Medical Surgical Nursing MCQs for AIIMS NORCET 11: Most Expected Questions

Medical-Surgical Nursing: Chapter-Wise Weightage from Past Papers

Cardiovascular, Endocrine, and Oncology together account for close to half of all Medical-Surgical questions in this dataset. These three chapters are worth prioritising first.

Chapter-wise Medical-Surgical Nursing MCQs for AIIMS NORCET 11

Medical-Surgical Nursing MCQs: Cardiovascular Disorders

Q1. A nurse is attending to a client diagnosed with heart failure, who is dyspneic with crackles on auscultation. Which finding would also be expected in a client with excess fluid volume?

A. Decreased central venous pressure B. Flat neck and hand veins C. Hypertension D. Weight loss

Answer: C. Hypertension
Explanation: Excess fluid volume raises circulating blood volume, which raises blood pressure. The other three options describe the opposite of fluid overload: central venous pressure rises rather than falls, neck and hand veins distend rather than flatten, and weight increases rather than drops. This question is built for elimination, not just recall.

Q2. In a patient, the apical pulse is 80/min and the radial pulse is 65/min. What is the pulse deficit?

A. 10 B. 15 C. 25 D. 35

Answer: B. 15
Explanation: Pulse deficit is the apical rate minus the radial rate: 80 − 65 = 15. A pulse deficit points to peripheral pulses that are too weak to be felt at the wrist, often seen in arrhythmias such as atrial fibrillation.

Medical-Surgical Nursing MCQs: Endocrine Disorders

Q3. After a thyroidectomy, a patient develops carpopedal spasm. This is the result of which electrolyte imbalance?

A. Hypercalcemia B. Hypocalcemia C. Hyperkalemia D. Hypokalemia

Answer: B. Hypocalcemia
Explanation: Thyroidectomy carries a risk of accidental damage to the parathyroid glands, which regulate calcium. Reduced parathyroid function drops serum calcium, and carpopedal spasm is one of the classic early signs of resulting hypocalcemia.

Q4. After a rapid blood transfusion, a patient develops tetany. What does this indicate?

A. Hypocalcemia B. Hypercalcemia C. Hypokalemia D. Hyperkalemia

Answer: A. Hypocalcemia
Explanation: Stored blood contains citrate as an anticoagulant, and citrate binds circulating calcium. A rapid transfusion can lower serum calcium quickly enough to produce tetany, which is why calcium levels are monitored during large-volume transfusions.

Medical-Surgical Nursing MCQs: Oncology

Q5. A female patient presents with a 2 cm breast nodule that is freely movable and palpable, with no nipple discharge. What is the best investigation for this condition?

A. FNAC B. Core needle biopsy C. Breast USG D. Mammography

Answer: D. Mammography (as marked in the source paper)
Explanation: This answer is worth a note of caution. In real clinical practice, the choice between mammography and ultrasound depends heavily on the patient's age: breast ultrasound is generally preferred as the first investigation in younger women with dense breast tissue, while mammography is favoured in older women. The question as written does not state the patient's age, which makes the marked answer somewhat context-dependent rather than universally correct. Read this one carefully if it appears in a mock test, and don't over-generalise the answer to every breast lump scenario.

Q6. A nurse educates a group of middle-aged women on screening for cervical cancer. Which test should they undergo?

A. Mantoux test B. Ultrasonography C. Fine needle aspiration cytology D. Pap smear

Answer: D. Pap smear
Explanation: The Pap smear remains the standard screening test for cervical cancer, detecting precancerous and cancerous changes in cervical cells before symptoms appear. This exact question, worded almost identically, appeared more than once within the same year's paper in the source document, which suggests it is a frequently recycled fact in NORCET-style question banks.

Medical-Surgical Nursing MCQs: Fluid, Electrolyte, and Acid-Base Balance

Q7. A patient's arterial blood gas shows pH 7.25, pCO2 40, HCO3 22, Na 150, Cl 100. What abnormality does this represent?

A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis

Answer: A. Metabolic acidosis
Explanation: The pH is acidic, which rules out both alkalosis options. The pCO2 sits at the normal midpoint, meaning respiratory compensation has not yet kicked in, which points away from a primary respiratory problem. The HCO3 sits at the low end of the normal range, consistent with a metabolic process pulling the pH down. Read ABGs in this order: check the pH first, then decide whether pCO2 or HCO3 is driving it.

Q8. Which electrolyte imbalance is associated with digoxin toxicity?

A. Hypokalemia B. Hypernatremia C. Hypernatremia D. Hypocalcemia

Answer: A. Hypokalemia
Explanation: Digoxin and potassium compete for the same binding site on the Na-K-ATPase pump. When potassium levels fall, digoxin binds more readily, increasing the risk of toxicity even at a stable digoxin dose. This is why potassium levels are checked routinely in patients on digoxin therapy.

Medical-Surgical Nursing MCQs: Neurological Disorders

Q9. What is the cerebral perfusion pressure (CPP) if BP is 90/60 and ICP is 18?

A. 48 mmHg B. 65 mmHg C. 52 mmHg D. 30 mmHg

Answer: C. 52 mmHg
Explanation: This is a two-step calculation. First, find the mean arterial pressure: MAP = DBP + ⅓(SBP − DBP) = 60 + ⅓(30) = 70 mmHg. Then apply CPP = MAP − ICP = 70 − 18 = 52 mmHg. NORCET tests this formula precisely because it requires two steps, not one, and skipping the MAP calculation is the most common way to get it wrong.

Q10. What symptom differentiates eclampsia from pre-eclampsia?

