P1 Nursing Exams for nurses
Question 1 | Medical-Surgical Nursing
A patient with Type 2 Diabetes Mellitus presents with fasting blood glucose of 14
mmol/L. Which of the following is the PRIORITY nursing intervention?
• A. Administer oral hypoglycaemic as prescribed
• B. Encourage oral fluid intake
• C. Notify the physician immediately
• D. Recheck blood glucose in 30 minutes
Rationale: A fasting blood glucose of 14 mmol/L is significantly above the normal
range and indicates uncontrolled hyperglycaemia. The priority action is to
communicate this critical finding to the physician.
Question 2 | Medical-Surgical Nursing
A nurse is caring for a post-operative patient 8 hours after abdominal surgery. The
patient reports increasing pain at the surgical site, has a temperature of 38.8°C, and
the wound appears red and warm. What should the nurse suspect?
• A. Normal post-operative inflammation
• B. Wound dehiscence
• C. Surgical site infection (SSI)
• D. Deep vein thrombosis (DVT)
Rationale: The signs of increasing pain, fever (>38°C), and localised redness and
warmth are classic signs of a surgical site infection.
Question 3 | Pharmacology / Med-Surg
A nurse is administering Furosemide (Lasix) 40mg IV to a patient with heart failure.
Which of the following electrolyte imbalances should the nurse monitor for MOST
closely?
• A. Hypernatraemia
• B. Hypokalaemia
• C. Hypercalcaemia
• D. Hypermagnesaemia
Rationale: Furosemide is a loop diuretic, and the most common and clinically
significant electrolyte imbalance it can cause is hypokalaemia (low potassium).
Question 4 | Community Health Nursing
During a community health assessment, a nurse identifies that a majority of under-5
children in a village have stunted growth. What is the MOST likely underlying cause
the nurse should investigate?
, • A. Malaria prevalence
• B. Chronic malnutrition
• C. Inadequate immunisation coverage
• D. Poor sanitation and water quality
Rationale: Stunting (low height-for-age) is the classic indicator of chronic
malnutrition. The nurse should investigate dietary practices and food security.
Question 5 | Community Health Nursing
A public health nurse is planning a health education session on malaria prevention
for a rural community in Kenya. Which of the following is the MOST cost-effective
and evidence-based intervention to recommend?
• A. Indoor residual spraying (IRS) monthly
• B. Distribution of Long-Lasting Insecticidal Nets (LLINs)
• C. Mass drug administration with Artemether-Lumefantrine
• D. Draining all stagnant water in the community
Rationale: LLINs are the most cost-effective, evidence-based primary prevention
strategy for malaria at the community level, strongly supported by WHO and Kenya's
National Malaria Control Programme.
Question 6 | Midwifery Nursing
A primigravida at 38 weeks gestation presents to the antenatal clinic with blood
pressure of 158/104 mmHg, proteinuria 2+ on dipstick, and reports severe headache.
What is the CORRECT diagnosis?
• A. Gestational hypertension
• B. Mild pre-eclampsia
• C. Severe pre-eclampsia
• D. Chronic hypertension with superimposed pre-eclampsia
Rationale: Severe pre-eclampsia is diagnosed when BP is ≥160/110 mmHg OR there
is significant proteinuria (2+ or more) WITH severe symptoms such as severe
headache. This patient's presentation, especially the severe headache, classifies this
as severe pre-eclampsia.
Question 7 | Midwifery Nursing
A woman in active labour has a partograph that shows the cervical dilation line has
crossed the action line. What is the MOST appropriate immediate nursing action?
• A. Prepare the mother for emergency Caesarean section
• B. Administer oxytocin infusion immediately
• C. Notify the doctor or midwife in charge urgently
• D. Encourage the mother to push harder
Rationale: When the partograph line crosses the action line, it indicates prolonged
or obstructed labour. The nurse's immediate action is to notify the doctor or senior
, midwife in charge so that a medical assessment can determine the appropriate
management.
Question 8 | Paediatric Nursing
A 9-month-old infant is brought to the clinic. According to Kenya's immunisation
schedule (KEPI), which vaccines should this child receive at this visit?
• A. BCG and OPV 0
• B. DPT-HepB-Hib 3, OPV 3, and PCV 3
• C. Measles-Rubella (MR) vaccine only
• D. Yellow Fever vaccine
Rationale: According to the Kenya Expanded Programme on Immunisation (KEPI), at
9 months a child receives the third doses of DPT-HepB-Hib, OPV, and PCV.
Question 9 | Paediatric Nursing
A nurse is assessing a 3-year-old child using the IMCI guidelines. The child has a
temperature of 38.5°C, no stiff neck, no bulging fontanelle, and petechiae are absent.
According to IMCI, how should this child be classified?
• A. Very Severe Febrile Disease
• B. Severe Malaria or Very Severe Febrile Disease
• C. Malaria (or fever — no severe signs)
• D. No malaria risk
Rationale: According to IMCI guidelines, a child with fever but NO general danger
signs is classified as 'Malaria' or 'Fever — no severe signs' in malaria-risk areas.
Question 10 | Mental Health Nursing
A patient on the psychiatric ward approaches the nurse, agitated, and says 'I hear
voices telling me to hurt myself.' What is the nurse's PRIORITY action?
• A. Document the statement in the patient's notes
• B. Reassure the patient the voices are not real
• C. Ensure the patient's immediate safety and remove harmful objects
from the environment
• D. Administer PRN sedation as prescribed
Rationale: The priority in psychiatric nursing is patient safety. When a patient
expresses active auditory command hallucinations directing self-harm, the immediate
11. The proponent of the adaptation model was:
• A. Betty Neuman
• B. Callista Roy
• C. Dorothea Orem
• D. Hildegard Peplau
Question 1 | Medical-Surgical Nursing
A patient with Type 2 Diabetes Mellitus presents with fasting blood glucose of 14
mmol/L. Which of the following is the PRIORITY nursing intervention?
• A. Administer oral hypoglycaemic as prescribed
• B. Encourage oral fluid intake
• C. Notify the physician immediately
• D. Recheck blood glucose in 30 minutes
Rationale: A fasting blood glucose of 14 mmol/L is significantly above the normal
range and indicates uncontrolled hyperglycaemia. The priority action is to
communicate this critical finding to the physician.
Question 2 | Medical-Surgical Nursing
A nurse is caring for a post-operative patient 8 hours after abdominal surgery. The
patient reports increasing pain at the surgical site, has a temperature of 38.8°C, and
the wound appears red and warm. What should the nurse suspect?
• A. Normal post-operative inflammation
• B. Wound dehiscence
• C. Surgical site infection (SSI)
• D. Deep vein thrombosis (DVT)
Rationale: The signs of increasing pain, fever (>38°C), and localised redness and
warmth are classic signs of a surgical site infection.
Question 3 | Pharmacology / Med-Surg
A nurse is administering Furosemide (Lasix) 40mg IV to a patient with heart failure.
Which of the following electrolyte imbalances should the nurse monitor for MOST
closely?
• A. Hypernatraemia
• B. Hypokalaemia
• C. Hypercalcaemia
• D. Hypermagnesaemia
Rationale: Furosemide is a loop diuretic, and the most common and clinically
significant electrolyte imbalance it can cause is hypokalaemia (low potassium).
Question 4 | Community Health Nursing
During a community health assessment, a nurse identifies that a majority of under-5
children in a village have stunted growth. What is the MOST likely underlying cause
the nurse should investigate?
, • A. Malaria prevalence
• B. Chronic malnutrition
• C. Inadequate immunisation coverage
• D. Poor sanitation and water quality
Rationale: Stunting (low height-for-age) is the classic indicator of chronic
malnutrition. The nurse should investigate dietary practices and food security.
Question 5 | Community Health Nursing
A public health nurse is planning a health education session on malaria prevention
for a rural community in Kenya. Which of the following is the MOST cost-effective
and evidence-based intervention to recommend?
• A. Indoor residual spraying (IRS) monthly
• B. Distribution of Long-Lasting Insecticidal Nets (LLINs)
• C. Mass drug administration with Artemether-Lumefantrine
• D. Draining all stagnant water in the community
Rationale: LLINs are the most cost-effective, evidence-based primary prevention
strategy for malaria at the community level, strongly supported by WHO and Kenya's
National Malaria Control Programme.
Question 6 | Midwifery Nursing
A primigravida at 38 weeks gestation presents to the antenatal clinic with blood
pressure of 158/104 mmHg, proteinuria 2+ on dipstick, and reports severe headache.
What is the CORRECT diagnosis?
• A. Gestational hypertension
• B. Mild pre-eclampsia
• C. Severe pre-eclampsia
• D. Chronic hypertension with superimposed pre-eclampsia
Rationale: Severe pre-eclampsia is diagnosed when BP is ≥160/110 mmHg OR there
is significant proteinuria (2+ or more) WITH severe symptoms such as severe
headache. This patient's presentation, especially the severe headache, classifies this
as severe pre-eclampsia.
Question 7 | Midwifery Nursing
A woman in active labour has a partograph that shows the cervical dilation line has
crossed the action line. What is the MOST appropriate immediate nursing action?
• A. Prepare the mother for emergency Caesarean section
• B. Administer oxytocin infusion immediately
• C. Notify the doctor or midwife in charge urgently
• D. Encourage the mother to push harder
Rationale: When the partograph line crosses the action line, it indicates prolonged
or obstructed labour. The nurse's immediate action is to notify the doctor or senior
, midwife in charge so that a medical assessment can determine the appropriate
management.
Question 8 | Paediatric Nursing
A 9-month-old infant is brought to the clinic. According to Kenya's immunisation
schedule (KEPI), which vaccines should this child receive at this visit?
• A. BCG and OPV 0
• B. DPT-HepB-Hib 3, OPV 3, and PCV 3
• C. Measles-Rubella (MR) vaccine only
• D. Yellow Fever vaccine
Rationale: According to the Kenya Expanded Programme on Immunisation (KEPI), at
9 months a child receives the third doses of DPT-HepB-Hib, OPV, and PCV.
Question 9 | Paediatric Nursing
A nurse is assessing a 3-year-old child using the IMCI guidelines. The child has a
temperature of 38.5°C, no stiff neck, no bulging fontanelle, and petechiae are absent.
According to IMCI, how should this child be classified?
• A. Very Severe Febrile Disease
• B. Severe Malaria or Very Severe Febrile Disease
• C. Malaria (or fever — no severe signs)
• D. No malaria risk
Rationale: According to IMCI guidelines, a child with fever but NO general danger
signs is classified as 'Malaria' or 'Fever — no severe signs' in malaria-risk areas.
Question 10 | Mental Health Nursing
A patient on the psychiatric ward approaches the nurse, agitated, and says 'I hear
voices telling me to hurt myself.' What is the nurse's PRIORITY action?
• A. Document the statement in the patient's notes
• B. Reassure the patient the voices are not real
• C. Ensure the patient's immediate safety and remove harmful objects
from the environment
• D. Administer PRN sedation as prescribed
Rationale: The priority in psychiatric nursing is patient safety. When a patient
expresses active auditory command hallucinations directing self-harm, the immediate
11. The proponent of the adaptation model was:
• A. Betty Neuman
• B. Callista Roy
• C. Dorothea Orem
• D. Hildegard Peplau
