Before a newly inserted subclavian central venous catheter is used for infusions, the nurse must ensure that:

A chest X-ray has confirmed the tip position

A blood culture has been drawn from the line

The catheter has been flushed with heparin

The dressing has been changed after one hour

A farmer is bitten on the ankle by a snake while working in a paddy field. Which first aid measure is correct?

Splint the limb and transport him to hospital

Tie a tight tourniquet above the knee to stop venom spread

Pack ice around the bite to slow absorption of venom

Make a cut over the fang marks and suck out the venom

A construction worker collapses at noon in May. He is confused and agitated, with core temperature 41.6 °C, HR 136/min, BP 96/60 mmHg and hot skin. After airway and breathing are secured, what is the priority intervention?

Rapid cooling by cold-water immersion or spraying

Give him cold oral rehydration solution to drink

Give rectal paracetamol to bring the fever down

Wrap him in a blanket to prevent shivering

Emergency, triage and critical care

18 AIIMS NORCET (Nursing Officer) practice questions on Emergency, triage and critical care, part of Medical-Surgical Nursing. The first 18 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
A head-injured patient opens the eyes only to pain, makes incomprehensible sounds and withdraws a limb from a painful stimulus. The Glasgow Coma Scale score is:
1. A8
2. B10
3. C7
4. D9
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Answer: A · 8
Eye opening to pain scores E2, incomprehensible sounds score V2, and withdrawal from pain scores M4, so the total is 2 + 2 + 4 = 8. The scale runs from 3 to 15. A score of 8 or less marks severe head injury, and such a patient usually cannot protect the airway, so intubation is considered. The motor score, which carries the most weight, is the best response of either arm.
- B: 10 counts both eyes and voice one step too high.
- C: 7 counts withdrawal as abnormal flexion (M3).
- D: 9 counts incomprehensible sounds as inappropriate words (V3).
Question 2 · Medium
Before a newly inserted subclavian central venous catheter is used for infusions, the nurse must ensure that:
1. AA chest X-ray has confirmed the tip position
2. BA blood culture has been drawn from the line
3. CThe catheter has been flushed with heparin
4. DThe dressing has been changed after one hour
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Answer: A · A chest X-ray has confirmed the tip position
After subclavian or internal jugular insertion, a chest X-ray confirms that the tip lies in the lower superior vena cava near the cavoatrial junction and rules out a pneumothorax. A misplaced tip can cause arrhythmia, vessel perforation or infusion into the wrong vein. The line is not used for infusions until the position has been confirmed and documented. Subclavian puncture carries the highest pneumothorax risk of the common sites.
- B: A blood culture is not a routine requirement before use.
- C: Flushing confirms patency but cannot show where the tip lies.
- D: A transparent dressing does not need changing after one hour.
Question 3 · Medium
A farmer is bitten on the ankle by a snake while working in a paddy field. Which first aid measure is correct?
1. ATie a tight tourniquet above the knee to stop venom spread
2. BSplint the limb and transport him to hospital
3. CPack ice around the bite to slow absorption of venom
4. DMake a cut over the fang marks and suck out the venom
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Answer: B · Splint the limb and transport him to hospital
Indian snakebite guidance follows a simple rule: reassure the patient, immobilise the bitten limb with a splint as for a fracture, and get to a hospital with antisnake venom quickly. Rings, anklets and tight clothing are removed before swelling starts. Tight tourniquets, cutting, sucking and ice all cause harm: ischaemia, infection, bleeding or tissue damage, without removing venom. Keeping the patient still slows lymphatic spread.
- A: A tight tourniquet causes ischaemia and gangrene and releases venom in a rush when removed.
- C: Ice damages tissue already injured by local venom.
- D: Cutting and sucking add bleeding and infection and remove no useful venom.
Question 4 · Hard
A construction worker collapses at noon in May. He is confused and agitated, with core temperature 41.6 °C, HR 136/min, BP 96/60 mmHg and hot skin. After airway and breathing are secured, what is the priority intervention?
1. ARapid cooling by cold-water immersion or spraying
2. BGive him cold oral rehydration solution to drink
3. CGive rectal paracetamol to bring the fever down
4. DWrap him in a blanket to prevent shivering
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Answer: A · Rapid cooling by cold-water immersion or spraying
A core temperature above 40 °C with confusion is heat stroke, and the death and organ damage it causes depend on how long the temperature stays high. Rapid cooling is the priority: cold or ice-water immersion, or spraying with water while fanning, with ice packs to the neck, axillae and groin, and stopping at about 38-39 °C. Antipyretics do not work because the hypothalamic set point is not raised. A confused patient must not drink, because he may aspirate.
- B: Oral fluids risk aspiration in a confused patient and do not cool fast enough.
- C: Antipyretics act on a raised set point, which is absent in heat stroke.
- D: A blanket traps heat and delays cooling.
Question 5 · Medium
At a building collapse, a nurse doing START triage finds a man who cannot walk. After his airway is opened he is breathing at 34/min. He should be tagged:
