Fundamental Nursing MCQ Quiz - Objective Question with Answer for Fundamental Nursing - Download Free PDF

• Sodium hypochlorite is a widely recognized disinfectant used in healthcare settings for cleaning and disinfection purposes, especially in environments where infection control is critical. It is effective against a broad range of microorganisms, including viruses like HIV.
• Sodium hypochlorite, commonly referred to as bleach, works by releasing chlorine, which denatures proteins and disrupts essential enzymatic and structural functions in microorganisms, rendering them inactive.
• For disinfection of items and surfaces used by an HIV-positive patient, a diluted solution of sodium hypochlorite (typically 1:10 dilution of household bleach) is recommended to ensure proper sterilization and to reduce the risk of transmission of the virus.
• The use of sodium hypochlorite is endorsed by health organizations like the CDC and WHO for its efficacy in inactivating bloodborne pathogens, including HIV, in clinical and home settings.

• Rationale: Cidex is a brand name for glutaraldehyde, which is primarily used for high-level disinfection of medical instruments like endoscopes. While it is a potent disinfectant, it is not commonly used for routine surface disinfection or for items exposed to HIV-positive patients in non-instrumental settings.
• Additionally, Cidex is more expensive and requires careful handling due to its toxic fumes, making it less practical for general disinfection purposes.

• Rationale: Lysol is a disinfectant that contains quaternary ammonium compounds or phenolic compounds, which are effective against a variety of bacteria and viruses. However, its efficacy against HIV specifically is not as well-documented or recommended as sodium hypochlorite.
• Lysol is more commonly used for general household cleaning rather than for disinfection in medical or high-risk settings.

• Rationale: Both Dettol and Savlon are antiseptics commonly used for personal hygiene and cleaning minor wounds. While they possess antimicrobial properties, they are not recommended for high-level disinfection of surfaces or medical equipment, especially for viruses like HIV.
• These products are not as effective in breaking down viral structures as sodium hypochlorite and are more suited for skin application rather than surface disinfection in healthcare scenarios.

• Sodium hypochlorite is the most effective and widely recommended disinfectant for cleaning items and surfaces used by an HIV-positive patient. Its ability to inactivate the HIV virus and other pathogens makes it a key tool in infection control.
• Other options like Cidex, Lysol, and Dettol with Savlon serve specific purposes but are not as effective or practical for disinfecting surfaces in HIV-related scenarios.

• Hypovolemic shock occurs due to a significant loss of blood volume, leading to inadequate perfusion of tissues and organs. The primary goal of treatment is to restore intravascular volume and improve blood pressure and tissue perfusion.
• Normal saline at 0.9% is an isotonic solution, meaning its osmolarity is similar to that of plasma. This ensures that the fluid remains in the extracellular compartment, including the intravascular space, effectively replenishing lost blood volume without causing a shift of fluids into or out of cells.
• Isotonic fluids like 0.9% normal saline are the first-line intravenous fluids for treating hypovolemic shock because they help stabilize circulation and improve cardiac output rapidly.
• Normal saline is widely available, safe, and commonly used in emergency and hospital settings for fluid resuscitation in cases of hypovolemic shock due to trauma, dehydration, or other causes.

• Rationale: Normal saline at 0.45% is a hypotonic solution. It has a lower concentration of solutes compared to plasma, causing water to move into cells. This can lead to cellular swelling and does not effectively restore intravascular volume in hypovolemic shock.
• Use: Hypotonic solutions are typically used for conditions like hypernatremia or intracellular dehydration, not for fluid resuscitation in hypovolemic shock.

• Rationale: Dextrose 5% is initially isotonic, but once the dextrose is metabolized, the solution becomes hypotonic, leading to water movement into the cells. This does not effectively increase intravascular volume and is not suitable for treating hypovolemic shock.
• Use: Dextrose solutions are often used to provide calories or treat hypoglycemia, rather than for fluid resuscitation.

• Rationale: Normal saline at 3% is a hypertonic solution. It has a significantly higher concentration of solutes compared to plasma, causing water to move out of cells into the extracellular space. While hypertonic saline can be used for severe hyponatremia, it is not appropriate for treating hypovolemic shock as it could worsen dehydration.
• Use: Hypertonic saline is reserved for specific conditions like cerebral edema or severe electrolyte imbalances, not for general fluid resuscitation.

