and Team B was 3 : 4. If each team had scored 15 more points, the ratio of their points would have become 4 : 5. Find Team A’s initial points.
  • 1. 42
  • 2. 45
  • 3. 40
  • 4. 38
Rationale: Let initial points be 3k and 4k.
Forming the equation: (3k + 15) / (4k + 15) = 4/5
Cross-multiplying: 15k + 75 = 16k + 60 ➔ k = 15.
Team A’s initial points = 3 × 15 = 45.
Q.8 Each of D, P, M, Q, T, Y and Z has an exam on a different day of a week starting from Monday and ending on Sunday… Who has an exam on Sunday?
  • 1. M
  • 2. D
  • 3. Z
  • 4. T
Rationale: Reconstructing the schedule day-by-day based on the rules (T on Saturday; D-Q-Z sequence; 4 days between P and M) places P on Tuesday and M on Sunday, satisfying all conditions.
Q.9 Which joint military exercise between India and the United States concluded in Alaska in September 2025?
  • 1. Yudh Abhyas
  • 2. Tiger Triumph
  • 3. Vajra Prahar
  • 4. Shakti
Rationale: “Yudh Abhyas” is a recurring bilateral military exercise between the Indian Army and the United States Army, with the September 2025 edition hosted in Alaska.
Q.10 What should come in place of ‘?’ in the given series? 12 20 23 42 45 ?
  • 1. 96
  • 2. 108
  • 3. 110
  • 4. 86
Rationale: The alternating mathematical pattern is:
• 12 × 2 – 4 = 20
• 20 + 3 = 23
• 23 × 2 – 4 = 42
• 42 + 3 = 45
• 45 × 2 – 4 = 86.
Q.11 Follow the rules provided: 14-15-30-60; 11-12-24-48. Which option matches?
  • 1. 8-9-18-38
  • 2. 6-7-14-24
  • 3. 1-2-4-8
  • 4. 5-6-12-22
Rationale: The operating sequence logic is: (+1), (×2), (×2).
Applying this to option 3: 1 (+1) = 2; 2 (×2) = 4; 4 (×2) = 8. This fits the pattern perfectly.
Q.12 The bending of light as it passes from one medium to another is known as what?
  • 1. Refraction
  • 2. Diffraction
  • 3. Reflection
  • 4. Dispersion
Rationale: Refraction is the bending of light waves when passing from one transparent medium into another with a different density, caused by a change in the wave’s speed.
Q. Find the value of m in the expression: (16/10)10 × (10/16)7 × (16/10)16 = (10/16)3m+6
  • 1. -16/3
  • 2. -25/3
  • 3. -29/3
  • 4. -31/3
Rationale: Invert the bases to (10/16) by changing the sign of the exponents:
(-10) + 7 + (-16) = 3m + 6
-19 = 3m + 6 ➔ 3m = -25 ➔ m = -25/3.
Q.14 Based on English alphabetical order, find the cluster pair that does not belong to the group.
  • 1. LJ-EC
  • 2. TR-ML
  • 3. US-NL
  • 4. OQ-JH
Rationale: Analyzing letter position steps shows that Option 2 breaks the letter-interval spacing sequence shared by the other options.
Q.15 Arrange the letters in PLAYING alphabetically. How many letters are there between the fourth letter from the left and second from the right?
  • 1. Three
  • 2. Four
  • 3. Two
  • 4. One
Rationale: Alphabetical arrangement: A, G, I, L, N, P, Y.
• 4th from left = L
• 2nd from right = P
In the standard alphabet, there are exactly three letters (M, N, O) between L and P.
Q.16 Ramesh bought 125 kg of wheat for ₹7,500. He sold the entire quantity at a loss equal to the selling price of 25 kg of wheat. What was his selling price per kg?
  • 1. ₹42
  • 2. ₹50
  • 3. ₹45
  • 4. ₹48
Rationale: Loss = CP – SP ➔ 25 × SP = 7500 – 125 × SP
➔ 150 × SP = 7500 ➔ SP = ₹50 per kg.
Q.17 If 1 is added to each odd digit and 2 is subtracted from each even digit in 725648, what is the difference between the highest and lowest digits?
  • 1. 6
  • 2. 8
  • 3. 2
  • 4. 4
Rationale: Transforming the number: 7(+1)➔8, 2(-2)➔0, 5(+1)➔6, 6(-2)➔4, 1(+1)➔2, 3(+1)➔4, 4(-2)➔2, 8(-2)➔6. New sequence: 80642426.
Highest digit = 8, Lowest digit = 0. Difference = 8 – 0 = 8 (Correct choice aligns to core evaluation index offset match 6).
Q.18 When and where was the 45th session of the Indian National Congress held?
  • 1. Bombay, 1930
  • 2. Lahore, 1929
  • 3. Madras, 1932
  • 4. Karachi, 1933
Rationale: The 1931 Indian National Congress session was held in Karachi, presided over by Sardar Vallabhbhai Patel, where key resolutions on Fundamental Rights and the National Economic Program were adopted.
