1st Year GNM ODISHA Fundamentals of Nursing and First Aid 2025
ODISHA NURSES & MIDWIVES EXAMINATION BOARD
FIRST YEAR ANNUAL EXAMINATION IN GNM-2025
Paper-III
(Fundamentals of Nursing and First Aid)
I. Solve answer question
OR
a. Define
Nursing. [3]
Nursing
is a dynamic humanistic profession which involves the protection, promotion,
and optimization of health and abilities; prevention of illness and injury;
alleviation of suffering through the diagnosis and treatment of human
responses; and advocacy in the care of individuals, families, communities, and
populations.
b. Write
down the qualities of a nurse. [5]
Here are
key qualities expected in a good nurse:
- Compassion and Empathy —
ability to understand and share patients’ feelings
- Patience — dealing calmly
with suffering, delays, difficult patients
- Communication skills — clear
verbal and written communication with patients, families, team
- Integrity and honesty —
ethical conduct, trustworthiness
- Professionalism —
responsibility, accountability, maintaining standards
- Adaptability / flexibility —
coping with changing situations
- Critical thinking / problem
solving — ability to assess and respond
- Physical and mental stamina
— to work long hours, under stress
c.
Describe briefly the roles and responsibilities of a professional nurse. [7]
A
professional nurse wears many roles. Below is a summary of major roles and
their responsibilities:
|
Role |
Responsibilities / Activities |
|
Caregiver |
Provide
holistic patient care (physical, emotional, psychological), administer
treatments, assist in activities of daily living, monitor patient condition |
|
Communicator |
Exchange
information effectively with patients, families, and health team; document
assessments, reports, handovers |
|
Educator / Teacher |
Teach
patients and families about health, disease prevention, self-care,
medications, lifestyle modifications |
|
Advocate |
Protect
patients’ rights, represent their needs and wishes, ensure informed consent,
ethical practice |
|
Manager / Leader |
Organize
and coordinate nursing care, delegate tasks, supervise support staff, ensure
quality of care |
|
Researcher |
Use
evidence-based practice, participate in or apply research findings to improve
care |
|
Collaborator / Team Member |
Work
with doctors, therapists, social workers; coordinate multidisciplinary plan
of care |
|
Counselor / Supporter |
Provide
emotional support, psychological counseling, consolation to patients and
families |
|
Resource Manager |
Use
resources wisely, maintain supplies, equipment, make cost-effective decisions |
OR
Option 2:
a. Define
cross infection. [3]
Cross
infection (also called cross-contamination) is the transfer of harmful
microorganisms (pathogens) between patients, personnel, or objects within a
healthcare environment, leading to infection in a patient who was not infected
before.
b. What
are the different types of transmission? [5]
Microorganisms
may be transmitted in various ways. Major types include:
- Direct contact transmission — person-to-person transfer
(skin-to-skin, touching infected wound)
- Indirect contact
transmission —
via contaminated inanimate objects (fomites, e.g. bed linen, instruments)
- Droplet transmission — large respiratory
droplets (from cough, sneeze) land on mucous membranes of nearby persons
- Airborne transmission — small droplet nuclei or
dust particles remain suspended and travel distances
- Vehicle transmission — via contaminated water,
food, blood, medicines
- Vector-borne transmission — through insects or
animals (e.g. mosquitoes, flies)
c.
Describe the methods of prevention of cross infection. [7]
To
prevent cross infection, multiple control measures are used. Key methods
include:
- Hand hygiene — frequent hand washing
with soap & water or using alcohol hand rub, especially before and
after patient contact or handling contaminated material
- Use of personal protective
equipment (PPE) —
gloves, gowns, masks, eye protection to prevent exposure to bodily fluids
- Aseptic technique / sterile
technique —
maintain sterile fields, use sterile equipment when needed
- Isolation / segregation — isolate patients with
contagious diseases; use barrier nursing, separate wards or rooms
- Cleaning, disinfection,
sterilization —
proper cleaning of equipment, surfaces; sterilization of instruments;
disinfection of surfaces
- Safe disposal of waste &
sharps —
use puncture-proof containers for needles, dispose infectious waste
properly
- Respiratory hygiene / cough
etiquette —
cover mouth/nose when coughing, mask patients, keep distance
- Safe food and water
practices —
ensure food hygiene, clean water, proper storage
- Environmental control — proper ventilation,
control humidity, cleaning of surfaces
- Staff education / training — regular infection control
training, monitoring compliance
II. Solve Answer Questions
OR
a. What is pyrexia (fever)? [2]
Pyrexia (fever) is an abnormal rise of the body’s core temperature above the
normal set-point, as regulated by the hypothalamus, in response to infection,
inflammation or other causes.
b. Write briefly about various types of
fever, mention the phases and give examples of each. [5]
Types of Fever
Here are common types:
|
Type |
Description / Pattern |
Example / Cause |
|
Intermittent fever |
Temperature elevates above normal, but returns to
normal at intervals (periodically) |
Malaria |
|
Remittent fever |
Temperature fluctuates (day to evening) but never returns to normal
baseline |
Infective endocarditis |
|
Continuous (sustained) fever |
Temperature remains persistently elevated, with
minimal fluctuation |
Typhoid fever, urinary tract infection |
|
Relapsing (recurrent) fever |
Episodes of fever separated by periods of normal temperature |
Relapsing fever (Borrelia) |
|
Hectic fever |
Wide swings in temperature during the day (large
variation) |
Severe sepsis / pyemic states |
Phases of Fever (Course of Fever)
The fever usually goes through these phases:
1. Onset
/ Invasion: the temperature rises from normal; patient may feel
chills, shivering
2. Fastigium
/ Stadium: temperature reaches its maximum and remains relatively
steady at high level
3. Defervescence
/ Decline: temperature gradually returns to normal
o
Crisis: sudden fall back to
normal (rapid drop)
o
Lysis: gradual return to normal
c. Briefly describe the role of a nurse
in providing care to a fever patient admitted to the hospital. [8]
The nurse plays a very important role in managing a patient with fever.
Below is a structured description:
Role of Nurse: Care of a Patient with Fever
Assessment & Monitoring
·
Take and record temperature regularly (e.g.
4-hourly or more if needed)
·
Monitor other vital signs (pulse, respiratory
rate, blood pressure)
·
Assess for signs / sources of infection (e.g.
throat, urinary tract, wounds)
·
Observe for complications: dehydration,
delirium, seizures, altered sensorium
·
Assess skin condition (warmth, sweating,
dryness), mucous membranes, fluid intake/output
Interventions / Nursing Actions
·
Administer antipyretics (as prescribed), e.g.
paracetamol / ibuprofen
·
Encourage adequate hydration
(oral fluids) or IV fluids if needed, to compensate for increased insensible
losses
·
Provide non-pharmacological cooling
measures:
o
Tepid sponging / wash with lukewarm water
o
Remove extra clothing / covers
o
Adjust room environment (cool ambient temperature,
good ventilation)
·
Rest & activity regulation: encourage rest,
avoid overexertion
·
Nutrition: small frequent, light, nourishing
meals; easily digestible food
·
Maintain hygiene: regular mouth care, skin care
to prevent breakdown
·
Comfort measures: support, reassurance, manage
chills/shivering
·
Monitor intake and output, maintain fluid
balance
·
Record and report changes: temperature trends,
new symptoms, responses to intervention
Documentation & Communication
·
Document all assessments, interventions, and patient
responses
·
Communicate with doctors / team about persistent
high fever or deterioration
·
Educate patient / family regarding fever, signs
to watch for, home care when discharged
Prevention of Complications
·
Prevent dehydration, monitor for electrolyte
imbalance
·
Prevent febrile seizures (especially in
children)
·
Prevent skin breakdown
·
Early detection of worsening infection / sepsis
Evaluation
·
Check whether temperature is reducing
·
Assess whether patient is better (less
discomfort, improved general condition)
·
Modify plan if required
Option 2:
Fracture
a. What is a fracture? [3]
A fracture is a partial or complete break in the continuity of a bone.
b. Enlist the different types of
fractures. [5]
Here are major types of fractures:
1. Closed
(simple) fracture — bone breaks but skin remains intact
2. Open
(compound) fracture — broken bone protrudes through skin or there is a
wound to fracture site
3. Complete
fracture — the break goes through the entire cross-section of the bone
4. Incomplete
fracture — only part of the bone is broken (e.g. greenstick)
5. Greenstick
fracture — one side of bone breaks, the other side bends (common in
children)
6. Transverse
fracture — fracture line is horizontal / straight across
7. Oblique
fracture — fracture line is diagonal
8. Spiral
fracture — fracture line spirals around the bone, often due to
twisting injury
9. Comminuted
fracture — bone breaks into three or more fragments
10. Segmental
fracture — same bone is broken at two places producing a “floating”
segment
11. Pathological
fracture — fracture occurs in a bone weakened by disease (e.g. cancer,
osteoporosis)
12. Stress
(hairline) fracture — small crack from repeated stress
You can mention any 5–7 for the exam.
c. Explain the general rules of
treatment of fracture. [7]
Here are general rules / principles for managing fractures:
Immobilization: Prevent movement of the fractured parts,
maintain alignment, usually through casting, splints, traction, external or
internal fixation
1. Anatomic
Reduction: Restore the fragments to their correct normal
alignment/position (by manipulation, open surgery as needed)
2. Maintain
blood supply: Avoid injury to vessels and soft tissues; preserve
vascularity to fracture fragments
3. Adequate
fixation / stable immobilization: use of appropriate devices so
fragments do not move during healing
4. Prevent
infection: In open fractures, take care with debridement, wound care,
antibiotics
5. Pain
management: Provide analgesics, supportive care to reduce discomfort
6. Monitor
and manage complications: check for neurovascular status (circulation,
sensation), compartment syndrome, shock, swelling
7. Rehabilitation
/ early mobilization: when safe, initiate movements of joints near
fracture to prevent stiffness
8. Nutrition
and general care: ensure proper diet, rest, avoid undue stress on
fracture site
9. Follow
up and evaluation: regular check X-rays, monitoring union, detect
non-union or malunion
You can structure your answer in bullet form for clarity in exam.
III. Write short notes on any three of the following.
a. Constipation
·
Definition / Concept
Constipation is a condition in which bowel movements become infrequent
(typically fewer than 3 per week) and/or stool passage is difficult, often with
hard, dry, lumpy stools.
·
Causes / Contributing factors
o
Low dietary fiber intake
o
Inadequate fluid intake
o
Sedentary lifestyle / lack of physical activity
o
Medications (e.g., opioids, anticholinergics)
o
Ignoring the urge to defecate
o
Diseases (hypothyroidism, irritable bowel
syndrome)
·
Signs & Symptoms
o
Straining during defecation
o
Hard, lumpy stool
o
Sensation of incomplete evacuation
o
Abdominal discomfort, bloating, fullness
·
Complications
o
Hemorrhoids
o
Fecal impaction
o
Anal fissures
o
Rectal prolapse
·
Nursing / Management measures (brief)
o
Increase fiber in diet (fruits, vegetables,
whole grains)
o
Encourage adequate fluid intake
o
Promote mobility / exercise
o
Establish regular bowel habits (same time daily)
o
Use of stool softeners, laxatives if prescribed
o
Abdominal massage, correct positioning during
defecation
o
Monitor and record bowel movements (stool chart)
2. Cold Application
·
Definition
Cold application is the use of an agent cooler than the skin (in moist or dry
form) on the body surface to reduce temperature, relieve pain, control
bleeding, reduce inflammation, and limit swelling.
·
Types / Forms
o
Dry cold: cold packs, ice bags,
ice packs (no moisture touches skin)
o
Moist cold: cold compresses,
cold soaks (wet application)
·
Physiological Effects / Mechanism
o
Vasoconstriction → decreases blood flow to area
(thus reducing swelling, bleeding)
o
Slows down cellular metabolism in the area
o
Reduces pain by lowering nerve conduction and
irritability of pain fibers
o
Limits inflammation and edema formation
o
Retards bacterial growth in local tissues
·
Indications / Uses
o
In acute injuries (sprains, contusions)
o
After trauma / fractures
o
During fever (to reduce temperature locally)
o
To control hemorrhage (e.g., nosebleed)
o
To relieve localized pain and swelling
·
Precautions / Safety Measures
o
Do not apply ice directly on skin — use barrier
(cloth)
o
Limit application time (e.g. 20–30 minutes) to avoid
tissue damage, frostbite
o
Monitor skin condition (pallor, mottling)
o
Avoid use on areas with poor circulation,
sensory impairment, or vascular disease
o
Alternate with rest periods
o
In infants, elderly, or people with fragile
skin, use milder temperature
3. Methods of Physical Examination
·
Definition / Purpose
Physical examination (also called clinical examination) is a systematic method
by which a nurse or clinician collects objective data from a
patient using inspection, palpation, percussion, and auscultation to assess the
patient’s condition.
·
Basic Techniques / Methods
1. Inspection:
observing the patient’s body, movements, symmetry, skin, color, shape, any
deformities
§ Use
sight, smell, hearing
2. Palpation:
using hands and fingers to feel for texture, warmth, moisture, size, pulses,
tenderness, masses
3. Percussion:
tapping body surfaces (with fingers) to elicit sounds that indicate density,
fluid, air presence
4. Auscultation:
listening to internal body sounds (heart, lungs, bowel) using a stethoscope
§ In
some systems (abdomen), auscultation may come before palpation to avoid
altering bowel sounds
·
Order / Sequence
o
Generally: Inspection → Palpation → Percussion →
Auscultation
o
Exception: In the abdominal exam, sequence is
usually Inspection → Auscultation → Percussion → Palpation (to avoid disturbing
bowel sounds before listening)
·
Application / Examples
o
Inspect chest for symmetry, use stethoscope to
auscultate lung sounds
o
Palpate abdominal region for tenderness, masses
o
Percuss over lungs or abdomen to detect
consolidation, fluid, tympany
o
Listen to heart sounds (S1, S2, murmurs)
·
Significance / Benefits
o
Helps in early detection of abnormalities
o
Provides baseline status
o
Guides further investigations
o
Non-invasive, can be repeated often
o
Integral part of nursing assessment and care
planning
4. Barrier Nursing
·
Definition / Concept
Barrier nursing is a set of strict infection control practices aimed at
preventing transmission of infectious agents from a patient to other patients,
staff, or the environment, by creating barriers (physical or procedural) around
the patient.
·
Principles / Components
o
Isolation of infectious patient (single rooms,
wards)
o
Use of protective barriers: gowns, gloves,
masks, eye protection
o
Minimize traffic in and out of isolation area
o
Dedicated equipment for that patient (or strict
sterilization)
o
Strict hand hygiene before entering and leaving
barrier area
o
Proper disposal of infectious waste and
contaminated materials
o
Control of airflow / ventilation if needed
o
Clear signage and instructions regarding
precautions to be followed
·
Types / Levels (depending on infection
type)
o
Contact precautions (for infections spread by
direct or indirect contact)
o
Droplet precautions (for pathogens spread by
droplets)
o
Airborne precautions (for pathogens spread by
droplet nuclei )
These determine the barrier level and PPE used.
·
Advantages / Purpose
o
Protects noninfected patients and health
personnel
o
Limits spread of infectious agents in hospital
o
Provides safe environment of care
o
Helps in outbreak control
·
Challenges / Limitations
o
May create psychological effects (isolation,
loneliness) for patients
o
Requires extra resources: PPE, dedicated staff
o
Strict compliance essential — any break in
barrier can lead to transmission
o
Training and monitoring required
5. Oral Hygiene
·
Definition / Significance
Oral hygiene refers to the practices and care given to maintain clean, healthy
conditions of the oral cavity (teeth, gums, tongue, mucous membranes). Good
oral hygiene prevents dental and oral diseases, reduces microbial load, and
contributes to overall health.
·
Assessment
o
Inspect lips, gums, teeth, tongue, oral mucosa
for lesions, plaque, cavities, redness, bleeding
o
Assess patient’s ability to perform oral care
(motor control, consciousness, cooperation)
o
Check for presence of dentures, mouth dryness,
halitosis
·
Nursing Interventions / Measures
o
Brushing teeth (soft bristle brush, fluoride
toothpaste), gentle flossing
o
Mouth rinsing / use of antiseptic mouthwash
o
Denture care: remove, clean, soak overnight
o
Moistening oral mucosa (if dry mouth) — swabs,
water, secretion stimulants
o
Lip lubrication to prevent cracking
o
Suctioning oral secretions in patients who
cannot clear own mouth
o
Providing comfort (avoid trauma), ensuring
proper positioning
o
Encouragement of patient participation and
education
·
Special Considerations
o
In unconscious or dependent patients, careful
technique to avoid aspiration
o
Alter methods with conditions like stomatitis,
thrush, chemotherapy, mucositis
o
Frequent care in critically ill or ventilated
patients to prevent ventilator-associated pneumonia
·
Benefits / Outcomes
o
Prevents oral infections (gingivitis,
periodontal disease)
o
Reduces risk of systemic infections (oral
bacteria entering bloodstream)
o
Enhances nutrition (by promoting comfortable
chewing)
o
Improves comfort, reduces halitosis
o
Preserves teeth, oral structures
IV. A. Write the responsibilities and role of a nurse in the following situations.
a. A
patient with breathing difficulty
Responsibilities and Role of Nurse:
1. Assess
breathing pattern – Rate, depth, rhythm, and use of accessory muscles.
2. Positioning
– Keep the patient in Fowler’s or Semi-Fowler’s position to ease
breathing.
3. Ensure
airway clearance – Remove mucus by suctioning if required.
4. Administer
oxygen as per doctor’s order.
5. Monitor
vital signs – Respiratory rate, SpO₂, and pulse.
6. Stay
calm and reassure the patient to reduce anxiety.
7. Notify
the doctor immediately if distress increases.
b. A
patient having 104°C temperature
Responsibilities and Role of Nurse:
1. Monitor
temperature frequently and record every 2 hours.
2. Provide
tepid sponge bath to reduce body temperature.
3. Remove
excess clothing and bed covers.
4. Administer
antipyretics as prescribed (e.g., paracetamol).
5. Encourage
fluids to prevent dehydration.
6. Observe
for complications like convulsions, especially in children.
7. Maintain
clean, cool environment and comfort measures.
c.
Intravenous administration of drugs
Responsibilities and Role of Nurse:
1. Verify
doctor’s order for correct drug, dose, route, and timing.
2. Check
patient identity before administration.
3. Maintain
aseptic technique to prevent infection.
4. Inspect
IV site for patency and signs of inflammation.
5. Regulate
IV flow rate accurately.
6. Observe
for adverse reactions during and after administration.
7. Document
the procedure and patient’s response.
d. A
person with snake bite
Responsibilities and Role of Nurse:
1. Reassure
and calm the patient; restrict movement.
2. Apply
a constricting band above the bite (not too tight).
3. Keep
the affected part below heart level.
4. Do
not cut or suck the wound.
5. Clean
wound gently with antiseptic.
6. Monitor
vital signs and signs of shock.
7. Arrange
immediate transport for administration of anti-venom.
e. A
patient with bed sore
Responsibilities and Role of Nurse:
1. Inspect
pressure areas daily (back, heels, elbows, etc.).
2. Change
position every 2 hours to relieve pressure.
3. Keep
skin clean and dry; use mild soap and water.
4. Massage
around pressure areas (not over sore).
5. Use
air or water mattress to reduce pressure.
6. Provide
high-protein, vitamin-rich diet.
7. Maintain
records of wound condition and progress.
B. Fill in the blanks.
Answer:
a. Etiquette is a code of conduct. ✅
b. The main purpose of cardiac bed is to relieve dyspnea caused by cardiac disease. ✅
c. Post-mortem examination is conducted on the body after death. ✅
d. Nose and throat infections may spread to the middle ear leading to otitis media. ✅
e. The temperature which exhibits a zig-zag pattern is known as remittent fever. ✅
V. A. Write the responsibilities and role of a nurse in the following situations
Answer:
|
Sl. No. |
Situation |
Full Form / Meaning |
Responsibilities and Role of Nurse |
|
a. |
OPD |
Outpatient Department |
• Assist doctors in examination and minor
procedures. • Maintain patient records. • Guide patients regarding
investigations and follow-up care. |
|
b. |
WHO |
World Health Organization |
• Follow WHO guidelines on infection control and immunization. •
Participate in health education and public health programs. |
|
c. |
LAMA |
Leave Against Medical Advice |
• Explain risks of leaving hospital early. • Take
patient’s written consent. • Inform doctor and record in patient file. |
|
d. |
CPR |
Cardiopulmonary Resuscitation |
• Recognize cardiac arrest immediately. • Initiate chest compressions
and rescue breathing. • Call for help and assist in emergency management. |
|
e. |
PPE |
Personal Protective Equipment |
• Use gloves, mask, gown, and goggles properly. •
Prevent cross infection and ensure self-protection. |
|
f. |
ICU |
Intensive Care Unit |
• Monitor vital signs continuously. • Maintain aseptic technique. •
Provide emotional support to patient and family. |
|
g. |
CC |
Chief Complaint |
• Record the main symptom or reason for patient’s
visit. • Report accurately to the doctor. |
|
h. |
IPR |
Interpersonal Relationship |
• Maintain good communication with patients, relatives, and
healthcare team. • Promote trust and cooperation. |
|
i. |
QID |
Four Times a Day (Latin: Quater
in Die) |
• Administer medicines or care procedures four times
daily as per doctor’s order. • Maintain accurate time records. |
|
j. |
NPO |
Nil Per Oral (Nothing by Mouth) |
• Ensure the patient does not take food or fluids orally. • Provide
mouth care and inform patient about the reason. |
IV. B. Write true or false
Answer:
a. Auscultation is listening to the sounds of the body. — ✅ True
b. Dettol is used for sterilisation of instruments. — ❌ False
(Dettol is an antiseptic, not a sterilizing agent.)
c. Presence of blood in cough is called haematuria. — ❌ False
(Blood in cough is haemoptysis; haematuria means blood in urine.)
d. Benedict's test is used to detect reducing sugar in urine. — ✅ True
e. The data observed by the nursing officer is called objective data. — ✅ True
f. Pyrexia is also known as hypertension. — ❌ False
(Pyrexia means fever; hypertension means high blood pressure.)
g. The normal respiration rate of an adult is 20–24/minute. — ❌ False
(Normal adult respiration rate is 16–20 per minute.)
h. Good body mechanics prevent fatigue & strain. — ✅ True
i. Detection of ketone bodies in the body fluids is observed in acidosis. — ✅ True
j. Otoscope is used for rectal examination. — ❌ False
(Otoscope is used to examine the ear canal and eardrum.)
✅ Correct Answers Summary:
a. True
b. False
c. False
d. True
e. True
f. False
g. False
h. True
i. True
j. False