1. ABlack (expectant)
2. BRed (immediate)
3. CYellow (delayed)
4. DGreen (minor)
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Answer: B · Red (immediate)
In START, a casualty who cannot walk but breathes is checked for rate: more than 30 breaths per minute is an immediate (red) priority, without further checks. Those breathing 30 or fewer are then judged on perfusion (radial pulse or capillary refill over 2 seconds) and on whether they obey simple commands. A casualty who does not breathe after the airway is opened is tagged black. Each triage takes less than a minute.
- A: Black is for those who do not breathe after the airway is opened.
- C: Yellow needs a rate of 30 or below with normal perfusion and mental status.
- D: Green is for casualties who can walk.
Question 6 · Hard
A man pulled from a cold river is unresponsive, with a core temperature of 28 °C and a slow, irregular pulse. While moving him from the stretcher to the emergency bed, which precaution matters most?
1. AStop CPR if no pulse returns after 20 minutes
2. BRub his arms and legs briskly to restore circulation
3. CMove him gently and keep him horizontal
4. DRaise him to sitting to help his breathing
Answer and explanation in LearnFree account
Question 7 · Hard
A patient given repeated doses of IV morphine after surgery is drowsy, with RR 8/min. Arterial blood gas: pH 7.24, PaCO2 62 mmHg, HCO3- 25 mEq/L (reference pH 7.35-7.45, PaCO2 35-45 mmHg, HCO3- 22-26 mEq/L). The ABG shows:
1. AUncompensated respiratory acidosis
2. BPartly compensated metabolic alkalosis
3. CUncompensated metabolic acidosis
4. DCompensated respiratory acidosis
Answer and explanation in LearnFree account
Question 8 · Medium
In a snakebite victim, the 20-minute whole blood clotting test (20WBCT) shows blood that is still liquid when the tube is tipped at 20 minutes. This result indicates:
1. AA normal result that needs no action
2. BA dry bite with no envenomation
3. CA neurotoxic bite needing only neostigmine
4. DVenom-induced coagulopathy needing antisnake venom
Answer and explanation in LearnFree account
Question 9 · Easy
For an adult in anaphylaxis, the recommended first dose of adrenaline is:
1. A0.5 mg of 1:1000 IM into the outer thigh
2. B0.5 mg of 1:10,000 SC into the arm
3. C5 mg of 1:1000 by nebuliser
4. D1 mg of 1:10,000 as an IV bolus
Answer and explanation in LearnFree account
Question 10 · Easy
The feature that distinguishes heat stroke from heat exhaustion is:
1. AThirst, headache and a fast, weak pulse
2. BConfusion or coma with core temperature over 40 °C
3. CMuscle cramps after prolonged exercise in the heat
4. DHeavy sweating with pale, cool and clammy skin
Answer and explanation in LearnFree account
Question 11 · Easy
In organophosphate insecticide poisoning, which drug is given in repeated doses until bronchial secretions dry up?
1. AAtropine
2. BNeostigmine
3. CPralidoxime
4. DAdrenaline
Answer and explanation in LearnFree account
Question 12 · Easy
In START triage at a mass-casualty scene, a casualty who can walk to the collection point is tagged:
1. ABlack (expectant)
2. BYellow (delayed)
3. CGreen (minor)
4. DRed (immediate)
Answer and explanation in LearnFree account
Question 13 · Medium
On the first day after a laparotomy, a patient has BP 92/58 mmHg, HR 118/min, urine output 15 mL/h for 3 hours, and CVP 2 cmH2O (unit reference 5-10 cmH2O). These findings suggest:
1. ARight heart failure needing an inotrope
2. BNormal postoperative values needing no action
3. CHypovolaemia needing a fluid challenge
4. DFluid overload needing a diuretic
Answer and explanation in LearnFree account
Question 14 · Easy
Which antidote is used for paracetamol (acetaminophen) overdose?
1. ADesferrioxamine
2. BN-acetylcysteine
3. CNaloxone
4. DFlumazenil
Answer and explanation in LearnFree account
Question 15 · Medium
While a central venous catheter is being removed, the patient suddenly becomes breathless, with chest pain, cyanosis and a fall in blood pressure. After occluding the site, the nurse should place the patient:
1. AOn the right side with the legs raised
2. BOn the left side with the head tilted down
3. CFlat on the back with the head raised
4. DUpright in the high Fowler's position
Answer and explanation in LearnFree account
Question 16 · Hard
A 40-year-old farmer who drank an organophosphate insecticide has pinpoint pupils, profuse secretions, crackles over both lungs, HR 48/min and BP 84/50 mmHg. Atropine is being given in doubling doses. Which finding best shows that atropinisation is adequate?
1. AClear chest with HR above 80/min and SBP above 80 mmHg
2. BDisappearance of muscle fasciculations
3. CHeart rate above 140/min with a flushed face
4. DWidely dilated pupils in both eyes
Answer and explanation in LearnFree account
Question 17 · Medium
Why does resuscitation of a drowning victim who is not breathing begin with rescue breaths rather than chest compressions alone?
1. ACompressions are unsafe in cold-water victims
2. BWater in the lungs must first be blown out
3. CA drowned heart restarts with breaths alone
4. DThe arrest in drowning is caused by hypoxia
Answer and explanation in LearnFree account
Question 18 · Medium
An unconscious motorcyclist is brought in after a crash. He has snoring respirations and a bleeding scalp wound, and the cervical spine has not yet been cleared. What is the nurse's first action?
1. AJaw thrust with manual in-line neck stabilisation
2. BApply firm pressure to the bleeding scalp wound
3. CInsert two large-bore cannulas and start fluids
4. DHead tilt and chin lift to open the airway
Answer and explanation in LearnFree account

