Mini Nurses / Learn Nursing. Build Confidence. Excel in Practice.
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1. A water-safety cohort records illness in 30 of 150 exposed residents and 10 of 200 unexposed residents. What is the risk ratio? 0.25 1.5 4.0 6.0 Answer: C . Risk is 0.20 among exposed residents and 0.05 among unexposed residents; 0.20 divided by 0.05 equals 4.
2. Two wards have different age structures. Ward A has a higher crude death rate but lower age-specific death rates in every age band. What comparison is most appropriate? Conclude that care is worse in Ward A Compare age-standardised mortality rates Compare the total number of deaths alone Exclude older residents from both wards Answer: B . Age standardisation improves comparability when populations have different age distributions.
3. A screening programme finds 45 true-positive and 15 false-positive results. What proportion of positive results are true positives? 75% 25% 60% 90% Answer: A . Positive predictive value is 45 divided by all 60 positive results, multiplied by 100.
4. A disease register contains 90 cases at the start of a year. During the year, 18 new cases occur among 600 initially disease-free residents followed completely. What is the one-year cumulative incidence? 15% 18% 30% 3% Answer: D . Only new cases and the initially at-risk population are used: 18 divided by 600 equals 3%.
5. Village A reports 60 cases among 3,000 residents; Village B reports 40 among 1,000. Which statement best guides prioritisation? Village A has the higher risk because its count is larger The villages have identical risk Village B has the higher case proportion despite fewer cases Population size is irrelevant when comparing risk Answer: C . Using denominators gives 2% in Village A and 4% in Village B; counts alone can mislead.
6. A cohort reports disease risks of 12% without an intervention and 7% with it. What is the absolute risk reduction? 5% relative reduction 5 percentage points 19 percentage points 58 percentage points Answer: B . Absolute risk reduction is the difference between risks: 12% minus 7% equals 5 percentage points.
7. A trial's relative risk estimate is 0.80 with a 95% confidence interval of 0.55 to 1.16. What is the best interpretation? The interval includes no difference, so benefit is uncertain at this confidence level The intervention is proven ineffective The risk is reduced by exactly 80% The interval establishes that the intervention causes harm Answer: A . For a risk ratio, 1 represents no association. This interval permits both benefit and some increase in risk.
8. After a screening campaign, recorded disease prevalence rises while confirmed disease incidence remains stable. Which explanation should the nurse consider first? The disease must have become more transmissible All new records must be errors The screening campaign necessarily caused the disease The campaign identified previously undiagnosed existing cases Answer: D . Case finding can increase recognition of existing disease without increasing the occurrence of new disease.
9. A survey interviews only adults attending a private fitness centre to estimate district obesity. What is the main threat to validity? A larger sample automatically removes every bias Random measurement error in age alone Selection bias because participants may differ from the target population The lack of a drug intervention Answer: C . A convenient subgroup may not represent district residents; increasing its size does not repair systematic selection bias.
10. A nurse observes that districts with higher income have fewer reported TB cases. Why should this not establish that every wealthy individual has lower TB risk? Ecological data always establish individual causation Group-level associations cannot automatically be applied to individuals Income cannot be measured at district level Individual data are never useful in public health Answer: B . Inferring an individual's risk from aggregate associations is the ecological fallacy.
11. A facility has no suspected cases of a notifiable condition this week. The reporting system requires weekly reports. What should the nurse submit? A zero report through the required reporting channel No report because there are no cases An invented case to keep the system active A report only if the district calls Answer: A . Zero reporting distinguishes no detected cases from missing reports and supports surveillance completeness.
12. A weekly report suddenly doubles after two clinics begin submitting data for the first time. What should be checked before declaring a rise in transmission? Whether all nurses used the same pen colour Whether the new clinics can be removed permanently Whether the larger count can be ignored Whether reporting coverage and population denominators changed Answer: D . Changes in ascertainment or reporting coverage can produce apparent increases that need contextual interpretation.
13. During an investigation, some teams count any diarrhoea and others count only laboratory-confirmed cholera. What is the priority data-quality action? Combine every count without checking definitions Require the same treatment outcome for all cases Agree on a standard case definition with appropriate classifications Discard all suspected cases automatically Answer: C . Consistent suspected, probable and confirmed classifications improve comparability without making laboratory confirmation essential for every surveillance purpose.
14. An outbreak team proposes defining cases as 'ill people who drank water from Well X'. Why is this problematic when testing whether Well X caused the outbreak? It makes the definition too easy to translate It builds the exposure being investigated into the case definition A case definition must always include the suspected source It prevents recording the date of onset Answer: B . Including the exposure under study can bias the exposure-disease comparison and obscure alternative causes.
15. A line list contains two entries with the same identifier, age, address and onset date. What should happen before totals are reported? Verify whether they describe the same episode and resolve the duplicate Count both because two forms were completed Delete all records from that household Change one onset date to preserve both records Answer: A . Record verification prevents double counting while protecting genuine separate episodes from accidental removal.
16. A district receives a credible report of several children with sudden flaccid weakness. What is the appropriate surveillance response? Wait until the monthly review meeting Wait for every laboratory result before alerting anyone Publish the children's names on social media Notify the designated surveillance officer urgently and follow investigation procedures Answer: D . Signals of serious notifiable conditions require prompt escalation and investigation under the applicable surveillance protocol.
17. A case's specimen is sent without a unique identifier while several similar specimens travel together. What is the main risk? The specimen becomes automatically positive The test becomes more sensitive Laboratory results may be linked to the wrong patient or become unusable The illness becomes less infectious Answer: C . Accurate specimen labelling and linkage to case records are essential for safe clinical and surveillance interpretation.
18. Most cases in a food-related outbreak begin within one short period after a single wedding meal. Which hypothesis best fits that pattern? Continuous exposure lasting several months A point-source exposure Repeated person-to-person waves are proven There was no common exposure Answer: B . A narrow cluster after a shared event is compatible with a point source, although investigation must test the hypothesis.
19. An unusual disease signal is detected on Friday. Laboratory confirmation will take several days, but a plausible exposure is still ongoing. What should the team do? Begin proportionate control measures while investigating and refining the evidence Postpone every control action until all tests return Announce a definite source without evidence Close the investigation because confirmation is delayed Answer: A . Investigation and control can proceed together when waiting would permit preventable exposure.
20. Of 25 facilities expected to report this week, 20 submitted reports and 15 submitted by the deadline. What is reporting timeliness among all expected facilities? 75% 80% 125% 60% Answer: D . Using the stated denominator, timely reports divided by expected reports is 15 divided by 25, or 60%.
21. At opening, a vaccine refrigerator alarm shows an overnight temperature excursion. What is the best immediate action for affected stock? Use every vial before its printed expiry Discard every vial before documenting the event Keep it under appropriate conditions, label it not for use and seek cold-chain guidance Turn off the alarm and continue as usual Answer: C . Quarantine and document the affected stock while authorised staff assess the excursion; appearance alone cannot establish potency.
22. A vaccine vial monitor's inner square is the same colour as its surrounding circle. What should the vaccinator do? Use it if it feels cold now Do not use the vial and follow discard procedures Shake it until the square becomes pale Use double the dose to compensate Answer: B . The VVM discard point is reached when the inner square matches or becomes darker than the outer circle.
23. A freeze-sensitive vaccine has a satisfactory VVM, but its transport monitor indicates freezing. Which statement is correct? A satisfactory VVM does not rule out freeze damage The VVM proves there was no freezing Freezing always restores vaccine potency All vaccines tolerate freezing equally Answer: A . A VVM tracks cumulative heat exposure; freezing requires separate assessment according to vaccine guidance.
24. A caregiver brings a child with a mild runny nose who is otherwise well and eligible for vaccination. What should the nurse do? Defer all vaccines until one month after recovery Give antibiotics before every vaccine Restart the entire schedule later Assess normally and vaccinate if no true contraindication is present Answer: D . Minor illness alone is generally not a reason to miss an otherwise indicated vaccination opportunity.
25. A nurse is preparing a freeze-dried vaccine but only a diluent from another vaccine is available. What is the safest decision? Use any sterile clear liquid Substitute normal saline without checking instructions Obtain the manufacturer's designated diluent for that vaccine Mix two available diluents together Answer: C . Only the correct supplied or designated diluent should be used; the wrong diluent can make vaccination unsafe or ineffective.
26. A caregiver reports a serious illness beginning the day after vaccination. How should the nurse initially handle causality? Declare every event after vaccination vaccine-caused Assess and report the event without assuming the vaccine caused it Dismiss the report because causality is unproven Alter the vaccination record to remove the dose Answer: B . An AEFI is a temporal event requiring assessment; reporting does not by itself establish a causal relationship.
