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Q1
In Nepal, which advanced nursing role is authorized to lead a multidisciplinary team in a primary health care center and oversee community health programs?
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D
Q2
The Advanced Practice Nursing Core Competencies (as described by Hamric et al.) include all of the following EXCEPT:
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D
Q3
A nurse sees a colleague preparing an insulin infusion without a double-check. According to the Nepal Nursing Council's Code of Ethics, the nurse should:
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D
Q4
A patient with chronic kidney disease stage 5 is scheduled for hemodialysis. Which dietary recommendation should the nurse reinforce prior to the first session?
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D
Q5
The nurse's most appropriate action when a patient experiences sudden hypotension during induction of anaesthesia is to
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D
Q6
What laboratory finding is most indicative of a HELLP syndrome?
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D
Q7
A woman presents with a ruptured ectopic pregnancy. Which of the following is the most urgent clinical priority?
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D
Q8
Which statement correctly describes the rotavirus vaccine schedule in Nepal's NIP?
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D
Q9
According to the National Vitamin A Supplementation Programme in Nepal, what is the recommended interval between doses for children aged 6 months to 5 years?
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D
Q10
A 28-year-old woman presents with sudden onset of mania. What is the WHO recommended first-line pharmacotherapy?
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D
Q11
Which of the following is a non-probability sampling technique?
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D
Q12
What does 'external validity' refer to in the context of research utilization?
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D
Q13
The curriculum principle that emphasizes the relevance of learning to real-world practice is known as:
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D
Q14
In Nepal's nursing education, which evaluation method is most appropriate for assessing the effectiveness of a simulation-based learning experience?
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D
Q15
In Kotter's 8-step change model, which step follows "creating a sense of urgency"?
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D
Q16
Which ministry is responsible for health policy and regulation in Nepal?
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D
Q17
In nursing research, which informatics tool assists in managing large datasets and performing statistical analysis?
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D
Q18
Which clinical sign is most characteristic of cardiac tamponade in a trauma patient, completing the 'Beck's Triad'?
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D
Q19
In health economics, the term 'marginal cost' refers to:
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D
Q20
A study that assigns participants to intervention and comparison groups but does not use randomization is known as:
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D
Q21
Which of the following is NOT a typical component of a nursing department's capital budget?
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D
Q22
Which of the following is the primary objective of the 'Health Facility Management Committee' (HFMC) at the local level in Nepal?
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D
Q23
Which advanced nursing role is typically appointed to the Nepal Nursing Council's committee that reviews and updates the standards for advanced nursing practice education programs?
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D
Q24
When implementing a new safety protocol for chemotherapy administration, which strategy best promotes 'Culture of Safety' among nursing staff?
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D
Q25
Which diagnostic modality provides the highest accuracy for detecting placenta accreta before delivery?
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D
Q26
According to IMNCI guidelines, which danger sign in an infant up to 2 weeks old requires immediate referral?
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D
Q27
In psychiatric nursing, 'transference' occurs when:
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D
Q28
The Cronbach's alpha coefficient is commonly used to assess which type of reliability?
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D
Q29
What is the primary goal of 'Knowledge Translation' (KT) in nursing?
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D
Q30
Research on interprofessional simulation in Nepalese health education shows the greatest impact on which of the following outcomes?
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D
Q31
Which mental health screening tool is endorsed by Nepal's Ministry of Health for detecting depression in primary care settings?
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D
Q32
During a peripheral intravenous chemotherapy infusion, the nurse suspects extravasation of a vesicant agent. What is the immediate nursing action?
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D
Q33
Which statement best describes a clinical decision support system (CDSS) used in nursing informatics?
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D
Q34
In developing a curriculum for nursing students in a resource-limited setting, which of the following resource considerations is most critical?
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C
D
Q35
During the intraoperative phase, the nurse notices the patient's end-tidal CO2 (EtCO2) is steadily rising despite stable ventilation. This finding is an early indicator of which condition?
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D
Q36
For assessing nurse leadership effectiveness, structured 360-degree feedback combining peers, subordinates, and supervisors provides multi-source validation of actual behaviors.
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D
Q37
In a child with diabetic ketoacidosis, which electrolyte abnormality is most likely to develop after initiation of insulin therapy, and what nursing action should be taken?
