A 70-year-old has an irregular pulse. The nurse counts an apical rate of 112 and, at the same time, a radial rate of 90 per minute. What does this most suggest?

A pulse deficit of 22, typical of atrial fibrillation

A normal finding in elderly patients

A pulse deficit of 22, typical of sinus tachycardia

Counting error; the radial rate is the true rate

Why is the short delay of the impulse at the atrioventricular node useful?

Atria finish emptying before ventricles contract

It lets the SA node recover its rhythm

It allows the coronary arteries to fill

It stops impulses from reaching the Purkinje fibres

Anatomy and physiology: circulatory, respiratory and blood

25 Kerala PSC Staff Nurse Gr II practice questions on Anatomy and physiology: circulatory, respiratory and blood, part of Anatomy, Physiology and Microbiology. The first 25 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 · Hard
A 70-year-old has an irregular pulse. The nurse counts an apical rate of 112 and, at the same time, a radial rate of 90 per minute. What does this most suggest?
1. AA normal finding in elderly patients
2. BA pulse deficit of 22, typical of sinus tachycardia
3. CCounting error; the radial rate is the true rate
4. DA pulse deficit of 22, typical of atrial fibrillation
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Answer: D · A pulse deficit of 22, typical of atrial fibrillation
Pulse deficit = apical rate minus radial rate = 112 - 90 = 22. In atrial fibrillation some beats come so early that the ventricle has not filled, so they are heard at the apex but too weak to reach the wrist. Two nurses should count apical and radial pulses together for a full minute.
- A: A pulse deficit is never normal at any age.
- B: Sinus tachycardia is regular, and each beat reaches the wrist.
- C: The apical rate is the true heart rate; the radial count misses weak beats.
Question 2 · Hard
A patient with blood group B Rh-negative needs urgent red cell transfusion. No B-negative unit is available. Which group of packed cells is safest to give?
1. AAB Rh-negative
2. BO Rh-positive
3. CO Rh-negative
4. DB Rh-positive
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Answer: C · O Rh-negative
Group B plasma has anti-A, so red cells must lack the A antigen: B or O. As the patient is Rh-negative, the cells should also be Rh-negative to avoid anti-D sensitisation, which matters greatly in a woman of child-bearing age. So O Rh-negative packed cells are the compatible choice after cross-matching.
- A: AB cells carry the A antigen, which the patient's anti-A will destroy.
- B: O-positive cells are ABO compatible but carry the D antigen.
- D: Rh-positive cells can sensitise an Rh-negative patient to make anti-D.
Question 3 · Medium
Lymph from the right arm and right side of the head and chest drains into the:
1. ARight axillary vein
2. BRight lymphatic duct
3. CCisterna chyli
4. DThoracic duct
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Answer: B · Right lymphatic duct
The right lymphatic duct collects lymph from the right upper limb and the right side of the head, neck and thorax, and empties into the right subclavian vein. The thoracic duct drains the rest of the body. This is why lymph from the left side and both legs all reaches the thoracic duct.
- A: The axillary vein does not receive a lymph duct.
- C: The cisterna chyli collects lymph from the abdomen and legs.
- D: The thoracic duct drains the left upper body and everything below the diaphragm.
Question 4 · Medium
Why is the short delay of the impulse at the atrioventricular node useful?
1. AIt lets the SA node recover its rhythm
2. BAtria finish emptying before ventricles contract
3. CIt allows the coronary arteries to fill
4. DIt stops impulses from reaching the Purkinje fibres
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Answer: B · Atria finish emptying before ventricles contract
The impulse is held at the AV node for about 0.1 second. This lets the atria complete their contraction and top up ventricular filling before the ventricles contract. If the delay is lost or the AV node is diseased, filling and cardiac output fall; a prolonged delay shows as a long PR interval (heart block).
- A: The SA node fires on its own and does not depend on the AV delay.
- C: Coronary filling happens in ventricular diastole, not because of AV delay.
- D: The impulse does reach the Purkinje fibres after the delay.
Question 5 · Easy
The thoracic duct empties its lymph into the:
1. AInferior vena cava
2. BRight subclavian vein
3. CLeft subclavian vein
4. DRight atrium directly
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Answer: C · Left subclavian vein
The thoracic duct is the largest lymph vessel. It begins at the cisterna chyli and drains lymph from both legs, the abdomen and the left upper body into the junction of the left subclavian and left internal jugular veins. Injury to it during neck or chest surgery can cause a milky chylous leak.
- A: The inferior vena cava does not receive a lymph duct.
- B: The right subclavian vein receives the right lymphatic duct.
- D: Lymph returns to the veins of the neck, not straight into the heart.
Question 6 · Medium
A young man has had his spleen removed after a road accident. He is at the greatest lifelong risk of overwhelming infection by:
1. AViruses such as influenza
2. BEncapsulated bacteria such as pneumococcus
3. CParasites such as Plasmodium vivax
4. DFungi such as Candida
Answer and explanation in LearnFree account
Question 7 · Hard
After mastectomy with removal of the axillary lymph nodes, a woman is told never to have blood pressure checked or injections on that arm. Why?
1. AVenous blood from the arm now drains backwards
2. BThe brachial artery was tied off during surgery
3. CLymph drainage is impaired, risking lymphoedema
4. DThe arm has lost its sensory nerve supply
Answer and explanation in LearnFree account
Question 8 · Hard
A 4-year-old chokes on a groundnut. Chest X-ray shows the nut lodged in a main bronchus. It is most likely in the right main bronchus because the right one is:
1. ALonger, narrower and more horizontal
2. BShorter, wider and more vertical
3. CSupplied by more cartilage rings
4. DPlaced in front of the aortic arch
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Question 9 · Easy
T lymphocytes mature in the:
1. ABone marrow
2. BThymus
3. CLiver
4. DSpleen
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Question 10 · Easy
All of the following vessels carry deoxygenated blood EXCEPT:
1. APulmonary vein
2. BCoronary sinus
3. CSuperior vena cava
4. DPulmonary artery
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Question 11 · Easy
Plasma forms about what percentage of the total blood volume?
1. A45%
2. B90%
3. C75%
4. D55%
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Question 12 · Hard
On a standard ECG strip run at 25 mm/s, the R-R interval is exactly 4 large squares. The heart rate is:
1. A60 per minute
2. B100 per minute
3. C120 per minute
4. D75 per minute
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Question 13 · Easy
The right and left coronary arteries arise from the:
1. APulmonary trunk
2. BDescending thoracic aorta
3. CArch of the aorta
4. DAscending aorta
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Question 14 · Medium
Stridor, a harsh high-pitched sound heard mainly during inspiration, indicates narrowing of the:
1. AAlveoli
2. BLarynx or trachea
3. CSmall bronchioles
4. DPleural space
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Question 15 · Medium
At a heart rate of 75 beats per minute, one cardiac cycle lasts about:
1. A0.3 second
2. B0.08 second
3. C1.2 seconds
4. D0.8 second
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Question 16 · Medium
In a healthy person, the strongest stimulus that drives breathing is a rise in the blood level of:
1. ABicarbonate
2. BOxygen
3. CNitrogen
4. DCarbon dioxide
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Question 17 · Medium
A child from a rural area has anaemia and a differential count showing 18% eosinophils. Which condition does this most suggest?
1. ABacterial pneumonia
2. BHookworm infestation
3. CViral hepatitis
4. DTyphoid fever
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Question 18 · Medium
Vital capacity is the sum of:
1. AExpiratory reserve and residual volumes
2. BTidal volume and residual volume
3. CInspiratory reserve and residual volumes
4. DTidal, inspiratory reserve and expiratory reserve volumes
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Question 19 · Easy
Tissue macrophages develop from which white blood cells?
1. ALymphocytes
2. BEosinophils
3. CBasophils
4. DMonocytes
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Question 20 · Medium
Breathing that gradually deepens, then becomes shallow and is followed by a period of apnoea is seen typically in:
1. ABronchial asthma
2. BDiabetic ketoacidosis
3. CHeart failure and the dying patient
4. DAnxiety and panic attack
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Question 21 · Easy
Difficulty in breathing when lying flat, relieved by sitting up, is called:
1. ATachypnoea
2. BHyperpnoea
3. CBradypnoea
4. DOrthopnoea
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Question 22 · Medium
The first heart sound (lub) is produced by closure of the:
1. ATricuspid and pulmonary valves
2. BMitral and aortic valves
3. CAortic and pulmonary valves
4. DMitral and tricuspid valves
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Question 23 · Easy
The bicuspid (mitral) valve lies between the:
1. ALeft ventricle and aorta
2. BLeft atrium and left ventricle
3. CRight ventricle and pulmonary trunk
4. DRight atrium and right ventricle
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Question 24 · Easy
Which organ is known as the graveyard of red blood cells?
1. AKidney
2. BLiver
3. CBone marrow
4. DSpleen
Answer and explanation in LearnFree account
Question 25 · Easy
The sagittal plane divides the body into:
1. AFront and back parts
2. BInner and outer parts
3. CRight and left parts
4. DUpper and lower parts
Answer and explanation in LearnFree account

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Anatomy and physiology: circulatory, respiratory and blood

A 70-year-old has an irregular pulse. The nurse counts an apical rate of 112 and, at the same time, a radial rate of 90 per minute. What does this most suggest?

A patient with blood group B Rh-negative needs urgent red cell transfusion. No B-negative unit is available. Which group of packed cells is safest to give?

Lymph from the right arm and right side of the head and chest drains into the:

Why is the short delay of the impulse at the atrioventricular node useful?

The thoracic duct empties its lymph into the:

A young man has had his spleen removed after a road accident. He is at the greatest lifelong risk of overwhelming infection by:

After mastectomy with removal of the axillary lymph nodes, a woman is told never to have blood pressure checked or injections on that arm. Why?

A 4-year-old chokes on a groundnut. Chest X-ray shows the nut lodged in a main bronchus. It is most likely in the right main bronchus because the right one is:

T lymphocytes mature in the:

All of the following vessels carry deoxygenated blood EXCEPT:

Plasma forms about what percentage of the total blood volume?

On a standard ECG strip run at 25 mm/s, the R-R interval is exactly 4 large squares. The heart rate is:

The right and left coronary arteries arise from the:

Stridor, a harsh high-pitched sound heard mainly during inspiration, indicates narrowing of the:

At a heart rate of 75 beats per minute, one cardiac cycle lasts about:

In a healthy person, the strongest stimulus that drives breathing is a rise in the blood level of:

A child from a rural area has anaemia and a differential count showing 18% eosinophils. Which condition does this most suggest?

Vital capacity is the sum of:

Tissue macrophages develop from which white blood cells?

Breathing that gradually deepens, then becomes shallow and is followed by a period of apnoea is seen typically in:

Difficulty in breathing when lying flat, relieved by sitting up, is called:

The first heart sound (lub) is produced by closure of the:

The bicuspid (mitral) valve lies between the:

Which organ is known as the graveyard of red blood cells?

The sagittal plane divides the body into: