On the first evening after a total thyroidectomy, a patient complains of tingling around the mouth and in the fingertips. This is most likely due to:

Injury to the parathyroid glands

Haematoma pressing on the trachea

Damage to the recurrent laryngeal nerve

Excess release of thyroid hormone

A patient on chemotherapy has a platelet count of 18,000/µL (normal 1.5-4.0 lakh/µL). Which nursing measure is most appropriate?

Use a soft toothbrush and avoid IM injections

Encourage brisk walking to improve circulation

Give aspirin as ordered for joint pain

Check the temperature rectally every four hours

Anatomy and physiology applied to nursing

22 AIIMS NORCET (Nursing Officer) practice questions on Anatomy and physiology applied to nursing, part of Anatomy, Physiology and Microbiology. The first 22 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
On the first evening after a total thyroidectomy, a patient complains of tingling around the mouth and in the fingertips. This is most likely due to:
1. AInjury to the parathyroid glands
2. BHaematoma pressing on the trachea
3. CDamage to the recurrent laryngeal nerve
4. DExcess release of thyroid hormone
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Answer: A · Injury to the parathyroid glands
The parathyroid glands lie on the back of the thyroid and can be bruised, devascularised or removed during total thyroidectomy. Loss of parathyroid hormone lowers serum calcium (normal about 8.5-10.5 mg/dL), causing circumoral and fingertip tingling, then Chvostek and Trousseau signs and tetany. The nurse reports it at once and keeps IV calcium gluconate ready. Calcium is checked regularly for the first 24-72 hours.
- B: A neck haematoma causes swelling and breathing difficulty, not paraesthesia.
- C: Recurrent laryngeal nerve injury causes hoarseness or stridor, not tingling.
- D: Thyroid storm causes fever, tachycardia and agitation, not perioral tingling.
Question 2 · Hard
A postoperative patient's blood pressure is 130/70 mmHg. Using the standard bedside formula, his mean arterial pressure is:
1. A100 mmHg
2. B60 mmHg
3. C113 mmHg
4. D90 mmHg
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Answer: D · 90 mmHg
MAP = diastolic pressure + one third of the pulse pressure, or (2 x DBP + SBP) / 3. The pulse pressure is 130 - 70 = 60, so MAP = 70 + 20 = 90 mmHg. Diastole lasts about two thirds of each cycle, which is why the diastolic pressure is weighted more. A MAP of at least 65 mmHg is the usual target to keep the kidneys and brain perfused.
- A: 100 is the simple average of 130 and 70, which ignores that diastole lasts longer.
- B: 60 is the pulse pressure, not the mean pressure.
- C: 113 adds one third of the systolic pressure, not of the pulse pressure, to the diastolic.
Question 3 · Medium
A patient on chemotherapy has a platelet count of 18,000/µL (normal 1.5-4.0 lakh/µL). Which nursing measure is most appropriate?
1. AUse a soft toothbrush and avoid IM injections
2. BEncourage brisk walking to improve circulation
3. CGive aspirin as ordered for joint pain
4. DCheck the temperature rectally every four hours
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Answer: A · Use a soft toothbrush and avoid IM injections
Platelets plug small vessel breaks, and a count below about 20,000/µL carries a risk of spontaneous bleeding. Bleeding precautions protect the skin and mucosa: a soft toothbrush, an electric razor, no IM injections, firm pressure on puncture sites, and no rectal temperatures, enemas or suppositories. The nurse watches for petechiae, gum bleeding, blood in urine or stool and headache. A platelet transfusion may be ordered.
- B: Vigorous activity raises the risk of falls and injury; gentle activity is preferred.
- C: Aspirin blocks platelet function and worsens bleeding.
- D: A rectal thermometer can injure the mucosa and cause bleeding.
Question 4 · Medium
Which condition shifts the oxygen-haemoglobin dissociation curve to the right, so that more oxygen is released to the tissues?
1. AMetabolic acidosis
2. BHypothermia
3. CCarbon monoxide poisoning
4. DRespiratory alkalosis
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Answer: A · Metabolic acidosis
A right shift lowers haemoglobin's affinity for oxygen, so oxygen is unloaded more readily. It is caused by a fall in pH, a rise in CO2, a rise in temperature and a rise in 2,3-DPG, all features of active tissue. This is the Bohr effect, which matches oxygen delivery to need. A left shift does the reverse, and the SpO2 may then look good while the tissues receive less oxygen.
- B: Hypothermia shifts the curve to the left and holds oxygen on haemoglobin.
- C: Carbon monoxide shifts the remaining curve to the left and blocks oxygen binding.
- D: Alkalosis raises pH and shifts the curve to the left.
Question 5 · Easy
The normal adult serum potassium range is:
1. A3.5-5.0 mEq/L
2. B8.5-10.5 mEq/L
3. C135-145 mEq/L
4. D1.5-2.5 mEq/L
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Answer: A · 3.5-5.0 mEq/L
Normal serum potassium is about 3.5-5.0 mEq/L, a narrow range because potassium sets the resting membrane potential of heart and muscle cells. Values outside it cause arrhythmias, so both hypokalaemia and hyperkalaemia are urgent. A haemolysed sample can falsely raise the result. Intravenous potassium is never given as a bolus.
- B: 8.5-10.5 is the normal serum calcium range in mg/dL.
- C: 135-145 mEq/L is the normal serum sodium range.