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D
Q38
Which advanced nursing role is characterized by the 'triple threat' of providing expert clinical practice, educating staff, and conducting research within a specific clinical specialty?
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D
Q39
Which of the following is NOT typically included in a nursing department's capital budget in a public hospital of Nepal?
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D
Q40
Which of the following is an example of a 'Nursing-Sensitive Outcome' (NSO) as defined by the National Database of Nursing Quality Indicators (NDNQI)?
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D
Q41
A patient with severe preeclampsia is receiving magnesium sulfate. Which clinical sign indicates magnesium toxicity requiring immediate cessation of the infusion?
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D
Q42
Within what time frame after birth should the BCG vaccine be given to newborns in Nepal?
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D
Q43
During education about early warning signs of relapse in bipolar disorder, which sign most strongly predicts an upcoming manic episode?
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D
Q44
When every kth element is selected from a list after a random start, the sampling method is known as:
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Q45
In qualitative research, which term describes the detailed, rich description of the research context and participants to enable transferability of findings?
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D
Q46
In Kotter's 8-Step Process for Leading Change, which action is critical during the 'Generating Short-term Wins' step?
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D
Q47
A patient with stage 3 chronic kidney disease and significant proteinuria is advised to modify diet. Which dietary change is most likely to slow progression of renal disease?
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D
Q48
In the EBP process, which step involves critically appraising the validity, reliability, and applicability of the evidence?
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D
Q49
In nursing education, the term 'curricular overload' refers to:
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D
Q50
A community health worker uses a mobile application to record household-level health indicators. What feature ensures that data remains protected during transmission?
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D
Q51
In a disaster response scenario, which advanced nursing role would serve as the lead liaison between emergency medical services and the hospital's critical care unit?
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D
Q52
Which recruitment strategy is most effective for ensuring cultural competence in Nepal's diverse healthcare settings?
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D
Q53
A peritoneal dialysis patient presents with cloudy dialysate, abdominal pain, and fever. Which nursing action is most appropriate immediately after recognizing possible peritonitis?
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D
Q54
During emergency assessment of a patient with suspected acute stroke, the nurse uses the FAST tool. What does the 'T' in FAST stand for?
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Q55
In Nepal's tertiary hospitals, which staffing approach is recommended to match nurse numbers with patient acuity levels?
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D
Q56
Which diagnostic modality is considered the gold standard for confirming a patent ductus arteriosus in a preterm neonate in the NICU?
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D
Q57
In Nepali primary health centers, which instrument is most frequently employed by nurses to identify depressive symptoms among patients with chronic illnesses?
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D
Q58
The nurse is caring for a client in the coronary care unit. The display on the cardiac monitor indicates ventricular fibrillation. What ought to be done first by the nurse?
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D
Q59
When teaching a client about an oral hypoglycemic medication, the nurse should place primary emphasis on:
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D
Q60
What is the significance of cultural competence in nursing?
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D
Q61
The RE-AIM framework evaluates health-promotion interventions across which domains?
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D
Q62
A faculty member wants to evaluate the impact of a virtual patient case on clinical reasoning. Which assessment tool provides the most valid measurement of reasoning processes?
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Q63
In King's Goal Attainment Theory, the contracting process involves all of the following steps except:
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D
Q64
Thematic analysis is primarily employed in which type of research methodology?
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D
Q65
Which committee, operating at the local level, is responsible for overseeing the management and operation of health facilities within its jurisdiction?
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D
Q66
The recommended interval for routine antenatal visits in an uncomplicated pregnancy after 28 weeks of gestation in Nepal is:
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D
Q67
A patient on risperidone develops weight gain, fasting glucose of 130 mg/dL, and increased waist circumference. Which syndrome should the nurse monitor for?
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D
Q68
Which mechanism best explains opioid-induced pruritus in long-term opioid users?
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D
Q69
In Arnstein's ladder of citizen participation, which rung represents the highest level of authority granted to the community?
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D
Q70
A nurse researcher is appraising a study and finds a 'p-value' of 0.03 with an alpha level set at 0.05. How should this be interpreted in terms of evidence appraisal?
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D
Q71
In Nepal's Female Community Health Volunteer (FCHV) program, what is the minimum duration of training required for a volunteer?
