RRB staff nurse exam 2015 model 1

                         RRB STAFF NURSE EXAM 2015

                                                                                                                            

1. which of the following drugs is used as cardiotonic ?

(A)   Senna                                              B)Rhubarb

(C) Aloe                                               (D)Digitalis

ANS; D

(pertaining to a substance that tends to increase the Efficiency Of contractions of the heart muscle.

         a pharmacologic agent that increases the force of myocardial contractions. Cardiac glycosides, derived from certain plant alkaloids, exert a tonic effect by altering the transport of electrolytes across themyocardial membrane, causing a decreased efflux of sodium and calcium and a decreased influx of potassium. Digitoxin and digoxin, widely used cardiac glycosidesobtained from  leaves of a species of foxglove, increasethe force of myocardial contractions, extend therefractory period of the atrioventricular node, and, to alesser degree, affect the sinoatrial node and the heart's conduction system).

2. Which of the following are the four basic types of tissues that the body contains ?

(A) Epithelial, connective, muscle and nervous

(B) Loose, dense connective, dense regular and dense irregular

(C) Bone, cartilage,glands and adipose tissue

(D) Muscle, cartilage, glandular and connective tissue

ANS; A

(Tissues are groups of similar cells that perform a common function. There are four categories of tissues in the human body: epithelial, connective, nervous, and muscle.

Epithelial tissue protects your body from moisture loss, bacteria, and internal injury. There are two kinds of epithelial tissues:

·       Covering and lining epithelium covers or lines almost all of your internal and external body surfaces; for example, the outermost layer of your skin and other organs, and the internal surface lining of your lymph vessels and digestive tract.

·       Glandular epithelium secretes hormones or other products such as stomach acid, sweat, saliva, and milk.

Connective tissue generally provides structure and support to the body. There are two types of connective tissue:

·       Loose connective tissue holds structures together. For example, loose connective tissue holds the outer layer of skin to the underlying muscle tissue. This tissue is also found in your fat layers, lymph nodes, and red bone marrow.

·       Fibrous connective tissue also holds body parts together, but its structure is a bit more rigid than loose connective tissue. Fibrous connective tissue is found in ligaments, tendons, cartilage, and bone.

Nervous tissue forms the nervous system, which is responsible for coordinating the activities and movements of your body through its network of nerves. Parts of the nervous system include the brain, spinal cord, and nerves that branch off of those two key parts.

Nervous tissue consists of two kinds of nerve cells:

·       Neurons are the basic structural unit of the nervous system. Each cell consists of the cell body, dendrites, and axon.

·       Neuroglia, or glial cells, provide support functions for the neurons, such as insulation or anchoring neurons to blood vessels.

Muscle tissue differs from other tissue types in that it contracts. Muscle tissue comes in three types: cardiac, smooth, and skeletal. Those muscle tissues are made up of muscle fibers. The muscle fibers contain many myofibrils, which are the parts of the fiber that actually contract. There are three kinds of muscle tissues:

·       Skeletal muscle is attached to bones and causes movements of the body.

·       Cardiac muscle is found in the heart.

·       Smooth muscle lines the walls of blood vessels and certain organs such as the digestive and urogenital tracts.)

3. A general term denoting inflammation of heart ?

(A)       Angina pectoris

(B)            Coronary thrombosis

(C)   Carditis

(D)   Bradycardia

ANS; C

(Carditis is the inflammation of the heart or its surroundings.

It is usually studied and treated by specifying it as:

·         Pericarditis is the inflammation of the pericardium

·         Myocarditis is the inflammation of the heart muscle

·         Endocarditis is the inflammation of the endocardium

4. Which of the following infections is most frequently found in long term care patients ?

(A)   Skin and soft tissue

(B)   Gastro intestinal tracat

(C)   Urinaty tracat

(D)   Respiratory tract

ANS; (Urinary tract infections are the most common type of nosocomialinfection)

5. What is the approximate time that the blastocyst spends travelling to the uterus for implantation ?

A.    2 days

B.    7 days

C.    10 days

D.    14 days

ANS; B

(A blastocyst is an embryo that has developed in culture in the IVF laboratory for at least five days after egg retrieval and has divided into two different cell types. The surface cells are termed the trophectoderm and will eventually become the placenta and the inner cells, termed inner cell mass will become the fetus. A healthy blastocyst should hatch from its shell (zona pellucida) by the end of six days or earlier and is then ready to begin to implant within the lining of the uterus)