27. A clinic records 240 first doses and 180 third doses of a three-dose series in a comparable cohort. What is the first-to-third dose dropout percentage? 25% 60% 75% 33.3% Answer: A . Dropout is (240 minus 180) divided by 240, multiplied by 100, which equals 25%.
28. A child attends for wound review. The immunisation card shows an overdue eligible dose, but staff do not check vaccination needs. What service improvement best prevents this recurring? Restrict vaccination checks to a yearly campaign Require a new registration before any card review Ask caregivers to remember all future doses without support Review vaccination status at every appropriate health contact Answer: D . Integrating eligibility checks into health contacts reduces missed vaccination opportunities.
29. An outreach team lists 400 eligible children, but several remote settlements are missing from the map. What should be corrected before estimating coverage? Increase the numerator until the rate looks acceptable Exclude all remote settlements from the programme Validate the target population with local settlement information Use doses issued to the team as doses administered Answer: C . An incomplete denominator can conceal unreached children and overstate coverage; local microplanning helps identify omissions.
30. Two families decline vaccination after hearing a rumour. What is the most constructive first conversation? Threaten to remove all other care Ask about their concerns, listen respectfully and address the specific misinformation Repeat technical slogans without allowing questions Publicly identify them as irresponsible Answer: B . Respectful, specific dialogue is more useful than coercion or generic messaging for understanding and addressing concerns.
31. A three-year-old lives with a person with bacteriologically confirmed pulmonary TB. The child currently seems well. What should the nurse arrange? Assessment for TB disease and eligibility for preventive treatment under the TB programme No action unless the child develops severe cough Adult TB medicines shared without assessment Routine cough syrup as preventive treatment Answer: A . Young household contacts need evaluation; preventive treatment is considered after TB disease is appropriately excluded.
32. A person receiving TB treatment repeatedly misses appointments because transport is unaffordable. What is the best nursing response? Label the person noncompliant and close the record Advise stopping treatment whenever travel is difficult Increase the medicine dose after every missed visit Explore barriers and coordinate acceptable adherence and transport support Answer: D . Practical, person-centred support addresses barriers to completing treatment more effectively than blame.
33. A previously unvaccinated child is bitten through the skin by a dog of uncertain rabies status. What action is most appropriate? Wait for symptoms before seeking care Apply a tight tourniquet and return next month Wash with soap and water for at least 15 minutes and arrange urgent post-exposure assessment Close the wound with household glue Answer: C . Immediate thorough washing and prompt assessment for rabies prophylaxis are time-critical; waiting for symptoms is unsafe.
34. A person with suspected infectious pulmonary TB enters a crowded clinic. Which initial arrangement best reduces exposure while maintaining care? Place the person at the centre of the crowded queue Offer a mask if tolerated, fast-track assessment and use a well-ventilated waiting area Delay assessment until the clinic closes Close all windows to maintain privacy Answer: B . Administrative measures, source control and appropriate ventilation help reduce transmission during assessment.
35. A client with a negative malaria rapid test remains severely ill and is becoming confused. What should the nurse prioritise? Urgent assessment and referral for severe illness, including alternative causes Assume that the negative test means the client is safe Send the client home with no safety-net advice Repeat home remedies until the test becomes positive Answer: A . Danger signs require urgent escalation irrespective of one test result; other serious illnesses must be considered.
36. A woman receiving HIV care misses visits because others can see the clinic register. What is the most appropriate service response? Announce her diagnosis during community meetings Stop follow-up to avoid all discussion Require public disclosure before treatment continues Improve privacy and agree on discreet follow-up arrangements with her Answer: D . Privacy-preserving, acceptable services support engagement in care and reduce avoidable stigma.
37. Several patients ask for antibiotics for uncomplicated colds without evidence of bacterial infection. Which response best supports antimicrobial stewardship? Give antibiotics to every patient to prevent complaints Use the strongest available antibiotic routinely Explain the likely viral cause, advise appropriate symptom care and give safety-net advice Recommend sharing leftover antibiotics Answer: C . Antibiotics do not treat viral infections; clear advice and review triggers support safe, appropriate use.
38. A child with profuse watery diarrhoea is lethargic, has weak pulses and cannot drink. What should the outreach nurse do? Give routine dietary advice and review next week Arrange emergency referral and begin available protocol-based stabilisation Wait for a stool result before starting any care Send the child alone to buy oral salts Answer: B . These findings suggest severe dehydration or shock and need immediate emergency management, not delayed routine care.
39. A patient stops using a prescribed antibiotic when feeling better and saves the remainder for a relative. What counselling is best? Take it exactly as prescribed and seek prescriber advice before changing or sharing treatment Save all remaining doses for future undiagnosed illness Share the medicine if symptoms look similar Double the dose during the next illness Answer: A . Antibiotic selection and duration depend on the clinical indication; sharing or independently changing treatment is unsafe.
40. A health worker sustains a needlestick from a used needle. What is the priority after immediate wound care? Wait several weeks to see whether symptoms develop Squeeze the wound aggressively until it bleeds Keep the incident secret if the patient looks healthy Report promptly for urgent exposure assessment and indicated prophylaxis Answer: D . Prompt occupational exposure assessment allows time-sensitive preventive care and baseline evaluation.
41. A household treats water correctly but stores it in an open bucket and dips an unwashed cup into it. What improvement most directly reduces recontamination? Add more cups to the bucket Store it beside uncovered refuse Use a clean covered container with a tap or safe pouring method Stop cleaning containers once water has been treated Answer: C . Safe storage and dispensing are needed to preserve water quality after treatment.
42. Floodwater enters a community well. Which advice is safest until authorities confirm the source is safe? Rely on clear appearance as proof of safety Use a verified safe alternative or correctly treated water and coordinate well assessment Drink from the well if the water has no odour Add an unspecified handful of any chemical Answer: B . Flood contamination requires risk management; appearance cannot establish microbiological safety.
43. A clinic's handwashing station has water but no soap, and staff frequently skip washing after toilet use. What is the most appropriate immediate improvement? Provide reliable soap and water at the point of use and address the supply gap Display more posters while leaving soap unavailable Provide gloves as a permanent replacement for handwashing Close the toilet without an alternative Answer: A . Behavioural messages need enabling facilities and supplies; gloves do not replace hand hygiene.
44. A cook with active vomiting and diarrhoea prepares ready-to-eat food for a school event. What should the nurse recommend? Allow work if the cook wears perfume Permit tasting food instead of touching it Serve the food without asking further questions Exclude the symptomatic cook from food handling under local policy and arrange assessment Answer: D . Symptomatic food handlers can contaminate food and require exclusion according to applicable food-safety procedures.
45. Cooked rice is left in a warm room from morning until evening before serving. Which concern is most appropriate? Cooked rice cannot support foodborne illness Reheating always destroys every possible toxin Time-temperature abuse can allow microbial growth and toxin formation Food is safe whenever its smell is acceptable Answer: C . Food can become unsafe without obvious spoilage; some toxins may persist despite reheating.
46. A kitchen uses a meat thermometer but records only the oven temperature. What measurement is most useful for checking that the food itself reached the required cooking temperature? The kitchen wall temperature The internal temperature in the thickest relevant part of the food The outside surface of the oven The temperature of an empty serving plate Answer: B . An appliance setting does not prove adequate heat reached the food's interior.
47. A family sleeps beside a charcoal brazier in a poorly ventilated room. Several people develop headache and dizziness together. What is the priority? Move everyone to fresh air safely and seek emergency help for possible carbon monoxide exposure Advise sleep and review the symptoms tomorrow Close the door to retain heat Give each person an antibiotic Answer: A . Combustion in enclosed spaces can cause life-threatening carbon monoxide exposure; rescuers must also avoid entering unsafe air.
48. Children play near informal battery recycling and have possible lead exposure. Which community action is most appropriate? Treat symptoms while allowing exposure to continue Assume lead is harmless if no child has convulsions Use household paint to cover contaminated soil without assessment Stop exposure and coordinate environmental control with clinical assessment Answer: D . Lead prevention requires control of the source together with appropriate assessment of exposed children.
49. A new waste contractor proposes mixing infectious healthcare waste with ordinary household waste. What should the nurse insist on? Mixing first and sorting manually later Open dumping behind the clinic Segregation at the point of generation and safe category-specific handling Burning every waste type in an open barrel Answer: C . Segregation reduces exposure and supports appropriate handling and treatment for each waste stream.
50. A community reports skin and breathing symptoms after a chemical spill into a stream. What should the nurse advise first? Boil the water and assume every chemical is removed Avoid contact with the affected source and alert emergency/environmental authorities Taste the water to identify the chemical Wait for dead fish before reporting Answer: B . Boiling is not a general remedy for chemical contamination; exposure control and expert assessment are needed.