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D
Q72
A postoperative patient on CPAP after a lobectomy suddenly desaturates. Which nursing action should be prioritized?
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D
Q73
Which of the following is a 'Process Measure' for evaluating the quality of care in a diabetic clinic?
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D
Q74
In the context of nursing administration, which tool is primarily used to compare actual expenditures with the planned nursing budget and identify variances?
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D
Q75
According to the Path-Goal theory, a leader who removes obstacles, provides resources, and clarifies the path to goal attainment is demonstrating the:
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Q76
Which theorist proposed the 'human becoming' theory, which views health as a process of meaning-making?
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D
Q77
Which financing mechanism is characterized by a fixed payment per enrolled person per period, regardless of the number of services used?
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D
Q78
A pregnant woman at 28 weeks gestation is diagnosed with gestational diabetes mellitus using the one-step 75 g OGTT. According to Nepal guidelines, which plasma glucose value confirms the diagnosis?
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D
Q79
Which of the following is the correct storage temperature for the 'Cold Chain' at the district level (District Health Office) for vaccines like OPV and Measles?
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D
Q80
A 30-year-old woman at 34 weeks presents with sudden severe dyspnea, hypotension, and diffuse bleeding during labor. Which immediate nursing intervention is most appropriate?
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D
Q81
Which ethical principle requires that participants be informed about the study's purpose, procedures, risks, and benefits before agreeing to participate?
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D
Q82
A patient with chronic cancer pain is transitioned from an immediate-release opioid to a long-acting opioid. What is the primary goal of this pharmacological shift?
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D
Q83
Which legislation introduced in 2018 establishes the requirement for all health facilities in Nepal to obtain a license before providing services?
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D
Q84
Which administrative indicator improves most significantly when nursing informatics tools are effectively utilized in a hospital setting in Nepal?
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D
Q85
According to Nepal's National Mental Health Policy 2073 (2016), which level of health facility is primarily responsible for delivering basic mental health services through integration into primary health care?
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D
Q86
A Do-Not-Resuscitate (DNR) order in Nepal is considered valid when:
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D
Q87
The National Malaria Elimination Programme recommends long-lasting insecticidal nets (LLINs) as a core vector control measure. What is the target household coverage of LLINs in high-risk districts?
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D
Q88
Which element of the I-PASS handoff tool is not explicitly part of SBAR?
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D
Q89
During the management of a patient with acute pulmonary edema, which position is most effective in reducing venous return to the heart and decreasing pulmonary congestion?
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D
Q90
The Resource Utilization Committee in a tertiary hospital is primarily responsible for:
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D
Q91
The process of aligning assessment methods with declared learning outcomes in a nursing curriculum is known as:
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D
Q92
A nurse educator is using the 'Socratic Method' during a clinical conference. What is the primary goal of this teaching-learning approach?
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D
Q93
According to the AACN Essentials for Advanced Practice Nursing, which domain specifically emphasizes leadership within health-care systems?
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D
Q94
A patient with gestational diabetes is being managed. Which of the following is the most common fetal complication associated with poorly controlled maternal hyperglycemia?
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D
Q95
Which intervention is associated with the lowest risk of central line-associated bloodstream infection in the PICU?
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D
Q96
Which governmental body is designated as the main agency responsible for health financing and administration of Nepal's social health insurance scheme?
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D
Q97
In the context of human resource management in nursing, 'Job Enlargement' is best distinguished from 'Job Enrichment' by which characteristic?
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D
Q98
According to the WHO and Nepal's child health guidelines, 'exclusive breastfeeding' is recommended for the first:
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D
Q99
A nursing researcher wants to compare the effectiveness of two different wound dressing materials on the rate of healing. Which of the following is the 'Dependent Variable'?
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D
Q100
Which health-education technique is most effective for improving hand-washing practices among school children in a rural Nepali village?
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D
Q101
Which outcome is most directly linked to effective use of nursing informatics in nursing administration?
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D
Q102
According to the WHO analgesic ladder, a patient with severe cancer pain uncontrolled on step 2 medications should be started on:
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D
Q103
In the PARiHS (Promoting Action on Research Implementation in Health Services) framework, what does the 'Evidence' element encompass?
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D
Q104
Under Nepal's National Adolescent Health and Development Programme, which of the following services is primarily provided through Adolescent-Friendly Service (AFS) corners at health facilities?
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D
Q105
Which of the following is the most important consideration when adapting a nursing curriculum for a diverse student population?
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D
Q106
A patient with Stage 3 CKD and hypertension is prescribed an ACE inhibitor. Which laboratory parameter should be monitored within 1-2 weeks of initiation?
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D
Q107
In the management of neonatal sepsis, which laboratory finding is most specific for early-onset sepsis due to Group B Streptococcus?
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D
Q108
Which advanced nursing role holds primary responsibility for ensuring that all staff nurses meet the Nepal Nursing Council's Continuing Professional Development requirements?
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D
Q109
Which metric is widely used as an indicator of effective nursing resource management?
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D
Q110
What is the earliest gestational age at which Nepal's national antenatal care guideline recommends the first routine ANC visit for a primigravida with no risk factors?
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Q111
Which of the following is the most appropriate nursing action for a patient presenting with a suspected cord prolapse?
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D
Q112
In a longitudinal cohort study, measurement of a time-varying covariate after the outcome has occurred can lead to:
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Q113
Risk adjustment in health financing is used to:
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D
Q114
Which clinical manifestation is most characteristic of hypocalcemia?
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Q115
When reporting a qualitative study, the COREQ checklist is used to ensure:
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D
Q116
In the context of Nepal's National Leprosy Control Programme, a patient is classified as 'Paucibacillary (PB)' if they exhibit which of the following clinical features?
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Q117
According to IMNCI guidelines, a 3-month-old infant who presents with fever (38.2 °C) but no other signs is classified as:
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D
Q118
A patient with advanced cancer is receiving a palliative infusion of morphine. The nurse notes the patient has developed severe constipation. Which pharmacological approach is most recommended for opioid-induced bowel dysfunction in oncology?
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D
Q119
Which advanced nursing role in Nepal is authorized to diagnose and manage common mental health disorders independently within primary health care settings?
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D
Q120
Which curriculum model utilizes a spiral organization of content, revisiting concepts at increasing levels of complexity?
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D
Q121
When caring for a neonate on continuous positive airway pressure (CPAP), which nursing action helps prevent nasal trauma?
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D
Q122
In the Thomas-Kilmann Conflict Mode Instrument, the "Collaborating" mode is best described as:
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D
Q123
Which service is NOT included in Nepal's Essential Health Care Package (EHCP)?
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D
Q124
In nursing resource planning, the term "skill mix" most accurately refers to:
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D
Q125
Which feature is essential for a study to be classified as a randomized controlled trial?
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D
Q126
Which micronutrient supplement is routinely provided to pregnant women during antenatal care in Nepal to prevent neural tube defects?
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D
Q127
A researcher wants to estimate the proportion of nurses who report burnout in a hospital. How should the sample size equation n = (z² × p × (1-p)) / d² be used?
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D
Q128
What is the most effective method for training nursing staff on a new EHR system in a multi-site Nepalese hospital network?
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Q129
In the pre-operative holding area, which documentation is essential before the patient is transferred to the operating theatre?
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D
Q130
For prophylaxis of postpartum haemorrhage in low-resource settings, which misoprostol dose and route is most commonly used?
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D
Q131
When determining nursing staff requirements for a medical ward, which factor has the greatest direct impact on workload?
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D
Q132
Which indicator is used to monitor iodine status in the general population in Nepal's National Iodine Deficiency Disorders Control Programme?
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D
Q133
A patient with advanced gastric cancer is started on total parenteral nutrition (TPN) via a central venous catheter. To prevent catheter-related bloodstream infection, which nursing action is most critical during catheter maintenance?
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D
Q134
Which assessment tool is most widely used to evaluate the risk of pressure ulcer development in elderly hospitalized patients?
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D
Q135
In a systematic review, what is the main purpose of using the GRADE approach?
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D
Q136
According to the Nepal Nursing Council guidelines, the primary responsibility of a designated patient safety officer in a hospital is:
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D
Q137
For effective interprofessional education (IPE) integration, the curriculum should include learning outcomes that emphasize:
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D
Q138
Which of the following best characterizes the term 'implementation gap' in evidence-based nursing?
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D
Q139
Which e-learning feature most strongly supports self-directed learning for postgraduate nursing students?