- D: 1.5-2.5 mEq/L is the normal range of serum magnesium.
Question 6 · Medium
A patient with chronic kidney disease has a haemoglobin of 8.2 g/dL with normal-sized red cells and normal iron stores. The main reason for this anaemia is:
1. ADeficiency of vitamin B12 absorption
2. BDestruction of red cells in the spleen
3. CReduced renal erythropoietin production
4. DLoss of red cells in the urine
Answer and explanation in LearnFree account
Question 7 · Easy
How long does a normal red blood cell survive in the circulation?
1. AAbout 10 days
2. BAbout 120 days
3. CAbout 30 days
4. DAbout 365 days
Answer and explanation in LearnFree account
Question 8 · Medium
Lumbar puncture in an adult is done at the L3-L4 or L4-L5 space because at this level:
1. AThe dura mater has already ended
2. BThe vertebral canal is at its widest
3. CThe spinal nerves have not yet formed
4. DThe spinal cord has already ended
Answer and explanation in LearnFree account
Question 9 · Medium
A right-handed man with a left middle cerebral artery stroke understands what is said to him and follows commands, but speaks in short, halting, effortful phrases. Which area is most likely damaged?
1. AMotor cortex of the right hemisphere
2. BWernicke's area in the temporal lobe
3. CPrimary visual cortex in the occipital lobe
4. DBroca's area in the frontal lobe
Answer and explanation in LearnFree account
Question 10 · Medium
A 68-year-old with long-standing COPD is given 10 L/min oxygen by face mask in the ward. An hour later he is drowsy and hard to rouse, with SpO2 99%. The most likely cause of his drowsiness is:
1. ALow blood glucose from fasting
2. BOxygen toxicity of the lungs
3. CFalling arterial oxygen tension
4. DRising arterial carbon dioxide
Answer and explanation in LearnFree account
Question 11 · Easy
For an adult with a urinary catheter, the minimum acceptable hourly urine output is about:
1. A0.5 mL/kg per hour
2. B2 mL/kg per hour
3. C0.1 mL/kg per hour
4. D5 mL/kg per hour
Answer and explanation in LearnFree account
Question 12 · Medium
A patient who had a total gastrectomy for cancer is taught that he will need vitamin B12 injections for life. The reason is the loss of:
1. AMucus from the surface epithelial cells
2. BIntrinsic factor from the parietal cells
3. CPepsinogen from the chief cells
4. DGastrin from the G cells of the antrum
Answer and explanation in LearnFree account
Question 13 · Hard
Two days after a severe head injury, a patient passes 400 mL of pale urine every hour. Urine specific gravity is 1.002, serum sodium 152 mEq/L (135-145) and blood glucose 110 mg/dL. Lack of which hormone best explains this?
1. AAldosterone
2. BAntidiuretic hormone
3. CCortisol
4. DInsulin
Answer and explanation in LearnFree account
Question 14 · Hard
A 35-year-old woman has weeks of fatigue, weight loss, dizziness on standing and darkening of her skin creases. Results: BP 88/56 mmHg, sodium 126 mEq/L (135-145), potassium 5.9 mEq/L (3.5-5.0), fasting glucose 58 mg/dL (70-100). Failure of which gland best explains these findings?
1. AThyroid gland
2. BPosterior pituitary
3. CAdrenal cortex
4. DAdrenal medulla
Answer and explanation in LearnFree account
Question 15 · Easy
Pulmonary surfactant, which keeps the alveoli from collapsing at the end of expiration, is secreted by:
1. AAlveolar macrophages
2. BType II alveolar cells
3. CType I alveolar cells
4. DCiliated bronchial cells
Answer and explanation in LearnFree account
Question 16 · Easy
The natural pacemaker of the heart, the sinoatrial node, normally fires in an adult at a rate of:
1. A20-40 beats per minute
2. B60-100 beats per minute
3. C40-60 beats per minute
4. D100-150 beats per minute
Answer and explanation in LearnFree account
Question 17 · Medium
On the ECG, the PR interval mainly reflects atrial depolarisation and the delay of the impulse in the:
1. AAtrioventricular node
2. BSinoatrial node
3. CBundle branches
4. DPurkinje fibres
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Question 18 · Hard
A patient in the ICU has a heart rate of 110 per minute and a stroke volume of 45 mL measured by a monitoring device. What is his cardiac output?
1. A2.44 L/min
2. B4.95 L/min
3. C0.50 L/min
4. D49.5 L/min
Answer and explanation in LearnFree account
Question 19 · Easy
When a baby suckles, the hormone that contracts the cells around the breast alveoli and causes milk let-down is:
1. AProgesterone
2. BOestrogen
3. COxytocin
4. DProlactin
Answer and explanation in LearnFree account
Question 20 · Easy
After a gastric bypass that routes food past the duodenum, patients often become iron deficient because iron is taken up mainly in the:
1. ADuodenum and upper jejunum
2. BBody and fundus of the stomach
3. CTerminal ileum
4. DAscending colon
Answer and explanation in LearnFree account
Question 21 · Hard
A 60 kg adult is brought in after a road accident. The surgeon estimates that she has lost about 1,300 mL of blood. Taking adult blood volume as 70 mL/kg, she has lost about what percentage of her blood volume?
1. A26%
2. B22%
3. C31%
4. D43%
Answer and explanation in LearnFree account
Question 22 · Medium
A patient with angina has a heart rate of 130 per minute. Tachycardia worsens myocardial ischaemia mainly because the left ventricle receives most of its coronary blood flow during:
1. AVentricular systole
2. BAtrial systole
3. CIsovolumetric contraction
4. DVentricular diastole
Answer and explanation in LearnFree account