• Normal saline at 0.9% is the best choice for treating hypovolemic shock among the given options because it effectively restores intravascular volume without causing fluid shifts that could exacerbate the condition.
• Other solutions, such as hypotonic or hypertonic fluids, are not suitable for this purpose and are used for different clinical scenarios.

• A urine culture and sensitivity test is performed to identify the presence of bacteria or other pathogens in the urinary tract and to determine the most effective treatment. For accurate results, the sample collected must be representative of the urine in the bladder, not contaminated by bacteria from the urethra or external genitalia.
• The midstream urine sample (also known as a clean-catch sample) is preferred because it minimizes contamination. The early part of the urine stream may wash away bacteria or debris from the urethra, while the later part may also carry contaminants. Collecting the mid part ensures the sample is representative of the bladder's contents.
• The patient should be instructed to clean the genital area with sterile wipes, begin urinating, and then collect the urine after the initial flow has been discarded. This process reduces the risk of contamination and ensures the accuracy of the test.

• Rationale: The early part of the urine stream may be contaminated by bacteria, cells, or debris from the urethra or external genitalia. This can lead to inaccurate culture results and potentially misguide treatment.

• Rationale: While the later part of the urine stream may be less contaminated than the early part, it still carries a risk of introducing non-representative bacteria or debris, especially if the flow has been disrupted or prolonged.

• Rationale: Collecting any part of the urine stream without consideration for contamination increases the likelihood of introducing external bacteria or other artifacts into the sample. This can compromise the reliability of the urine culture results.

• The mid part of the urine stream is the most appropriate sample for a urine culture and sensitivity test as it reduces the risk of contamination and ensures the results are accurate. Proper collection techniques, including genital cleaning and discarding the initial urine flow, are essential for obtaining a reliable sample.

• Specimens such as urine, stool, and swabs are often stored at room temperature (approximately 25 degrees Celsius) for short durations, especially when immediate transport or testing is planned. Storing these specimens at room temperature preserves their integrity for a brief period and prevents undesirable changes, such as bacterial overgrowth or loss of pathogens, which may compromise diagnostic accuracy.
• Urine, stool, and swabs contain microorganisms and other biological components that can degrade or grow uncontrollably under inappropriate storage conditions. Room temperature storage is ideal for these specimens in specific cases where testing or transport occurs promptly after collection.
• In microbiology labs, maintaining the correct storage temperature for specimens is critical to ensure the validity of test results. The appropriate conditions depend on the type of specimen and the diagnostic purpose.

• Rationale: -80 degrees Celsius is typically used for long-term storage of biological specimens, such as bacterial cultures, DNA, or RNA samples. It is not a standard temperature for routine storage of specimens like urine, stool, or swabs, as extreme freezing can degrade certain sample components or alter microbial viability.
• This temperature is more suitable for preserving samples for research purposes or when repeated analyses may be necessary over an extended period.

• Rationale: 4 degrees Celsius is a common refrigeration temperature used for short-term storage of certain biological samples to slow bacterial growth. However, it is not always ideal for specimens like urine, stool, or swabs because some microorganisms may still grow slowly or die off, affecting the diagnostic outcome.
• This temperature may be used for specific specimens or when there is a delay in processing, but it is not the most appropriate standard for all cases.

• Rationale: 37 degrees Celsius is the temperature of the human body and is commonly used for incubating microbiological cultures to promote the growth of pathogens, such as bacteria or fungi. However, storing specimens at this temperature before testing can lead to overgrowth of microorganisms, making it unsuitable for routine specimen storage.
• This condition is inappropriate for maintaining the integrity of samples such as urine, stool, and swabs before laboratory analysis.

• Proper specimen storage is crucial in clinical microbiology to ensure accurate test results. Incorrect storage conditions can lead to degradation or contamination of the specimen, compromising the reliability of diagnostic findings.
• The choice of storage temperature depends on the type of specimen, the time until analysis, and the specific microorganisms being tested for. Laboratories should follow standard guidelines and protocols to maintain specimen integrity during transport and storage.

• For specimens such as urine, stool, and swabs, storing them at room temperature (25 degrees Celsius) is the correct standard method when immediate testing or transport is planned. This helps maintain their viability and integrity for accurate diagnostic testing.