Emergency, triage and critical care

A head-injured patient opens the eyes only to pain, makes incomprehensible sounds and withdraws a limb from a painful stimulus. The Glasgow Coma Scale score is:

Before a newly inserted subclavian central venous catheter is used for infusions, the nurse must ensure that:

A farmer is bitten on the ankle by a snake while working in a paddy field. Which first aid measure is correct?

A construction worker collapses at noon in May. He is confused and agitated, with core temperature 41.6 °C, HR 136/min, BP 96/60 mmHg and hot skin. After airway and breathing are secured, what is the priority intervention?

At a building collapse, a nurse doing START triage finds a man who cannot walk. After his airway is opened he is breathing at 34/min. He should be tagged:

A man pulled from a cold river is unresponsive, with a core temperature of 28 °C and a slow, irregular pulse. While moving him from the stretcher to the emergency bed, which precaution matters most?

A patient given repeated doses of IV morphine after surgery is drowsy, with RR 8/min. Arterial blood gas: pH 7.24, PaCO2 62 mmHg, HCO3- 25 mEq/L (reference pH 7.35-7.45, PaCO2 35-45 mmHg, HCO3- 22-26 mEq/L). The ABG shows:

In a snakebite victim, the 20-minute whole blood clotting test (20WBCT) shows blood that is still liquid when the tube is tipped at 20 minutes. This result indicates:

For an adult in anaphylaxis, the recommended first dose of adrenaline is:

The feature that distinguishes heat stroke from heat exhaustion is:

In organophosphate insecticide poisoning, which drug is given in repeated doses until bronchial secretions dry up?

In START triage at a mass-casualty scene, a casualty who can walk to the collection point is tagged:

On the first day after a laparotomy, a patient has BP 92/58 mmHg, HR 118/min, urine output 15 mL/h for 3 hours, and CVP 2 cmH2O (unit reference 5-10 cmH2O). These findings suggest:

Which antidote is used for paracetamol (acetaminophen) overdose?

While a central venous catheter is being removed, the patient suddenly becomes breathless, with chest pain, cyanosis and a fall in blood pressure. After occluding the site, the nurse should place the patient:

A 40-year-old farmer who drank an organophosphate insecticide has pinpoint pupils, profuse secretions, crackles over both lungs, HR 48/min and BP 84/50 mmHg. Atropine is being given in doubling doses. Which finding best shows that atropinisation is adequate?

Why does resuscitation of a drowning victim who is not breathing begin with rescue breaths rather than chest compressions alone?

An unconscious motorcyclist is brought in after a crash. He has snoring respirations and a bleeding scalp wound, and the cervical spine has not yet been cleared. What is the nurse's first action?