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Anatomy and physiology applied to nursing

On the first evening after a total thyroidectomy, a patient complains of tingling around the mouth and in the fingertips. This is most likely due to:

A postoperative patient's blood pressure is 130/70 mmHg. Using the standard bedside formula, his mean arterial pressure is:

A patient on chemotherapy has a platelet count of 18,000/µL (normal 1.5-4.0 lakh/µL). Which nursing measure is most appropriate?

Which condition shifts the oxygen-haemoglobin dissociation curve to the right, so that more oxygen is released to the tissues?

The normal adult serum potassium range is:

A patient with chronic kidney disease has a haemoglobin of 8.2 g/dL with normal-sized red cells and normal iron stores. The main reason for this anaemia is:

How long does a normal red blood cell survive in the circulation?

Lumbar puncture in an adult is done at the L3-L4 or L4-L5 space because at this level:

A right-handed man with a left middle cerebral artery stroke understands what is said to him and follows commands, but speaks in short, halting, effortful phrases. Which area is most likely damaged?

A 68-year-old with long-standing COPD is given 10 L/min oxygen by face mask in the ward. An hour later he is drowsy and hard to rouse, with SpO2 99%. The most likely cause of his drowsiness is:

For an adult with a urinary catheter, the minimum acceptable hourly urine output is about:

A patient who had a total gastrectomy for cancer is taught that he will need vitamin B12 injections for life. The reason is the loss of:

Two days after a severe head injury, a patient passes 400 mL of pale urine every hour. Urine specific gravity is 1.002, serum sodium 152 mEq/L (135-145) and blood glucose 110 mg/dL. Lack of which hormone best explains this?

A 35-year-old woman has weeks of fatigue, weight loss, dizziness on standing and darkening of her skin creases. Results: BP 88/56 mmHg, sodium 126 mEq/L (135-145), potassium 5.9 mEq/L (3.5-5.0), fasting glucose 58 mg/dL (70-100). Failure of which gland best explains these findings?

Pulmonary surfactant, which keeps the alveoli from collapsing at the end of expiration, is secreted by:

The natural pacemaker of the heart, the sinoatrial node, normally fires in an adult at a rate of:

On the ECG, the PR interval mainly reflects atrial depolarisation and the delay of the impulse in the:

A patient in the ICU has a heart rate of 110 per minute and a stroke volume of 45 mL measured by a monitoring device. What is his cardiac output?

When a baby suckles, the hormone that contracts the cells around the breast alveoli and causes milk let-down is:

After a gastric bypass that routes food past the duodenum, patients often become iron deficient because iron is taken up mainly in the:

A 60 kg adult is brought in after a road accident. The surgeon estimates that she has lost about 1,300 mL of blood. Taking adult blood volume as 70 mL/kg, she has lost about what percentage of her blood volume?

A patient with angina has a heart rate of 130 per minute. Tachycardia worsens myocardial ischaemia mainly because the left ventricle receives most of its coronary blood flow during: