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Tamil Nadu HSE Second Year Nursing (General) study materials
Tamil Nadu HSE Second Year Nursing (General) study resources

Tamil Nadu HSE Second Year Nursing (General) practice questions

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Question 1Fundamentals of Nursing

A patient is to receive 500 mL of normal saline over 4 hours using a giving set with a drop factor of 20 drops per mL. What is the correct drip rate?

  1. 63 drops per minute
  2. 25 drops per minute
  3. 125 drops per minute
  4. 42 drops per minute Correct answer.

Explanation

The formula is drops per minute = (total volume in mL × drop factor) ÷ total time in minutes. Here (500 × 20) ÷ 240 = 10000 ÷ 240, which equals about 42 drops per minute.

Question 2Fundamentals of Nursing

Which position is most appropriate for a conscious patient who has just vomited and is at risk of aspiration?

  1. High Fowler position
  2. Trendelenburg position
  3. Left lateral with the head lowered Correct answer.
  4. Supine with a pillow

Explanation

A lateral position with the head turned and slightly lowered allows vomitus to drain out of the mouth by gravity and keeps the airway clear. Supine and head-low-flat positions increase the risk of aspirating gastric contents.

Question 3Fundamentals of Nursing

Which route of drug administration is described as parenteral?

  1. Intramuscular Correct answer.
  2. Oral
  3. Sublingual
  4. Rectal

Explanation

Parenteral means administration by a route other than the alimentary canal, so injections such as the intramuscular route are parenteral. Oral, sublingual and rectal routes all deliver drug through or into the digestive tract.

Question 4Fundamentals of Nursing

A nurse is preparing to give an intramuscular injection to an adult. Which site carries the greatest risk of sciatic nerve injury if poorly selected?

  1. Deltoid site
  2. Dorsogluteal site Correct answer.
  3. Vastus lateralis site
  4. Ventrogluteal site

Explanation

The dorsogluteal site lies close to the sciatic nerve and major vessels, so an incorrectly placed needle can damage the nerve. The ventrogluteal site is preferred for adults because it is away from major nerves and blood vessels.

Question 5Fundamentals of Nursing

What is the primary purpose of maintaining surgical asepsis during a dressing change?

  1. To reduce pain during the procedure
  2. To remove dead tissue from the wound
  3. To speed up clot formation
  4. To prevent microorganisms from entering the wound Correct answer.

Explanation

Surgical asepsis, also called sterile technique, aims to keep all microorganisms out of a sterile field and away from a wound. It does not debride tissue, relieve pain or promote clotting directly.

Question 6Fundamentals of Nursing

A nurse is counting a patient's radial pulse and finds it irregular. What is the most appropriate next action?

  1. Auscultate the apical pulse for a full minute Correct answer.
  2. Record the radial rate and continue routine care
  3. Recount the radial pulse for 15 seconds and multiply by four
  4. Ask the patient to hold the breath and recount

Explanation

An irregular radial pulse may reflect an arrhythmia, and the apical rate gives the true ventricular rate. Counting apically for one full minute also allows detection of a pulse deficit when compared with the radial rate.

Question 7Fundamentals of Nursing

Which temperature site is generally considered the most reliable core temperature measurement in an adult?

  1. Axillary
  2. Temporal artery
  3. Rectal Correct answer.
  4. Oral

Explanation

Rectal temperature closely reflects core body temperature because the rectum is deep within the body cavity. Axillary readings tend to be lower and less reliable, and oral readings are affected by recent food or drink.

Question 8Fundamentals of Nursing

When measuring blood pressure with a cuff, the cuff bladder should ideally cover what proportion of the upper arm circumference?

  1. About 80 per cent Correct answer.
  2. About 40 per cent
  3. About 20 per cent
  4. About 100 per cent

Explanation

The bladder should encircle roughly 80 per cent of the arm circumference and cover about two-thirds of the upper arm length. A cuff that is too small gives falsely high readings and one that is too large gives falsely low readings.

Question 9Fundamentals of Nursing

A patient with a fractured femur is to be moved from the bed to a trolley. Which principle best guides the nurse's body mechanics?

  1. Bend the knees and keep the load close to the body Correct answer.
  2. Keep the feet close together and bend at the waist
  3. Hold the load away from the body to improve balance
  4. Twist the trunk while lifting to reach the trolley

Explanation

Bending the knees and holding the load close to the body reduces the strain on the lumbar spine and uses the strong leg muscles. Feet should be apart for a stable base, and twisting the trunk during lifting should be avoided.

Question 10Fundamentals of Nursing

What is the recommended duration for performing hand hygiene with soap and water during routine patient care?

  1. 5 seconds
  2. At least 40 to 60 seconds Correct answer.
  3. At least 5 minutes
  4. Exactly 10 seconds

Explanation

Routine handwashing with soap and water should last about 40 to 60 seconds, covering all surfaces of the hands including the thumbs and fingertips. Rubbing for only a few seconds does not adequately remove transient organisms.

Question 11Fundamentals of Nursing

A nurse is preparing to insert a nasogastric tube. Which action best verifies correct placement before the first feed?

  1. Asking the patient to speak clearly
  2. Observing the tube markings at the nostril
  3. Checking the pH of aspirated gastric fluid Correct answer.
  4. Auscultating a whoosh of air over the epigastrium

Explanation

Testing the pH of aspirated fluid is the most reliable bedside method, since gastric aspirate is usually acidic. The auscultation method is unreliable because injected air can be heard over the lungs when the tube is misplaced.

Question 12Fundamentals of Nursing

Which finding is the earliest indicator that a pressure ulcer may be developing over the sacrum?

  1. A dry, scaly plaque
  2. Non-blanchable erythema of intact skin Correct answer.
  3. A foul-smelling discharge
  4. A deep crater with visible bone

Explanation

Non-blanchable erythema of intact skin is the hallmark of a stage 1 pressure injury and is the earliest visible sign. Cratering, discharge and deep tissue exposure indicate more advanced injury.

Question 13Fundamentals of Nursing

A nurse is asked to apply a cold compress to a sprained ankle. Which physiological effect is the primary reason for this intervention?

  1. Relaxation of the smooth muscle in the vessels
  2. Vasoconstriction reducing swelling Correct answer.
  3. Vasodilation improving blood flow
  4. Increased local metabolism

Explanation

Cold causes vasoconstriction, which decreases blood flow to the injured area and thereby limits oedema and pain. Heat produces the opposite effect and is used later to promote healing.

Question 14Fundamentals of Nursing

Which statement correctly describes the purpose of a colostomy irrigation?

  1. To treat a colonic infection with antibiotics
  2. To measure the length of the remaining colon
  3. To sterilise the bowel before surgery
  4. To regulate bowel elimination in a person with a colostomy Correct answer.

Explanation

Colostomy irrigation uses a controlled infusion of warm water to stimulate evacuation at a planned time, helping the person gain regularity and control. It is not a sterilising, antibiotic or diagnostic procedure.

Question 15Fundamentals of Nursing

A patient with a new ileostomy is being taught about dietary management. Which advice is most appropriate?

  1. Chew food thoroughly and eat small frequent meals Correct answer.
  2. Drink very little fluid to reduce output
  3. Increase intake of high-fibre foods immediately
  4. Avoid all fluids with meals permanently

Explanation

Chewing thoroughly and eating small frequent meals helps the shortened bowel absorb nutrients and reduces the risk of blockage. Fibre should be introduced gradually and fluid intake must be adequate because ileostomy output is high.

Question 16Fundamentals of Nursing

Which measure is most effective in preventing a catheter-associated urinary tract infection?

  1. Routine daily change of the catheter
  2. Irrigating the bladder with antiseptic daily
  3. Removing the catheter as soon as it is no longer needed Correct answer.
  4. Using a larger bore catheter to improve drainage

Explanation

The single most effective measure is to avoid unnecessary catheterisation and remove the catheter promptly when it is no longer indicated. Routine changes, antiseptic irrigation and larger catheters do not prevent infection and may increase trauma.

Question 17Fundamentals of Nursing

What is the normal range for adult resting respiratory rate per minute?

  1. 6 to 10
  2. 22 to 30
  3. 12 to 20 Correct answer.
  4. 30 to 40

Explanation

The accepted normal adult resting respiratory rate is about 12 to 20 breaths per minute. Rates below 12 indicate bradypnoea and above 20 indicate tachypnoea.

Question 18Fundamentals of Nursing

A nurse is collecting a midstream urine specimen from a patient. Which action is correct?

  1. Collect urine from the drainage bag of a catheter
  2. Collect the first few drops of urine
  3. Clean the urethral meatus and collect urine midstream Correct answer.
  4. Collect urine after 24 hours of storage

Explanation

Cleaning the meatus and collecting the midstream portion reduces contamination from skin flora and gives a representative bladder specimen. The first drops are flushed out and bag urine is unsuitable for culture.

Question 19Fundamentals of Nursing

Which of the following is the correct order for donning personal protective equipment before a procedure?

  1. Gloves, gown, mask, goggles
  2. Gown, mask, goggles, gloves Correct answer.
  3. Goggles, gloves, mask, gown
  4. Mask, gloves, gown, goggles

Explanation

The recommended sequence is to put on the gown first, then the mask, then eye protection, and finally the gloves, which cover the gown cuffs. Removing the gloves last on doffing prevents contamination of the hands.

Question 20Fundamentals of Nursing

A patient is prescribed oxygen at 2 litres per minute by nasal cannula. What is the approximate inspired oxygen concentration delivered?

  1. About 100 per cent
  2. About 24 to 28 per cent Correct answer.
  3. About 60 per cent
  4. About 40 to 44 per cent

Explanation

A nasal cannula at 1 to 2 litres per minute delivers roughly 24 to 28 per cent oxygen, with each extra litre adding about 4 per cent. Higher concentrations require masks or higher flows.

Question 21Fundamentals of Nursing

Which finding would most strongly suggest that a patient is experiencing hypoxia?

  1. Warm, dry skin and bradycardia
  2. Deep sleep with slow regular breathing
  3. Restlessness, confusion and tachycardia Correct answer.
  4. Increased appetite and thirst

Explanation

Early hypoxia often presents with restlessness, confusion, tachycardia and tachypnoea as the body compensates. Warm dry skin and bradycardia are not typical early hypoxic signs.

Question 22Fundamentals of Nursing

A nurse is preparing a sterile field on a trolley. Which action would break sterile technique?

  1. Keeping the field at waist level while working
  2. Placing sterile items on the field with sterile forceps
  3. Reaching across the sterile field with a bare arm Correct answer.
  4. Holding the sterile drape by its corners

Explanation

Reaching across a sterile field with a bare arm risks contamination from clothing and skin and obscures the field. The field should be held at waist level and items transferred with sterile forceps.

Question 23Fundamentals of Nursing

Which statement about the administration of oral medications is correct?

  1. Medications may be left at the bedside for the patient to take later
  2. Oral drugs are always absorbed faster than injections
  3. Enteric-coated tablets may be crushed for easier swallowing
  4. The nurse should verify the five rights before administration Correct answer.

Explanation

Verifying the five rights, namely right patient, drug, dose, route and time, is a core safety requirement before any administration. Crushing enteric-coated tablets and leaving drugs at the bedside are unsafe practices.

Question 24Fundamentals of Nursing

A patient with a recent history of falls is being assessed. Which factor is a modifiable risk most directly addressed by nursing intervention?

  1. Cognitive impairment due to dementia
  2. Cluttered flooring and poor lighting Correct answer.
  3. Advanced age
  4. Family history of osteoporosis

Explanation

Cluttered flooring and poor lighting are environmental hazards that can be corrected through housekeeping and adequate illumination. Age, genetic history and established dementia are not directly modifiable by nursing measures.

Question 25Fundamentals of Nursing

Which nursing action best demonstrates respect for a patient's autonomy when obtaining informed consent for a procedure?

  1. Asking the family to sign on the patient's behalf without discussion
  2. Explaining the procedure and allowing the patient to ask questions and decide Correct answer.
  3. Obtaining the signature immediately after admission
  4. Signing the form as a witness before the doctor explains the procedure

Explanation

Autonomy requires that the patient receives adequate information and voluntarily decides whether to consent. Obtaining signatures before explanation or from relatives without the patient's involvement undermines that principle.

Question 26Fundamentals of Nursing

During a bed bath, the nurse cleans the patient's eyes. Which technique follows correct hygiene practice?

  1. Wipe in a circular motion over the closed eyelid
  2. Wipe from the inner canthus towards the outer canthus Correct answer.
  3. Wipe from the outer canthus towards the inner canthus
  4. Use the same corner of the washcloth for both eyes

Explanation

Cleaning the eye from the inner canthus outward carries secretions away from the nasolacrimal duct, reducing the risk of introducing organisms into the tear drainage system. A separate area of the cloth is used for each eye to prevent cross-contamination between eyes.

Question 27Fundamentals of Nursing

A nurse is recording a patient's intake and output. Which item should be documented on the intake side of the chart?

  1. Ice chips taken by mouth Correct answer.
  2. Serous drainage on a wound dressing
  3. Vomit collected in an emesis basin
  4. Urine drained into a catheter bag

Explanation

Intake records all fluid entering the body by any route, and ice chips are counted as oral fluid intake, usually at half their volume once melted. Vomit, urine and wound drainage are measured as output because they leave the body.

Question 28Fundamentals of Nursing

A nurse is about to give a patient a bedpan. Which action best protects the patient's skin and comfort during the procedure?

  1. Raise the head of the bed fully before sliding the pan under
  2. Lift the hips and check that the pan is centred and warm before lowering Correct answer.
  3. Place the bedpan directly on the sheet without lifting the hips
  4. Leave the patient alone immediately after positioning the pan

Explanation

Lifting the hips rather than dragging the patient prevents shearing injury to the skin, and ensuring the pan is centred and warmed reduces pressure and discomfort. The patient should also be given privacy while remaining within call.

Question 29Fundamentals of Nursing

A nurse is preparing to give a subcutaneous injection of insulin. Which angle of insertion is generally recommended for an average adult?

  1. 10 degrees
  2. 45 degrees
  3. 15 degrees
  4. 90 degrees Correct answer.

Explanation

For a normal adult with adequate subcutaneous tissue, a 90-degree angle delivers insulin into the fatty layer when using a short needle. A 45-degree angle is reserved for thin patients or short needles where skin folding is used.

Question 30Fundamentals of Nursing

A patient is receiving a continuous intravenous infusion. Which observation should prompt the nurse to stop the infusion and reassess the site immediately?

  1. A dry dressing over the puncture site
  2. Cool, pale skin and swelling around the cannula Correct answer.
  3. A blood pressure of 118/76 mmHg
  4. Clear fluid dripping slowly from the drip chamber

Explanation

Cool, pale skin with swelling suggests the cannula has slipped out of the vein and fluid is entering surrounding tissue, which requires stopping the infusion and restarting at another site. A dry dressing, stable blood pressure and a slow drip do not indicate infiltration.

Question 31Fundamentals of Nursing

A nurse is caring for a patient with an indwelling urinary catheter. Which nursing measure helps prevent ascending infection?

  1. Disconnecting the tubing to obtain urine samples
  2. Clamping the catheter for long periods to build bladder tone
  3. Keeping the drainage bag below the level of the bladder Correct answer.
  4. Irrigating the catheter routinely every shift

Explanation

Gravity drainage with the bag kept below bladder level prevents urine from flowing back into the bladder and introducing organisms. A closed system and avoiding unnecessary disconnections further reduce infection risk.

Question 32Fundamentals of Nursing

A patient is prescribed a hot water bottle for abdominal pain. Which instruction reflects correct application of local heat?

  1. Use water at boiling point to prolong the warmth
  2. Wrap the bottle in a towel and check the skin every few minutes Correct answer.
  3. Place the bottle over a numb area to improve sensation
  4. Apply the bottle directly to the skin for one hour

Explanation

Local heat should be applied with a protective layer such as a towel, and the skin must be inspected frequently for redness or blistering. The temperature should be moderate, and numb areas should be avoided because the patient cannot feel pain or burning.

Question 33Fundamentals of Nursing

A nurse is caring for a patient who has just returned from surgery and is drowsy. Which position is most appropriate to maintain a patent airway while limiting aspiration risk?

  1. Lateral position with the head slightly elevated Correct answer.
  2. Flat supine with the head turned to one side
  3. Trendelenburg position with the feet raised
  4. Prone with the face down

Explanation

A lateral position with slight head elevation allows secretions and vomit to drain from the mouth and reduces the risk of aspiration in a drowsy postoperative patient. The airway is kept clear and the patient is observed closely until fully awake.

Question 34Fundamentals of Nursing

A nurse is teaching a patient how to use a metered-dose inhaler with a spacer. Which step should the patient perform first?

  1. Breathe in rapidly while pressing the canister
  2. Rinse the mouth immediately after pressing the canister
  3. Shake the inhaler and attach it to the spacer Correct answer.
  4. Hold the breath for ten seconds before inhaling

Explanation

The inhaler must be shaken and fitted to the spacer before use so the drug is evenly mixed and the dose is delivered correctly. The patient then exhales, actuates the dose and inhales slowly and deeply, holding the breath afterwards.

Question 35Fundamentals of Nursing

A nurse receives a verbal order for a controlled drug. Which action is the safest professional response?

  1. Record the order only after the shift ends
  2. Ask another nurse to administer the drug without documentation
  3. Accept the order and administer the drug immediately
  4. Write the order and read it back to the prescriber for confirmation Correct answer.

Explanation

Verbal orders should be written down and read back to the prescriber to confirm accuracy, and the prescriber should sign the order within the time frame set by hospital policy. Controlled drugs carry additional risks, so documentation must be prompt and exact.

Question 36Fundamentals of Nursing

A patient refuses a prescribed injection and explains that she does not understand why it is needed. Which nursing action best demonstrates respect for autonomy?

  1. Explain the purpose and risks, answer questions and respect the decision Correct answer.
  2. Give the injection because the doctor ordered it
  3. Ask a relative to persuade the patient to accept
  4. Tell the patient that refusal will delay discharge

Explanation

Autonomy requires that the patient receives clear information about the purpose, benefits and risks of treatment and is then free to decide. The nurse should document the refusal, inform the prescriber and continue to provide care without coercion.

Question 37Anatomy and Physiology

In the human heart, the atrioventricular (AV) node is located in which region of the conduction system?

  1. The lower interatrial septum near the opening of the coronary sinus Correct answer.
  2. The apex of the left ventricle
  3. The upper part of the interventricular septum
  4. The wall of the right atrium near the superior vena cava

Explanation

The AV node lies in the lower part of the interatrial septum, just above the opening of the coronary sinus and close to the tricuspid valve. It delays the impulse briefly so the atria can empty into the ventricles before ventricular contraction begins.

Question 38Anatomy and Physiology

Which formed element of blood is chiefly responsible for transporting oxygen from the lungs to the tissues?

  1. Neutrophils
  2. Lymphocytes
  3. Thrombocytes
  4. Erythrocytes Correct answer.

Explanation

Erythrocytes contain haemoglobin, which binds oxygen in the pulmonary capillaries and releases it in the tissues. Their biconcave shape and lack of a nucleus allow maximum haemoglobin content and flexibility through narrow capillaries.

Question 39Anatomy and Physiology

A patient's spirometry shows a tidal volume of 500 mL, inspiratory reserve volume of 2500 mL and expiratory reserve volume of 1000 mL. What is the inspiratory capacity?

  1. 4000 mL
  2. 3000 mL Correct answer.
  3. 1500 mL
  4. 3500 mL

Explanation

Inspiratory capacity equals tidal volume plus inspiratory reserve volume, that is 500 + 2500 = 3000 mL. It represents the maximum volume that can be inspired from the resting end-expiratory position.

Question 40Anatomy and Physiology

Which structure of the nephron is the principal site of glucose reabsorption from the filtrate?

  1. Proximal convoluted tubule Correct answer.
  2. Distal convoluted tubule
  3. Descending limb of the loop of Henle
  4. Collecting duct

Explanation

The proximal convoluted tubule reabsorbs almost all filtered glucose by active transport linked to sodium, along with most water and electrolytes. Its brush border greatly increases surface area for this reabsorptive work.

Question 41Anatomy and Physiology

During which phase of the cardiac cycle do the atrioventricular valves close?