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D
Q140
Which fetal heart rate pattern is most reliably associated with fetal hypoxia during active labor?
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D
Q141
When mapping stakeholders on a power-versus-interest matrix, which group would most likely be placed in the high-power, low-interest quadrant?
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D
Q142
In the WHO "Health-Promoting Schools" model, which component should community health nurses prioritize when working with Nepalese schools?
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D
Q143
The sample size formula n = (z² × p × (1-p)) / d² is used primarily to determine the required sample size for estimating:
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D
Q144
Which sequence correctly describes the steps of a clinical audit cycle?
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D
Q145
The National Non-Communicable Disease Control Programme identifies which of the following as its most modifiable risk factor for intervention?
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D
Q146
A patient with bipolar disorder in remission is at risk for self-harm. Which nursing action is most effective in reducing this risk?
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D
Q147
When appraising a qualitative study for an EBP project, which of the following concepts refers to the process of verifying the findings by returning to the participants for feedback?
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D
Q148
After coronary artery bypass grafting, a patient has mediastinal chest tube output of 250 mL in the first hour and 230 mL in the second hour. What is the standard threshold that mandates surgical re-exploration?
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D
Q149
A patient in the emergency department presents with a suspected tension pneumothorax. Which nursing intervention should be performed first?
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D
Q150
The fluid of choice for initial resuscitation of a traumatic hemorrhagic shock patient is:
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D
Q151
Which assessment method best demonstrates long-term retention of wound-dressing skills after a high-fidelity simulation?
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D
Q152
A systematic review includes both randomized trials and observational studies. Which tool is most appropriate for assessing risk of bias across these heterogeneous designs?
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D
Q153
In a high-reliability organization, which practice is most characteristic of 'preoccupation with failure'?
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D
Q154
Which nursing theory is based on the premise that nurses are experts in interpersonal relationships who help clients adapt emotionally and socially?
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D
Q155
The National Non-Communicable Diseases (NCD) Control Programme identifies which modifiable risk factor as the top priority for intervention?
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D
Q156
Which of the following is the primary purpose of using a 'Vaccine Vial Monitor' (VVM) on vaccine vials in Nepal's immunization program?
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D
Q157
Which fluid is recommended for the initial resuscitation of a patient in hemorrhagic shock secondary to traumatic injury?
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D
Q158
A community health nurse is leading a participatory action research (PAR) project to reduce indoor air pollution in a hill district. Which step should be taken first according to the PAR cycle?
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D
Q159
In a tertiary hospital adopting an electronic health record, which informatics principle best ensures that nursing documentation remains aligned with the clinical workflow?
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D
Q160
When evaluating the quality of nursing care, 'Reliability' refers to:
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D
Q161
During a change to a new medication reconciliation process, a nurse manager uses a stakeholder matrix to identify influential individuals and their level of interest. This tool exemplifies which change management concept?
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D
Q162
In a mixed-methods study combining a survey and focus group discussions, the qualitative component primarily aims to _______.
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D
Q163
In the context of evidence-based practice, what is the primary purpose of 'triangulation' in qualitative research synthesis?
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D
Q164
A patient is receiving continuous renal replacement therapy (CRRT). The nurse notes a sudden drop in the effluent flow rate and an increase in filter pressure. What is the most likely cause?
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D
Q165
Which of the following best describes the purpose of the 'time-out' phase in the WHO Surgical Safety Checklist?
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D
Q166
When appraising a study, 'blinding' (masking) is primarily employed to reduce which type of bias?
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D
Q167
A woman with major placenta previa presents for induction at 34 weeks with vaginal bleeding. Which is the most appropriate initial management?
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D
Q168
Under the National Mental Health Programme, which cadre receives a five-day training on the mhGAP-IG for identification of depression and anxiety?
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D
Q169
Which document serves as the guiding framework for the 'Minimum Service Standards' (MSS) in Nepal's public health facilities?
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D
Q170
Which fluid is recommended for the initial resuscitation of a patient with hemorrhagic shock due to trauma, according to ATLS guidelines?
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D
Q171
According to IMNCI, which of the following is classified as a 'General Danger Sign' in a child aged 2 months to 5 years?