51. During a postnatal home visit, a mother reports very heavy vaginal bleeding and feels faint. What is the priority? Activate urgent referral and immediate emergency support within nursing scope Arrange a routine visit in one month Recommend rest without assessment Delay referral until the baby's next vaccination Answer: A . Heavy postpartum bleeding with faintness is a maternal emergency requiring rapid stabilisation and definitive care.
52. A pregnant woman in a remote village develops severe headache, visual disturbance and upper abdominal pain. What should the nurse arrange? Routine counselling at her next scheduled visit Reassurance that these symptoms always occur in pregnancy A community exercise session before assessment Urgent assessment and referral for possible severe hypertensive disease Answer: D . This symptom combination can signal pre-eclampsia with severe features and needs urgent evaluation.
53. A newborn at home is unusually sleepy, feels cold and feeds poorly. What advice should the nurse give? Wait several days for the baby to become more active Give an adult cough preparation Keep the baby warm and arrange urgent clinical assessment Stop all feeding without seeking help Answer: C . Poor feeding, abnormal activity and temperature concerns in a newborn are danger signs requiring prompt assessment.
54. A mother reports painful breastfeeding. The baby takes only the nipple and the cheeks dimple with sucking. What should skilled support prioritise? Recommend permanently stopping breastfeeding without assessment Observe a full feed and help improve positioning and deep attachment Advise scrubbing the nipples before every feed Assume the pain proves the milk is unsuitable Answer: B . Direct observation can identify attachment problems and guide practical breastfeeding support.
55. An eight-month-old receives only very thin cereal water and breast milk. Which feeding improvement is most appropriate? Add age-appropriate nutrient-dense, varied complementary foods while continuing breastfeeding Replace all feeds with sweetened drinks Continue only cereal water until two years Withhold food whenever the child refuses once Answer: A . Complementary foods should provide adequate nutrients and suitable texture alongside continued breastfeeding.
56. A caregiver force-feeds a toddler who turns away and cries. Which alternative best reflects responsive feeding? Restrain the child until every portion is finished Withhold all future meals as punishment Give only sugary drinks to prevent refusal Offer patient encouragement, suitable portions and attention to hunger and fullness cues Answer: D . Responsive feeding respects cues while providing supportive, active feeding assistance.
57. An 18-month-old child's mid-upper-arm circumference is 112 mm and bilateral pitting oedema is present. What is the most appropriate next step? Routine review in six months Reassurance because oedema indicates good hydration Prompt referral for severe acute malnutrition assessment and management Adult weight-loss counselling Answer: C . MUAC below 115 mm in a child aged 6-59 months or bilateral nutritional oedema warrants assessment for severe acute malnutrition.
58. A woman at 36 weeks of pregnancy lives far from the referral hospital and has no transport plan. What is the most useful birth-preparedness action? Wait for labour to identify transport Agree on a delivery facility, emergency transport, funds and a contact plan with her Recommend delivery with whoever happens to be nearby Arrange baby clothing as the only preparedness step Answer: B . Planning transport, resources and contacts before an emergency can reduce avoidable delays in reaching skilled care.
59. A woman wants contraception but her partner insists on choosing the method for her. How should the nurse proceed? Offer private counselling and support her informed, voluntary choice Ask the partner to sign the only consent form Select the most expensive method without discussion Deny contraception until the couple agrees Answer: A . Contraceptive services should protect the client's informed decision-making and freedom from coercion.
60. A caregiver reports that a child with diarrhoea is still breastfeeding and can drink. What feeding advice is appropriate alongside assessment and rehydration? Stop breastfeeding until stools are normal Give only undiluted fruit juice Withhold all food for two days Continue breastfeeding and appropriate feeding while managing dehydration Answer: D . Continued feeding and breastfeeding support nutrition and recovery during diarrhoeal illness.
61. At an outreach screen, an adult has one blood pressure reading of 152/96 mmHg without emergency symptoms. What is the best next step? Diagnose lifelong hypertension from this single reading alone Ignore the reading because there are no symptoms Repeat correctly and arrange follow-up confirmation and risk assessment Advise borrowing a neighbour's medication Answer: C . An elevated screen needs correct remeasurement and appropriate diagnostic follow-up; one routine reading alone is usually insufficient.