6. Droplet precautions  require?

1. Use of surgical mask when within three feet of the patient
2. Special air handling and ventilation systems
3. Gloves and gowns at all times
4. Strict isolation of the infected patient in a private room

ANS ; D

(Droplet precautions are intended to prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions. Because these pathogens do not remain infectious over long distances in a healthcare facility, special air handling and ventilation are not required to prevent droplet transmission. Infectious agents for which droplet precautions are indicated are found in Appendix A and include B. pertussis,influenza virus, adenovirus, rhinovirus, N. meningitides, and group A streptococcus (for the first 24 hours of antimicrobial therapy). A single patient room is preferred for patients who require droplet precautions)

7. The most useful drug in enuresis ?

1. Haloperidol
2. Diazepam
3. Imipramine
4. chlorpromazine

ANS;C

(Imipramine is used in the treatment of depression, such as depression associated with agitation or anxiety and is similar in efficacy to the antidepressant drug moclobemide.^[4] It has also been used to treat nocturnal enuresisbecause of its ability to shorten the time of delta wave stage sleep, where wetting occurs.)

8. what is the nerve cell that conveys impulses from the central nervous system to the periphery ?

A.  celia

B.  afferent neuron

C.  efferent neuron

D.  dendrite

ANS;C

(The functional classification of neurons

Functionally, there are three kinds of neurons:

—Afferent neurons

These neurons convey sensory information towards the CNS.

—Efferent neurons

These neurons convey motor impulses away from the CNS.

—Interneurons

These neurons interlink and coordinate activity in the other two neurons.  

9. A nurse caring for a patient in labour. The estanal feotal monitor shows a pattern of variable declarations in fetal heart rate. What should the nurse do FIRST?

A.      Change the patient positon

B.      Prepare for the emergency cesarian section

C.      Check for placenta previa

D.      Administer 02

ANS; A

(Variable Decelerations

 

·  Vagally mediated through chemoreceptors or baroreceptors.

·  Accelerations "shoulders" before and after a variable deceleration are thought to be caused by partial cord occlusion .Decreased venous return causes a baroreceptor-mediated acceleration.

·  Hypertension and decreased arterial oxygen tension secondary to complete cord occlusion results in deceleration.

·  Variables occur with head compression secondary to vagal nerve activation, and with movement in the premature fetus[30]

·  The timing of the deceleration may occur periodically either with or after the contraction [31].

Management of Variables 
 

·  Change position to where FHR pattern is most improved. Trendelenburg may be helpful.

·  Discontinue oxytocin.

·  Check for cord prolapse or imminent delivery by vaginal exam.

·  Consider amnioinfusion[35-37]

·  Administer 100% O2 by tight face mask )

10. Sedative action is shown in by which of the following ?

A.    Aloe

B.    Digitalis

C.    Vinca

D.    Ashwagandha

 

ANS; B

(potential benefits of Digitalis including contraindications, adverse ... leaves are used to relieve asthma, as sedatives, and as diuretic/cardiotonics)

11. Which of the following constituents of food is the chief source of energy ?

1. Carbohydrates
2. Proteins
3. Vitamins
4. lipids

ANS ; A

(Carbohydrates serve as the body's main source of calories or energy and should comprise 50 to 60 percent of your total caloric intake

Fat- 30 %, protein – 10 %.)

12. the  quality of protein is assessed by  comparison to the “reference  protein “  which is ?

A.      human protein

B.      pork protein

C.      chicken protein

D.      egg protein

ANS ; D

(The egg is a complete protein food because egg protein has all nine of the essential amino acids (as well as all nine of the non-essential amino acids). Scientists often use egg protein as the standard against which they judge all other proteins. Based on the essential amino acids it provides, egg protein is second only to mother’s milk for human nutrition. A large egg contains 6.29 grams of high-quality protein, about 12.6% of the Daily Reference Value (DRV) for protein.)

13. All of the following require hospitalization, except ?

A.      5 % Burns in children

B.      10 % scalds in children

C.      Electrocusion

D.      15 % deep burns in adults

ANS; C

(Electrocution is death caused by electric shock, either accidental or deliberate)

14. An irreversible urge to move about along with inner restlessness, is called ?

A.      Akathisia

B.      Akinesia

C.      Hyper kinesia

D.      Dyskinesia

ANS; C

(a disorder occurring in children andadolescents, characterized by excessiveactivity, extreme restlessness, impulsivity,and a short attention span.)

