NBME CBSE Actual Test Questions 2026/2027 | Comprehensive Basic
Science Examination Study Guide, CBSE Exam Prep, USMLE Step 1
Preparation, Basic Science Practice Questions with Answers, Pathology,
Pharmacology, Physiology, Biochemistry, Microbiology, Anatomy and
Immunology Review
Question 1: A nurse is conducting an initial interview with a client diagnosed
with major depressive disorder who speaks in a monotonous tone and avoids
eye contact. Which therapeutic communication technique should the nurse
prioritize to establish trust?
A. Asking multiple closed-ended questions to gather data efficiently
B. Using silence and offering a simple, open-ended invitation to speak
C. Cheerfully reassuring the client that everything will improve soon
D. Sharing a personal story of overcoming sadness to build rapport
CORRECT ANSWER: B. Using silence and offering a simple, open-ended
invitation to speak
Rationale: Clients with major depressive disorder often experience psychomotor
retardation and may need time to formulate responses. Using silence and a
simple, open-ended invitation respects the client's pace and conveys acceptance
without pressure. Closed-ended questions may feel interrogative; false
reassurance minimizes the client's experience; and self-disclosure shifts focus
away from the client.
Question 2: A client with schizophrenia repeatedly states, "The CIA has
implanted a chip in my brain to monitor my thoughts." Which term best
describes this symptom?
A. Hallucination
B. Delusion of persecution
C. Obsession
D. Phobia
CORRECT ANSWER: B. Delusion of persecution
Rationale: A delusion of persecution is a fixed, false belief that one is being
targeted, harmed, or monitored by others or an external entity. Hallucinations
involve sensory perceptions without external stimuli. Obsessions are intrusive,
unwanted thoughts, and phobias are irrational fears of specific objects or
situations.
,Question 3: A nurse is assessing a client who experienced a panic attack. Which
physiological finding is most consistent with acute anxiety?
A. Bradycardia
B. Hyperventilation
C. Decreased respiratory rate
D. Hypotension
CORRECT ANSWER: B. Hyperventilation
Rationale: During a panic attack, the sympathetic nervous system activation leads
to increased respiratory rate and hyperventilation, often resulting in respiratory
alkalosis. Tachycardia and elevated blood pressure are also common, not
bradycardia or hypotension.
Question 4: A client prescribed lithium carbonate reports a 3-day history of
vomiting and diarrhea. Which nursing action is the priority?
A. Encourage increased fluid intake and continue the medication
B. Hold the next dose and obtain a serum lithium level
C. Administer an antiemetic and reassure the client
D. Document the findings and reassess in 24 hours
CORRECT ANSWER: B. Hold the next dose and obtain a serum lithium level
Rationale: Gastrointestinal fluid loss can rapidly elevate serum lithium levels,
leading to toxicity. The priority is to hold the medication and obtain a serum level
to prevent life-threatening lithium toxicity. Encouraging fluids without holding the
dose could worsen the imbalance; antiemetics do not address the underlying risk;
and delaying assessment could be dangerous.
Question 5: A nurse is caring for a client admitted with alcohol withdrawal.
Which medication is most commonly used to manage withdrawal symptoms
and prevent complications?
A. Naloxone
B. Lorazepam
C. Disulfiram
D. Acamprosate
,CORRECT ANSWER: B. Lorazepam
Rationale: Benzodiazepines such as lorazepam are the first-line treatment for
alcohol withdrawal because they prevent seizures and delirium tremens by
modulating GABA activity. Naloxone reverses opioid overdose; disulfiram and
acamprosate are used for maintaining abstinence, not acute withdrawal.
Question 6: A client with bipolar disorder is admitted in a manic state. Which
nursing intervention is most appropriate initially?
A. Encourage group participation to channel energy
B. Provide a quiet, low-stimulation environment
C. Allow the client to skip meals to reduce restlessness
D. Discuss the consequences of impulsive behavior
CORRECT ANSWER: B. Provide a quiet, low-stimulation environment
Rationale: During acute mania, clients are highly distractible and overstimulated.
A quiet, low-stimulation environment helps reduce agitation and supports safety.
Group participation can increase stimulation; skipping meals risks nutritional
deficits; and discussing consequences is unlikely to be effective until the acute
phase subsides.
Question 7: A nurse is teaching a client about sertraline. Which statement by
the client indicates correct understanding?
A. "I should stop taking it as soon as I feel better."
B. "It may take several weeks before I notice improvement."
C. "I can drink alcohol while taking this medication."
D. "This medication will cure my depression immediately."
CORRECT ANSWER: B. "It may take several weeks before I notice improvement."
Rationale: SSRIs like sertraline typically require 2–4 weeks to produce therapeutic
effects. Clients should not stop abruptly, alcohol should be avoided, and
medication manages symptoms rather than curing the disorder.
Question 8: A client states, "I hear voices telling me I am worthless." Which
nursing response is most therapeutic?
, A. "There are no voices; you are safe here."
B. "What are the voices saying to you right now?"
C. "Try to ignore the voices and focus on your day."
D. "You should not listen to those voices."
CORRECT ANSWER: B. "What are the voices saying to you right now?"
Rationale: Asking what the voices are saying helps the nurse assess the content,
command nature, and risk of harm. Directly denying the experience damages
trust; advising to ignore them is not helpful during acute distress; and telling the
client not to listen dismisses the experience.
Question 9: A nurse is assessing a client for suicide risk. Which finding indicates
the highest immediate risk?
A. The client has a history of depression
B. The client has a specific plan and access to means
C. The client reports feeling hopeless
D. The client has recently experienced a loss
CORRECT ANSWER: B. The client has a specific plan and access to means
Rationale: A specific plan with access to lethal means represents the highest
immediate risk for suicide. While hopelessness, depression history, and recent
loss are risk factors, the presence of a plan and means requires immediate safety
interventions.
Question 10: A client with obsessive-compulsive disorder performs
handwashing rituals for 30 minutes. Which nursing intervention is most
appropriate?
A. Interrupt the ritual to save time
B. Allow the ritual but set limits on duration
C. Prevent the ritual entirely to reduce anxiety
D. Ignore the behavior and document it later
CORRECT ANSWER: B. Allow the ritual but set limits on duration
Rationale: Allowing the ritual initially respects the client's need to reduce anxiety,
while gradually setting limits helps the client develop healthier coping strategies.
Science Examination Study Guide, CBSE Exam Prep, USMLE Step 1
Preparation, Basic Science Practice Questions with Answers, Pathology,
Pharmacology, Physiology, Biochemistry, Microbiology, Anatomy and
Immunology Review
Question 1: A nurse is conducting an initial interview with a client diagnosed
with major depressive disorder who speaks in a monotonous tone and avoids
eye contact. Which therapeutic communication technique should the nurse
prioritize to establish trust?
A. Asking multiple closed-ended questions to gather data efficiently
B. Using silence and offering a simple, open-ended invitation to speak
C. Cheerfully reassuring the client that everything will improve soon
D. Sharing a personal story of overcoming sadness to build rapport
CORRECT ANSWER: B. Using silence and offering a simple, open-ended
invitation to speak
Rationale: Clients with major depressive disorder often experience psychomotor
retardation and may need time to formulate responses. Using silence and a
simple, open-ended invitation respects the client's pace and conveys acceptance
without pressure. Closed-ended questions may feel interrogative; false
reassurance minimizes the client's experience; and self-disclosure shifts focus
away from the client.
Question 2: A client with schizophrenia repeatedly states, "The CIA has
implanted a chip in my brain to monitor my thoughts." Which term best
describes this symptom?
A. Hallucination
B. Delusion of persecution
C. Obsession
D. Phobia
CORRECT ANSWER: B. Delusion of persecution
Rationale: A delusion of persecution is a fixed, false belief that one is being
targeted, harmed, or monitored by others or an external entity. Hallucinations
involve sensory perceptions without external stimuli. Obsessions are intrusive,
unwanted thoughts, and phobias are irrational fears of specific objects or
situations.
,Question 3: A nurse is assessing a client who experienced a panic attack. Which
physiological finding is most consistent with acute anxiety?
A. Bradycardia
B. Hyperventilation
C. Decreased respiratory rate
D. Hypotension
CORRECT ANSWER: B. Hyperventilation
Rationale: During a panic attack, the sympathetic nervous system activation leads
to increased respiratory rate and hyperventilation, often resulting in respiratory
alkalosis. Tachycardia and elevated blood pressure are also common, not
bradycardia or hypotension.
Question 4: A client prescribed lithium carbonate reports a 3-day history of
vomiting and diarrhea. Which nursing action is the priority?
A. Encourage increased fluid intake and continue the medication
B. Hold the next dose and obtain a serum lithium level
C. Administer an antiemetic and reassure the client
D. Document the findings and reassess in 24 hours
CORRECT ANSWER: B. Hold the next dose and obtain a serum lithium level
Rationale: Gastrointestinal fluid loss can rapidly elevate serum lithium levels,
leading to toxicity. The priority is to hold the medication and obtain a serum level
to prevent life-threatening lithium toxicity. Encouraging fluids without holding the
dose could worsen the imbalance; antiemetics do not address the underlying risk;
and delaying assessment could be dangerous.
Question 5: A nurse is caring for a client admitted with alcohol withdrawal.
Which medication is most commonly used to manage withdrawal symptoms
and prevent complications?
A. Naloxone
B. Lorazepam
C. Disulfiram
D. Acamprosate
,CORRECT ANSWER: B. Lorazepam
Rationale: Benzodiazepines such as lorazepam are the first-line treatment for
alcohol withdrawal because they prevent seizures and delirium tremens by
modulating GABA activity. Naloxone reverses opioid overdose; disulfiram and
acamprosate are used for maintaining abstinence, not acute withdrawal.
Question 6: A client with bipolar disorder is admitted in a manic state. Which
nursing intervention is most appropriate initially?
A. Encourage group participation to channel energy
B. Provide a quiet, low-stimulation environment
C. Allow the client to skip meals to reduce restlessness
D. Discuss the consequences of impulsive behavior
CORRECT ANSWER: B. Provide a quiet, low-stimulation environment
Rationale: During acute mania, clients are highly distractible and overstimulated.
A quiet, low-stimulation environment helps reduce agitation and supports safety.
Group participation can increase stimulation; skipping meals risks nutritional
deficits; and discussing consequences is unlikely to be effective until the acute
phase subsides.
Question 7: A nurse is teaching a client about sertraline. Which statement by
the client indicates correct understanding?
A. "I should stop taking it as soon as I feel better."
B. "It may take several weeks before I notice improvement."
C. "I can drink alcohol while taking this medication."
D. "This medication will cure my depression immediately."
CORRECT ANSWER: B. "It may take several weeks before I notice improvement."
Rationale: SSRIs like sertraline typically require 2–4 weeks to produce therapeutic
effects. Clients should not stop abruptly, alcohol should be avoided, and
medication manages symptoms rather than curing the disorder.
Question 8: A client states, "I hear voices telling me I am worthless." Which
nursing response is most therapeutic?
, A. "There are no voices; you are safe here."
B. "What are the voices saying to you right now?"
C. "Try to ignore the voices and focus on your day."
D. "You should not listen to those voices."
CORRECT ANSWER: B. "What are the voices saying to you right now?"
Rationale: Asking what the voices are saying helps the nurse assess the content,
command nature, and risk of harm. Directly denying the experience damages
trust; advising to ignore them is not helpful during acute distress; and telling the
client not to listen dismisses the experience.
Question 9: A nurse is assessing a client for suicide risk. Which finding indicates
the highest immediate risk?
A. The client has a history of depression
B. The client has a specific plan and access to means
C. The client reports feeling hopeless
D. The client has recently experienced a loss
CORRECT ANSWER: B. The client has a specific plan and access to means
Rationale: A specific plan with access to lethal means represents the highest
immediate risk for suicide. While hopelessness, depression history, and recent
loss are risk factors, the presence of a plan and means requires immediate safety
interventions.
Question 10: A client with obsessive-compulsive disorder performs
handwashing rituals for 30 minutes. Which nursing intervention is most
appropriate?
A. Interrupt the ritual to save time
B. Allow the ritual but set limits on duration
C. Prevent the ritual entirely to reduce anxiety
D. Ignore the behavior and document it later
CORRECT ANSWER: B. Allow the ritual but set limits on duration
Rationale: Allowing the ritual initially respects the client's need to reduce anxiety,
while gradually setting limits helps the client develop healthier coping strategies.