62. Which preparation most improves the accuracy of a routine seated blood pressure measurement? Measure immediately after running upstairs Rest quietly, support the arm and use an appropriate cuff size Place the cuff over thick clothing Ask the client to speak continuously during measurement Answer: B . Standardised positioning, rest and cuff selection reduce avoidable measurement error.
63. A man with previously high blood pressure says he stopped treatment because he feels well. What is the most appropriate explanation? High blood pressure may cause harm without symptoms, so review and ongoing management are important Feeling well proves blood pressure has normalised Medicines are only needed during headache Treatment should stop whenever work becomes busy Answer: A . Hypertension is frequently asymptomatic; review should address adverse effects, access and adherence rather than symptoms alone.
64. During a home visit, an adult suddenly develops facial droop, arm weakness and slurred speech. What should the nurse prioritise? Book a routine clinic appointment next week Give food to test swallowing before referral Wait to see whether sleep resolves the symptoms Activate emergency referral and record when the person was last known well Answer: D . Possible stroke requires urgent evaluation; onset or last-known-well time helps guide treatment decisions.
65. A client with diabetes has reduced foot sensation and a new painless plantar wound. What action is best? Reassure because painless wounds are harmless Recommend walking barefoot to improve sensation Arrange prompt clinical assessment and teach daily foot inspection and protection Apply a caustic household chemical Answer: C . Neuropathy can hide significant injury; prompt wound assessment and protective care help prevent complications.
66. A nurse plans a tobacco cessation conversation with a smoker who is uncertain about quitting. What is the best opening? Tell the person that care will stop unless they quit today Ask permission to discuss smoking and explore the person's own concerns and goals Argue until the person agrees Assume uncertainty means counselling cannot help Answer: B . A respectful, person-centred conversation can build motivation and lead to agreed support rather than confrontation.
67. A woman with a positive cervical screening result feels well and asks whether she can ignore follow-up. What advice is best? Explain that a positive screen requires appropriate assessment even without symptoms Reassure that absence of symptoms excludes significant disease State that every positive screen is confirmed cancer Recommend repeating the test indefinitely without a management plan Answer: A . Screening detects risk or abnormalities; appropriate follow-up is essential and a positive screen is not itself a cancer diagnosis.
68. A community walking group measures only attendance after six months. Which additional measure would better assess a health-related outcome? Number of posters printed before launch Number of planning meetings held Number of invitations sent Change in participants' activity levels using a consistent measure Answer: D . Attendance is a participation indicator; consistently measured behavioural change provides more direct outcome information.
69. A nurse counsels adults with sedentary jobs. Which plan is most realistic for someone starting from very low activity? Demand vigorous exercise immediately regardless of health status Recommend no activity unless a gym membership is available Agree on gradual, achievable activity increases and reduce prolonged sitting Count watching sport as physical activity Answer: C . A tailored, gradual plan supports participation and safety; some activity is preferable to none.
70. A healthy-eating campaign recommends only costly imported foods. Residents say they cannot afford them. What revision is most useful? Repeat the same advice more loudly Build affordable options around available local foods and household constraints Exclude low-income households from the campaign Replace food counselling with supplement sales Answer: B . Practical nutrition advice needs to fit local access, preferences and resources to be usable.
71. A pupil sits very close to the board and repeatedly squints. What should the school nurse do? Arrange vision assessment and communicate privately with the caregiver Assume the pupil is deliberately inattentive Advise dropping out of school Share the suspected problem publicly as a warning Answer: A . Observed functional difficulties warrant appropriate assessment and a confidential referral pathway.
72. Several pupils miss school during menstruation because toilets lack doors and water. What intervention best addresses the barrier? Punish pupils for absence Offer lectures without changing facilities Prohibit attendance during menstruation Provide private, safe sanitation with water and suitable menstrual support Answer: D . Supportive facilities and supplies address practical barriers to attendance and dignity.
73. A school child discloses possible abuse and asks the nurse to promise absolute secrecy. What response is best? Promise secrecy regardless of immediate danger Investigate by confronting the suspected abuser alone Explain privacy limits, listen without blame and follow safeguarding procedures Ask classmates to verify the story publicly Answer: C . Safeguarding may require appropriate disclosure; supportive listening and clear limits avoid false promises and further harm.
74. A workplace introduces a new chemical cleaner. What information should be reviewed before staff begin using it? Only the colour of the container The safety data sheet and task-specific exposure controls Only whether the smell is pleasant The cheapest glove brand without compatibility checks Answer: B . Chemical hazard information guides safe handling, ventilation, storage, first aid and appropriate protective equipment.