A. Hypertension B. Seizures C. Oedema D. Stroke

Answer: B. Seizures
Explanation: Pre-eclampsia is defined by hypertension with proteinuria, sometimes with oedema. Eclampsia is pre-eclampsia plus the onset of seizures. The presence of seizures is the single feature that reclassifies the condition from pre-eclampsia to eclampsia.

Medical-Surgical Nursing MCQs: GI and Hepatobiliary Disorders

Q11. A nurse sustains a needle stick injury with a needle known to be infected with hepatitis B. What is the priority nursing action?

A. Wash the puncture site with soap and water B. Start PEP treatment immediately C. Get a doctor's appointment D. Collect the needle for laboratory testing

Answer: A. Wash the puncture site with soap and water
Explanation: Immediate wound care comes first in any needle stick injury protocol, before reporting, before post-exposure prophylaxis, and before further testing. Post-exposure prophylaxis follows, but only after the exposed site has been washed.

Q12. What is the most common cause of peptic ulcers?

A. Stress B. Spicy food C. H. pylori infection D. Smoking

Answer: C. H. pylori infection
Explanation: H. pylori infection is the leading cause of peptic ulcer disease, ahead of NSAID use as the second major cause. Stress and diet can aggravate existing ulcers but are not the primary cause in most cases, a distinction NORCET tests often.

Medical-Surgical Nursing MCQs: Respiratory Disorders

Q13. On auscultation, which finding suggests a right pneumothorax?

A. Bilateral inspiratory and expiratory crackles B. Absence of breath sounds in the right thorax C. Inspiratory wheezes in the right thorax D. Bilateral pleural friction rub

Answer: B. Absence of breath sounds in the right thorax
Explanation: Air trapped in the pleural space on one side prevents normal lung expansion on that side, which shows up on auscultation as absent or markedly diminished breath sounds localised to the affected side, not both sides.

Q14. A lung disease caused by prolonged inhalation of cotton fibre dust is called:

A. Bagassosis B. Byssinosis C. Farmer's lung D. Pneumonia

Answer: B. Byssinosis
Explanation: Each of these occupational lung diseases is tied to a specific exposure: byssinosis to cotton dust, bagassosis to sugarcane fibre, and farmer's lung to mouldy hay. NORCET tests these as a matched set, so learning them together, exposure to disease, is faster than learning them one at a time.

Medical-Surgical Nursing MCQs: Emergency and Critical Care

Q15. A patient arrives at the emergency department after a road traffic accident, with a pulse rate of 127 bpm, blood pressure of 90/56, and cold extremities. What type of shock is this patient at risk of?

A. Neurogenic shock B. Hypovolemic shock C. Spinal shock D. Cardiogenic shock

Answer: B. Hypovolemic shock
Explanation: Tachycardia, a low-normal blood pressure, and cold extremities together describe the body compensating for blood loss by shunting circulation away from the periphery. This is the classic early presentation of hypovolemic shock following trauma, before blood pressure drops further.

Q16. What is the Parkland formula for fluid calculation in burn patients?

A. 4 mL × %BSA × weight (kg) B. 3 mL × %BSA × weight (kg) C. 2 mL × %BSA × weight (kg) D. 1 mL × %BSA × weight (kg)

Answer: A. 4 mL × %BSA × weight (kg)
Explanation: The Parkland formula calculates total Ringer's Lactate for the first 24 hours after a burn, with half given in the first 8 hours and the remaining half over the next 16. The 4 mL figure is fixed and worth memorising exactly, since the other options are common distractors built around plausible but incorrect multipliers.

Medical-Surgical Nursing MCQs: Orthopaedic Disorders

Q17. What is the immediate management to restore blood pressure and peripheral circulation in a client with multiple fractures and fluid loss?

A. RL infusion B. Blood transfusion C. NS infusion D. Dextrose 5%

Answer: A. RL infusion
Explanation: Ringer's Lactate is the standard first-line fluid for rapid volume resuscitation in trauma, restoring circulating volume quickly while blood is cross-matched. Blood transfusion may follow once blood loss is confirmed and matched blood is available, but it is not the immediate first step.

Q18. The process of restoring a dislocated joint to its normal position is called:

A. Reduction B. Fixation C. Amputation D. Traction

Answer: A. Reduction
Explanation: Reduction refers specifically to realigning a dislocated or fractured bone back into its normal anatomical position. Fixation refers to holding it there afterward, a related but distinct step.

Medical-Surgical Nursing MCQs: Renal and Urinary Disorders

Q19. Identify the post-renal cause of acute renal failure.

A. Benign prostatic hyperplasia B. Acute glomerulonephritis C. Heart failure D. Anti-hypertensive medications

Answer: A. Benign prostatic hyperplasia
Explanation: Acute renal failure is classified by where the problem originates. BPH causes obstruction to urine outflow after the kidneys, making it post-renal. Glomerulonephritis is an intrinsic renal cause, while heart failure and anti-hypertensive medications reduce renal perfusion, making them pre-renal causes.

Q20. In burn patients, isotonic fluid is given to prevent the risk of:

A. Renal failure B. Inadequate lung perfusion C. Hypovolemia D. Electrolyte imbalance

Answer: C. Hypovolemia
Explanation: Burns cause massive fluid loss from damaged skin and capillary leak. Isotonic fluids like Ringer's Lactate replace this lost volume directly, and their primary purpose in the first 24 hours is preventing hypovolemic shock, with renal protection as a downstream benefit rather than the direct target.

These questions are from NORCET previous year papers, 2020 to 2024, not rewritten or simplified. The explanations are original and added for clarity. One question, Q5 on breast nodule investigation, is flagged above because the marked answer is more context-dependent in real clinical practice than the question format suggests.