15. Which of the following do water soluble vitamins include ?

A.      Vitamin A

B.      Vitamin C

C.      Vitamin E

D.      Vitamin K

ANS ; B

1.     (Because of this, your body cannot store excess amounts of water-soluble vitamins for later use. There are a total of nine water-soluble vitamins: the B vitamins -- folate, thiamine, riboflavin, niacin,pantothenic acid, biotin, vitamin B6 and vitamin B12 -- and vitamin C.

Fat soluble vitamins – A,D,E,K)

16. Which structure is responsible for protecting the fetus ?

1. Decidua
2. Amniotic fluid
3. Corpus luteum
4. Yolk sac

ANS; B(Amniotic fluid or liquor amni  is the protective liquid contained by theamniotic sac of a pregnant female.)

17. Autism is considered a ?

A.      Neurodevelopmental disorder

B.      Social and language communication problem

C.      Metabolic disease

D.      Result of hypothalamus damage

ANS ; B

(a mental condition, present from early childhood, characterized by great difficulty in communicating and forming relationships with other people and in using language and abstract concepts.)

18. Maslow,s hierarchy of needs is useful to nurses who continually proioritize a client,s nursing care needs. The most basic or first level needs include ?

A.      Esteem and self esteem needs

B.      Self – actualization

C.      Love and belongings

D.      Air, water and food

ANS; D 

The original hierarchy of needs five-stage model includes:

1. Biological and Physiological needs - air, food, drink, shelter, warmth, sex, sleep.

2. Safety needs - protection from elements, security, order, law, stability, freedom from fear.

3. Love and belongingness needs - friendship, intimacy, affection and love, - from work group, family, friends, romantic relationships.

4. Esteem needs - achievement, mastery, independence, status, dominance, prestige, self-respect, respect from others.

5. Self-Actualization needs - realizing personal potential, self-fulfillment, seeking personal growth and peak experiences.

19. The nurse is caring for patient who’s hypoglycemic. This patient will have a blood glucose level ?

A.      Below 70 mg / dl

B.      Between 70 and 120 mg / dl

C.      Between 120 and 180 mg / dl

D.      Over 180 mg / dl

ANS; A the mother

20. Breasfeeding is contraindicated if is taking ?

A.      Propanolol

B.      Broad spectrum antibiotics

C.      Sulfonylureas

D.      Insulin

ANS; C

(sulfonylureas have been found to cross into breast milk)

21. The progressive dehydration of indigestible materials and organic wastes prior to the elimination from the body is called ?

A.      Compaction

B.      Excretion

C.      Absorption

D.      Ingestion

ANS; A

22. Founder of modern nursing ?

A.      Dorthea Dix

B.      Florance Nightingale

C.      Clara Barton

D.      Mary mahoney

ANS; B

23. the functions of the oral cavity include ?

A.      Mechanical processing

B.      Lubrication

C.      Analysis of the food

D.      All of the above

ANS; D

(The function of the oral cavity and its structures is to begin the process of digestion. The oral cavity receives food, chews and mixes it with saliva and then begins the swallowing process. The taste buds on the tongue provide the different sensations of taste. The oral cavity plays an important role in speech.)

24. Thirty year old banu begam was brought to the casulity  in a state of altered sensorium. She was on lithum treatment for the affective disoreder and suffered an attack of epileptic fits. On examination she has tremors, incresed deep tension reflexives, and incontinence of urine. She also had undergone an apisode of severe gastro- entrities 2 days ago. Lithium  level in the serum is 1.95 deq/L. the most likely cause is?

A.      Lithium toxicity

B.      Severe dehydreation

C.      Manic stupor

D.      Epileptic fits

ANS; A

(The therapeutic range for lithium has been established at 0.6 - 1.2 mmol/L. Within this range)

25.   Which of the following is not a major function of the stomach?

A.      Absoption of water and nutrients

B.       Bulk storeage

C.       Chemical digestion

D.      Mechanical breakdown

ANS; A (The stomach secretes acid and enzymes that digest food. Ridges of muscle tissue called rugae line the stomach. The stomach muscles contract periodically, churning food to enhance digestion. The pyloric sphincter is a muscular valve that opens to allow food to pass from the stomach to the small intestine.)

26.   Which of the following is the most important essential fatty acid ?

A.      Linnoleic acid

B.       Folic acid

C.       Stearic acid

D.      Leptoleic acid

ANS; A

(The two most important essential fatty acids are;

1.    Linoleic acid: The principal precursor of omega-6 fatty acids that play a crucial role in pro-inflammatory reactions, such as formation thrombus (blood clots), allergic reactions.