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D
Q172
Which teaching-learning strategy is characterized by the use of a 'facilitator' rather than a 'teacher' to guide students through a self-directed inquiry process?
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D
Q173
In Nepal's hospital accreditation standards, which indicator most directly reflects efficient use of nursing consumable supplies?
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D
Q174
In the management of a patient with Spinal Cord Compression secondary to metastatic epidural disease, which medication is typically administered first to reduce edema and prevent permanent neurological deficit?
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D
Q175
Which of the following is the most common complication associated with the administration of prolonged parenteral nutrition (PN) in neonates?
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C
D
Q176
In Lewin's model of change, which stage involves establishing a new stable state after the desired behavior has been institutionalized?
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D
Q177
A nursing informatics project aims to reduce 'Alert Fatigue' among ICU nurses. What is the most effective strategy to achieve this?
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D
Q178
An advanced practice nurse who provides primary psychiatric care, including the ability to order diagnostic tests and manage therapeutic regimens for patients with depression and anxiety, is a:
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D
Q179
A patient with severe burns is in the emergent phase. Which electrolyte imbalance is most commonly expected during the first 24-48 hours due to massive cell destruction and fluid shifts?
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B
C
D
Q180
When evaluating the effectiveness of a high-fidelity obstetric emergency simulation using the Kirkpatrick model, which level assesses the transfer of learning to the clinical setting?
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B
C
D
Q181
For a healthy adult undergoing elective surgery, the maximum allowable oral intake of clear fluids is up to how many hours before induction of anesthesia?
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D
Q182
Which fetal heart rate pattern is most reliably associated with cord compression?
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B
C
D
Q183
A nurse educator wants to integrate the latest research on diabetic foot care into the curriculum. Which step of the research utilization process does this represent?
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B
C
D
Q184
In a resource‑limited nursing school, which of the following strategies is most effective for sustaining the curriculum’s clinical component without compromising learning quality?
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D
Q185
A 3-year-old child in Nepal is brought for a routine check-up. According to the national child health guidelines, which of the following supplements should be administered every 6 months?
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B
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D
Q186
The National Non‑Communicable Disease (NCD) Programme prioritizes which modifiable risk factor for reducing cardiovascular mortality in Nepal?
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B
C
D
Q187
When analyzing quality of care, which of the following is an example of an 'External Benchmark'?
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D
Q188
In evaluating the financial viability of a nurse‑led hypertension clinic, which indicator provides the most direct evidence of cost‑effectiveness?
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B
C
D
Q189
In the 'Kirkpatrick Model' of training evaluation, which level evaluates the actual change in the learner's behavior when they return to the clinical workplace?
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D
Q190
When implementing Total Quality Management (TQM) in a nursing department, what is the primary focus of the philosophy?
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D
Q191
During the management of a patient with Acute Respiratory Distress Syndrome (ARDS), why is the 'prone position' recommended for patients with severe hypoxemia?
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Q192
An oncology patient in the ICU demonstrates a Richmond Agitation‑Sedation Scale (RASS) score of –4 while on a continuous morphine infusion. What is the priority nursing action?
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Q193
When conducting multiple pairwise comparisons after an ANOVA, which method controls the family‑wise error rate most conservatively?
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Q194
Which statement accurately reflects the principle of "cultural competence" in community health nursing practice in Nepal?
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Q195
A nurse manager wishes to evaluate the effect of an electronic medication administration record (EMAR) on medication error rates. Which study design provides the most rigorous evidence?
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Q196
A 78-year-old postoperative patient with severe dementia is unable to verbalize pain. Which pain assessment tool is most appropriate for this patient?
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Q197
For agitation due to delirium in a terminally ill elderly patient, which medication is preferred because of rapid onset and minimal respiratory depression?
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Q198
Which of the following is a facilitator that most likely enhances implementation of evidence‑based guidelines in Nepalese primary health‑care settings?
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Q199
When administering blood products intra‑operatively, which of the following is the most important step to prevent a transfusion reaction?
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Q200
A woman with severe hypertension (BP = 180/110 mmHg) in the third trimester requires immediate antihypertensive therapy. Which medication is considered first‑line for rapid blood pressure control in pregnancy?
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MSc Nursing Entrance Exam preparation SET 2
200 multiple-choice questions · 200 questions · 3 hours · Masters entrance exam
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