• A Random Blood Sugar (RBS) level of 40 mg/dL is critically low and indicates severe hypoglycemia. Hypoglycemia can lead to neurological symptoms such as confusion, seizures, and even coma if not promptly addressed.
• 50% dextrose is a hypertonic solution containing a concentrated amount of glucose. It is administered intravenously to rapidly elevate blood glucose levels in cases of acute hypoglycemia.
• The immediate management of severe hypoglycemia involves providing a rapid source of glucose to prevent further neurological damage and stabilize the patient.

• Rationale: 5% dextrose is an isotonic solution that provides a lower concentration of glucose compared to 50% dextrose. It is typically used for maintenance fluid therapy rather than for the acute correction of hypoglycemia. In a critically hypoglycemic patient, its glucose content is insufficient to rapidly restore blood sugar levels.

• Rationale: 5% DNS contains both glucose and saline. While it can provide glucose, the concentration is similar to 5% dextrose, which is inadequate for the immediate management of severe hypoglycemia. It is more commonly used in cases requiring hydration along with mild glucose supplementation.

• Rationale: Ringer Lactate is a balanced electrolyte solution used for fluid replacement in cases such as dehydration, shock, or electrolyte imbalances. It does not contain glucose and is not suitable for treating hypoglycemia.

• Severe hypoglycemia is a medical emergency requiring prompt intervention. Among the given options, 50% dextrose is the most appropriate choice for rapidly increasing blood glucose levels and stabilizing the patient. Other solutions either lack sufficient glucose or are intended for hydration and electrolyte replacement rather than acute hypoglycemia management.

'Halitosis' commonly known as Bad breath.

• Halitosis (bad breath) is mostly caused by sulphur-producing bacteria that normally live on the surface of the tongue and in the throat.
• It is used to describe any disagreeable bad or unpleasant odor emanating from the mouth air and breath.
• Halitosis is a latin word which derived from halitus (breathed air) and the osis (pathologic alteration).
• Bad breath is typically caused by bacteria present on the teeth and debris on the tongue.
• Most cases of halitosis are associated with poor oral hygiene, gum diseases such as gingivitis and periodontitis, and dry mouth.
• Dry mouth is a condition in which the salivary glands cannot make enough saliva to keep your mouth moist. 
• Halitosis is not infectious.
• High Blood Pressure may be referred to as Hypertension and Low Blood Pressure may be referred to as Hypotension.
• A headache is called cephalgia in medical terminology.
• Influenza is commonly referred to as Flu.

ECG is the process of recording the electrical activity of the heart over a period of time using electrodes placed on the skin.

Explanation:

5 Moments for Hand Hygiene according to WHO.

Confusion Points

• There is a difference between “Moments of Hand Hygiene” and Steps of Hand Hygiene.
• The 5 Moments for Hand Hygiene defines the key Incidences or situations when health care workers must demonstrate hand hygiene.
• The key to hand washing with 7 Steps of Hand Washing is to ensure that you thoroughly clean all surfaces and areas of your hands, fingers, and wrists.

Concept:

• Rectal examination is a diagnostic method used to inspect :-
  • Disorder of lower gastrointestinal GI tract
  • Prostatic disorders like benign prostatic hyperplasia
  • Active unexplained gastrointestinal bleed
  • Examining women for vaginal wall prolapse.
  • Sometimes prior to a colonoscopy or proctoscopy
• In sims position the person will be placed in side lying position with one leg flexed because of which the anus is clearly visualized and can facilitate the anal related procedures
• Sims' position, named after the gynaecologist -> J. Marion Sims, 

Additional Information

• Lithotomy position is a position where both the legs are flexed at knees and the vagina is clearly visualized for labor and other gynaecological examinations this position is used 
• Dorsal recumbent or supine position is the most common position used to observe the face and chest
• Prone position is when the face is placed downwards, in this position the back is clearly visible 

• The last preoperative assessment is crucial to ensure the patient’s stability and readiness for anesthesia and surgery. Checking vital signs is essential as it provides immediate data on the patient’s physiological status.
• Vital signs include measurements of heart rate, blood pressure, respiratory rate, and temperature, which are critical indicators of a patient’s current health state.
• This final check confirms the patient is in a stable condition to proceed with the operation, ensuring that any immediate issues can be addressed promptly.

• Rationale: A name band is used for patient identification, ensuring that the correct individual receives the correct procedure. While this is vital for preventing medical errors, it is generally verified earlier in the preparation process.