  1. Isovolumetric ventricular relaxation
  2. Ventricular ejection
  3. Atrial systole
  4. Isovolumetric ventricular contraction Correct answer.

Explanation

As the ventricles begin to contract, pressure rises above atrial pressure and the AV valves snap shut, producing the first heart sound. This occurs during isovolumetric contraction, before the semilunar valves open.

Question 42Anatomy and Physiology

Which cranial nerve supplies the diaphragm through the phrenic nerve?

  1. Vagus nerve
  2. Glossopharyngeal nerve
  3. Accessory nerve
  4. Phrenic nerve arises from cervical spinal nerves C3 to C5 Correct answer.

Explanation

The phrenic nerve is formed from the anterior rami of spinal nerves C3, C4 and C5 and provides the sole motor supply to the diaphragm. Its cervical origin explains why irritation of the diaphragm can be felt as shoulder-tip pain.

Question 43Anatomy and Physiology

Which hormone raises blood calcium by stimulating osteoclast activity and renal calcium reabsorption?

  1. Insulin
  2. Parathyroid hormone Correct answer.
  3. Aldosterone
  4. Calcitonin

Explanation

Parathyroid hormone acts on bone to increase osteoclastic resorption, on the kidney to retain calcium and activate vitamin D, and thereby raises serum calcium. Calcitonin has the opposite effect and lowers blood calcium.

Question 44Anatomy and Physiology

A patient has damage to the left cerebral hemisphere involving the motor cortex. Which deficit is most likely?

  1. Weakness of the left side of the body
  2. Loss of sensation over the left leg only
  3. Bilateral loss of vision
  4. Weakness of the right side of the body Correct answer.

Explanation

Corticospinal fibres cross in the medulla, so a lesion of the left motor cortex produces weakness on the opposite, that is right, side. This contralateral control is a key principle of motor pathway anatomy.

Question 45Anatomy and Physiology

Which type of muscle tissue is involuntary, striated and found only in the heart?

  1. Areolar connective tissue
  2. Smooth muscle
  3. Skeletal muscle
  4. Cardiac muscle Correct answer.

Explanation

Cardiac muscle is striated like skeletal muscle but contracts involuntarily and is confined to the myocardium. Its intercalated discs allow rapid spread of impulses between cells.

Question 46Anatomy and Physiology

Which part of the small intestine receives bile and pancreatic juice?

  1. Ileum
  2. Caecum
  3. Jejunum
  4. Duodenum Correct answer.

Explanation

The duodenum receives the common bile duct and the main pancreatic duct through the hepatopancreatic ampulla. It is thus the main site where biliary and pancreatic secretions enter the small intestine.

Question 47Anatomy and Physiology

Which plasma protein is most abundant and maintains the colloid osmotic pressure of blood?

  1. Albumin Correct answer.
  2. Prothrombin
  3. Fibrinogen
  4. Globulin

Explanation

Albumin forms about half of the plasma protein and is the chief contributor to colloid osmotic pressure, holding fluid within the capillaries. Its small size and high concentration make it effective for this osmotic role.

Question 48Anatomy and Physiology

Oxygenated blood from the lungs enters the heart through which vessels?

  1. Pulmonary veins Correct answer.
  2. Superior vena cava
  3. Coronary sinus
  4. Pulmonary arteries

Explanation

The pulmonary veins carry oxygenated blood from the lungs into the left atrium, the only veins in the body that carry oxygen-rich blood. From there blood passes to the left ventricle for systemic circulation.

Question 49Anatomy and Physiology

Which structure prevents food from entering the trachea during swallowing?

  1. Glottis
  2. Uvula
  3. Soft palate
  4. Epiglottis Correct answer.

Explanation

During the pharyngeal phase of swallowing the epiglottis folds over the laryngeal opening, directing the bolus into the oesophagus. This protective reflex prevents aspiration into the airway.

Question 50Anatomy and Physiology

Which hormone is released by the posterior pituitary gland?

  1. Growth hormone
  2. Thyroid-stimulating hormone
  3. Adrenocorticotropic hormone
  4. Antidiuretic hormone Correct answer.

Explanation

The posterior pituitary stores and releases antidiuretic hormone and oxytocin, which are synthesised in the hypothalamus. It does not manufacture hormones of its own.