2.    Linolenic acid: The precursor of omega-3 fatty acid that is important for growth and development.

)

27.   Cleaning agents desingated as hospital grade detergents/ disinfectants must ?

A.      Be safe for use on the patients skin

B.       Inactivate specific  organisms such as streptococcus

C.       Contain appropriate concentrations of household bleech

D.      Be free of harsh chemicals such as isopropyl alcohol

ANS; B

Disinfectants are antimicrobial agents that are applied to non-living objects to destroy microorganisms that are living on the objects.^[1] Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than sterilization, which is an extreme physical and/or chemical process that kills all types of life.^[1] Disinfectants are different from other antimicrobial agents such as antibiotics, which destroy microorganisms within the body, and antiseptics, which destroy microorganisms on living tissue. Disinfectants are also different from biocides — the latter are intended to destroy all forms of life, not just microorganisms. Disinfectants work by destroying the cell wall of microbes or interfering with the metabolism.

28.   Which is the stucture that plays the biggest role in cellular function ?

A.      Golgi apparatus

B.       Nucleus

C.       Mitochondria

D.      Ribosome

ANS; B

 The function of the nucleus is to maintain the integrity of these genes and to control the activities of the cell by regulating gene expression—the nucleus is, therefore, the control center of the cell. The main structures making up the nucleus are the nuclear envelope, a double membrane that encloses the entire organelle and isolates its contents from the cellular cytoplasm, and the nucleoskeleton (which includes nuclear lamina), a network within the nucleus that adds mechanical support, much like the cytoskeleton, which supports the cell as a whole.

29.   pregnancy continued beyond 2 weeks of expected date of delivery is termed as

A.      Post term pregnancy

B.       Preterm pregnancy

C.       False pregnancy

D.      Pseudocyesis

ANS;A

Although pregnancy is said to last nine months, healthcare providers track pregnancy by weeks and days. The estimated delivery date, also called the estimated due date, is calculated as 40 weeks or 280 days from the first day of the last menstrual period. Only 4 percent (1 in 20) women will deliver on their due date. The normal duration of pregnancy is 37 to 42 weeks, which is referred to as “term.”

A postterm pregnancy, also called a prolonged pregnancy, is one that has extended beyond 42 weeks or 294 days from the first day of the last menstrual period. As many as 10 percent of pregnancies will deliver postterm.

Accurate dating — Accurate dating is essential to ensure that the pregnancy is in fact postterm. Ideally, an accurate gestational age is determined early in the pregnancy. In women who have regular menstrual periods, the date can often be reliably calculated based on the last menstrual period and a physical examination.

If there is uncertainty about the dates, or if the size of the woman's uterus is larger or smaller than expected based on the date of the last period, the gestational age of the fetus and due date can be estimated based upon findings on fetal ultrasound examination. This estimate is most accurate when performed early in pregnancy; ultrasounds performed in the last half of pregnancy are less reliable for estimating the due date.

30.   for disposable items, the most effective method for sterilization is

A.      dry heat

B.       incineration

C.       gamma ratiation

D.      boiling heat

ANS;B

Incineration will also burn any organism to ash. It is used to sterilize medical and other biohazardous waste before it is discarded with non-hazardous waste.

31.   in which of the following cases would oral temperature be contraindicated ?

A.      Patient had oral surgery

B.       Patient with hostory of epilepsy

C.       Patient experiencing shaking chill

D.      All of these

ANS; D

Oral temperatures are contraindicated for an unconscious patient, for an infant, or when the patient must breathe through the mouth.

32.   Alcohol – based hand rinse should not be used ?

A.      If the patient has a respiratory infection

B.       Prior to patient contact

C.       If fingernails are chipped

D.      If hands are visibly dirty

ANS; A

Some specific studies have looked at inhalation of ethanol and this has resulted in some countries reviewing its use. However, for hand hygiene, due to the limited time of exposure alcohol is not absorbed in measurable quantities. . In the unlikely event that the Task Force finds ethanol use should be limited, then this formulation will not be recommended by the WHO. The Guidelines will be finalized before the end of 2008.

33.   A condition  in which the coronary circulation becomes blocked and the cardiac muscle cells die from oxygen starvation is called ?

A.      Myocardial infarction

B.       Coronary thrombosis

C.       Angina pectoris

D.      Tachycardia

ANS; A

Limitation of blood flow to the heart causes ischemia(cell starvation secondary to a lack of oxygen) of the myocardial cells. Myocardial cells may die from lack of oxygen and this is called a myocardial infarction(commonly called a heart attack)

34.   In antacid preparation constipating effect of calcium is balanced by which of the following ?

A.      Aluminium antacids

B.       Magnesium antacids

C.       Sodium bicarbonate

D.      Alginic acid

ANS; B

It can be also found with magnesium containing antacids in an attempt to balance the constipative effect of calcium with the laxative effect of magnesium.

35.   The banana fruit is rich in which of the following vitamins ?

A.      Vitamin A

B.       Vitamin C

C.       Vitamin K

D.      None of the above

ANS;B

One cup of this sweet yellow fruit also contains:

·         41% of your recommended vitamin B6

·         33% of your recommended vitamin C

·         30% of your recommended manganese

·         23% of your recommended potassium

·         15% of your recommended magnesium

·         Copper

·         Phosphorus

·         Riboflavin

·         Vitamin C

·         Folate

·         Fiber

·         Iron

36.   A client with bacterial pnemonia is to be started on intravenous antibiotics. Which of the following diagnostic tests must be completed before antibiotic therapy begins?

A.      Urinalysis

B.       Sputum culture

C.       Chest radiograph

D.      Red blood cell count     

ANS;  B

Culture and sensitivity test only reveals the bacterial organism cause pneumonia . so the answer is sputum culture  

37.   The common cause of diarrhoea in children, is?

A.      Rato virus

B.       Narwalk virus

C.       Adenovirus

D.      Giardiasis

ANS; A

Viruses cause about 70% of episodes of infectious diarrhea in the pediatric age group  Rotavirus 

38.   Which of the following instructions should a nurse give to a patient who is 26 weeks pregnant and complains of constipation ?

A.      Encourage her to increase her intake of roughage and to drink at least six glasses of  water per day

B.       Tell her to ask her caregiver for a mild laxative

C.       Tell her to go to the evaluation unit because constipation may cause contractions.

D.      None of the these.

ANS ;A

encourage the client to increase her intake of high-fiber foods (roughage) and to drink at least six glasses of water per day. Mild laxatives and stool softeners may be needed, but dietary changes should be tried first. Straining during defecation and diarrhea can stimulate uterine contractions, but telling the client to go to the evaluation unit doesn't address her concern. - See more at: http://allfornursing.blogspot.in/2012/05/exam-notes-mchn-antepartum-period-part.html#sthash.62hF9zGf.dpuf

39.   Attention deficit hyperactivity disorder (ADHD) does not lead to which of the following?

A.      Schizophrenia

B.       Alcoholism

C.       Intellectual changes

D.      Antisocial becaviour

ANS;A

The exact cause of attention deficit hyperactivity disorder (ADHD) is not fully understood, although a combination of factors is thought to be responsible.

Genetics

ADHD tends to run in families and, in most cases, it is thought the genes you inherit from your parents are a significant factor in developing the condition.

Research shows that both parents and siblings of a child with ADHD are four to five times more likely to have ADHD themselves.

However, the way ADHD is inherited is likely to be complex and isn't thought to be related to a single genetic fault.

Brain function and structure

Research has identified a number of possible differences in the brains of people with ADHD compared to those who don't have the condition, although the exact significance of these is not clear.

For example, studies involving brain imaging scans have suggested that certain areas of the brain may be smaller in people with ADHD, whereas other areas may be larger.

Research has also shown that the brain may take an average of two to three years longer to mature in children with ADHD, compared to children who don't have the condition.

Other studies have suggested that people with ADHD may have an imbalance in the level of chemicals in the brain called neurotransmitters, or that these chemicals may not work properly.

Other possible causes

Various other causes have also been suggested as having a role in the development of ADHD, including:

• being born prematurely (before the 37th week of pregnancy)
• having a low birthweight
• brain damage either in the womb or in the first few years of life
• drinking alcohol, smoking or misusing drugs while pregnant
• exposure to high levels of toxic lead at a young age

40.   BCG vaccine is admnistered to children  under one year old?

A.      Intradermally

B.       Subcutaneously

C.       Intramuscularly

D.      Orally

ANS;A

BCG is the only vaccine with this route of administration. Intradermal injection of BCG vaccine reduces the risk of neurovascular injury

41.   When cephalic presentaion is complicated by the presence of a hand or foot it is called ?

A.      Vertex presentation

B.       Face presentation

C.       Compound presentation

D.      Brow presentation.

ANS;D

When a cephalic presentation is complicated by the presence of a hand or a foot or both alongside the head or presence of one or both hands by the side of the breech, it is called compound presentation