NMC Past Questions and Answers: 150+ Practice Questions (2026 Update)

If you are a final-year nursing student or a foreign-trained nurse preparing to sit for the Ghana Nursing and Midwifery Council (NMC) licensure examination, you are likely searching for reliable NMC past questions and answers to practice with. You need these materials to understand the exam format, identify high-yield topics, and build the confidence required to pass on your first attempt.

This comprehensive guide provides exactly that: a curated collection of NMC past questions and answers focused on the Ghanaian curriculum, complete with detailed explanations to enhance your learning. Using authentic NMC past questions and answers is the single most effective strategy for exam success, and we have compiled over 150 NMC past questions and answers across key nursing areas to give you the competitive edge you need.

Why Practicing with NMC Past Questions and Answers is Your Secret Weapon

Before diving into the questions, it’s crucial to understand why this method is superior to passive reading. The Ghana NMC exam is known for testing not just theoretical knowledge, but its application in clinical scenarios, particularly within the Ghanaian healthcare context (e.g., Korle Bu Teaching Hospital, Komfo Anokye Teaching Hospital). Practicing with NMC past questions and answers helps you:

• Identify Weak Areas: Pinpoint the specific topics where you need more revision.
• Understand Question Patterns: Recognize how examiners phrase questions on maternal health, medical-surgical nursing, and professional ethics.
• Improve Time Management: Get accustomed to the pace required to answer multiple-choice questions (MCQs) within the allotted time.
• Boost Confidence: Familiarity with the format reduces anxiety on exam day.

Key Topics Covered in Ghana NMC Past Questions

Based on analysis of previous exams and trends, the questions are heavily weighted toward practical, high-stakes areas. The following NMC past questions and answers are grouped by these core topics.

Topic 1: Maternal and Child Health Nursing (Obstetrics)

Maternal and Child Health is a cornerstone of the Ghana NMC exam, reflecting the country’s focus on reducing maternal and infant mortality. These questions cover antepartum, intrapartum, and postpartum care .

Question 1:
When assessing the adequacy of sperm for conception to occur, which of the following is the most useful criterion?
A. Sperm count
B. Sperm motility
C. Sperm maturity
D. Semen volume

Answer & Explanation:
Correct Answer: B. Sperm motility
Explanation: While a normal sperm count is important, motility (the ability to swim) is the most critical functional criterion. For conception to occur, sperm must be able to travel through the cervical mucus and female reproductive tract to reach and fertilize the egg. Immobile sperm cannot achieve this, regardless of count.

Question 2:
A couple who wants to conceive but has been unsuccessful during the last 2 years has undergone many diagnostic procedures. When discussing the situation with the nurse, one partner states, “We know several friends in our age group and all of them have their own child already, Why can’t we have one?”. Which of the following would be the most pertinent nursing diagnosis for this couple?
A. Fear related to the unknown
B. Pain related to numerous procedures.
C. Ineffective family coping related to infertility.
D. Self-esteem disturbance related to infertility.

Answer & Explanation:
Correct Answer: D. Self-esteem disturbance related to infertility.
Explanation: The partner’s statement comparing themselves to friends who have children reflects feelings of inadequacy and a blow to their self-concept. This is a classic presentation of self-esteem disturbance. While fear and pain may be present, the core issue expressed here is psychosocial, related to their identity and perceived failure.

Question 3:
Which of the following urinary symptoms does the pregnant woman most frequently experience during the first trimester?
A. Dysuria
B. Frequency
C. Incontinence
D. Burning

Answer & Explanation:
Correct Answer: B. Frequency
Explanation: Urinary frequency in the first trimester is primarily due to the enlarging uterus pressing on the bladder. Dysuria and burning are signs of a urinary tract infection, not a normal physiological change.

Question 4:
Heartburn and flatulence, common in the second trimester, are most likely the result of which of the following?
A. Increased plasma HCG levels
B. Decreased intestinal motility
C. Decreased gastric acidity
D. Elevated estrogen levels

Answer & Explanation:
Correct Answer: B. Decreased intestinal motility
Explanation: Elevated progesterone levels during pregnancy cause smooth muscle relaxation throughout the body, including the gastrointestinal tract. This leads to decreased motility, slowing digestion and allowing more time for gas formation and acid reflux (heartburn).

Question 5:
On which of the following areas would the nurse expect to observe chloasma?
A. Breast, areola, and nipples
B. Chest, neck, arms, and legs
C. Abdomen, breast, and thighs
D. Cheeks, forehead, and nose

Answer & Explanation:
Correct Answer: D. Cheeks, forehead, and nose
Explanation: Chloasma, also known as the “mask of pregnancy,” is a pigmentation condition that appears as brownish patches on the face, specifically the cheeks, forehead, and nose. It is caused by increased melanocyte-stimulating hormone.

Question 6:
A pregnant client states that she “waddles” when she walks. The nurse’s explanation is based on which of the following as the cause?
A. The large size of the newborn
B. Pressure on the pelvic muscles
C. Relaxation of the pelvic joints
D. Excessive weight gain

Answer & Explanation:
Correct Answer: C. Relaxation of the pelvic joints
Explanation: The hormone relaxin causes ligaments and joints throughout the pelvis to soften and relax in preparation for delivery. This increases pelvic mobility but also alters the woman’s gait, leading to the characteristic “waddling” walk.

Question 7:
Which of the following represents the average amount of weight gained during pregnancy?
A. 12 to 22 lb
B. 15 to 25 lb
C. 24 to 30 lb
D. 25 to 40 lb

Answer & Explanation:
Correct Answer: C. 24 to 30 lb
Explanation: For a woman of normal pre-pregnancy weight, the recommended total weight gain is typically 25 to 35 pounds (approx. 11-16 kg) . The option 24-30 lb is the closest approximation to this evidence-based recommendation.

Question 8:
When talking with a pregnant client who is experiencing aching swollen, leg veins, the nurse would explain that this is most probably the result of which of the following?
A. Thrombophlebitis
B. Pregnancy-induced hypertension
C. Pressure on blood vessels from the enlarging uterus
D. The force of gravity pulling down on the uterus

Answer & Explanation:
Correct Answer: C. Pressure on blood vessels from the enlarging uterus
Explanation: The gravid uterus presses on the pelvic veins and the inferior vena cava, impeding venous return from the lower extremities. This increased venous pressure causes the veins to distend and become swollen and aching (varicose veins).

Question 9:
Cervical softening and uterine souffle are classified as which of the following?
A. Diagnostic signs
B. Presumptive signs
C. Probable signs
D. Positive signs

Answer & Explanation:
Correct Answer: C. Probable signs
Explanation: Probable signs are objective findings detected by an examiner that strongly suggest pregnancy but could also be caused by other conditions. Cervical softening (Goodell’s sign) and uterine souffle (the sound of blood flowing through uterine arteries) fall into this category.

Question 10:
Which of the following would the nurse identify as a presumptive sign of pregnancy?
A. Hegar sign
B. Nausea and vomiting
C. Skin pigmentation changes
D. Positive serum pregnancy test

Answer & Explanation:
Correct Answer: B. Nausea and vomiting
Explanation: Presumptive signs are subjective symptoms reported by the woman, which are the least reliable indicators as they can be caused by other factors. Nausea and vomiting (“morning sickness”) is a classic presumptive sign. Hegar’s sign is probable; a positive test is diagnostic/positive.

Question 11:
Which of the following common emotional reactions to pregnancy would the nurse expect to occur during the first trimester?
A. Introversion, egocentrism, narcissism
B. Awkwardness, clumsiness, and unattractiveness
C. Anxiety, passivity, extroversion
D. Ambivalence, fear, fantasies

Answer & Explanation:
Correct Answer: D. Ambivalence, fear, fantasies
Explanation: The first trimester is often characterized by ambivalence (mixed feelings about the pregnancy), fear (of miscarriage, of the unknown), and fantasies about the baby’s sex and appearance, even if the woman is happy about the pregnancy.

Question 12:
During which of the following would the focus of classes be mainly on physiologic changes, fetal development, sexuality, during pregnancy, and nutrition?
A. Prepregnant period
B. First trimester
C. Second trimester
D. Third trimester

Answer & Explanation:
Correct Answer: C. Second trimester
Explanation: By the second trimester, the risk of miscarriage has dropped, and the woman is usually feeling better physically. This is an ideal time for education focused on the normal physiologic changes she is experiencing, fetal development, and ensuring proper nutrition for the growing baby.

Question 13:
Which of the following would be disadvantage of breast feeding?
A. Involution occurs more rapidly
B. The incidence of allergies increases due to maternal antibodies
C. The father may resent the infant’s demands on the mother’s body
D. There is a greater chance for error during preparation

Answer & Explanation:
Correct Answer: C. The father may resent the infant’s demands on the mother’s body
Explanation: While breastfeeding has overwhelming benefits, a potential disadvantage is the psychosocial dynamic where the father might feel left out or jealous of the intense physical bond and demands the baby has on the mother, leading to feelings of resentment if not managed well.

Question 14:
Which of the following would cause a false-positive result on a pregnancy test?
A. The test was performed less than 10 days after an abortion
B. The test was performed too early or too late in the pregnancy
C. The urine sample was stored too long at room temperature
D. A spontaneous abortion or a missed abortion is impending

Answer & Explanation:
Correct Answer: A. The test was performed less than 10 days after an abortion
Explanation: A false-positive means the test says “pregnant” when the woman is not. After an abortion or delivery, hCG levels remain in the blood and urine for a period of time (up to a few weeks). Performing a test during this time will detect residual hCG, leading to a false-positive result.

Question 15:
FHR can be auscultated with a fetoscope as early as which of the following?
A. 5 weeks gestation
B. 10 weeks gestation
C. 15 weeks gestation
D. 20 weeks gestation

Answer & Explanation:
Correct Answer: D. 20 weeks gestation
Explanation: A fetoscope is a mechanical stethoscope, not a Doppler ultrasound. The fetal heart rate is typically not audible with a fetoscope until 20 weeks of gestation or later. A Doppler can detect it much earlier (around 10-12 weeks).

---

Question 16:
A client’s last menstrual period (LMP) began July 5. Her estimated date of delivery (EDD) should be which of the following?
A. January 2
B. March 28
C. April 12
D. October 12

Answer & Explanation:
Correct Answer: C. April 12
Explanation: To calculate EDD using Naegele’s rule, subtract 3 months and add 7 days to the first day of the LMP. July 5 minus 3 months = April 5; plus 7 days = April 12 .

Question 17:
Which of the following fundal heights indicates less than 12 weeks’ gestation when the date of the LMP is unknown?
A. Uterus in the pelvis
B. Uterus at the xiphoid
C. Uterus in the abdomen
D. Uterus at the umbilicus

Answer & Explanation:
Correct Answer: A. Uterus in the pelvis
Explanation: Before 12 weeks gestation, the uterus remains a pelvic organ and cannot be palpated abdominally. It rises out of the pelvis into the abdominal cavity around 12 weeks, where it becomes palpable just above the symphysis pubis .

Question 18:
Which of the following danger signs should be reported promptly during the antepartum period?
A. Constipation
B. Breast tenderness
C. Nasal stuffiness
D. Leaking amniotic fluid

Answer & Explanation:
Correct Answer: D. Leaking amniotic fluid
Explanation: Leaking amniotic fluid suggests rupture of the amniotic membranes, which increases the risk of ascending infection, cord prolapse, and preterm labor. This requires immediate medical evaluation. Constipation, breast tenderness, and nasal stuffiness are common discomforts of pregnancy .

Question 19:
Which of the following prenatal laboratory test values would the nurse consider as significant?
A. Hematocrit 33.5%
B. Rubella titer less than 1:8
C. White blood cells 8,000/mm³
D. One-hour glucose challenge test 110 g/dL

Answer & Explanation:
Correct Answer: B. Rubella titer less than 1:8
Explanation: A rubella titer less than 1:8 indicates non-immunity to rubella. This is significant because contracting rubella during early pregnancy can cause serious fetal anomalies. Non-immune clients should receive the MMR vaccine postpartum. The other values are within normal ranges for pregnancy .

Question 20:
Which of the following characteristics of contractions would the nurse expect to find in a client experiencing true labor?
A. Occurring at irregular intervals
B. Starting mainly in the abdomen
C. Gradually increasing intervals
D. Increasing intensity with walking

Answer & Explanation:
Correct Answer: D. Increasing intensity with walking
Explanation: True labor contractions become more regular, longer, and stronger over time. They typically start in the back and radiate to the abdomen. Importantly, they increase in intensity with walking or activity, whereas false labor contractions often decrease or stop with activity .

Question 21:
During which of the following stages of labor would the nurse assess “crowning”?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage

Answer & Explanation:
Correct Answer: B. Second stage
Explanation: Crowning refers to the point when the fetal head remains visible between contractions without slipping back inside. This occurs during the second stage of labor, which begins with full cervical dilation (10 cm) and ends with delivery of the fetus .

Question 22:
Barbiturates are usually not given for pain relief during active labor for which of the following reasons?
A. The neonatal effects include hypotonia, hypothermia, generalized drowsiness, and reluctance to feed for the first few days.
B. These drugs readily cross the placental barrier, causing depressive effects in the newborn 2 to 3 hours after intramuscular injection.
C. They rapidly transfer across the placenta, and lack of an antagonist make them generally inappropriate during labor.
D. Adverse reactions may include maternal hypotension, allergic or toxic reaction, or partial or total respiratory failure.

Answer & Explanation:
Correct Answer: C. They rapidly transfer across the placenta, and lack of an antagonist make them generally inappropriate during labor.
Explanation: Barbiturates rapidly cross the placenta and can cause significant neonatal respiratory depression. Unlike narcotics, barbiturates have no available antagonist to reverse their effects, making them particularly dangerous during active labor when delivery may be imminent .

Question 23:
Which of the following nursing interventions would the nurse perform during the third stage of labor?
A. Obtain a urine specimen and other laboratory tests.
B. Assess uterine contractions every 30 minutes.
C. Coach for effective client pushing.
D. Promote parent-newborn interaction.

Answer & Explanation:
Correct Answer: D. Promote parent-newborn interaction.
Explanation: The third stage of labor begins immediately after birth of the infant and ends with delivery of the placenta. During this stage, the nurse promotes parent-newborn interaction through early skin-to-skin contact and bonding opportunities. Coaching for pushing occurs in the second stage .

Question 24:
Which of the following actions demonstrates the nurse’s understanding about the newborn’s thermoregulatory ability?
A. Placing the newborn under a radiant warmer.
B. Suctioning with a bulb syringe.
C. Obtaining an Apgar score.
D. Inspecting the newborn’s umbilical cord.

Answer & Explanation:
Correct Answer: A. Placing the newborn under a radiant warmer.
Explanation: Newborns have poor thermoregulation due to a large surface area-to-body weight ratio, minimal subcutaneous fat, and immature temperature control centers. Placing the newborn under a radiant warmer prevents cold stress and conserves glucose and oxygen resources .

Question 25:
Immediately before expulsion, which of the following cardinal movements occur?
A. Descent
B. Flexion
C. Extension
D. External rotation

Answer & Explanation:
Correct Answer: C. Extension
Explanation: The cardinal movements of labor occur in sequence: engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and expulsion. Extension occurs as the fetal head passes under the symphysis pubis and extends to deliver the face, occurring immediately before expulsion .

Question 26:
Before birth, which of the following structures connects the right and left auricles of the heart?
A. Umbilical vein
B. Foramen ovale
C. Ductus arteriosus
D. Ductus venosus

Answer & Explanation:
Correct Answer: B. Foramen ovale
Explanation: The foramen ovale is an opening in the interatrial septum of the fetal heart that allows blood to bypass the non-functioning fetal lungs by shunting blood directly from the right atrium to the left atrium. It normally closes shortly after birth .

Question 27:
Which of the following when present in the urine may cause a reddish stain on the diaper of a newborn?
A. Mucus
B. Uric acid crystals
C. Bilirubin
D. Excess iron

Answer & Explanation:
Correct Answer: B. Uric acid crystals
Explanation: Uric acid crystals are commonly found in newborn urine during the first week of life and may cause a pink or reddish-orange “brick dust” stain on diapers. This is a normal, transient finding that requires no intervention, though it sometimes alarms parents .

Question 28:
When assessing the newborn’s heart rate, which of the following ranges would be considered normal if the newborn were sleeping?
A. 80 beats per minute
B. 100 beats per minute
C. 120 beats per minute
D. 140 beats per minute

Answer & Explanation:
Correct Answer: C. 120 beats per minute
Explanation: The normal newborn heart rate ranges from 110-160 beats per minute when awake but may drop to 85-100 bpm during deep sleep. Among the options, 120 bpm is within the normal range for a sleeping newborn, though 100 bpm would be borderline low .

Question 29:
Which of the following is true regarding the fontanels of the newborn?
A. The anterior is triangular shaped; the posterior is diamond shaped.
B. The posterior closes at 18 months; the anterior closes at 8 to 12 weeks.
C. The anterior is large in size when compared to the posterior fontanel.
D. The anterior is bulging; the posterior appears sunken.

Answer & Explanation:
Correct Answer: C. The anterior is large in size when compared to the posterior fontanel.
Explanation: The anterior fontanel is diamond-shaped, measures approximately 4-6 cm, and closes between 12-18 months. The posterior fontanel is triangular, much smaller (0.5-1 cm), and closes by 2-3 months. A bulging fontanel indicates increased intracranial pressure .

Question 30:
Which of the following groups of newborn reflexes below are present at birth and remain unchanged through adulthood?
A. Blink, cough, rooting, and gag
B. Blink, cough, sneeze, and gag
C. Rooting, sneeze, swallowing, and cough
D. Stepping, blink, cough, and sneeze

Answer & Explanation:
Correct Answer: B. Blink, cough, sneeze, and gag
Explanation: Blink, cough, sneeze, and gag are protective reflexes that persist throughout life. In contrast, primitive reflexes like rooting, sucking, stepping, and Moro are present at birth but become integrated and disappear as the nervous system matures .

Question 31:
Which of the following describes the Babinski reflex?
A. The newborn’s toes will hyperextend and fan apart from dorsiflexion of the big toe when one side of the foot is stroked upward from the ball of the heel and across the ball of the foot.
B. The newborn abducts and flexes all extremities and may begin to cry when exposed to sudden movement or loud noise.
C. The newborn turns the head in the direction of stimulus, opens the mouth, and begins to suck when cheek, lip, or corner of mouth is touched.
D. The newborn will attempt to crawl forward with both arms and legs when he is placed on his abdomen on a flat surface.

Answer & Explanation:
Correct Answer: A. The newborn’s toes will hyperextend and fan apart from dorsiflexion of the big toe when one side of the foot is stroked upward from the ball of the heel and across the ball of the foot.
Explanation: The Babinski reflex is elicited by stroking the lateral aspect of the sole from heel to toe. A positive response is dorsiflexion of the great toe and fanning of the other toes. This is normal in newborns and infants up to 12 months but indicates upper motor neuron lesion in adults .

Question 32:
Which of the following statements best describes hyperemesis gravidarum?
A. Severe anemia leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
B. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
C. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing maternal nutrients.
D. Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding.

Answer & Explanation:
Correct Answer: B. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
Explanation: Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy that extends beyond typical “morning sickness.” It is characterized by persistent vomiting leading to weight loss (>5% of pre-pregnancy weight), dehydration, electrolyte imbalances, and ketonuria, requiring medical intervention .

Question 33:
Which of the following would the nurse identify as a classic sign of PIH?
A. Edema of the feet and ankles
B. Edema of the hands and face
C. Weight gain of 1 lb/week
D. Early morning headache

Answer & Explanation:
Correct Answer: B. Edema of the hands and face
Explanation: While some dependent edema of feet and ankles is common in pregnancy, edema of the hands and face (non-dependent edema) is a classic sign of Pregnancy-Induced Hypertension (PIH), now referred to as gestational hypertension or preeclampsia. This indicates generalized fluid retention and requires further assessment for proteinuria and elevated blood pressure .

Question 34:
In which of the following types of spontaneous abortions would the nurse assess dark brown vaginal discharge and a negative pregnancy test?
A. Threatened
B. Imminent
C. Missed
D. Incomplete

Answer & Explanation:
Correct Answer: C. Missed abortion
Explanation: A missed abortion occurs when the embryo or fetus dies but is retained within the uterus. The woman may experience dark brown vaginal discharge due to old blood, and pregnancy tests become negative as hCG levels fall. The cervix remains closed, and there may be no active bleeding or pain .

Question 35:
A primigravida at 38 weeks gestation is admitted with contractions every 3 minutes, lasting 60 seconds, strong in intensity. Cervical examination reveals 6 cm dilation, 90% effacement, and 0 station. Which phase of labor is this client experiencing?
A. Latent phase
B. Active phase
C. Transition phase
D. Prodromal labor

Answer & Explanation:
Correct Answer: B. Active phase
Explanation: The active phase of the first stage of labor is characterized by cervical dilation from approximately 4-7 cm, with more rapid dilation (1-1.2 cm/hour in nulliparas). Contractions are regular, strong, and frequent (every 2-5 minutes). This client’s findings of 6 cm dilation confirm she is in active labor.

Question 36:
A newborn is 5 minutes old and has a heart rate of 110 bpm, slow irregular respirations, some flexion of extremities, grimaces to suctioning, and has pink body with blue extremities. What is this newborn’s Apgar score?
A. 5
B. 6
C. 7
D. 8

Answer & Explanation:
Correct Answer: C. 7
Explanation: Calculating Apgar scores: Heart rate 110 bpm = 2; Respirations slow/irregular = 1; Muscle tone some flexion = 1; Reflex irritability grimace = 1; Color pink body/blue extremities (acrocyanosis) = 1. Total = 7. This is a normal, healthy newborn transitioning well.

Question 37:
Which of the following nursing interventions is most appropriate for a client with premature rupture of membranes (PROM) at 34 weeks gestation?
A. Perform a vaginal exam to assess dilation
B. Administer oral fluids liberally
C. Assess maternal temperature every 2-4 hours
D. Prepare the client for immediate cesarean section

Answer & Explanation:
Correct Answer: C. Assess maternal temperature every 2-4 hours
Explanation: With PROM, the risk of chorioamnionitis (intra-amniotic infection) increases. Frequent temperature assessment is essential for early detection of infection. Vaginal exams are minimized to reduce infection risk. Management depends on gestational age and infection signs.

Question 38:
A postpartum client who delivered 6 hours ago has a fundus that is boggy, deviated to the right, and located 2 cm above the umbilicus. The nurse’s first action should be to:
A. Notify the healthcare provider immediately
B. Massage the fundus until firm and assist the client to empty her bladder
C. Increase the IV oxytocin rate
D. Document the findings as normal for 6 hours postpartum

Answer & Explanation:
Correct Answer: B. Massage the fundus until firm and assist the client to empty her bladder
Explanation: A boggy fundus displaced to the right suggests uterine atony and a distended bladder. A full bladder displaces the uterus upward and to the side, preventing effective contraction. The nurse should first massage the fundus to promote firmness and then assist the client to void.

Question 39:
Which of the following is an early sign of postpartum hemorrhage?
A. Bradycardia
B. Increased blood pressure
C. Profuse bright red vaginal bleeding
D. Saturation of one perineal pad per hour

Answer & Explanation:
Correct Answer: C. Profuse bright red vaginal bleeding
Explanation: Postpartum hemorrhage is defined as blood loss >500 mL after vaginal delivery or >1000 mL after cesarean section. Profuse bright red bleeding is an early, obvious sign. Vital sign changes (tachycardia, hypotension) occur later after significant blood loss has already occurred.

Question 40:
When assessing a newborn at 24 hours of age, the nurse notes a yellow tint to the skin on the face and chest. The remainder of the assessment is normal. This finding most likely indicates:
A. Pathological jaundice requiring exchange transfusion
B. Physiological jaundice related to immature liver function
C. Hemolytic disease from ABO incompatibility
D. Biliary atresia

Answer & Explanation:
Correct Answer: B. Physiological jaundice related to immature liver function
Explanation: Physiological jaundice typically appears after the first 24 hours of life (usually day 2-3) as the newborn’s immature liver cannot adequately conjugate bilirubin from broken-down fetal red blood cells. It typically peaks on day 3-5 and resolves without treatment. Jaundice within the first 24 hours is pathological.

Question 41:
A client in active labor requests an epidural for pain relief. Which of the following assessment findings would require the nurse to withhold the epidural and notify the provider?
A. Cervical dilation of 5 cm
B. Platelet count of 90,000/mm³
C. Blood pressure of 130/80 mmHg
D. Temperature of 37.2°C (99°F)

Answer & Explanation:
Correct Answer: B. Platelet count of 90,000/mm³
Explanation: A low platelet count (thrombocytopenia) is a contraindication for epidural placement due to the risk of spinal epidural hematoma from bleeding into the spinal column. Normal platelet count is 150,000-400,000/mm³. A level of 90,000 increases bleeding risk significantly.

Question 42:
Which of the following is a positive sign of pregnancy?
A. Positive pregnancy test
B. Fetal heart tones detected by Doppler
C. Chadwick’s sign
D. Ballottement

Answer & Explanation:
Correct Answer: B. Fetal heart tones detected by Doppler
Explanation: Positive signs of pregnancy are objective evidence of the fetus itself and include: auscultation of fetal heart tones, visualization of the fetus by ultrasound, and palpation of fetal movements by an examiner. A positive pregnancy test and Chadwick’s sign are probable signs only.

Question 43:
A newborn is exhibiting nasal flaring, grunting, and intercostal retractions. The nurse interprets these as signs of:
A. Neurological immaturity
B. Respiratory distress
C. Hypoglycemia
D. Normal newborn transition

Answer & Explanation:
Correct Answer: B. Respiratory distress
Explanation: Nasal flaring, grunting, and intercostal retractions are classic signs of respiratory distress in the newborn. These compensatory mechanisms indicate the newborn is working harder to breathe due to conditions such as respiratory distress syndrome, transient tachypnea, or meconium aspiration.

Question 44:
A client with preeclampsia is receiving magnesium sulfate. Which of the following assessment findings would indicate magnesium toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate of 14 breaths per minute
C. Urine output of 40 mL/hour
D. Decreased level of consciousness

Answer & Explanation:
Correct Answer: D. Decreased level of consciousness
Explanation: Magnesium toxicity progresses in a predictable pattern: loss of deep tendon reflexes (usually at 8-10 mEq/L), then respiratory depression (10-12 mEq/L), and finally cardiac arrest and decreased level of consciousness (15-17 mEq/L). Decreased consciousness indicates severe toxicity requiring immediate intervention with calcium gluconate.

Question 45:
Which of the following positions is most appropriate for a client in the second stage of labor with a fetus in the occiput posterior position?
A. Supine with legs together
B. Lithotomy position
C. Hands and knees position
D. Semi-Fowler’s position

Answer & Explanation:
Correct Answer: C. Hands and knees position
Explanation: The hands and knees position (or kneeling position) uses gravity and changes the pelvic diameter, which can encourage the fetus to rotate from the occiput posterior position to the more favorable occiput anterior position. This may relieve severe back pain (“back labor”) associated with OP position.

Question 46:
A breastfeeding mother reports sore, cracked nipples. Which of the following suggestions would be most helpful?
A. Limit breastfeeding to every 4 hours to allow nipples to heal
B. Apply soap and water thoroughly after each feeding
C. Ensure the baby’s mouth covers most of the areola during latching
D. Use plastic breast shields between feedings

Answer & Explanation:
Correct Answer: C. Ensure the baby’s mouth covers most of the areola during latching
Explanation: Sore, cracked nipples most commonly result from improper latch. Teaching the mother to ensure the baby’s mouth covers a large portion of the areola (not just the nipple) reduces friction and trauma. Breast milk applied to nipples and air drying also promotes healing.

Question 47:
Which of the following findings in a 2-hour-old newborn requires immediate notification of the pediatrician?
A. Apical heart rate of 158 bpm while awake
B. Respiratory rate of 68 breaths per minute
C. Central cyanosis of the trunk and lips
D. Passage of first meconium stool

Answer & Explanation:
Correct Answer: C. Central cyanosis of the trunk and lips
Explanation: Central cyanosis (bluish discoloration of the trunk, lips, and mucous membranes) indicates hypoxemia and suggests serious cardiac or respiratory pathology. Acrocyanosis (blue hands and feet) is normal in the first 24-48 hours. Tachycardia and tachypnea may be normal, and meconium passage is expected.

Question 48:
The nurse is assessing a client’s lochia on postpartum day 3. Which finding would be considered normal?
A. Bright red bleeding with small clots
B. Pinkish-brown serosanguineous discharge
C. White to yellowish discharge
D. Heavy bleeding with large clots

Answer & Explanation:
Correct Answer: B. Pinkish-brown serosanguineous discharge
Explanation: Lochia progresses through three stages: lochia rubra (bright red, days 1-3), lochia serosa (pinkish-brown, serosanguineous, days 4-10), and lochia alba (white-yellow, days 11-21+). On day 3, the transition from rubra to serosa begins, so pinkish-brown discharge is appropriate.

Question 49:
A pregnant client at 28 weeks gestation reports occasional painless tightening of her uterus that lasts about 30 seconds and resolves spontaneously. The nurse explains these are:
A. True labor contractions requiring assessment
B. Braxton Hicks contractions, which are common in the third trimester
C. Signs of preterm labor
D. Uterine hyperstimulation

Answer & Explanation:
Correct Answer: B. Braxton Hicks contractions, which are common in the third trimester
Explanation: Braxton Hicks contractions are irregular, painless uterine tightenings that occur throughout pregnancy but become more noticeable in the third trimester. They do not cause cervical change and are considered “practice contractions.” They differ from true labor contractions, which are regular, increase in intensity, and cause cervical change.

Question 50:
Which of the following immunizations is contraindicated during pregnancy?
A. Tetanus toxoid
B. Hepatitis B vaccine
C. Measles, mumps, rubella (MMR) vaccine
D. Inactivated influenza vaccine

Answer & Explanation:
Correct Answer: C. Measles, mumps, rubella (MMR) vaccine
Explanation: Live virus vaccines such as MMR, varicella, and live attenuated influenza vaccine are contraindicated during pregnancy due to theoretical risk of fetal transmission. Inactivated vaccines (tetanus, hepatitis B, inactivated influenza) are considered safe and are recommended when indicated.

---

Topic 2: NMC Code and Professional Practice (Ethics & Law)

This section covers the standards expected by the Nursing and Midwifery Council of Ghana, focusing on the professional code of conduct, legal frameworks, patient rights, and the functions of regulatory bodies. These NMC past questions and answers reflect the types of ethical scenarios you will encounter in the licensure examination .

Question 51:
According to the NMC, Ghana, which of the following is a key ethical code of conduct that all nurses must adhere to?
A. Prioritizing personal beliefs over patient care
B. Maintaining patient confidentiality at all times
C. Sharing patient information with family without consent
D. Delegating all tasks to junior staff

Answer & Explanation:
Correct Answer: B. Maintaining patient confidentiality at all times
Explanation: Confidentiality is a fundamental ethical principle in healthcare. The NMC, Ghana prescribes that nurses must protect patient information and only share it with authorized individuals involved in the patient’s care. Breaching confidentiality undermines trust and violates professional standards .

Question 52:
Which of the following is a primary function of the Nursing and Midwifery Council of Ghana (NMCG)?
A. Advocating for improved nurse salaries
B. Organizing social events for nurses
C. Setting and maintaining standards for nursing education programs
D. Providing legal assistance to nurses in malpractice cases

Answer & Explanation:
Correct Answer: C. Setting and maintaining standards for nursing education programs
Explanation: The NMCG is the regulatory body responsible for ensuring that nursing and midwifery training programs meet established standards. This includes curriculum approval, school accreditation, and quality assurance. While other organizations like the Ghana Registered Nurses Association (GRNA) handle advocacy and welfare, regulation is the core function of the NMC .

Question 53:
A patient refuses a prescribed treatment after receiving full information about the procedure. The nurse should recognize this as exercising which patient right?
A. The right to informed consent
B. The right to refuse treatment
C. The right to access medical records
D. The right to a second opinion

Answer & Explanation:
Correct Answer: B. The right to refuse treatment
Explanation: Patient autonomy includes both the right to accept and the right to refuse treatment. Even when a nurse believes a treatment is beneficial, the patient has the legal and ethical right to decline after understanding the risks and consequences. This refusal must be respected and documented .

Question 54:
Myra Levine’s Conservation Model includes four principles. Which principle would be prioritized when positioning a hemiplegic patient to prevent contractures?
A. Conservation of energy
B. Conservation of structural integrity
C. Conservation of personal integrity
D. Conservation of social integrity

Answer & Explanation:
Correct Answer: B. Conservation of structural integrity
Explanation: Structural integrity refers to maintaining the body’s anatomical and physiological wholeness. Proper positioning, range of motion exercises, and preventing contractures in a hemiplegic patient directly preserve musculoskeletal structure and function .

Question 55:
According to Maslow’s Hierarchy of Needs, which of the following must be addressed first in a patient experiencing acute respiratory distress?
A. Self-esteem needs
B. Love and belonging needs
C. Physiological needs (airway, breathing)
D. Self-actualization needs

Answer & Explanation:
Correct Answer: C. Physiological needs (airway, breathing)
Explanation: Maslow’s hierarchy places physiological needs (air, water, food, shelter) at the base as the most fundamental. Before any higher-level needs can be considered, the patient’s airway, breathing, and circulation must be stabilized. This prioritization guides nursing clinical judgment .

Question 56:
Which of the following best defines “informed consent”?
A. A patient signing a form without reading it
B. A doctor telling a patient what will be done
C. A patient voluntarily agreeing to a procedure after understanding its risks, benefits, and alternatives
D. A family member deciding for an unconscious patient

Answer & Explanation:
Correct Answer: C. A patient voluntarily agreeing to a procedure after understanding its risks, benefits, and alternatives
Explanation: Informed consent is a process, not just a signature. It requires that the patient has decision-making capacity, receives adequate information (including risks, benefits, and alternatives), and voluntarily agrees to the procedure without coercion .

Question 57:
A nurse discovers she made a medication error. The most appropriate action based on ethical principles is to:
A. Ignore the error and hope no harm occurs
B. Document the medication as given correctly
C. Report the error immediately and assess the patient
D. Blame another staff member

Answer & Explanation:
Correct Answer: C. Report the error immediately and assess the patient
Explanation: Ethical practice requires honesty and integrity. The nurse’s primary duty is patient safety. Reporting the error immediately allows for prompt assessment and intervention to prevent harm. Covering up errors violates professional trust and the NMC code .

Question 58:
Which of the following is an activity of the Ghana Registered Nurses Association (GRNA)?
A. Disciplining nurses for professional misconduct
B. Accrediting nursing training institutions
C. Advocating for improved working conditions and fair compensation for nurses
D. Setting the licensure examination passing score

Answer & Explanation:
Correct Answer: C. Advocating for improved working conditions and fair compensation for nurses
Explanation: The GRNA is a professional association that advocates for the welfare of its members, including salary negotiations, working conditions, and continuing professional development. Regulatory functions like discipline and accreditation belong to the NMC .

Question 59:
A patient’s family requests information about the patient’s diagnosis. The patient is alert and oriented but has not given permission to share information. The nurse should:
A. Provide full information to the family
B. Inform the family that confidentiality prevents sharing without the patient’s consent
C. Share only the basic information
D. Ask the doctor to speak with the family privately

Answer & Explanation:
Correct Answer: B. Inform the family that confidentiality prevents sharing without the patient’s consent
Explanation: Confidentiality is a legal and ethical duty owed to the patient. If the patient is competent and has not consented, the nurse must respect their privacy. The nurse can encourage the patient to speak with their family or facilitate a conversation, but cannot disclose information unilaterally .

Question 60:
Which of the following is a quality of a professional midwife?
A. Impatience with clients
B. Poor communication skills
C. Empathy and compassion
D. Disregard for evidence-based practice

Answer & Explanation:
Correct Answer: C. Empathy and compassion
Explanation: A professional midwife must demonstrate empathy and compassion to provide holistic, patient-centered care. These qualities help build trust with mothers and families during the vulnerable perinatal period. The other options are contrary to professional standards .

Question 61:
What is the primary purpose of law in nursing and midwifery practice?
A. To make nursing care more difficult
B. To protect the rights of clients and healthcare professionals
C. To limit the scope of nursing practice
D. To increase hospital revenue

Answer & Explanation:
Correct Answer: B. To protect the rights of clients and healthcare professionals
Explanation: Law in healthcare establishes standards of practice, defines scope, and provides a framework for accountability. Its purpose is to protect both the public and practitioners by ensuring safe, competent, and ethical care .

Question 62:
A midwife’s responsibility in relation to the law includes:
A. Ignoring suspected abuse to avoid conflict
B. Maintaining inaccurate records to protect the hospital
C. Reporting any suspected cases of abuse or neglect
D. Discussing patient cases on social media

Answer & Explanation:
Correct Answer: C. Reporting any suspected cases of abuse or neglect
Explanation: Midwives are mandated reporters. Legally and ethically, they must report any suspicion of child abuse, domestic violence, or neglect to the appropriate authorities. Failure to do so may result in legal consequences and professional discipline .

Question 63:
Which of the following patient rights ensures that a patient can request another healthcare provider’s opinion about their condition?
A. Right to pain management
B. Right to a second opinion
C. Right to refuse treatment
D. Right to access medical records

Answer & Explanation:
Correct Answer: B. Right to a second opinion
Explanation: Patients have the right to seek additional medical opinions to confirm a diagnosis or explore alternative treatment options. This right supports informed decision-making and patient autonomy .

Question 64:
A nurse is caring for a patient from a different cultural background who requests a traditional healer visit while hospitalized. The nurse should:
A. Refuse the request immediately
B. Ignore the request
C. Respect the patient’s cultural beliefs and accommodate the request if safe and permitted by hospital policy
D. Ridicule the patient’s beliefs

Answer & Explanation:
Correct Answer: C. Respect the patient’s cultural beliefs and accommodate the request if safe and permitted by hospital policy
Explanation: Culturally sensitive care is an essential component of professional nursing. Respecting diverse beliefs and practices, within safety boundaries, upholds patient dignity and the ethical principle of beneficence .

Question 65:
In the context of nursing ethics, what does “veracity” mean?
A. Keeping promises
B. Doing good
C. Truthfulness
D. Avoiding harm

Answer & Explanation:
Correct Answer: C. Truthfulness
Explanation: Veracity is the ethical principle of truthfulness. It requires healthcare providers to be honest with patients and not deliberately deceive or mislead them. This principle underpins trust in the therapeutic relationship.

Question 66:
According to the NMC code, a nurse who practices beyond their level of competence is violating which standard?
A. Prioritizing people
B. Preserving safety
C. Promoting professionalism and trust
D. All of the above

Answer & Explanation:
Correct Answer: D. All of the above
Explanation: Practicing beyond competence compromises safety (risk of harm), fails to prioritize people (by not providing safe care), and damages professionalism and trust. The Code requires nurses to recognize and work within the limits of their knowledge and skill.

Question 67:
Which of the following is an example of a crime in nursing practice?
A. Forgetting to document a dressing change
B. Willfully and intentionally administering a lethal dose of medication
C. Accidentally giving the wrong time for a patient’s medication
D. Being late for a shift

Answer & Explanation:
Correct Answer: B. Willfully and intentionally administering a lethal dose of medication
Explanation: A crime involves an act that violates the law and is punishable by the state. Intentional harm to a patient, such as murder or assault, is a criminal offense. Negligent errors are typically addressed through civil litigation or professional discipline, not criminal prosecution .

Question 68:
The principle of “non-maleficence” in healthcare means:
A. Doing good for the patient
B. Respecting patient choices
C. Avoiding harm to the patient
D. Being fair and just

Answer & Explanation:
Correct Answer: C. Avoiding harm to the patient
Explanation: Non-maleficence is the ethical principle of “first, do no harm.” It requires healthcare providers to avoid causing injury or suffering to patients, whether through acts of commission or omission.

Question 69:
A client in the hospital has the right to:
A. Be discriminated against based on tribe
B. Receive respectful and dignified care
C. Have their pain ignored
D. Be denied access to their medical records

Answer & Explanation:
Correct Answer: B. Receive respectful and dignified care
Explanation: All patients have the right to be treated with respect and dignity, regardless of their background, condition, or circumstances. This is a fundamental human right and a cornerstone of ethical healthcare .

Question 70:
What is the main difference between the GRNA and the NMC?
A. There is no difference; they are the same organization
B. GRNA is for midwives only; NMC is for nurses only
C. GRNA is a professional association for welfare; NMC is a regulatory body for standards and discipline
D. GRNA sets examination questions; NMC advocates for salaries

Answer & Explanation:
Correct Answer: C. GRNA is a professional association for welfare; NMC is a regulatory body for standards and discipline
Explanation: The GRNA functions as a trade union and professional association focused on member welfare. The NMC is the statutory regulatory body with legal authority to set standards, register practitioners, and discipline those who violate the code .

Question 71:
When applying Myra Levine’s principle of “conservation of personal integrity” to a patient with a new colostomy, the nurse should:
A. Focus only on the physical care of the stoma
B. Minimize the patient’s involvement in care
C. Respect the patient’s privacy, support emotional adjustment, and affirm their identity
D. Discourage questions about body image

Answer & Explanation:
Correct Answer: C. Respect the patient’s privacy, support emotional adjustment, and affirm their identity
Explanation: Personal integrity refers to the patient’s sense of identity, self-worth, and wholeness. A new colostomy can threaten this. Nursing care must address emotional and psychological needs, not just physical tasks .

Question 72:
Which of the following is NOT a function of law in nursing and midwifery?
A. Establishing standards of practice
B. Protecting client rights
C. Increasing nurses’ personal income
D. Providing a framework for dispute resolution

Answer & Explanation:
Correct Answer: C. Increasing nurses’ personal income
Explanation: While labor laws may influence compensation, the primary functions of law in professional practice are regulation, protection, and accountability. Income is a matter of employment contracts and negotiation, not a direct function of healthcare law .

Question 73:
A nurse observes a colleague taking medications from the unit for personal use. The most appropriate action is to:
A. Ignore it to avoid conflict
B. Confront the colleague publicly
C. Report the observation to the nurse manager immediately
D. Ask the colleague to share the medication

Answer & Explanation:
Correct Answer: C. Report the observation to the nurse manager immediately
Explanation: Theft of medications is a serious legal and ethical violation. The nurse has a duty to protect patients and uphold professional standards by reporting the observed misconduct through proper channels.

Question 74:
The ethical principle of “justice” in healthcare refers to:
A. Doing good for the patient
B. Being fair and distributing resources equitably
C. Telling the truth
D. Keeping promises

Answer & Explanation:
Correct Answer: B. Being fair and distributing resources equitably
Explanation: Justice requires that patients be treated fairly and that healthcare resources be distributed without discrimination based on age, gender, ethnicity, socioeconomic status, or other non-medical factors.

Question 75:
In Maslow’s Hierarchy, which level includes needs such as friendship, intimacy, and family?
A. Physiological
B. Safety
C. Love and belonging
D. Esteem

Answer & Explanation:
Correct Answer: C. Love and belonging
Explanation: The third level of Maslow’s hierarchy encompasses social needs: relationships, belonging, love, and connection with others. These needs emerge after physiological and safety needs are reasonably satisfied .

Question 76:
A patient has the right to be free from unnecessary physical restraint. This falls under which category of rights?
A. Right to treatment
B. Right to refuse treatment
C. Right to respectful and dignified care
D. Right to information

Answer & Explanation:
Correct Answer: C. Right to respectful and dignified care
Explanation: Using restraints unnecessarily is a form of indignity and a violation of patient autonomy. Patients have the right to be free from physical or chemical restraints except in emergencies where there is imminent risk of harm to self or others .

Question 77:
What is “fidelity” in nursing ethics?
A. Telling the truth
B. Doing good
C. Avoiding harm
D. Keeping promises and being faithful to commitments

Answer & Explanation:
Correct Answer: D. Keeping promises and being faithful to commitments
Explanation: Fidelity is the principle of faithfulness. It involves being loyal, keeping promises, and following through on commitments made to patients and colleagues. It is essential for building trusting relationships.

Question 78:
Which of the following would be considered battery in healthcare?
A. Failing to give a medication on time
B. Performing a procedure on a patient who has refused consent
C. Documenting incorrectly
D. Speaking rudely to a patient

Answer & Explanation:
Correct Answer: B. Performing a procedure on a patient who has refused consent
Explanation: Battery is the intentional, non-consensual touching of another person. In healthcare, any procedure performed without the patient’s consent (or after consent is withdrawn) constitutes battery, even if it is medically beneficial.

Question 79:
The NMC’s role in “discipline” involves:
A. Organizing social events for nurses
B. Investigating complaints against nurses and midwives
C. Negotiating salary increases
D. Publishing nursing textbooks

Answer & Explanation:
Correct Answer: B. Investigating complaints against nurses and midwives
Explanation: As a regulatory body, the NMC has the legal authority to receive complaints, conduct hearings, and impose sanctions on practitioners who breach professional standards. This protects the public from unsafe practice .

Question 80:
A patient who is alert and oriented asks the nurse not to share their diagnosis with their spouse. The nurse should:
A. Tell the spouse anyway because they are family
B. Respect the patient’s wish and maintain confidentiality
C. Disclose only the prognosis, not the diagnosis
D. Ignore the patient’s request

Answer & Explanation:
Correct Answer: B. Respect the patient’s wish and maintain confidentiality
Explanation: A competent adult patient has the right to control the disclosure of their health information. The nurse must respect the patient’s autonomy and confidentiality unless there is an overriding legal or safety concern (e.g., threat of harm) .

Question 81:
Which of the following is a responsibility of a midwife according to the NMC?
A. Prescribing all medications independently
B. Performing surgeries
C. Providing antenatal, intrapartum, and postnatal care
D. Diagnosing rare genetic disorders

Answer & Explanation:
Correct Answer: C. Providing antenatal, intrapartum, and postnatal care
Explanation: The core role of a midwife is to provide care throughout the childbirth continuum: antenatal (pregnancy), intrapartum (labor and delivery), and postnatal (after birth) care for both mother and newborn. This is within their defined scope of practice .

Question 82:
According to Myra Levine, conserving energy in a patient with severe chest pain would include:
A. Encouraging ambulation
B. Promoting bed rest and minimizing unnecessary activities
C. Providing a heavy meal
D. Discouraging sleep

Answer & Explanation:
Correct Answer: B. Promoting bed rest and minimizing unnecessary activities
Explanation: Chest pain, especially in suspected myocardial infarction, increases cardiac workload. Conserving energy through rest reduces myocardial oxygen demand and prevents further cardiac strain, aligning with Levine’s principle .

Question 83:
Which of the following statements about informed consent is TRUE?
A. Consent is valid indefinitely once signed
B. Consent must be obtained by the nurse in all cases
C. Consent can be withdrawn by the patient at any time
D. Consent is not needed for emergency procedures under any circumstances

Answer & Explanation:
Correct Answer: C. Consent can be withdrawn by the patient at any time
Explanation: Consent is an ongoing process, not a one-time event. A patient has the right to withdraw consent at any point during a procedure or treatment, and healthcare providers must respect this withdrawal immediately.

Question 84:
A nurse’s legal responsibility for accurate documentation is based on the fact that:
A. Records are legal documents that may be used in court
B. Documentation takes time away from patient care
C. Only doctors need to document
D. Electronic records are optional

Answer & Explanation:
Correct Answer: A. Records are legal documents that may be used in court
Explanation: The patient’s health record is a legal document. Accurate, timely, and complete documentation provides evidence of the care provided and is essential for defending against malpractice claims or other legal actions .

Question 85:
A quality of a professional midwife includes:
A. Arrogance
B. Disrespect for client autonomy
C. Commitment to evidence-based practice
D. Resistance to learning new skills

Answer & Explanation:
Correct Answer: C. Commitment to evidence-based practice
Explanation: Professional midwives must base their care on current, valid research evidence to ensure safe and effective outcomes. A commitment to evidence-based practice reflects dedication to quality and lifelong learning .

Question 86:
The term “tort” in law refers to:
A. A criminal act
B. A civil wrong committed against a person or property
C. A type of medication
D. A hospital policy

Answer & Explanation:
Correct Answer: B. A civil wrong committed against a person or property
Explanation: A tort is a civil wrong (as opposed to a criminal wrong) for which the injured party may seek legal remedy, usually in the form of damages. Negligence and malpractice are examples of torts in healthcare.

Question 87:
Which of the following is an element required to prove negligence?
A. The patient was dissatisfied
B. The nurse was having a bad day
C. Duty, breach of duty, causation, and damages
D. The hospital lost money

Answer & Explanation:
Correct Answer: C. Duty, breach of duty, causation, and damages
Explanation: To prove negligence in court, four elements must be established: 1) The nurse owed a duty to the patient, 2) The nurse breached that duty (failed to meet the standard of care), 3) The breach caused the injury, and 4) Actual damages (harm) occurred.

Question 88:
A patient’s right to pain management means the nurse should:
A. Ignore complaints of pain
B. Assume the patient is exaggerating
C. Assess pain regularly and intervene appropriately
D. Wait for the patient to scream before acting

Answer & Explanation:
Correct Answer: C. Assess pain regularly and intervene appropriately
Explanation: Pain is often called the “fifth vital sign.” Patients have a right to adequate pain assessment and management. The nurse must use validated tools, believe the patient’s report of pain, and implement appropriate interventions .

Question 89:
According to the NMC code, “promote professionalism and trust” includes:
A. Being honest and acting with integrity
B. Gossiping about patients
C. Ignoring professional boundaries
D. Refusing to update skills

Answer & Explanation:
Correct Answer: A. Being honest and acting with integrity
Explanation: Upholding the reputation of the profession requires nurses to act with honesty and integrity at all times. This includes being a role model, maintaining boundaries, and justifying the public’s trust .

Question 90:
In the scenario of Mrs. White with chest pain, applying Levine’s “conservation of social integrity” involves:
A. Monitoring her blood pressure
B. Providing supplemental oxygen
C. Supporting communication between Mrs. White and her husband
D. Positioning her for comfort

Answer & Explanation:
Correct Answer: C. Supporting communication between Mrs. White and her husband
Explanation: Social integrity refers to the patient’s connections with others—family, community, and support systems. Allowing and facilitating the husband’s presence and addressing their shared concerns preserves Mrs. White’s social wholeness .

Question 91:
Which of the following is an example of a midwife’s role in health education?
A. Performing a C-section
B. Prescribing antibiotics for a cold
C. Teaching a new mother how to breastfeed and care for her newborn
D. Diagnosing cancer

Answer & Explanation:
Correct Answer: C. Teaching a new mother how to breastfeed and care for her newborn
Explanation: Health education is a core midwifery responsibility. Teaching new mothers about breastfeeding, newborn hygiene, danger signs, and family planning empowers them and promotes positive health outcomes .

Question 92:
What does “scope of practice” mean?
A. The range of roles and procedures that a healthcare professional is legally permitted to perform
B. The physical area of the hospital where a nurse works
C. The nurse’s preferred tasks
D. The number of years a nurse has practiced

Answer & Explanation:
Correct Answer: A. The range of roles and procedures that a healthcare professional is legally permitted to perform
Explanation: Scope of practice is defined by legislation, regulatory bodies (like the NMC), and employer policies. It outlines what activities a practitioner is educated, competent, and authorized to perform. Practicing outside this scope is a violation .

Question 93:
A patient who is a minor (under 18) requires surgery. Consent should generally be obtained from:
A. The patient
B. The parent or legal guardian
C. Any adult relative
D. The hospital administrator

Answer & Explanation:
Correct Answer: B. The parent or legal guardian
Explanation: Minors are generally considered legally incompetent to give consent. Permission for medical treatment must be obtained from a parent or legal guardian, except in specific circumstances (emancipated minors, emergencies, certain reproductive health services as defined by law).

Question 94:
The NMC’s function of “registration” means:
A. Listing qualified nurses and midwives in an official register
B. Enrolling nurses in social events
C. Registering nurses for vacation leave
D. Signing nurses up for insurance

Answer & Explanation:
Correct Answer: A. Listing qualified nurses and midwives in an official register
Explanation: Registration is the process by which the NMC verifies that an individual has met all requirements (education, examination) and enters their name into the official register. Only registered practitioners may legally practice .

Question 95:
Which of the following best describes “advocacy” in nursing?
A. Speaking on behalf of the patient to protect their rights and interests
B. Making all decisions for the patient
C. Ignoring the patient’s wishes
D. Following doctor’s orders without question

Answer & Explanation:
Correct Answer: A. Speaking on behalf of the patient to protect their rights and interests
Explanation: Patient advocacy is a fundamental nursing role. It involves supporting the patient’s decisions, protecting their rights, ensuring they have information to make informed choices, and intervening when their best interests are at risk.

Question 96:
A nurse who fails to monitor a post-operative patient’s vital signs as ordered, and the patient hemorrhages, may be liable for:
A. Assault
B. Battery
C. Negligence
D. Slander

Answer & Explanation:
Correct Answer: C. Negligence
Explanation: Negligence is the failure to act as a reasonably prudent nurse would act in a similar situation, resulting in harm to the patient. Failing to monitor as ordered is a breach of duty that can lead to liability if it causes harm.

Question 97:
According to the rights of the patient, a client is entitled to:
A. Free medications always
B. Immediate discharge upon request regardless of medical condition
C. Make decisions about their own care
D. Have all family members present in the operating room

Answer & Explanation:
Correct Answer: C. Make decisions about their own care
Explanation: The right to participate in care decisions is fundamental to patient autonomy. While rights have limits (e.g., a patient cannot demand inappropriate treatment), they are entitled to be active participants in their healthcare planning .

Question 98:
A midwife’s responsibility to maintain accurate records is primarily for:
A. Impressing the hospital administrators
B. Ensuring continuity of care and providing a legal record
C. Keeping busy during quiet shifts
D. Testing handwriting skills

Answer & Explanation:
Correct Answer: B. Ensuring continuity of care and providing a legal record
Explanation: Accurate records ensure that all healthcare team members have the information needed to provide consistent care. They also serve as the legal document of the care provided, protecting both the patient and the professional .

Question 99:
Which ethical principle is primarily involved when a nurse respects a patient’s decision to refuse a blood transfusion based on religious beliefs?
A. Beneficence
B. Non-maleficence
C. Autonomy
D. Justice

Answer & Explanation:
Correct Answer: C. Autonomy
Explanation: Respecting a patient’s right to make their own decisions, even when the nurse disagrees, is an application of the principle of autonomy. This principle recognizes the patient’s right to self-determination based on their personal values and beliefs.

Question 100:
Completing this set of professional adjustment questions helps the nurse candidate:
A. Guarantee a perfect exam score
B. Understand the ethical and legal frameworks governing Ghanaian nursing practice
C. Skip studying clinical subjects
D. Replace clinical experience entirely

Answer & Explanation:
Correct Answer: B. Understand the ethical and legal frameworks governing Ghanaian nursing practice
Explanation: Practicing with NMC past questions and answers on professional adjustment prepares candidates for the significant portion of the licensure exam dedicated to ethics and law. This knowledge is essential for safe, legal, and ethical practice as a registered nurse in Ghana .

---

Topic 3: Medical-Surgical Nursing & Fundamentals

This section tests your knowledge of common adult health conditions and basic nursing interventions.

Question 101:
A nurse delegates a task to a healthcare assistant. What is the nurse’s primary responsibility regarding this delegation?
A. The nurse is no longer accountable for the outcome.
B. The healthcare assistant assumes full accountability.
C. The nurse remains accountable for the overall care and the appropriateness of the delegation.
D. Accountability is shared equally between the nurse and the assistant.

Answer & Explanation:
Correct Answer: C. The RN retains accountability for the overall care of the patient. While the responsibility for performing the task is transferred, the nurse is accountable for the decision to delegate, for ensuring the delegate is competent, and for the proper supervision and follow-up.

Here is the continuation and completion of the NMC past questions and answers article, covering questions 101 through 150 on Medical-Surgical Nursing, Fundamentals, and Pharmacology.

---

Topic 3: Medical-Surgical Nursing & Fundamentals

This section tests your knowledge of common adult health conditions, nursing interventions, pharmacology, and basic patient care principles. Mastering these NMC past questions and answers is essential, as Medical-Surgical Nursing typically constitutes the largest portion of the Ghana licensure examination.

Question 101:
A nurse is preparing to administer an intramuscular injection to an adult patient. Which of the following sites is the safest and most recommended for IM injections in adults?
A. Deltoid muscle
B. Dorsogluteal site
C. Ventrogluteal site
D. Rectus femoris muscle

Answer & Explanation:
Correct Answer: C. Ventrogluteal site
Explanation: The ventrogluteal site (over the greater trochanter) is the preferred IM site for adults because it is free of major nerves and blood vessels, has a thick muscle layer, and has consistent anatomy. The dorsogluteal site is near the sciatic nerve and superior gluteal artery, posing greater risk of injury .

Question 102:
A patient with type 1 diabetes mellitus is exhibiting confusion, diaphoresis, and tachycardia. The nurse should first:
A. Administer insulin
B. Give the patient a glass of orange juice
C. Check the patient’s blood glucose level
D. Call the doctor immediately

Answer & Explanation:
Correct Answer: C. Check the patient’s blood glucose level
Explanation: The symptoms described (confusion, sweating, rapid heart rate) suggest hypoglycemia, but the nurse must confirm this with a blood glucose measurement before intervening. However, if the patient is unconscious or cannot swallow, emergency protocols (like glucagon or IV dextrose) would supersede oral glucose administration. Checking blood glucose is the immediate assessment step .

Question 103:
Which of the following positions is most appropriate for a patient who just underwent a lumbar puncture?
A. Supine position
B. Prone position
C. High Fowler’s position
D. Lithotomy position

Answer & Explanation:
Correct Answer: A. Supine position
Explanation: After a lumbar puncture, the patient should remain supine (flat on back) for several hours to prevent cerebrospinal fluid (CSF) leakage from the puncture site, which can cause a “spinal headache.” Fluids are also encouraged .

Question 104:
A nurse is caring for a patient with a nasogastric (NG) tube set to low intermittent suction. Which of the following findings would indicate the tube is functioning properly?
A. The patient reports nausea
B. The suction canister contains gastric contents
C. The abdomen is distended
D. No drainage is noted for 8 hours

Answer & Explanation:
Correct Answer: B. The suction canister contains gastric contents
Explanation: Proper function of an NG tube on suction is evidenced by the presence of gastric drainage in the collection canister. Nausea, abdominal distention, and lack of drainage suggest the tube may be clogged, misplaced, or not connected properly .

Question 105:
Which of the following is the priority nursing diagnosis for a patient with a new colostomy?
A. Disturbed body image
B. Risk for impaired skin integrity
C. Deficient knowledge regarding stoma care
D. Social isolation

Answer & Explanation:
Correct Answer: B. Risk for impaired skin integrity
Explanation: While all options are valid, using Maslow’s Hierarchy and airway/breathing/circulation/ safety priorities, Risk for impaired skin integrity is often the immediate physiological priority. Digestive enzymes in stool can quickly excoriate the peristomal skin, leading to pain and infection. Addressing body image and knowledge deficits follows once physical safety is ensured .

Question 106:
A patient is receiving a blood transfusion. Fifteen minutes after the infusion begins, the patient reports chills, low back pain, and appears flushed. The nurse’s FIRST action should be to:
A. Slow the infusion rate
B. Notify the healthcare provider
C. Stop the transfusion immediately
D. Administer diphenhydramine (Benadryl)

Answer & Explanation:
Correct Answer: C. Stop the transfusion immediately
Explanation: These symptoms indicate a possible transfusion reaction. The first and most critical action is to stop the transfusion to prevent more of the incompatible or reactive blood from entering the patient. After stopping, the nurse maintains IV access with normal saline, notifies the provider, and returns the blood bag to the lab for analysis .

Question 107:
Which of the following techniques is correct for measuring blood pressure?
A. Using a cuff that is too small for the patient’s arm
B. Applying the cuff over thick clothing
C. Positioning the patient’s arm at heart level
D. Deflating the cuff rapidly to hear sounds quickly

Answer & Explanation:
Correct Answer: C. Positioning the patient’s arm at heart level
Explanation: For an accurate blood pressure reading, the patient’s arm must be supported and positioned at the level of the heart. An incorrect cuff size, clothing under the cuff, or rapid deflation will yield inaccurate readings .

Question 108:
A nurse is assessing a patient’s wound and notes yellow, thick drainage. The nurse documents this finding as:
A. Serous drainage
B. Sanguineous drainage
C. Serosanguineous drainage
D. Purulent drainage

Answer & Explanation:
Correct Answer: D. Purulent drainage
Explanation: Purulent drainage is thick, yellow, green, or brown exudate indicating infection. Serous drainage is clear and watery (like plasma). Sanguineous is bloody. Serosanguineous is thin, pink, and watery (mix of blood and serum) .

Question 109:
When administering oxygen to a patient with chronic obstructive pulmonary disease (COPD), the nurse should:
A. Administer high flow oxygen (8-10 L/min)
B. Administer low flow oxygen (1-2 L/min)
C. Withhold oxygen to avoid respiratory depression
D. Administer oxygen only if the patient is cyanotic

Answer & Explanation:
Correct Answer: B. Administer low flow oxygen (1-2 L/min)
Explanation: Patients with severe COPD may have a hypoxic drive to breathe, meaning their primary stimulus to breathe is low oxygen levels rather than high CO2 levels. Administering high concentrations of oxygen can remove this drive, leading to respiratory depression and carbon dioxide narcosis. Low flow oxygen is used to maintain SaO2 at 88-92% .

Question 110:
A nurse is inserting a Foley catheter. After inserting the catheter and obtaining urine, the nurse inflates the balloon. The patient suddenly cries out in pain. What should the nurse do?
A. Continue with the procedure as some discomfort is expected
B. Deflate the balloon immediately and advance the catheter further
C. Ignore the pain and document the procedure as complete
D. Withdraw the catheter completely and start over

Answer & Explanation:
Correct Answer: B. Deflate the balloon immediately and advance the catheter further
Explanation: Pain during balloon inflation indicates the balloon is likely still in the urethra, not fully in the bladder. The nurse should immediately deflate the balloon, advance the catheter another 1-2 inches to ensure it is in the bladder, and then reinflate the balloon .

Question 111:
A patient has orders for an IV infusion of 1000 mL of 0.9% Normal Saline to run over 8 hours. The IV tubing has a drop factor of 15 gtts/mL. What is the correct flow rate in drops per minute?
A. 21 gtts/min
B. 31 gtts/min
C. 125 gtts/min
D. 250 gtts/min

Answer & Explanation:
Correct Answer: B. 31 gtts/min
Explanation: Formula: (Total volume × Drop factor) / Time in minutes = (1000 mL × 15 gtts/mL) / (8 hours × 60 minutes) = (15,000) / (480) = 31.25 gtts/min (rounded to 31 gtts/min) .

Question 112:
Which of the following is an early sign of hypoxia?
A. Bradycardia
B. Restlessness and anxiety
C. Deep, regular respirations
D. Hypertension

Answer & Explanation:
Correct Answer: B. Restlessness and anxiety
Explanation: Restlessness, anxiety, and confusion are often the earliest signs of cerebral hypoxia. The body’s initial response to low oxygen is agitation. As hypoxia worsens, bradycardia, bradypnea, and cyanosis may appear as late signs .

Question 113:
A nurse is providing discharge teaching to a patient with a new prescription for warfarin (Coumadin). Which of the following foods should the patient be instructed to avoid eating in large, consistent amounts?
A. Apples
B. Green leafy vegetables (spinach, kale)
C. Chicken
D. Rice

Answer & Explanation:
Correct Answer: B. Green leafy vegetables (spinach, kale)
Explanation: Warfarin acts by antagonizing vitamin K. Green leafy vegetables are high in vitamin K, which can reverse the effects of warfarin and reduce its anticoagulant properties. Patients should be taught to maintain a consistent intake of vitamin K-rich foods, not necessarily avoid them entirely .

Question 114:
When caring for a patient with a tracheostomy, which of the following actions is most important to prevent infection?
A. Changing the tracheostomy ties daily
B. Suctioning the airway every hour
C. Using sterile technique during tracheostomy care and suctioning
D. Keeping the humidifier off to keep the stoma dry

Answer & Explanation:
Correct Answer: C. Using sterile technique during tracheostomy care and suctioning
Explanation: The tracheostomy provides a direct portal of entry to the lower airway, bypassing the body’s natural upper airway defenses. Strict sterile technique (sterile gloves, sterile catheter, sterile solutions) during care and suctioning is essential to prevent introducing pathogens into the lungs .

Question 115:
A patient with heart failure has pitting edema in the lower extremities. Which of the following nursing interventions is most appropriate?
A. Elevate the patient’s legs above the level of the heart
B. Keep the patient’s legs in a dependent position
C. Apply warm compresses to the feet
D. Restrict movement of the legs

Answer & Explanation:
Correct Answer: A. Elevate the patient’s legs above the level of the heart
Explanation: Elevating the extremities uses gravity to promote venous return and mobilize excess interstitial fluid, helping to reduce edema. Dependent positioning would worsen edema .

Question 116:
Which of the following assessments is a priority for a patient receiving intravenous furosemide (Lasix)?
A. Blood glucose levels
B. Serum potassium levels
C. Liver function tests
D. Hemoglobin and hematocrit

Answer & Explanation:
Correct Answer: B. Serum potassium levels
Explanation: Furosemide is a loop diuretic that can cause significant potassium loss (hypokalemia) . Hypokalemia can lead to life-threatening cardiac dysrhythmias. Monitoring potassium levels and assessing for signs of hypokalemia (muscle weakness, ECG changes) is a priority .

Question 117:
A patient has a nursing diagnosis of “Impaired physical mobility related to pain.” Which of the following nursing interventions is most appropriate?
A. Encourage complete bed rest
B. Administer pain medication before activity
C. Perform all activities for the patient
D. Restrict visitors to minimize stimulation

Answer & Explanation:
Correct Answer: B. Administer pain medication before activity
Explanation: To promote mobility, the nurse should address the barrier—pain. Administering analgesics prior to planned activities helps the patient participate more effectively in ambulation, turning, and exercises, preventing complications of immobility .

Question 118:
Which of the following is a priority assessment for a patient in traction?
A. Fluid intake
B. Nutritional status
C. Neurovascular status of the affected extremity
D. Bowel elimination patterns

Answer & Explanation:
Correct Answer: C. Neurovascular status of the affected extremity
Explanation: Traction devices can compress nerves and blood vessels. Frequent assessment of neurovascular status (the 6 Ps: Pain, Pulselessness, Pallor, Paresthesia, Paralysis, Poikilothermia) is critical to detect early signs of compartment syndrome or nerve damage .

Question 119:
A nurse is preparing to administer digoxin (Lanoxin). Which of the following apical pulse rates would require holding the dose and notifying the provider?
A. 72 beats per minute
B. 68 beats per minute
C. 58 beats per minute
D. 80 beats per minute

Answer & Explanation:
Correct Answer: C. 58 beats per minute
Explanation: Digoxin increases the force of myocardial contraction and slows the heart rate. The apical pulse should be assessed for one full minute before administration. The general guideline is to hold the dose and notify the provider if the apical pulse is below 60 bpm in an adult, as this may indicate toxicity or excessive slowing .

Question 120:
A patient has a chest tube connected to a water-seal drainage system. Which of the following findings indicates the system is functioning correctly?
A. Continuous bubbling in the water-seal chamber
B. No fluctuation (tidaling) in the water-seal chamber
C. Intermittent bubbling in the suction control chamber
D. Drainage that suddenly stops after an initial period of drainage

Answer & Explanation:
Correct Answer: C. Intermittent bubbling in the suction control chamber
Explanation: Intermittent bubbling in the suction control chamber is expected when suction is applied. Tidaling (fluctuation) in the water-seal chamber with respiration is normal. Continuous bubbling in the water-seal chamber indicates an air leak .

Question 121:
Which of the following is the most common cause of acute pancreatitis?
A. Viral infection
B. Gallstones and alcohol abuse
C. High protein diet
D. Trauma

Answer & Explanation:
Correct Answer: B. Gallstones and alcohol abuse
Explanation: The two most common causes of acute pancreatitis are gallstones (impacted in the common bile duct) and chronic heavy alcohol consumption, accounting for approximately 80% of cases .

Question 122:
A patient is diagnosed with deep vein thrombosis (DVT) in the left leg. Which of the following nursing interventions is most appropriate?
A. Massage the affected leg to promote circulation
B. Apply warm, moist compresses to the leg
C. Encourage active range of motion exercises
D. Measure the circumference of both legs daily

Answer & Explanation:
Correct Answer: D. Measure the circumference of both legs daily
Explanation: For a patient with DVT, daily measurement and comparison of leg circumferences helps monitor for progression or resolution of edema. Massage is contraindicated as it can dislodge the clot. Warm compresses may be ordered, but measurement is a key assessment .

Question 123:
A patient has a seizure while the nurse is in the room. Which of the following actions should the nurse take FIRST?
A. Insert a tongue blade to protect the airway
B. Restrain the patient’s movements to prevent injury
C. Turn the patient to the side if possible
D. Call for help immediately

Answer & Explanation:
Correct Answer: C. Turn the patient to the side if possible
Explanation: The priority during a seizure is maintaining a patent airway and preventing aspiration. If possible, the nurse should gently turn the patient to the side to allow secretions to drain. Never force objects into the mouth. Restraints can cause injury .

Question 124:
Which of the following is a sign of digoxin toxicity?
A. Tachycardia and hypertension
B. Nausea, vomiting, and anorexia
C. Increased appetite and weight gain
D. Diarrhea and hyperglycemia

Answer & Explanation:
Correct Answer: B. Nausea, vomiting, and anorexia
Explanation: Gastrointestinal symptoms such as nausea, vomiting, anorexia, and abdominal pain are often early signs of digoxin toxicity. Visual disturbances (yellow-green halos, blurred vision) and cardiac dysrhythmias are also common .

Question 125:
A patient with a fractured femur has been in skeletal traction for several days. The nurse notes that the patient is suddenly short of breath, tachypneic, and anxious. The nurse should suspect:
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Anxiety attack

Answer & Explanation:
Correct Answer: C. Pulmonary embolism
Explanation: Long bone fractures (like the femur) carry a high risk of fat embolism syndrome. Sudden onset of respiratory distress, tachypnea, and anxiety in a patient with a recent fracture or traction should raise immediate suspicion of a pulmonary embolism (fat or clot). This is a life-threatening emergency .

Question 126:
A nurse is providing colostomy care. Which of the following observations indicates that the stoma is healthy?
A. Pale, dry appearance
B. Dark purple or black color
C. Moist, red, and slightly edematous appearance
D. Excessive bleeding when touched

Answer & Explanation:
Correct Answer: C. Moist, red, and slightly edematous appearance
Explanation: A healthy, viable stoma should be moist, pink to red in color, and may appear slightly swollen post-operatively. A pale, dusky, or purple/black stoma indicates ischemia or necrosis .

Question 127:
When assessing a patient’s pain, the nurse understands that the most reliable indicator of pain is:
A. The patient’s self-report
B. Objective vital sign changes
C. The nurse’s personal opinion
D. Observations of family members

Answer & Explanation:
Correct Answer: A. The patient’s self-report
Explanation: Pain is subjective. The patient’s self-report of pain is the single most reliable indicator of its existence and intensity. Vital signs may or may not correlate with pain, especially in chronic pain patients .

Question 128:
A patient with a fever has an order for acetaminophen (Paracetamol). The nurse understands that this medication works by:
A. Killing bacteria
B. Blocking pain receptors in the brain
C. Acting on the hypothalamus to reduce the set point
D. Increasing blood flow to the skin

Answer & Explanation:
Correct Answer: C. Acting on the hypothalamus to reduce the set point
Explanation: Antipyretics like acetaminophen work by inhibiting prostaglandin synthesis in the hypothalamus, which lowers the body’s temperature “set point.” This allows the body to initiate heat-loss mechanisms .

Question 129:
Which of the following nursing actions is most important when caring for a patient receiving a continuous IV infusion of heparin?
A. Monitoring blood glucose levels
B. Monitoring partial thromboplastin time (PTT)
C. Monitoring liver function tests
D. Monitoring serum electrolytes

Answer & Explanation:
Correct Answer: B. Monitoring partial thromboplastin time (PTT)
Explanation: Heparin therapy is monitored by the activated partial thromboplastin time (aPTT or PTT) . This test measures the intrinsic pathway of coagulation, which heparin affects. The dose is adjusted to maintain a therapeutic PTT level (usually 1.5-2.5 times the control) .

Question 130:
A patient with pneumonia has a fever, chills, and productive cough with green sputum. Which of the following nursing diagnoses is highest priority?
A. Activity intolerance
B. Ineffective airway clearance
C. Imbalanced nutrition: less than body requirements
D. Social isolation

Answer & Explanation:
Correct Answer: B. Ineffective airway clearance
Explanation: The priority for a patient with pneumonia is maintaining a clear airway to ensure adequate oxygenation and ventilation. Ineffective airway clearance related to excessive secretions is the most immediate physiological threat .

Question 131:
A patient is ordered 500 mg of oral amoxicillin. The available tablets are 250 mg each. How many tablets should the nurse administer?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets
D. 4 tablets

Answer & Explanation:
Correct Answer: C. 2 tablets
Explanation: Desired dose (500 mg) ÷ Available dose (250 mg/tablet) = 2 tablets .

Question 132:
Which of the following is a classic sign of a hemolytic transfusion reaction?
A. Hypertension and bradycardia
B. Flank pain and dark urine
C. Warm, dry skin
D. Constipation

Answer & Explanation:
Correct Answer: B. Flank pain and dark urine
Explanation: In a hemolytic reaction (incompatible blood), antibodies attack the donor red blood cells. This can cause flank or low back pain (from kidney involvement) and hemoglobinuria (dark urine from free hemoglobin). Fever, chills, and hypotension are also common .

Question 133:
A nurse is suctioning a patient’s endotracheal tube. Each suction pass should last no longer than:
A. 5 seconds
B. 10-15 seconds
C. 30 seconds
D. 60 seconds

Answer & Explanation:
Correct Answer: B. 10-15 seconds
Explanation: Suctioning removes oxygen as well as secretions. Prolonged suctioning can cause severe hypoxemia and cardiac dysrhythmias. The standard recommendation is to limit each suction pass to 10-15 seconds .

Question 134:
A patient is admitted with diabetic ketoacidosis (DKA). Which of the following assessment findings would the nurse expect?
A. Slow, deep respirations (Kussmaul)
B. Bradycardia and hypertension
C. Jugular venous distention
D. Moist, productive cough

Answer & Explanation:
Correct Answer: A. Slow, deep respirations (Kussmaul)
Explanation: In DKA, the body attempts to compensate for metabolic acidosis by blowing off carbon dioxide through Kussmaul respirations—deep, rapid, and labored breathing. Fruity (acetone) breath odor is also common .

Question 135:
When administering an enema, the nurse should position the patient in which of the following positions?
A. Supine
B. Prone
C. Left Sims’ position
D. High Fowler’s

Answer & Explanation:
Correct Answer: C. Left Sims’ position
Explanation: The left Sims’ position (left side-lying with right knee flexed) allows the enema solution to follow the natural anatomical curve of the sigmoid colon and rectum, facilitating retention and effectiveness .

Question 136:
A patient is receiving morphine sulfate for severe post-operative pain. Which of the following is a priority nursing assessment?
A. Blood pressure
B. Pain level
C. Respiratory rate and depth
D. Level of consciousness

Answer & Explanation:
Correct Answer: C. Respiratory rate and depth
Explanation: While all are important, the most critical side effect of morphine is respiratory depression. The nurse must assess respiratory rate and depth before and after administration, especially with IV push .

Question 137:
A patient on bed rest needs to be moved up in bed. Which of the following techniques should the nurse use to reduce friction and shearing?
A. Pull the patient by the arms
B. Use a draw sheet and have the patient bend their knees
C. Push the patient from the feet
D. Ask the patient to lift themselves with the trapeze without assistance

Answer & Explanation:
Correct Answer: B. Use a draw sheet and have the patient bend their knees
Explanation: Using a draw sheet (lift sheet) to move the patient distributes the force and reduces friction. Asking the patient to bend their knees and push with their feet helps them assist, further reducing shear forces on the skin .

Question 138:
Which of the following is an indication for using a pureed diet?
A. Patient with no teeth or difficulty chewing
B. Patient with diabetes needing portion control
C. Patient with hypertension needing low sodium
D. Patient with a fractured jaw who is wired shut

Answer & Explanation:
Correct Answer: A. Patient with no teeth or difficulty chewing
Explanation: A pureed diet consists of foods that are blended to a smooth, pudding-like consistency. It is indicated for patients who have difficulty chewing or swallowing, such as those with no teeth, oral surgeries, or neurological conditions. A patient with a wired jaw would require a liquid diet .

Question 139:
A nurse is caring for a patient with a fecal impaction. The nurse expects the patient to exhibit which of the following?
A. Frequent, small, liquid stools
B. Constipation for one day
C. Hard, formed stools daily
D. Black, tarry stools

Answer & Explanation:
Correct Answer: A. Frequent, small, liquid stools
Explanation: A classic sign of fecal impaction is paradoxical diarrhea—the leakage of liquid stool around the impacted fecal mass. The patient may also report an inability to pass formed stool and abdominal discomfort .

Question 140:
When assessing a patient’s IV site, the nurse notes swelling, coolness, and pallor. The infusion is running slowly. The nurse suspects:
A. Phlebitis
B. Infiltration
C. Infection
D. Circulatory overload

Answer & Explanation:
Correct Answer: B. Infiltration
Explanation: Infiltration occurs when IV fluid leaks into the surrounding tissue. Signs include swelling, coolness (fluid is room temperature), pallor, and a sluggish flow rate. Phlebitis presents with warmth, redness, and a palpable venous cord .

Question 141:
Which of the following patients is at highest risk for developing a pressure ulcer?
A. A patient who is ambulatory with incontinence
B. A patient who is bedridden and incontinent
C. A patient who eats a balanced diet
D. A patient who turns independently every 2 hours

Answer & Explanation:
Correct Answer: B. A patient who is bedridden and incontinent
Explanation: The highest risk factors for pressure ulcers are immobility (prolonged pressure) and moisture (incontinence macerates skin). A bedridden, incontinent patient has both major risk factors .

Question 142:
A patient has a seizure disorder and is prescribed phenytoin (Dilantin). Which of the following statements indicates the patient needs further teaching?
A. “I will need to see my dentist regularly.”
B. “I can stop taking this medication once I am seizure-free for a month.”
C. “I should not suddenly stop taking this medication.”
D. “I should wear a medical alert bracelet.”

Answer & Explanation:
Correct Answer: B. “I can stop taking this medication once I am seizure-free for a month.”
Explanation: Antiepileptic drugs like phenytoin must be taken consistently to maintain therapeutic blood levels. Abruptly stopping the medication can precipitate withdrawal seizures and status epilepticus. The medication is typically taken for years, often for life .

Question 143:
A nurse is changing a postoperative dressing and notes the wound edges are separated, with loops of intestine visible. What should the nurse do first?
A. Apply a tight abdominal binder
B. Attempt to reinsert the organs
C. Cover the wound with sterile, saline-soaked gauze
D. Leave the wound open to air

Answer & Explanation:
Correct Answer: C. Cover the wound with sterile, saline-soaked gauze
Explanation: This describes wound dehiscence with evisceration (protrusion of organs). This is a surgical emergency. The nurse should cover the exposed organs with sterile gauze moistened with sterile normal saline to keep them moist and prevent trauma, then notify the surgeon immediately .

Question 144:
A patient with a urinary tract infection (UTI) complains of burning on urination. The nurse documents this symptom as:
A. Hematuria
B. Dysuria
C. Oliguria
D. Nocturia

Answer & Explanation:
Correct Answer: B. Dysuria
Explanation: Dysuria refers to painful or difficult urination, often described as burning. Hematuria is blood in urine. Oliguria is low urine output. Nocturia is excessive urination at night .

Question 145:
Which of the following is the correct method for measuring intake and output?
A. Measuring solids in ounces
B. Estimating the amount of urine voided
C. Measuring all liquids the patient takes in and all liquids the patient puts out
D. Recording only oral fluids

Answer & Explanation:
Correct Answer: C. Measuring all liquids the patient takes in and all liquids the patient puts out
Explanation: Accurate I&O requires measuring and recording all sources of intake (oral, IV, tube feedings) and all output (urine, vomitus, diarrhea, drainage from tubes) to assess fluid balance accurately .

Question 146:
A patient is to have a wound culture taken from a surgical site. Which of the following actions is correct?
A. Culture the old, dried drainage
B. Cleanse the wound with sterile saline before obtaining the culture
C. Swab the wound edges only
D. Obtain the culture from the area with the most pus using a rotating motion

Answer & Explanation:
Correct Answer: D. Obtain the culture from the area with the most pus using a rotating motion
Explanation: The culture should be obtained from a clean area of exudate, rotating the swab to ensure adequate collection of organisms. Old, dried drainage contains non-viable organisms. The wound may be cleansed of old debris first, but the culture should target fresh exudate .

Question 147:
A nurse is preparing to administer an eye drop. Which of the following techniques is correct?
A. Instill the drop directly onto the cornea
B. Have the patient look down and close eyes tightly
C. Pull the lower eyelid down to form a conjunctival sac and instill the drop there
D. Place the dropper directly against the eye to prevent waste

Answer & Explanation:
Correct Answer: C. Pull the lower eyelid down to form a conjunctival sac and instill the drop there
Explanation: Eye drops should be instilled into the lower conjunctival sac, not directly on the cornea (which is sensitive). The dropper should not touch the eye to prevent contamination .

Question 148:
Which of the following is a common side effect of opioid analgesics that the nurse must anticipate and manage?
A. Diarrhea
B. Constipation
C. Hypertension
D. Hyperventilation

Answer & Explanation:
Correct Answer: B. Constipation
Explanation: Opioids slow peristalsis throughout the gastrointestinal tract, leading to constipation. This side effect does not diminish with time, so a bowel regimen (stool softeners, stimulants, increased fluids/fiber) should be started concurrently .

Question 149:
A patient has just returned from the post-anesthesia care unit (PACU) after abdominal surgery. The nurse should position the patient in:
A. Supine with head flat
B. Side-lying (lateral) position
C. High Fowler’s position
D. Trendelenburg position

Answer & Explanation:
Correct Answer: B. Side-lying (lateral) position
Explanation: The immediate post-operative position is often side-lying (or supine with head turned to the side) to maintain a patent airway and allow drainage of secretions, preventing aspiration until the patient is fully awake and has protective reflexes .

Question 150:
A patient with hypertension is prescribed a low-sodium diet. Which of the following food choices by the patient indicates understanding of the teaching?
A. Canned soup and crackers
B. Fresh grilled chicken with steamed vegetables
C. Processed cheese and deli meat sandwich
D. French fries with ketchup

Answer & Explanation:
Correct Answer: B. Fresh grilled chicken with steamed vegetables
Explanation: A low-sodium diet emphasizes fresh, unprocessed foods. Fresh chicken and vegetables are naturally low in sodium. Canned soups, processed meats, cheeses, and fast foods are very high in sodium .

---

People Also Ask (FAQ) About NMC Past Questions

1. Where can I download NMC past questions and answers for free?
You can find free resources on educational blogs (like Licensurehub) and public document sites. However, the quality and accuracy can vary. This article provides a high-quality, free set of 150 questions tailored for the Ghana NMC exam. You can also check nursing forums and groups on social media where students share materials.

2. Are NMC past questions enough to pass the exam?
While practicing with NMC past questions and answers is essential, it should not be your only study method. Use them to identify your weak areas and understand the exam pattern, but also review your textbooks and lecture notes for deep theoretical understanding.

3. How many NMC past questions should I practice?
Aim to practice at least 500-1000 questions across all major topics (Medical-Surgical, Maternal/Child Health, Mental Health, and Professional Ethics). This volume helps you encounter a wide variety of question styles and content.

4. Does the Ghana NMC repeat past questions?
While questions are rarely repeated verbatim, the concepts and topics are frequently repeated. By practicing past questions, you are effectively studying the high-yield topics that are likely to appear again in a different format.

5. What are the main topics covered in Ghana NMC exams?
The exams primarily cover Adult Medical-Surgical Nursing, Maternal and Child Health (Obstetrics), Pediatric Nursing, Mental Health/Psychiatric Nursing, Community Health Nursing, and Professional Ethics/Legal Issues.

6. How often does the Ghana NMC update their exam syllabus?
The NMC reviews its curriculum periodically. It’s always best to cross-reference past questions with the current, approved NMC syllabus to ensure you aren’t studying outdated material.

7. Where can I find NMC questions on obstetrics specifically?
You can find specific questions on obstetrics in this guide (see questions 1-50) and on dedicated nursing education sites. Some past questions focus heavily on complications of labor, newborn reflexes, and postpartum care .

8. What is the passing score for the NMC licensure exam?
The passing mark is generally around 50-60%, but this can vary slightly depending on the specific exam and cohort. The goal is to demonstrate minimum competency across all domains.

Your Path to NMC Success

Mastering the NMC past questions and answers is a proven strategy to conquer the Ghana licensure exam. By working through the 150+ questions provided, understanding the detailed explanations, and identifying your weak areas, you are building a solid foundation for success.