75. A worker repeatedly lifts dependent adults alone and develops back pain. Which change is most appropriate? Assess handling tasks and provide suitable aids, staffing and training Give a back belt as the only control Encourage faster lifting to finish sooner Advise ignoring pain until a fall occurs Answer: A . Reducing hazardous manual handling requires task and system changes, not reliance on a belt or individual endurance.
76. A nurse discovers a safety device has been removed from a cutting machine. What should happen? Allow continued use if the operator is experienced Replace the guard with a warning poster only Wait for an injury to justify action Stop unsafe use and report for correction through the workplace safety system Answer: D . A missing machine guard creates preventable risk that requires prompt control before further operation.
77. A homebound older adult repeatedly misses medicine refills because the clinic is inaccessible. What is the best care plan? Mark every missed visit as refusal Stop chronic care because clinic attendance is difficult Coordinate accessible refill arrangements and follow-up with the person's agreement Ask neighbours to choose medicines without assessment Answer: C . Continuity of care requires adapting delivery to barriers and involving the person in feasible arrangements.
78. A visiting nurse finds that a family's refrigerator is unreliable for a medicine requiring refrigeration. What is the safest response? Assume every medicine remains safe at room temperature Check product-specific storage instructions and arrange a reliable storage or supply plan Freeze the medicine to compensate for warm periods Discard all medicines without checking or arranging replacement Answer: B . Storage needs vary; a practical plan should preserve product quality and uninterrupted treatment.
79. A community meeting is held only upstairs, excluding wheelchair users. What change best supports meaningful participation? Use an accessible venue and ask participants about other access needs Send them minutes after all decisions are final Ask them to nominate someone to speak permanently in their place Exclude access needs from future planning Answer: A . Participation requires accessible processes and opportunities for people to express their own priorities.
80. A community nurse is planning care for an adult with hearing impairment. What should guide communication? Speak only to the accompanying relative Assume every hearing-impaired person can lip-read Shout complex instructions from behind the person Ask the person's preferred method and provide accessible communication support Answer: D . Communication support should follow the individual's preferences and preserve their involvement in decisions.
81. A clinic's monthly chart reports more fully immunised children than its entire estimated eligible population. What should the team do first? Celebrate coverage without validation Delete records until the percentage falls below 100 Check numerator records, target estimates and possible duplicate or out-of-area entries Assume all families gave false information Answer: C . Implausible coverage requires data-quality review; silent adjustment obscures the reason for the discrepancy.
82. A health education team reports that knowledge scores improved immediately after training. What would best assess whether skills were retained? Count the chairs used at training Repeat a practical assessment after an appropriate follow-up interval Rely only on participants' applause Assume immediate scores prove permanent behaviour change Answer: B . Delayed assessment helps distinguish short-term recall from retention and practical performance.
83. A nurse wants to understand why women avoid a clinic despite its proximity. Which approach best explores their experiences? Confidential qualitative interviews with a range of eligible women Only counting clinic chairs Asking staff to guess every woman's motives Using only the attendance total without discussion Answer: A . Qualitative enquiry can identify concerns, meanings and service barriers that routine counts do not reveal.
84. A survey recruits every tenth household after a random start. What sampling method is being used? Snowball sampling Purposive sampling Convenience sampling Systematic sampling Answer: D . A fixed selection interval following an appropriate random start is systematic sampling; list patterns should still be considered.
85. A nurse accidentally sends an identifiable client report to the wrong authorised-work email address. What is the appropriate next step? Ignore it unless the recipient complains Erase the clinic's entire reporting database Follow the incident procedure promptly and take steps to limit disclosure Share the report more widely to explain the error Answer: C . Prompt reporting and containment allow an appropriate privacy response and learning from the incident.
86. A research participant asks to withdraw. The researcher threatens loss of routine care. Which ethical problem is present? A necessary method of improving response rates Coercion that undermines voluntary participation Acceptable blinding Proper random allocation Answer: B . Research participation and withdrawal must be voluntary; access to routine care should not be used as a threat.
87. A community project records household GPS locations even though district-level totals answer its question. Which revision best follows data minimisation? Collect only the location detail necessary for the defined purpose Collect more identifiers because they may be interesting later Publish exact coordinates to improve transparency Keep identifiers indefinitely without a purpose Answer: A . Limiting collection to necessary information reduces privacy risks while preserving the intended use.
