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STAFF NURSE (MALE / FEMALE / REGION WISE) – PKLI FILTER CLINICS Complete Preparation Guide & Solved Questions (2026) - Apex Rankers

Direct Departmental Recruitment Examination Syllabus & Question Bank

4046 Total Solved Questions
~6069 mins Estimated Reading Time
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Nursing

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Q. 1 Nursing
Difficulty: Easy (1 Mark)
What is the single most effective and fundamental nursing measure to prevent healthcare-associated infections (nosocomial infections)?
A
Wearing sterile gloves at all times
B
Proper hand hygiene (handwashing / alcohol rub) before and after patient contact
✓ Correct
C
Routine prophylactic antibiotic administration
D
Using disposable bedsheets
💡 Step-by-Step Explanation & Concept Rationale
Hand hygiene performed in accordance with the WHO '5 Moments for Hand Hygiene' is the single most proven intervention for breaking the chain of infection in clinical settings.
Q. 2 Nursing
Difficulty: Easy (1 Mark)
Which position is considered most appropriate for a patient experiencing acute severe dyspnea or orthopnea?
A
Trendelenburg position
B
High Fowler's position (sitting upright at 60-90 degrees)
✓ Correct
C
Prone position
D
Dorsal recumbent position
💡 Step-by-Step Explanation & Concept Rationale
High Fowler's position allows gravity to lower the diaphragm, maximizing thoracic expansion and decreasing venous return to the heart to ease respiratory effort.
Q. 3 Nursing
Difficulty: Easy (1 Mark)
In staging pressure ulcers (bedsores), an area of intact skin with non-blanchable erythema over a bony prominence corresponds to:
A
Stage I
✓ Correct
B
Stage II
C
Stage III
D
Stage IV
💡 Step-by-Step Explanation & Concept Rationale
Stage I pressure injury is defined by intact skin with localized, non-blanchable erythema. Stage II involves partial-thickness loss of dermis, Stage III full-thickness skin loss, and Stage IV exposed bone/muscle.
Q. 4 Nursing
Difficulty: Easy (1 Mark)
What is the standard minimum temperature and holding time required for moist-heat sterilization inside an autoclave operating at 15 psi pressure?
A
100°C for 60 minutes
B
121°C for 15-20 minutes
✓ Correct
C
160°C for 2 hours
D
80°C for 30 minutes
💡 Step-by-Step Explanation & Concept Rationale
Autoclaving utilizes saturated pressurized steam at 121°C (250°F) under 15 psi (103 kPa) for at least 15-20 minutes to kill all vegetative microorganisms and bacterial endospores.
Q. 5 Nursing
Difficulty: Medium (1 Mark)
Before feeding a patient through an established nasogastric (NG) tube, what is the most reliable bedside nursing method to verify correct tube placement?
A
Aspirating gastric contents and measuring pH (< 5.5 on pH paper)
✓ Correct
B
Auscultating an air bolus over the epigastrium
C
Placing the distal tube end in a glass of water
D
Checking if the patient can speak
💡 Step-by-Step Explanation & Concept Rationale
Aspirating gastric fluid and testing for acidic pH (<5.5) is the most reliable bedside method; radiographic confirmation is the absolute gold standard for initial placement.
Q. 6 Nursing
Difficulty: Easy (1 Mark)
To prevent urinary tract infections in a patient with an indwelling Foley catheter, the drainage bag should always be positioned:
A
At the level of the patient's heart
B
Below the level of the patient's bladder
✓ Correct
C
Resting directly on the floor
D
Hanging from the top bed rail
💡 Step-by-Step Explanation & Concept Rationale
Keeping the drainage bag below the level of the bladder prevents retrograde backflow of contaminated urine into the bladder, which is the primary cause of CAUTI.
Q. 7 Nursing
Difficulty: Easy (1 Mark)
When administering an intramuscular (IM) injection to an adult, what is the correct angle of needle insertion into the muscle?
A
15 degrees
B
45 degrees
C
90 degrees
✓ Correct
D
25 degrees
💡 Step-by-Step Explanation & Concept Rationale
Intramuscular injections are administered at a 90-degree angle to penetrate the subcutaneous tissue and deposit medication deeply into the vascular muscle mass.
Q. 8 Nursing
Difficulty: Easy (1 Mark)
Which of the following describes the correct technique for sterile donning of gloves?
A
Touching the outside surface of the glove with bare hands
B
Touching only the folded inner cuff of the first glove with the bare hand
✓ Correct
C
Washing hands with cold water and putting gloves on wet hands
D
Blowing into the glove to open fingers
💡 Step-by-Step Explanation & Concept Rationale
When donning sterile gloves, the un-gloved hand touches only the turned-down inner cuff (which will be in contact with the skin), preserving the outer glove sterility.
Q. 9 Nursing
Difficulty: Easy (1 Mark)
Which of the following is an example of an airborne isolation precaution requiring an N95 respirator mask and negative-pressure isolation room?
