Neurological, musculoskeletal, oncology, burns and special senses

25 Kerala PSC Staff Nurse Gr II practice questions on Neurological, musculoskeletal, oncology, burns and special senses, part of Medical Surgical Nursing. 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 · Easy
Alpha-fetoprotein is a tumour marker used mainly for:
1. AColorectal cancer
2. BProstate cancer
3. CHepatocellular carcinoma
4. DOvarian cancer
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Answer: C · Hepatocellular carcinoma
Alpha-fetoprotein is raised in hepatocellular carcinoma and in some germ cell tumours of the testis. It is used to follow patients with cirrhosis or hepatitis B and to track response to treatment. A raised level alone does not confirm cancer. Other common markers are PSA for prostate, CA-125 for ovary and CEA for bowel.
- A: Colorectal cancer is followed with CEA.
- B: Prostate cancer is followed with PSA.
- D: Ovarian cancer is followed with CA-125.
Question 2 · Medium
Doxorubicin requires regular monitoring of which organ function during treatment?
1. AEar
2. BHeart
3. CLung
4. DLiver
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Answer: B · Heart
Doxorubicin, an anthracycline, damages heart muscle, and the risk rises with the total cumulative dose. An echocardiogram or MUGA scan is done before treatment and at intervals. Signs of heart failure, such as breathlessness and oedema, are reported. It also turns the urine red for a day or two, which patients should be warned about.
- A: Hearing is monitored with cisplatin.
- C: Lung function is monitored with bleomycin.
- D: Liver monitoring matters for methotrexate, not mainly doxorubicin.
Question 3 · Hard
After a diving accident, a young man with a cervical spine injury has BP 80/50 mmHg, pulse 50/min and warm, dry skin. The most likely cause is:
1. ANeurogenic shock
2. BAnaphylactic shock
3. CHypovolaemic shock
4. DCardiogenic shock
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Answer: A · Neurogenic shock
Injury to the cervical or high thoracic cord cuts sympathetic outflow, so blood vessels dilate and the vagus slows the heart unopposed. The result is hypotension with bradycardia and warm, dry skin. Bleeding instead causes a fast pulse and cold, clammy skin. Treatment is fluids, vasopressors and atropine for bradycardia, with the spine immobilised.
- B: Anaphylaxis follows an allergen and causes tachycardia, wheeze or rash.
- C: Hypovolaemic shock causes tachycardia and cold, clammy skin.
- D: Cardiogenic shock usually follows heart disease and gives cold skin and tachycardia.
Question 4 · Easy
The Tensilon test for myasthenia gravis uses which drug?
1. AAtropine
2. BPhysostigmine
3. CEdrophonium
4. DNeostigmine methylsulphate
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Answer: C · Edrophonium
Edrophonium is a very short-acting anticholinesterase. In myasthenia it briefly improves muscle strength, for example lifting a drooping eyelid, within a minute. Atropine is kept ready because excess acetylcholine can cause bradycardia. Antibody tests and nerve studies are now preferred, but the test remains a classic exam point.
- A: Atropine is the antidote kept ready, not the test drug.
- B: Physostigmine crosses into the brain and is used for anticholinergic poisoning.
- D: Neostigmine acts longer and is used for treatment, not this rapid test.
Question 5 · Easy
The recommended first aid for a fresh thermal burn is to cool it under cool running water for about:
1. A20 minutes
2. B2 minutes
3. C5 seconds
4. D1 hour
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Answer: A · 20 minutes
Cooling under cool running tap water for around 20 minutes, started as soon as possible, stops the burning process and reduces pain and depth. Ice, toothpaste, oil and butter are avoided. Rings and tight items are removed before swelling begins. The patient is kept warm, since cooling large areas can cause hypothermia.
- B: 2 minutes is too short to stop tissue damage.
- C: 5 seconds has no cooling benefit.
- D: An hour risks hypothermia, especially in children.
Question 6 · Medium
Antibodies to double-stranded DNA are most specific for:
1. ARheumatoid arthritis
2. BSystemic sclerosis
3. CAnkylosing spondylitis
4. DSystemic lupus erythematosus
Answer and explanation in LearnFree account
Question 7 · Easy
A greenstick fracture is seen mostly in:
1. AAdults with cancer
2. BAthletes
3. CChildren
4. DElderly women
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Question 8 · Medium
Episodes of vertigo with tinnitus, fullness in the ear and fluctuating hearing loss suggest:
1. AWax impaction
2. BOtosclerosis
3. CAcute otitis media
4. DMeniere disease
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Question 9 · Hard
After a blow to the temple, a patient was briefly unconscious, then talked normally for an hour. He is now drowsy with a fixed, dilated pupil on the side of the injury. The likely diagnosis is:
1. ASubarachnoid haemorrhage
2. BChronic subdural haematoma
3. CCerebral concussion
4. DExtradural haematoma
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Question 10 · Medium
An acute stress ulcer of the stomach or duodenum after major burns is called:
1. ACushing ulcer
2. BRodent ulcer
3. CCurling ulcer
4. DMarjolin ulcer
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Question 11 · Medium
After spinal surgery, the patient is turned by log-rolling in order to:
1. AImprove venous return from the legs
2. BReduce the need for analgesics
3. CLower the risk of postoperative headache
4. DKeep the spine aligned during the turn
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Question 12 · Easy
The joint pattern typical of rheumatoid arthritis is:
1. AThe first toe joint alone
2. BThe lower spine and sacroiliac joints
3. COne large weight-bearing joint
4. DSymmetrical small joints of hands and feet
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Question 13 · Easy
Cataract is an opacity of the:
1. ALens
2. BRetina
3. CVitreous
4. DCornea
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Question 14 · Medium
The tremor of Parkinson disease is typically:
1. ASeen only during sleep
2. BWorse on reaching a target
3. CPresent at rest and lessened by movement
4. DPresent only during purposeful movement
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Question 15 · Medium
A patient reports sudden flashes of light, many new floaters and a curtain coming over part of the vision, without pain. These suggest:
1. AAcute conjunctivitis
2. BRetinal detachment
3. CAcute angle-closure glaucoma
4. DSenile cataract
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Question 16 · Easy
A Colles fracture with a dinner-fork deformity involves the:
1. ADistal radius
2. BScaphoid bone
3. CNeck of the femur
4. DShaft of the humerus
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Question 17 · Easy
The crystals deposited in the joints in gout are:
1. ACalcium oxalate
2. BCalcium pyrophosphate
3. CMonosodium urate
4. DCholesterol
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Question 18 · Easy
Bell palsy is a lower motor neurone paralysis of which cranial nerve?
1. AFacial (VII)
2. BOculomotor (III)
3. CTrigeminal (V)
4. DHypoglossal (XII)
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Question 19 · Easy
Multiple sclerosis is a disease of:
1. ADegeneration of the anterior horn cells
2. BDemyelination in the brain and spinal cord
3. CLoss of dopamine in the basal ganglia
4. DAutoimmune attack on peripheral nerves
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Question 20 · Medium
A patient using axillary crutches complains of tingling in the hands. The nurse checks that the crutch top is two to three finger widths below the axilla because pressure there can injure the:
1. AShoulder joint capsule
2. BAxillary artery wall
3. CBrachial plexus nerves
4. DLong thoracic nerve
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Question 21 · Hard
A worker splashes an alkali cleaning solution into his eye. He reaches the casualty in pain. The nurse's first action is to:
1. AIrrigate the eye with plenty of water or saline
2. BInstil antibiotic ointment and bandage
3. CInstil a neutralising acid eye drop
4. DPad the eye and wait for the ophthalmologist
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Question 22 · Hard
A man with lymphoma started chemotherapy yesterday. Today he has K+ 6.4 mEq/L, uric acid 14 mg/dL, phosphate raised, calcium 7.2 mg/dL and falling urine output. The likely cause is:
1. ASyndrome of inappropriate ADH
2. BTumour lysis syndrome
3. CHypercalcaemia of malignancy
4. DSeptic shock
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Question 23 · Medium
The drug of first choice for trigeminal neuralgia is:
1. AMorphine
2. BPrednisolone
3. CParacetamol
4. DCarbamazepine
Answer and explanation in LearnFree account
Question 24 · Medium
Mesna is given with high-dose cyclophosphamide or ifosfamide to prevent:
1. APeripheral neuropathy
2. BPulmonary fibrosis
3. CHaemorrhagic cystitis
4. DCardiotoxicity
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Question 25 · Hard
Five minutes after an IV antibiotic, an adult develops wheeze, facial swelling and BP 80/50 mmHg. After stopping the drug, the nurse should prepare to give adrenaline:
1. A0.5 mg (1:1000) IM into the thigh
2. B1 mg (1:10,000) subcutaneously
3. C0.5 mg (1:1000) IV as a bolus
4. D5 mg (1:1000) IM into the deltoid
Answer and explanation in LearnFree account