88. A new outreach service is tested in one settlement before wider rollout. What is the main purpose of this small pilot? Prove effectiveness for every population without further evaluation Avoid obtaining community feedback Replace all monitoring after expansion Identify feasibility problems and refine implementation Answer: D . A pilot examines feasibility and practical problems; it does not automatically establish generalisable effectiveness.
89. A nurse identifies a bottleneck, tests a small scheduling change, studies waiting times and revises the approach. Which improvement cycle does this illustrate? A one-time disciplinary audit Random medication allocation Plan-Do-Study-Act Case-control matching Answer: C . PDSA uses small iterative tests, observation and adaptation to improve a service.
90. Two programmes reach similar populations and achieve similar outcomes, but one uses fewer resources. Which evaluation dimension is being compared? Case-definition sensitivity Efficiency Disease severity Diagnostic specificity Answer: B . Efficiency considers results in relation to resources used; outcomes and context must be sufficiently comparable.
91. After flooding, displaced families with chronic illnesses cannot access their medicines. Which response best supports continuity of care? Identify urgent needs, reconcile treatment and link people to reliable refills and follow-up Provide the same medicine to every adult Stop chronic care until the emergency ends Ask families to exchange medicines between households Answer: A . Emergency services need to maintain essential chronic care as well as respond to acute injury and infection.
92. An adult is distressed after losing a home but does not want to describe the event. What is appropriate psychological first aid? Require a detailed retelling before giving water Promise that no further difficulties will occur Arrange public questioning by the whole response team Offer calm, practical support and listen without pressuring disclosure Answer: D . Psychological first aid supports safety, practical needs and connection without forcing a trauma narrative.
93. A disaster response team receives conflicting instructions from several agencies. What arrangement best reduces confusion? Independent action without shared information Multiple unverified public instructions A coordinated command structure with defined roles and communication routes Assigning every task to the newest volunteer Answer: C . Clear coordination reduces duplication, gaps and conflicting decisions during response.
94. A nurse tells residents that an outbreak source is still being investigated. What should the message also include? A definite source invented to sound confident What is known, practical protective steps and when updates will be provided Every rumour collected without clarification A guarantee that no further cases can occur Answer: B . Credible risk communication explains uncertainty while giving useful actions and a plan for updates.
95. After a cholera response, the team reviews delays and agrees on actions, owners and deadlines. What process is this? An after-action review directed toward learning and improvement A replacement for all future surveillance A process intended only to allocate blame A clinical diagnosis meeting Answer: A . An after-action review captures lessons and converts them into accountable improvements.
96. In a displacement camp, women report avoiding distant unlit toilets at night. What is the best coordinated response? Advise drinking less water to avoid toilets Dismiss the concern because latrines already exist Publish the names of women who complained Work with residents to improve safe access, lighting, privacy and protection referral pathways Answer: D . Sanitation access must consider protection and dignity, not only the number of facilities.
97. A family wants to handle the body of a person who died from an infectious disease. Which approach is best? Assume every infectious disease needs identical burial restrictions Exclude the family from all discussion Explain disease-specific precautions and agree on safe, dignified arrangements with the family Allow unsafe handling because grief overrides infection risks Answer: C . Precautions depend on the pathogen; respectful collaboration supports both safety and dignity.
98. A heat-exposed outdoor worker becomes confused and collapses. What should the nurse prioritise? Give a hot drink and wait for sweating Emergency assistance and rapid cooling with safe measures while arranging urgent care Leave the worker alone to sleep Resume work once the worker briefly stands Answer: B . Altered mental status after heat exposure can indicate heatstroke and requires immediate cooling and emergency care.
99. Rumours spread that a mobile clinic is collecting data for an unrelated agency. What should the team do first? Listen to concerns and explain who collects which data, why and how privacy is protected Increase data collection without explanation Refuse all questions from residents Name the people who started the rumour publicly Answer: A . Listening and transparent explanation can address trust concerns and guide changes to service delivery.
100. An emergency drill reveals that the referral vehicle has no fuel and no backup transport exists. What is the most useful follow-up? Record the drill as successful because staff attended Repeat the same drill without correcting the gap Remove transport from the emergency plan Assign responsibility for transport readiness, fund a backup plan and test it again Answer: D . Preparedness improves when identified operational failures are corrected and the revised arrangement is tested.