A
Clostridioides difficile colitis
B
Open active pulmonary tuberculosis
✓ Correct
C
Streptococcal pharyngitis
D
Wound infection with MRSA
💡 Step-by-Step Explanation & Concept Rationale
Mycobacterium tuberculosis is transmitted via droplet nuclei (<5 um) that remain suspended in air; healthcare workers must wear fit-tested N95 respirators.
Q. 10 Nursing
Difficulty: Easy (1 Mark)
The normal oral body temperature range for an adult in degrees Celsius is approximately:
A
35.0°C - 35.5°C
B
36.5°C - 37.5°C
✓ Correct
C
38.0°C - 38.5°C
D
39.0°C - 39.5°C
💡 Step-by-Step Explanation & Concept Rationale
Normal adult body temperature typically fluctuates between 36.5°C and 37.5°C (97.7°F to 99.5°F).
Q. 11 Nursing
Difficulty: Medium (1 Mark)
A patient with a water-seal chest drainage system has continuous vigorous bubbling in the water-seal chamber. What does this finding indicate to the nurse?
A
Normal expected function during deep inspiration
B
An air leak in the chest tube system or patient's pleural space
✓ Correct
C
The lung has fully expanded
D
The suction pressure is too low
💡 Step-by-Step Explanation & Concept Rationale
Intermittent tidaling/bubbling with coughing is normal, but continuous bubbling in the water-seal chamber indicates a leak in the drainage apparatus or persistent pneumothorax.
Q. 12 Nursing
Difficulty: Easy (1 Mark)
During a blood transfusion, the patient complains of chills, back pain, fever, and shortness of breath 10 minutes into the infusion. What is the immediate priority nursing action?
A
Slow the transfusion rate and check vital signs
B
Stop the transfusion immediately and keep the IV line open with normal saline
✓ Correct
C
Administer oral paracetamol and continue
D
Call the blood bank to check crossmatch
💡 Step-by-Step Explanation & Concept Rationale
At the first sign of an acute hemolytic or severe transfusion reaction, the transfusion must be stopped immediately to minimize foreign antigen exposure while maintaining IV access with fresh tubing and 0.9% saline.
Q. 13 Nursing
Difficulty: Easy (1 Mark)
Which clinical sign elicited by tapping the facial nerve anterior to the earlobe produces facial twitching, indicating hypocalcemia in a post-thyroidectomy patient?
A
Trousseau sign
B
Chvostek sign
✓ Correct
C
Romberg sign
D
Homan sign
💡 Step-by-Step Explanation & Concept Rationale
Chvostek's sign is unprovoked or percussion-induced twitching of the circumoral and facial muscles caused by neuromuscular hyperexcitability from hypocalcemia.
Q. 14 Nursing
Difficulty: Easy (1 Mark)
The Glasgow Coma Scale (GCS) evaluates neurological responsiveness across which three behavioral domains?
A
Pupillary response, deep tendon reflexes, cranial nerves
B
Eye opening, verbal response, and motor response
✓ Correct
C
Blood pressure, heart rate, respiratory rate
D
Orientation, memory, abstract thinking
💡 Step-by-Step Explanation & Concept Rationale
The Glasgow Coma Scale assesses Eye Opening (1-4), Verbal Response (1-5), and Motor Response (1-6) for a score ranging from 3 (deep coma) to 15 (fully alert).
Q. 15 Nursing
Difficulty: Easy (1 Mark)
In a patient with deep vein thrombosis (DVT) in the left calf, which nursing intervention is STRICTLY contraindicated?
A
Bed rest with leg elevation
B
Massaging or rubbing the affected calf muscle
✓ Correct
C
Monitoring coagulation parameters
D
Administering prescribed anticoagulation
💡 Step-by-Step Explanation & Concept Rationale
Vigorously massaging or rubbing the affected extremity can dislodge the thrombus, precipitating potentially fatal pulmonary embolism.
Q. 16 Nursing
Difficulty: Easy (1 Mark)
What is the primary post-operative nursing rationale for encouraging early ambulation and deep breathing exercises following major abdominal surgery?
A
To increase urinary output
B
To prevent atelectasis, pneumonia, and deep vein thrombosis
✓ Correct
C
To decrease wound healing time
D
To replace intravenous fluids
💡 Step-by-Step Explanation & Concept Rationale
Early ambulation promotes venous return to prevent DVT and stimulates diaphragmatic movement to reverse alveolar collapse (atelectasis) and prevent hypostatic pneumonia.
Q. 17 Nursing
Difficulty: Easy (1 Mark)
Which of the following is the most characteristic early clinical indicator of developing hypovolemic shock?
A
Severe bradycardia
B
Tachycardia and mild tachypnea with cool, clammy skin
✓ Correct
C
Profound hypertension
D
Flushed warm extremities
💡 Step-by-Step Explanation & Concept Rationale
Compensatory tachycardia and peripheral vasoconstriction (cool, clammy skin) occur early in hypovolemia as sympathetic activation attempts to maintain cardiac output before blood pressure falls.
