PRINCIPAL’S HEALTH & BUSINESS COLLEGE

Each of the items in this test is followed by four possible responses. For each item,
choose ONE correct answer. Indicate your answer by circling the letter of your choice.
Each correct response is worth one point

1. A 28 year-old man brought in to the hospital with a clinical sign and symptoms of polydypsia,
polyphagia, and polyuria and weight loss. After detailed diagnosis, the physician recommends
lifelong insulin therapy.

Which type of diabetes mellitus is most likely diagnosed?

A. Gestational Diabetes Mellitus

B. Secondary Diabetes Mellitus
C. Type I Diabetes Mellitus
D. Type II Diabetes Mellitus
2. A 20 year-old man comes to a Hospital with Diabetes Mellitus. After arrival and detailed
assessment, the patients every organ system of the body become Affected. Which one of the
following is macro vascular complication?
A. Coronary artery disease
B. Diabetic Nephropathy
C. Diabetic Neuropathy
D. Diabetic retinopathy
3. Most people with newly discovered type II DM are overweight. The important management for
such type of patients is diet and exercise. In addition to this, which of the following Oral agent
is recommending as first line therapy?
A. Meglitinides
B. Metformin
C. Satagliptin
D. Sulfonylureas
4. Which one of the following Insulin injection area has the greatest speed of absorption from its
site?
A. Abdomen
B. Arms(posterior surface)
C. Hips
D. Thighs(anterior surface)
5. You explain to the patient about hypothyroidism that the symptoms should resolve as the
medication reaches an appropriate level. Which of the Presenting signs and symptoms of
hypothyroidism include:
A. Fatigue and cold intolerance.
B. Polydypsia and polyphagia.

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C. Tachycardia and diarrhea.

D. Weight loss and hyperglycemia.
6. When there is a disorder over the musculoskeletal system, we have many options of diagnostic
modalities. Among those modalities,which of the following procedure is used for aspiration and
examination of synovial fluid from the joints?
A. Arthrocentesis
B. Arthroplasty
C. Arthroscopy
D. Myelogram
7. A patient presents with abdominal pain that is initially periumbilical but over time moves to the
right lower quadrant area. Which of the following clinical condition is most likely suspected?
A. Appendicitis
B. Cholecystitis
C. PUD
D. Diverticulitis
8. Which of the following problem is mostly associated with osteoporosis?
A. Infection in the bone
B. Peripheral blood clot formation.
C. Fracture formation.
D. Painful joint inflammation
9. Assume you are working in the emergency surgical OPD with an Orthopedician who is
examining a patient with facture. The Orthopedician found that the bone is broken into many
fragments with crepitus and he asks you to tell him the type of fracture that has occurred. What
should be your answer from the given alternatives?
A. Comminuted fracture
B. Compressed fracture
C. Impacted fracture
D. Spiral fracture
10. Which of the following is the most common cause of acute Osteomyelitis?
A. S. aureus
B. Gram negative rods
C. H. Influenza
D. Enterococci
11. Which one of the following shows the sequential steps of fracture management in the hospital?
A. Reduction----rehabilitation----immobilization
B. Immobilization----reduction----rehabilitation
C. Reduction----immobilization----rehabilitation

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D. Rehabilitation----immobilization----reduction
12. Which of the following is the most common confirmatory diagnostic mechanism of fracture?
A. Physical examination
B. History taking
C. Laboratory tests
D. X-ray/radiography

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13. There are different factors that affect fracture healing process. Among those factors, which one of
the following enhances the fracture healing time?
A. Extensive local trauma
B. Metabolic bone disease
C. Prompt reduction of bone fragments
D. Space or tissue between bone fragments
14. What is the biological hallmark of Hyperuricemia in gout patients?
A. Increased uric acid excretion or uric acid overproduction or both.
B. Hyper production of uric acid or reduced uric acid excretion or both.
C. Reduced uric acid production or decreased uric acid excretion or both.
D. Idiopathic origins.
15. A Twenty eight-year-old patient has recently been diagnosed with Diabetes Mellitus. After a week,
the patient complains progressive rise in blood glucose from bed time to [Link] of the
following characteristics of morning hyperglycemia is described?
A. Dawn phenomenon
B. Hypoglycemia
C. Insulin waning
D. Somogyieffect
16. A 25 year-old man with known type I DM is brought to a hospital. He is also a known
hypertensive patient. His blood glucose level is 800 mg/dl, urine keton 3+, and PCO2 is 10mmHg.
Which one of is the following fluid is most appropriate to be given to this patient?
A. 0.45% sodium chloride solution
B. 0.9% sodium chloride solution
C. DNS solution
D. Dextrose 5% solutionj
17. A 55 year-old woman brought to a Hospital with a diagnosis of dehydration. After physical
examination, what initial assessment findings would you expect to see?
A. Bradycardia, slowed respirations, low body temperature, and weight gain.
B. Rales, peripheral edema, palpitations, and diaphoresis.
C. Tachycardia, hypotension, poor skin turgor, and decreased urinary output.
D. Malaise, lymphadenopathy, fever, shortness of breath, and nausea
18. What is the definitive treatment of the patients with appendicitis?
A. Bowel preparation for cleansing.
B. Medications to lower pH within the stomach.

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C. Surgical removal of appendix.

D. Transfusion to replace blood loss.
19. What is the process of removing as many microorganisms as possible from the hands and arms by
mechanical washing and chemical antisepsis before participating in a surgical procedure?
A. Antiseptic Hand rub
B. Hand antisepsis
C. Hand washing
D. Surgical scrub
20. What is the Process of removing soil and debris and reduce transient flora from the hands using
plain soap and water?
A. Antiseptic hand rub
B. Hand antisepsis
C. Hand washing
D. Surgical scrub
21. A 25- year- old male patient is brought to a hospital and undergone abdominal surgery. After two
days, the patient‟s internal organs were found protruded through the disrupted wound edge. Which
of the following term most likely describe this finding?
A. Keloid
B. Hematoma
C. Dehiscence
D. Evisceration
22. Which of the following procedure require strict aseptic technique?
A. Catheterization B. Retention enema C. Cleansing enema D. NGT insertion
23. Which of the following ratio describes the correct alcohol to glycerin preparation for hand rub?
A. 1 : 100 ml
B. 2 : 100 ml
C. 100 : 2 ml
D. 200 : 1 ml
24. A 35- year- old man brought to a hospital with car accident on his lower leg. On physical
examination, he has open fracture on it. What is the preferred method to control bleeding on the
site?
A. Direct pressure
B. Indirect pressure
C. Elevation of the affected limb

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D. Apply Tourniquet
25. Which one of the following diagnostic procedures is the direct inspection and examination of the
larynx, trachea, and lower structures through either a flexible or a rigid scope?
A. Bronchoscopy
B. Endoscopy
C. Magnetic Resonance Imaging
D. Thoracoscopy
26. Which of the following is the most important risk factors for Respiratory Disease?
A. Occupation
B. Family history of lung disease
C. Smoking
D. Allergens and environmental pollutants
27. A -29-year old patient presented with an intermittent cough, dyspnea and wheezing. On P/E, he
has bilateral decreased air entry, rapid respiration and weakness. Which of the following is the
most likely, problem of the patient?
A. Bronchial Asthma
B. Chronic obstructive pulmonary disease
C. Pulmonary tuberculosis
D. Pneumonia
28. A 42- year –old patient had surgery before two months and brought to a Hospital with crampy pain
that is wave like and colicky in nature. There is no passage of bowel contents and on physical
examination the abdomen is distended. Which one of the following is the probable cause for his
obstruction?
A. Intussusception
B. Adhesion
C. Volvlus
D. Tumors and neoplasm
29. Your patient is experiencing congestive heart failure. What medication would you expect to
administer to strengthen myocardial contractility?
A. Nitroprusside
B. Digoxin
C. Nitroglycerine
D. Furosemide

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30. A 35- year-old patient is brought to a Hospital with a diagnosis of pneumonia following a recent
intrathoracic surgery. Which of the following drug is most likely prescribed?
A. Gentamycin
B. Amoxacillin
C. Levofloxacin
D. Docycline
31. Which one of the following is true about prevention of pressure ulcer in comatose patient?
A. Positioning disturb patients in coma
B. Changing the position of a bed-ridden patient every 8 hours
C. Rub the skin vigorously with alcohol
D. Minimize pressure on the bony prominence of a bed-ridden patient
32. A-40- year old patient is brought to a Hospital with a diagnosis of nephrolithiasis and advised to
increase fluid [Link] is the importance of increasing fluid intake in this patient?
A. To concentrate the urine
B. To help flush the stones through the urinary tract
C. To crystallize the struvite from the renal tubules
D. Tobreak down the stones into smaller pieces that will more easily pass through the
urinary tract
33. One of your patients is awaiting lab results for kidney function. The patient has recently recovered
from a streptococcal throat infection. Which one of the following kidney disorders might the
patient have?
A. Chronic renal failure
B. Glomerulonephritis
C. Acute renal failure
D. Pyelonephritis
34. Which of the following is an example of type IV hypersensitivity reactions?
A. Allergic rhinitis
B. Asthma
C. Atopic dermatitis
D. Contact dermatitis
35. Which of the following is the first line drug of choice for a hospital acquired gram negative
bacterial pneumonia?
A. Metronidazole500mg po tid
B. Amoxicillin 500mg po/ iv tid

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C. Gentamycin 80mg iv / im tid

D. Cloxacillin500mg po/ iv qid
36. Which one of the following vital sign is not affected by diurnal variations?
A. Blood pressure
B. Body temperature
C. Respiratory rate
D. Pulse rate
37. A nursing care that begins when the patient is transferred to the operating table and ends when the
patient is admitted to the post anesthesia [Link] one of the following term describes this phase
of nursing care?
A. Perioperative care
B. Preoperative care
C. Postoperative care
D. Intraoperative care
38. Which one of the following is the correct sequence from the slowest to fastest rate of absorption of
drugs at the sites of administration?
A. Sublingual, Oral, SC, IV, IM
B. Oral, Sublingual, SC, IM, IV
C. SC, oral, Sublingual, IV, IM
D. Oral, SC, Sublingual, IM, IV
39. Which one of the following is correct to manage sharp injury of the abdomen?
A. Removing the sharp object is helps to minimize further tissue damage
B. Give fluids by mouth to severely thirsted victims to counteract blood loss
C. Try to replace protruding organs & cover with dressings to prevent dryness
D. Place the victim on semi fowler’s position to avoid breathing difficulty
40. Even a single break in the chain of aseptic & sterile techniques in healthcare settings will result in
introduction of microorganisms in to our body. Which of the following statement describes an
infection acquired in such a way?
A. Opportunistic infection
B. Nosocomial infection
C. Medical asepsis
D. Surgical asepsis
41. What is the dose of TAT to be administered for an adult following an open wound?
A. 1500IM IM

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B. 1500IU SC
C. 3000IU IM
D. 3000IU ID
42. Which WHO clinical stage is suitable for an HIV positive patient with extra-pulmonary
tuberculosis and pneumocystis carinii pneumonia/PCP/?
A. Stage-1
B. Stage-2
C. Stage-3
D. Stage-4
43. A -24- year old woman is brought to a hospital with a diagnosis of blood disorder. On laboratory
analysis hematocrit become 55%. Which type of blood disorder will explain it?
A. Hemolytic anemia
B. Iron deficiency anemia
C. Aplastic anemia
D. Polycythemia
44. Which of the following is not a sign/symptom of depression according to the DSM-IV criteria?
A. Markedly diminished interest or pleasure in all,
B. Insomnia or hypersomnia nearly every day.
C. Fatigue or loss of energy nearly every day.
D. Feelings of self-worthiness
45. A 30 years old daily laborer presented with a belief that people are talking about him, being
prosecuted and followed by others. On further history and P/E, he has no insight on the disease
and feels anger towards the nurse and his attendant. Which of the following would be the most
likely problem of this patient?
A. Schizoid psychosis
B. Paranoid psychosis
C. Manic depressive psychosis
D. Hypomania
46. Which of the following is not a route of hepatitis B transmission?
A. Blood contact
B. Sexual contact
C. Animal contact
D. Perinatal transmission
47. What is the first thing you should do for a patient having epileptic seizure?

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A. Give diazepam
B. Prevent tong biting by inserting oral air way
C. Put him or her on the lateral position
D. Restrains the patient
48. A patient in ICU has frequent oral and endotreachal tube secretion. One of the following
statements is correct about suctioning of a patient.
A. Sterility is mandatory
B. Atelectasis is unlikely
C. Pre-oxygenation is not mandatory
D. The time of suctioning exceeds 30 seconds
49. What would be the first line emergency management of a patient with acute asthma?
A. Aminophyline C. Oxygen
B. Hydrocortisone D. Salbutamol
50. A -32- year old known RVI patient who has diarrhea for the past 1month with decrease intake
came to the ED with weakness and change in mentation of 1 day duration. On physical
examination, Bp- un recordable, PR 140 b/m, RR 36 b/m, To 35oc, Oxygen saturation- 80%. What
is your priority management for this patient?
A. Check his airway, breathing and secure wide bore bilateral IV line
B. Secure bilateral IV line
C. Start warming up the patient because he is hypothermic
D. Take further history regarding the duration and the quality of the diarrhea
51. A -20-year old male patient who sustained car accident came to you with loss of consciousness of
5 hours duration. On P/E, the patient is snoring with excessive secretions from his mouth. What
will be the priority nursing management for this patient?
A. Take vital signs
B. Assess for presence of bleeding
C. Open airway and apply suctioning
D. Secure bilateral IV lines to manage shock
52. What is the preferable position for female urinary catheterization?
A. Left lateral position
B. Dorsal recumbent position
C. Supine position
D. Trendelenburg position
53. Which of the following is the most commonly used catheter size for an adult male?
A. # 14fr C. # 18fr
B. # 16fr D. . #10fr
54. Which of the following routes of drug administration has fast onset of action?
A. Intramuscular route C. Oral route
B. Intravenous route D. Subcutaneous route
55. Which of the following is safest, most convenient and least expensive route of medication
administration?
A. Oral C. Subcutaneous
B. Intramuscular D. Intradermal
56. Injection of drug in to the tissue just beneath the skin.

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A. Intravenous C. Subcutaneous
B. Intramuscular D. Intradermal
57. W/ro Almaz comes to your department with shock and she has no peripheral pulse. If venous cut
down would be an option to resuscitate her, which of the following is the most commonly used
vein for the cut down?
A. Basalic vein C. Femoral vein
B. Cephalic vein D. Sephaneous vein
58. Which of the following is true about blood transfusion?
A. Immediate Transfusion reaction is likely after 24 hours
B. Skin rash is an immediate complication
C. The blood should be transfused within 30min of its removal from the blood bank
D. The transfusion usually takes 12 hours
59. Which one of the following statement is true?
A. Partial pressure of carbon dioxide is greater than 45mmHg indicates hyperventilation
B. Partial pressures of carbon dioxide is less than 35mmHg indicates hypoventilation
C. The normal Arterial partial pressure of carbon dioxide is 35-45mmHg
D. The normal Arterial Partial pressure of oxygen is 70-90mmHg
60. W/ro Hanna is a known Chronic kidney disease patient with urine output of <300ml per day. How
do you report W/ro Hanna‟s finding?
A. Anuria C. Oliguria
B. Nocturia D. Polyuria
61. Which one of the following is the correct sequence of abdominal assessment?
A. Auscultation→Inspection→palpation →percussion
B. Inspection→Auscultation →palpation →percussion
C. Inspection→Auscultation→percussion → palpation
D. Inspection→Palpation→Percussion→ Auscultation

62. Which one of the following assessment is subjective data?

A. Tenderness C. Fever
B. Pain D. BP=100/60mmhg
63. A patient has “Fluid volume deficit related to persistent nausea and vomiting as evidenced by
Bp=70/40 mmHg”. What type of nursing diagnosis is it?
A. Actual nursing diagnosis
B. Potential nursing diagnosis
C. Syndromic nursing diagnosis
D. Well nursing diagnosis
64. A patient has “Fluid volume deficit related to persistent nausea and vomiting as evidenced by
Bp=70/40 mmHg”. Which part of the statement is the etiology?
A. Bp=70/40mmHg
B. Fluid volume deficit
C. Persistent nausea vomiting
D. Persistent nausea vomiting evidenced by BP
65. What is the priority nursing intervention for a patient who has hypotension secondary to diarrhea
and vomiting?