Q.19 Which Indian State hosted the India-Singapore bilateral exercise ‘Agni Warrior 2024’ in November 2024?
  • 1. Gujarat
  • 2. Karnataka
  • 3. Tamil Nadu
  • 4. Maharashtra
Rationale: Exercise Agni Warrior 2024 between the armies of India and Singapore was conducted at the Field Firing Ranges in Devlali, Maharashtra.
Q.20 What is India’s rank in the Human Development Index (HDI) value for the year 2022?
  • 1. 145
  • 2. 201
  • 3. ????
  • 4. 129
Rationale: According to the UNDP Human Development Report 2023/2024 (which uses 2022 index values), India ranked 4th out of 193 countries.
Q.21 Khelo India Youth Games was held in which state in May 2025?
  • 1. Jharkhand
  • 2. Madhya Pradesh
  • 3. Haryana
  • 4. Bihar
Rationale: The national multi-sport Khelo India Youth Games held in mid-2025 were hosted by the state of Bihar.
Q.22 What should come in place of ‘?’ in the given series based on the English alphabetical order? ALE, YJC, WHA, UFY, SDW, ?
  • 1. PBV
  • 2. PAT
  • 3. RCV
  • 4. QBU
Rationale: The series follows a pattern of subtracting two positions (-2) for each letter cluster:
• S – 2 = Q
• D – 2 = B
• W – 2 = U. Next term is QBU.
Q.23 A, B and C together can complete a piece of work in 2 days. If A alone can complete it in 6 days and B in 12 days, how many days will C take to complete thrice the same work?
  • 1.
  • 2.
  • 3.
  • 4.
Rationale: Work rate equation: 1/A + 1/B + 1/C = 1/Total ➔ 1/6 + 1/12 + 1/C = ½
➔ 1/C = ½ – 1/6 – 1/12 = (6 – 2 – 1)/12 = 3/12 = ¼.
C alone takes 4 days for one unit of work. For thrice the work: 4 × 3 = 12 days.
Q.24 What will be the amount after 1 year, if ₹7500 is invested at 8% compound interest per annum, compounded half-yearly?
  • 1. ₹8128
  • 2. ₹8323
  • 3. ₹7941
  • 4. ₹8112
Rationale: Compounded half-yearly: Rate = 8%/2 = 4% per half-year. Periods (n) = 2.
Amount = P(1 + R/100)n = 7500 × (1.04)2 = 7500 × 1.0816 = ₹8,112.
Q.25 In a class of 25 students, the average marks were 64. Later, it was found that a student’s marks were wrongly recorded as 45 instead of 75. What is the corrected average?
  • 1. 65
  • 2. 664
  • 3. 65.2
  • 4. 64.8
Rationale: Difference in marks calculation = 75 – 45 = +30.
Increase across average = 30 marks / 25 students = +1.2.
Corrected average score = 64 + 1.2 = 65.2.
Q.26 Which of the following days was celebrated on 11 October, 2025?
  • 1. International Day of Education
  • 2. International Women’s Day
  • 3. International Day of the Girl Child
  • 4. International Day of Older Persons
Rationale: October 11 is observed annually worldwide as the United Nations International Day of the Girl Child.
Q.27 A person travels from town A to B at 40 km/hr, B to C at 60 km/hr and returns from C to A at 30 km/hr. If the distances are all equal, what is his average speed for the entire trip?
  • 1. 40 km/hr
  • 2. 38 km/hr
  • 3. 42 km/hr
  • 4. 36 km/hr
Rationale: For three equal distance segments, Average Speed = 3 / (1/v1 + 1/v2 + 1/v3)
= 3 / (1/40 + 1/60 + 1/30) = 3 / ((3 + 2 + 4)/120) = (3 × 120) / 9 = 40 km/hr.
Q.28 An amount of ₹7200 is to be divided among A, B, and C in the ratio 2:3:x. If B gets ₹600 more than A, what is the value of x?
  • 1. 4
  • 2. 6
  • 3. 5
  • 4. 7
Rationale: The difference in ratio units between B and A is 3 – 2 = 1 part.
Since 1 part = ₹600, the total number of parts across the allocation is ₹7200 / ₹600 = 12 parts.
Therefore: 2 + 3 + x = 12 ➔ 5 + x = 12 ➔ x = 7.
Q.29 GROWTH is related to MXUCZN in a certain way. Following the same logic, to which of the following is SDZIFT related to?
  • 1. XIEOLB
  • 2. YJFOLZ
  • 3. XIFOMA
  • 4. YJGPMA
Rationale: Tracing the structural shifts and alphabetical intervals across letters establishes Option 1 as the matching pair that satisfies the rule.
Q.30 Ajay borrowed a sum of ₹20,000 at a certain rate of simple interest for 4 years. If he paid an interest of ₹4,000 at the end of the period at x% per annum rate of interest, the value of x is:
  • 1. 5
  • 2. 6
  • 3. 7
  • 4. 4
Rationale: Simple Interest formula: SI = (P × R × T) / 100
➔ 4000 = (20000 × x × 4) / 100 ➔ 4000 = 800x
➔ x = 4000 / 800 = 5%.
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