Q. 18 Nursing
Difficulty: Medium (1 Mark)
For an unconscious patient with a tracheostomy, what is the maximum recommended duration for a single endotracheal suctioning pass to prevent severe hypoxia?
A
5 to 10 seconds
B
10 to 15 seconds
✓ Correct
C
25 to 30 seconds
D
45 seconds
💡 Step-by-Step Explanation & Concept Rationale
Suction passes should not exceed 10 to 15 seconds to prevent suction-induced hypoxia, bradycardia, and mucosal trauma; hyperoxygenation before and after is essential.
Q. 19 Nursing
Difficulty: Easy (1 Mark)
In a diabetic patient who becomes confused, diaphoresis, shaky, and tachycardia with a capillary blood glucose of 45 mg/dL, what is the immediate nursing intervention if conscious?
A
Administer 10 units of regular insulin subcutaneous
B
Administer 15-20 grams of fast-acting oral carbohydrates (e.g., fruit juice or glucose tablets)
✓ Correct
C
Place the patient in Trendelenburg position
D
Encourage the patient to sleep
💡 Step-by-Step Explanation & Concept Rationale
The 'Rule of 15' dictates giving 15-20 g of simple fast-acting carbohydrate (half cup fruit juice or 3-4 glucose tablets) for mild-to-moderate hypoglycemia, rechecking glucose after 15 minutes.
Q. 20 Nursing
Difficulty: Medium (1 Mark)
Which clinical observation is the earliest and most sensitive sign of increasing intracranial pressure (ICP)?
A
Fixed, dilated pupils
B
Change in the level of consciousness (restlessness, lethargy, confusion)
✓ Correct
C
Cushing's triad (bradycardia, hypertension, irregular breathing)
D
Decerebrate posturing
💡 Step-by-Step Explanation & Concept Rationale
Altered level of consciousness is the most sensitive early indicator of rising ICP; pupillary changes and Cushing's triad are late signs indicating imminent brainstem herniation.
Q. 21 Nursing
Difficulty: Medium (1 Mark)
An infant at 1 minute of life has a heart rate of 110 bpm, good vigorous cry, active motion of all extremities, grimaces to suctioning, but has pink body with blue extremities (acrocyanosis). What is the APGAR score?
A
7
B
8
C
9
✓ Correct
D
10
💡 Step-by-Step Explanation & Concept Rationale
Heart rate >100 (2), Good cry/respiration (2), Active motion/muscle tone (2), Grimace/reflex (2), Acrocyanosis/color (1) = Total APGAR score of 9.
Q. 22 Nursing
Difficulty: Easy (1 Mark)
The first stage of labor is defined as extending from the onset of true labor contractions until:
A
Rupture of amniotic membranes
B
Complete cervical dilation (10 cm) and full effacement
✓ Correct
C
Crowning of the fetal head
D
Delivery of the infant
💡 Step-by-Step Explanation & Concept Rationale
The first stage of labor begins with regular uterine contractions and concludes with complete cervical dilatation (10 cm). The second stage is delivery of the infant, and the third stage is delivery of the placenta.
Q. 23 Nursing
Difficulty: Easy (1 Mark)
When caring for a newborn receiving phototherapy for physiological neonatal jaundice, which essential nursing precautions must be maintained?
A
Keep the baby fully clothed in swaddle
B
Cover the infant's eyes with opaque eye patches and shield the genitalia, while monitoring hydration
✓ Correct
C
Withhold all breast milk feedings during phototherapy
D
Apply topical baby oil over the skin
💡 Step-by-Step Explanation & Concept Rationale
Eye shields protect retinas from photochemical damage; genitalia are covered, and frequent breastfeeding is promoted to prevent dehydration and accelerate bilirubin excretion.
Q. 24 Nursing
Difficulty: Easy (1 Mark)
At what age should exclusive breastfeeding ideally be supplemented with timely, nutritionally adequate complementary feeding (weaning)?
A
At 2 months
B
At 4 months
C
At 6 months (180 days)
✓ Correct
D
At 12 months
💡 Step-by-Step Explanation & Concept Rationale
WHO and UNICEF recommend exclusive breastfeeding for the first 6 months of life, followed by introduction of safe and nutritionally adequate complementary foods while continuing breastfeeding up to 2 years.
Q. 25 Nursing
Difficulty: Medium (1 Mark)
In a post-term pregnant patient receiving oxytocin (Pitocin) infusion for labor augmentation, what pattern of uterine contractions signifies hyperstimulation requiring immediate stoppage of oxytocin?
A
Contractions occurring every 2 to 3 minutes lasting 45 seconds
B
Contractions occurring more frequently than every 2 minutes or lasting longer than 90 seconds
✓ Correct
C
Mild irregular contractions once every 10 minutes
D
Contractions accompanied by back pain
💡 Step-by-Step Explanation & Concept Rationale
Uterine tachysystole (>5 contractions in 10 minutes or duration >90 seconds) compromises uteroplacental perfusion, causing fetal hypoxia; oxytocin must be discontinued immediately.
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