• Rationale: Obtaining signed consent is essential for legal and ethical reasons, ensuring that the patient understands the procedure and agrees to undergo it. This step is completed well before the final stages of preoperative assessment.

• Rationale: Having an empty bladder is important to reduce discomfort during and after surgery and to prevent potential complications. However, this is usually instructed and checked before moving the patient to the operating room area.

• Among the given options, checking vital signs is the final assessment prior to an elective splenectomy. This ensures the patient’s physiological parameters are within safe limits for anesthesia and surgery, thus confirming readiness and overall safety just before the procedure begins.

Explanation:

Oximeter

• Pulse oximetry is a non-invasive test that measures the oxygen saturation level of your blood.
• It can rapidly detect even small changes in Oxygen levels, Pulse, Oxygen saturation level (SpO2%).
• The pulse oximeter is a small, clip-like device that attaches to a body part, most commonly to a finger.
• Medical professionals often use it in emergency rooms or hospitals. 

Concept:

• Chemical burn -> Caused due to exposure to a corrosive chemical.
• Concentrated acids like sulphuric acid and hydrochloric acid can cause chemical burns.
• Immediate medical care must be provided to reduce the impact of the burn.

Explanation:

• Initial care for chemical burn -> Excessive flushing with water for 20-30 minutes.
• Remove the remnants of the chemical from the surface of the body.
• Other steps of chemical burn management -> Removal of dressing -> Done later on.
• Based on the type of burn -> Treatment is provided to the patient.

Additional Information

• Immediately cover the burn area -> Not the first step.
• Remove all the dressings -> Not the initial step.
• Provide the calm environment -> It is done later to help the patient relax.

Concept:

• Nurse should wait for 20 to 30 minutes before you take a temperature by mouth to normalize the body temperature and to prevent from the wrong result
• When the patient drinks some cold drinks there are changes in temperature of buccal cavity cold drinks take down temperature to an extent that false reading on thermometer is evident.
• This greatly affect on health records of patient and also possibly alter the care plan
• However after drinking hot drinks it might take a little long time to return baseline temperature of buccal cavity

Additional Information

Sites of measuring body temperature:-

• Oral
• Tympanic
• Axillary
• Rectal
• Temporal artery temperature

Temperature reading relations

• A normal axillary temperature is between 96.6° (35.9° C) and 98° F (36.7° C). The normal axillary temperature is usually a degree lower than the oral (by mouth) temperature. The axillary temperature may be as much as two degrees lower than the rectal temperature.
• A <- O -> R
• -1     1    +1

Concept:

• The nosocomial infection is an infection which a person can get from the the hospital after 48 hours of the admission. It's also called a hospital-acquired infection or a health-care associated infection. Hence option 1 is the Correct Answer.

​Types

• Bacterial infections are mainly caused by the bacteria which are tiny living things that are too small to see. Most aren’t harmful indeed, but some can cause serious illness. Bacteria are the most common source of nosocomial infections. Common bacteria include E. coli and staph.
• Fungal infections are caused by the fungi a living things, like mushrooms, mold, and yeast. Some fungi can cause harmful contagious infections sometimes. The most common fungi that cause nosocomial infections are Candida (thrush) and Aspergillus.‌
• Viral infections are mainly caused by the Viruses which are are tiny germs that spread through the body by imitating your natural genetic code. They trick your body into making copies of them, just like the body makes copies of other cells. Viruses can cause severe sickness. 

Additional Information

• Idiopathic disease is basically any disease with an unknown cause or mechanism of apparent spontaneous origin.
• Primary infection is the type of infection when first time  people are exposed to and infected by a pathogen. During a primary infection, body has no innate defenses against the organism, such as antibodies.
• Iatrogenic infection is defined as an infection after medical or surgical management, whether or not the patient was hospitalized.

Concept:

• Pain is considered to be the fifth vital sign.
• The four vital signs are:
  • Temperature
  • Respiration
  • Blood pressure
  • Heart rate or pulse
• The assessment of the vital signs provides baseline data of the patient.
• They provide initial information at the time of admission.
• A patient may be in distress, vital signs help to assess the condition.

Explanation:

• Pain is another sign signifying any bodily distress.
• Therefore, health care staff should always assess for any pain at the time of vital assessment.
• Pain can also alter the vital signs.
• For example, it can lead to an increase in blood pressure.
• Therefore, it should be a priority.