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A. Give medication
B. Identify underline cause
C. Resuscitate with fluid
D. Taking detailed history
66. A Physician ordered 1000ml of normal saline to run over 6 hours. What is the drop rate per
minute to administer the fluid?
A. 41 drop/min
B. 42 drop/min
C. 52 drop/min
D. 56 drop/min
67. What is the correct compression to ventilation ratio of an adult patient receiving CPR,
respectively?
A. 15:2 B. 2:30
C. 30:2 D. 60:2
68. M/r Alemu has cervical spine injury. What maneuver is recommended for air way management?
A. Head tilt and chin lift C. Chin lift
B. Jaw trust D. Head tilt ,chin lift and jaw trust

69. W/ro Alemitu has metastasized uterine cancer and she is terminally ill. Up on assessment, She
says „‟ I feel fine.‟‟ In which stage of death is W/ro Alemitu?
A. Bargaining C. Depresion
B. Anger D. Denial
70. Which one of the following is absorbable suturing material?
A. Catgut C. Silk
B. Nylon D. Stainless steel
71. Which one of the following is a clean procedure?
A. Catheterization C. Enema
B. Endo-tracheal tube insertion D. Opening IV line
72. Which of the following is the route of transmission of cholera?
A. Air borne C. Feco-oral
B. Blood transfusion D. Vector borne
73. Which of the following is not true about the management of cholera?
A. Antibiotics
B. Fluid resuscitation
C. Immunization
D. Screening and management of contact
E.
74. Which of the following is true about MDR TB?
A. Resistance to Ethambutol and Isonaizide
B. Resistance to Isonaizide
C. Resistance to Refampcin
D. Resistance to Refampcin and Isonazide
75. Which one of the following statement is correct about HIV/AIDS?
A. AIDS is curable diseases

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B. AIDS is virus that causes HIV

C. Everyone who is infected with HIV has AIDS.
D. HIV is the virus that causes AIDS
76. Which one of the following wound should not be sutured?
A. Animal bit C. Fall down accident
B. Car accident D. Stick/blow injury
77. Which one of the following statement is true about type 1 DM?
A. DKA is less likely than type 2 DM
B. More common in old age than type 2 DM
C. Necessarily needs insulin therapy
D. Nutritional management is mandatory than type 2
78. Which one of the following feature characterize duodenal ulcer?
A. It is aggravated by food
B. It is Relived by food
C. Vomiting is common
D. Wight loss is common
79. Which of the following drug is used for managing non-cardiogenic anaphylactic shock?
A. Adrenaline C. Dopamine
B. Atropine D. Doputamin
80. Which one of the following investigation is a golden standard test for TB?
A. A.X-ray
B. AFB
C. CT
D. Culture
81. W/ro Abebech comes to your institution within an hour of ingestion of rat poison. What will be the
emergency management of this patient?
A. Cleansing Enema C. Gastric Gavage
B. Decompression D. Gastric Lavage
82. Which one of the following is the major criterion for diagnosing acute rheumatic fever?
A. Arthlargia C. Fever
B. Carditis D. Lab investigation
83. Which one of the following is positive clinical finding of meningitis?
A. Brudzinski sign C. Headache
B. Fever D. Vomiting
84. Which one of the following is important for iron absorption after meal/food?
A. Coca cola C. Fruit juice
B. Coffee D. Tea
85. Which one of the following is true about hypertensive emergency?
A. Bp>180/120mmhg and no organ failure
B. Bp>180/120mmhg and organ failure
C. Organ failure
D. Severe rise in blood pressure (Bp>180/120mmhg)
86. What is the preferable site for administering pentavalent vaccine for an infant intramuscularly?
A. Deltoid B. Dorso gluteal

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C. Vastus laterals D. Ventro gluteal

87. Which of the following is isotonic solution?
A. 3% Normal saline C. 0.9% Normal saline
B. 5% Normal saline D. 0.45% Normal saline
88. Which one of the following is the best manifestation of right side heart failure?
A. Cough
B. Decreased urine production
C. Difficulty of laying flat
D. Jugular vein distention
89. A -35-year old patient comes to your health facility with BP=190/110mmhg, PR=72bpm,
RR=18breath/min and To=35oc. Which of the following is correct about this finding?
A. Stage I hypertension C. Systolic hypertension
B. Stage II hypertension D. Stage III hypertension
90. What makes the pain of myocardial infarction different from that of angina pectoris?
A. The pain is localized
B. The pain is sever and radiating
C. Pain is relieved by rest
D. The pain begin after vigorous exercise
91. Which one of the following is true about semi- fowler position of a patient with congestive heart
failure?
A. Reduce venous return from the lower body
B. Enhance renal perfusion
C. Enhance digestion
D. Reduce jugular venous pressure
92. Which one of the following anti- hypertensive drugs does not act by lowering vascular
resistance?
A. Enala pril
B. Hydralizine
C. Nifidipine
D. Nitro-prusside
93. A 24- year- old patient is brought to a hospital with a clinical manifestation of Dyspepsia,
discomfort on the epigastrium and burning sensation in the esophageal area. Upon Laboratory
examination,Serologic test revealed positive for H. pylori Ag.
Which of the following antimicrobial agent will not treat the bacteria?

A. Amoxacillin
B. Claritromycin
C. Metronidazole
D. Omeprazole
94. Which of the following manifestation describes severe cerebral malaria?
A. Fever
B. Chills
C. Shiver
D. Hypoglycemia

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95. Which of the following situation will be contraindicated for digoxin treatment?
A. Heart rate >80 b/m
B. Heart rate >90 b/m
C. Heart rate <70 b/m
D. Heart rate <60 b/m
j
96. Which of the following emergency situation demand priority intervention?
A. Dehydration

B. Malnutrition /Marasmus

C. Poisoning

D. Burn

97. Which of the following are the leading causes of neonatal mortality in Ethiopia?
A. Pretem, jaundice and malnutrition
B. Diarrhea, malnutrition and asphyxia
C. Preterm, infections and asphyxia
D. Infections, sepsis and diarrhea
98. Which of the following is true about pathological jaundice?
A. Appear after 24 hours of life
B. Appear within 24 hours of life
C. Serum of bilirubin <12 mg / dl
D. Serum bilirubin <5 mg / dl/day
99. Which of the following is not the feature of respiratory distress syndrome (RDS)?
A. Bluish discolouration of the mucous membrane
B. Chest in drawing
C. Flaring of the ala nasi
D. Hyperventilation
100. What is the recommended time to begin complementary feeding to infants?
A. At 4 to 5 months of age
B. At 6 months of age
C. When the birth weight has tripled
D. When tooth eruption has started
101. Which of the following is a sign of good attachment?
A. Mouth wide open

B. Baby facing towards the mother

C. Whole body supported

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D. Baby close to the mother

102. A nurse in the well-baby clinic is conducting an assessment on a 6-month-old infant. Which of
these observations would warrant further investigation?
A. Able to sit unsupported

B. Crying when the nurse approaches

C. Rolls from abdomen to back only

D. Absence of Moro reflex

103. A 2- year old child brought to you with history of labored breathing associated with barking
cough and inspiratory stridor. What will be the most likely problem of the child?
A. Pneumonia
B. Croup
C. Very severe disease
D. Asthma
104. Betty” who is 16 month of age came to your clinic with vomiting everything, unable to drink and
suck breast, and has history of convulsion. During P/E you have found that she has severe chest-
indrawing, stridor and breathing rate is 53 breaths per minute. What is the possible classification
of Betty?
A. Possible severe bacterial infection
B. Pneumonia
C. No pneumonia: cough or cold
D. Severe pneumonia or very severe diseases
105. Which one is the first line drug for an infant presented with pneumonia?
A. Amoxicillin

B. Ciprofloxacillin

C. Cotrimoxazole

D. Ceftriaxone

106. Which of the following fluid is preferred for a child presented with both dehydration and
malnutrition with edema?
A. Ringer lactate

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B. ORS

C. ReSoMal

D. Normal saline

107. A 14-month-old male infant is brought to the clinic for evaluation of diarrhea. The child has an
area of hair loss over the occiput. Ribs are prominent and the skin is loose, but muscle tone is
increased. The child weighs 5 kg. What is the BEST course of action?
A. Urgent outpatient referral to an endocrinologist
B. Admission, skeletal survey, and social service evaluation
C. Elimination diet for evaluation of food allergies
D. Stool culture and test for fecal leukocytes
108. Firew, aged 2 years is brought with diarrhea, fever and vomiting. On P/E, he is alert but irritable
and restless with T0=39 oC, eye-balls are not sunken and his skin pinch goes backquickly. Which
of the following statement is correct?
A. Firew has some dehydration
B. Firew should be given antibiotics
C. Firew should be treated according to treatment plan “B”
D. Firew has no dehydration
109. A child with diarrhoea is assessed for all of the following except
A) Signs and/or symptoms of dehydration
B) The presence or absence of blood in the stool
C) Duration of the diarrhoea
D) Age of child
110. Sr. Yeshiwork was conducting a survey to assess to nutritional status of under five children in
Bahir Dar district. Based on water low classification, she found that more than 8.0% of children
have, Height – for – age > 95%, Weight – for – height < 70%. What is your interpretation of the
finding in the district?
A. Stunted
B. Underweight
C. Wasted
D. Stunted and wasted
111. Which of the following group as being most at risk for developing iron-deficiency anemia?
A. School-aged children

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B. Breast-fed infants under the age of 6 months

C. Children ages 6 months to 5 years of age

D. 3- to 5-year-old children

112. Which of the following type of malnutrition is characterized by flag sign on hair?
A. Kwashiorkor

B. Pellagra

C. Marasmus

D. Folate deficiency

113. Which of the following are the recommended immunizations for an infant coming in the second
visit?
A. Polio 2, penata 2, PCV2, Rota 2

B. Polio 2, penata 2, PCV2, Rota 1

C. BCG, Polio 2, penata 2, PCV2

D. Polio 2, penata 2, PCV2, Rota 1

114. What would be the most likely diagnosis of a child presented fever, macculopapular rash and
conjunctivitis?
A. Rubella

B. Measles

C. Scabies

D. Chiken pox

115. Which of the following is not true about acute rheumatic fever in children?
[Link] is common cause of acquired heart disease in children.

B. Acute rheumatic fever is preventable

C. Proper treatment of streptococcal pharyngitis can eliminate its risk

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D. Peak age for acute rheumatic fever is up to 3 years.

116. Which of the following classification is appropriate for an infant born to HIV positive woman?
A. Confirmed HIV infection

B. HIV exposed infant

C. HIV infection unlikely

D. No HIV infection

117. According to WHO clinical staging HIV/ADS for infant and children, a child with esophageal
candidiasis (or candida of the trachea) and recurrent severe bacterial infections could be classified
as
A. Stage I

B. Stage II

C. Stage III

D. Stage IV

118. Which the following is the most common malignancy in children?

A. Wilm's tumor

B. CNS tumor

C. Acute leukemia

D. Neuroblastoma

119. Which of the following is not feature of Down syndrome?

A. Single simian crease

B. Epicanthal fold

C. General hypertonia

D. Flat facial profile

120. Which of the following neuro-developmental problem causes impairment in socialization,

communication and behavioral domains of children?

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A. Autistic spectrum disorder

B. Down syndrome

C. Mental retardation

D. Cerebral palsy

121. What is the best indication to the nurse that antibiotic treatment for a urinary tract infection in a 6-
year-old girl is effective?
A. Symptoms have subsided within 24 hours.

B. The entire amount of prescribed antibiotic has been taken as ordered.

C. Follow-up urine culture within 72 hours is negative.

D. Mother states the child is voiding normally.

122. Which of the following diseases is most often associated with polyuria and polydipsia in a child?
A. Diabetes insipidus

B. Nephritic syndrome

C. Addison's disease

D. Type I diabetes mellitus

123. Which of the following is a predisposing factor for urinary tract infection in children?
[Link] sex

B. Front to back anal cleaning

C. Use of diaper

D. Urinary tract catheterization

124. Which of the following is the most common etiologic agent of urinary tract infection in children?
A. Escherichia-Coli
B. Streptococcus Species
C. Staphylococcus aureus
D. Klebsiella

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125. A 5 years old child came to your health center with generalized edema. Laboratory investigation
of urine showed gross proteinuria and blood test showed hypoprotieinemia and
hypercholesterolemia. What would be the possible diagnosis of this child?
A. Nephrotic syndrome
B. Kwashiorkor
C. Heart failure
D. Acute glomerulonephritis
126. Which of the following are the most common causes of acute otitis media in children?
A. Strep. Pneumonia and H-influenza

B. H-influenza and staph. aureus

C. Strep. Pneumonia and [Link]

D. H-influenza and pseudomonas argunosa

127. Which of the following condition is the most common route of transmission of neonatal tetanus?
A. Injection sites
B. Umbilical stamp
C. Aseptic procedure
D. Circumcision
128. When do you think a health care issue becomes an ethical dilemma?
A. A clients legal rights coexist with a health professionals obligation
B. Decisions must be made quickly, often under stressful conditions
C. Decisions must be made based on value systems
D. The choices involved do not appear to be clearly right or wrong
129. Which of the following professional nursing value enhance nurses' cultural-competency skills to
apply sensitivity towards to others?
A. Autonomy
B. Strong commitment to service
C. Belief in the dignity and worth of each person
D. Commitment to education
130. The nurse questions a physician order of Morphine sulfate 50 mg, IM for a client with
pancreatitis. Which role of the nurse is described by this statement?
A. Change agent
B. Client advocate

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C. Case manager
D. Collaborator

131. Which of the following term is used to describe the ability of an agent to produce clinically
apparent infection?
A. Infectivity
B. Virulence
C. Pathogenicity
D. Infection rate
132. Direct transmission includes which of the following modes of transmission?
A. Air born
B. Trans-placental transmission
C. Vehicle-borne transmission
D. Vector-borne transmission
133. Which of the following is the objective of PRIMARY PREVENTION?
A. To prevent exposure and prevent disease
B. To stop or slow the progression of disease

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C. To limit the impact of damage

D. For early detection and treatment of disease
134. In one district schizophrenic patients taken to traditional medicine and spiritual places for
treatment. This makes difficult to know the magnitude of schizophrenia in the district. Manager of
the district health bureau wants to know “what is the prevalence of schizophrenia in the
district”.Which method of study design is most appropriate?
A. Cross sectional
B. Case control
C. Cohort
D. Experimental
135. Researcher wants to check efficacy of new drug over the old drug for depression treatment. He
recruited patients and randomly assigned 150 patients to take the new drug and 120 patients on old
drug. After provision of the treatment for 3 months he measured the recovery rate from depression.
Which method of study design the investigator used?
A. Experimental
B. Cohort
C. Case control
D. Cross sectional
136. Which one of the following is not correct about screening program?
A. Specificity is important when one is screening for rare diseases
B. Instituted when the disease has long period between first signs and overt disease
C. Sensitivity and Specificity are two measures of validity
D. Specificity should be increased at the expense of Sensitivity when the disease is serious
137. Which one of the following is not an action verb in writing specific objectives?
A. To determine
B. To compare
C. To verify
D. To understand
138. The General Social Survey asked respondents to assess their own health as excellent, good, fair,
or poor. What is the level of measurement of this variable?

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A. Nominal.
B. Ordinal.
C. Interval
D. Ratio.
139. Which one of the following is true about mode?
A. Is found only for discrete variables.
B. Is less than the mean.
C. Is the value of the most frequently occurring score.
D. Is less for ordinal than for interval variables.
140. Which of the following is a probability sampling technique?
A. Quota sampling technique
B. Convenience sampling technique
C. Snowball sampling technique
D. Cluster sampling technique
141. Which one of the following is correct measure of mortality for “the proportion of death from
malaria out of those adults who develop malaria in Bahir Dar town in the year 2008”?
A. Case fatality rate
B. Proportionate mortality ratio
C. Cause-specific mortality rate
D. Crude death rate
142. You are approached by a person in the street who asks you to participate in a study on life
insurance by answering a number of questions. What is the type of sampling method the person
has used?

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A. Random sampling
B. Convenience sampling
C. Stratified random sampling
D. Systematic sampling
143. Which one of the following is not a characteristic of substances that are not easily broken down
into harmless substances?
A. They are environmentally unfriendly
B. They travel long distance from their source
C. They are water soluble
D. They accumulate in fat
144. Which of the following is stationary type of pollution?
A. Water pollution
B. Sound pollution
C. Air pollution
D. Soil pollution
145. Which one of the following is not used as an indicator of sanitation and hygiene coverage in our
country?
A. Latrine coverage
B. Latrine utilization
C. Accessibility to water
D. Open defecation free
146. Which one of the following gas is greenhouse gas?
A. Oxygen
B. Carbon dioxide
C. Nitrogen
D. Nitrogen dioxide
147. Which one of the following behavioural change theories and Models assumes that the most
important determinants of people‟s behaviours are their perceptions?
A. Health Belief Model
B. The Theory of Planned Behavior
C. The Trans‐theoretical Model
D. Precede-Proceed model
148. Which one of the following is not a characteristic of good message?
A. Epidemiologically correct
B. Affordable

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C. Requires maximum effort

D. Culturally acceptable
149. What is the importance of the presence of the ozone layer in the upper atmosphere?
A. It enhances the greenhouse effect
B. It absorbs greenhouse gasses
C. It absorbs ultraviolet radiation
D. It reduces the amount of acid rain and urban smog
150. Which of the following gives more calories per gram than others?
A. Fat
B. Carbohydrates
C. Protein
D. Alcohol
151. Which of the following vitamin is water soluble?
A. Vitamin D
B. Vitamin A
C. Vitamin B
D. Vitamin K
152. Which of the following anthropometric index indicates chronic nutritional status?
A. Weight for Height
B. Weight for age
C. Body mass index
D. Height for age
153. Which of the following is chronic complication of vitamin A deficiency?
A. Night blindness
B. Xerophtalmia
C. Double vision
D. Conjunctivitis
154. Which One of the following is not component of Essential nutrition Actions (ENA) in Ethiopia?
A. Promoting optimal breastfeeding.
B. Promoting optimal complementary feeding at birth.
C. Nutritional care of the sick child during and after illness.
D. Vitamin A deficiency control
155. What of the following is the smallest unite of proteins?
A. Amino acids

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B. Fatty acids
C. Lipoproteins
D. Triglyceride
156. Which One of the following is not direct cause of maternal death?
A. Hemorrhage
B. Cardiovascular disease
C. Infection
D. Preeclampsia
157. Which one of the following is safe motherhood initiative strategy currently?
A. Accesses to risk assessment health facilities.
B. Promote use of traditional birth attendants for low risk women
C. Family planning to avoid unwanted pregnancies and unsafe abortion
D. Early detection of complication by local community health workers.
158. In counseling a woman about the advantages of the Cu T IUCD, What you inform her?
A. It Is permanent
B. It Is highly effective
C. It Has no side effects
D. It Is effective in preventing anemia
159. Which of the following is not delivery services strategy?
A. All institutional deliveries should be monitored using partograph.
B. All women and birth attendants should be aware of the requirements of instrumental delivery
C. All women and their birth attendants should be aware of the need to refer prolonged labor
D. All health care providers should be trained and practice clean and safe delivery techniques
160. Which of the following is true about reproductive health in Ethiopia?
A. Quality reproductive health services
B. High rate of gender based violence
C. Access to a range of health services to adolescents
D. Adequate contraceptive prevalence rates
161. Which component of care is very essential to asphyxiated new born?
A. Prevention and management of ophthalmic neonatorum
B. Resuscitation
C. Early and exclusive breastfeeding
D. Prevention and management of hypothermia
162. Which service component is common in both basic and comprehensive essential obstetric care?
A. Parenteral anticonvulsants

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B. Surgical obstetrics
C. Anesthesia
D. Blood transfusion
163. Which of the following leadership style is more concerned on team building and full
participation?
A. Laissez-faire
B. Autocrats
C. Democrats
D. Consultative
164. Which one of the following is not rational of motivation at work place?
A. Reduce absenteeism and tardiness
B. Increase labor turn over
C. Building of good relationship
D. Increase efficiency
165. Among the following which one is not characteristic of social insurance?
A. Social insurance is not a right of all citizens but only those who have paid the contribution.
B. People perceive that they paid a premium contribution in exchange to specified benefits.
C. Contributions paid for social insurance programs are shared equally in the community.
D. Contribution rates and benefits cannot be unilaterally changed by executive government
decision
166. Which one of the following is the process of attracting and selecting qualified job candidates to
fill vacant positions?
A. Profiling
B. Recruitment
C. Estimating
D. Forecasting
167. Which communication channel is best to immediately announce disease outbreak?
A. Scientific journal
B. News paper
C. News media
D. Lay health workers
168. Which of the following is not principle of health ethics?
A. Autonomy
B. Beneficence
C. Maleficence

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D. Justice
169. Which of the following is a relatively high risk factor for mother to child transmission of HIV
infection?
A. Second infant in multiple birth
B. Vaginal delivery
C. Elective caesarean section delivery
D. Early infant cleaning and eye care

170. Which of the following is continuous function of management?

A. Planning
B. Implementation
C. Decision making
D. Evaluation
171. Which of the following is the leading cause of maternal mortality in Ethiopia?
A. Preeclampsia/eclampsia
B. Hemorrhage
C. Obstructed labor
D. Sepsis
172. Which of the following figure indicates the current maternal mortality ratio (MMR) in Ethiopia?
A. 420/100,000 live births
B. 676/100,000 live births
C. 353/100,000 live births
D. 397/100,000 live births
173. A-30-year old pregnant woman came to your health facility for routine antenatal care (ANC). On
history, she had two abortions, two stillbirths, one neonatal death and three alive children. Based
on the information given, what will be her Gravida (G) and Para (P) respectively?
A. G-VIII and P-IV
B. G-VIII and P-VI
C. G-IX and P-III
D. G-IX and P-VI
174. Which of the following is a classic signs of preeclampsia?
A. Hypertension
B. Proteinuria
C. Edema
D. Convulsion
175. A-20-year-old Primigravida woman presented with a chief complaint of pushing down pain and
rupture of membranes (amniotic fluid). On physical examination, you found that she has strong
urge to push, fully dilated cervix and palpable presenting part. Based on your finding, which of the
following signs observed signals that she is on second stage of labor?
A. Strong urge to push
B. Dilated cervix

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C. Palpable presenting part

D. Rupture of membranes
176. Which of the following is the first line emergency treatment of eclampsia?
A. Anticonvulsants
B. Antihypertensive
C. Maintaining ABC of life
D. Termination of pregnancy
177. A woman diagnosed to have severe preeclampsia has been on magnesium sulfate maintenance
therapy. As a nurse, which of the following drug toxicity warrants you to stop the drug in this
patient?
A. Respiratory rate <16 breaths/minute
B. Urine output 30-50ml/minute
C. Minimal deep tendon reflex
D. Decreased level of consciousness
178. Based on the focused antenatal care (FANC) model, a woman is advised to have four visits; the
first visit to be conducted at about 16th weeks of gestation. Which of the following assessment does
not necessarily be done during the first ANC visit?
A. HIV testing
B. Diagnosis of preeclampsia
C. Syphilis screening
D. Detection of anemia
179. Delay in receiving appropriate care at the health facility is one of the three delays in care seeking
that affect the survival of both mothers and newborns. Which of the following finding/s
characterize presence if such delays?
A. Shortage of competent providers
B. Shortage of money to reach to the health facility
C. Lack of transportation
D. Lack of power to make decision and seek health care
180. A-31-weeks pregnant woman presented with abdominal pain and bright red vaginal bleeding of 6
hours duration. The detailed history revealed that the bleeding begins after a fall down accident.
On P/E, you identified that the abdomen is tender and no fetal heart beat is detected. What would
be the most likely diagnosis of this woman?
A. Vasa prevea
B. Abruptio placenta
C. Placenta prevea
D. Mole pregnancy
181. Which of the following is a requirement for assisted instrumental delivery?
A. Cephalic presentation
B. Fully dilated cervix
C. Strong maternal effort

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D. Alive fetus
182. Which of the following parameter identified on the partograph suggests satisfactory progress of
first stage of labor?
A. Regular and progressive uterine contraction
B. Steady decent of the fetus through the birth canal
C. Pattern of cervical dilatation goes to the right of the alert line
D. Fetal heart beat (FHB) <100 or >180 beat/minute
183. Which of the following is the most common cause of uterine rupture?
A. Obstructed labor
B. Previous CS scar
C. Twin pregnancy
D. Excessive use of oxytocin
184. Which of the following woman is more likely to develop atonic postpartum hemorrhage?
A. A woman who had breech delivery
B. A woman who had prolonged labor
C. A woman who had instrumental delivery
D. A woman who had cesarean section
185. Which of the following is not component of active management of third stage of labor?
A. Manual removal of placenta
B. Uterine massage
C. Administering uterotonic drugs
D. Giving appropriate IM/IV antibiotics
186. A pregnant woman at term presented with leakage of amniotic fluid, but she has no signs of labor.
On P/E, the nurse found that membranes are ruptured and feels a pulsating umbilical cord at the
pelvic floor. What is the diagnosis and immediate management of this client at health center level,
respectively?
A. Cord presentation, immediate referral to hospital
B. Cord presentation, reassurance of the woman to stay calm
C. Cord prolapse, immediate referral to hospital
D. Cord prolapse, induce labor to save the life of the fetus
187. Which of the following drug is the first line treatment of choice for a woman with severe malaria
in Ethiopia?
A. Coartum
B. IV Quinine
C. Arthemeter
D. Artesunate
188. Which of the following newborn requires a special care with steroid supplement?
A. A fetus born at 32 weeks of gestation
B. A fetus born to a woman with diabetes mellitus
C. A fetus born with congenital abnormality
D. A fetus born to a woman with HIV

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189. An 18 year old university student presented with vaginal bleeding and lower abdominal pain. On
history, she said that she has been sexually active and amenorhic over the last three months. On
vaginal examination, the cervix is open and has vaginal bleeding, but there is no expulsion of any
product of conception. Based on the given information, what would be the most likely diagnosis
and management of this patient, respectively?
A. Incomplete abortion, evacuation of the conceptus tissue
B. Inevitable abortion, evacuation of the conceptus tissue
C. Missed abortion, let the pregnancy ends by itself
D. Threatened abortion, let the pregnancy continues as the fetus is viable
190. Which of the following is necessarily a true sign of labor?
A. Engagement of the presenting part into the pelvic brim
B. Rupture of amniotic fluid membranes
C. Regular uterine contraction with progressive cervical dilation
D. Pushing down pain and back ache
191. Tocolysis is one of the management of pregnant woman. Which of the following woman requires
this treatment?
A. A woman with preterm labor
B. A woman with twin pregnancy
C. A woman with previous CS scar
D. A woman with preeclampsia
192. Ethiopia does not achieve the millennium development goal set to reduce neonatal mortality.
Which one of the following is the leading cause of neonatal mortality in the country?
A. Prematurity
B. Birth asphyxia
C. Neonatal sepsis
D. Congenital abnormality
193. Which of the following is normal finding in a woman on second stage of labor?
A. FHB < 100 or > 180 beat/minute
B. Vaginal bleeding
C. Shoulder dystocia
D. Spontaneous rotation of fetal head
194. Which of the following immediate newborn care needs to be done right after birth?
A. Dry baby’s body with dry towel
B. Wipe eyes
C. Assess breathing and color
D. Tie and cut the cord
195. Which of the following vaccine prevents diarrhea among under-5 children?
A. Rota
B. PCV
C. Hib

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D. HBV
196. Which one of the following is not key component of health sector transformation plan?
A. Availing caring, compassionate and respectful health professional
B. Quality and equity of health care
C. Ensuring access to health service
D. Woreda transformation
197. Which of the following modern contraceptive is not preferred to a breastfeeding woman?
A. DMPA (depo)
B. Implants
C. IUCD
D. COC
198. Which of the following woman has a lessor chance of cervical cancer?
A. A woman living with HIV
B. A woman having multiple sexual partners
C. A woman having a history of STI
D. A woman living in monogamous relation
199. The last normal menstrual period of a pregnant was on 22/07/2008. What will be her expected
date of delivery according to the Ethiopian calendar?
A. December 27, 2009
B. January 02, 20009
C. December 2, 2009
D. October 28, 2009
200. Which of the following is inappropriate while managing a newborn with birth asphyxia?
A. Position the newborn supine with neck slightly extended
B. Clear the mouth and nose with gauze or bulb syringe
C. Ventilate with appropriate size mask and self-inflating bag
D. Stop resuscitation after 10 minutes if there is no response

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