AIIMS Nursing Practice Set 1

Explanation: The nephron is the structural and functional unit of the kidney. Each kidney contains approximately 1 million nephrons. Each nephron consists of a renal corpuscle (Bowman's capsule + glomerulus) and a renal tubule (PCT, loop of Henle, DCT, collecting duct). Urine formation involves filtration, reabsorption, and secretion.

Explanation: The sinoatrial (SA) node is located in the wall of the right atrium, near the opening of the superior vena cava. It generates electrical impulses at 60-100 per minute and is the natural pacemaker of the heart. Its intrinsic rate is the fastest among all cardiac conduction tissues.

Explanation: Cranial nerve I (Olfactory nerve) is responsible for the sense of smell. It is a purely sensory nerve whose fibres pass through the cribriform plate of the ethmoid bone to reach the olfactory bulb. It is the only cranial nerve that does not relay through the thalamus before reaching the cortex.

Explanation: The normal arterial blood pH range is 7.35-7.45. A pH below 7.35 indicates acidosis and above 7.45 indicates alkalosis. The body maintains this narrow range through buffer systems (bicarbonate, phosphate, protein), respiratory regulation (CO2 elimination), and renal regulation (H+ secretion, HCO3- reabsorption).

Explanation: Scurvy is caused by deficiency of Vitamin C (ascorbic acid). It presents with bleeding gums (spongy, swollen), petechiae, perifollicular haemorrhage, poor wound healing, corkscrew hair, and loosening of teeth. Vitamin C is essential for collagen synthesis, acting as a cofactor for prolyl and lysyl hydroxylase enzymes.

Explanation: Salivary amylase (ptyalin) is the enzyme that begins the digestion of starch in the mouth, breaking it down to maltose and dextrin. It works optimally at a neutral pH of about 6.8. Its action ceases in the acidic environment of the stomach.

Explanation: In hepatic encephalopathy, the liver cannot adequately metabolise ammonia (from protein metabolism). The diet should be low in protein (0.5-0.8 g/kg initially, with vegetable protein preferred over animal protein), high in carbohydrates (to provide energy and reduce catabolism), and adequate in calories. Branched-chain amino acid supplements may be beneficial.

Explanation: Florence Nightingale earned the title 'Lady with the Lamp' for her dedicated service during the Crimean War (1853-1856). She revolutionised military nursing at the British hospital in Scutari, Turkey, reducing the death rate from 42% to 2% through improved sanitation, nutrition, and hygiene practices.

Explanation: The nursing process is a systematic, client-centred approach consisting of five sequential steps: Assessment (data collection), Diagnosis (identifying problems), Planning (setting goals and interventions), Implementation (carrying out the plan), and Evaluation (determining effectiveness). It is a continuous, cyclical process.

Explanation: For intramuscular injections in adults, a 21-23 gauge needle (1-1.5 inches long) is most commonly used. The deltoid site uses a shorter needle (1 inch) while the gluteal and vastus lateralis sites require a longer needle (1.5 inches). Thinner gauges (25-27G) are used for subcutaneous injections.

Explanation: According to the Biomedical Waste Management Rules 2016 (India), yellow-coloured containers/bags are used for human anatomical waste (body parts, organs, placenta, tissues), soiled waste (cotton, dressings, linen contaminated with blood), and expired medicines. Red bags are for contaminated recyclable waste, white puncture-proof containers for sharps, and blue for glassware.

Explanation: In Maslow's hierarchy of needs, physiological needs (food, water, air, shelter, sleep, clothing, reproduction) form the base level. The hierarchy from bottom to top is: Physiological → Safety → Love/Belonging → Esteem → Self-actualisation. Higher needs emerge only after lower needs are substantially met.

Explanation: Pavlov's experiment demonstrating salivation in dogs in response to a bell (conditioned stimulus, paired with food — unconditioned stimulus) is the classic example of classical (respondent) conditioning. Key concepts include stimulus generalisation, discrimination, extinction, and spontaneous recovery.

Explanation: Projection is the defence mechanism in which a person unconsciously attributes their own unacceptable feelings, thoughts, or impulses to another person. For example, a person who dislikes a colleague may believe that the colleague dislikes them. It reduces anxiety by externalising the source of discomfort.

Explanation: Alcohol-based hand rubs (ABHR containing 60-80% alcohol) are the preferred method for routine hand hygiene in healthcare settings according to WHO guidelines. They are more effective than soap and water against most pathogens, require less time (20-30 seconds), and cause less skin damage. Soap and water is preferred when hands are visibly soiled or contaminated with Clostridium difficile spores.

Explanation: The window period is the interval between HIV infection and the detection of HIV antibodies in the blood. During this period (typically 2-12 weeks with third-generation ELISA tests, shorter with fourth-generation Ag/Ab combo tests), the person is infected and potentially infectious but tests antibody-negative. This is why repeat testing is recommended.

Explanation: The autoclave uses moist heat under pressure (steam under pressure). Standard settings are 121 degrees C at 15 psi for 15 minutes (or 134 degrees C at 30 psi for 3 minutes for flash sterilisation). The increased pressure raises the boiling point of water, generating steam at higher temperatures that effectively kills all microorganisms including spores.

Explanation: The Alma-Ata Declaration (1978) emphasised 'Health for All by 2000 AD' through Primary Health Care (PHC). PHC principles include: essential health care made universally accessible, based on socially acceptable methods and technology, full participation of the community, and at a cost the country and community can afford. It focuses on promotive, preventive, curative, and rehabilitative services.

Explanation: Cholera (caused by Vibrio cholerae) is primarily transmitted through the faecal-oral route via contaminated water. This is why safe drinking water, sanitation, and hygiene (WASH) interventions are the cornerstone of cholera prevention. Person-to-person transmission is rare. The infectious dose is high (10^8 organisms) unless gastric acid barrier is reduced.

Explanation: The Copper-T 380A IUCD provides effective contraception for up to 10 years. It works by creating a sterile inflammatory reaction in the endometrium, making it hostile to sperm and implantation. The copper ions are also directly spermicidal. It has a failure rate of less than 1% and is reversible.

Explanation: After chlorination of water, the free residual chlorine after 30 minutes of contact time should be at least 0.5 mg/L (0.5 ppm) at the point of use according to WHO guidelines. This ensures that the water is adequately disinfected and maintains a protective residual against recontamination during distribution.

Explanation: The Glasgow Coma Scale assesses three parameters: Eye opening response (1-4), Verbal response (1-5), and Motor response (1-6). The total score ranges from 3 (deep coma) to 15 (fully conscious). Pupillary response is assessed separately and is not part of the GCS, though it is an important neurological assessment.

Explanation: Maintaining a closed, airtight drainage system is the most critical nursing priority for a patient with an intercostal drain. Air entering the system would cause or worsen a pneumothorax. The nurse must ensure all connections are secure, the underwater seal is maintained (water seal bottle below chest level), the water level oscillates with respiration (tidaling), and the system is never raised above chest level.

Explanation: Normal fasting blood sugar is 70-100 mg/dL (3.9-5.6 mmol/L). A fasting level of 100-125 mg/dL indicates impaired fasting glucose (prediabetes), and 126 mg/dL or above on two occasions is diagnostic of diabetes mellitus. The HbA1c target for diabetics is generally <7%.

Explanation: According to the American Heart Association (AHA) guidelines, the compression-to-ventilation ratio for adult CPR is 30:2 (30 compressions followed by 2 breaths) for single rescuer. Compressions should be at a rate of 100-120 per minute, at a depth of at least 5 cm (2 inches), with full chest recoil between compressions (C-A-B sequence).

Explanation: 'To burn the midnight oil' means to work or study late into the night. The phrase originates from the time when oil lamps were used for lighting — working past midnight would require burning lamp oil during the late hours.

Explanation: The correct sentence is 'Neither the doctor nor the nurses were available.' With 'neither...nor', the verb agrees with the nearer subject. Since 'nurses' (plural) is closer to the verb, the plural verb 'were' is correct. This is the proximity rule of subject-verb agreement.

Explanation: Speed = Distance / Time = 360 km / 4 hours = 90 km/h. To convert km/h to m/s, multiply by 5/18. So 90 x 5/18 = 450/18 = 25 m/s.

Explanation: The pattern is that each word is written in reverse. APPLE reversed becomes ELPPA. Similarly, MANGO reversed becomes OGNAM.

Explanation: Let the cost price be 100. Marked price = 100 + 20% = 120. Selling price after 10% discount = 120 - 10% of 120 = 120 - 12 = 108. Profit = 108 - 100 = 8. Profit percentage = (8/100) x 100 = 8%.