Neurological, musculoskeletal, oncology, burns and special senses

Alpha-fetoprotein is a tumour marker used mainly for:

Doxorubicin requires regular monitoring of which organ function during treatment?

After a diving accident, a young man with a cervical spine injury has BP 80/50 mmHg, pulse 50/min and warm, dry skin. The most likely cause is:

The Tensilon test for myasthenia gravis uses which drug?

The recommended first aid for a fresh thermal burn is to cool it under cool running water for about:

Antibodies to double-stranded DNA are most specific for:

A greenstick fracture is seen mostly in:

Episodes of vertigo with tinnitus, fullness in the ear and fluctuating hearing loss suggest:

After a blow to the temple, a patient was briefly unconscious, then talked normally for an hour. He is now drowsy with a fixed, dilated pupil on the side of the injury. The likely diagnosis is:

An acute stress ulcer of the stomach or duodenum after major burns is called:

After spinal surgery, the patient is turned by log-rolling in order to:

The joint pattern typical of rheumatoid arthritis is:

Cataract is an opacity of the:

The tremor of Parkinson disease is typically:

A patient reports sudden flashes of light, many new floaters and a curtain coming over part of the vision, without pain. These suggest:

A Colles fracture with a dinner-fork deformity involves the:

The crystals deposited in the joints in gout are:

Bell palsy is a lower motor neurone paralysis of which cranial nerve?

Multiple sclerosis is a disease of:

A patient using axillary crutches complains of tingling in the hands. The nurse checks that the crutch top is two to three finger widths below the axilla because pressure there can injure the:

A worker splashes an alkali cleaning solution into his eye. He reaches the casualty in pain. The nurse's first action is to:

A man with lymphoma started chemotherapy yesterday. Today he has K+ 6.4 mEq/L, uric acid 14 mg/dL, phosphate raised, calcium 7.2 mg/dL and falling urine output. The likely cause is:

The drug of first choice for trigeminal neuralgia is:

Mesna is given with high-dose cyclophosphamide or ifosfamide to prevent:

Five minutes after an IV antibiotic, an adult develops wheeze, facial swelling and BP 80/50 mmHg. After stopping the drug, the nurse should prepare to give adrenaline: