Telangana Staff Nurse Recruitment

574 Questions 0 IXL Skills

#1 Level 1

What is the normal adult blood pressure?

A) 90/60 mmHg

B) 120/80 mmHg

C) 140/90 mmHg

D) 100/70 mmHg

Explanation: Normal adult blood pressure is approximately 120/80 mmHg.

#2 Level 1

How many chambers are present in the human heart?

A) 2

B) 3

C) 4

D) 5

Explanation: The human heart has four chambers: two atria and two ventricles.

#3 Level 1

What is the normal respiratory rate for a healthy adult?

A) 8-10 breaths/min

B) 12-20 breaths/min

C) 25-30 breaths/min

D) 35-40 breaths/min

Explanation: The normal adult respiratory rate is 12-20 breaths per minute.

#4 Level 2

Which enzyme is primarily responsible for protein digestion in the stomach?

A) Amylase

B) Lipase

C) Pepsin

D) Trypsin

Explanation: Pepsin is secreted by the chief cells of the stomach and begins protein digestion.

#5 Level 2

What is the functional unit of the kidney?

A) Neuron

B) Nephron

C) Alveolus

D) Hepatocyte

Explanation: The nephron is the functional unit of the kidney where urine is formed.

#6 Level 2

Which part of the brain controls balance and coordination?

A) Cerebrum

B) Cerebellum

C) Medulla oblongata

D) Hypothalamus

Explanation: The cerebellum coordinates voluntary movements, posture, and balance.

#7 Level 1

Which hormone lowers blood glucose levels?

A) Glucagon

B) Insulin

C) Cortisol

D) Thyroxine

Explanation: Insulin, produced by the beta cells of the pancreas, lowers blood glucose.

#8 Level 2

What is the average length of the human menstrual cycle?

A) 14 days

B) 21 days

C) 28 days

D) 40 days

Explanation: The average menstrual cycle is about 28 days, though 21-35 days is considered normal.

#9 Level 2

Which bone is the longest bone in the human body?

A) Humerus

B) Tibia

C) Femur

D) Fibula

Explanation: The femur (thigh bone) is the longest and strongest bone in the body.

#10 Level 2

Which type of muscle is under voluntary control?

A) Cardiac muscle

B) Smooth muscle

C) Skeletal muscle

D) All of the above

Explanation: Skeletal muscle is voluntary; cardiac and smooth muscles are involuntary.

#11 Level 2

Which organelle is known as the 'powerhouse of the cell'?

A) Nucleus

B) Ribosome

C) Mitochondria

D) Golgi apparatus

Explanation: Mitochondria produce ATP, the cell's energy currency.

#12 Level 2

Which blood group is known as the universal donor?

A) A positive

B) B positive

C) AB positive

D) O negative

Explanation: O negative red blood cells lack A, B, and Rh antigens, making them the universal donor.

#13 Level 2

Where does gas exchange occur in the lungs?

A) Bronchi

B) Trachea

C) Alveoli

D) Larynx

Explanation: Gas exchange occurs across the thin walls of the alveoli.

#14 Level 2

What is the normal daily urine output for an adult?

A) 100-200 mL

B) 400-500 mL

C) 800-1000 mL

D) 1000-2000 mL

Explanation: Normal adult urine output is approximately 1000-2000 mL per day.

#15 Level 2

Which structure transmits impulses away from the central nervous system to muscles?

A) Sensory neuron

B) Interneuron

C) Motor neuron

D) Glial cell

Explanation: Motor neurons carry impulses from the CNS to effector muscles or glands.

#16 Level 1

What is the normal oral body temperature?

A) 35.0°C

B) 36.5°C

C) 37.0°C

D) 38.0°C

Explanation: Normal oral body temperature is approximately 37.0°C (98.6°F).

#17 Level 1

Which artery is commonly used to check the pulse in adults?

A) Carotid artery

B) Radial artery

C) Femoral artery

D) Brachial artery

Explanation: The radial artery at the wrist is the most common site for routine pulse measurement.

#18 Level 2

What does the 'A' stand for in the nursing process ADPIE?

A) Analysis

B) Assessment

C) Action

D) Audit

Explanation: ADPIE stands for Assessment, Diagnosis, Planning, Implementation, and Evaluation.

#19 Level 1

What is the most effective way to prevent healthcare-associated infections?

A) Wearing gloves

B) Hand hygiene

C) Using antibiotics

D) Isolation

Explanation: Hand hygiene is the single most effective measure to prevent infections.

#20 Level 2

Which position is most likely to cause pressure sores on the sacrum?

A) Side-lying

B) Prone

C) Supine

D) Sitting upright

Explanation: The sacrum bears weight in supine position, increasing pressure sore risk.

#21 Level 2

In which position is the head of the bed elevated 45-60 degrees?

A) Supine

B) Trendelenburg

C) Fowler's position

D) Prone

Explanation: Fowler's position elevates the head of the bed 45-60 degrees.

#22 Level 2

Which type of wound healing occurs when a wound is left open and heals from the bottom up?

A) Primary intention

B) Secondary intention

C) Tertiary intention

D) Fourth intention

Explanation: Secondary intention healing occurs when wound edges are not approximated.

#23 Level 2

Which of the following is a fundamental patient right?

A) Right to refuse treatment

B) Right to free medicines

C) Right to choose any doctor

D) Right to unlimited visitors

Explanation: Patients have the right to informed consent and to refuse treatment.

#24 Level 1

What is the normal adult pulse rate at rest?

A) 40-60 beats/min

B) 60-100 beats/min

C) 100-120 beats/min

D) 120-140 beats/min

Explanation: Normal adult resting pulse rate is 60-100 beats per minute.

#25 Level 2

Which method is most reliable for sterilizing surgical instruments?

A) Boiling

B) Autoclaving

C) UV light

D) Alcohol wipe

Explanation: Autoclaving uses steam under pressure and is the most reliable sterilization method.

#26 Level 2

What is the primary purpose of nursing documentation?

A) Legal protection

B) Communication

C) Billing

D) Research

Explanation: The primary purpose of documentation is communication among the healthcare team.

#27 Level 2

Which patient is at highest risk for oral infections and requires frequent oral care?

A) Post-operative appendectomy

B) Unconscious patient

C) Ambulatory patient

D) Patient with hypertension

Explanation: Unconscious patients cannot maintain their own oral hygiene and are at high risk.

#28 Level 2

When caring for a patient with airborne disease, which PPE is essential?

A) Gloves only

B) Gown and gloves

C) N95 respirator

D) Face shield only

Explanation: Airborne precautions require an N95 or higher-level respirator.

#29 Level 2

Trendelenburg position is used primarily for:

A) Respiratory distress

B) Shock and hypotension

C) Post-spinal surgery

D) Gastric suction

Explanation: Trendelenburg position (head down, feet up) is used to improve perfusion in shock.

#30 Level 3

Which practice violates surgical asepsis?

A) Keeping sterile field above waist level

B) Turning back to sterile field

C) Using sterile gloves

D) Discarding contaminated items

Explanation: Turning your back to a sterile field risks contamination.

#31 Level 1

Which microorganism is responsible for tuberculosis?

A) Streptococcus

B) Mycobacterium tuberculosis

C) Escherichia coli

D) Staphylococcus

Explanation: Tuberculosis is caused by Mycobacterium tuberculosis.

#32 Level 2

What is the minimum temperature typically reached in an autoclave?

A) 100°C

B) 121°C

C) 80°C

D) 150°C

Explanation: Autoclaves typically operate at 121°C under 15 psi pressure.

#33 Level 1

Which vaccine is given at birth to prevent tuberculosis?

A) OPV

B) BCG

C) DPT

D) Measles

Explanation: BCG (Bacillus Calmette-Guérin) vaccine is given at birth for TB protection.

#34 Level 2

Which is an example of a high-level disinfectant?

A) Soap and water

B) Alcohol

C) Glutaraldehyde

D) Normal saline

Explanation: Glutaraldehyde is a high-level disinfectant used for heat-sensitive instruments.

#35 Level 2

Which of the following is NOT a link in the chain of infection?

A) Infectious agent

B) Reservoir

C) Nurse's attitude

D) Portal of entry

Explanation: The chain of infection includes infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.

#36 Level 2

What does 'cold chain' refer to in immunization?

A) Freezing all vaccines

B) Maintaining required temperature from production to administration

C) Storing vaccines in ice

D) Transporting vaccines quickly

Explanation: Cold chain is the temperature-controlled supply chain for vaccines.

#37 Level 3

Which color-coded bag is used for infectious waste disposal?

A) Black

B) Yellow

C) Red

D) Green

Explanation: In the BMW (Biomedical Waste) colour coding, yellow bags are used for infectious waste.

#38 Level 1

Which is NOT one of the 'five rights' of medication administration?

A) Right patient

B) Right dose

C) Right time

D) Right cost

Explanation: The five rights are right patient, drug, dose, route, and time.

#39 Level 2

Which route of administration has the fastest onset of action?

A) Oral

B) Intramuscular

C) Intravenous

D) Subcutaneous

Explanation: Intravenous administration delivers drug directly into circulation.

#40 Level 1

Which drug is commonly used to reduce fever?

A) Paracetamol

B) Insulin

C) Amlodipine

D) Metformin

Explanation: Paracetamol (acetaminophen) is a common antipyretic.

#41 Level 2

Which medication is used to treat bacterial infections?

A) Antibiotic

B) Antiviral

C) Antifungal

D) Antihistamine

Explanation: Antibiotics are used to treat bacterial infections.

#42 Level 2

A patient is prescribed 500 mg of a drug available as 250 mg tablets. How many tablets should be given?

A) 1

B) 2

C) 3

D) 4

Explanation: 500 mg / 250 mg = 2 tablets.

#43 Level 2

Which IV fluid is isotonic?

A) Dextrose 5%

B) Normal saline 0.9%

C) Half-normal saline

D) Mannitol

Explanation: Normal saline (0.9% NaCl) is isotonic to plasma.

#44 Level 3

Which class of drugs is used to treat hypertension?

A) ACE inhibitors

B) Antibiotics

C) Antacids

D) Bronchodilators

Explanation: ACE inhibitors are a common class of antihypertensive drugs.

#45 Level 1

Blood pressure consistently above which value is classified as hypertension?

A) 120/80 mmHg

B) 130/85 mmHg

C) 140/90 mmHg

D) 160/100 mmHg

Explanation: Hypertension is generally defined as BP ≥ 140/90 mmHg.

#46 Level 2

Which sample is most commonly used to diagnose pulmonary tuberculosis?

A) Blood

B) Urine

C) Sputum

D) Stool

Explanation: Sputum microscopy and culture are standard for diagnosing pulmonary TB.

#47 Level 2

What is the most common postoperative respiratory complication?

A) Pneumonia

B) Atelectasis

C) Pulmonary embolism

D) Pleural effusion

Explanation: Atelectasis (collapse of alveoli) is the most common postoperative respiratory complication.

#48 Level 2

Which sign is most characteristic of a stroke?

A) Sudden severe headache

B) Sudden unilateral weakness

C) Gradual confusion

D) Mild fever

Explanation: Sudden unilateral weakness or numbness is a hallmark of stroke.

#49 Level 2

Before administering medication through an NG tube, what should the nurse do?

A) Crush all tablets

B) Check tube placement

C) Use cold water

D) Administer rapidly

Explanation: Tube placement must be verified before any instillation.

#50 Level 2

What is the primary complication associated with urinary catheterization?

A) Hematuria

B) Urinary tract infection

C) Kidney stones

D) Incontinence

Explanation: Catheter-associated urinary tract infection (CAUTI) is the most common complication.

#51 Level 3

Which enzyme rises within hours after a myocardial infarction?

A) Amylase

B) Troponin

C) Lipase

D) Bilirubin

Explanation: Troponin levels rise within hours of myocardial damage.

#52 Level 2

Which precaution is essential when handling chemotherapy drugs?

A) Use double gloves

B) No special precautions

C) Use bare hands

D) Store at room temperature only

Explanation: Double gloving and safe handling procedures are required for chemotherapy.

#53 Level 2

What is the safe maximum oxygen flow rate for a simple nasal cannula?

A) 2 L/min

B) 4 L/min

C) 6 L/min

D) 10 L/min

Explanation: Nasal cannula flow rates are typically 1-6 L/min.

#54 Level 2

In which position is the patient lying flat on the back?

A) Prone

B) Lateral

C) Supine

D) Sims'

Explanation: Supine position means lying flat on the back.

#55 Level 2

Which vitamin is stored in the liver?

A) Vitamin C

B) Vitamin D

C) Vitamin B12

D) All fat-soluble vitamins

Explanation: The liver stores fat-soluble vitamins A, D, E, and K.

#56 Level 2

How many hours before surgery should a patient typically be NPO for solids?

A) 2 hours

B) 4 hours

C) 6-8 hours

D) 12 hours

Explanation: Standard pre-op fasting for solids is 6-8 hours to reduce aspiration risk.

#57 Level 2

What is the priority nursing action during a generalized seizure?

A) Insert an oral airway

B) Restrain the patient

C) Protect from injury

D) Give oral medication

Explanation: Protecting the patient from injury is the priority during a seizure.

#58 Level 3

Which symptom is most suggestive of left-sided heart failure?

A) Peripheral edema

B) Pulmonary edema

C) Hepatomegaly

D) Jugular venous distension

Explanation: Left-sided heart failure causes pulmonary congestion and edema.

#59 Level 3

Which condition indicates the need for dialysis?

A) Mild dehydration

B) End-stage renal disease

C) Urinary tract infection

D) Kidney stones

Explanation: End-stage renal disease often requires dialysis or transplantation.

#60 Level 1

Which is a key principle of Primary Health Care?

A) Specialised hospital care

B) Community participation

C) Expensive technology

D) Urban focus only

Explanation: Community participation is a core principle of Primary Health Care.

#61 Level 2

Which disease is transmitted by the Aedes mosquito?

A) Malaria

B) Dengue

C) Filariasis

D) Typhoid

Explanation: Dengue is transmitted by Aedes aegypti mosquito.

#62 Level 1

How many doses of DPT vaccine are given in the primary series?

A) 2

B) 3

C) 4

D) 5

Explanation: DPT primary series consists of three doses.

#63 Level 2

Which method is most effective for disinfecting drinking water at household level?

A) Filtration

B) Boiling

C) Sunlight exposure

D) Adding sugar

Explanation: Boiling water for at least one minute kills most pathogens.

#64 Level 2

Which national programme focuses on tuberculosis control in India?

A) RNTCP

B) NVBDCP

C) NLEP

D) NACO

Explanation: RNTCP (Revised National Tuberculosis Control Programme) focuses on TB.

#65 Level 2

Which is a permanent method of family planning?

A) Condom

B) Oral pills

C) Tubectomy

D) Copper-T

Explanation: Tubectomy is a permanent surgical contraceptive method for females.

#66 Level 3

What does 'herd immunity' mean?

A) Immunity of animals

B) Protection of unvaccinated individuals due to high vaccination coverage

C) Immunity from infection

D) Natural immunity only

Explanation: Herd immunity occurs when a large portion of a community is immune, protecting those who are not.

#67 Level 2

Which waste should be disposed in a yellow bag?

A) Glass vials

B) Infectious waste

C) Radioactive waste

D) General waste

Explanation: Yellow bags are used for infectious biomedical waste.

#68 Level 2

Which technique demonstrates therapeutic communication?

A) Giving advice

B) Active listening

C) Changing the subject

D) False reassurance

Explanation: Active listening is a core therapeutic communication technique.

#69 Level 2

Which symptom is most characteristic of major depression?

A) Euphoria

B) Persistent sadness

C) Hyperactivity

D) Increased appetite always

Explanation: Persistent sadness or anhedonia is characteristic of depression.

#70 Level 3

Which symptom is a positive symptom of schizophrenia?

A) Flat affect

B) Social withdrawal

C) Hallucinations

D) Avolition

Explanation: Hallucinations and delusions are positive symptoms of schizophrenia.

#71 Level 2

A patient who denies having an alcohol problem despite evidence is using which defense mechanism?

A) Projection

B) Denial

C) Rationalization

D) Sublimation

Explanation: Denial is refusing to accept reality or facts.

#72 Level 2

Which class of drugs is used to treat bipolar disorder?

A) Antidepressants

B) Mood stabilizers

C) Antihistamines

D) Antibiotics

Explanation: Mood stabilizers such as lithium are used for bipolar disorder.

#73 Level 2

Which substance causes withdrawal symptoms including tremors and seizures?

A) Alcohol

B) Cannabis

C) Caffeine

D) Nicotine

Explanation: Alcohol withdrawal can cause tremors, seizures, and delirium tremens.

#74 Level 3

What is the most important nursing action when a patient expresses suicidal ideation?

A) Ignore it to avoid reinforcing

B) Ensure safety and constant observation

C) Promise confidentiality

D) Leave the patient alone

Explanation: Patient safety is the priority; continuous observation and risk assessment are required.

#75 Level 2

At what age does an infant typically sit without support?

A) 3 months

B) 6 months

C) 9 months

D) 12 months

Explanation: Most infants can sit without support by around 6 months.

#76 Level 1

What is the best initial treatment for uncomplicated childhood diarrhea?

A) Antibiotics

B) ORS

C) Anti-diarrheal drugs

D) Fasting

Explanation: Oral Rehydration Salts (ORS) are the first-line treatment for diarrhea.

#77 Level 2

What is the normal birth weight of a full-term Indian newborn?

A) 1.5-2 kg

B) 2.5-3.5 kg

C) 4-5 kg

D) 1-1.5 kg

Explanation: Average full-term newborn weight is 2.5-3.5 kg.

#78 Level 2

At what age is the first dose of measles vaccine given?

A) 6 weeks

B) 9 months

C) 12 months

D) 5 years

Explanation: The first dose of measles vaccine is given at 9 months of age.

#79 Level 2

Which sign indicates severe pneumonia in a child?

A) Mild cough

B) Chest indrawing

C) Runny nose

D) Sore throat

Explanation: Chest indrawing is a sign of severe pneumonia in children.

#80 Level 1

When should breastfeeding ideally be initiated after birth?

A) After 24 hours

B) Within 1 hour

C) After 6 hours

D) After 12 hours

Explanation: Early initiation of breastfeeding within 1 hour is recommended.

#81 Level 2

Which anthropometric indicator is used to assess acute malnutrition in children?

A) Height-for-age

B) Weight-for-height

C) Head circumference

D) Birth weight

Explanation: Weight-for-height is used to assess acute malnutrition.

#82 Level 2

At what age do primary teeth usually begin to erupt?

A) 2-3 months

B) 6 months

C) 12 months

D) 18 months

Explanation: Primary teeth typically begin to erupt around 6 months of age.

#83 Level 1

How many antenatal check-ups are recommended for a normal pregnancy?

A) 2

B) 4

C) 6

D) 8

Explanation: A minimum of 4 antenatal visits is recommended for a normal pregnancy.

#84 Level 2

Which stage of labour ends with full dilation of the cervix?

A) First stage

B) Second stage

C) Third stage

D) Fourth stage

Explanation: The first stage of labour ends when the cervix is fully dilated (10 cm).

#85 Level 1

At what intervals after birth is the Apgar score assessed?

A) 1 and 5 minutes

B) 5 and 10 minutes

C) 10 and 15 minutes

D) 15 and 20 minutes

Explanation: Apgar score is assessed at 1 minute and 5 minutes after birth.

#86 Level 2

What is the normal duration of the puerperium?

A) 1 week

B) 2 weeks

C) 6 weeks

D) 3 months

Explanation: The puerperium is the 6-week period following childbirth.

#87 Level 2

What is the diagnostic triad of preeclampsia?

A) Hypertension, proteinuria, edema

B) Fever, pain, bleeding

C) Headache, vomiting, diarrhea

D) Jaundice, anemia, oliguria

Explanation: Preeclampsia is classically diagnosed by hypertension, proteinuria, and edema.

#88 Level 3

What is the most common cause of postpartum hemorrhage?

A) Infection

B) Uterine atony

C) Retained placenta

D) Coagulopathy

Explanation: Uterine atony is the most common cause of postpartum hemorrhage.

#89 Level 2

What is the term for painful menstruation?

A) Amenorrhea

B) Dysmenorrhea

C) Menorrhagia

D) Metrorrhagia

Explanation: Dysmenorrhea refers to painful menstrual periods.

#90 Level 2

Which female pelvis type is most favourable for vaginal delivery?

A) Android

B) Anthropoid

C) Gynaecoid

D) Platypelloid

Explanation: The gynaecoid pelvis is the most favourable for vaginal delivery.

#91 Level 2

Naegele's rule calculates the expected date of delivery by adding 7 days and subtracting 3 months from:

A) Last menstrual period

B) Date of conception

C) First fetal movement

D) First antenatal visit

Explanation: Naegele's rule uses the first day of the last menstrual period.

#92 Level 3

Which is the first movement in the mechanism of normal labour?

A) Internal rotation

B) Descent

C) Flexion

D) Extension

Explanation: Descent of the fetal head is the first movement in the mechanism of labour.

#93 Level 2

What is the defining feature of eclampsia?

A) High blood pressure only

B) Seizures in a woman with preeclampsia

C) Severe headache

D) Proteinuria only

Explanation: Eclampsia is preeclampsia complicated by seizures.

#94 Level 2

Which hormone is responsible for milk ejection during breastfeeding?

A) Progesterone

B) Oxytocin

C) Estrogen

D) Prolactin

Explanation: Oxytocin causes the milk ejection reflex (let-down).

#95 Level 1

Which nutrient is the main source of energy for the body?

A) Protein

B) Fat

C) Carbohydrate

D) Vitamin

Explanation: Carbohydrates are the body's main energy source.

#96 Level 2

Which disease is caused by severe protein-energy malnutrition?

A) Rickets

B) Kwashiorkor

C) Scurvy

D) Night blindness

Explanation: Kwashiorkor results from severe protein deficiency.

#97 Level 2

Which nutrient is most important to prevent neural tube defects in early pregnancy?

A) Iron

B) Calcium

C) Folic acid

D) Vitamin C

Explanation: Folic acid supplementation prevents neural tube defects.

#98 Level 2

Which vitamin deficiency causes scurvy?

A) Vitamin A

B) Vitamin B12

C) Vitamin C

D) Vitamin D

Explanation: Vitamin C deficiency causes scurvy.

#99 Level 2

Which condition is most commonly caused by iron deficiency?

A) Night blindness

B) Anemia

C) Rickets

D) Beriberi

Explanation: Iron deficiency is the most common cause of anemia.

#100 Level 1

What is the recommended compression-to-ventilation ratio for adult CPR with one rescuer?

A) 15:2

B) 30:2

C) 5:1

D) 50:2

Explanation: Adult CPR compression-to-ventilation ratio is 30:2 for one rescuer.

#101 Level 2

What is the first step in managing a patient in shock?

A) Give oral fluids

B) Maintain airway and breathing

C) Apply tourniquet

D) Elevate legs only

Explanation: Airway, breathing, and circulation are the first priorities in shock.

#102 Level 2

How should a minor thermal burn be initially managed?

A) Apply ice directly

B) Cool running water

C) Apply butter

D) Pop blisters

Explanation: Cool running water is recommended for minor burns.

#103 Level 3

In triage, which category is given highest priority?

A) Dead/expectant

B) Minor

C) Delayed

D) Immediate

Explanation: Immediate category needs life-saving intervention first.

#104 Level 2

Which manoeuvre is used to relieve airway obstruction in an adult?

A) Back blows only

B) Heimlich manoeuvre

C) Finger sweep

D) Chest thrusts only

Explanation: Abdominal thrusts (Heimlich manoeuvre) are used for adult choking.

#105 Level 2

Which structure controls what enters and leaves the cell?

A) Nucleus

B) Cytoplasm

C) Cell membrane

D) Ribosome

Explanation: The cell membrane regulates the movement of substances into and out of the cell.

#106 Level 2

Which type of joint allows the widest range of movement?

A) Fibrous joint

B) Cartilaginous joint

C) Synovial joint

D) Suture joint

Explanation: Synovial joints, such as the shoulder and knee, allow free movement.

#107 Level 2

What is the basic functional unit of skeletal muscle contraction?

A) Neuron

B) Sarcomere

C) Nephron

D) Axon

Explanation: The sarcomere is the basic contractile unit of muscle fiber.

#108 Level 2

Where are most nutrients absorbed in the digestive tract?

A) Stomach

B) Large intestine

C) Small intestine

D) Esophagus

Explanation: Most nutrient absorption occurs in the small intestine.

#109 Level 2

Which hormone is produced by the thyroid gland?

A) Insulin

B) Thyroxine

C) Cortisol

D) Estrogen

Explanation: The thyroid gland produces thyroxine (T4) and triiodothyronine (T3).

#110 Level 2

Where does fertilization normally occur in the female reproductive system?

A) Uterus

B) Ovary

C) Fallopian tube

D) Vagina

Explanation: Fertilization usually occurs in the fallopian tube.

#111 Level 2

When giving a bed bath, which body part should be washed last?

A) Face

B) Arms

C) Chest

D) Perineal area

Explanation: The perineal area is washed last to prevent transferring microorganisms to cleaner areas.

#112 Level 2

Semi-Fowler's position is used mainly for:

A) Shock

B) Respiratory distress

C) Pelvic surgery

D) Spinal anesthesia

Explanation: Semi-Fowler's position (head elevated 30-45 degrees) eases breathing.

#113 Level 3

Which finding indicates a wound infection?

A) Dry scab formation

B) Pink granulation tissue

C) Purulent drainage

D) Decreased warmth

Explanation: Purulent (pus-like) drainage is a sign of wound infection.

#114 Level 2

Which sign is most indicative of severe dehydration?

A) Bounding pulse

B) Moist mucous membranes

C) Sunken eyes

D) Hypertension

Explanation: Sunken eyes, dry mucous membranes, and decreased skin turgor indicate dehydration.

#115 Level 2

Which oxygen delivery device delivers the highest concentration of oxygen?

A) Nasal cannula

B) Simple face mask

C) Non-rebreather mask

D) Venturi mask

Explanation: A non-rebreather mask can deliver up to 90% oxygen.

#116 Level 3

A patient with chest pain is given aspirin. What is the primary reason?

A) To relieve pain

B) To reduce fever

C) To inhibit platelet aggregation

D) To lower blood pressure

Explanation: Aspirin inhibits platelet aggregation and is given in suspected myocardial infarction.

#117 Level 2

Before administering feedings through an NG tube, what must the nurse verify?

A) Tube length

B) Tube placement

C) Patient weight

D) Urine output

Explanation: Tube placement must be verified before every feeding to prevent aspiration.

#118 Level 2

Which action is correct when caring for a patient with an indwelling urinary catheter?

A) Pull the catheter gently to test placement

B) Keep the drainage bag above bladder level

C) Secure the tubing to prevent tension on the catheter

D) Disconnect the tubing frequently for cleaning

Explanation: The catheter tubing should be secured to prevent tension and trauma.

#119 Level 2

The Glasgow Coma Scale assesses:

A) Motor strength only

B) Eye opening, verbal response, and motor response

C) Pupil reaction only

D) Blood pressure and pulse

Explanation: The GCS assesses eye opening, verbal response, and motor response.

#120 Level 3

When handling chemotherapy drugs, which PPE is essential?

A) Gloves only

B) Gown and double gloves

C) Face shield only

D) Mask only

Explanation: Chemotherapy handling requires a gown and double gloves for safety.

#121 Level 3

Which extrapyramidal symptom is associated with antipsychotic medications?

A) Hypotension

B) Tardive dyskinesia

C) Diarrhea

D) Bradycardia

Explanation: Tardive dyskinesia is a long-term extrapyramidal side effect of antipsychotics.

#122 Level 2

Which contraceptive method also provides protection against sexually transmitted infections?

A) Oral contraceptive pills

B) Intrauterine device

C) Condom

D) Injectable hormones

Explanation: Condoms are the only listed method that reduces STI transmission risk.

#123 Level 2

The normal fetal head position at the onset of labour is:

A) Breech

B) Transverse lie

C) Cephalic presentation

D) Face presentation

Explanation: Cephalic presentation (head down) is the normal position for labour.

#124 Level 2

What is the first aid management of a suspected fracture?

A) Massage the area

B) Immobilize the affected part

C) Apply heat immediately

D) Attempt to straighten the limb

Explanation: The affected part should be immobilized to prevent further injury.

#125 Level 2

Which is a principle of primary health care?

A) Specialized hospital care

B) Community participation

C) Expensive technology

D) Urban-focused services

Explanation: Community participation is a core principle of primary health care.

#126 Level 2

Which parameter is most commonly used to assess a child's growth?

A) Head circumference only

B) Weight for age

C) Blood pressure

D) Temperature

Explanation: Weight for age is a standard growth monitoring indicator.

#127 Level 2

Which food group is the best source of dietary fiber?

A) Meat

B) Dairy

C) Fruits and vegetables

D) Fats

Explanation: Fruits, vegetables, and whole grains are good sources of dietary fiber.

#128 Level 2

Which disease is caused by a virus?

A) Tuberculosis

B) Tetanus

C) Measles

D) Typhoid

Explanation: Measles is caused by the measles virus.

#129 Level 3

Which route of administration avoids first-pass metabolism?

A) Oral

B) Intravenous

C) Subcutaneous

D) Both B and C

Explanation: Parenteral routes such as intravenous and subcutaneous avoid first-pass hepatic metabolism.

#130 Level 2

Which condition is treated with insulin?

A) Hypertension

B) Diabetes mellitus

C) Asthma

D) Epilepsy

Explanation: Insulin is used to manage diabetes mellitus.

#131 Level 1

What is the primary function of the circulatory system?

A) To assist in digestion

B) To regulate body temperature

C) To transport nutrients and oxygen

D) To enable movement of limbs

Explanation: The primary function of the circulatory system is to transport nutrients and oxygen to cells throughout the body.

#132 Level 2

Which valve prevents backflow of blood from the aorta into the left ventricle?

A) Tricuspid valve

B) Pulmonary valve

C) Mitral valve

D) Aortic valve

Explanation: The aortic valve prevents the backflow of blood from the aorta into the left ventricle after contraction.

#133 Level 3

If a patient's heart rate is 75 beats per minute and stroke volume is 70 mL, what is their cardiac output?

A) 5250 mL/min

B) 4200 mL/min

C) 6000 mL/min

D) 8000 mL/min

Explanation: Cardiac output is calculated using the formula: Heart Rate x Stroke Volume. Therefore, 75 beats/min x 70 mL = 5250 mL/min.

#134 Level 2

What are the two main phases of the cardiac cycle?

A) Diastole and Systole

B) Exhalation and Inhalation

C) Resting and Active

D) Contraction and Relaxation

Explanation: The cardiac cycle consists of two main phases: diastole (when the heart relaxes) and systole (when the heart contracts).

#135 Level 3

During a physical examination, a nurse notes a patient has a significant blockage in their coronary arteries. What is the most likely effect on blood flow?

A) Increased blood flow to the heart

B) Decreased oxygen supply to the heart muscle

C) Uninterrupted blood flow

D) Increased blood pressure in the arteries

Explanation: A significant blockage in the coronary arteries limits blood flow, thereby reducing the oxygen supply to the heart muscle, which can lead to ischemia.

#136 Level 1

Which heart valve prevents backflow from the aorta into the left ventricle?

A) Tricuspid valve

B) Pulmonary valve

C) Aortic valve

D) Mitral valve

Explanation: The aortic valve prevents backflow from the aorta into the left ventricle during diastole.

#137 Level 2

A nurse is assessing a patient and needs to check the radial pulse. Where should the nurse place her fingers?

A) On the neck

B) On the inside of the elbow

C) On the wrist, below the thumb

D) On the top of the foot

Explanation: The radial pulse is located on the wrist, below the thumb, where the radial artery is accessible for palpation.

#138 Level 2

What component of blood is primarily responsible for the transportation of oxygen?

A) Plasma

B) White blood cells

C) Red blood cells

D) Platelets

Explanation: Red blood cells contain hemoglobin, which binds to oxygen and allows for its transportation throughout the body.

#139 Level 3

A patient presents with signs of congestive heart failure. Which compensatory mechanism might the body employ to try to maintain cardiac output?

A) Decrease heart rate

B) Increase blood volume

C) Increase peripheral resistance

D) Decrease contractility of the heart

Explanation: In congestive heart failure, the body may attempt to compensate by increasing blood volume to improve cardiac output, despite potential risks of fluid overload.

#140 Level 2

Which type of tissue is primarily responsible for contraction and movement?

A) Epithelial tissue

B) Connective tissue

C) Nervous tissue

D) Muscle tissue

Explanation: Muscle tissue is specialized for contraction and is responsible for movement in the body.

#141 Level 1

What is the main function of epithelial tissue?

A) Support and bind other tissues

B) Cover and protect surfaces

C) Transmit impulses

D) Contract for movement

Explanation: Epithelial tissue primarily serves to cover and protect surfaces both internally and externally.

#142 Level 2

Which of the following is a characteristic of connective tissue?

A) It has a high cellular density.

B) It is primarily composed of cells.

C) It provides structural support and connects different tissues.

D) It is involved in signal transmission.

Explanation: Connective tissue provides structural support and connects different tissues, often having a lower density of cells compared to other tissue types.

#143 Level 3

What is the primary role of nervous tissue in the body?

A) To provide support and insulation to organs.

B) To transmit signals throughout the body.

C) To facilitate absorption and secretion.

D) To protect against pathogens.

Explanation: Nervous tissue is specialized for transmitting signals throughout the body, facilitating communication between different parts of the body.

#144 Level 2

What is a unique characteristic of stem cells?

A) They can only differentiate into nerve cells.

B) They can replicate indefinitely and differentiate into various cell types.

C) They are specialized cells with specific functions.

D) They are only found in embryos.

Explanation: Stem cells have the unique ability to replicate indefinitely and can differentiate into various specialized cell types.

#145 Level 2

Which type of muscle tissue is under voluntary control?

A) Cardiac muscle

B) Smooth muscle

C) Skeletal muscle

D) All muscle tissues

Explanation: Skeletal muscle tissue is the only type that is under voluntary control, allowing for conscious movement.

#146 Level 3

Which phase of the cell cycle is characterized by DNA replication?

A) G1 phase

B) S phase

C) G2 phase

D) M phase

Explanation: The S phase of the cell cycle is where DNA replication occurs, preparing the cell for division.

#147 Level 2

What is apoptosis?

A) The process of cell division.

B) The programmed death of cells.

C) The abnormal growth of cells.

D) The process of cell differentiation.

Explanation: Apoptosis is a regulated process that leads to the programmed death of cells, which is crucial for maintaining healthy tissue homeostasis.

#148 Level 1

Which organelle is responsible for protein synthesis?

A) Nucleus

B) Ribosome

C) Lysosome

D) Endoplasmic reticulum

Explanation: Ribosomes are the cellular structures where protein synthesis occurs.

#149 Level 3

What is the primary function of the extracellular matrix?

A) To act as a barrier against pathogens.

B) To store genetic information.

C) To provide structural and biochemical support to surrounding cells.

D) To facilitate cell division.

Explanation: The extracellular matrix provides essential structural and biochemical support to surrounding cells, influencing their behavior.

#150 Level 1

What is the primary function of the digestive system?

A) Circulation of blood

B) Breakdown and absorption of nutrients

C) Regulation of body temperature

D) Production of hormones

Explanation: The primary function of the digestive system is to break down food and absorb nutrients.

#151 Level 2

What role does saliva play in the digestive process?

A) It neutralizes stomach acid.

B) It contains enzymes that begin starch digestion.

C) It promotes fat absorption.

D) It increases bile production.

Explanation: Saliva contains amylase, an enzyme that begins the digestion of starch in the mouth.

#152 Level 3

What is the role of hydrochloric acid in the stomach?

A) It inhibits enzyme activity.

B) It activates pepsinogen to pepsin.

C) It emulsifies fats.

D) It neutralizes alkaline substances.

Explanation: Hydrochloric acid activates pepsinogen to pepsin, which is essential for protein digestion.

#153 Level 2

What is the primary function of bile in digestion?

A) Digestion of proteins

B) Emulsification of fats

C) Absorption of carbohydrates

D) Neutralization of stomach acid

Explanation: Bile primarily functions to emulsify fats, making them easier to digest.

#154 Level 2

Which structure in the small intestine increases the surface area for absorption?

A) Villi

B) Rugae

C) Crypts

D) Microvilli

Explanation: Villi are finger-like projections in the small intestine that increase surface area for nutrient absorption.

#155 Level 1

Which organ is primarily responsible for water absorption in the digestive system?

A) Stomach

B) Large intestine

C) Small intestine

D) Pancreas

Explanation: The large intestine is primarily responsible for the absorption of water and electrolytes from indigestible food residues.

#156 Level 3

How does the pancreas contribute to digestion?

A) By secreting bile

B) By producing digestive enzymes

C) By absorbing nutrients

D) By neutralizing stomach acid

Explanation: The pancreas produces digestive enzymes that break down carbohydrates, proteins, and fats in the small intestine.

#157 Level 2

What is the function of the esophagus in the digestive system?

A) Digestion of food

B) Absorption of nutrients

C) Transport of food to the stomach

D) Secretion of digestive juices

Explanation: The esophagus is responsible for transporting food from the mouth to the stomach.

#158 Level 3

What is peristalsis, and why is it important in digestion?

A) It is the absorption of nutrients.

B) It is the voluntary movement of muscles.

C) It is a series of wave-like muscle contractions that move food through the digestive tract.

D) It is the breakdown of food by enzymes.

Explanation: Peristalsis is a series of wave-like muscle contractions that move food through the digestive tract, essential for digestion and absorption.

#159 Level 2

What is the function of intestinal juices in the digestive process?

A) To stimulate appetite

B) To neutralize stomach acid and aid digestion

C) To absorb nutrients

D) To produce bile

Explanation: Intestinal juices help to neutralize stomach acid and contain enzymes that further aid in digestion.

#160 Level 1

Which hormone is primarily produced by the adrenal cortex?

A) Epinephrine

B) Cortisol

C) Norepinephrine

D) Insulin

Explanation: Cortisol is the main hormone produced by the adrenal cortex, playing a role in metabolism and stress response.

#161 Level 2

What is the primary function of growth hormone in the body?

A) Regulating blood sugar levels

B) Stimulating growth and cell reproduction

C) Regulating metabolism of fats

D) Controlling sleep-wake cycles

Explanation: Growth hormone is responsible for stimulating growth, cell reproduction, and cell regeneration in humans.

#162 Level 2

What is the effect of parathyroid hormone on calcium levels in the blood?

A) Decreases calcium levels

B) Increases calcium levels

C) No effect on calcium levels

D) Only affects phosphate levels

Explanation: Parathyroid hormone increases blood calcium levels by stimulating osteoclasts, which release calcium from bones.

#163 Level 3

Which of the following is a direct consequence of hypothyroidism?

A) Increased metabolic rate

B) Weight loss

C) Fatigue and weight gain

D) Hyperactivity

Explanation: Hypothyroidism results in a decreased metabolic rate, leading to fatigue and weight gain among other symptoms.

#164 Level 1

What is the primary target organ for insulin action?

A) Liver

B) Muscle

C) Kidney

D) All of the above

Explanation: Insulin acts on multiple organs, including the liver, muscle, and kidney, to regulate glucose metabolism.

#165 Level 2

Which hormone is primarily responsible for the development of female secondary sexual characteristics?

A) Testosterone

B) Estrogen

C) Progesterone

D) Luteinizing hormone

Explanation: Estrogen is crucial for the development of female secondary sexual characteristics like breast development and regulation of the menstrual cycle.

#166 Level 2

What role does testosterone play in male physiology?

A) Regulating glucose metabolism

B) Development of male reproductive tissues

C) Stimulating milk production

D) Regulating sleep cycles

Explanation: Testosterone is crucial for the development of male reproductive tissues, including the testes and prostate.

#167 Level 3

What is the primary function of oxytocin during childbirth?

A) Stimulate milk production

B) Regulate blood pressure

C) Induce uterine contractions

D) Increase heart rate

Explanation: Oxytocin is crucial for inducing uterine contractions during childbirth and facilitating labor.

#168 Level 1

Which hormone is known as the 'fight or flight' hormone?

A) Cortisol

B) Insulin

C) Adrenaline

D) Norepinephrine

Explanation: Adrenaline, produced by the adrenal medulla, prepares the body for 'fight or flight' responses in stressful situations.

#169 Level 2

What is the main role of melatonin in the human body?

A) Regulating metabolism

B) Managing sleep-wake cycles

C) Stimulating growth

D) Enhancing immune function

Explanation: Melatonin is primarily involved in regulating sleep-wake cycles and is produced in response to darkness.

#170 Level 1

Which structure in the kidney is responsible for filtering blood?

A) Ureter

B) Glomerulus

C) Renal pelvis

D) Urethra

Explanation: The glomerulus is the network of capillaries in the nephron responsible for filtering blood.

#171 Level 2

What is the main function of the loop of Henle in the nephron?

A) Filtration of blood

B) Reabsorption of water and sodium

C) Excretion of waste

D) Regulation of pH

Explanation: The loop of Henle is primarily responsible for the reabsorption of water and sodium, concentrating urine.

#172 Level 3

Which of the following is NOT typically found in urine?

A) Urea

B) Creatinine

C) Glucose

D) Uric Acid

Explanation: Glucose is typically reabsorbed in the kidneys and is not normally found in urine unless blood glucose levels are abnormally high.

#173 Level 1

What is the primary purpose of the kidneys?

A) Hormone production

B) Blood filtration and waste elimination

C) Gas exchange

D) Nutrient absorption

Explanation: The primary purpose of the kidneys is to filter blood and eliminate waste, regulating fluid and electrolyte balance.

#174 Level 2

A patient presents with decreased urine output and swelling in the legs. Which condition may these symptoms indicate?

A) Diabetes Mellitus

B) Acute Kidney Injury

C) Hypertension

D) Urinary Tract Infection

Explanation: Decreased urine output and swelling often indicate acute kidney injury, which impairs the kidneys' ability to filter waste.

#175 Level 2

What does the term 'glomerular filtration rate' (GFR) refer to?

A) The amount of blood filtered by the kidneys per minute

B) The total urine output in 24 hours

C) The concentration of urine

D) The volume of blood in the body

Explanation: Glomerular filtration rate (GFR) refers to the rate at which blood is filtered through the kidneys, indicating their function.

#176 Level 3

Which of the following conditions can lead to chronic kidney disease?

A) Acute dehydration

B) Diabetes Mellitus

C) Urinary Tract Infection

D) Hypertensive crisis

Explanation: Diabetes Mellitus is one of the leading causes of chronic kidney disease due to long-term damage to blood vessels in the kidneys.

#177 Level 1

Which electrolyte is primarily regulated by the kidneys?

A) Calcium

B) Sodium

C) Potassium

D) Magnesium

Explanation: The kidneys play a vital role in regulating sodium levels, which are crucial for fluid balance and blood pressure.

#178 Level 2

Which process in the nephron is primarily responsible for urine formation?

A) Filtration

B) Secretion

C) Reabsorption

D) All of the above

Explanation: Urine formation involves filtration, secretion, and reabsorption, each contributing to the final urine composition.

#179 Level 2

What is the primary protein found in skeletal muscle that is responsible for contraction?

A) Actin

B) Myosin

C) Collagen

D) Elastin

Explanation: Myosin is the main protein involved in muscle contraction, working with actin.

#180 Level 1

What is the main function of skeletal muscles?

A) Blood circulation

B) Movement of the body

C) Digestion

D) Hormone production

Explanation: Skeletal muscles primarily function to facilitate movement of the body.

#181 Level 2

Which type of muscle is responsible for involuntary movements in the body?

A) Cardiac muscle

B) Skeletal muscle

C) Smooth muscle

D) Both A and C

Explanation: Both cardiac and smooth muscles are involuntary, while skeletal muscle is voluntary.

#182 Level 3

During muscle contraction, which ion is primarily responsible for initiating the process?

A) Sodium

B) Potassium

C) Calcium

D) Magnesium

Explanation: Calcium ions play a crucial role in initiating muscle contraction by binding to troponin.

#183 Level 2

What is the primary source of energy for muscle contraction?

A) Glucose

B) ATP

C) Oxygen

D) Lactic acid

Explanation: ATP (adenosine triphosphate) is the immediate source of energy for muscle contraction.

#184 Level 3

What is a common cause of muscle fatigue during prolonged exercise?

A) Increased ATP production

B) Depletion of glycogen stores

C) Elevated calcium levels

D) Increased oxygen availability

Explanation: Depletion of glycogen stores during prolonged exercise can lead to muscle fatigue.

#185 Level 2

In a muscle group, which muscle is primarily responsible for the action of flexion?

A) Agonist

B) Antagonist

C) Synergist

D) Stabilizer

Explanation: The agonist muscle is the primary muscle responsible for executing a certain movement, such as flexion.

#186 Level 2

What is the physiological response of a muscle when it is stretched?

A) Contraction

B) Relaxation

C) Strengthening

D) Fatigue

Explanation: When a muscle is stretched, it typically relaxes to allow for elongation.

#187 Level 3

What is the primary process that occurs during muscle repair after injury?

A) Inflammation

B) Hypertrophy

C) Atrophy

D) Regeneration

Explanation: Regeneration is the primary process involved in muscle repair following an injury.

#188 Level 2

What adaptation occurs in muscles as a result of regular strength training?

A) Decreased muscle mass

B) Increased muscle flexibility

C) Muscle hypertrophy

D) Decreased endurance

Explanation: Muscle hypertrophy refers to the increase in muscle size that occurs as a result of strength training.

#189 Level 1

What is the primary function of the nervous system?

A) Digestion

B) Coordination of body activities

C) Blood circulation

D) Respiration

Explanation: The primary function of the nervous system is to coordinate body activities by transmitting signals between different parts of the body.

#190 Level 2

Which part of the neuron receives signals from other neurons?

A) Axon

B) Dendrites

C) Soma

D) Myelin sheath

Explanation: Dendrites are the branching extensions of a neuron that receive signals from other neurons.

#191 Level 2

Which components make up the central nervous system (CNS)?

A) Brain and spinal cord

B) Brain and nerves

C) Spinal cord and ganglia

D) Brain, spinal cord, and peripheral nerves

Explanation: The central nervous system is comprised of the brain and spinal cord, which coordinate and process information.

#192 Level 3

What differentiates the peripheral nervous system (PNS) from the central nervous system (CNS)?

A) The PNS connects to muscles and organs, while the CNS consists of the brain and spinal cord.

B) The PNS includes only sensory neurons, while the CNS handles motor functions.

C) The PNS is encased in bone, whereas the CNS is not.

D) There is no difference; they are the same system.

Explanation: The peripheral nervous system connects the CNS to the limbs and organs, while the CNS comprises the brain and spinal cord.

#193 Level 2

What role do neurotransmitters play in the nervous system?

A) They form the structural components of neurons.

B) They transmit electrical impulses along the axon.

C) They facilitate communication between neurons.

D) They protect neurons from damage.

Explanation: Neurotransmitters are chemicals that transmit signals across a synapse from one neuron to another, facilitating communication.

#194 Level 3

Which of the following correctly describes the pathway of a reflex arc?

A) Sensory neuron → spinal cord → interneuron → motor neuron

B) Motor neuron → sensory neuron → spinal cord → brain

C) Interneuron → motor neuron → sensory neuron → spinal cord

D) Sensory neuron → motor neuron → brain

Explanation: The reflex arc pathway typically follows the course: sensory neuron to spinal cord to interneuron and then to motor neuron.

#195 Level 2

Which term describes the part of the autonomic nervous system responsible for 'fight or flight' responses?

A) Parasympathetic nervous system

B) Somatic nervous system

C) Sympathetic nervous system

D) Central nervous system

Explanation: The sympathetic nervous system is responsible for the body's 'fight or flight' responses during stressful situations.

#196 Level 2

What is the primary role of the cerebrum in the brain?

A) Regulation of heart rate

B) Processing sensory information and higher cognitive functions

C) Coordination of movement

D) Balance and posture control

Explanation: The cerebrum is responsible for processing sensory information and is involved in higher cognitive functions such as thinking and decision-making.

#197 Level 3

Which function is NOT a role of the spinal cord?

A) Conducting signals to and from the brain

B) Reflex actions

C) Producing hormones

D) Protective function of the vertebrae

Explanation: The spinal cord does not produce hormones; its primary functions include conducting signals and mediating reflex actions.

#198 Level 2

What is the primary function of the autonomic nervous system?

A) Control voluntary movements

B) Regulate involuntary bodily functions

C) Process sensory information

D) Coordinate muscle contractions

Explanation: The autonomic nervous system regulates involuntary bodily functions such as heart rate, digestion, and respiratory rate.

#199 Level 2

What are the two phases of the ovarian cycle?

A) Proliferative and secretory

B) Follicular and luteal

C) Menstrual and proliferative

D) Anovulatory and ovulatory

Explanation: The ovarian cycle consists of the follicular phase and the luteal phase.

#200 Level 3

What is the significance of implantation in the reproductive process?

A) It marks the beginning of the menstrual cycle.

B) It allows the embryo to attach to the uterine wall.

C) It leads to the expulsion of the ovum.

D) It triggers ovulation.

Explanation: Implantation is crucial for the embryo to attach to the uterine wall, allowing for nutrient exchange and development.

#201 Level 1

What is the process of sperm production called?

A) Oogenesis

B) Spermatogenesis

C) Fertilization

D) Menstruation

Explanation: Spermatogenesis is the process through which sperm is produced in the male reproductive system.

#202 Level 2

Which hormone is primarily responsible for stimulating ovulation?

A) Estrogen

B) Testosterone

C) Luteinizing hormone (LH)

D) Follicle-stimulating hormone (FSH)

Explanation: Luteinizing hormone (LH) is mainly responsible for triggering ovulation in the menstrual cycle.

#203 Level 2

What structure is primarily responsible for the production of estrogen?

A) Uterus

B) Ovaries

C) Fallopian tubes

D) Pituitary gland

Explanation: The ovaries are the primary reproductive organs responsible for producing estrogen in females.

#204 Level 3

Which condition is characterized by painful menstruation?

A) Amenorrhea

B) Dysmenorrhea

C) Menorrhagia

D) Oligomenorrhea

Explanation: Dysmenorrhea is the medical term for painful menstruation, affecting many individuals during their menstrual cycles.

#205 Level 2

What is the primary function of the corpus luteum?

A) To produce testosterone

B) To maintain the uterine lining

C) To trigger ovulation

D) To facilitate fertilization

Explanation: The corpus luteum's primary function is to produce hormones that maintain the uterine lining for possible implantation.

#206 Level 2

Which sexually transmitted infection is known for causing genital warts?

A) Gonorrhea

B) Chlamydia

C) Human Papillomavirus (HPV)

D) Syphilis

Explanation: Human Papillomavirus (HPV) is the sexually transmitted infection primarily associated with the development of genital warts.

#207 Level 2

Which contraceptive method involves the use of hormonal pills?

A) Barrier methods

B) Natural methods

C) Hormonal contraception

D) Surgical methods

Explanation: Hormonal contraception involves the use of hormonal pills to prevent ovulation and regulate the menstrual cycle.

#208 Level 1

What is the primary function of the lungs?

A) Circulation of blood

B) Gas exchange

C) Digestion of food

D) Regulation of body temperature

Explanation: The primary function of the lungs is gas exchange, where oxygen is absorbed and carbon dioxide is expelled.

#209 Level 2

Which part of the respiratory system is responsible for the filtering and humidifying of air?

A) Alveoli

B) Bronchi

C) Nasal cavity

D) Trachea

Explanation: The nasal cavity filters, humidifies, and warms the air before it enters the lungs.

#210 Level 2

During inhalation, which of the following muscles actively contracts?

A) Abdominal muscles

B) Intercostal muscles

C) Diaphragm

D) Both B and C

Explanation: During inhalation, both the intercostal muscles and diaphragm contract to expand the thoracic cavity.

#211 Level 3

Which molecule is primarily responsible for the transport of oxygen in the blood?

A) Hemoglobin

B) Plasma proteins

C) White blood cells

D) Platelets

Explanation: Hemoglobin in red blood cells binds to oxygen and transports it from the lungs to tissues throughout the body.

#212 Level 2

How is carbon dioxide primarily removed from the body?

A) Through urine

B) By the lungs during exhalation

C) Through sweat

D) By the kidneys

Explanation: Carbon dioxide is primarily removed from the body by the lungs during the process of exhalation.

#213 Level 3

Which respiratory volume represents the amount of air inhaled or exhaled during normal breathing?

A) Tidal volume

B) Vital capacity

C) Residual volume

D) Inspiratory reserve volume

Explanation: Tidal volume is the amount of air that is inhaled or exhaled during normal, relaxed breathing.

#214 Level 2

Which of the following conditions is characterized by inflammation and narrowing of the airways?

A) Pneumonia

B) Chronic bronchitis

C) Asthma

D) Emphysema

Explanation: Asthma is characterized by inflammation and narrowing of the airways, leading to difficulty in breathing.

#215 Level 3

What is the primary purpose of pulmonary circulation?

A) To supply oxygen-rich blood to the body

B) To bring deoxygenated blood to the lungs for oxygenation

C) To remove waste from the body

D) To regulate blood pressure

Explanation: The primary purpose of pulmonary circulation is to transport deoxygenated blood from the heart to the lungs for oxygenation.

#216 Level 2

Which of the following infections primarily affects the lower respiratory tract?

A) Sinusitis

B) Laryngitis

C) Bronchitis

D) Pharyngitis

Explanation: Bronchitis primarily affects the lower respiratory tract, causing inflammation of the bronchial tubes.

#217 Level 2

What is the primary function of the skeletal system?

A) To circulate blood

B) To support and protect the body

C) To facilitate digestion

D) To regulate temperature

Explanation: The skeletal system provides support and protection to the body's organs and structures.

#218 Level 3

Which of the following bones is NOT part of the human skull?

A) Maxilla

B) Sternum

C) Zygomatic

D) Frontal

Explanation: The sternum is part of the thoracic skeleton, while the other options are bones that make up the human skull.

#219 Level 2

What is the process of bone healing after a fracture called?

A) Osteogenesis

B) Osteoporosis

C) Hematopoiesis

D) Callus formation

Explanation: Callus formation is a crucial step in the healing process of a fractured bone.

#220 Level 1

What is the function of ligaments in the skeletal system?

A) To connect muscles to bones

B) To connect bones to other bones

C) To produce blood cells

D) To absorb shock

Explanation: Ligaments are connective tissues that connect bones to other bones at joints.

#221 Level 2

Which type of bone is primarily responsible for producing red blood cells?

A) Compact bone

B) Spongy bone

C) Cartilage

D) Periosteum

Explanation: Spongy bone contains red bone marrow, which is responsible for the production of red blood cells.

#222 Level 1

Which joint type allows for rotational movement?

A) Hinge joint

B) Ball-and-socket joint

C) Pivot joint

D) Saddle joint

Explanation: Pivot joints, such as the one in the neck, allow for rotational movement.

#223 Level 3

What is the primary mineral found in bones that contributes to their hardness?

A) Sodium

B) Calcium

C) Iron

D) Magnesium

Explanation: Calcium is the primary mineral responsible for the hardness and strength of bones.

#224 Level 2

How many vertebrae are typically found in the human adult spinal column?

A) 24

B) 26

C) 33

D) 30

Explanation: The adult human spinal column typically consists of 33 vertebrae, including cervical, thoracic, and lumbar regions.

#225 Level 1

What is the classification of bones based on their shape?

A) Long, short, flat, irregular

B) Rigid, flexible, semi-rigid, fluid

C) Compact, spongy, cortical, trabecular

D) Elastic, fibrous, cellular, vascular

Explanation: Bones are classified based on their shape into long, short, flat, and irregular bones.

#226 Level 2

Which function of the skeletal system provides a framework for the body?

A) Protection

B) Movement

C) Support

D) Blood cell production

Explanation: The support function of the skeletal system provides a structural framework for the body.

#227 Level 2

What is a key characteristic symptom of measles in children?

A) High fever

B) Skin rash

C) Persistent cough

D) Abdominal pain

Explanation: A skin rash is a key characteristic symptom of measles, appearing after the onset of fever.

#228 Level 2

Which of the following is a common complication of chickenpox in children?

A) Pneumonia

B) Gastroenteritis

C) Meningitis

D) Otitis media

Explanation: Pneumonia is a common complication of chickenpox, especially in children with weakened immune systems.

#229 Level 3

What triggers would most likely exacerbate an asthma attack in a child?

A) Cold air

B) Warm weather

C) Exercise

D) High humidity

Explanation: Cold air is a common trigger that can exacerbate asthma attacks in children.

#230 Level 2

Which skin condition is caused by a mite infestation in children?

A) Eczema

B) Scabies

C) Psoriasis

D) Impetigo

Explanation: Scabies is caused by an infestation of the Sarcoptes scabiei mite, leading to intense itching.

#231 Level 3

A child presents with prolonged fever, abdominal pain, and diarrhea. Which condition should be suspected?

A) Dengue

B) Typhoid fever

C) Appendicitis

D) Acute gastroenteritis

Explanation: The symptoms of prolonged fever, abdominal pain, and diarrhea are indicative of typhoid fever, which is common in children.

#232 Level 1

What is the primary causative agent of pneumonia in children?

A) Virus

B) Bacteria

C) Fungi

D) Parasites

Explanation: Bacterial pneumonia is a leading cause of pneumonia in children, often caused by Streptococcus pneumoniae.

#233 Level 3

Which factor increases the risk of tuberculosis in children?

A) Good nutrition

B) Close contact with infected individuals

C) Regular vaccinations

D) High socioeconomic status

Explanation: Close contact with individuals infected with tuberculosis significantly increases the risk of transmission to children.

#234 Level 1

What is the most common cause of constipation in children?

A) Dehydration

B) Lack of exercise

C) Poor diet

D) Stress

Explanation: Poor dietary habits, particularly low fiber intake, are the most common cause of constipation in children.

#235 Level 1

What is the expected growth pattern for infants during the first year of life?

A) Steady decrease in weight

B) Tripling of birth weight

C) No significant weight change

D) Doubling of birth weight at 12 months

Explanation: Infants typically triple their birth weight by the end of the first year.

#236 Level 2

During puberty, which of the following changes is commonly observed in children?

A) Decrease in height

B) Increase in muscle mass

C) Decrease in body fat

D) Stagnation of growth

Explanation: Puberty is characterized by an increase in muscle mass due to hormonal changes.

#237 Level 3

A 2-year-old child exhibits signs of stunted growth. Which dietary change would be most beneficial?

A) Increase milk intake

B) Reduce carbohydrate consumption

C) Include more protein-rich foods

D) Limit fruits and vegetables

Explanation: Increasing protein-rich foods is essential for supporting growth and development in young children.

#238 Level 2

At what age do most children start to walk independently?

A) 8 months

B) 10 months

C) 12 months

D) 15 months

Explanation: Most children typically start to walk independently around 12 months of age.

#239 Level 3

Which parameter is crucial for analyzing a child's growth chart effectively?

A) Age of child

B) Weight only

C) Height only

D) Body temperature

Explanation: The age of the child is crucial as growth charts are age-specific to assess growth patterns accurately.

#240 Level 2

Which developmental milestone is typically expected by 18 months of age?

A) Speaking in full sentences

B) Running without falling

C) Walking up steps with assistance

D) Drawing a circle

Explanation: By 18 months, most children can walk up steps with assistance.

#241 Level 1

Why is immunization important in early childhood?

A) It helps in bone growth

B) It prevents infectious diseases

C) It improves eyesight

D) It reduces appetite

Explanation: Immunization plays a crucial role in preventing infectious diseases in early childhood.

#242 Level 2

How can parental behaviors influence a child's growth and development?

A) Ignoring the child's diet

B) Providing a stimulating environment

C) Withholding playtime

D) Limiting social interactions

Explanation: Providing a stimulating environment is essential for healthy growth and development in children.

#243 Level 2

What is a common cause of neonatal jaundice in the first week of life?

A) Hemolytic disease of the newborn

B) Congenital hypothyroidism

C) Cystic fibrosis

D) Rickettsia infection

Explanation: Hemolytic disease of the newborn is a common cause of jaundice due to increased bilirubin levels from red blood cell breakdown.

#244 Level 1

What is the primary reason for maintaining thermal stability in neonates?

A) Preventing hypoglycemia

B) Preventing hypothermia

C) Promoting weight gain

D) Enhancing feeding

Explanation: Maintaining thermal stability helps prevent hypothermia, which can lead to serious complications in neonates.

#245 Level 3

A newborn is not breathing adequately at birth. What is the first step in neonatal resuscitation?

A) Administer medications

B) Provide positive pressure ventilation

C) Stimulate the newborn

D) Call for additional help

Explanation: The first step in neonatal resuscitation is to stimulate the newborn to initiate breathing.

#246 Level 1

What is the recommended position for a neonate during sleep to reduce the risk of sudden infant death syndrome (SIDS)?

A) On the stomach

B) On the side

C) On the back

D) Sitting upright

Explanation: Placing a neonate on their back during sleep is recommended to reduce the risk of SIDS.

#247 Level 2

What is the appropriate care for a newborn's umbilical cord stump?

A) Keep it covered with a bandage

B) Clean with alcohol and keep dry

C) Apply ointment regularly

D) Immerse in water

Explanation: The umbilical cord stump should be kept clean and dry, often cleaned with alcohol to prevent infection.

#248 Level 2

What is the primary nutritional source for a newborn in the first six months?

A) Formula milk

B) Solid foods

C) Breast milk

D) Cow's milk

Explanation: Breast milk is the primary nutritional source for newborns, providing essential nutrients and antibodies.

#249 Level 3

At what age should a newborn typically be able to lift their head while lying on their stomach?

A) 1 month

B) 2 months

C) 4 months

D) 6 months

Explanation: By 2 months of age, most infants can lift their head while lying on their stomach, indicating motor development.

#250 Level 2

Which vaccine is typically administered at birth to protect against hepatitis B?

A) BCG vaccine

B) Oral polio vaccine

C) Hepatitis B vaccine

D) DTP vaccine

Explanation: The hepatitis B vaccine is administered at birth to provide early protection against the virus.

#251 Level 1

What is the purpose of the newborn screening test?

A) To check for congenital anomalies

B) To assess motor skills

C) To detect metabolic disorders

D) To evaluate vision

Explanation: The newborn screening test aims to detect metabolic disorders that can be managed early to prevent complications.

#252 Level 1

Which vaccine is primarily used to prevent measles?

A) BCG

B) DPT

C) MMR

D) Hepatitis B

Explanation: The MMR vaccine protects against measles, mumps, and rubella.

#253 Level 2

Which of the following is a common mode of transmission for respiratory infections?

A) Vector-borne

B) Airborne

C) Fecal-oral

D) Direct contact

Explanation: Respiratory infections commonly spread through airborne transmission.

#254 Level 3

What is the primary purpose of epidemiological studies in public health?

A) To develop new medications

B) To monitor health statistics

C) To establish causative factors of diseases

D) To provide direct patient care

Explanation: Epidemiological studies help identify causative factors of diseases to inform prevention strategies.

#255 Level 2

A community nurse is educating families about the importance of hand hygiene to prevent infections. Which method is most effective?

A) Using hand sanitizers only

B) Washing hands with soap and water

C) Wearing gloves while cooking

D) Avoiding direct contact with sick individuals

Explanation: Washing hands with soap and water is the most effective method for preventing infections.

#256 Level 2

What is the main objective of the National Vector Borne Disease Control Programme (NVBDCP)?

A) To control drug-resistant tuberculosis

B) To reduce the incidence of mosquito-borne diseases

C) To improve maternal health

D) To provide free vaccinations

Explanation: NVBDCP aims to reduce the incidence of diseases transmitted by vectors like mosquitoes.

#257 Level 2

Which of the following symptoms is most commonly associated with tuberculosis?

A) High fever

B) Persistent cough

C) Skin rashes

D) Joint pain

Explanation: Persistent cough is one of the hallmark symptoms of tuberculosis.

#258 Level 1

What is an essential practice to reduce the spread of communicable diseases in communities?

A) Regular immunization

B) Consuming street food

C) Ignoring personal hygiene

D) Close contact with infected individuals

Explanation: Regular immunization is crucial in preventing the spread of communicable diseases.

#259 Level 3

What is the most effective method to control malaria transmission?

A) Indoor residual spraying

B) Promotion of herbal remedies

C) Increased outdoor activities

D) Use of antibiotics

Explanation: Indoor residual spraying is highly effective in controlling malaria by killing mosquitoes that transmit the disease.

#260 Level 2

How should community health workers encourage participation in vaccination programs?

A) By providing misinformation

B) By highlighting success stories

C) By minimizing the benefits of vaccination

D) By avoiding discussions with families

Explanation: Highlighting success stories can motivate community members to participate in vaccination programs.

#261 Level 1

What is one main function of the Indian Nursing Council (INC)?

A) To provide nursing care

B) To establish Uniform Standards of nursing education

C) To manage hospitals

D) To conduct surgeries

Explanation: The Indian Nursing Council is responsible for establishing Uniform Standards of nursing education.

#262 Level 2

What significant change was made in the GNM nursing program duration in the 2015 revision?

A) Increased from 2 years to 3 years

B) Reduced from 3 ½ years to 3 years

C) No change in duration

D) Expanded to 4 years

Explanation: The duration of the GNM nursing program was reduced from 3 ½ years to 3 years in the 2015 revision.

#263 Level 2

How has the internship component been integrated into the revised GNM program?

A) Added after graduation

B) Integrated within the 3-year course

C) Conducted only in urban areas

D) Not required anymore

Explanation: The revised GNM program integrates the internship component within the 3-year course duration.

#264 Level 3

Why is the structured format of the revised syllabus important for nursing education?

A) It simplifies teaching materials

B) It provides clear guidelines for teachers and students

C) It focuses only on theory

D) It eliminates practical requirements

Explanation: The structured format of the revised syllabus provides clear guidelines for teachers to effectively implement the curriculum.

#265 Level 1

What component does the revised GNM syllabus provide for practical subjects?

A) General objectives only

B) Detailed descriptions with skills to be acquired

C) No practical requirements

D) Only theoretical assessments

Explanation: The revised GNM syllabus includes detailed descriptions of practical subjects, outlining skills to be acquired.

#266 Level 2

What is a primary objective of the Indian Nursing Council's revised GNM syllabus?

A) To increase nursing fees

B) To prepare nurses for qualitative nursing care

C) To limit nursing education

D) To focus solely on research

Explanation: A primary objective of the revised syllabus is to prepare nurses to provide qualitative care in hospitals and communities.

#267 Level 3

What guidelines are provided for establishing a School of Nursing according to the syllabus?

A) Only physical facilities

B) No specific guidelines

C) Guidelines and minimum requirements

D) Only theoretical knowledge

Explanation: The syllabus includes guidelines and minimum requirements to establish a School of Nursing.

#268 Level 1

What is included in the regulations of the GNM syllabus to promote a safe learning environment?

A) Anti-ragging policies

B) Only academic performance

C) Focus on research

D) External examinations only

Explanation: The GNM syllabus includes anti-ragging policies to promote a safe and secure learning environment for students.

#269 Level 2

What is a requirement for Nursing Teaching Faculty according to the GNM syllabus regulations?

A) No specific qualifications required

B) Must have relevant nursing qualifications and experience

C) Only diploma holders are allowed

D) Must be above 60 years old

Explanation: The GNM syllabus regulations state that Nursing Teaching Faculty must have relevant nursing qualifications and experience.

#270 Level 2

What is the primary role of nutrition in community health?

A) To reduce healthcare costs

B) To promote food security

C) To enhance immunity and prevent diseases

D) To increase the production of food items

Explanation: Proper nutrition enhances immunity and helps prevent diseases in the community.

#271 Level 2

Which of the following is a common indoor air pollutant?

A) Carbon monoxide

B) Oxygen

C) Nitrogen

D) Helium

Explanation: Carbon monoxide is a common indoor air pollutant that can cause health issues.

#272 Level 3

What is the most effective method for improving sanitation in rural communities?

A) Building more toilets

B) Promoting hygiene education

C) Providing clean water sources

D) Enforcing sanitation laws

Explanation: Promoting hygiene education is crucial as it empowers communities to maintain sanitation practices effectively.

#273 Level 2

Which method is effective in controlling mosquito populations?

A) Planting more trees

B) Using chemical sprays

C) Encouraging open water bodies

D) Reducing vegetation

Explanation: Chemical sprays are a common and effective method for reducing mosquito populations.

#274 Level 3

Which waste management strategy is most sustainable for community health?

A) Incineration

B) Recycling and composting

C) Landfilling

D) Open dumping

Explanation: Recycling and composting reduce waste and promote resource efficiency, making them sustainable options.

#275 Level 1

What is the primary goal of community health promotion?

A) To increase healthcare access

B) To enhance community engagement

C) To improve overall community well-being

D) To reduce health disparities

Explanation: The primary goal of community health promotion is to improve the overall well-being of the community.

#276 Level 2

What is a significant environmental health issue in urban areas?

A) Soil erosion

B) Indoor heating

C) Air pollution

D) Flooding

Explanation: Air pollution is a significant environmental health issue commonly found in urban areas.

#277 Level 3

Which community-based program is essential for promoting mental health?

A) Substance abuse prevention

B) Family planning

C) Nutritional education

D) Disease management

Explanation: Substance abuse prevention programs are crucial for promoting mental health in communities.

#278 Level 1

What does public health primarily focus on?

A) Individual patient care

B) Community-wide health issues

C) Hospital administration

D) Clinical guidelines

Explanation: Public health primarily focuses on community-wide health issues to improve population health.

#279 Level 2

What is the best approach to prevent the spread of infectious diseases in communities?

A) Isolation of infected individuals

B) Vaccination programs

C) Improved sanitation

D) All of the above

Explanation: All of the listed approaches - isolation, vaccination, and improved sanitation - are effective in preventing the spread of infectious diseases.

#280 Level 1

What is the primary purpose of the Indian Nursing Council?

A) To publish nursing journals

B) To establish uniform standards of nursing education

C) To recruit nurses for hospitals

D) To provide direct patient care

Explanation: The Indian Nursing Council's primary purpose is to establish uniform standards of nursing education.

#281 Level 2

What is the duration of the revised General Nursing and Midwifery program?

A) 2 years

B) 3 years

C) 3.5 years

D) 4 years

Explanation: The duration of the revised General Nursing and Midwifery program is 3 years.

#282 Level 2

How has the curriculum format changed in the revised GNM syllabus?

A) It includes more textbooks.

B) It provides only theoretical knowledge.

C) It includes course description and assessment methods.

D) It eliminates practical components.

Explanation: The revised curriculum format includes course descriptions, general objectives, and assessment methods.

#283 Level 3

What is a significant change in the revised nursing curriculum regarding the internship?

A) It is optional.

B) It has been integrated within the 3 years course.

C) It lasts for 1 year.

D) It is conducted only in hospitals.

Explanation: The internship has been integrated within the 3-year General Nursing and Midwifery course.

#284 Level 2

Which committee contributed to the preparation of the revised GNM syllabus?

A) Nursing Education Committee

B) Hospital Management Committee

C) Medical Council of India

D) Nursing Advisory Board

Explanation: The Nursing Education Committee of the Indian Nursing Council contributed to the preparation of the revised GNM syllabus.

#285 Level 1

What is the minimum requirement to establish a school of nursing according to the INC?

A) Adequate physical facilities

B) A nursing library

C) Specialized faculty

D) International collaborations

Explanation: Adequate physical facilities are essential minimum requirements for establishing a school of nursing.

#286 Level 3

How does the revised syllabus guide nursing educators in teaching?

A) By providing detailed teaching strategies for each subject

B) By eliminating practical sessions

C) By standardizing teaching across all institutions

D) By focusing only on theoretical knowledge

Explanation: The revised syllabus provides detailed teaching strategies, helping educators effectively cover the curriculum.

#287 Level 1

What is the main objective of the General Nursing and Midwifery program?

A) To promote research in nursing

B) To prepare nurses for qualitative nursing care

C) To increase the number of nurses

D) To standardize medication administration

Explanation: The main objective of the program is to prepare nurses to provide qualitative nursing care in both hospital and community settings.

#288 Level 2

What is one of the assessment methods mentioned in the revised GNM syllabus?

A) Only written exams

B) Practical assessments

C) No assessments

D) Group projects only

Explanation: Practical assessments are included as part of the assessment methods in the revised GNM syllabus.

#289 Level 3

Which change in the GNM program aims to enhance the nurses' readiness for community and hospital care?

A) Reduction of practical training

B) Integration of internship within the course duration

C) Increase in classroom hours

D) Introduction of more theoretical subjects

Explanation: The integration of the internship within the course duration aims to enhance nurses' readiness for both community and hospital care.

#290 Level 1

What is the primary purpose of applying a sterile dressing to a wound?

A) To maintain pressure

B) To prevent infection

C) To promote healing

D) To absorb blood

Explanation: The primary purpose of a sterile dressing is to prevent infection in the wound.

#291 Level 2

A patient is bleeding profusely from a deep cut on the arm. What is the first action you should take?

A) Apply a tourniquet above the cut

B) Elevate the arm

C) Apply direct pressure to the wound

D) Clean the wound with antiseptic

Explanation: The first action in managing severe bleeding is to apply direct pressure to the wound to control the blood loss.

#292 Level 3

A child is choking and cannot breathe. What is the appropriate first aid step to take?

A) Give them water

B) Perform the Heimlich maneuver

C) Slap them on the back

D) Call for help

Explanation: Performing the Heimlich maneuver is the appropriate first aid step for a choking child who cannot breathe.

#293 Level 2

What is the best initial management for a suspected fracture?

A) Move the patient to comfort

B) Immobilize the affected area

C) Apply heat to the area

D) Massage the area

Explanation: The best initial management for a suspected fracture is to immobilize the affected area to prevent further injury.

#294 Level 1

Which type of burn is characterized by redness and pain but no blisters?

A) First-degree burn

B) Second-degree burn

C) Third-degree burn

D) Chemical burn

Explanation: A first-degree burn is characterized by redness and pain without the presence of blisters.

#295 Level 2

A patient is suspected to have ingested poison. What is the first step you should take?

A) Induce vomiting

B) Call Poison Control

C) Give activated charcoal

D) Provide water

Explanation: The first step in managing suspected poisoning is to call Poison Control for guidance on the appropriate actions to take.

#296 Level 3

A person is showing signs of heat exhaustion. Which of the following actions should be prioritized?

A) Move them to a cooler area

B) Give them a warm beverage

C) Encourage them to exercise

D) Apply ice directly to the skin

Explanation: Moving a person showing signs of heat exhaustion to a cooler area is the first priority to help them recover.

#297 Level 2

What is the immediate first aid step for a burn injury?

A) Cover with a dry cloth

B) Immerse in cold water

C) Apply ointment

D) Massage the area

Explanation: Immersing the burn in cold water helps to cool the area and reduce pain.

#298 Level 2

A person is choking and cannot speak. What should you do first?

A) Give them water

B) Perform back blows

C) Check their pulse

D) Encourage them to cough

Explanation: Performing back blows can help dislodge the object causing the choking.

#299 Level 3

A patient presents with severe bleeding from a leg wound. What is the priority action to control the bleeding?

A) Apply a tourniquet

B) Elevate the leg

C) Apply direct pressure

D) Clean the wound

Explanation: Applying direct pressure is the most effective way to control bleeding immediately.

#300 Level 2

What is a common sign of shock in a patient?

A) Flushed skin

B) High blood pressure

C) Rapid heartbeat

D) Warm extremities

Explanation: A rapid heartbeat is a common physiological response to shock as the body tries to maintain blood flow.

#301 Level 2

You suspect a patient has a fractured arm. What should you do first?

A) Apply ice to the area

B) Move the arm to check for pain

C) Immobilize the arm

D) Give them pain medication

Explanation: Immobilizing the arm prevents further injury and alleviates pain.

#302 Level 3

What is the first step in managing a drowning victim who is unresponsive?

A) Start CPR immediately

B) Assess the airway

C) Call for emergency help

D) Remove them from the water

Explanation: Removing the victim from the water is critical before any other steps can be taken.

#303 Level 2

Which of the following is a common symptom of poisoning?

A) Increased energy

B) Nausea and vomiting

C) Clear skin

D) Slow heart rate

Explanation: Nausea and vomiting are typical symptoms associated with various types of poisoning.

#304 Level 3

You suspect a person is having a heart attack. What should you do first?

A) Call for emergency medical assistance

B) Offer them water

C) Have them lie down

D) Perform CPR

Explanation: Calling for emergency medical assistance is crucial for timely medical intervention.

#305 Level 2

What is a common sign of a stroke that caregivers should recognize?

A) Sudden confusion

B) Gradual loss of vision

C) Constant headache

D) Fever

Explanation: Sudden confusion is a key sign of a stroke and requires immediate medical attention.

#306 Level 2

During a seizure, what is the most important thing to do?

A) Hold the person down

B) Place something in their mouth

C) Move objects away to prevent injury

D) Leave them alone

Explanation: Moving objects away helps to prevent injury during a seizure.

#307 Level 2

What is the primary function of the Indian Nursing Council (INC)?

A) To provide healthcare services

B) To establish uniform standards of nursing education

C) To conduct medical research

D) To manage hospitals

Explanation: The INC's main function is to establish uniform standards of nursing education for nursing personnel.

#308 Level 3

What significant change was made in the revised GNM curriculum regarding its duration?

A) Increased from 3 years to 4 years

B) Reduced from 3 ½ years to 3 years

C) Remained the same at 3 ½ years

D) Extended to 4 ½ years

Explanation: The duration of the GNM program has been reduced from 3 ½ years to 3 years in the revised curriculum.

#309 Level 2

What does the revised curriculum include that aids teaching and assessment?

A) Only theoretical content

B) Detailed description of assessment methods

C) Exemptions for practical sessions

D) Only assignments without assessments

Explanation: The revised curriculum includes a detailed description of assessment methods for each subject.

#310 Level 3

Why was the GNM syllabus revised according to the Indian Nursing Council?

A) To reduce the number of subjects

B) To comply with international standards

C) To increase the duration of the course

D) To integrate internships without compromising course content

Explanation: The syllabus was revised to integrate internships within the 3-year course without compromising the course content and objectives.

#311 Level 1

What is one of the minimum requirements to establish a school of nursing according to the regulations?

A) A swimming pool

B) Sufficient clinical facilities

C) A large faculty lounge

D) Unlimited patient access

Explanation: Sufficient clinical facilities are essential to establish a school of nursing as per the regulations.

#312 Level 2

What does the nursing philosophy emphasize in the GNM program?

A) Theoretical knowledge only

B) Practical skills without theory

C) Holistic patient care

D) Strict adherence to protocols only

Explanation: The nursing philosophy in the GNM program emphasizes holistic patient care.

#313 Level 2

What is an important component of teaching-learning activities outlined in the revised GNM syllabus?

A) Only lectures

B) Integration of practical skills

C) Focus solely on theoretical exams

D) Exclusion of group activities

Explanation: The revised syllabus emphasizes the integration of practical skills in teaching-learning activities.

#314 Level 2

What is one of the general objectives of the GNM program?

A) To limit nursing practice to hospitals

B) To prepare nurses for community health care

C) To exclude all practical training

D) To focus only on administrative roles

Explanation: One of the general objectives of the GNM program is to prepare nurses to provide care in both hospitals and community health.

#315 Level 1

What type of facilities are necessary for the establishment of a nursing school?

A) Recreational facilities only

B) Sufficient teaching and clinical facilities

C) Administrative offices only

D) Transportation services only

Explanation: Sufficient teaching and clinical facilities are necessary for the establishment of a nursing school.

#316 Level 1

What is the primary purpose of hand hygiene in nursing?

A) To prevent patient falls

B) To reduce healthcare-associated infections

C) To enhance patient comfort

D) To comply with hospital policies

Explanation: Hand hygiene is crucial in reducing the spread of infections in healthcare settings.

#317 Level 2

Why is personal hygiene important for nurses?

A) To promote a professional appearance

B) To avoid disciplinary action

C) To prevent the transmission of infections

D) To comply with dress codes

Explanation: Maintaining personal hygiene prevents the transmission of infections to patients.

#318 Level 3

A nurse notices that several patients on a unit have developed similar infections. What should be the nurse's first action?

A) Notify the infection control committee

B) Review patient charts for common treatments

C) Increase the frequency of cleaning in the area

D) Assess staff compliance with hand hygiene

Explanation: Assessing staff compliance with hand hygiene is crucial to identify potential sources of infection spread.

#319 Level 2

Which procedure requires the use of aseptic technique?

A) Bathing a patient

B) Administering an injection

C) Taking vital signs

D) Assisting with feeding

Explanation: Administering injections requires aseptic technique to prevent infection.

#320 Level 2

What is the main goal of environmental hygiene in healthcare settings?

A) To enhance aesthetic appeal

B) To ensure patient comfort

C) To maintain clean and safe spaces

D) To comply with health regulations

Explanation: Environmental hygiene aims to maintain clean and safe spaces to prevent infection.

#321 Level 3

During a surgical procedure, which action is essential for maintaining surgical hygiene?

A) Wearing jewelry

B) Scrubbing hands for an adequate duration

C) Using non-sterile instruments

D) Wearing a mask only when necessary

Explanation: Scrubbing hands for an adequate duration is crucial to remove microorganisms before surgery.

#322 Level 1

What should a nurse emphasize to patients regarding personal hygiene?

A) It is only necessary during hospital stays

B) It helps in preventing diseases

C) It is a sign of personal vanity

D) It is not important if you feel healthy

Explanation: Emphasizing personal hygiene helps patients understand its role in preventing diseases.

#323 Level 2

Which of the following is a recommended practice for maintaining good hygiene in the clinical setting?

A) Sharing personal items among staff

B) Regularly disinfecting high-touch surfaces

C) Wearing street clothes while on duty

D) Ignoring spills and accidents

Explanation: Regular disinfection of high-touch surfaces helps to prevent the spread of infections.

#324 Level 1

What is the primary goal of infection control in healthcare settings?

A) To reduce costs

B) To improve patient satisfaction

C) To prevent the spread of infections

D) To minimize staff workload

Explanation: The primary goal of infection control is to prevent the spread of infections among patients and healthcare workers.

#325 Level 2

Which of the following describes the mode of transmission of infections?

A) Direct contact with contaminated surfaces

B) Receiving vaccinations

C) Proper hand hygiene

D) Healthy diet

Explanation: Direct contact with contaminated surfaces is a common mode of transmission for infections, highlighting the importance of cleanliness.

#326 Level 2

What is the main difference between cleaning and disinfection?

A) Cleaning removes dirt; disinfection kills germs

B) Both have the same purpose

C) Cleaning is more effective than disinfection

D) Disinfection is only for surfaces

Explanation: Cleaning involves removing dirt and debris, while disinfection specifically targets and kills germs on surfaces.

#327 Level 3

How does immunization contribute to infection control?

A) It sterilizes the environment

B) It provides passive immunity only

C) It helps to develop active immunity against specific pathogens

D) It eliminates the need for hygiene practices

Explanation: Immunization helps to develop active immunity against specific pathogens, reducing the risk of infection spread.

#328 Level 3

What is antimicrobial resistance?

A) Increased effectiveness of antibiotics

B) Pathogens becoming resistant to medications

C) Decreased incidence of infections

D) Enhanced immune response to infections

Explanation: Antimicrobial resistance occurs when pathogens evolve and become resistant to medications, making infections harder to treat.

#329 Level 2

A patient with a contagious disease requires isolation. What is the most appropriate type of isolation for this patient?

A) Contact isolation

B) Droplet isolation

C) Airborne isolation

D) Protective isolation

Explanation: Airborne isolation is appropriate for patients with contagious diseases that can be spread through the air, such as tuberculosis.

#330 Level 2

When performing wound care, which practice is essential to prevent infection?

A) Washing hands before the procedure

B) Using any type of bandage

C) Leaving the wound exposed

D) Skipping antiseptic application

Explanation: Washing hands before any procedure is essential to prevent the introduction of pathogens and infections.

#331 Level 2

Which aspect of the hospital environment is critical for infection control?

A) Use of decorative items

B) Regular cleaning and disinfection

C) Open windows for ventilation

D) High humidity levels

Explanation: Regular cleaning and disinfection of the hospital environment is critical to prevent the spread of infections.

#332 Level 1

Why is patient education important in infection control?

A) It increases hospital revenue

B) It empowers patients to participate in their care

C) It complicates treatment plans

D) It is not relevant to infection control

Explanation: Patient education is important in infection control because it empowers patients to understand and actively participate in their own care to prevent infections.

#333 Level 1

What is the supine position in nursing?

A) Lying on the stomach

B) Lying on the back

C) Sitting upright

D) Lying on one side

Explanation: The supine position refers to a person lying flat on their back.

#334 Level 2

What is the primary use of the prone position in patient care?

A) To improve circulation

B) For respiratory therapy

C) To prevent pressure ulcers

D) For abdominal surgery recovery

Explanation: The prone position helps relieve pressure on the back and can prevent pressure ulcers.

#335 Level 2

Which position is described as lying on the side?

A) Supine

B) Prone

C) Lateral

D) Fowler's

Explanation: The lateral position involves the patient lying on their side, which is often used for comfort and to improve ventilation.

#336 Level 3

A patient with difficulty breathing is placed in a modified Fowler's position. What is the angle of elevation?

A) 0-15 degrees

B) 15-30 degrees

C) 30-45 degrees

D) 45-60 degrees

Explanation: Modified Fowler's position typically involves an elevation of 15-30 degrees to assist with breathing.

#337 Level 2

In which situation is the Trendelenburg position most commonly utilized?

A) To relieve back pain

B) To increase venous return in hypotensive patients

C) For administering certain medications

D) During abdominal surgeries

Explanation: The Trendelenburg position is used to increase blood return to the heart, particularly in cases of hypotension.

#338 Level 3

What principle of body mechanics should be considered when positioning a patient?

A) Keep the weight away from the body

B) Use the large muscles of the legs for lifting

C) Twist the body while lifting

D) Keep the feet close together for stability

Explanation: Using the large muscles of the legs for lifting helps to reduce strain and injury when repositioning a patient.

#339 Level 2

Which of the following is a critical consideration for patient safety during positioning?

A) Ensuring the patient's comfort only

B) Monitoring the patient for any signs of distress

C) Using only one staff member for positioning

D) Frequently changing the positioning without assessment

Explanation: Monitoring the patient for signs of distress is crucial for ensuring their safety during any positioning.

#340 Level 2

A nurse needs to position a patient at risk for aspiration. What position should the nurse place the patient in?

A) Prone position

B) Lateral position

C) Fowler's position

D) Supine position

Explanation: Fowler's position is ideal for patients at risk for aspiration as it helps keep the airway clear.

#341 Level 1

Why is effective communication important when positioning patients?

A) It helps to explain the procedure to the patient

B) It reduces the time taken for positioning

C) It ensures that the nurse understands the patient's preferences

D) All of the above

Explanation: Effective communication is essential for ensuring the patient's understanding, preferences, and efficiency of the procedure.

#342 Level 1

What is the normal respiratory rate for an adult at rest?

A) 10-20 breaths/min

B) 20-30 breaths/min

C) 30-40 breaths/min

D) 40-50 breaths/min

Explanation: The normal respiratory rate for an adult at rest is typically between 10-20 breaths per minute.

#343 Level 2

What does the blood pressure reading of 120/80 mmHg represent?

A) Normal blood pressure

B) Hypertension stage 1

C) Hypotension

D) Hypertension stage 2

Explanation: A blood pressure reading of 120/80 mmHg is considered to be within the normal range.

#344 Level 2

If a nurse is measuring body temperature using a tympanic thermometer, which method is she using?

A) Oral

B) Axillary

C) Rectal

D) Ear

Explanation: A tympanic thermometer measures temperature from the ear, making it an ear temperature measurement.

#345 Level 3

Which factor is least likely to affect a person's vital signs?

A) Age

B) Exercise

C) Time of day

D) Hair color

Explanation: Hair color does not influence vital signs, while age, exercise, and time of day can significantly affect them.

#346 Level 2

Which type of body temperature is measured by placing the thermometer in the armpit?

A) Oral temperature

B) Rectal temperature

C) Axillary temperature

D) Tympanic temperature

Explanation: The temperature measured in the armpit is known as axillary temperature.

#347 Level 1

What does a 'bounding' pulse indicate?

A) Weakness

B) Normalcy

C) Increased stroke volume

D) Decreased cardiac output

Explanation: 'Bounding' pulse indicates an increased stroke volume, often resulting from conditions such as fever or anxiety.

#348 Level 3

What does the presence of a pulse deficit indicate?

A) Normal heart function

B) Aortic stenosis

C) Irregular heart rhythms

D) High blood pressure

Explanation: A pulse deficit indicates that not all heartbeats are being felt at the pulse points, which can occur with irregular heart rhythms.

#349 Level 2

When measuring blood pressure, which position should the patient be in for accurate results?

A) Standing

B) Sitting

C) Lying flat

D) Any position

Explanation: For accurate blood pressure measurement, the patient should be seated comfortably with their arm supported at heart level.

#350 Level 1

What is the purpose of a sphygmomanometer?

A) To measure temperature

B) To measure blood pressure

C) To measure pulse rate

D) To measure respiratory rate

Explanation: A sphygmomanometer is an instrument specifically used to measure blood pressure.

#351 Level 2

What is the primary purpose of assessing a wound?

A) To determine the patient's age

B) To evaluate the healing process

C) To prescribe medication

D) To decide on surgical intervention

Explanation: Wound assessment helps evaluate the healing process and any complications.

#352 Level 1

What type of wound is inflicted by a sharp object cutting through the skin?

A) Abrasion

B) Laceration

C) Puncture

D) Incision

Explanation: An incision is a clean cut made by a sharp object through the skin.

#353 Level 3

Which phase of wound healing involves the formation of granulation tissue?

A) Inflammatory phase

B) Proliferative phase

C) Maturation phase

D) Hemostasis phase

Explanation: The proliferative phase is characterized by the formation of granulation tissue.

#354 Level 2

Which practice is essential for preventing infection in wound care?

A) Using non-sterile gloves

B) Cleaning the wound with antiseptic

C) Exposing the wound to air

D) Avoiding dressing changes

Explanation: Cleaning the wound with antiseptic reduces the risk of infection.

#355 Level 2

What type of dressing is best used for a heavy exudate wound?

A) Hydrocolloid dressing

B) Transparent film dressing

C) Alginate dressing

D) Gauze dressing

Explanation: Alginate dressings are highly absorbent and suitable for heavy exudate.

#356 Level 3

A nurse is caring for a patient with a deep pressure ulcer. Which intervention is most appropriate?

A) Massage the area around the ulcer

B) Use a dry dressing without any moisture

C) Implement a repositioning schedule every two hours

D) Leave the ulcer exposed to air

Explanation: Repositioning helps relieve pressure on the ulcer and supports healing.

#357 Level 2

Which of the following is a key principle in wound care?

A) Keeping the wound dry at all times

B) Maintaining a moist wound environment

C) Avoiding any form of dressing

D) Exposing the wound to sunlight

Explanation: Maintaining a moist wound environment promotes healing and reduces scarring.

#358 Level 3

Which complication is characterized by the formation of a pocket of pus in a wound?

A) Hematoma

B) Seroma

C) Abscess

D) Keloid

Explanation: An abscess is a localized collection of pus that can occur in response to infection.

#359 Level 1

What is the first step in wound care management?

A) Applying a dressing

B) Cleaning the wound

C) Assessing the wound

D) Notifying the physician

Explanation: Assessing the wound is the first crucial step in effective wound care management.

#360 Level 2

What is one of the main objectives of the Indian Nursing Council's revised syllabus?

A) To increase the duration of the program

B) To establish uniform standards in nursing education

C) To reduce the practical components of training

D) To eliminate theory-based assessments

Explanation: The primary objective of the Indian Nursing Council's revised syllabus is to establish uniform standards in nursing education.

#361 Level 1

What is the new duration of the General Nursing and Midwifery program as per the revised syllabus?

A) 4 years

B) 3 years

C) 3.5 years

D) 2 years

Explanation: The revised duration of the General Nursing and Midwifery program has been reduced to 3 years.

#362 Level 3

What does the revised syllabus emphasize for teachers to ensure effective coverage of the syllabus?

A) Focus only on theoretical components

B) Implement a variety of teaching-learning activities

C) Reduce the time allocated for practical sessions

D) Minimize assessments and evaluations

Explanation: The revised syllabus emphasizes the implementation of a variety of teaching-learning activities for effective coverage.

#363 Level 2

Which body is responsible for prescribing the syllabus and regulations for nursing personnel in India?

A) Ministry of Health

B) Nursing Education Committee

C) Indian Nursing Council

D) The World Health Organization

Explanation: The Indian Nursing Council is responsible for prescribing the syllabus and regulations for nursing personnel in India.

#364 Level 2

What is included in the revised curriculum for subjects with practical requirements?

A) Only theoretical assessments

B) Detailed description of practical areas and assessment methods

C) Elimination of practical sessions

D) Focus only on observational learning

Explanation: The revised curriculum includes a detailed description of practical areas and assessment methods for subjects with practical requirements.

#365 Level 1

In which year is the subject 'Fundamentals of Nursing' taught according to the GNM syllabus?

A) First Year

B) Second Year

C) Third Year

D) None of the above

Explanation: 'Fundamentals of Nursing' is taught in the First Year of the GNM program according to the syllabus.

#366 Level 2

Which aspect is emphasized in the Community Health Nursing curriculum part of the GNM syllabus?

A) Hospital-based care only

B) Community-based nursing practices

C) Theoretical learning without practical application

D) Independent nursing practice without supervision

Explanation: The Community Health Nursing curriculum emphasizes community-based nursing practices.

#367 Level 2

What is one of the minimum requirements for establishing a School of Nursing as per the regulations?

A) No need for clinical facilities

B) Adequate physical infrastructure and teaching faculty

C) Only theoretical knowledge is sufficient

D) Lack of hostel facilities

Explanation: Adequate physical infrastructure and qualified teaching faculty are essential minimum requirements for establishing a School of Nursing.

#368 Level 3

What role did the Nursing Education Committee play in the revision of the GNM syllabus?

A) They had no involvement

B) They solely created the syllabus

C) They provided input and feedback during consultations

D) They implemented the syllabus without revision

Explanation: The Nursing Education Committee provided input and feedback during consultations for the revision of the GNM syllabus.

#369 Level 1

What is the phase of the cardiac cycle when the heart muscle relaxes and the chambers fill with blood?

A) Systole

B) Diastole

C) Isovolumetric contraction

D) Ejection phase

Explanation: Diastole is the phase of the cardiac cycle during which the heart muscle relaxes and the chambers fill with blood.

#370 Level 2

Which of the following is a major risk factor for developing coronary artery disease?

A) Regular physical activity

B) High cholesterol levels

C) Low sodium intake

D) Good hydration

Explanation: High cholesterol levels are a significant risk factor for the development of coronary artery disease due to their role in plaque formation.

#371 Level 3

A patient presents with a heart rate of 180 beats per minute that is irregular. What is the most likely type of arrhythmia?

A) Atrial fibrillation

B) Sinus tachycardia

C) Ventricular tachycardia

D) Atrial flutter

Explanation: Atrial fibrillation is characterized by an irregular and often rapid heart rate, which fits the patient's presentation.

#372 Level 2

Which of the following is a common symptom of heart failure?

A) Increased appetite

B) Fatigue

C) Elevated blood pressure

D) Sudden weight loss

Explanation: Fatigue is a common symptom of heart failure due to the heart's reduced ability to pump effectively.

#373 Level 1

What is myocardial infarction commonly known as?

A) Stroke

B) Heart attack

C) Angina

D) Arrhythmia

Explanation: Myocardial infarction is commonly referred to as a heart attack, where blood flow to a part of the heart is blocked.

#374 Level 2

What is the normal range for systolic blood pressure in adults?

A) 90-120 mmHg

B) 120-139 mmHg

C) 130-150 mmHg

D) 150-180 mmHg

Explanation: The normal range for systolic blood pressure in adults is typically considered to be 90-120 mmHg.

#375 Level 3

What is the physiological consequence of left ventricular hypertrophy?

A) Decreased cardiac output

B) Increased stroke volume

C) Improved exercise tolerance

D) Enhanced coronary perfusion

Explanation: Left ventricular hypertrophy can lead to decreased cardiac output due to the heart's reduced ability to fill properly and pump effectively.

#376 Level 2

Which symptom is commonly associated with peripheral vascular disease?

A) Chest pain

B) Leg pain during exercise

C) Shortness of breath

D) Palpitations

Explanation: Leg pain during exercise, known as claudication, is a classic symptom of peripheral vascular disease due to reduced blood flow.

#377 Level 1

What is the primary focus of nursing foundations in the GNM curriculum?

A) Advanced pharmacology

B) Basic nursing skills

C) Clinical research

D) Community health policies

Explanation: Nursing foundations primarily teach basic nursing skills necessary for competent patient care.

#378 Level 2

Which of the following is a key component of first aid?

A) Diagnosis of disease

B) Immediate care for injuries

C) Long-term patient treatment

D) Surgical intervention

Explanation: First aid focuses on providing immediate care to stabilize a patient before further medical help can be obtained.

#379 Level 2

In a community health nursing setting, what is the nurse's primary role?

A) Conducting surgeries

B) Educating the community on health practices

C) Performing complex diagnostic tests

D) Distributing medications

Explanation: The primary role of a community health nurse is to educate the community about health practices and promote healthy behaviors.

#380 Level 3

Which anatomical structure is primarily involved in nutrient absorption in the gastrointestinal tract?

A) Stomach

B) Large intestine

C) Small intestine

D) Esophagus

Explanation: The small intestine is the main site for nutrient absorption due to its extensive surface area and villi.

#381 Level 2

Which microorganism is commonly responsible for foodborne illnesses?

A) Staphylococcus aureus

B) Escherichia coli

C) Salmonella

D) All of the above

Explanation: Staphylococcus aureus, Escherichia coli, and Salmonella are all known to cause foodborne illnesses.

#382 Level 1

What does sociology primarily study in the context of nursing?

A) Human anatomy

B) Social behaviors and interactions

C) Microbial pathogens

D) Nutritional guidelines

Explanation: Sociology studies social behaviors and interactions, which are essential for understanding patient care within communities.

#383 Level 2

How does understanding psychology benefit nursing practice?

A) It eliminates the need for physical assessments.

B) It helps in understanding patient behaviors and emotions.

C) It focuses solely on medications.

D) It is unrelated to nursing.

Explanation: Understanding psychology aids nurses in interpreting patient behaviors and emotions, enhancing patient care.

#384 Level 3

What is the primary purpose of the Indian Nursing Council's regulations for nursing education?

A) To limit the number of nursing schools

B) To establish uniform standards for nursing education

C) To increase tuition fees

D) To promote only theoretical knowledge

Explanation: The Indian Nursing Council's regulations aim to establish uniform standards for nursing education, ensuring quality training.

#385 Level 1

Which part of the brain is responsible for regulating balance and coordination?

A) Cerebrum

B) Cerebellum

C) Brainstem

D) Limbic system

Explanation: The cerebellum is primarily responsible for balance and coordination of movement.

#386 Level 2

What does a neurological assessment primarily evaluate?

A) Respiratory function

B) Cardiovascular health

C) Cognitive and motor function

D) Gastrointestinal activity

Explanation: A neurological assessment evaluates cognitive and motor functions to assess brain health.

#387 Level 3

In a patient with a spinal cord injury at the T6 level, which symptom would be expected?

A) Loss of bladder control

B) Increased upper limb strength

C) Improved lower limb sensation

D) Enhanced respiratory function

Explanation: Patients with a spinal cord injury at T6 typically experience loss of bladder control due to disrupted nerve signals.

#388 Level 2

Which symptom is most commonly associated with meningitis?

A) Peripheral edema

B) Stiff neck

C) Sudden weight loss

D) Abdominal pain

Explanation: A stiff neck is a classic symptom of meningitis due to inflammation of the meninges.

#389 Level 3

What is a common early sign of dementia?

A) Frequent headaches

B) Memory loss affecting daily life

C) Unexplained weight gain

D) Increased energy levels

Explanation: Memory loss that affects daily activities is one of the earliest signs of dementia.

#390 Level 2

During a shift, a nurse notices that an elderly patient with Alzheimer's disease is unable to recognize familiar faces. What should the nurse do first?

A) Administer antipsychotic medication

B) Reassure the patient and speak calmly

C) Document the behavior in the chart

D) Call the physician immediately

Explanation: Reassuring the patient and speaking calmly helps to ease anxiety and confusion.

#391 Level 2

What is a characteristic symptom of Parkinson's disease?

A) Increased muscle tone

B) Sudden weight loss

C) Intense thirst

D) Hyperactivity

Explanation: Increased muscle tone, also known as rigidity, is a hallmark symptom of Parkinson's disease.

#392 Level 3

A patient presents with a history of recurrent seizures. What diagnostic test would be most appropriate to evaluate the underlying cause?

A) MRI of the brain

B) Electrocardiogram (ECG)

C) Chest X-ray

D) Complete blood count (CBC)

Explanation: An MRI of the brain is appropriate to identify structural causes of recurrent seizures.

#393 Level 3

A patient arrives at the emergency department with signs of a stroke. What is the most critical intervention that the nurse should initiate?

A) Administer aspirin

B) Begin intravenous thrombolysis

C) Perform a CT scan

D) Start oxygen therapy

Explanation: Initiating intravenous thrombolysis is critical to dissolve a clot in ischemic stroke cases.

#394 Level 1

What is the primary role of a nurse in caring for a patient undergoing chemotherapy?

A) Administering medication

B) Performing surgery

C) Diagnosing cancer

D) Counseling on financial matters

Explanation: Nurses primarily administer medications and monitor patients during chemotherapy.

#395 Level 2

Which of the following is a common side effect of chemotherapy?

A) Weight gain

B) Hair loss

C) Increased energy

D) Enhanced vision

Explanation: Hair loss is a well-documented side effect of many chemotherapy drugs.

#396 Level 3

A nurse is educating a patient about dietary modifications during chemotherapy. Which food group should they emphasize?

A) High-fiber foods

B) Sugary snacks

C) High-sodium foods

D) Processed meats

Explanation: High-fiber foods can help manage gastrointestinal side effects associated with chemotherapy.

#397 Level 2

Which type of care is provided alongside chemotherapy to alleviate symptoms?

A) Palliative care

B) Preventive care

C) Emergency care

D) Surgical care

Explanation: Palliative care focuses on providing relief from symptoms and stress of cancer treatment.

#398 Level 3

A patient receiving chemotherapy reports nausea. What is the best nursing intervention?

A) Encourage the patient to eat large meals

B) Offer anti-nausea medication as prescribed

C) Suggest vigorous exercise

D) Ignore the complaint

Explanation: Offering anti-nausea medication helps to alleviate the patient's discomfort effectively.

#399 Level 2

What is the purpose of radiation therapy in oncology?

A) To treat infections

B) To shrink tumors

C) To enhance appetite

D) To improve circulation

Explanation: Radiation therapy is primarily used to shrink tumors and kill cancer cells.

#400 Level 1

What is an important aspect of psychosocial support for cancer patients?

A) Isolation from family

B) Emotional reassurance

C) Avoiding discussions about cancer

D) Limiting social interactions

Explanation: Emotional reassurance is crucial for helping patients cope with their diagnosis and treatment.

#401 Level 2

Why is accurate documentation essential in oncology nursing?

A) It helps in billing

B) It ensures care continuity

C) It is required by law only

D) It can be ignored if time-constrained

Explanation: Accurate documentation ensures continuity of care and effective communication among healthcare providers.

#402 Level 3

A nurse observes a patient is experiencing severe pain after chemotherapy. What should be the nurse's priority action?

A) Assess the pain level using a scale

B) Wait to see if the pain decreases

C) Offer a snack to distract the patient

D) Increase the light in the room

Explanation: Assessing the pain level is crucial to determine the appropriate intervention for pain management.

#403 Level 3

In end-of-life care for a cancer patient, what is a key consideration for the nurse?

A) Focus solely on physical symptoms

B) Prioritize the family's needs

C) Avoid discussing death

D) Minimize emotional support

Explanation: Prioritizing the family's needs is essential in providing holistic end-of-life care for cancer patients.

#404 Level 1

What is an essential focus of post-operative care?

A) Patient comfort

B) Financial assessment

C) Dietary preferences

D) Family counseling

Explanation: Patient comfort is a primary focus in post-operative care to aid recovery.

#405 Level 2

What should be included in the pre-operative assessment?

A) Post-operative pain management plan

B) Patient's medical history

C) Family's financial situation

D) Future medication prescriptions

Explanation: A patient's medical history is crucial for assessing risks before surgery.

#406 Level 3

Which type of anesthesia provides complete unconsciousness?

A) Local anesthesia

B) Regional anesthesia

C) General anesthesia

D) Sedation

Explanation: General anesthesia induces complete unconsciousness and loss of sensation throughout the body.

#407 Level 2

A patient develops a fever 24 hours after surgery. What is the most likely cause?

A) Normal response to surgery

B) Infection

C) Allergic reaction

D) Pain medication side effect

Explanation: A fever post-surgery can indicate a potential infection, which needs to be investigated.

#408 Level 1

What does NPO stand for in the context of pre-operative care?

A) Nothing per os

B) Null per os

C) No prior observation

D) Needs pre-op observation

Explanation: NPO stands for 'Nothing per os', indicating that a patient should not consume anything by mouth.

#409 Level 2

After surgery, a patient is observed to have a drop in blood pressure. What should the nurse do first?

A) Notify the physician

B) Administer IV fluids

C) Assess the patient’s pulse

D) Check the surgical site

Explanation: The nurse should first assess the patient's pulse to determine the severity of the situation.

#410 Level 2

What is the primary purpose of obtaining informed consent before surgery?

A) To prepare the surgical team

B) To ensure patient understanding of risks

C) To document the procedure

D) To schedule the surgery

Explanation: Informed consent ensures that the patient understands the risks and benefits of the surgery.

#411 Level 3

Which post-operative complication should be monitored for following abdominal surgery?

A) Urinary retention

B) Cardiac arrest

C) Deep vein thrombosis

D) Fever

Explanation: Deep vein thrombosis is a significant risk following abdominal surgery due to decreased mobility.

#412 Level 2

A nurse is preparing for a patient’s discharge after surgery. What is most important to include in discharge teaching?

A) Follow-up appointment schedule

B) Medication side effects

C) Dietary restrictions

D) All of the above

Explanation: All of these elements are crucial for safe recovery and follow-up care post-surgery.

#413 Level 2

Which method is commonly used for managing post-operative pain?

A) Intravenous fluids only

B) Oral analgesics

C) Ice packs application

D) All of the above

Explanation: All these methods are commonly used to manage post-operative pain effectively.

#414 Level 2

What is a common cause of chronic kidney disease (CKD)?

A) Diabetes mellitus

B) Acute urinary infection

C) Rapid dehydration

D) Gastroenteritis

Explanation: Diabetes mellitus is one of the leading causes of chronic kidney disease due to prolonged high blood sugar levels damaging the kidneys.

#415 Level 3

Which laboratory finding is most indicative of acute kidney injury (AKI)?

A) Decreased serum creatinine

B) Increased blood urea nitrogen (BUN)

C) Elevated hemoglobin levels

D) Normal electrolyte levels

Explanation: Increased blood urea nitrogen (BUN) is a common laboratory finding in acute kidney injury, indicating impaired kidney function.

#416 Level 2

Which symptom is commonly associated with renal disease?

A) Increased appetite

B) Frequent headaches

C) Swelling in the feet and ankles

D) Healthy skin appearance

Explanation: Swelling in the feet and ankles is a common symptom of renal disease due to fluid retention.

#417 Level 1

What is the primary purpose of a urinalysis?

A) To diagnose urinary tract infections

B) To measure kidney size

C) To assess blood pressure

D) To determine blood sugar levels

Explanation: A urinalysis is primarily used to diagnose urinary tract infections and assess various conditions affecting the kidneys.

#418 Level 2

A patient presents with severe flank pain and hematuria. What condition should be suspected?

A) Chronic kidney disease

B) Kidney stones

C) Glomerulonephritis

D) Urinary tract infection

Explanation: Severe flank pain and hematuria are classic symptoms of kidney stones due to obstruction in the urinary tract.

#419 Level 3

Which treatment is most appropriate for a patient with end-stage renal disease?

A) Increased fluid intake

B) Kidney transplantation

C) Antibiotic therapy

D) Pain management only

Explanation: Kidney transplantation is usually the most definitive treatment for end-stage renal disease as it can restore normal kidney function.

#420 Level 2

What dietary modification is often recommended for patients with chronic kidney disease?

A) High protein diet

B) Low-sodium diet

C) Increased sugar intake

D) High potassium foods

Explanation: A low-sodium diet helps manage blood pressure and fluid retention in chronic kidney disease patients.

#421 Level 3

How should a nurse respond to a patient showing signs of acute renal failure?

A) Encourage increased fluid intake immediately

B) Administer prescribed medications and monitor closely

C) Suggest dietary modifications without consulting a doctor

D) Provide comfort measures only

Explanation: Administering prescribed medications and closely monitoring the patient's condition is critical in managing acute renal failure.

#422 Level 2

What is a primary concern following a kidney transplant?

A) Weight gain

B) Graft rejection

C) High blood sugar

D) Skin rashes

Explanation: Graft rejection is a primary concern after a kidney transplant due to the body's immune response against the new organ.

#423 Level 2

What is the primary pathophysiological change observed in asthma?

A) Increased lung volume

B) Airway inflammation and obstruction

C) Bronchial dilation

D) Alveolar wall thickening

Explanation: Asthma is characterized by airway inflammation and obstruction, leading to difficulty in breathing.

#424 Level 1

Which of the following is a common cause of community-acquired pneumonia?

A) Mycobacterium tuberculosis

B) Streptococcus pneumoniae

C) Staphylococcus aureus

D) Pseudomonas aeruginosa

Explanation: Streptococcus pneumoniae is the most common organism responsible for community-acquired pneumonia.

#425 Level 3

Which of the following is NOT a typical characteristic of Chronic Obstructive Pulmonary Disease (COPD)?

A) Progressive airflow limitation

B) Increased mucus production

C) Reversible airway obstruction

D) Chronic respiratory inflammation

Explanation: COPD is characterized by irreversible airflow limitation, unlike asthma which is often reversible.

#426 Level 2

What does spirometry primarily measure?

A) Blood gas levels

B) Lung volumes and airflow

C) Oxygen saturation

D) Respiratory rate

Explanation: Spirometry measures lung volumes and airflow, which are essential for diagnosing respiratory conditions.

#427 Level 3

Which of the following findings is most indicative of a pulmonary embolism?

A) Elevated blood pressure

B) Sudden onset of dyspnea

C) Fever and chills

D) Productive cough

Explanation: Sudden onset of dyspnea is a classic symptom of pulmonary embolism, indicating a blockage in the pulmonary artery.

#428 Level 2

What is the primary clinical manifestation of pleural effusion?

A) Chest pain

B) Hemoptysis

C) Shortness of breath

D) Stridor

Explanation: Shortness of breath is the primary clinical manifestation of pleural effusion due to restricted lung expansion.

#429 Level 3

Which of the following is a common risk factor for lung cancer?

A) Low-fat diet

B) Non-smoker

C) Exposure to asbestos

D) Regular exercise

Explanation: Exposure to asbestos is a significant risk factor for developing lung cancer, particularly in occupational settings.

#430 Level 2

What is the primary purpose of mechanical ventilation?

A) Increase blood pressure

B) Ensure adequate gas exchange

C) Decrease heart rate

D) Promote gastric emptying

Explanation: The primary purpose of mechanical ventilation is to ensure adequate gas exchange for patients with respiratory failure.

#431 Level 1

What is the primary function of the Indian Nursing Council?

A) Provide patient care

B) Establish uniform standards of nursing education

C) Conduct nursing examinations

D) Provide financial support to nursing schools

Explanation: The Indian Nursing Council's main function is to establish uniform standards of nursing education for nursing personnel.

#432 Level 2

What significant change was made to the duration of the GNM program in the revised curriculum?

A) Increased to 4 years

B) Remained the same at 3 ½ years

C) Reduced to 3 years

D) Extended to 5 years

Explanation: The revised curriculum reduced the duration of the GNM program from 3 ½ years to 3 years.

#433 Level 3

How does the revised GNM curriculum facilitate teachers in implementing the course?

A) By reducing the number of hours required

B) By integrating theory and practical components

C) By allowing more flexibility in teaching methods

D) By eliminating assessments

Explanation: The curriculum facilitates teachers by integrating theory and practical components, which helps guide the implementation of the course.

#434 Level 2

Which of the following best describes the focus during the community health nursing practical components?

A) Hospital-based care

B) Home care only

C) Assessment of community needs

D) Administrative tasks

Explanation: Community health nursing practical components focus on the assessment of community needs to provide appropriate care.

#435 Level 1

What is included in the nursing foundations course of the GNM program?

A) Advanced surgical techniques

B) Fundamentals of nursing and first aid

C) Social media management

D) Marketing strategies

Explanation: The nursing foundations course includes fundamentals of nursing and first aid, which are essential for nursing practice.

#436 Level 2

What is the purpose of detailing practical requirements in the GNM syllabus?

A) To confuse students

B) To streamline the teaching process

C) To limit hands-on experience

D) To reduce course content

Explanation: Detailing practical requirements in the syllabus helps streamline the teaching process and ensures all necessary skills are covered.

#437 Level 3

How does the revised GNM curriculum improve assessment methods for nursing students?

A) By removing all written assessments

B) By incorporating diverse evaluation strategies

C) By allowing only practical exams

D) By standardizing all assessments to one format

Explanation: The revised curriculum incorporates diverse evaluation strategies to assess students' understanding and skills effectively.

#438 Level 2

What should be a nurse's primary objective during patient care in a community health setting?

A) Focus solely on medical treatment

B) Promote overall health and well-being

C) Limit patient interaction

D) Conduct only assessments

Explanation: The primary objective in a community health setting is to promote overall health and well-being of the community members.

#439 Level 2

What is a common physical manifestation of anxiety disorders?

A) Weight gain

B) Muscle tension

C) Increased energy

D) Euphoria

Explanation: Muscle tension is a common physical symptom associated with anxiety disorders.

#440 Level 3

Which of the following episodes is characteristic of bipolar disorder?

A) Persistent sadness

B) Euphoric mood

C) Total lack of energy

D) Avoidance of social situations

Explanation: Euphoric mood is a hallmark of the manic episodes seen in bipolar disorder.

#441 Level 2

What is a key symptom of Post-Traumatic Stress Disorder (PTSD)?

A) Hallucinations

B) Avoidance of reminders of the trauma

C) Compulsive behavior

D) Elevated mood

Explanation: Avoidance of reminders of the traumatic event is a significant symptom of PTSD.

#442 Level 2

Which of the following is a common compulsive behavior in Obsessive-Compulsive Disorder (OCD)?

A) Excessive cleanliness

B) Constant talking

C) Social withdrawal

D) Memory loss

Explanation: Excessive cleanliness is a typical compulsive behavior experienced by individuals with OCD.

#443 Level 3

Which behavior is commonly associated with Anorexia Nervosa?

A) Binge eating

B) Self-induced vomiting

C) Excessive exercise

D) Frequent snacking

Explanation: Excessive exercise is a common behavior among individuals with Anorexia Nervosa, often to lose weight.

#444 Level 3

What is a common negative symptom of schizophrenia?

A) Hallucinations

B) Delusions

C) Avolition

D) Disorganized speech

Explanation: Avolition, or lack of motivation, is a negative symptom often seen in schizophrenia.

#445 Level 2

Which of the following is a characteristic of Borderline Personality Disorder?

A) Stable relationships

B) Intense emotional swings

C) Consistent self-image

D) Lack of impulsivity

Explanation: Intense emotional swings are a hallmark of Borderline Personality Disorder.

#446 Level 3

What is a potential psychological effect of long-term substance abuse?

A) Heightened concentration

B) Improved mood

C) Increased risk of anxiety disorders

D) Enhanced memory retention

Explanation: Long-term substance abuse can lead to an increased risk of anxiety disorders.

#447 Level 2

Which of the following is a sign of gambling disorder?

A) Playing without financial consequences

B) Frequent social gatherings

C) Lying about gambling habits

D) Enjoying the thrill of winning

Explanation: Lying about gambling habits is a common sign of gambling disorder, indicating a lack of honesty about the addiction.

#448 Level 1

Which body is responsible for establishing uniform standards of nursing education in India?

A) Indian Nursing Council

B) World Health Organization

C) Ministry of Health and Family Welfare

D) National Nursing Association

Explanation: The Indian Nursing Council (INC) is the statutory body for establishing standards of nursing education in India.

#449 Level 2

What is the new duration of the General Nursing and Midwifery training programme as per the revised syllabus?

A) 2 years

B) 3 years

C) 3 ½ years

D) 4 years

Explanation: The duration of the General Nursing and Midwifery training programme has been revised to 3 years.

#450 Level 2

What was a significant change in the format of the revised nursing curriculum?

A) Elimination of practical training

B) Inclusion of course description and objectives

C) Extension of course duration

D) No changes were made

Explanation: The revised curriculum format now includes detailed course descriptions and learning objectives.

#451 Level 3

How does the revised nursing curriculum ensure effective teaching?

A) By eliminating practical components

B) By integrating internship within the course

C) By reducing theoretical hours

D) By increasing the number of examinations

Explanation: The integration of internships within the 3-year course allows for practical experience, contributing to effective teaching.

#452 Level 1

What is one of the main objectives of the revised nursing syllabus?

A) To increase the teaching staff

B) To prepare nurses for qualitative nursing care

C) To shorten the internship duration

D) To reduce the number of subjects

Explanation: The revised syllabus aims to prepare nurses to provide qualitative nursing care in hospitals and communities.

#453 Level 2

What aspect of nursing education does the curriculum emphasize through clear descriptions?

A) Clinical facilities

B) Theoretical knowledge only

C) Extracurricular activities

D) Online learning modules

Explanation: The curriculum emphasizes clinical facilities through detailed descriptions, aiding in practical skill development.

#454 Level 3

What is the purpose of the guidelines and minimum requirements established by the INC?

A) To reduce student enrollment

B) To ensure uniformity in nursing education

C) To minimize teaching resources

D) To eliminate practical training

Explanation: The guidelines and minimum requirements are established to ensure uniform standards of nursing education across institutions.

#455 Level 1

What policy has been addressed in the nursing syllabus to ensure student safety?

A) Grading system

B) Anti-ragging

C) Attendance requirements

D) Uniform policy

Explanation: The syllabus includes an anti-ragging policy to protect students and ensure a safe educational environment.

#456 Level 2

What is a requirement for the nursing teaching faculty as per the curriculum?

A) No specific qualifications

B) Higher education and experience in nursing

C) Only part-time instructors allowed

D) No need for practical experience

Explanation: The nursing teaching faculty is required to have higher education and relevant experience in the field of nursing.

#457 Level 1

What does the nursing curriculum specify regarding admission terms?

A) Open admissions for everyone

B) Selective criteria based on academic performance

C) No admissions allowed

D) Admissions based only on financial status

Explanation: The curriculum outlines specific admission terms and conditions that are based on academic performance.

#458 Level 1

What is the primary factor that influences microbial growth?

A) Light

B) Temperature

C) Pressure

D) Sound

Explanation: Temperature is a critical factor affecting microbial metabolism and reproduction.

#459 Level 2

Which of the following is not considered an antiseptic?

A) Iodine

B) Ethanol

C) Hydrogen Peroxide

D) Penicillin

Explanation: Penicillin is an antibiotic, not an antiseptic, as it specifically targets bacteria rather than acting on all microbes on the skin.

#460 Level 3

A nurse is preparing an area for a surgical procedure. Which practice is most effective in controlling potential infection?

A) Using antiseptic wipes on surfaces

B) Wearing gloves during the procedure

C) Cleaning hands with soap and water

D) Using a mask

Explanation: Cleaning hands with soap and water is the most effective practice in infection control prior to any procedure.

#461 Level 2

Which chemical is commonly used as a disinfectant in healthcare settings?

A) Vinegar

B) Sodium Hypochlorite

C) Rubbing Alcohol

D) Glycerin

Explanation: Sodium Hypochlorite is widely used as a disinfectant due to its effectiveness against a broad spectrum of pathogens.

#462 Level 2

What is the primary goal of biosafety in a healthcare facility?

A) To protect the environment

B) To ensure staff safety

C) To prevent infection spread

D) To minimize costs

Explanation: The primary goal of biosafety is to prevent the spread of infections to both healthcare workers and patients.

#463 Level 3

Which of the following antibiotics is effective against Gram-negative bacteria?

A) Penicillin

B) Vancomycin

C) Ceftriaxone

D) Bacitracin

Explanation: Ceftriaxone is a broad-spectrum antibiotic effective against many Gram-negative bacteria.

#464 Level 3

During a pandemic, which infection prevention strategy should be prioritized in a healthcare setting?

A) Isolation of confirmed cases

B) Increased patient visitation

C) Relaxation of hand hygiene protocols

D) Routine cleaning of all surfaces

Explanation: Isolation of confirmed cases is critical in preventing further spread during a pandemic.

#465 Level 1

What is the meaning of sanitation in the context of healthcare?

A) Cleaning with soap and water

B) Disposal of waste

C) Prevention of disease transmission

D) All of the above

Explanation: Sanitation encompasses cleaning, waste disposal, and measures to prevent disease transmission.

#466 Level 2

What is the most effective method of sterilization for surgical instruments?

A) Dry heat

B) Autoclaving

C) Ethylene oxide gas

D) Boiling water

Explanation: Autoclaving is the most effective sterilization method for surgical instruments, utilizing steam under pressure.

#467 Level 2

What is a characteristic of live attenuated vaccines?

A) They contain killed pathogens

B) They require multiple doses for immunity

C) They stimulate a strong immune response similar to natural infection

D) They are safe for immunocompromised individuals

Explanation: Live attenuated vaccines closely mimic natural infections, eliciting a strong immune response.

#468 Level 1

Which of the following is an example of an inactivated vaccine?

A) Polio vaccine

B) MMR vaccine

C) Varicella vaccine

D) Yellow fever vaccine

Explanation: The polio vaccine is an example of an inactivated (killed) vaccine.

#469 Level 3

How does herd immunity protect unvaccinated individuals?

A) By ensuring everyone gets vaccinated

B) By decreasing the overall presence of the disease in the community

C) By providing lifetime immunity to the unvaccinated

D) By allowing the disease to spread more easily

Explanation: Herd immunity occurs when a sufficient portion of the population is immune, reducing disease spread and protecting those who are unvaccinated.

#470 Level 2

What is the recommended storage temperature range for most vaccines?

A) -20°C to -10°C

B) 0°C to 5°C

C) 10°C to 15°C

D) 20°C to 25°C

Explanation: Most vaccines should be stored within the 0°C to 5°C range to maintain their efficacy.

#471 Level 2

What is a common mild adverse effect of vaccination?

A) High fever

B) Injection site pain

C) Anaphylaxis

D) Severe headache

Explanation: Injection site pain is a common and mild adverse effect following vaccination.

#472 Level 3

Why is it important to follow the recommended vaccine schedule?

A) To reduce healthcare costs

B) To ensure timely immunity development

C) To allow for natural exposure to diseases

D) To increase the number of vaccinations

Explanation: Following the recommended vaccine schedule ensures that individuals develop immunity at the appropriate time to protect against diseases.

#473 Level 2

What is the purpose of post-exposure prophylaxis in vaccination?

A) To treat existing infections

B) To reduce the risk of disease after exposure

C) To enhance immune response to a vaccine

D) To replace the need for vaccination

Explanation: Post-exposure prophylaxis is used to reduce the risk of disease after exposure to a pathogen.

#474 Level 1

What does vaccination primarily aim to achieve?

A) Immediate treatment of diseases

B) Long-term immunity against specific infections

C) Reducing the healthcare workforce

D) Preventing all diseases

Explanation: Vaccination aims to provide long-term immunity against specific infections.

#475 Level 2

Which of the following individuals should typically avoid vaccination?

A) Individuals with mild fever

B) Individuals allergic to a vaccine component

C) Individuals who recently had a cold

D) Individuals with a family history of vaccination

Explanation: Individuals with a known allergy to a component of a vaccine should avoid vaccination due to the risk of severe allergic reactions.

#476 Level 3

In which scenario would vaccination not be considered a therapeutic approach?

A) Preventing disease in healthy individuals

B) Treating an active infection

C) Providing immunity in outbreak situations

D) Reducing the spread of infectious diseases

Explanation: Vaccination is not used to treat active infections; it is primarily preventive.

#477 Level 2

What is pathogenicity in microorganisms?

A) The ability to survive outside a host

B) The ability to cause disease

C) The ability to replicate rapidly

D) The ability to resist antibiotics

Explanation: Pathogenicity refers to the ability of a microorganism to cause disease in a host.

#478 Level 1

Which of the following is a type of fungus?

A) E. coli

B) Candida

C) Streptococcus

D) Mycobacterium

Explanation: Candida is a genus of fungi known to cause infections in humans.

#479 Level 3

Which of the following is considered a protozoan parasite?

A) Plasmodium

B) Salmonella

C) Staphylococcus

D) Clostridium

Explanation: Plasmodium is a genus of protozoan parasites that includes species responsible for malaria.

#480 Level 2

What environmental factor is most critical for bacterial growth?

A) Presence of oxygen

B) Temperature

C) pH level

D) All of the above

Explanation: Bacterial growth requires optimal conditions including temperature, pH, and in some cases, the presence of oxygen.

#481 Level 1

Which of the following structures is found in viruses?

A) Cell wall

B) Nucleus

C) Capsid

D) Cytoplasm

Explanation: Viruses are composed of a protein coat called a capsid and do not have cellular structures like a cell wall or nucleus.

#482 Level 2

What is the primary purpose of antibiotics?

A) To promote growth in livestock

B) To kill or inhibit the growth of bacteria

C) To treat viral infections

D) To enhance immune response

Explanation: Antibiotics are designed to kill or inhibit the growth of bacteria, not viruses or other microorganisms.

#483 Level 3

In a hospital setting, which of the following practices is the most effective for preventing the spread of infection?

A) Handwashing

B) Wearing gloves

C) Isolation of patients

D) Disinfecting surfaces

Explanation: Handwashing is recognized as the most effective method for preventing the transmission of infections in healthcare settings.

#484 Level 1

Which disease is primarily caused by bacteria?

A) Influenza

B) Cholera

C) HIV/AIDS

D) Malaria

Explanation: Cholera is a bacterial infection caused by Vibrio cholerae.

#485 Level 2

Which of the following diseases is caused by a virus?

A) Hepatitis B

B) Tuberculosis

C) Syphilis

D) Typhoid

Explanation: Hepatitis B is a viral infection caused by the Hepatitis B virus.

#486 Level 1

What is the primary muscle type that makes up the uterine wall?

A) Skeletal muscle

B) Smooth muscle

C) Cardiac muscle

D) Striated muscle

Explanation: The uterine wall is primarily composed of smooth muscle, which allows for contractions during labor.

#487 Level 2

Which of the following is a primary function of the placenta during pregnancy?

A) Producing hormones

B) Providing a protective barrier

C) Facilitating gas exchange

D) All of the above

Explanation: The placenta performs multiple functions including hormone production, providing a barrier, and facilitating gas and nutrient exchange.

#488 Level 2

Which hormone is primarily responsible for triggering ovulation?

A) Estrogen

B) Progesterone

C) Luteinizing hormone (LH)

D) Follicle-stimulating hormone (FSH)

Explanation: Luteinizing hormone (LH) surges to trigger ovulation during the ovarian cycle.

#489 Level 2

What is the primary function of the fallopian tubes?

A) Hormone production

B) Site of fertilization

C) Nutrient absorption

D) Menstrual fluid passage

Explanation: The fallopian tubes serve as the site of fertilization where the sperm meets the egg.

#490 Level 3

Which layer of the perineum is primarily involved in childbirth?

A) Superficial perineal layer

B) Deep perineal layer

C) Perineal fascia

D) Pelvic diaphragm

Explanation: The pelvic diaphragm is crucial during childbirth as it supports the pelvic organs and aids in the delivery process.

#491 Level 3

What is the significance of the fetal position during labor?

A) It determines the pain level during contractions

B) It affects the ease of delivery

C) It does not influence labor

D) It only affects the mother's comfort

Explanation: The fetal position greatly affects the ease of delivery, as certain positions facilitate a smoother labor process.

#492 Level 1

Which structure is responsible for milk production in the breast?

A) Lactiferous ducts

B) Alveoli

C) Nipple

D) Areola

Explanation: The alveoli are the milk-producing glands located in the breast.

#493 Level 2

What is the primary role of the cervix during pregnancy?

A) Hormonal regulation

B) Protection of the fetus

C) Facilitating contractions

D) Providing nourishment

Explanation: The cervix acts as a protective barrier to keep the fetus safe within the uterus during pregnancy.

#494 Level 1

What is the primary function of amniotic fluid during pregnancy?

A) Provide nutrients

B) Cushion the fetus

C) Facilitate breathing

D) Assist in hormone regulation

Explanation: Amniotic fluid cushions the fetus, providing a protective environment during development.

#495 Level 2

What is the role of the pubic symphysis during childbirth?

A) It restricts movement

B) It allows slight movement for delivery

C) It protects the fetus

D) It does not play a role

Explanation: The pubic symphysis allows slight movement during childbirth to facilitate the passage of the baby.

#496 Level 2

What is a common consequence of obstructed labor?

A) Increased risk of vaginal tears

B) Decreased fetal heart rate

C) Enhanced uterine contractions

D) Improved maternal well-being

Explanation: Obstructed labor can lead to increased risk of vaginal tears due to the prolonged pressure and difficulty in delivery.

#497 Level 2

What is the primary risk factor for developing gestational diabetes?

A) Age over 25

B) Family history of diabetes

C) Obesity

D) All of the above

Explanation: All listed factors—age over 25, family history of diabetes, and obesity—are significant risk factors for developing gestational diabetes.

#498 Level 3

Which of the following is a severe complication of hyperemesis gravidarum?

A) Dehydration

B) Increased appetite

C) Elevated energy levels

D) Low blood pressure

Explanation: Hyperemesis gravidarum can lead to severe dehydration due to excessive vomiting, which can be hazardous to both mother and fetus.

#499 Level 3

What is a primary risk associated with placenta accreta?

A) Increased likelihood of cesarean delivery

B) Placental abruption

C) Preterm labor

D) Fetal growth restriction

Explanation: Women with placenta accreta are at an increased risk for cesarean delivery due to the abnormal attachment of the placenta to the uterine wall.

#500 Level 2

What is the immediate priority if a cord prolapse is detected during labor?

A) Administer pain relief

B) Perform a vaginal examination

C) Relieve pressure on the cord

D) Monitor fetal heart rate

Explanation: The immediate priority in the case of cord prolapse is to relieve pressure on the cord to prevent fetal distress.

#501 Level 3

What is the hallmark symptom of amniotic fluid embolism?

A) Severe headache

B) Sudden hypotension

C) Excessive bleeding

D) Persistent fever

Explanation: Sudden hypotension is a hallmark symptom of amniotic fluid embolism, indicating a critical and life-threatening condition.

#502 Level 3

Which intervention is critical in managing uterine inversion?

A) Administering intravenous antibiotics

B) Replacing the uterus manually

C) Performing a hysterectomy

D) Monitoring vital signs closely

Explanation: Manually replacing the uterus is critical in managing uterine inversion to restore normal anatomy and prevent severe complications.

#503 Level 2

What is a common risk factor for venous thrombosis during pregnancy?

A) Frequent exercise

B) Prolonged immobility

C) Decreased blood volume

D) Low body mass index (BMI)

Explanation: Prolonged immobility during pregnancy is a significant risk factor for venous thrombosis, leading to potential complications.

#504 Level 2

What is a primary risk factor for preterm birth?

A) Maternal age over 35

B) Poor prenatal care

C) History of preterm birth

D) All of the above

Explanation: All listed factors, including maternal age over 35, poor prenatal care, and a history of preterm birth, increase the risk of preterm birth.

#505 Level 1

What is the typical duration of a full-term pregnancy?

A) 28 weeks

B) 36 weeks

C) 40 weeks

D) 44 weeks

Explanation: A full-term pregnancy typically lasts about 40 weeks from the last menstrual period.

#506 Level 2

What is menopause characterized by?

A) Increase in menstrual flow

B) Cessation of menstruation

C) Irregular menstrual cycles

D) Increased fertility

Explanation: Menopause is characterized by the cessation of menstruation and marks the end of a woman's reproductive years.

#507 Level 1

What does the term 'hysterectomy' refer to?

A) Removal of the ovaries

B) Removal of the uterus

C) Removal of the fallopian tubes

D) Surgical repair of the vulva

Explanation: Hysterectomy is the surgical procedure for the removal of the uterus.

#508 Level 3

Which condition is characterized by the presence of endometrial tissue outside the uterus?

A) Ovarian cyst

B) Endometriosis

C) Fibroids

D) Pelvic inflammatory disease

Explanation: Endometriosis is a condition where endometrial-like tissue grows outside the uterus, often leading to pain and fertility issues.

#509 Level 2

Which contraceptive method is permanent?

A) Male condom

B) Tubal ligation

C) Birth control pills

D) Copper IUD

Explanation: Tubal ligation is a surgical procedure that permanently prevents pregnancy by blocking the fallopian tubes.

#510 Level 3

What is the purpose of a Pap smear?

A) To detect pregnancy

B) To screen for cervical cancer

C) To assess ovulation

D) To diagnose STIs

Explanation: A Pap smear is primarily used to screen for cervical cancer by detecting precancerous changes in cervical cells.

#511 Level 2

Which of the following is a common cause of infertility in women?

A) High blood pressure

B) Ovulatory disorders

C) Anemia

D) Diabetes

Explanation: Ovulatory disorders are one of the most common causes of infertility in women, affecting their ability to conceive.

#512 Level 1

What is the normal pH range of the vagina?

A) 2.5 - 3.5

B) 4.0 - 4.5

C) 5.0 - 5.5

D) 7.0 - 8.0

Explanation: The normal pH range of the vagina is typically between 4.0 and 4.5, which helps maintain a healthy flora.

#513 Level 3

Which sexually transmitted infection is caused by a virus and can lead to cervical cancer?

A) Gonorrhea

B) Chlamydia

C) Human Papillomavirus (HPV)

D) Syphilis

Explanation: Human Papillomavirus (HPV) is a viral infection that can lead to cervical cancer, along with other health issues.

#514 Level 2

Which condition is characterized by heavy menstrual bleeding?

A) Amenorrhea

B) Menorrhagia

C) Oligomenorrhea

D) Dysmenorrhea

Explanation: Menorrhagia refers to abnormally heavy or prolonged menstrual bleeding.

#515 Level 1

What is the term for the position of the fetus in the uterus during labor?

A) Presentation

B) Station

C) Engagement

D) Position

Explanation: The term 'presentation' refers to the part of the fetus that is presenting at the cervix during labor.

#516 Level 2

Which method is commonly used for pain relief during labor?

A) General anesthesia

B) Epidural anesthesia

C) Oral analgesics

D) Local anesthesia

Explanation: Epidural anesthesia is one of the most effective methods of pain relief during labor.

#517 Level 1

What is the first sign of labor that many women may experience?

A) Rupture of membranes

B) Regular contractions

C) Bloody show

D) Nesting instinct

Explanation: The 'bloody show' is often the first sign of labor, indicating cervical changes.

#518 Level 2

During which stage of labor does the delivery of the baby occur?

A) First stage

B) Second stage

C) Third stage

D) Fourth stage

Explanation: The second stage of labor is when the baby is delivered.

#519 Level 3

A nurse is providing care to a woman after delivery. Which assessment is the priority in the immediate postpartum period?

A) Assessing for lacerations

B) Monitoring vital signs

C) Checking the baby's weight

D) Providing breastfeeding support

Explanation: Monitoring vital signs is critical in the immediate postpartum period to detect any complications.

#520 Level 3

Which complication of labor is characterized by a prolonged labor lasting more than 20 hours?

A) Precipitate labor

B) Prolonged labor

C) Dystocia

D) Breech presentation

Explanation: Prolonged labor is defined as labor lasting more than 20 hours for primiparas.

#521 Level 2

A nurse is assessing a laboring woman. What is the best method to determine the frequency of contractions?

A) Palpation of the abdomen

B) Electronic fetal monitoring

C) Vaginal examination

D) Maternal report

Explanation: Electronic fetal monitoring provides accurate information regarding the frequency and duration of contractions.

#522 Level 1

What is the term used for the gradual opening of the cervix during labor?

A) Effacement

B) Dilation

C) Descent

D) Engagement

Explanation: Dilation refers specifically to the gradual opening of the cervix during labor.

#523 Level 2

Which of the following is a common physiological change during pregnancy?

A) Decreased heart rate

B) Increased blood volume

C) Decreased respiratory rate

D) Increased platelet count

Explanation: During pregnancy, there is an increase in blood volume to support the growing fetus and placenta.

#524 Level 2

A pregnant woman is seeking advice on her diet. Which nutrient is particularly important for neural tube development?

A) Vitamin C

B) Folate

C) Protein

D) Iron

Explanation: Folate is crucial for the development of the neural tube and helps prevent neural tube defects.

#525 Level 1

Which of the following is a primary sign of labor onset?

A) Lightening

B) Increased appetite

C) Fatigue

D) Pelvic discomfort

Explanation: Lightening, or the baby dropping into the pelvis, is a primary sign that labor may begin soon.

#526 Level 3

Which of the following factors is considered a high-risk factor during pregnancy?

A) Age 25

B) Pre-existing diabetes

C) Non-smoker

D) Healthy BMI

Explanation: Pre-existing diabetes is a significant high-risk factor that can lead to complications during pregnancy.

#527 Level 2

At what week of gestation does the fetal heart typically begin to beat?

A) 4-5 weeks

B) 6-7 weeks

C) 8-10 weeks

D) 12 weeks

Explanation: The fetal heart typically begins to beat around 6 to 7 weeks of gestation.

#528 Level 3

Which of the following is a common complication associated with gestational diabetes?

A) Low birth weight

B) Preeclampsia

C) Hyperemesis gravidarum

D) Premature rupture of membranes

Explanation: Gestational diabetes can increase the risk of developing preeclampsia during pregnancy.

#529 Level 1

What is the primary purpose of antenatal care?

A) To provide education on labor

B) To monitor the mother's health

C) To schedule delivery dates

D) To assess newborn viability

Explanation: Antenatal care primarily focuses on monitoring the mother's health throughout the pregnancy.

#530 Level 2

Which of the following is a common physical change during the postpartum period?

A) Increased energy levels

B) Uterine involution

C) Decreased appetite

D) Enhanced immune response

Explanation: Uterine involution is the process by which the uterus returns to its pre-pregnant size following delivery.

#531 Level 2

A woman in her first trimester reports fatigue and nausea. Which condition should the nurse assess for?

A) Ectopic pregnancy

B) Hyperemesis gravidarum

C) Gestational hypertension

D) Premature labor

Explanation: Hyperemesis gravidarum is characterized by severe nausea and vomiting during pregnancy, particularly in the first trimester.

#532 Level 1

What type of exercise is generally recommended for pregnant women?

A) High-intensity interval training

B) Yoga and swimming

C) Heavy weightlifting

D) Contact sports

Explanation: Yoga and swimming are low-impact exercises that are generally recommended for pregnant women to maintain fitness.

#533 Level 1

Which of the following is a common physical change during the puerperium?

A) Increase in breast size

B) Decrease in body weight

C) Return of menstruation immediately

D) Uterine involution

Explanation: Uterine involution, or the return of the uterus to its pre-pregnancy size, is a common physical change during the puerperium.

#534 Level 2

What is a common emotional change experienced by mothers during the puerperium?

A) Increased self-confidence

B) Postpartum blues

C) Constant happiness

D) Withdrawal from social interactions

Explanation: Postpartum blues, characterized by mood swings and emotional instability, is a common emotional change during this period.

#535 Level 3

During the puerperium, which factor significantly increases the risk of infection?

A) Proper hand hygiene

B) Vaginal delivery

C) Retained placental fragments

D) Adequate rest

Explanation: Retained placental fragments can lead to postpartum infections due to the presence of necrotic tissue.

#536 Level 1

What is recommended for mothers to promote breastfeeding during the puerperium?

A) Formula feeding

B) Skin-to-skin contact

C) Avoiding colostrum

D) Pumping milk exclusively

Explanation: Skin-to-skin contact is recommended to stimulate breastfeeding and enhance mother-infant bonding.

#537 Level 2

A nurse is educating a postpartum mother about nutrition. Which nutrient is most important for healing during the puerperium?

A) Vitamin C

B) Carbohydrates

C) Fats

D) Fiber

Explanation: Vitamin C is vital for tissue repair and immune function, making it essential during the healing period.

#538 Level 3

Which postpartum exercise is considered beneficial for strengthening pelvic floor muscles?

A) Kegel exercises

B) Crunches

C) Aerobics

D) Weight lifting

Explanation: Kegel exercises are specifically designed to strengthen pelvic floor muscles, which can be weakened during childbirth.

#539 Level 2

What mental health condition is crucial to screen for during the puerperium?

A) Anxiety disorders

B) Postpartum depression

C) Schizophrenia

D) Bipolar disorder

Explanation: Postpartum depression is a significant mental health concern that can affect mothers during the puerperium and requires screening.

#540 Level 3

Which physiological mechanism is affected during the puerperium, leading to temperature variations?

A) Hormonal changes

B) Increased metabolism

C) Fluid retention

D) Decreased appetite

Explanation: Hormonal changes during the puerperium can affect thermoregulation, leading to temperature fluctuations.

#541 Level 2

During a home visit, a nurse observes a mother struggling with her newborn. What is the best way for the nurse to promote family support?

A) Encourage isolation

B) Involve family members in caregiving

C) Provide only verbal instructions

D) Dismiss concerns and provide no guidance

Explanation: Involving family members in caregiving can enhance support for the mother and improve her confidence and well-being.

#542 Level 1

What is the recommended follow-up time for mothers after delivery?

A) 1 week

B) 2 weeks

C) 6 weeks

D) 3 months

Explanation: A follow-up at 6 weeks postpartum is recommended to assess maternal health and recovery.

#543 Level 2

Which mineral is essential for maintaining healthy bones and teeth?

A) Iron

B) Calcium

C) Potassium

D) Sodium

Explanation: Calcium is crucial for the development and maintenance of healthy bones and teeth.

#544 Level 1

What type of fat is considered unhealthy and can raise cholesterol levels?

A) Saturated fat

B) Polyunsaturated fat

C) Monounsaturated fat

D) Omega-3 fatty acids

Explanation: Saturated fats can increase levels of LDL (bad) cholesterol in the blood.

#545 Level 1

Which of the following is a simple carbohydrate?

A) Glucose

B) Starch

C) Fiber

D) Glycogen

Explanation: Glucose is a simple carbohydrate, while starch, fiber, and glycogen are complex carbohydrates.

#546 Level 3

What percentage of the human body is made up of water?

A) 30%

B) 50%

C) 60%

D) 70%

Explanation: Approximately 60% of the human body weight is made up of water, highlighting its importance in bodily functions.

#547 Level 2

What is the main benefit of dietary fiber in the diet?

A) Helps in weight gain

B) Aids in digestion

C) Provides energy

D) Increases blood sugar

Explanation: Dietary fiber is known for aiding in digestion and promoting regular bowel movements.

#548 Level 3

Which food source is highest in Vitamin A?

A) Carrots

B) Milk

C) Spinach

D) Fish oil

Explanation: Fish oil is one of the richest sources of Vitamin A, contributing significantly to dietary intake.

#549 Level 2

What factor influences the daily nutritional requirements of an individual?

A) Age and gender

B) Favorite food

C) Geographic location

D) Social media trends

Explanation: Age and gender are key factors that influence an individual's daily nutritional needs.

#550 Level 3

How does the body primarily obtain energy from food?

A) By converting proteins into carbohydrates

B) By storing fats as energy reserves

C) By metabolizing carbohydrates and fats

D) By absorbing vitamins directly into the bloodstream

Explanation: The body primarily obtains energy by metabolizing carbohydrates and fats, which are broken down during digestion.

#551 Level 2

What is the primary reason for increased caloric needs during lactation?

A) Growth of maternal tissues

B) Production of breast milk

C) Increased physical activity

D) Hormonal changes

Explanation: Lactating women require more calories primarily to support the production of breast milk.

#552 Level 1

Which vitamin is crucial for the development of bone health in children?

A) Vitamin A

B) Vitamin D

C) Vitamin E

D) Vitamin K

Explanation: Vitamin D is essential for calcium absorption, which is vital for bone health in children.

#553 Level 3

What change in metabolism is commonly observed in elderly individuals?

A) Increased protein synthesis

B) Decreased caloric requirements

C) Increased absorption of nutrients

D) Decreased fluid intake

Explanation: Elderly individuals often experience decreased metabolic rates and thus have lower caloric requirements.

#554 Level 2

Why is iron intake particularly important for adolescents, especially females?

A) To enhance energy levels

B) To prevent anemia during menstruation

C) To support muscle growth

D) To aid in digestion

Explanation: Adolescents, particularly females, need adequate iron to compensate for blood loss during menstruation and to prevent anemia.

#555 Level 2

What is the recommended dietary addition for pregnant women to support fetal development?

A) Omega-3 fatty acids

B) Fiber

C) High-protein foods

D) Folic acid

Explanation: Folic acid is crucial for fetal development, particularly in preventing neural tube defects.

#556 Level 2

Which factor can impair the absorption of fat-soluble vitamins?

A) Low-fat diet

B) High fiber intake

C) High protein intake

D) Regular exercise

Explanation: A low-fat diet can impede the absorption of fat-soluble vitamins (A, D, E, K) because these vitamins require fat for absorption.

#557 Level 1

Which of the following is considered a macronutrient?

A) Vitamins

B) Minerals

C) Carbohydrates

D) Antioxidants

Explanation: Carbohydrates are classified as macronutrients, which are needed in larger amounts in the diet.

#558 Level 3

An elderly patient presents with loss of appetite and weight loss. What should be the initial focus of the nutritional assessment?

A) Assess calorie intake

B) Evaluate physical activity levels

C) Review medication list

D) Conduct a dietary recall

Explanation: Conducting a dietary recall helps in understanding the patient's current eating habits, which is crucial for identifying nutritional deficiencies.

#559 Level 2

What dietary adjustments might be necessary for a pregnant woman experiencing nausea?

A) Increase fiber intake

B) Eat small, frequent meals

C) Drink large amounts of water

D) Limit protein intake

Explanation: Eating small, frequent meals can help manage nausea in pregnant women by preventing the stomach from becoming too empty.

#560 Level 1

What is the key reason for maintaining proper hydration during all life stages?

A) Regulates body temperature

B) Enhances taste of food

C) Increases appetite

D) Reduces digestive time

Explanation: Proper hydration is essential for regulating body temperature and maintaining overall bodily functions throughout all life stages.

#561 Level 1

What is the primary purpose of the Indian Nursing Council (INC) in relation to nursing education?

A) To conduct clinical trials

B) To establish uniform standards of nursing education

C) To manage hospitals

D) To provide financial support to nurses

Explanation: The INC's main function is to establish uniform standards for nursing education and prescribe the syllabus for nursing personnel.

#562 Level 2

How has the duration of the General Nursing and Midwifery program changed in the revised curriculum?

A) Increased from 3 years to 3 ½ years

B) Remained the same at 3 years

C) Decreased from 3 ½ years to 3 years

D) Increased from 2 years to 3 years

Explanation: The duration of the program has been reduced from 3 ½ years to 3 years as per the revised curriculum.

#563 Level 3

What does the revised curriculum of the GNM program include regarding assessment methods?

A) Only theory tests

B) Practical assessments only

C) A variety of assessment methods including practical and theoretical

D) No assessments are specified

Explanation: The revised curriculum specifies a variety of assessment methods for both practical and theoretical components.

#564 Level 2

What is a key component integrated into the 3-year General Nursing program?

A) Additional elective subjects

B) Theoretical exams

C) Internship

D) Extended leave periods

Explanation: The revision integrates internship within the 3-year course to enhance practical learning.

#565 Level 1

Which subject is included in the first-year curriculum of the GNM program?

A) Pharmacology

B) Community Health Nursing

C) Anatomy and Physiology

D) Medical-Surgical Nursing

Explanation: Anatomy and Physiology is one of the subjects included in the first-year curriculum of the GNM program.

#566 Level 2

What significant change was made to the syllabus format in the revised GNM curriculum?

A) Elimination of practical components

B) Inclusion of detailed descriptions for practical areas

C) Focus solely on theoretical knowledge

D) No changes were made to the syllabus format

Explanation: The revised format includes detailed descriptions for practical areas with objectives and assessment methods.

#567 Level 3

Why is the Indian Nursing Council's involvement crucial in the revision of nursing curricula?

A) To standardize nursing education and ensure quality

B) To increase the duration of nursing programs

C) To eliminate internship requirements

D) To focus solely on theoretical knowledge

Explanation: The INC's involvement is crucial to standardize nursing education and ensure that it meets quality benchmarks for future nurses.

#568 Level 1

Which of the following is a common analgesic?

A) Ibuprofen

B) Metformin

C) Amlodipine

D) Amoxicillin

Explanation: Ibuprofen is a widely used nonsteroidal anti-inflammatory drug (NSAID) that acts as an analgesic.

#569 Level 2

What is the primary use of antihypertensive medications?

A) To treat high blood pressure

B) To lower blood sugar levels

C) To treat infections

D) To relieve pain

Explanation: Antihypertensive medications are primarily used to manage and treat high blood pressure.

#570 Level 2

Which of the following medications is classified as an anticoagulant?

A) Warfarin

B) Furosemide

C) Dexamethasone

D) Metoprolol

Explanation: Warfarin is an anticoagulant that helps prevent blood clots.

#571 Level 3

Which class of medications is commonly prescribed for depression?

A) SSRIs

B) Beta-blockers

C) NSAIDs

D) Diuretics

Explanation: Selective Serotonin Reuptake Inhibitors (SSRIs) are a common class of antidepressants used to treat depression.

#572 Level 1

What is the primary purpose of vaccines?

A) To prevent diseases

B) To treat infections

C) To relieve pain

D) To reduce inflammation

Explanation: Vaccines are primarily used to prevent diseases by stimulating the immune response.

#573 Level 2

Which of the following is a common sedative used to induce sleep?

A) Diazepam

B) Amoxicillin

C) Aspirin

D) Levothyroxine

Explanation: Diazepam is a common sedative that is often prescribed to help patients with sleep issues.

#574 Level 3

Which of the following best describes the action of antimicrobials?

A) They inhibit microbial growth.

B) They enhance blood flow.

C) They increase pain perception.

D) They raise blood sugar levels.

Explanation: Antimicrobials are agents that inhibit the growth of microorganisms, including bacteria, fungi, and viruses.

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      "difficulty": 2,
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      "question": "What is the functional unit of the kidney?",
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      "source_url": null,
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        "A) Glucagon",
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      "concept_tag": "menstrual cycle",
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        "A) 14 days",
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      "source_url": null,
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      "concept_tag": "bone types",
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      "correct_answer": "C",
      "difficulty": 2,
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      "question": "Which bone is the longest bone in the human body?",
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      "source_url": null,
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      "topic_id": "ap_skeletal",
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      "concept_tag": "muscle types",
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      "difficulty": 2,
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        "A) Cardiac muscle",
        "B) Smooth muscle",
        "C) Skeletal muscle",
        "D) All of the above"
      ],
      "question": "Which type of muscle is under voluntary control?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle types",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
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      "cognitive_level": "understand",
      "concept_tag": "cell organelle",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Mitochondria produce ATP, the cell\u0027s energy currency.",
      "format": "mcq",
      "id": 11,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Nucleus",
        "B) Ribosome",
        "C) Mitochondria",
        "D) Golgi apparatus"
      ],
      "question": "Which organelle is known as the \u0027powerhouse of the cell\u0027?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cell organelle",
      "source_url": null,
      "subject_id": "anatomy_physiology",
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      "verified_at": "2026-06-29",
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    },
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      "cognitive_level": "understand",
      "concept_tag": "blood groups",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "O negative red blood cells lack A, B, and Rh antigens, making them the universal donor.",
      "format": "mcq",
      "id": 12,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) A positive",
        "B) B positive",
        "C) AB positive",
        "D) O negative"
      ],
      "question": "Which blood group is known as the universal donor?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "blood groups",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
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      "cognitive_level": "understand",
      "concept_tag": "gas exchange",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Gas exchange occurs across the thin walls of the alveoli.",
      "format": "mcq",
      "id": 13,
      "last_reviewed": "2026-06-29",
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        "A) Bronchi",
        "B) Trachea",
        "C) Alveoli",
        "D) Larynx"
      ],
      "question": "Where does gas exchange occur in the lungs?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "gas exchange",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "urine output",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Normal adult urine output is approximately 1000-2000 mL per day.",
      "format": "mcq",
      "id": 14,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 100-200 mL",
        "B) 400-500 mL",
        "C) 800-1000 mL",
        "D) 1000-2000 mL"
      ],
      "question": "What is the normal daily urine output for an adult?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "urine output",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "reflex arc",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Motor neurons carry impulses from the CNS to effector muscles or glands.",
      "format": "mcq",
      "id": 15,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Sensory neuron",
        "B) Interneuron",
        "C) Motor neuron",
        "D) Glial cell"
      ],
      "question": "Which structure transmits impulses away from the central nervous system to muscles?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "reflex arc",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "normal temperature",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Normal oral body temperature is approximately 37.0\u00b0C (98.6\u00b0F).",
      "format": "mcq",
      "id": 16,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 35.0\u00b0C",
        "B) 36.5\u00b0C",
        "C) 37.0\u00b0C",
        "D) 38.0\u00b0C"
      ],
      "question": "What is the normal oral body temperature?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "normal temperature",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "pulse sites",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The radial artery at the wrist is the most common site for routine pulse measurement.",
      "format": "mcq",
      "id": 17,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Carotid artery",
        "B) Radial artery",
        "C) Femoral artery",
        "D) Brachial artery"
      ],
      "question": "Which artery is commonly used to check the pulse in adults?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pulse sites",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing process",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "ADPIE stands for Assessment, Diagnosis, Planning, Implementation, and Evaluation.",
      "format": "mcq",
      "id": 18,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Analysis",
        "B) Assessment",
        "C) Action",
        "D) Audit"
      ],
      "question": "What does the \u0027A\u0027 stand for in the nursing process ADPIE?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing process",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "hand hygiene",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Hand hygiene is the single most effective measure to prevent infections.",
      "format": "mcq",
      "id": 19,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Wearing gloves",
        "B) Hand hygiene",
        "C) Using antibiotics",
        "D) Isolation"
      ],
      "question": "What is the most effective way to prevent healthcare-associated infections?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hand hygiene",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pressure sore",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The sacrum bears weight in supine position, increasing pressure sore risk.",
      "format": "mcq",
      "id": 20,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Side-lying",
        "B) Prone",
        "C) Supine",
        "D) Sitting upright"
      ],
      "question": "Which position is most likely to cause pressure sores on the sacrum?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pressure sore",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "fowler position",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Fowler\u0027s position elevates the head of the bed 45-60 degrees.",
      "format": "mcq",
      "id": 21,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Supine",
        "B) Trendelenburg",
        "C) Fowler\u0027s position",
        "D) Prone"
      ],
      "question": "In which position is the head of the bed elevated 45-60 degrees?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fowler position",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "wound healing",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Secondary intention healing occurs when wound edges are not approximated.",
      "format": "mcq",
      "id": 22,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Primary intention",
        "B) Secondary intention",
        "C) Tertiary intention",
        "D) Fourth intention"
      ],
      "question": "Which type of wound healing occurs when a wound is left open and heals from the bottom up?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound healing",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "patient rights",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Patients have the right to informed consent and to refuse treatment.",
      "format": "mcq",
      "id": 23,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Right to refuse treatment",
        "B) Right to free medicines",
        "C) Right to choose any doctor",
        "D) Right to unlimited visitors"
      ],
      "question": "Which of the following is a fundamental patient right?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "patient rights",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "pulse rate",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Normal adult resting pulse rate is 60-100 beats per minute.",
      "format": "mcq",
      "id": 24,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 40-60 beats/min",
        "B) 60-100 beats/min",
        "C) 100-120 beats/min",
        "D) 120-140 beats/min"
      ],
      "question": "What is the normal adult pulse rate at rest?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pulse rate",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "sterilization",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Autoclaving uses steam under pressure and is the most reliable sterilization method.",
      "format": "mcq",
      "id": 25,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Boiling",
        "B) Autoclaving",
        "C) UV light",
        "D) Alcohol wipe"
      ],
      "question": "Which method is most reliable for sterilizing surgical instruments?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sterilization",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "documentation",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The primary purpose of documentation is communication among the healthcare team.",
      "format": "mcq",
      "id": 26,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Legal protection",
        "B) Communication",
        "C) Billing",
        "D) Research"
      ],
      "question": "What is the primary purpose of nursing documentation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "documentation",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "oral care",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Unconscious patients cannot maintain their own oral hygiene and are at high risk.",
      "format": "mcq",
      "id": 27,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Post-operative appendectomy",
        "B) Unconscious patient",
        "C) Ambulatory patient",
        "D) Patient with hypertension"
      ],
      "question": "Which patient is at highest risk for oral infections and requires frequent oral care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "oral care",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "ppe",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Airborne precautions require an N95 or higher-level respirator.",
      "format": "mcq",
      "id": 28,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Gloves only",
        "B) Gown and gloves",
        "C) N95 respirator",
        "D) Face shield only"
      ],
      "question": "When caring for a patient with airborne disease, which PPE is essential?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ppe",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "trendelenburg",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Trendelenburg position (head down, feet up) is used to improve perfusion in shock.",
      "format": "mcq",
      "id": 29,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Respiratory distress",
        "B) Shock and hypotension",
        "C) Post-spinal surgery",
        "D) Gastric suction"
      ],
      "question": "Trendelenburg position is used primarily for:",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "trendelenburg",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "surgical asepsis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Turning your back to a sterile field risks contamination.",
      "format": "mcq",
      "id": 30,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Keeping sterile field above waist level",
        "B) Turning back to sterile field",
        "C) Using sterile gloves",
        "D) Discarding contaminated items"
      ],
      "question": "Which practice violates surgical asepsis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "surgical asepsis",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "bacteria shape",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Tuberculosis is caused by Mycobacterium tuberculosis.",
      "format": "mcq",
      "id": 31,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Streptococcus",
        "B) Mycobacterium tuberculosis",
        "C) Escherichia coli",
        "D) Staphylococcus"
      ],
      "question": "Which microorganism is responsible for tuberculosis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bacteria shape",
      "source_url": null,
      "subject_id": "microbiology",
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "sterilization methods",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Autoclaves typically operate at 121\u00b0C under 15 psi pressure.",
      "format": "mcq",
      "id": 32,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 100\u00b0C",
        "B) 121\u00b0C",
        "C) 80\u00b0C",
        "D) 150\u00b0C"
      ],
      "question": "What is the minimum temperature typically reached in an autoclave?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sterilization methods",
      "source_url": null,
      "subject_id": "microbiology",
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "vaccination",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "BCG (Bacillus Calmette-Gu\u00e9rin) vaccine is given at birth for TB protection.",
      "format": "mcq",
      "id": 33,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) OPV",
        "B) BCG",
        "C) DPT",
        "D) Measles"
      ],
      "question": "Which vaccine is given at birth to prevent tuberculosis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vaccination",
      "source_url": null,
      "subject_id": "microbiology",
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "disinfection",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Glutaraldehyde is a high-level disinfectant used for heat-sensitive instruments.",
      "format": "mcq",
      "id": 34,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Soap and water",
        "B) Alcohol",
        "C) Glutaraldehyde",
        "D) Normal saline"
      ],
      "question": "Which is an example of a high-level disinfectant?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "disinfection",
      "source_url": null,
      "subject_id": "microbiology",
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "chain of infection",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The chain of infection includes infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.",
      "format": "mcq",
      "id": 35,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Infectious agent",
        "B) Reservoir",
        "C) Nurse\u0027s attitude",
        "D) Portal of entry"
      ],
      "question": "Which of the following is NOT a link in the chain of infection?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "chain of infection",
      "source_url": null,
      "subject_id": "microbiology",
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "cold chain",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Cold chain is the temperature-controlled supply chain for vaccines.",
      "format": "mcq",
      "id": 36,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Freezing all vaccines",
        "B) Maintaining required temperature from production to administration",
        "C) Storing vaccines in ice",
        "D) Transporting vaccines quickly"
      ],
      "question": "What does \u0027cold chain\u0027 refer to in immunization?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cold chain",
      "source_url": null,
      "subject_id": "microbiology",
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "biosafety",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "In the BMW (Biomedical Waste) colour coding, yellow bags are used for infectious waste.",
      "format": "mcq",
      "id": 37,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Black",
        "B) Yellow",
        "C) Red",
        "D) Green"
      ],
      "question": "Which color-coded bag is used for infectious waste disposal?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "biosafety",
      "source_url": null,
      "subject_id": "microbiology",
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "five rights",
      "context": "calculation",
      "correct_answer": "D",
      "difficulty": 1,
      "explanation": "The five rights are right patient, drug, dose, route, and time.",
      "format": "mcq",
      "id": 38,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Right patient",
        "B) Right dose",
        "C) Right time",
        "D) Right cost"
      ],
      "question": "Which is NOT one of the \u0027five rights\u0027 of medication administration?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "five rights",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "routes of administration",
      "context": "calculation",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Intravenous administration delivers drug directly into circulation.",
      "format": "mcq",
      "id": 39,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Oral",
        "B) Intramuscular",
        "C) Intravenous",
        "D) Subcutaneous"
      ],
      "question": "Which route of administration has the fastest onset of action?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "routes of administration",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "antipyretics",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Paracetamol (acetaminophen) is a common antipyretic.",
      "format": "mcq",
      "id": 40,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Paracetamol",
        "B) Insulin",
        "C) Amlodipine",
        "D) Metformin"
      ],
      "question": "Which drug is commonly used to reduce fever?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antipyretics",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "antibiotics",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Antibiotics are used to treat bacterial infections.",
      "format": "mcq",
      "id": 41,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Antibiotic",
        "B) Antiviral",
        "C) Antifungal",
        "D) Antihistamine"
      ],
      "question": "Which medication is used to treat bacterial infections?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antibiotics",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "drug calculation",
      "context": "calculation",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "500 mg / 250 mg = 2 tablets.",
      "format": "mcq",
      "id": 42,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 1",
        "B) 2",
        "C) 3",
        "D) 4"
      ],
      "question": "A patient is prescribed 500 mg of a drug available as 250 mg tablets. How many tablets should be given?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "drug calculation",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "iv fluids",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Normal saline (0.9% NaCl) is isotonic to plasma.",
      "format": "mcq",
      "id": 43,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Dextrose 5%",
        "B) Normal saline 0.9%",
        "C) Half-normal saline",
        "D) Mannitol"
      ],
      "question": "Which IV fluid is isotonic?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "iv fluids",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "antihypertensives",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "ACE inhibitors are a common class of antihypertensive drugs.",
      "format": "mcq",
      "id": 44,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) ACE inhibitors",
        "B) Antibiotics",
        "C) Antacids",
        "D) Bronchodilators"
      ],
      "question": "Which class of drugs is used to treat hypertension?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antihypertensives",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "hypertension",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Hypertension is generally defined as BP \u2265 140/90 mmHg.",
      "format": "mcq",
      "id": 45,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 120/80 mmHg",
        "B) 130/85 mmHg",
        "C) 140/90 mmHg",
        "D) 160/100 mmHg"
      ],
      "question": "Blood pressure consistently above which value is classified as hypertension?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hypertension",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "tb",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Sputum microscopy and culture are standard for diagnosing pulmonary TB.",
      "format": "mcq",
      "id": 46,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Blood",
        "B) Urine",
        "C) Sputum",
        "D) Stool"
      ],
      "question": "Which sample is most commonly used to diagnose pulmonary tuberculosis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "tb",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "post-op complications",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Atelectasis (collapse of alveoli) is the most common postoperative respiratory complication.",
      "format": "mcq",
      "id": 47,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Pneumonia",
        "B) Atelectasis",
        "C) Pulmonary embolism",
        "D) Pleural effusion"
      ],
      "question": "What is the most common postoperative respiratory complication?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "post-op complications",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "stroke",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Sudden unilateral weakness or numbness is a hallmark of stroke.",
      "format": "mcq",
      "id": 48,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Sudden severe headache",
        "B) Sudden unilateral weakness",
        "C) Gradual confusion",
        "D) Mild fever"
      ],
      "question": "Which sign is most characteristic of a stroke?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "stroke",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "ng tube",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Tube placement must be verified before any instillation.",
      "format": "mcq",
      "id": 49,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Crush all tablets",
        "B) Check tube placement",
        "C) Use cold water",
        "D) Administer rapidly"
      ],
      "question": "Before administering medication through an NG tube, what should the nurse do?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ng tube",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "catheterization",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Catheter-associated urinary tract infection (CAUTI) is the most common complication.",
      "format": "mcq",
      "id": 50,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Hematuria",
        "B) Urinary tract infection",
        "C) Kidney stones",
        "D) Incontinence"
      ],
      "question": "What is the primary complication associated with urinary catheterization?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "catheterization",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "mi",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Troponin levels rise within hours of myocardial damage.",
      "format": "mcq",
      "id": 51,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Amylase",
        "B) Troponin",
        "C) Lipase",
        "D) Bilirubin"
      ],
      "question": "Which enzyme rises within hours after a myocardial infarction?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "mi",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "chemotherapy",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Double gloving and safe handling procedures are required for chemotherapy.",
      "format": "mcq",
      "id": 52,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Use double gloves",
        "B) No special precautions",
        "C) Use bare hands",
        "D) Store at room temperature only"
      ],
      "question": "Which precaution is essential when handling chemotherapy drugs?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "chemotherapy",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "oxygen therapy",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Nasal cannula flow rates are typically 1-6 L/min.",
      "format": "mcq",
      "id": 53,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 2 L/min",
        "B) 4 L/min",
        "C) 6 L/min",
        "D) 10 L/min"
      ],
      "question": "What is the safe maximum oxygen flow rate for a simple nasal cannula?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "oxygen therapy",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "physical exam",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Supine position means lying flat on the back.",
      "format": "mcq",
      "id": 54,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Prone",
        "B) Lateral",
        "C) Supine",
        "D) Sims\u0027"
      ],
      "question": "In which position is the patient lying flat on the back?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "physical exam",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "liver",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "The liver stores fat-soluble vitamins A, D, E, and K.",
      "format": "mcq",
      "id": 55,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Vitamin C",
        "B) Vitamin D",
        "C) Vitamin B12",
        "D) All fat-soluble vitamins"
      ],
      "question": "Which vitamin is stored in the liver?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "liver",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pre-op",
      "context": "calculation",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Standard pre-op fasting for solids is 6-8 hours to reduce aspiration risk.",
      "format": "mcq",
      "id": 56,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 2 hours",
        "B) 4 hours",
        "C) 6-8 hours",
        "D) 12 hours"
      ],
      "question": "How many hours before surgery should a patient typically be NPO for solids?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pre-op",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "seizure",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Protecting the patient from injury is the priority during a seizure.",
      "format": "mcq",
      "id": 57,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Insert an oral airway",
        "B) Restrain the patient",
        "C) Protect from injury",
        "D) Give oral medication"
      ],
      "question": "What is the priority nursing action during a generalized seizure?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "seizure",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "heart failure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Left-sided heart failure causes pulmonary congestion and edema.",
      "format": "mcq",
      "id": 58,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Peripheral edema",
        "B) Pulmonary edema",
        "C) Hepatomegaly",
        "D) Jugular venous distension"
      ],
      "question": "Which symptom is most suggestive of left-sided heart failure?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "heart failure",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "dialysis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "End-stage renal disease often requires dialysis or transplantation.",
      "format": "mcq",
      "id": 59,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Mild dehydration",
        "B) End-stage renal disease",
        "C) Urinary tract infection",
        "D) Kidney stones"
      ],
      "question": "Which condition indicates the need for dialysis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "dialysis",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "primary health care",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Community participation is a core principle of Primary Health Care.",
      "format": "mcq",
      "id": 60,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Specialised hospital care",
        "B) Community participation",
        "C) Expensive technology",
        "D) Urban focus only"
      ],
      "question": "Which is a key principle of Primary Health Care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "primary health care",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "vector control",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Dengue is transmitted by Aedes aegypti mosquito.",
      "format": "mcq",
      "id": 61,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Malaria",
        "B) Dengue",
        "C) Filariasis",
        "D) Typhoid"
      ],
      "question": "Which disease is transmitted by the Aedes mosquito?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vector control",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "immunization",
      "context": "calculation",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "DPT primary series consists of three doses.",
      "format": "mcq",
      "id": 62,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 2",
        "B) 3",
        "C) 4",
        "D) 5"
      ],
      "question": "How many doses of DPT vaccine are given in the primary series?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "immunization",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "safe water",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Boiling water for at least one minute kills most pathogens.",
      "format": "mcq",
      "id": 63,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Filtration",
        "B) Boiling",
        "C) Sunlight exposure",
        "D) Adding sugar"
      ],
      "question": "Which method is most effective for disinfecting drinking water at household level?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "safe water",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "national programmes",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "RNTCP (Revised National Tuberculosis Control Programme) focuses on TB.",
      "format": "mcq",
      "id": 64,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) RNTCP",
        "B) NVBDCP",
        "C) NLEP",
        "D) NACO"
      ],
      "question": "Which national programme focuses on tuberculosis control in India?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "national programmes",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "family planning",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Tubectomy is a permanent surgical contraceptive method for females.",
      "format": "mcq",
      "id": 65,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Condom",
        "B) Oral pills",
        "C) Tubectomy",
        "D) Copper-T"
      ],
      "question": "Which is a permanent method of family planning?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "family planning",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "epidemiology",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Herd immunity occurs when a large portion of a community is immune, protecting those who are not.",
      "format": "mcq",
      "id": 66,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Immunity of animals",
        "B) Protection of unvaccinated individuals due to high vaccination coverage",
        "C) Immunity from infection",
        "D) Natural immunity only"
      ],
      "question": "What does \u0027herd immunity\u0027 mean?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "epidemiology",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "waste disposal",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Yellow bags are used for infectious biomedical waste.",
      "format": "mcq",
      "id": 67,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Glass vials",
        "B) Infectious waste",
        "C) Radioactive waste",
        "D) General waste"
      ],
      "question": "Which waste should be disposed in a yellow bag?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "waste disposal",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "therapeutic communication",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Active listening is a core therapeutic communication technique.",
      "format": "mcq",
      "id": 68,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Giving advice",
        "B) Active listening",
        "C) Changing the subject",
        "D) False reassurance"
      ],
      "question": "Which technique demonstrates therapeutic communication?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "therapeutic communication",
      "source_url": null,
      "subject_id": "mental_health",
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "depression",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Persistent sadness or anhedonia is characteristic of depression.",
      "format": "mcq",
      "id": 69,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Euphoria",
        "B) Persistent sadness",
        "C) Hyperactivity",
        "D) Increased appetite always"
      ],
      "question": "Which symptom is most characteristic of major depression?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "depression",
      "source_url": null,
      "subject_id": "mental_health",
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "schizophrenia",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Hallucinations and delusions are positive symptoms of schizophrenia.",
      "format": "mcq",
      "id": 70,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Flat affect",
        "B) Social withdrawal",
        "C) Hallucinations",
        "D) Avolition"
      ],
      "question": "Which symptom is a positive symptom of schizophrenia?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "schizophrenia",
      "source_url": null,
      "subject_id": "mental_health",
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "defense mechanisms",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Denial is refusing to accept reality or facts.",
      "format": "mcq",
      "id": 71,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Projection",
        "B) Denial",
        "C) Rationalization",
        "D) Sublimation"
      ],
      "question": "A patient who denies having an alcohol problem despite evidence is using which defense mechanism?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "defense mechanisms",
      "source_url": null,
      "subject_id": "mental_health",
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "medications",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Mood stabilizers such as lithium are used for bipolar disorder.",
      "format": "mcq",
      "id": 72,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Antidepressants",
        "B) Mood stabilizers",
        "C) Antihistamines",
        "D) Antibiotics"
      ],
      "question": "Which class of drugs is used to treat bipolar disorder?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "medications",
      "source_url": null,
      "subject_id": "mental_health",
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "substance use",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Alcohol withdrawal can cause tremors, seizures, and delirium tremens.",
      "format": "mcq",
      "id": 73,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Alcohol",
        "B) Cannabis",
        "C) Caffeine",
        "D) Nicotine"
      ],
      "question": "Which substance causes withdrawal symptoms including tremors and seizures?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "substance use",
      "source_url": null,
      "subject_id": "mental_health",
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "suicide prevention",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Patient safety is the priority; continuous observation and risk assessment are required.",
      "format": "mcq",
      "id": 74,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Ignore it to avoid reinforcing",
        "B) Ensure safety and constant observation",
        "C) Promise confidentiality",
        "D) Leave the patient alone"
      ],
      "question": "What is the most important nursing action when a patient expresses suicidal ideation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "suicide prevention",
      "source_url": null,
      "subject_id": "mental_health",
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "developmental milestones",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Most infants can sit without support by around 6 months.",
      "format": "mcq",
      "id": 75,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 3 months",
        "B) 6 months",
        "C) 9 months",
        "D) 12 months"
      ],
      "question": "At what age does an infant typically sit without support?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "developmental milestones",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "diarrhea",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Oral Rehydration Salts (ORS) are the first-line treatment for diarrhea.",
      "format": "mcq",
      "id": 76,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Antibiotics",
        "B) ORS",
        "C) Anti-diarrheal drugs",
        "D) Fasting"
      ],
      "question": "What is the best initial treatment for uncomplicated childhood diarrhea?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "diarrhea",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "newborn care",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Average full-term newborn weight is 2.5-3.5 kg.",
      "format": "mcq",
      "id": 77,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 1.5-2 kg",
        "B) 2.5-3.5 kg",
        "C) 4-5 kg",
        "D) 1-1.5 kg"
      ],
      "question": "What is the normal birth weight of a full-term Indian newborn?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "newborn care",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "immunization schedule",
      "context": "calculation",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The first dose of measles vaccine is given at 9 months of age.",
      "format": "mcq",
      "id": 78,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 6 weeks",
        "B) 9 months",
        "C) 12 months",
        "D) 5 years"
      ],
      "question": "At what age is the first dose of measles vaccine given?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "immunization schedule",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "ari",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Chest indrawing is a sign of severe pneumonia in children.",
      "format": "mcq",
      "id": 79,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Mild cough",
        "B) Chest indrawing",
        "C) Runny nose",
        "D) Sore throat"
      ],
      "question": "Which sign indicates severe pneumonia in a child?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ari",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "breastfeeding",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Early initiation of breastfeeding within 1 hour is recommended.",
      "format": "mcq",
      "id": 80,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) After 24 hours",
        "B) Within 1 hour",
        "C) After 6 hours",
        "D) After 12 hours"
      ],
      "question": "When should breastfeeding ideally be initiated after birth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "breastfeeding",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "malnutrition",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Weight-for-height is used to assess acute malnutrition.",
      "format": "mcq",
      "id": 81,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Height-for-age",
        "B) Weight-for-height",
        "C) Head circumference",
        "D) Birth weight"
      ],
      "question": "Which anthropometric indicator is used to assess acute malnutrition in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "malnutrition",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "teething",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Primary teeth typically begin to erupt around 6 months of age.",
      "format": "mcq",
      "id": 82,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 2-3 months",
        "B) 6 months",
        "C) 12 months",
        "D) 18 months"
      ],
      "question": "At what age do primary teeth usually begin to erupt?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "teething",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "antenatal care",
      "context": "calculation",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "A minimum of 4 antenatal visits is recommended for a normal pregnancy.",
      "format": "mcq",
      "id": 83,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 2",
        "B) 4",
        "C) 6",
        "D) 8"
      ],
      "question": "How many antenatal check-ups are recommended for a normal pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antenatal care",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "stages of labour",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "The first stage of labour ends when the cervix is fully dilated (10 cm).",
      "format": "mcq",
      "id": 84,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) First stage",
        "B) Second stage",
        "C) Third stage",
        "D) Fourth stage"
      ],
      "question": "Which stage of labour ends with full dilation of the cervix?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "stages of labour",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "apgar",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Apgar score is assessed at 1 minute and 5 minutes after birth.",
      "format": "mcq",
      "id": 85,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 1 and 5 minutes",
        "B) 5 and 10 minutes",
        "C) 10 and 15 minutes",
        "D) 15 and 20 minutes"
      ],
      "question": "At what intervals after birth is the Apgar score assessed?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "apgar",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "postnatal care",
      "context": "calculation",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The puerperium is the 6-week period following childbirth.",
      "format": "mcq",
      "id": 86,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 1 week",
        "B) 2 weeks",
        "C) 6 weeks",
        "D) 3 months"
      ],
      "question": "What is the normal duration of the puerperium?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "postnatal care",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pih",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Preeclampsia is classically diagnosed by hypertension, proteinuria, and edema.",
      "format": "mcq",
      "id": 87,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Hypertension, proteinuria, edema",
        "B) Fever, pain, bleeding",
        "C) Headache, vomiting, diarrhea",
        "D) Jaundice, anemia, oliguria"
      ],
      "question": "What is the diagnostic triad of preeclampsia?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pih",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "pph",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Uterine atony is the most common cause of postpartum hemorrhage.",
      "format": "mcq",
      "id": 88,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Infection",
        "B) Uterine atony",
        "C) Retained placenta",
        "D) Coagulopathy"
      ],
      "question": "What is the most common cause of postpartum hemorrhage?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pph",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "menstrual disorders",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Dysmenorrhea refers to painful menstrual periods.",
      "format": "mcq",
      "id": 89,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Amenorrhea",
        "B) Dysmenorrhea",
        "C) Menorrhagia",
        "D) Metrorrhagia"
      ],
      "question": "What is the term for painful menstruation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "menstrual disorders",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pelvis",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The gynaecoid pelvis is the most favourable for vaginal delivery.",
      "format": "mcq",
      "id": 90,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Android",
        "B) Anthropoid",
        "C) Gynaecoid",
        "D) Platypelloid"
      ],
      "question": "Which female pelvis type is most favourable for vaginal delivery?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pelvis",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "expected date",
      "context": "calculation",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Naegele\u0027s rule uses the first day of the last menstrual period.",
      "format": "mcq",
      "id": 91,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Last menstrual period",
        "B) Date of conception",
        "C) First fetal movement",
        "D) First antenatal visit"
      ],
      "question": "Naegele\u0027s rule calculates the expected date of delivery by adding 7 days and subtracting 3 months from:",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "expected date",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "mechanism of labour",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Descent of the fetal head is the first movement in the mechanism of labour.",
      "format": "mcq",
      "id": 92,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Internal rotation",
        "B) Descent",
        "C) Flexion",
        "D) Extension"
      ],
      "question": "Which is the first movement in the mechanism of normal labour?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "mechanism of labour",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "eclampsia",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Eclampsia is preeclampsia complicated by seizures.",
      "format": "mcq",
      "id": 93,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) High blood pressure only",
        "B) Seizures in a woman with preeclampsia",
        "C) Severe headache",
        "D) Proteinuria only"
      ],
      "question": "What is the defining feature of eclampsia?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "eclampsia",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "breastfeeding",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Oxytocin causes the milk ejection reflex (let-down).",
      "format": "mcq",
      "id": 94,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Progesterone",
        "B) Oxytocin",
        "C) Estrogen",
        "D) Prolactin"
      ],
      "question": "Which hormone is responsible for milk ejection during breastfeeding?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "breastfeeding",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "balanced diet",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Carbohydrates are the body\u0027s main energy source.",
      "format": "mcq",
      "id": 95,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Protein",
        "B) Fat",
        "C) Carbohydrate",
        "D) Vitamin"
      ],
      "question": "Which nutrient is the main source of energy for the body?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "balanced diet",
      "source_url": null,
      "subject_id": "nutrition",
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "protein",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Kwashiorkor results from severe protein deficiency.",
      "format": "mcq",
      "id": 96,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Rickets",
        "B) Kwashiorkor",
        "C) Scurvy",
        "D) Night blindness"
      ],
      "question": "Which disease is caused by severe protein-energy malnutrition?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "protein",
      "source_url": null,
      "subject_id": "nutrition",
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pregnancy nutrition",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Folic acid supplementation prevents neural tube defects.",
      "format": "mcq",
      "id": 97,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Iron",
        "B) Calcium",
        "C) Folic acid",
        "D) Vitamin C"
      ],
      "question": "Which nutrient is most important to prevent neural tube defects in early pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pregnancy nutrition",
      "source_url": null,
      "subject_id": "nutrition",
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "vitamins",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Vitamin C deficiency causes scurvy.",
      "format": "mcq",
      "id": 98,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Vitamin A",
        "B) Vitamin B12",
        "C) Vitamin C",
        "D) Vitamin D"
      ],
      "question": "Which vitamin deficiency causes scurvy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vitamins",
      "source_url": null,
      "subject_id": "nutrition",
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "iron deficiency",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Iron deficiency is the most common cause of anemia.",
      "format": "mcq",
      "id": 99,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Night blindness",
        "B) Anemia",
        "C) Rickets",
        "D) Beriberi"
      ],
      "question": "Which condition is most commonly caused by iron deficiency?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "iron deficiency",
      "source_url": null,
      "subject_id": "nutrition",
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "cpr",
      "context": "calculation",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Adult CPR compression-to-ventilation ratio is 30:2 for one rescuer.",
      "format": "mcq",
      "id": 100,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 15:2",
        "B) 30:2",
        "C) 5:1",
        "D) 50:2"
      ],
      "question": "What is the recommended compression-to-ventilation ratio for adult CPR with one rescuer?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cpr",
      "source_url": null,
      "subject_id": "first_aid",
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "shock",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Airway, breathing, and circulation are the first priorities in shock.",
      "format": "mcq",
      "id": 101,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Give oral fluids",
        "B) Maintain airway and breathing",
        "C) Apply tourniquet",
        "D) Elevate legs only"
      ],
      "question": "What is the first step in managing a patient in shock?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "shock",
      "source_url": null,
      "subject_id": "first_aid",
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "burns",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Cool running water is recommended for minor burns.",
      "format": "mcq",
      "id": 102,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Apply ice directly",
        "B) Cool running water",
        "C) Apply butter",
        "D) Pop blisters"
      ],
      "question": "How should a minor thermal burn be initially managed?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "burns",
      "source_url": null,
      "subject_id": "first_aid",
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "triage",
      "context": "scenario",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "Immediate category needs life-saving intervention first.",
      "format": "mcq",
      "id": 103,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Dead/expectant",
        "B) Minor",
        "C) Delayed",
        "D) Immediate"
      ],
      "question": "In triage, which category is given highest priority?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "triage",
      "source_url": null,
      "subject_id": "first_aid",
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "choking",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Abdominal thrusts (Heimlich manoeuvre) are used for adult choking.",
      "format": "mcq",
      "id": 104,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Back blows only",
        "B) Heimlich manoeuvre",
        "C) Finger sweep",
        "D) Chest thrusts only"
      ],
      "question": "Which manoeuvre is used to relieve airway obstruction in an adult?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "choking",
      "source_url": null,
      "subject_id": "first_aid",
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "cell membrane",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The cell membrane regulates the movement of substances into and out of the cell.",
      "format": "mcq",
      "id": 105,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Nucleus",
        "B) Cytoplasm",
        "C) Cell membrane",
        "D) Ribosome"
      ],
      "question": "Which structure controls what enters and leaves the cell?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cell membrane",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "joint types",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Synovial joints, such as the shoulder and knee, allow free movement.",
      "format": "mcq",
      "id": 106,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Fibrous joint",
        "B) Cartilaginous joint",
        "C) Synovial joint",
        "D) Suture joint"
      ],
      "question": "Which type of joint allows the widest range of movement?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "joint types",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "muscle contraction",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The sarcomere is the basic contractile unit of muscle fiber.",
      "format": "mcq",
      "id": 107,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Neuron",
        "B) Sarcomere",
        "C) Nephron",
        "D) Axon"
      ],
      "question": "What is the basic functional unit of skeletal muscle contraction?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle contraction",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "absorption",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Most nutrient absorption occurs in the small intestine.",
      "format": "mcq",
      "id": 108,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Stomach",
        "B) Large intestine",
        "C) Small intestine",
        "D) Esophagus"
      ],
      "question": "Where are most nutrients absorbed in the digestive tract?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "absorption",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "thyroid hormone",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The thyroid gland produces thyroxine (T4) and triiodothyronine (T3).",
      "format": "mcq",
      "id": 109,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Insulin",
        "B) Thyroxine",
        "C) Cortisol",
        "D) Estrogen"
      ],
      "question": "Which hormone is produced by the thyroid gland?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "thyroid hormone",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "fertilization",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Fertilization usually occurs in the fallopian tube.",
      "format": "mcq",
      "id": 110,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Uterus",
        "B) Ovary",
        "C) Fallopian tube",
        "D) Vagina"
      ],
      "question": "Where does fertilization normally occur in the female reproductive system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fertilization",
      "source_url": null,
      "subject_id": "anatomy_physiology",
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "bed bath",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "The perineal area is washed last to prevent transferring microorganisms to cleaner areas.",
      "format": "mcq",
      "id": 111,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Face",
        "B) Arms",
        "C) Chest",
        "D) Perineal area"
      ],
      "question": "When giving a bed bath, which body part should be washed last?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bed bath",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "semi fowler",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Semi-Fowler\u0027s position (head elevated 30-45 degrees) eases breathing.",
      "format": "mcq",
      "id": 112,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Shock",
        "B) Respiratory distress",
        "C) Pelvic surgery",
        "D) Spinal anesthesia"
      ],
      "question": "Semi-Fowler\u0027s position is used mainly for:",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "semi fowler",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "signs of infection",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Purulent (pus-like) drainage is a sign of wound infection.",
      "format": "mcq",
      "id": 113,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Dry scab formation",
        "B) Pink granulation tissue",
        "C) Purulent drainage",
        "D) Decreased warmth"
      ],
      "question": "Which finding indicates a wound infection?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "signs of infection",
      "source_url": null,
      "subject_id": "fundamentals_nursing",
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "signs of dehydration",
      "context": "calculation",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Sunken eyes, dry mucous membranes, and decreased skin turgor indicate dehydration.",
      "format": "mcq",
      "id": 114,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Bounding pulse",
        "B) Moist mucous membranes",
        "C) Sunken eyes",
        "D) Hypertension"
      ],
      "question": "Which sign is most indicative of severe dehydration?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "signs of dehydration",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "oxygen therapy",
      "context": "calculation",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "A non-rebreather mask can deliver up to 90% oxygen.",
      "format": "mcq",
      "id": 115,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Nasal cannula",
        "B) Simple face mask",
        "C) Non-rebreather mask",
        "D) Venturi mask"
      ],
      "question": "Which oxygen delivery device delivers the highest concentration of oxygen?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "oxygen therapy",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "myocardial infarction",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Aspirin inhibits platelet aggregation and is given in suspected myocardial infarction.",
      "format": "mcq",
      "id": 116,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) To relieve pain",
        "B) To reduce fever",
        "C) To inhibit platelet aggregation",
        "D) To lower blood pressure"
      ],
      "question": "A patient with chest pain is given aspirin. What is the primary reason?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "myocardial infarction",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "ng tube",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Tube placement must be verified before every feeding to prevent aspiration.",
      "format": "mcq",
      "id": 117,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Tube length",
        "B) Tube placement",
        "C) Patient weight",
        "D) Urine output"
      ],
      "question": "Before administering feedings through an NG tube, what must the nurse verify?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ng tube",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "urinary catheter care",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The catheter tubing should be secured to prevent tension and trauma.",
      "format": "mcq",
      "id": 118,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Pull the catheter gently to test placement",
        "B) Keep the drainage bag above bladder level",
        "C) Secure the tubing to prevent tension on the catheter",
        "D) Disconnect the tubing frequently for cleaning"
      ],
      "question": "Which action is correct when caring for a patient with an indwelling urinary catheter?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "urinary catheter care",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "glasgow coma scale",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The GCS assesses eye opening, verbal response, and motor response.",
      "format": "mcq",
      "id": 119,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Motor strength only",
        "B) Eye opening, verbal response, and motor response",
        "C) Pupil reaction only",
        "D) Blood pressure and pulse"
      ],
      "question": "The Glasgow Coma Scale assesses:",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "glasgow coma scale",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "chemotherapy safety",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Chemotherapy handling requires a gown and double gloves for safety.",
      "format": "mcq",
      "id": 120,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Gloves only",
        "B) Gown and double gloves",
        "C) Face shield only",
        "D) Mask only"
      ],
      "question": "When handling chemotherapy drugs, which PPE is essential?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "chemotherapy safety",
      "source_url": null,
      "subject_id": "medical_surgical",
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "antipsychotic side effects",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Tardive dyskinesia is a long-term extrapyramidal side effect of antipsychotics.",
      "format": "mcq",
      "id": 121,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Hypotension",
        "B) Tardive dyskinesia",
        "C) Diarrhea",
        "D) Bradycardia"
      ],
      "question": "Which extrapyramidal symptom is associated with antipsychotic medications?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antipsychotic side effects",
      "source_url": null,
      "subject_id": "mental_health",
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "contraception",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Condoms are the only listed method that reduces STI transmission risk.",
      "format": "mcq",
      "id": 122,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Oral contraceptive pills",
        "B) Intrauterine device",
        "C) Condom",
        "D) Injectable hormones"
      ],
      "question": "Which contraceptive method also provides protection against sexually transmitted infections?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "contraception",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pelvic inlet",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Cephalic presentation (head down) is the normal position for labour.",
      "format": "mcq",
      "id": 123,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Breech",
        "B) Transverse lie",
        "C) Cephalic presentation",
        "D) Face presentation"
      ],
      "question": "The normal fetal head position at the onset of labour is:",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pelvic inlet",
      "source_url": null,
      "subject_id": "midwifery",
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "fracture",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The affected part should be immobilized to prevent further injury.",
      "format": "mcq",
      "id": 124,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Massage the area",
        "B) Immobilize the affected part",
        "C) Apply heat immediately",
        "D) Attempt to straighten the limb"
      ],
      "question": "What is the first aid management of a suspected fracture?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fracture",
      "source_url": null,
      "subject_id": "first_aid",
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "primary health care",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Community participation is a core principle of primary health care.",
      "format": "mcq",
      "id": 125,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Specialized hospital care",
        "B) Community participation",
        "C) Expensive technology",
        "D) Urban-focused services"
      ],
      "question": "Which is a principle of primary health care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "primary health care",
      "source_url": null,
      "subject_id": "community_health",
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "growth chart",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Weight for age is a standard growth monitoring indicator.",
      "format": "mcq",
      "id": 126,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Head circumference only",
        "B) Weight for age",
        "C) Blood pressure",
        "D) Temperature"
      ],
      "question": "Which parameter is most commonly used to assess a child\u0027s growth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "growth chart",
      "source_url": null,
      "subject_id": "child_health",
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "balanced diet",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Fruits, vegetables, and whole grains are good sources of dietary fiber.",
      "format": "mcq",
      "id": 127,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Meat",
        "B) Dairy",
        "C) Fruits and vegetables",
        "D) Fats"
      ],
      "question": "Which food group is the best source of dietary fiber?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "balanced diet",
      "source_url": null,
      "subject_id": "nutrition",
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "virus",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Measles is caused by the measles virus.",
      "format": "mcq",
      "id": 128,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Tuberculosis",
        "B) Tetanus",
        "C) Measles",
        "D) Typhoid"
      ],
      "question": "Which disease is caused by a virus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "virus",
      "source_url": null,
      "subject_id": "microbiology",
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "drug interactions",
      "context": "calculation",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "Parenteral routes such as intravenous and subcutaneous avoid first-pass hepatic metabolism.",
      "format": "mcq",
      "id": 129,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Oral",
        "B) Intravenous",
        "C) Subcutaneous",
        "D) Both B and C"
      ],
      "question": "Which route of administration avoids first-pass metabolism?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "drug interactions",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "insulin",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Insulin is used to manage diabetes mellitus.",
      "format": "mcq",
      "id": 130,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Hypertension",
        "B) Diabetes mellitus",
        "C) Asthma",
        "D) Epilepsy"
      ],
      "question": "Which condition is treated with insulin?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "insulin",
      "source_url": null,
      "subject_id": "pharmacology",
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "GNM syllabus cross-check + INC textbook review"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "circulatory_system",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "The primary function of the circulatory system is to transport nutrients and oxygen to cells throughout the body.",
      "format": "mcq",
      "id": 131,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) To assist in digestion",
        "B) To regulate body temperature",
        "C) To transport nutrients and oxygen",
        "D) To enable movement of limbs"
      ],
      "question": "What is the primary function of the circulatory system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "circulatory_system",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "heart valves",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "The aortic valve prevents the backflow of blood from the aorta into the left ventricle after contraction.",
      "format": "mcq",
      "id": 132,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Tricuspid valve",
        "B) Pulmonary valve",
        "C) Mitral valve",
        "D) Aortic valve"
      ],
      "question": "Which valve prevents backflow of blood from the aorta into the left ventricle?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "heart valves",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "cardiac_output",
      "context": "calculation",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Cardiac output is calculated using the formula: Heart Rate x Stroke Volume. Therefore, 75 beats/min x 70 mL = 5250 mL/min.",
      "format": "mcq",
      "id": 133,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) 5250 mL/min",
        "B) 4200 mL/min",
        "C) 6000 mL/min",
        "D) 8000 mL/min"
      ],
      "question": "If a patient\u0027s heart rate is 75 beats per minute and stroke volume is 70 mL, what is their cardiac output?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cardiac_output",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "cardiac cycle",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "The cardiac cycle consists of two main phases: diastole (when the heart relaxes) and systole (when the heart contracts).",
      "format": "mcq",
      "id": 134,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Diastole and Systole",
        "B) Exhalation and Inhalation",
        "C) Resting and Active",
        "D) Contraction and Relaxation"
      ],
      "question": "What are the two main phases of the cardiac cycle?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cardiac cycle",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "blood flow",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "A significant blockage in the coronary arteries limits blood flow, thereby reducing the oxygen supply to the heart muscle, which can lead to ischemia.",
      "format": "mcq",
      "id": 135,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Increased blood flow to the heart",
        "B) Decreased oxygen supply to the heart muscle",
        "C) Uninterrupted blood flow",
        "D) Increased blood pressure in the arteries"
      ],
      "question": "During a physical examination, a nurse notes a patient has a significant blockage in their coronary arteries. What is the most likely effect on blood flow?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "blood flow",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "heart valves",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "The aortic valve prevents backflow from the aorta into the left ventricle during diastole.",
      "format": "mcq",
      "id": 136,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Tricuspid valve",
        "B) Pulmonary valve",
        "C) Aortic valve",
        "D) Mitral valve"
      ],
      "question": "Which heart valve prevents backflow from the aorta into the left ventricle?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "heart valves",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "pulse points",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The radial pulse is located on the wrist, below the thumb, where the radial artery is accessible for palpation.",
      "format": "mcq",
      "id": 137,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) On the neck",
        "B) On the inside of the elbow",
        "C) On the wrist, below the thumb",
        "D) On the top of the foot"
      ],
      "question": "A nurse is assessing a patient and needs to check the radial pulse. Where should the nurse place her fingers?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pulse points",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "blood components",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Red blood cells contain hemoglobin, which binds to oxygen and allows for its transportation throughout the body.",
      "format": "mcq",
      "id": 138,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Plasma",
        "B) White blood cells",
        "C) Red blood cells",
        "D) Platelets"
      ],
      "question": "What component of blood is primarily responsible for the transportation of oxygen?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "blood components",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "circulatory system",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "In congestive heart failure, the body may attempt to compensate by increasing blood volume to improve cardiac output, despite potential risks of fluid overload.",
      "format": "mcq",
      "id": 139,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Decrease heart rate",
        "B) Increase blood volume",
        "C) Increase peripheral resistance",
        "D) Decrease contractility of the heart"
      ],
      "question": "A patient presents with signs of congestive heart failure. Which compensatory mechanism might the body employ to try to maintain cardiac output?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "circulatory system",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "tissue types",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Muscle tissue is specialized for contraction and is responsible for movement in the body.",
      "format": "mcq",
      "id": 140,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Epithelial tissue",
        "B) Connective tissue",
        "C) Nervous tissue",
        "D) Muscle tissue"
      ],
      "question": "Which type of tissue is primarily responsible for contraction and movement?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "tissue types",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "epithelial tissue",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Epithelial tissue primarily serves to cover and protect surfaces both internally and externally.",
      "format": "mcq",
      "id": 141,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Support and bind other tissues",
        "B) Cover and protect surfaces",
        "C) Transmit impulses",
        "D) Contract for movement"
      ],
      "question": "What is the main function of epithelial tissue?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "epithelial tissue",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "connective tissue",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Connective tissue provides structural support and connects different tissues, often having a lower density of cells compared to other tissue types.",
      "format": "mcq",
      "id": 142,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) It has a high cellular density.",
        "B) It is primarily composed of cells.",
        "C) It provides structural support and connects different tissues.",
        "D) It is involved in signal transmission."
      ],
      "question": "Which of the following is a characteristic of connective tissue?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "connective tissue",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nervous tissue",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Nervous tissue is specialized for transmitting signals throughout the body, facilitating communication between different parts of the body.",
      "format": "mcq",
      "id": 143,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To provide support and insulation to organs.",
        "B) To transmit signals throughout the body.",
        "C) To facilitate absorption and secretion.",
        "D) To protect against pathogens."
      ],
      "question": "What is the primary role of nervous tissue in the body?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nervous tissue",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "stem cells",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Stem cells have the unique ability to replicate indefinitely and can differentiate into various specialized cell types.",
      "format": "mcq",
      "id": 144,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) They can only differentiate into nerve cells.",
        "B) They can replicate indefinitely and differentiate into various cell types.",
        "C) They are specialized cells with specific functions.",
        "D) They are only found in embryos."
      ],
      "question": "What is a unique characteristic of stem cells?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "stem cells",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "muscle tissue",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Skeletal muscle tissue is the only type that is under voluntary control, allowing for conscious movement.",
      "format": "mcq",
      "id": 145,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Cardiac muscle",
        "B) Smooth muscle",
        "C) Skeletal muscle",
        "D) All muscle tissues"
      ],
      "question": "Which type of muscle tissue is under voluntary control?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle tissue",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "cell cycle",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The S phase of the cell cycle is where DNA replication occurs, preparing the cell for division.",
      "format": "mcq",
      "id": 146,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) G1 phase",
        "B) S phase",
        "C) G2 phase",
        "D) M phase"
      ],
      "question": "Which phase of the cell cycle is characterized by DNA replication?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cell cycle",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "apoptosis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Apoptosis is a regulated process that leads to the programmed death of cells, which is crucial for maintaining healthy tissue homeostasis.",
      "format": "mcq",
      "id": 147,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) The process of cell division.",
        "B) The programmed death of cells.",
        "C) The abnormal growth of cells.",
        "D) The process of cell differentiation."
      ],
      "question": "What is apoptosis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "apoptosis",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "cell organelles",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Ribosomes are the cellular structures where protein synthesis occurs.",
      "format": "mcq",
      "id": 148,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Nucleus",
        "B) Ribosome",
        "C) Lysosome",
        "D) Endoplasmic reticulum"
      ],
      "question": "Which organelle is responsible for protein synthesis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cell organelles",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "extracellular matrix",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "The extracellular matrix provides essential structural and biochemical support to surrounding cells, influencing their behavior.",
      "format": "mcq",
      "id": 149,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To act as a barrier against pathogens.",
        "B) To store genetic information.",
        "C) To provide structural and biochemical support to surrounding cells.",
        "D) To facilitate cell division."
      ],
      "question": "What is the primary function of the extracellular matrix?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "extracellular matrix",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_cells_tissues",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "digestive_process",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The primary function of the digestive system is to break down food and absorb nutrients.",
      "format": "mcq",
      "id": 150,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Circulation of blood",
        "B) Breakdown and absorption of nutrients",
        "C) Regulation of body temperature",
        "D) Production of hormones"
      ],
      "question": "What is the primary function of the digestive system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "digestive_process",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "saliva",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Saliva contains amylase, an enzyme that begins the digestion of starch in the mouth.",
      "format": "mcq",
      "id": 151,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) It neutralizes stomach acid.",
        "B) It contains enzymes that begin starch digestion.",
        "C) It promotes fat absorption.",
        "D) It increases bile production."
      ],
      "question": "What role does saliva play in the digestive process?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "saliva",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "stomach",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Hydrochloric acid activates pepsinogen to pepsin, which is essential for protein digestion.",
      "format": "mcq",
      "id": 152,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) It inhibits enzyme activity.",
        "B) It activates pepsinogen to pepsin.",
        "C) It emulsifies fats.",
        "D) It neutralizes alkaline substances."
      ],
      "question": "What is the role of hydrochloric acid in the stomach?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "stomach",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "bile",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Bile primarily functions to emulsify fats, making them easier to digest.",
      "format": "mcq",
      "id": 153,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Digestion of proteins",
        "B) Emulsification of fats",
        "C) Absorption of carbohydrates",
        "D) Neutralization of stomach acid"
      ],
      "question": "What is the primary function of bile in digestion?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bile",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "absorption",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Villi are finger-like projections in the small intestine that increase surface area for nutrient absorption.",
      "format": "mcq",
      "id": 154,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Villi",
        "B) Rugae",
        "C) Crypts",
        "D) Microvilli"
      ],
      "question": "Which structure in the small intestine increases the surface area for absorption?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "absorption",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "digestive_tract",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The large intestine is primarily responsible for the absorption of water and electrolytes from indigestible food residues.",
      "format": "mcq",
      "id": 155,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Stomach",
        "B) Large intestine",
        "C) Small intestine",
        "D) Pancreas"
      ],
      "question": "Which organ is primarily responsible for water absorption in the digestive system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "digestive_tract",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "pancreas",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The pancreas produces digestive enzymes that break down carbohydrates, proteins, and fats in the small intestine.",
      "format": "mcq",
      "id": 156,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) By secreting bile",
        "B) By producing digestive enzymes",
        "C) By absorbing nutrients",
        "D) By neutralizing stomach acid"
      ],
      "question": "How does the pancreas contribute to digestion?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pancreas",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "esophagus",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The esophagus is responsible for transporting food from the mouth to the stomach.",
      "format": "mcq",
      "id": 157,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Digestion of food",
        "B) Absorption of nutrients",
        "C) Transport of food to the stomach",
        "D) Secretion of digestive juices"
      ],
      "question": "What is the function of the esophagus in the digestive system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "esophagus",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "peristalsis",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Peristalsis is a series of wave-like muscle contractions that move food through the digestive tract, essential for digestion and absorption.",
      "format": "mcq",
      "id": 158,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) It is the absorption of nutrients.",
        "B) It is the voluntary movement of muscles.",
        "C) It is a series of wave-like muscle contractions that move food through the digestive tract.",
        "D) It is the breakdown of food by enzymes."
      ],
      "question": "What is peristalsis, and why is it important in digestion?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "peristalsis",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "intestinal_juices",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Intestinal juices help to neutralize stomach acid and contain enzymes that further aid in digestion.",
      "format": "mcq",
      "id": 159,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) To stimulate appetite",
        "B) To neutralize stomach acid and aid digestion",
        "C) To absorb nutrients",
        "D) To produce bile"
      ],
      "question": "What is the function of intestinal juices in the digestive process?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "intestinal_juices",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_digestive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "adrenal_gland",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Cortisol is the main hormone produced by the adrenal cortex, playing a role in metabolism and stress response.",
      "format": "mcq",
      "id": 160,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Epinephrine",
        "B) Cortisol",
        "C) Norepinephrine",
        "D) Insulin"
      ],
      "question": "Which hormone is primarily produced by the adrenal cortex?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "adrenal_gland",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "growth_hormone",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Growth hormone is responsible for stimulating growth, cell reproduction, and cell regeneration in humans.",
      "format": "mcq",
      "id": 161,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Regulating blood sugar levels",
        "B) Stimulating growth and cell reproduction",
        "C) Regulating metabolism of fats",
        "D) Controlling sleep-wake cycles"
      ],
      "question": "What is the primary function of growth hormone in the body?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "growth_hormone",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "parathyroid_hormone",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Parathyroid hormone increases blood calcium levels by stimulating osteoclasts, which release calcium from bones.",
      "format": "mcq",
      "id": 162,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Decreases calcium levels",
        "B) Increases calcium levels",
        "C) No effect on calcium levels",
        "D) Only affects phosphate levels"
      ],
      "question": "What is the effect of parathyroid hormone on calcium levels in the blood?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "parathyroid_hormone",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "thyroid_gland_function",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Hypothyroidism results in a decreased metabolic rate, leading to fatigue and weight gain among other symptoms.",
      "format": "mcq",
      "id": 163,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Increased metabolic rate",
        "B) Weight loss",
        "C) Fatigue and weight gain",
        "D) Hyperactivity"
      ],
      "question": "Which of the following is a direct consequence of hypothyroidism?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "thyroid_gland_function",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "insulin",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 1,
      "explanation": "Insulin acts on multiple organs, including the liver, muscle, and kidney, to regulate glucose metabolism.",
      "format": "mcq",
      "id": 164,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Liver",
        "B) Muscle",
        "C) Kidney",
        "D) All of the above"
      ],
      "question": "What is the primary target organ for insulin action?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "insulin",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "estrogen",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Estrogen is crucial for the development of female secondary sexual characteristics like breast development and regulation of the menstrual cycle.",
      "format": "mcq",
      "id": 165,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Testosterone",
        "B) Estrogen",
        "C) Progesterone",
        "D) Luteinizing hormone"
      ],
      "question": "Which hormone is primarily responsible for the development of female secondary sexual characteristics?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "estrogen",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "testosterone",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Testosterone is crucial for the development of male reproductive tissues, including the testes and prostate.",
      "format": "mcq",
      "id": 166,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Regulating glucose metabolism",
        "B) Development of male reproductive tissues",
        "C) Stimulating milk production",
        "D) Regulating sleep cycles"
      ],
      "question": "What role does testosterone play in male physiology?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "testosterone",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "oxytocin",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Oxytocin is crucial for inducing uterine contractions during childbirth and facilitating labor.",
      "format": "mcq",
      "id": 167,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Stimulate milk production",
        "B) Regulate blood pressure",
        "C) Induce uterine contractions",
        "D) Increase heart rate"
      ],
      "question": "What is the primary function of oxytocin during childbirth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "oxytocin",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "adrenaline",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Adrenaline, produced by the adrenal medulla, prepares the body for \u0027fight or flight\u0027 responses in stressful situations.",
      "format": "mcq",
      "id": 168,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Cortisol",
        "B) Insulin",
        "C) Adrenaline",
        "D) Norepinephrine"
      ],
      "question": "Which hormone is known as the \u0027fight or flight\u0027 hormone?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "adrenaline",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "melatonin",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Melatonin is primarily involved in regulating sleep-wake cycles and is produced in response to darkness.",
      "format": "mcq",
      "id": 169,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Regulating metabolism",
        "B) Managing sleep-wake cycles",
        "C) Stimulating growth",
        "D) Enhancing immune function"
      ],
      "question": "What is the main role of melatonin in the human body?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "melatonin",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_endocrine",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "renal anatomy",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The glomerulus is the network of capillaries in the nephron responsible for filtering blood.",
      "format": "mcq",
      "id": 170,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Ureter",
        "B) Glomerulus",
        "C) Renal pelvis",
        "D) Urethra"
      ],
      "question": "Which structure in the kidney is responsible for filtering blood?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal anatomy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nephron structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The loop of Henle is primarily responsible for the reabsorption of water and sodium, concentrating urine.",
      "format": "mcq",
      "id": 171,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Filtration of blood",
        "B) Reabsorption of water and sodium",
        "C) Excretion of waste",
        "D) Regulation of pH"
      ],
      "question": "What is the main function of the loop of Henle in the nephron?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nephron structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "urine composition",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Glucose is typically reabsorbed in the kidneys and is not normally found in urine unless blood glucose levels are abnormally high.",
      "format": "mcq",
      "id": 172,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Urea",
        "B) Creatinine",
        "C) Glucose",
        "D) Uric Acid"
      ],
      "question": "Which of the following is NOT typically found in urine?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "urine composition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "kidney function",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The primary purpose of the kidneys is to filter blood and eliminate waste, regulating fluid and electrolyte balance.",
      "format": "mcq",
      "id": 173,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Hormone production",
        "B) Blood filtration and waste elimination",
        "C) Gas exchange",
        "D) Nutrient absorption"
      ],
      "question": "What is the primary purpose of the kidneys?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "kidney function",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "renal failure",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Decreased urine output and swelling often indicate acute kidney injury, which impairs the kidneys\u0027 ability to filter waste.",
      "format": "mcq",
      "id": 174,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Diabetes Mellitus",
        "B) Acute Kidney Injury",
        "C) Hypertension",
        "D) Urinary Tract Infection"
      ],
      "question": "A patient presents with decreased urine output and swelling in the legs. Which condition may these symptoms indicate?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal failure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "glomerular filtration rate",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Glomerular filtration rate (GFR) refers to the rate at which blood is filtered through the kidneys, indicating their function.",
      "format": "mcq",
      "id": 175,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) The amount of blood filtered by the kidneys per minute",
        "B) The total urine output in 24 hours",
        "C) The concentration of urine",
        "D) The volume of blood in the body"
      ],
      "question": "What does the term \u0027glomerular filtration rate\u0027 (GFR) refer to?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "glomerular filtration rate",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "renal diseases",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Diabetes Mellitus is one of the leading causes of chronic kidney disease due to long-term damage to blood vessels in the kidneys.",
      "format": "mcq",
      "id": 176,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Acute dehydration",
        "B) Diabetes Mellitus",
        "C) Urinary Tract Infection",
        "D) Hypertensive crisis"
      ],
      "question": "Which of the following conditions can lead to chronic kidney disease?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal diseases",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "electrolyte balance",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The kidneys play a vital role in regulating sodium levels, which are crucial for fluid balance and blood pressure.",
      "format": "mcq",
      "id": 177,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Calcium",
        "B) Sodium",
        "C) Potassium",
        "D) Magnesium"
      ],
      "question": "Which electrolyte is primarily regulated by the kidneys?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "electrolyte balance",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "urine formation",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Urine formation involves filtration, secretion, and reabsorption, each contributing to the final urine composition.",
      "format": "mcq",
      "id": 178,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Filtration",
        "B) Secretion",
        "C) Reabsorption",
        "D) All of the above"
      ],
      "question": "Which process in the nephron is primarily responsible for urine formation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "urine formation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_excretory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "muscle structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Myosin is the main protein involved in muscle contraction, working with actin.",
      "format": "mcq",
      "id": 179,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Actin",
        "B) Myosin",
        "C) Collagen",
        "D) Elastin"
      ],
      "question": "What is the primary protein found in skeletal muscle that is responsible for contraction?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "muscle function",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Skeletal muscles primarily function to facilitate movement of the body.",
      "format": "mcq",
      "id": 180,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Blood circulation",
        "B) Movement of the body",
        "C) Digestion",
        "D) Hormone production"
      ],
      "question": "What is the main function of skeletal muscles?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle function",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "muscle types",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Both cardiac and smooth muscles are involuntary, while skeletal muscle is voluntary.",
      "format": "mcq",
      "id": 181,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Cardiac muscle",
        "B) Skeletal muscle",
        "C) Smooth muscle",
        "D) Both A and C"
      ],
      "question": "Which type of muscle is responsible for involuntary movements in the body?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle types",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "muscle contraction",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Calcium ions play a crucial role in initiating muscle contraction by binding to troponin.",
      "format": "mcq",
      "id": 182,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Sodium",
        "B) Potassium",
        "C) Calcium",
        "D) Magnesium"
      ],
      "question": "During muscle contraction, which ion is primarily responsible for initiating the process?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle contraction",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "muscle energy",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "ATP (adenosine triphosphate) is the immediate source of energy for muscle contraction.",
      "format": "mcq",
      "id": 183,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Glucose",
        "B) ATP",
        "C) Oxygen",
        "D) Lactic acid"
      ],
      "question": "What is the primary source of energy for muscle contraction?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle energy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "muscle fatigue",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Depletion of glycogen stores during prolonged exercise can lead to muscle fatigue.",
      "format": "mcq",
      "id": 184,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Increased ATP production",
        "B) Depletion of glycogen stores",
        "C) Elevated calcium levels",
        "D) Increased oxygen availability"
      ],
      "question": "What is a common cause of muscle fatigue during prolonged exercise?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle fatigue",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "muscle roles",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "The agonist muscle is the primary muscle responsible for executing a certain movement, such as flexion.",
      "format": "mcq",
      "id": 185,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Agonist",
        "B) Antagonist",
        "C) Synergist",
        "D) Stabilizer"
      ],
      "question": "In a muscle group, which muscle is primarily responsible for the action of flexion?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle roles",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "muscle stretch",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "When a muscle is stretched, it typically relaxes to allow for elongation.",
      "format": "mcq",
      "id": 186,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Contraction",
        "B) Relaxation",
        "C) Strengthening",
        "D) Fatigue"
      ],
      "question": "What is the physiological response of a muscle when it is stretched?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle stretch",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "muscle repair",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "Regeneration is the primary process involved in muscle repair following an injury.",
      "format": "mcq",
      "id": 187,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Inflammation",
        "B) Hypertrophy",
        "C) Atrophy",
        "D) Regeneration"
      ],
      "question": "What is the primary process that occurs during muscle repair after injury?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle repair",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "muscle adaptations",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Muscle hypertrophy refers to the increase in muscle size that occurs as a result of strength training.",
      "format": "mcq",
      "id": 188,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Decreased muscle mass",
        "B) Increased muscle flexibility",
        "C) Muscle hypertrophy",
        "D) Decreased endurance"
      ],
      "question": "What adaptation occurs in muscles as a result of regular strength training?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "muscle adaptations",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_muscular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nervous_system_overview",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The primary function of the nervous system is to coordinate body activities by transmitting signals between different parts of the body.",
      "format": "mcq",
      "id": 189,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Digestion",
        "B) Coordination of body activities",
        "C) Blood circulation",
        "D) Respiration"
      ],
      "question": "What is the primary function of the nervous system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nervous_system_overview",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "neuron_structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Dendrites are the branching extensions of a neuron that receive signals from other neurons.",
      "format": "mcq",
      "id": 190,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Axon",
        "B) Dendrites",
        "C) Soma",
        "D) Myelin sheath"
      ],
      "question": "Which part of the neuron receives signals from other neurons?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "neuron_structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "central_nervous_system",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "The central nervous system is comprised of the brain and spinal cord, which coordinate and process information.",
      "format": "mcq",
      "id": 191,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Brain and spinal cord",
        "B) Brain and nerves",
        "C) Spinal cord and ganglia",
        "D) Brain, spinal cord, and peripheral nerves"
      ],
      "question": "Which components make up the central nervous system (CNS)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "central_nervous_system",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "peripheral_nervous_system",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "The peripheral nervous system connects the CNS to the limbs and organs, while the CNS comprises the brain and spinal cord.",
      "format": "mcq",
      "id": 192,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) The PNS connects to muscles and organs, while the CNS consists of the brain and spinal cord.",
        "B) The PNS includes only sensory neurons, while the CNS handles motor functions.",
        "C) The PNS is encased in bone, whereas the CNS is not.",
        "D) There is no difference; they are the same system."
      ],
      "question": "What differentiates the peripheral nervous system (PNS) from the central nervous system (CNS)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "peripheral_nervous_system",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "neurotransmitters",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Neurotransmitters are chemicals that transmit signals across a synapse from one neuron to another, facilitating communication.",
      "format": "mcq",
      "id": 193,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) They form the structural components of neurons.",
        "B) They transmit electrical impulses along the axon.",
        "C) They facilitate communication between neurons.",
        "D) They protect neurons from damage."
      ],
      "question": "What role do neurotransmitters play in the nervous system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "neurotransmitters",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "reflex_arc_pathway",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "The reflex arc pathway typically follows the course: sensory neuron to spinal cord to interneuron and then to motor neuron.",
      "format": "mcq",
      "id": 194,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Sensory neuron \u2192 spinal cord \u2192 interneuron \u2192 motor neuron",
        "B) Motor neuron \u2192 sensory neuron \u2192 spinal cord \u2192 brain",
        "C) Interneuron \u2192 motor neuron \u2192 sensory neuron \u2192 spinal cord",
        "D) Sensory neuron \u2192 motor neuron \u2192 brain"
      ],
      "question": "Which of the following correctly describes the pathway of a reflex arc?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "reflex_arc_pathway",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "sympathetic_nervous_system",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The sympathetic nervous system is responsible for the body\u0027s \u0027fight or flight\u0027 responses during stressful situations.",
      "format": "mcq",
      "id": 195,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Parasympathetic nervous system",
        "B) Somatic nervous system",
        "C) Sympathetic nervous system",
        "D) Central nervous system"
      ],
      "question": "Which term describes the part of the autonomic nervous system responsible for \u0027fight or flight\u0027 responses?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sympathetic_nervous_system",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "brain_function",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The cerebrum is responsible for processing sensory information and is involved in higher cognitive functions such as thinking and decision-making.",
      "format": "mcq",
      "id": 196,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Regulation of heart rate",
        "B) Processing sensory information and higher cognitive functions",
        "C) Coordination of movement",
        "D) Balance and posture control"
      ],
      "question": "What is the primary role of the cerebrum in the brain?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "brain_function",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "spinal_cord",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "The spinal cord does not produce hormones; its primary functions include conducting signals and mediating reflex actions.",
      "format": "mcq",
      "id": 197,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Conducting signals to and from the brain",
        "B) Reflex actions",
        "C) Producing hormones",
        "D) Protective function of the vertebrae"
      ],
      "question": "Which function is NOT a role of the spinal cord?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "spinal_cord",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "autonomic_nervous_system",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The autonomic nervous system regulates involuntary bodily functions such as heart rate, digestion, and respiratory rate.",
      "format": "mcq",
      "id": 198,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Control voluntary movements",
        "B) Regulate involuntary bodily functions",
        "C) Process sensory information",
        "D) Coordinate muscle contractions"
      ],
      "question": "What is the primary function of the autonomic nervous system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "autonomic_nervous_system",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_nervous",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "ovarian_cycle",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The ovarian cycle consists of the follicular phase and the luteal phase.",
      "format": "mcq",
      "id": 199,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Proliferative and secretory",
        "B) Follicular and luteal",
        "C) Menstrual and proliferative",
        "D) Anovulatory and ovulatory"
      ],
      "question": "What are the two phases of the ovarian cycle?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ovarian_cycle",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "implantation",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Implantation is crucial for the embryo to attach to the uterine wall, allowing for nutrient exchange and development.",
      "format": "mcq",
      "id": 200,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) It marks the beginning of the menstrual cycle.",
        "B) It allows the embryo to attach to the uterine wall.",
        "C) It leads to the expulsion of the ovum.",
        "D) It triggers ovulation."
      ],
      "question": "What is the significance of implantation in the reproductive process?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "implantation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "spermatogenesis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Spermatogenesis is the process through which sperm is produced in the male reproductive system.",
      "format": "mcq",
      "id": 201,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Oogenesis",
        "B) Spermatogenesis",
        "C) Fertilization",
        "D) Menstruation"
      ],
      "question": "What is the process of sperm production called?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "spermatogenesis",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "hormonal_control",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Luteinizing hormone (LH) is mainly responsible for triggering ovulation in the menstrual cycle.",
      "format": "mcq",
      "id": 202,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Estrogen",
        "B) Testosterone",
        "C) Luteinizing hormone (LH)",
        "D) Follicle-stimulating hormone (FSH)"
      ],
      "question": "Which hormone is primarily responsible for stimulating ovulation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hormonal_control",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "reproductive_system",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The ovaries are the primary reproductive organs responsible for producing estrogen in females.",
      "format": "mcq",
      "id": 203,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Uterus",
        "B) Ovaries",
        "C) Fallopian tubes",
        "D) Pituitary gland"
      ],
      "question": "What structure is primarily responsible for the production of estrogen?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "reproductive_system",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "menstrual_disorders",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Dysmenorrhea is the medical term for painful menstruation, affecting many individuals during their menstrual cycles.",
      "format": "mcq",
      "id": 204,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Amenorrhea",
        "B) Dysmenorrhea",
        "C) Menorrhagia",
        "D) Oligomenorrhea"
      ],
      "question": "Which condition is characterized by painful menstruation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "menstrual_disorders",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "fertility",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The corpus luteum\u0027s primary function is to produce hormones that maintain the uterine lining for possible implantation.",
      "format": "mcq",
      "id": 205,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To produce testosterone",
        "B) To maintain the uterine lining",
        "C) To trigger ovulation",
        "D) To facilitate fertilization"
      ],
      "question": "What is the primary function of the corpus luteum?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fertility",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "sexually_transmitted_infections",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Human Papillomavirus (HPV) is the sexually transmitted infection primarily associated with the development of genital warts.",
      "format": "mcq",
      "id": 206,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Gonorrhea",
        "B) Chlamydia",
        "C) Human Papillomavirus (HPV)",
        "D) Syphilis"
      ],
      "question": "Which sexually transmitted infection is known for causing genital warts?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sexually_transmitted_infections",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "contraceptive_methods",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Hormonal contraception involves the use of hormonal pills to prevent ovulation and regulate the menstrual cycle.",
      "format": "mcq",
      "id": 207,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Barrier methods",
        "B) Natural methods",
        "C) Hormonal contraception",
        "D) Surgical methods"
      ],
      "question": "Which contraceptive method involves the use of hormonal pills?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "contraceptive_methods",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_reproductive",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "structure_of_lungs",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The primary function of the lungs is gas exchange, where oxygen is absorbed and carbon dioxide is expelled.",
      "format": "mcq",
      "id": 208,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Circulation of blood",
        "B) Gas exchange",
        "C) Digestion of food",
        "D) Regulation of body temperature"
      ],
      "question": "What is the primary function of the lungs?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "structure_of_lungs",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "respiratory_system_parts",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The nasal cavity filters, humidifies, and warms the air before it enters the lungs.",
      "format": "mcq",
      "id": 209,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Alveoli",
        "B) Bronchi",
        "C) Nasal cavity",
        "D) Trachea"
      ],
      "question": "Which part of the respiratory system is responsible for the filtering and humidifying of air?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "respiratory_system_parts",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "breathing_mechanics",
      "context": "scenario",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "During inhalation, both the intercostal muscles and diaphragm contract to expand the thoracic cavity.",
      "format": "mcq",
      "id": 210,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Abdominal muscles",
        "B) Intercostal muscles",
        "C) Diaphragm",
        "D) Both B and C"
      ],
      "question": "During inhalation, which of the following muscles actively contracts?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "breathing_mechanics",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "oxygen_transport",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Hemoglobin in red blood cells binds to oxygen and transports it from the lungs to tissues throughout the body.",
      "format": "mcq",
      "id": 211,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Hemoglobin",
        "B) Plasma proteins",
        "C) White blood cells",
        "D) Platelets"
      ],
      "question": "Which molecule is primarily responsible for the transport of oxygen in the blood?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "oxygen_transport",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "carbon_dioxide_removal",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Carbon dioxide is primarily removed from the body by the lungs during the process of exhalation.",
      "format": "mcq",
      "id": 212,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Through urine",
        "B) By the lungs during exhalation",
        "C) Through sweat",
        "D) By the kidneys"
      ],
      "question": "How is carbon dioxide primarily removed from the body?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "carbon_dioxide_removal",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "respiratory_volumes",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Tidal volume is the amount of air that is inhaled or exhaled during normal, relaxed breathing.",
      "format": "mcq",
      "id": 213,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Tidal volume",
        "B) Vital capacity",
        "C) Residual volume",
        "D) Inspiratory reserve volume"
      ],
      "question": "Which respiratory volume represents the amount of air inhaled or exhaled during normal breathing?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "respiratory_volumes",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "asthma",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Asthma is characterized by inflammation and narrowing of the airways, leading to difficulty in breathing.",
      "format": "mcq",
      "id": 214,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Pneumonia",
        "B) Chronic bronchitis",
        "C) Asthma",
        "D) Emphysema"
      ],
      "question": "Which of the following conditions is characterized by inflammation and narrowing of the airways?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "asthma",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "pulmonary_circulation",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The primary purpose of pulmonary circulation is to transport deoxygenated blood from the heart to the lungs for oxygenation.",
      "format": "mcq",
      "id": 215,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To supply oxygen-rich blood to the body",
        "B) To bring deoxygenated blood to the lungs for oxygenation",
        "C) To remove waste from the body",
        "D) To regulate blood pressure"
      ],
      "question": "What is the primary purpose of pulmonary circulation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pulmonary_circulation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "respiratory_infections",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Bronchitis primarily affects the lower respiratory tract, causing inflammation of the bronchial tubes.",
      "format": "mcq",
      "id": 216,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Sinusitis",
        "B) Laryngitis",
        "C) Bronchitis",
        "D) Pharyngitis"
      ],
      "question": "Which of the following infections primarily affects the lower respiratory tract?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "respiratory_infections",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "bone structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The skeletal system provides support and protection to the body\u0027s organs and structures.",
      "format": "mcq",
      "id": 217,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) To circulate blood",
        "B) To support and protect the body",
        "C) To facilitate digestion",
        "D) To regulate temperature"
      ],
      "question": "What is the primary function of the skeletal system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bone structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "skull anatomy",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The sternum is part of the thoracic skeleton, while the other options are bones that make up the human skull.",
      "format": "mcq",
      "id": 218,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Maxilla",
        "B) Sternum",
        "C) Zygomatic",
        "D) Frontal"
      ],
      "question": "Which of the following bones is NOT part of the human skull?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "skull anatomy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "bone healing",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Callus formation is a crucial step in the healing process of a fractured bone.",
      "format": "mcq",
      "id": 219,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Osteogenesis",
        "B) Osteoporosis",
        "C) Hematopoiesis",
        "D) Callus formation"
      ],
      "question": "What is the process of bone healing after a fracture called?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bone healing",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "joint structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Ligaments are connective tissues that connect bones to other bones at joints.",
      "format": "mcq",
      "id": 220,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) To connect muscles to bones",
        "B) To connect bones to other bones",
        "C) To produce blood cells",
        "D) To absorb shock"
      ],
      "question": "What is the function of ligaments in the skeletal system?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "joint structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "bone types",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Spongy bone contains red bone marrow, which is responsible for the production of red blood cells.",
      "format": "mcq",
      "id": 221,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Compact bone",
        "B) Spongy bone",
        "C) Cartilage",
        "D) Periosteum"
      ],
      "question": "Which type of bone is primarily responsible for producing red blood cells?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bone types",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "joints",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Pivot joints, such as the one in the neck, allow for rotational movement.",
      "format": "mcq",
      "id": 222,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Hinge joint",
        "B) Ball-and-socket joint",
        "C) Pivot joint",
        "D) Saddle joint"
      ],
      "question": "Which joint type allows for rotational movement?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "joints",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "bone composition",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Calcium is the primary mineral responsible for the hardness and strength of bones.",
      "format": "mcq",
      "id": 223,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Sodium",
        "B) Calcium",
        "C) Iron",
        "D) Magnesium"
      ],
      "question": "What is the primary mineral found in bones that contributes to their hardness?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bone composition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "spinal column",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The adult human spinal column typically consists of 33 vertebrae, including cervical, thoracic, and lumbar regions.",
      "format": "mcq",
      "id": 224,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) 24",
        "B) 26",
        "C) 33",
        "D) 30"
      ],
      "question": "How many vertebrae are typically found in the human adult spinal column?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "spinal column",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "bone classification",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Bones are classified based on their shape into long, short, flat, and irregular bones.",
      "format": "mcq",
      "id": 225,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Long, short, flat, irregular",
        "B) Rigid, flexible, semi-rigid, fluid",
        "C) Compact, spongy, cortical, trabecular",
        "D) Elastic, fibrous, cellular, vascular"
      ],
      "question": "What is the classification of bones based on their shape?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bone classification",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "bone function",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The support function of the skeletal system provides a structural framework for the body.",
      "format": "mcq",
      "id": 226,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Protection",
        "B) Movement",
        "C) Support",
        "D) Blood cell production"
      ],
      "question": "Which function of the skeletal system provides a framework for the body?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bone function",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "anatomy_physiology",
      "telugu_hint": null,
      "topic_id": "ap_skeletal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "measles",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "A skin rash is a key characteristic symptom of measles, appearing after the onset of fever.",
      "format": "mcq",
      "id": 227,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) High fever",
        "B) Skin rash",
        "C) Persistent cough",
        "D) Abdominal pain"
      ],
      "question": "What is a key characteristic symptom of measles in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "measles",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "chickenpox",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Pneumonia is a common complication of chickenpox, especially in children with weakened immune systems.",
      "format": "mcq",
      "id": 228,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Pneumonia",
        "B) Gastroenteritis",
        "C) Meningitis",
        "D) Otitis media"
      ],
      "question": "Which of the following is a common complication of chickenpox in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "chickenpox",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "asthma",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Cold air is a common trigger that can exacerbate asthma attacks in children.",
      "format": "mcq",
      "id": 229,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Cold air",
        "B) Warm weather",
        "C) Exercise",
        "D) High humidity"
      ],
      "question": "What triggers would most likely exacerbate an asthma attack in a child?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "asthma",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "scabies",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Scabies is caused by an infestation of the Sarcoptes scabiei mite, leading to intense itching.",
      "format": "mcq",
      "id": 230,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Eczema",
        "B) Scabies",
        "C) Psoriasis",
        "D) Impetigo"
      ],
      "question": "Which skin condition is caused by a mite infestation in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "scabies",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "typhoid",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The symptoms of prolonged fever, abdominal pain, and diarrhea are indicative of typhoid fever, which is common in children.",
      "format": "mcq",
      "id": 231,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Dengue",
        "B) Typhoid fever",
        "C) Appendicitis",
        "D) Acute gastroenteritis"
      ],
      "question": "A child presents with prolonged fever, abdominal pain, and diarrhea. Which condition should be suspected?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "typhoid",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "pneumonia",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Bacterial pneumonia is a leading cause of pneumonia in children, often caused by Streptococcus pneumoniae.",
      "format": "mcq",
      "id": 232,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Virus",
        "B) Bacteria",
        "C) Fungi",
        "D) Parasites"
      ],
      "question": "What is the primary causative agent of pneumonia in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pneumonia",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "tuberculosis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Close contact with individuals infected with tuberculosis significantly increases the risk of transmission to children.",
      "format": "mcq",
      "id": 233,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Good nutrition",
        "B) Close contact with infected individuals",
        "C) Regular vaccinations",
        "D) High socioeconomic status"
      ],
      "question": "Which factor increases the risk of tuberculosis in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "tuberculosis",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "constipation",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Poor dietary habits, particularly low fiber intake, are the most common cause of constipation in children.",
      "format": "mcq",
      "id": 234,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Dehydration",
        "B) Lack of exercise",
        "C) Poor diet",
        "D) Stress"
      ],
      "question": "What is the most common cause of constipation in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "constipation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_common_diseases",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "growth_patterns",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Infants typically triple their birth weight by the end of the first year.",
      "format": "mcq",
      "id": 235,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Steady decrease in weight",
        "B) Tripling of birth weight",
        "C) No significant weight change",
        "D) Doubling of birth weight at 12 months"
      ],
      "question": "What is the expected growth pattern for infants during the first year of life?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "growth_patterns",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "puberty_changes",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Puberty is characterized by an increase in muscle mass due to hormonal changes.",
      "format": "mcq",
      "id": 236,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Decrease in height",
        "B) Increase in muscle mass",
        "C) Decrease in body fat",
        "D) Stagnation of growth"
      ],
      "question": "During puberty, which of the following changes is commonly observed in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "puberty_changes",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "nutritional_needs",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Increasing protein-rich foods is essential for supporting growth and development in young children.",
      "format": "mcq",
      "id": 237,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Increase milk intake",
        "B) Reduce carbohydrate consumption",
        "C) Include more protein-rich foods",
        "D) Limit fruits and vegetables"
      ],
      "question": "A 2-year-old child exhibits signs of stunted growth. Which dietary change would be most beneficial?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutritional_needs",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "motor_skills",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Most children typically start to walk independently around 12 months of age.",
      "format": "mcq",
      "id": 238,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) 8 months",
        "B) 10 months",
        "C) 12 months",
        "D) 15 months"
      ],
      "question": "At what age do most children start to walk independently?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "motor_skills",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "growth_chart",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "The age of the child is crucial as growth charts are age-specific to assess growth patterns accurately.",
      "format": "mcq",
      "id": 239,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Age of child",
        "B) Weight only",
        "C) Height only",
        "D) Body temperature"
      ],
      "question": "Which parameter is crucial for analyzing a child\u0027s growth chart effectively?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "growth_chart",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "developmental_milestones",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "By 18 months, most children can walk up steps with assistance.",
      "format": "mcq",
      "id": 240,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Speaking in full sentences",
        "B) Running without falling",
        "C) Walking up steps with assistance",
        "D) Drawing a circle"
      ],
      "question": "Which developmental milestone is typically expected by 18 months of age?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "developmental_milestones",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "immunization_importance",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Immunization plays a crucial role in preventing infectious diseases in early childhood.",
      "format": "mcq",
      "id": 241,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) It helps in bone growth",
        "B) It prevents infectious diseases",
        "C) It improves eyesight",
        "D) It reduces appetite"
      ],
      "question": "Why is immunization important in early childhood?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "immunization_importance",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "parental_influence",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Providing a stimulating environment is essential for healthy growth and development in children.",
      "format": "mcq",
      "id": 242,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Ignoring the child\u0027s diet",
        "B) Providing a stimulating environment",
        "C) Withholding playtime",
        "D) Limiting social interactions"
      ],
      "question": "How can parental behaviors influence a child\u0027s growth and development?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "parental_influence",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_growth",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "neonatal_jaundice",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Hemolytic disease of the newborn is a common cause of jaundice due to increased bilirubin levels from red blood cell breakdown.",
      "format": "mcq",
      "id": 243,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Hemolytic disease of the newborn",
        "B) Congenital hypothyroidism",
        "C) Cystic fibrosis",
        "D) Rickettsia infection"
      ],
      "question": "What is a common cause of neonatal jaundice in the first week of life?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "neonatal jaundice",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "thermal_stability",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Maintaining thermal stability helps prevent hypothermia, which can lead to serious complications in neonates.",
      "format": "mcq",
      "id": 244,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Preventing hypoglycemia",
        "B) Preventing hypothermia",
        "C) Promoting weight gain",
        "D) Enhancing feeding"
      ],
      "question": "What is the primary reason for maintaining thermal stability in neonates?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "thermal stability",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "neonatal_resuscitation",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "The first step in neonatal resuscitation is to stimulate the newborn to initiate breathing.",
      "format": "mcq",
      "id": 245,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Administer medications",
        "B) Provide positive pressure ventilation",
        "C) Stimulate the newborn",
        "D) Call for additional help"
      ],
      "question": "A newborn is not breathing adequately at birth. What is the first step in neonatal resuscitation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "neonatal resuscitation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "neonatal_care",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Placing a neonate on their back during sleep is recommended to reduce the risk of SIDS.",
      "format": "mcq",
      "id": 246,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) On the stomach",
        "B) On the side",
        "C) On the back",
        "D) Sitting upright"
      ],
      "question": "What is the recommended position for a neonate during sleep to reduce the risk of sudden infant death syndrome (SIDS)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "neonatal care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "umbilical_cord_care",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The umbilical cord stump should be kept clean and dry, often cleaned with alcohol to prevent infection.",
      "format": "mcq",
      "id": 247,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Keep it covered with a bandage",
        "B) Clean with alcohol and keep dry",
        "C) Apply ointment regularly",
        "D) Immerse in water"
      ],
      "question": "What is the appropriate care for a newborn\u0027s umbilical cord stump?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "umbilical cord care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "nutrition",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Breast milk is the primary nutritional source for newborns, providing essential nutrients and antibodies.",
      "format": "mcq",
      "id": 248,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Formula milk",
        "B) Solid foods",
        "C) Breast milk",
        "D) Cow\u0027s milk"
      ],
      "question": "What is the primary nutritional source for a newborn in the first six months?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "developmental_milestones",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "By 2 months of age, most infants can lift their head while lying on their stomach, indicating motor development.",
      "format": "mcq",
      "id": 249,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) 1 month",
        "B) 2 months",
        "C) 4 months",
        "D) 6 months"
      ],
      "question": "At what age should a newborn typically be able to lift their head while lying on their stomach?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "developmental milestones",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "immunization",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The hepatitis B vaccine is administered at birth to provide early protection against the virus.",
      "format": "mcq",
      "id": 250,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) BCG vaccine",
        "B) Oral polio vaccine",
        "C) Hepatitis B vaccine",
        "D) DTP vaccine"
      ],
      "question": "Which vaccine is typically administered at birth to protect against hepatitis B?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "immunization",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "screening_tests",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "The newborn screening test aims to detect metabolic disorders that can be managed early to prevent complications.",
      "format": "mcq",
      "id": 251,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To check for congenital anomalies",
        "B) To assess motor skills",
        "C) To detect metabolic disorders",
        "D) To evaluate vision"
      ],
      "question": "What is the purpose of the newborn screening test?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "screening tests",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "child_health",
      "telugu_hint": null,
      "topic_id": "ch_neonatal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "immunization",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "The MMR vaccine protects against measles, mumps, and rubella.",
      "format": "mcq",
      "id": 252,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) BCG",
        "B) DPT",
        "C) MMR",
        "D) Hepatitis B"
      ],
      "question": "Which vaccine is primarily used to prevent measles?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "immunization",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "transmission",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Respiratory infections commonly spread through airborne transmission.",
      "format": "mcq",
      "id": 253,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Vector-borne",
        "B) Airborne",
        "C) Fecal-oral",
        "D) Direct contact"
      ],
      "question": "Which of the following is a common mode of transmission for respiratory infections?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "transmission",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "epidemiology",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Epidemiological studies help identify causative factors of diseases to inform prevention strategies.",
      "format": "mcq",
      "id": 254,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To develop new medications",
        "B) To monitor health statistics",
        "C) To establish causative factors of diseases",
        "D) To provide direct patient care"
      ],
      "question": "What is the primary purpose of epidemiological studies in public health?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "epidemiology",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "disease_prevention",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Washing hands with soap and water is the most effective method for preventing infections.",
      "format": "mcq",
      "id": 255,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Using hand sanitizers only",
        "B) Washing hands with soap and water",
        "C) Wearing gloves while cooking",
        "D) Avoiding direct contact with sick individuals"
      ],
      "question": "A community nurse is educating families about the importance of hand hygiene to prevent infections. Which method is most effective?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "disease_prevention",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "public_health_programs",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "NVBDCP aims to reduce the incidence of diseases transmitted by vectors like mosquitoes.",
      "format": "mcq",
      "id": 256,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To control drug-resistant tuberculosis",
        "B) To reduce the incidence of mosquito-borne diseases",
        "C) To improve maternal health",
        "D) To provide free vaccinations"
      ],
      "question": "What is the main objective of the National Vector Borne Disease Control Programme (NVBDCP)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "public_health_programs",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "symptom_recognition",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Persistent cough is one of the hallmark symptoms of tuberculosis.",
      "format": "mcq",
      "id": 257,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) High fever",
        "B) Persistent cough",
        "C) Skin rashes",
        "D) Joint pain"
      ],
      "question": "Which of the following symptoms is most commonly associated with tuberculosis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "symptom_recognition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "hygiene_practices",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Regular immunization is crucial in preventing the spread of communicable diseases.",
      "format": "mcq",
      "id": 258,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Regular immunization",
        "B) Consuming street food",
        "C) Ignoring personal hygiene",
        "D) Close contact with infected individuals"
      ],
      "question": "What is an essential practice to reduce the spread of communicable diseases in communities?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hygiene_practices",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "malaria_control",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Indoor residual spraying is highly effective in controlling malaria by killing mosquitoes that transmit the disease.",
      "format": "mcq",
      "id": 259,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Indoor residual spraying",
        "B) Promotion of herbal remedies",
        "C) Increased outdoor activities",
        "D) Use of antibiotics"
      ],
      "question": "What is the most effective method to control malaria transmission?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "malaria_control",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "community_engagement",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Highlighting success stories can motivate community members to participate in vaccination programs.",
      "format": "mcq",
      "id": 260,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) By providing misinformation",
        "B) By highlighting success stories",
        "C) By minimizing the benefits of vaccination",
        "D) By avoiding discussions with families"
      ],
      "question": "How should community health workers encourage participation in vaccination programs?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "community_engagement",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_communicable",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_education",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The Indian Nursing Council is responsible for establishing Uniform Standards of nursing education.",
      "format": "mcq",
      "id": 261,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) To provide nursing care",
        "B) To establish Uniform Standards of nursing education",
        "C) To manage hospitals",
        "D) To conduct surgeries"
      ],
      "question": "What is one main function of the Indian Nursing Council (INC)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_education",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "curriculum_revisions",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The duration of the GNM nursing program was reduced from 3 \u00bd years to 3 years in the 2015 revision.",
      "format": "mcq",
      "id": 262,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Increased from 2 years to 3 years",
        "B) Reduced from 3 \u00bd years to 3 years",
        "C) No change in duration",
        "D) Expanded to 4 years"
      ],
      "question": "What significant change was made in the GNM nursing program duration in the 2015 revision?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum_revisions",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "internship_in_nursing",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The revised GNM program integrates the internship component within the 3-year course duration.",
      "format": "mcq",
      "id": 263,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Added after graduation",
        "B) Integrated within the 3-year course",
        "C) Conducted only in urban areas",
        "D) Not required anymore"
      ],
      "question": "How has the internship component been integrated into the revised GNM program?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "internship_in_nursing",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "course_structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The structured format of the revised syllabus provides clear guidelines for teachers to effectively implement the curriculum.",
      "format": "mcq",
      "id": 264,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) It simplifies teaching materials",
        "B) It provides clear guidelines for teachers and students",
        "C) It focuses only on theory",
        "D) It eliminates practical requirements"
      ],
      "question": "Why is the structured format of the revised syllabus important for nursing education?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "course_structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "practical_requirements",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The revised GNM syllabus includes detailed descriptions of practical subjects, outlining skills to be acquired.",
      "format": "mcq",
      "id": 265,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) General objectives only",
        "B) Detailed descriptions with skills to be acquired",
        "C) No practical requirements",
        "D) Only theoretical assessments"
      ],
      "question": "What component does the revised GNM syllabus provide for practical subjects?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "practical_requirements",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing_objectives",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "A primary objective of the revised syllabus is to prepare nurses to provide qualitative care in hospitals and communities.",
      "format": "mcq",
      "id": 266,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) To increase nursing fees",
        "B) To prepare nurses for qualitative nursing care",
        "C) To limit nursing education",
        "D) To focus solely on research"
      ],
      "question": "What is a primary objective of the Indian Nursing Council\u0027s revised GNM syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_objectives",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "school_establishment",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "The syllabus includes guidelines and minimum requirements to establish a School of Nursing.",
      "format": "mcq",
      "id": 267,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Only physical facilities",
        "B) No specific guidelines",
        "C) Guidelines and minimum requirements",
        "D) Only theoretical knowledge"
      ],
      "question": "What guidelines are provided for establishing a School of Nursing according to the syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "school_establishment",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "anti_ragging",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "The GNM syllabus includes anti-ragging policies to promote a safe and secure learning environment for students.",
      "format": "mcq",
      "id": 268,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Anti-ragging policies",
        "B) Only academic performance",
        "C) Focus on research",
        "D) External examinations only"
      ],
      "question": "What is included in the regulations of the GNM syllabus to promote a safe learning environment?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "anti_ragging",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing_faculty",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The GNM syllabus regulations state that Nursing Teaching Faculty must have relevant nursing qualifications and experience.",
      "format": "mcq",
      "id": 269,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) No specific qualifications required",
        "B) Must have relevant nursing qualifications and experience",
        "C) Only diploma holders are allowed",
        "D) Must be above 60 years old"
      ],
      "question": "What is a requirement for Nursing Teaching Faculty according to the GNM syllabus regulations?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_faculty",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nutrition",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Proper nutrition enhances immunity and helps prevent diseases in the community.",
      "format": "mcq",
      "id": 270,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To reduce healthcare costs",
        "B) To promote food security",
        "C) To enhance immunity and prevent diseases",
        "D) To increase the production of food items"
      ],
      "question": "What is the primary role of nutrition in community health?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "air_quality",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Carbon monoxide is a common indoor air pollutant that can cause health issues.",
      "format": "mcq",
      "id": 271,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Carbon monoxide",
        "B) Oxygen",
        "C) Nitrogen",
        "D) Helium"
      ],
      "question": "Which of the following is a common indoor air pollutant?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "air_quality",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "sanitation",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Promoting hygiene education is crucial as it empowers communities to maintain sanitation practices effectively.",
      "format": "mcq",
      "id": 272,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Building more toilets",
        "B) Promoting hygiene education",
        "C) Providing clean water sources",
        "D) Enforcing sanitation laws"
      ],
      "question": "What is the most effective method for improving sanitation in rural communities?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sanitation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "vector_control",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Chemical sprays are a common and effective method for reducing mosquito populations.",
      "format": "mcq",
      "id": 273,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Planting more trees",
        "B) Using chemical sprays",
        "C) Encouraging open water bodies",
        "D) Reducing vegetation"
      ],
      "question": "Which method is effective in controlling mosquito populations?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vector_control",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "waste_management",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Recycling and composting reduce waste and promote resource efficiency, making them sustainable options.",
      "format": "mcq",
      "id": 274,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Incineration",
        "B) Recycling and composting",
        "C) Landfilling",
        "D) Open dumping"
      ],
      "question": "Which waste management strategy is most sustainable for community health?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "waste_management",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "health_promotion",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "The primary goal of community health promotion is to improve the overall well-being of the community.",
      "format": "mcq",
      "id": 275,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To increase healthcare access",
        "B) To enhance community engagement",
        "C) To improve overall community well-being",
        "D) To reduce health disparities"
      ],
      "question": "What is the primary goal of community health promotion?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "health_promotion",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "environmental_health",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Air pollution is a significant environmental health issue commonly found in urban areas.",
      "format": "mcq",
      "id": 276,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Soil erosion",
        "B) Indoor heating",
        "C) Air pollution",
        "D) Flooding"
      ],
      "question": "What is a significant environmental health issue in urban areas?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "environmental_health",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "mental_health",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Substance abuse prevention programs are crucial for promoting mental health in communities.",
      "format": "mcq",
      "id": 277,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Substance abuse prevention",
        "B) Family planning",
        "C) Nutritional education",
        "D) Disease management"
      ],
      "question": "Which community-based program is essential for promoting mental health?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "mental_health",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "public_health",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Public health primarily focuses on community-wide health issues to improve population health.",
      "format": "mcq",
      "id": 278,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Individual patient care",
        "B) Community-wide health issues",
        "C) Hospital administration",
        "D) Clinical guidelines"
      ],
      "question": "What does public health primarily focus on?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "public_health",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "disease_prevention",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "All of the listed approaches - isolation, vaccination, and improved sanitation - are effective in preventing the spread of infectious diseases.",
      "format": "mcq",
      "id": 279,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Isolation of infected individuals",
        "B) Vaccination programs",
        "C) Improved sanitation",
        "D) All of the above"
      ],
      "question": "What is the best approach to prevent the spread of infectious diseases in communities?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "disease_prevention",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_environment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_foundations",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The Indian Nursing Council\u0027s primary purpose is to establish uniform standards of nursing education.",
      "format": "mcq",
      "id": 280,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) To publish nursing journals",
        "B) To establish uniform standards of nursing education",
        "C) To recruit nurses for hospitals",
        "D) To provide direct patient care"
      ],
      "question": "What is the primary purpose of the Indian Nursing Council?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "introduction",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "program_duration",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The duration of the revised General Nursing and Midwifery program is 3 years.",
      "format": "mcq",
      "id": 281,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) 2 years",
        "B) 3 years",
        "C) 3.5 years",
        "D) 4 years"
      ],
      "question": "What is the duration of the revised General Nursing and Midwifery program?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "curriculum_structure",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The revised curriculum format includes course descriptions, general objectives, and assessment methods.",
      "format": "mcq",
      "id": 282,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) It includes more textbooks.",
        "B) It provides only theoretical knowledge.",
        "C) It includes course description and assessment methods.",
        "D) It eliminates practical components."
      ],
      "question": "How has the curriculum format changed in the revised GNM syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nursing_objectives",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The internship has been integrated within the 3-year General Nursing and Midwifery course.",
      "format": "mcq",
      "id": 283,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) It is optional.",
        "B) It has been integrated within the 3 years course.",
        "C) It lasts for 1 year.",
        "D) It is conducted only in hospitals."
      ],
      "question": "What is a significant change in the revised nursing curriculum regarding the internship?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing_education",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "The Nursing Education Committee of the Indian Nursing Council contributed to the preparation of the revised GNM syllabus.",
      "format": "mcq",
      "id": 284,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Nursing Education Committee",
        "B) Hospital Management Committee",
        "C) Medical Council of India",
        "D) Nursing Advisory Board"
      ],
      "question": "Which committee contributed to the preparation of the revised GNM syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "introduction",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "regulations",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Adequate physical facilities are essential minimum requirements for establishing a school of nursing.",
      "format": "mcq",
      "id": 285,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Adequate physical facilities",
        "B) A nursing library",
        "C) Specialized faculty",
        "D) International collaborations"
      ],
      "question": "What is the minimum requirement to establish a school of nursing according to the INC?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "guidelines",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "teaching_methods",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "The revised syllabus provides detailed teaching strategies, helping educators effectively cover the curriculum.",
      "format": "mcq",
      "id": 286,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) By providing detailed teaching strategies for each subject",
        "B) By eliminating practical sessions",
        "C) By standardizing teaching across all institutions",
        "D) By focusing only on theoretical knowledge"
      ],
      "question": "How does the revised syllabus guide nursing educators in teaching?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_practice",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The main objective of the program is to prepare nurses to provide qualitative nursing care in both hospital and community settings.",
      "format": "mcq",
      "id": 287,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) To promote research in nursing",
        "B) To prepare nurses for qualitative nursing care",
        "C) To increase the number of nurses",
        "D) To standardize medication administration"
      ],
      "question": "What is the main objective of the General Nursing and Midwifery program?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "objectives",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "assessment_methods",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Practical assessments are included as part of the assessment methods in the revised GNM syllabus.",
      "format": "mcq",
      "id": 288,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Only written exams",
        "B) Practical assessments",
        "C) No assessments",
        "D) Group projects only"
      ],
      "question": "What is one of the assessment methods mentioned in the revised GNM syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "hospital_care",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The integration of the internship within the course duration aims to enhance nurses\u0027 readiness for both community and hospital care.",
      "format": "mcq",
      "id": 289,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Reduction of practical training",
        "B) Integration of internship within the course duration",
        "C) Increase in classroom hours",
        "D) Introduction of more theoretical subjects"
      ],
      "question": "Which change in the GNM program aims to enhance the nurses\u0027 readiness for community and hospital care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "community_health",
      "telugu_hint": null,
      "topic_id": "chn_maternal_child",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "wound_care",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The primary purpose of a sterile dressing is to prevent infection in the wound.",
      "format": "mcq",
      "id": 290,
      "last_reviewed": "2023-10-08",
      "options": [
        "A) To maintain pressure",
        "B) To prevent infection",
        "C) To promote healing",
        "D) To absorb blood"
      ],
      "question": "What is the primary purpose of applying a sterile dressing to a wound?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound_care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-08",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "bleeding",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The first action in managing severe bleeding is to apply direct pressure to the wound to control the blood loss.",
      "format": "mcq",
      "id": 291,
      "last_reviewed": "2023-10-08",
      "options": [
        "A) Apply a tourniquet above the cut",
        "B) Elevate the arm",
        "C) Apply direct pressure to the wound",
        "D) Clean the wound with antiseptic"
      ],
      "question": "A patient is bleeding profusely from a deep cut on the arm. What is the first action you should take?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bleeding",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-08",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "choking",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Performing the Heimlich maneuver is the appropriate first aid step for a choking child who cannot breathe.",
      "format": "mcq",
      "id": 292,
      "last_reviewed": "2023-10-08",
      "options": [
        "A) Give them water",
        "B) Perform the Heimlich maneuver",
        "C) Slap them on the back",
        "D) Call for help"
      ],
      "question": "A child is choking and cannot breathe. What is the appropriate first aid step to take?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "choking",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-08",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "fractures",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The best initial management for a suspected fracture is to immobilize the affected area to prevent further injury.",
      "format": "mcq",
      "id": 293,
      "last_reviewed": "2023-10-08",
      "options": [
        "A) Move the patient to comfort",
        "B) Immobilize the affected area",
        "C) Apply heat to the area",
        "D) Massage the area"
      ],
      "question": "What is the best initial management for a suspected fracture?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fractures",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-08",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "burns",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "A first-degree burn is characterized by redness and pain without the presence of blisters.",
      "format": "mcq",
      "id": 294,
      "last_reviewed": "2023-10-08",
      "options": [
        "A) First-degree burn",
        "B) Second-degree burn",
        "C) Third-degree burn",
        "D) Chemical burn"
      ],
      "question": "Which type of burn is characterized by redness and pain but no blisters?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "burns",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-08",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "poisoning",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The first step in managing suspected poisoning is to call Poison Control for guidance on the appropriate actions to take.",
      "format": "mcq",
      "id": 295,
      "last_reviewed": "2023-10-08",
      "options": [
        "A) Induce vomiting",
        "B) Call Poison Control",
        "C) Give activated charcoal",
        "D) Provide water"
      ],
      "question": "A patient is suspected to have ingested poison. What is the first step you should take?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "poisoning",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-08",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "heat_exhaustion",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Moving a person showing signs of heat exhaustion to a cooler area is the first priority to help them recover.",
      "format": "mcq",
      "id": 296,
      "last_reviewed": "2023-10-08",
      "options": [
        "A) Move them to a cooler area",
        "B) Give them a warm beverage",
        "C) Encourage them to exercise",
        "D) Apply ice directly to the skin"
      ],
      "question": "A person is showing signs of heat exhaustion. Which of the following actions should be prioritized?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "heat_exhaustion",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-08",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "burns",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Immersing the burn in cold water helps to cool the area and reduce pain.",
      "format": "mcq",
      "id": 297,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Cover with a dry cloth",
        "B) Immerse in cold water",
        "C) Apply ointment",
        "D) Massage the area"
      ],
      "question": "What is the immediate first aid step for a burn injury?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "burns",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "choking",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Performing back blows can help dislodge the object causing the choking.",
      "format": "mcq",
      "id": 298,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Give them water",
        "B) Perform back blows",
        "C) Check their pulse",
        "D) Encourage them to cough"
      ],
      "question": "A person is choking and cannot speak. What should you do first?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "choking",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "bleeding",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Applying direct pressure is the most effective way to control bleeding immediately.",
      "format": "mcq",
      "id": 299,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Apply a tourniquet",
        "B) Elevate the leg",
        "C) Apply direct pressure",
        "D) Clean the wound"
      ],
      "question": "A patient presents with severe bleeding from a leg wound. What is the priority action to control the bleeding?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bleeding",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "shock",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "A rapid heartbeat is a common physiological response to shock as the body tries to maintain blood flow.",
      "format": "mcq",
      "id": 300,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Flushed skin",
        "B) High blood pressure",
        "C) Rapid heartbeat",
        "D) Warm extremities"
      ],
      "question": "What is a common sign of shock in a patient?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "shock",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "fracture",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Immobilizing the arm prevents further injury and alleviates pain.",
      "format": "mcq",
      "id": 301,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Apply ice to the area",
        "B) Move the arm to check for pain",
        "C) Immobilize the arm",
        "D) Give them pain medication"
      ],
      "question": "You suspect a patient has a fractured arm. What should you do first?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fracture",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "drowning",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "Removing the victim from the water is critical before any other steps can be taken.",
      "format": "mcq",
      "id": 302,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Start CPR immediately",
        "B) Assess the airway",
        "C) Call for emergency help",
        "D) Remove them from the water"
      ],
      "question": "What is the first step in managing a drowning victim who is unresponsive?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "drowning",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "poisoning",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Nausea and vomiting are typical symptoms associated with various types of poisoning.",
      "format": "mcq",
      "id": 303,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Increased energy",
        "B) Nausea and vomiting",
        "C) Clear skin",
        "D) Slow heart rate"
      ],
      "question": "Which of the following is a common symptom of poisoning?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "poisoning",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "heart_attack",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Calling for emergency medical assistance is crucial for timely medical intervention.",
      "format": "mcq",
      "id": 304,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Call for emergency medical assistance",
        "B) Offer them water",
        "C) Have them lie down",
        "D) Perform CPR"
      ],
      "question": "You suspect a person is having a heart attack. What should you do first?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "heart_attack",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "stroke",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Sudden confusion is a key sign of a stroke and requires immediate medical attention.",
      "format": "mcq",
      "id": 305,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Sudden confusion",
        "B) Gradual loss of vision",
        "C) Constant headache",
        "D) Fever"
      ],
      "question": "What is a common sign of a stroke that caregivers should recognize?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "stroke",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "seizure",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Moving objects away helps to prevent injury during a seizure.",
      "format": "mcq",
      "id": 306,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Hold the person down",
        "B) Place something in their mouth",
        "C) Move objects away to prevent injury",
        "D) Leave them alone"
      ],
      "question": "During a seizure, what is the most important thing to do?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "seizure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "first_aid",
      "telugu_hint": null,
      "topic_id": "fa_emergency",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing education",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The INC\u0027s main function is to establish uniform standards of nursing education for nursing personnel.",
      "format": "mcq",
      "id": 307,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To provide healthcare services",
        "B) To establish uniform standards of nursing education",
        "C) To conduct medical research",
        "D) To manage hospitals"
      ],
      "question": "What is the primary function of the Indian Nursing Council (INC)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing education",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nursing curriculum",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The duration of the GNM program has been reduced from 3 \u00bd years to 3 years in the revised curriculum.",
      "format": "mcq",
      "id": 308,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Increased from 3 years to 4 years",
        "B) Reduced from 3 \u00bd years to 3 years",
        "C) Remained the same at 3 \u00bd years",
        "D) Extended to 4 \u00bd years"
      ],
      "question": "What significant change was made in the revised GNM curriculum regarding its duration?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "evaluation methods",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The revised curriculum includes a detailed description of assessment methods for each subject.",
      "format": "mcq",
      "id": 309,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Only theoretical content",
        "B) Detailed description of assessment methods",
        "C) Exemptions for practical sessions",
        "D) Only assignments without assessments"
      ],
      "question": "What does the revised curriculum include that aids teaching and assessment?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "evaluation methods",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nursing regulations",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "The syllabus was revised to integrate internships within the 3-year course without compromising the course content and objectives.",
      "format": "mcq",
      "id": 310,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To reduce the number of subjects",
        "B) To comply with international standards",
        "C) To increase the duration of the course",
        "D) To integrate internships without compromising course content"
      ],
      "question": "Why was the GNM syllabus revised according to the Indian Nursing Council?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing regulations",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "clinical facilities",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Sufficient clinical facilities are essential to establish a school of nursing as per the regulations.",
      "format": "mcq",
      "id": 311,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) A swimming pool",
        "B) Sufficient clinical facilities",
        "C) A large faculty lounge",
        "D) Unlimited patient access"
      ],
      "question": "What is one of the minimum requirements to establish a school of nursing according to the regulations?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "clinical facilities",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing philosophy",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The nursing philosophy in the GNM program emphasizes holistic patient care.",
      "format": "mcq",
      "id": 312,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Theoretical knowledge only",
        "B) Practical skills without theory",
        "C) Holistic patient care",
        "D) Strict adherence to protocols only"
      ],
      "question": "What does the nursing philosophy emphasize in the GNM program?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing philosophy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "teaching learning activities",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The revised syllabus emphasizes the integration of practical skills in teaching-learning activities.",
      "format": "mcq",
      "id": 313,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Only lectures",
        "B) Integration of practical skills",
        "C) Focus solely on theoretical exams",
        "D) Exclusion of group activities"
      ],
      "question": "What is an important component of teaching-learning activities outlined in the revised GNM syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "teaching learning activities",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing objectives",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "One of the general objectives of the GNM program is to prepare nurses to provide care in both hospitals and community health.",
      "format": "mcq",
      "id": 314,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To limit nursing practice to hospitals",
        "B) To prepare nurses for community health care",
        "C) To exclude all practical training",
        "D) To focus only on administrative roles"
      ],
      "question": "What is one of the general objectives of the GNM program?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing objectives",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing facilities",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Sufficient teaching and clinical facilities are necessary for the establishment of a nursing school.",
      "format": "mcq",
      "id": 315,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Recreational facilities only",
        "B) Sufficient teaching and clinical facilities",
        "C) Administrative offices only",
        "D) Transportation services only"
      ],
      "question": "What type of facilities are necessary for the establishment of a nursing school?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing facilities",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "hand_hygiene",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Hand hygiene is crucial in reducing the spread of infections in healthcare settings.",
      "format": "mcq",
      "id": 316,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) To prevent patient falls",
        "B) To reduce healthcare-associated infections",
        "C) To enhance patient comfort",
        "D) To comply with hospital policies"
      ],
      "question": "What is the primary purpose of hand hygiene in nursing?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hand hygiene",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "personal_hygiene",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Maintaining personal hygiene prevents the transmission of infections to patients.",
      "format": "mcq",
      "id": 317,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) To promote a professional appearance",
        "B) To avoid disciplinary action",
        "C) To prevent the transmission of infections",
        "D) To comply with dress codes"
      ],
      "question": "Why is personal hygiene important for nurses?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "personal hygiene",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "infection_control",
      "context": "scenario",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "Assessing staff compliance with hand hygiene is crucial to identify potential sources of infection spread.",
      "format": "mcq",
      "id": 318,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Notify the infection control committee",
        "B) Review patient charts for common treatments",
        "C) Increase the frequency of cleaning in the area",
        "D) Assess staff compliance with hand hygiene"
      ],
      "question": "A nurse notices that several patients on a unit have developed similar infections. What should be the nurse\u0027s first action?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "infection control",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "aseptic_technique",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Administering injections requires aseptic technique to prevent infection.",
      "format": "mcq",
      "id": 319,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Bathing a patient",
        "B) Administering an injection",
        "C) Taking vital signs",
        "D) Assisting with feeding"
      ],
      "question": "Which procedure requires the use of aseptic technique?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "aseptic technique",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "environmental_hygiene",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Environmental hygiene aims to maintain clean and safe spaces to prevent infection.",
      "format": "mcq",
      "id": 320,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) To enhance aesthetic appeal",
        "B) To ensure patient comfort",
        "C) To maintain clean and safe spaces",
        "D) To comply with health regulations"
      ],
      "question": "What is the main goal of environmental hygiene in healthcare settings?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "environmental hygiene",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "surgical_hygiene",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Scrubbing hands for an adequate duration is crucial to remove microorganisms before surgery.",
      "format": "mcq",
      "id": 321,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Wearing jewelry",
        "B) Scrubbing hands for an adequate duration",
        "C) Using non-sterile instruments",
        "D) Wearing a mask only when necessary"
      ],
      "question": "During a surgical procedure, which action is essential for maintaining surgical hygiene?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "surgical hygiene",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "patient_education",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Emphasizing personal hygiene helps patients understand its role in preventing diseases.",
      "format": "mcq",
      "id": 322,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) It is only necessary during hospital stays",
        "B) It helps in preventing diseases",
        "C) It is a sign of personal vanity",
        "D) It is not important if you feel healthy"
      ],
      "question": "What should a nurse emphasize to patients regarding personal hygiene?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "patient education",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "hygiene_practices",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Regular disinfection of high-touch surfaces helps to prevent the spread of infections.",
      "format": "mcq",
      "id": 323,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Sharing personal items among staff",
        "B) Regularly disinfecting high-touch surfaces",
        "C) Wearing street clothes while on duty",
        "D) Ignoring spills and accidents"
      ],
      "question": "Which of the following is a recommended practice for maintaining good hygiene in the clinical setting?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hygiene practices",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_hygiene",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "infection_prevention",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "The primary goal of infection control is to prevent the spread of infections among patients and healthcare workers.",
      "format": "mcq",
      "id": 324,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To reduce costs",
        "B) To improve patient satisfaction",
        "C) To prevent the spread of infections",
        "D) To minimize staff workload"
      ],
      "question": "What is the primary goal of infection control in healthcare settings?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "infection_prevention",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "mode_of_transmission",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Direct contact with contaminated surfaces is a common mode of transmission for infections, highlighting the importance of cleanliness.",
      "format": "mcq",
      "id": 325,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Direct contact with contaminated surfaces",
        "B) Receiving vaccinations",
        "C) Proper hand hygiene",
        "D) Healthy diet"
      ],
      "question": "Which of the following describes the mode of transmission of infections?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "mode_of_transmission",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "cleaning_vs_disinfection",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Cleaning involves removing dirt and debris, while disinfection specifically targets and kills germs on surfaces.",
      "format": "mcq",
      "id": 326,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Cleaning removes dirt; disinfection kills germs",
        "B) Both have the same purpose",
        "C) Cleaning is more effective than disinfection",
        "D) Disinfection is only for surfaces"
      ],
      "question": "What is the main difference between cleaning and disinfection?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cleaning_vs_disinfection",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "immunization",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Immunization helps to develop active immunity against specific pathogens, reducing the risk of infection spread.",
      "format": "mcq",
      "id": 327,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) It sterilizes the environment",
        "B) It provides passive immunity only",
        "C) It helps to develop active immunity against specific pathogens",
        "D) It eliminates the need for hygiene practices"
      ],
      "question": "How does immunization contribute to infection control?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "immunization",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "antimicrobial_resistance",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Antimicrobial resistance occurs when pathogens evolve and become resistant to medications, making infections harder to treat.",
      "format": "mcq",
      "id": 328,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Increased effectiveness of antibiotics",
        "B) Pathogens becoming resistant to medications",
        "C) Decreased incidence of infections",
        "D) Enhanced immune response to infections"
      ],
      "question": "What is antimicrobial resistance?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antimicrobial_resistance",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "patient_isolation",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Airborne isolation is appropriate for patients with contagious diseases that can be spread through the air, such as tuberculosis.",
      "format": "mcq",
      "id": 329,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Contact isolation",
        "B) Droplet isolation",
        "C) Airborne isolation",
        "D) Protective isolation"
      ],
      "question": "A patient with a contagious disease requires isolation. What is the most appropriate type of isolation for this patient?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "patient_isolation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "wound_care",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Washing hands before any procedure is essential to prevent the introduction of pathogens and infections.",
      "format": "mcq",
      "id": 330,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Washing hands before the procedure",
        "B) Using any type of bandage",
        "C) Leaving the wound exposed",
        "D) Skipping antiseptic application"
      ],
      "question": "When performing wound care, which practice is essential to prevent infection?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound_care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "hospital_environment",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Regular cleaning and disinfection of the hospital environment is critical to prevent the spread of infections.",
      "format": "mcq",
      "id": 331,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Use of decorative items",
        "B) Regular cleaning and disinfection",
        "C) Open windows for ventilation",
        "D) High humidity levels"
      ],
      "question": "Which aspect of the hospital environment is critical for infection control?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hospital_environment",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "patient_education",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Patient education is important in infection control because it empowers patients to understand and actively participate in their own care to prevent infections.",
      "format": "mcq",
      "id": 332,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) It increases hospital revenue",
        "B) It empowers patients to participate in their care",
        "C) It complicates treatment plans",
        "D) It is not relevant to infection control"
      ],
      "question": "Why is patient education important in infection control?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "patient_education",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_infection_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "supine position",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The supine position refers to a person lying flat on their back.",
      "format": "mcq",
      "id": 333,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Lying on the stomach",
        "B) Lying on the back",
        "C) Sitting upright",
        "D) Lying on one side"
      ],
      "question": "What is the supine position in nursing?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "supine position",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "prone position",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The prone position helps relieve pressure on the back and can prevent pressure ulcers.",
      "format": "mcq",
      "id": 334,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To improve circulation",
        "B) For respiratory therapy",
        "C) To prevent pressure ulcers",
        "D) For abdominal surgery recovery"
      ],
      "question": "What is the primary use of the prone position in patient care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "prone position",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "lateral position",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The lateral position involves the patient lying on their side, which is often used for comfort and to improve ventilation.",
      "format": "mcq",
      "id": 335,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Supine",
        "B) Prone",
        "C) Lateral",
        "D) Fowler\u0027s"
      ],
      "question": "Which position is described as lying on the side?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "lateral position",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "modified fowler",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Modified Fowler\u0027s position typically involves an elevation of 15-30 degrees to assist with breathing.",
      "format": "mcq",
      "id": 336,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) 0-15 degrees",
        "B) 15-30 degrees",
        "C) 30-45 degrees",
        "D) 45-60 degrees"
      ],
      "question": "A patient with difficulty breathing is placed in a modified Fowler\u0027s position. What is the angle of elevation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "modified fowler",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "trendelenburg",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The Trendelenburg position is used to increase blood return to the heart, particularly in cases of hypotension.",
      "format": "mcq",
      "id": 337,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To relieve back pain",
        "B) To increase venous return in hypotensive patients",
        "C) For administering certain medications",
        "D) During abdominal surgeries"
      ],
      "question": "In which situation is the Trendelenburg position most commonly utilized?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "trendelenburg",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "body mechanics",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Using the large muscles of the legs for lifting helps to reduce strain and injury when repositioning a patient.",
      "format": "mcq",
      "id": 338,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Keep the weight away from the body",
        "B) Use the large muscles of the legs for lifting",
        "C) Twist the body while lifting",
        "D) Keep the feet close together for stability"
      ],
      "question": "What principle of body mechanics should be considered when positioning a patient?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "body mechanics",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "patient safety",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Monitoring the patient for signs of distress is crucial for ensuring their safety during any positioning.",
      "format": "mcq",
      "id": 339,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Ensuring the patient\u0027s comfort only",
        "B) Monitoring the patient for any signs of distress",
        "C) Using only one staff member for positioning",
        "D) Frequently changing the positioning without assessment"
      ],
      "question": "Which of the following is a critical consideration for patient safety during positioning?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "patient safety",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "nursing interventions",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Fowler\u0027s position is ideal for patients at risk for aspiration as it helps keep the airway clear.",
      "format": "mcq",
      "id": 340,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Prone position",
        "B) Lateral position",
        "C) Fowler\u0027s position",
        "D) Supine position"
      ],
      "question": "A nurse needs to position a patient at risk for aspiration. What position should the nurse place the patient in?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing interventions",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "effective communication",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 1,
      "explanation": "Effective communication is essential for ensuring the patient\u0027s understanding, preferences, and efficiency of the procedure.",
      "format": "mcq",
      "id": 341,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) It helps to explain the procedure to the patient",
        "B) It reduces the time taken for positioning",
        "C) It ensures that the nurse understands the patient\u0027s preferences",
        "D) All of the above"
      ],
      "question": "Why is effective communication important when positioning patients?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "effective communication",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_positioning",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "respiratory_rate",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "The normal respiratory rate for an adult at rest is typically between 10-20 breaths per minute.",
      "format": "mcq",
      "id": 342,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) 10-20 breaths/min",
        "B) 20-30 breaths/min",
        "C) 30-40 breaths/min",
        "D) 40-50 breaths/min"
      ],
      "question": "What is the normal respiratory rate for an adult at rest?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "respiratory rate",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "blood_pressure",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "A blood pressure reading of 120/80 mmHg is considered to be within the normal range.",
      "format": "mcq",
      "id": 343,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Normal blood pressure",
        "B) Hypertension stage 1",
        "C) Hypotension",
        "D) Hypertension stage 2"
      ],
      "question": "What does the blood pressure reading of 120/80 mmHg represent?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "blood pressure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "temperature_measurement",
      "context": "scenario",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "A tympanic thermometer measures temperature from the ear, making it an ear temperature measurement.",
      "format": "mcq",
      "id": 344,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Oral",
        "B) Axillary",
        "C) Rectal",
        "D) Ear"
      ],
      "question": "If a nurse is measuring body temperature using a tympanic thermometer, which method is she using?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "temperature measurement",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "factors_affecting_vital_signs",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "Hair color does not influence vital signs, while age, exercise, and time of day can significantly affect them.",
      "format": "mcq",
      "id": 345,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Age",
        "B) Exercise",
        "C) Time of day",
        "D) Hair color"
      ],
      "question": "Which factor is least likely to affect a person\u0027s vital signs?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "factors affecting vital signs",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "temperature_types",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The temperature measured in the armpit is known as axillary temperature.",
      "format": "mcq",
      "id": 346,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Oral temperature",
        "B) Rectal temperature",
        "C) Axillary temperature",
        "D) Tympanic temperature"
      ],
      "question": "Which type of body temperature is measured by placing the thermometer in the armpit?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "temperature types",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "pulse_characteristics",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "\u0027Bounding\u0027 pulse indicates an increased stroke volume, often resulting from conditions such as fever or anxiety.",
      "format": "mcq",
      "id": 347,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Weakness",
        "B) Normalcy",
        "C) Increased stroke volume",
        "D) Decreased cardiac output"
      ],
      "question": "What does a \u0027bounding\u0027 pulse indicate?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pulse characteristics",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "pulse_deficits",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "A pulse deficit indicates that not all heartbeats are being felt at the pulse points, which can occur with irregular heart rhythms.",
      "format": "mcq",
      "id": 348,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Normal heart function",
        "B) Aortic stenosis",
        "C) Irregular heart rhythms",
        "D) High blood pressure"
      ],
      "question": "What does the presence of a pulse deficit indicate?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pulse deficits",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "blood_pressure_measurement",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "For accurate blood pressure measurement, the patient should be seated comfortably with their arm supported at heart level.",
      "format": "mcq",
      "id": 349,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Standing",
        "B) Sitting",
        "C) Lying flat",
        "D) Any position"
      ],
      "question": "When measuring blood pressure, which position should the patient be in for accurate results?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "blood pressure measurement",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "sphygmomanometer",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "A sphygmomanometer is an instrument specifically used to measure blood pressure.",
      "format": "mcq",
      "id": 350,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) To measure temperature",
        "B) To measure blood pressure",
        "C) To measure pulse rate",
        "D) To measure respiratory rate"
      ],
      "question": "What is the purpose of a sphygmomanometer?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sphygmomanometer",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_vital_signs",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "wound assessment",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Wound assessment helps evaluate the healing process and any complications.",
      "format": "mcq",
      "id": 351,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To determine the patient\u0027s age",
        "B) To evaluate the healing process",
        "C) To prescribe medication",
        "D) To decide on surgical intervention"
      ],
      "question": "What is the primary purpose of assessing a wound?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound assessment",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "types of wounds",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 1,
      "explanation": "An incision is a clean cut made by a sharp object through the skin.",
      "format": "mcq",
      "id": 352,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Abrasion",
        "B) Laceration",
        "C) Puncture",
        "D) Incision"
      ],
      "question": "What type of wound is inflicted by a sharp object cutting through the skin?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "types of wounds",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "wound healing process",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The proliferative phase is characterized by the formation of granulation tissue.",
      "format": "mcq",
      "id": 353,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Inflammatory phase",
        "B) Proliferative phase",
        "C) Maturation phase",
        "D) Hemostasis phase"
      ],
      "question": "Which phase of wound healing involves the formation of granulation tissue?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound healing process",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "infection prevention",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Cleaning the wound with antiseptic reduces the risk of infection.",
      "format": "mcq",
      "id": 354,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Using non-sterile gloves",
        "B) Cleaning the wound with antiseptic",
        "C) Exposing the wound to air",
        "D) Avoiding dressing changes"
      ],
      "question": "Which practice is essential for preventing infection in wound care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "infection prevention",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "dressing types",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Alginate dressings are highly absorbent and suitable for heavy exudate.",
      "format": "mcq",
      "id": 355,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Hydrocolloid dressing",
        "B) Transparent film dressing",
        "C) Alginate dressing",
        "D) Gauze dressing"
      ],
      "question": "What type of dressing is best used for a heavy exudate wound?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "dressing types",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "wound management",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Repositioning helps relieve pressure on the ulcer and supports healing.",
      "format": "mcq",
      "id": 356,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Massage the area around the ulcer",
        "B) Use a dry dressing without any moisture",
        "C) Implement a repositioning schedule every two hours",
        "D) Leave the ulcer exposed to air"
      ],
      "question": "A nurse is caring for a patient with a deep pressure ulcer. Which intervention is most appropriate?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound management",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "wound care techniques",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Maintaining a moist wound environment promotes healing and reduces scarring.",
      "format": "mcq",
      "id": 357,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Keeping the wound dry at all times",
        "B) Maintaining a moist wound environment",
        "C) Avoiding any form of dressing",
        "D) Exposing the wound to sunlight"
      ],
      "question": "Which of the following is a key principle in wound care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound care techniques",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "wound complications",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "An abscess is a localized collection of pus that can occur in response to infection.",
      "format": "mcq",
      "id": 358,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Hematoma",
        "B) Seroma",
        "C) Abscess",
        "D) Keloid"
      ],
      "question": "Which complication is characterized by the formation of a pocket of pus in a wound?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound complications",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "wound care principles",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Assessing the wound is the first crucial step in effective wound care management.",
      "format": "mcq",
      "id": 359,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Applying a dressing",
        "B) Cleaning the wound",
        "C) Assessing the wound",
        "D) Notifying the physician"
      ],
      "question": "What is the first step in wound care management?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "wound care principles",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "fundamentals_nursing",
      "telugu_hint": null,
      "topic_id": "fn_wound_care",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing_objectives",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The primary objective of the Indian Nursing Council\u0027s revised syllabus is to establish uniform standards in nursing education.",
      "format": "mcq",
      "id": 360,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To increase the duration of the program",
        "B) To establish uniform standards in nursing education",
        "C) To reduce the practical components of training",
        "D) To eliminate theory-based assessments"
      ],
      "question": "What is one of the main objectives of the Indian Nursing Council\u0027s revised syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_objectives",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "curriculum_structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The revised duration of the General Nursing and Midwifery program has been reduced to 3 years.",
      "format": "mcq",
      "id": 361,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) 4 years",
        "B) 3 years",
        "C) 3.5 years",
        "D) 2 years"
      ],
      "question": "What is the new duration of the General Nursing and Midwifery program as per the revised syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum_structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "teaching_activities",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The revised syllabus emphasizes the implementation of a variety of teaching-learning activities for effective coverage.",
      "format": "mcq",
      "id": 362,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Focus only on theoretical components",
        "B) Implement a variety of teaching-learning activities",
        "C) Reduce the time allocated for practical sessions",
        "D) Minimize assessments and evaluations"
      ],
      "question": "What does the revised syllabus emphasize for teachers to ensure effective coverage of the syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "teaching_activities",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing_regulations",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The Indian Nursing Council is responsible for prescribing the syllabus and regulations for nursing personnel in India.",
      "format": "mcq",
      "id": 363,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Ministry of Health",
        "B) Nursing Education Committee",
        "C) Indian Nursing Council",
        "D) The World Health Organization"
      ],
      "question": "Which body is responsible for prescribing the syllabus and regulations for nursing personnel in India?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_regulations",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "practical_requirements",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The revised curriculum includes a detailed description of practical areas and assessment methods for subjects with practical requirements.",
      "format": "mcq",
      "id": 364,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Only theoretical assessments",
        "B) Detailed description of practical areas and assessment methods",
        "C) Elimination of practical sessions",
        "D) Focus only on observational learning"
      ],
      "question": "What is included in the revised curriculum for subjects with practical requirements?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "practical_requirements",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_foundations",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "\u0027Fundamentals of Nursing\u0027 is taught in the First Year of the GNM program according to the syllabus.",
      "format": "mcq",
      "id": 365,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) First Year",
        "B) Second Year",
        "C) Third Year",
        "D) None of the above"
      ],
      "question": "In which year is the subject \u0027Fundamentals of Nursing\u0027 taught according to the GNM syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_foundations",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "community_health",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The Community Health Nursing curriculum emphasizes community-based nursing practices.",
      "format": "mcq",
      "id": 366,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Hospital-based care only",
        "B) Community-based nursing practices",
        "C) Theoretical learning without practical application",
        "D) Independent nursing practice without supervision"
      ],
      "question": "Which aspect is emphasized in the Community Health Nursing curriculum part of the GNM syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "community_health",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing_facilities",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Adequate physical infrastructure and qualified teaching faculty are essential minimum requirements for establishing a School of Nursing.",
      "format": "mcq",
      "id": 367,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) No need for clinical facilities",
        "B) Adequate physical infrastructure and teaching faculty",
        "C) Only theoretical knowledge is sufficient",
        "D) Lack of hostel facilities"
      ],
      "question": "What is one of the minimum requirements for establishing a School of Nursing as per the regulations?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_facilities",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nursing_committee",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "The Nursing Education Committee provided input and feedback during consultations for the revision of the GNM syllabus.",
      "format": "mcq",
      "id": 368,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) They had no involvement",
        "B) They solely created the syllabus",
        "C) They provided input and feedback during consultations",
        "D) They implemented the syllabus without revision"
      ],
      "question": "What role did the Nursing Education Committee play in the revision of the GNM syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_committee",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_assessment",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "cardiac_cycle",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Diastole is the phase of the cardiac cycle during which the heart muscle relaxes and the chambers fill with blood.",
      "format": "mcq",
      "id": 369,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Systole",
        "B) Diastole",
        "C) Isovolumetric contraction",
        "D) Ejection phase"
      ],
      "question": "What is the phase of the cardiac cycle when the heart muscle relaxes and the chambers fill with blood?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cardiac_cycle",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "coronary_artery_disease",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "High cholesterol levels are a significant risk factor for the development of coronary artery disease due to their role in plaque formation.",
      "format": "mcq",
      "id": 370,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Regular physical activity",
        "B) High cholesterol levels",
        "C) Low sodium intake",
        "D) Good hydration"
      ],
      "question": "Which of the following is a major risk factor for developing coronary artery disease?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "coronary_artery_disease",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "arrhythmias",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Atrial fibrillation is characterized by an irregular and often rapid heart rate, which fits the patient\u0027s presentation.",
      "format": "mcq",
      "id": 371,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Atrial fibrillation",
        "B) Sinus tachycardia",
        "C) Ventricular tachycardia",
        "D) Atrial flutter"
      ],
      "question": "A patient presents with a heart rate of 180 beats per minute that is irregular. What is the most likely type of arrhythmia?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "arrhythmias",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "heart_failure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Fatigue is a common symptom of heart failure due to the heart\u0027s reduced ability to pump effectively.",
      "format": "mcq",
      "id": 372,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Increased appetite",
        "B) Fatigue",
        "C) Elevated blood pressure",
        "D) Sudden weight loss"
      ],
      "question": "Which of the following is a common symptom of heart failure?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "heart_failure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "myocardial_infarction",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Myocardial infarction is commonly referred to as a heart attack, where blood flow to a part of the heart is blocked.",
      "format": "mcq",
      "id": 373,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Stroke",
        "B) Heart attack",
        "C) Angina",
        "D) Arrhythmia"
      ],
      "question": "What is myocardial infarction commonly known as?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "myocardial_infarction",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "blood_pressure",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "The normal range for systolic blood pressure in adults is typically considered to be 90-120 mmHg.",
      "format": "mcq",
      "id": 374,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) 90-120 mmHg",
        "B) 120-139 mmHg",
        "C) 130-150 mmHg",
        "D) 150-180 mmHg"
      ],
      "question": "What is the normal range for systolic blood pressure in adults?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "blood_pressure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "ventricular_hypertrophy",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Left ventricular hypertrophy can lead to decreased cardiac output due to the heart\u0027s reduced ability to fill properly and pump effectively.",
      "format": "mcq",
      "id": 375,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Decreased cardiac output",
        "B) Increased stroke volume",
        "C) Improved exercise tolerance",
        "D) Enhanced coronary perfusion"
      ],
      "question": "What is the physiological consequence of left ventricular hypertrophy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ventricular_hypertrophy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "peripheral_vascular_disease",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Leg pain during exercise, known as claudication, is a classic symptom of peripheral vascular disease due to reduced blood flow.",
      "format": "mcq",
      "id": 376,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Chest pain",
        "B) Leg pain during exercise",
        "C) Shortness of breath",
        "D) Palpitations"
      ],
      "question": "Which symptom is commonly associated with peripheral vascular disease?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "peripheral_vascular_disease",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_cardiovascular",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_foundations",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Nursing foundations primarily teach basic nursing skills necessary for competent patient care.",
      "format": "mcq",
      "id": 377,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Advanced pharmacology",
        "B) Basic nursing skills",
        "C) Clinical research",
        "D) Community health policies"
      ],
      "question": "What is the primary focus of nursing foundations in the GNM curriculum?",
      "source": "INC GNM Syllabus",
      "source_section": "nursing_foundations",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "first_aid",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "First aid focuses on providing immediate care to stabilize a patient before further medical help can be obtained.",
      "format": "mcq",
      "id": 378,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Diagnosis of disease",
        "B) Immediate care for injuries",
        "C) Long-term patient treatment",
        "D) Surgical intervention"
      ],
      "question": "Which of the following is a key component of first aid?",
      "source": "INC GNM Syllabus",
      "source_section": "first_aid",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "community_health",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The primary role of a community health nurse is to educate the community about health practices and promote healthy behaviors.",
      "format": "mcq",
      "id": 379,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Conducting surgeries",
        "B) Educating the community on health practices",
        "C) Performing complex diagnostic tests",
        "D) Distributing medications"
      ],
      "question": "In a community health nursing setting, what is the nurse\u0027s primary role?",
      "source": "INC GNM Syllabus",
      "source_section": "community_health",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "anatomy",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "The small intestine is the main site for nutrient absorption due to its extensive surface area and villi.",
      "format": "mcq",
      "id": 380,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Stomach",
        "B) Large intestine",
        "C) Small intestine",
        "D) Esophagus"
      ],
      "question": "Which anatomical structure is primarily involved in nutrient absorption in the gastrointestinal tract?",
      "source": "INC GNM Syllabus",
      "source_section": "anatomy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "microbiology",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Staphylococcus aureus, Escherichia coli, and Salmonella are all known to cause foodborne illnesses.",
      "format": "mcq",
      "id": 381,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Staphylococcus aureus",
        "B) Escherichia coli",
        "C) Salmonella",
        "D) All of the above"
      ],
      "question": "Which microorganism is commonly responsible for foodborne illnesses?",
      "source": "INC GNM Syllabus",
      "source_section": "microbiology",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "sociology",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Sociology studies social behaviors and interactions, which are essential for understanding patient care within communities.",
      "format": "mcq",
      "id": 382,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) Human anatomy",
        "B) Social behaviors and interactions",
        "C) Microbial pathogens",
        "D) Nutritional guidelines"
      ],
      "question": "What does sociology primarily study in the context of nursing?",
      "source": "INC GNM Syllabus",
      "source_section": "sociology",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "psychology",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Understanding psychology aids nurses in interpreting patient behaviors and emotions, enhancing patient care.",
      "format": "mcq",
      "id": 383,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) It eliminates the need for physical assessments.",
        "B) It helps in understanding patient behaviors and emotions.",
        "C) It focuses solely on medications.",
        "D) It is unrelated to nursing."
      ],
      "question": "How does understanding psychology benefit nursing practice?",
      "source": "INC GNM Syllabus",
      "source_section": "psychology",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "regulations",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The Indian Nursing Council\u0027s regulations aim to establish uniform standards for nursing education, ensuring quality training.",
      "format": "mcq",
      "id": 384,
      "last_reviewed": "2026-06-29",
      "options": [
        "A) To limit the number of nursing schools",
        "B) To establish uniform standards for nursing education",
        "C) To increase tuition fees",
        "D) To promote only theoretical knowledge"
      ],
      "question": "What is the primary purpose of the Indian Nursing Council\u0027s regulations for nursing education?",
      "source": "INC GNM Syllabus",
      "source_section": "regulations",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_gi",
      "verification_status": "reviewed",
      "verified_at": "2026-06-29",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "neuroanatomy",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The cerebellum is primarily responsible for balance and coordination of movement.",
      "format": "mcq",
      "id": 385,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Cerebrum",
        "B) Cerebellum",
        "C) Brainstem",
        "D) Limbic system"
      ],
      "question": "Which part of the brain is responsible for regulating balance and coordination?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "neuroanatomy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "neurological_assessment",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "A neurological assessment evaluates cognitive and motor functions to assess brain health.",
      "format": "mcq",
      "id": 386,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Respiratory function",
        "B) Cardiovascular health",
        "C) Cognitive and motor function",
        "D) Gastrointestinal activity"
      ],
      "question": "What does a neurological assessment primarily evaluate?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "neurological_assessment",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "spinal_cord_injury",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Patients with a spinal cord injury at T6 typically experience loss of bladder control due to disrupted nerve signals.",
      "format": "mcq",
      "id": 387,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Loss of bladder control",
        "B) Increased upper limb strength",
        "C) Improved lower limb sensation",
        "D) Enhanced respiratory function"
      ],
      "question": "In a patient with a spinal cord injury at the T6 level, which symptom would be expected?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "spinal_cord_injury",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "meningitis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "A stiff neck is a classic symptom of meningitis due to inflammation of the meninges.",
      "format": "mcq",
      "id": 388,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Peripheral edema",
        "B) Stiff neck",
        "C) Sudden weight loss",
        "D) Abdominal pain"
      ],
      "question": "Which symptom is most commonly associated with meningitis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "meningitis",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "dementia",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Memory loss that affects daily activities is one of the earliest signs of dementia.",
      "format": "mcq",
      "id": 389,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Frequent headaches",
        "B) Memory loss affecting daily life",
        "C) Unexplained weight gain",
        "D) Increased energy levels"
      ],
      "question": "What is a common early sign of dementia?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "dementia",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "alzheimer",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Reassuring the patient and speaking calmly helps to ease anxiety and confusion.",
      "format": "mcq",
      "id": 390,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Administer antipsychotic medication",
        "B) Reassure the patient and speak calmly",
        "C) Document the behavior in the chart",
        "D) Call the physician immediately"
      ],
      "question": "During a shift, a nurse notices that an elderly patient with Alzheimer\u0027s disease is unable to recognize familiar faces. What should the nurse do first?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "alzheimer",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "parkinson",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Increased muscle tone, also known as rigidity, is a hallmark symptom of Parkinson\u0027s disease.",
      "format": "mcq",
      "id": 391,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Increased muscle tone",
        "B) Sudden weight loss",
        "C) Intense thirst",
        "D) Hyperactivity"
      ],
      "question": "What is a characteristic symptom of Parkinson\u0027s disease?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "parkinson",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "epilepsy",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "An MRI of the brain is appropriate to identify structural causes of recurrent seizures.",
      "format": "mcq",
      "id": 392,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) MRI of the brain",
        "B) Electrocardiogram (ECG)",
        "C) Chest X-ray",
        "D) Complete blood count (CBC)"
      ],
      "question": "A patient presents with a history of recurrent seizures. What diagnostic test would be most appropriate to evaluate the underlying cause?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "epilepsy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "treatment_stroke",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Initiating intravenous thrombolysis is critical to dissolve a clot in ischemic stroke cases.",
      "format": "mcq",
      "id": 393,
      "last_reviewed": "2023-10-03",
      "options": [
        "A) Administer aspirin",
        "B) Begin intravenous thrombolysis",
        "C) Perform a CT scan",
        "D) Start oxygen therapy"
      ],
      "question": "A patient arrives at the emergency department with signs of a stroke. What is the most critical intervention that the nurse should initiate?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "treatment_stroke",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_neuro",
      "verification_status": "reviewed",
      "verified_at": "2023-10-03",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "patient_care",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Nurses primarily administer medications and monitor patients during chemotherapy.",
      "format": "mcq",
      "id": 394,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Administering medication",
        "B) Performing surgery",
        "C) Diagnosing cancer",
        "D) Counseling on financial matters"
      ],
      "question": "What is the primary role of a nurse in caring for a patient undergoing chemotherapy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "patient_care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "chemotherapy_side_effects",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Hair loss is a well-documented side effect of many chemotherapy drugs.",
      "format": "mcq",
      "id": 395,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Weight gain",
        "B) Hair loss",
        "C) Increased energy",
        "D) Enhanced vision"
      ],
      "question": "Which of the following is a common side effect of chemotherapy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "chemotherapy_side_effects",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "patient_education",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "High-fiber foods can help manage gastrointestinal side effects associated with chemotherapy.",
      "format": "mcq",
      "id": 396,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) High-fiber foods",
        "B) Sugary snacks",
        "C) High-sodium foods",
        "D) Processed meats"
      ],
      "question": "A nurse is educating a patient about dietary modifications during chemotherapy. Which food group should they emphasize?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "patient_education",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "supportive_care",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Palliative care focuses on providing relief from symptoms and stress of cancer treatment.",
      "format": "mcq",
      "id": 397,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Palliative care",
        "B) Preventive care",
        "C) Emergency care",
        "D) Surgical care"
      ],
      "question": "Which type of care is provided alongside chemotherapy to alleviate symptoms?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "supportive_care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nursing_interventions",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Offering anti-nausea medication helps to alleviate the patient\u0027s discomfort effectively.",
      "format": "mcq",
      "id": 398,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Encourage the patient to eat large meals",
        "B) Offer anti-nausea medication as prescribed",
        "C) Suggest vigorous exercise",
        "D) Ignore the complaint"
      ],
      "question": "A patient receiving chemotherapy reports nausea. What is the best nursing intervention?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_interventions",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "radiation_therapy",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Radiation therapy is primarily used to shrink tumors and kill cancer cells.",
      "format": "mcq",
      "id": 399,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To treat infections",
        "B) To shrink tumors",
        "C) To enhance appetite",
        "D) To improve circulation"
      ],
      "question": "What is the purpose of radiation therapy in oncology?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "radiation_therapy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "psychosocial_support",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Emotional reassurance is crucial for helping patients cope with their diagnosis and treatment.",
      "format": "mcq",
      "id": 400,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Isolation from family",
        "B) Emotional reassurance",
        "C) Avoiding discussions about cancer",
        "D) Limiting social interactions"
      ],
      "question": "What is an important aspect of psychosocial support for cancer patients?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "psychosocial_support",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "nursing_documentation",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Accurate documentation ensures continuity of care and effective communication among healthcare providers.",
      "format": "mcq",
      "id": 401,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) It helps in billing",
        "B) It ensures care continuity",
        "C) It is required by law only",
        "D) It can be ignored if time-constrained"
      ],
      "question": "Why is accurate documentation essential in oncology nursing?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_documentation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "symptom_management",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Assessing the pain level is crucial to determine the appropriate intervention for pain management.",
      "format": "mcq",
      "id": 402,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Assess the pain level using a scale",
        "B) Wait to see if the pain decreases",
        "C) Offer a snack to distract the patient",
        "D) Increase the light in the room"
      ],
      "question": "A nurse observes a patient is experiencing severe pain after chemotherapy. What should be the nurse\u0027s priority action?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "symptom_management",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "end_of_life_care",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Prioritizing the family\u0027s needs is essential in providing holistic end-of-life care for cancer patients.",
      "format": "mcq",
      "id": 403,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Focus solely on physical symptoms",
        "B) Prioritize the family\u0027s needs",
        "C) Avoid discussing death",
        "D) Minimize emotional support"
      ],
      "question": "In end-of-life care for a cancer patient, what is a key consideration for the nurse?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "end_of_life_care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_oncology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "post-op care",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Patient comfort is a primary focus in post-operative care to aid recovery.",
      "format": "mcq",
      "id": 404,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Patient comfort",
        "B) Financial assessment",
        "C) Dietary preferences",
        "D) Family counseling"
      ],
      "question": "What is an essential focus of post-operative care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "post-op care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pre-op assessment",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "A patient\u0027s medical history is crucial for assessing risks before surgery.",
      "format": "mcq",
      "id": 405,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Post-operative pain management plan",
        "B) Patient\u0027s medical history",
        "C) Family\u0027s financial situation",
        "D) Future medication prescriptions"
      ],
      "question": "What should be included in the pre-operative assessment?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pre-op assessment",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "anesthesia",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "General anesthesia induces complete unconsciousness and loss of sensation throughout the body.",
      "format": "mcq",
      "id": 406,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Local anesthesia",
        "B) Regional anesthesia",
        "C) General anesthesia",
        "D) Sedation"
      ],
      "question": "Which type of anesthesia provides complete unconsciousness?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "anesthesia",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "post-op complications",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "A fever post-surgery can indicate a potential infection, which needs to be investigated.",
      "format": "mcq",
      "id": 407,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Normal response to surgery",
        "B) Infection",
        "C) Allergic reaction",
        "D) Pain medication side effect"
      ],
      "question": "A patient develops a fever 24 hours after surgery. What is the most likely cause?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "post-op complications",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "NPO guidelines",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "NPO stands for \u0027Nothing per os\u0027, indicating that a patient should not consume anything by mouth.",
      "format": "mcq",
      "id": 408,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Nothing per os",
        "B) Null per os",
        "C) No prior observation",
        "D) Needs pre-op observation"
      ],
      "question": "What does NPO stand for in the context of pre-operative care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "NPO guidelines",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "post-op monitoring",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The nurse should first assess the patient\u0027s pulse to determine the severity of the situation.",
      "format": "mcq",
      "id": 409,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Notify the physician",
        "B) Administer IV fluids",
        "C) Assess the patient\u2019s pulse",
        "D) Check the surgical site"
      ],
      "question": "After surgery, a patient is observed to have a drop in blood pressure. What should the nurse do first?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "post-op monitoring",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "informed consent",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Informed consent ensures that the patient understands the risks and benefits of the surgery.",
      "format": "mcq",
      "id": 410,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) To prepare the surgical team",
        "B) To ensure patient understanding of risks",
        "C) To document the procedure",
        "D) To schedule the surgery"
      ],
      "question": "What is the primary purpose of obtaining informed consent before surgery?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "informed consent",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "post-op complications",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Deep vein thrombosis is a significant risk following abdominal surgery due to decreased mobility.",
      "format": "mcq",
      "id": 411,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Urinary retention",
        "B) Cardiac arrest",
        "C) Deep vein thrombosis",
        "D) Fever"
      ],
      "question": "Which post-operative complication should be monitored for following abdominal surgery?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "post-op complications",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "discharge planning",
      "context": "scenario",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "All of these elements are crucial for safe recovery and follow-up care post-surgery.",
      "format": "mcq",
      "id": 412,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Follow-up appointment schedule",
        "B) Medication side effects",
        "C) Dietary restrictions",
        "D) All of the above"
      ],
      "question": "A nurse is preparing for a patient\u2019s discharge after surgery. What is most important to include in discharge teaching?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "discharge planning",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "post-op pain management",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "All these methods are commonly used to manage post-operative pain effectively.",
      "format": "mcq",
      "id": 413,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Intravenous fluids only",
        "B) Oral analgesics",
        "C) Ice packs application",
        "D) All of the above"
      ],
      "question": "Which method is commonly used for managing post-operative pain?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "post-op pain management",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_pre_post_op",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "chronic_kidney_disease",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Diabetes mellitus is one of the leading causes of chronic kidney disease due to prolonged high blood sugar levels damaging the kidneys.",
      "format": "mcq",
      "id": 414,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Diabetes mellitus",
        "B) Acute urinary infection",
        "C) Rapid dehydration",
        "D) Gastroenteritis"
      ],
      "question": "What is a common cause of chronic kidney disease (CKD)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "chronic_kidney_disease",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "acute_kidney_injury",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Increased blood urea nitrogen (BUN) is a common laboratory finding in acute kidney injury, indicating impaired kidney function.",
      "format": "mcq",
      "id": 415,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Decreased serum creatinine",
        "B) Increased blood urea nitrogen (BUN)",
        "C) Elevated hemoglobin levels",
        "D) Normal electrolyte levels"
      ],
      "question": "Which laboratory finding is most indicative of acute kidney injury (AKI)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "acute_kidney_injury",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "renal_disease_symptoms",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Swelling in the feet and ankles is a common symptom of renal disease due to fluid retention.",
      "format": "mcq",
      "id": 416,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Increased appetite",
        "B) Frequent headaches",
        "C) Swelling in the feet and ankles",
        "D) Healthy skin appearance"
      ],
      "question": "Which symptom is commonly associated with renal disease?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal_disease_symptoms",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "renal_function_tests",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "A urinalysis is primarily used to diagnose urinary tract infections and assess various conditions affecting the kidneys.",
      "format": "mcq",
      "id": 417,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) To diagnose urinary tract infections",
        "B) To measure kidney size",
        "C) To assess blood pressure",
        "D) To determine blood sugar levels"
      ],
      "question": "What is the primary purpose of a urinalysis?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal_function_tests",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "kidney_stones",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Severe flank pain and hematuria are classic symptoms of kidney stones due to obstruction in the urinary tract.",
      "format": "mcq",
      "id": 418,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Chronic kidney disease",
        "B) Kidney stones",
        "C) Glomerulonephritis",
        "D) Urinary tract infection"
      ],
      "question": "A patient presents with severe flank pain and hematuria. What condition should be suspected?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "kidney_stones",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "renal_disease_treatment",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Kidney transplantation is usually the most definitive treatment for end-stage renal disease as it can restore normal kidney function.",
      "format": "mcq",
      "id": 419,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Increased fluid intake",
        "B) Kidney transplantation",
        "C) Antibiotic therapy",
        "D) Pain management only"
      ],
      "question": "Which treatment is most appropriate for a patient with end-stage renal disease?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal_disease_treatment",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "renal_disease_diet",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "A low-sodium diet helps manage blood pressure and fluid retention in chronic kidney disease patients.",
      "format": "mcq",
      "id": 420,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) High protein diet",
        "B) Low-sodium diet",
        "C) Increased sugar intake",
        "D) High potassium foods"
      ],
      "question": "What dietary modification is often recommended for patients with chronic kidney disease?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal_disease_diet",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "renal_failure_management",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Administering prescribed medications and closely monitoring the patient\u0027s condition is critical in managing acute renal failure.",
      "format": "mcq",
      "id": 421,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Encourage increased fluid intake immediately",
        "B) Administer prescribed medications and monitor closely",
        "C) Suggest dietary modifications without consulting a doctor",
        "D) Provide comfort measures only"
      ],
      "question": "How should a nurse respond to a patient showing signs of acute renal failure?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal_failure_management",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "renal_transplant",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Graft rejection is a primary concern after a kidney transplant due to the body\u0027s immune response against the new organ.",
      "format": "mcq",
      "id": 422,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Weight gain",
        "B) Graft rejection",
        "C) High blood sugar",
        "D) Skin rashes"
      ],
      "question": "What is a primary concern following a kidney transplant?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "renal_transplant",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_renal",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "asthma",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Asthma is characterized by airway inflammation and obstruction, leading to difficulty in breathing.",
      "format": "mcq",
      "id": 423,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Increased lung volume",
        "B) Airway inflammation and obstruction",
        "C) Bronchial dilation",
        "D) Alveolar wall thickening"
      ],
      "question": "What is the primary pathophysiological change observed in asthma?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "asthma",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "pneumonia",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Streptococcus pneumoniae is the most common organism responsible for community-acquired pneumonia.",
      "format": "mcq",
      "id": 424,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Mycobacterium tuberculosis",
        "B) Streptococcus pneumoniae",
        "C) Staphylococcus aureus",
        "D) Pseudomonas aeruginosa"
      ],
      "question": "Which of the following is a common cause of community-acquired pneumonia?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pneumonia",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "copd",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "COPD is characterized by irreversible airflow limitation, unlike asthma which is often reversible.",
      "format": "mcq",
      "id": 425,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Progressive airflow limitation",
        "B) Increased mucus production",
        "C) Reversible airway obstruction",
        "D) Chronic respiratory inflammation"
      ],
      "question": "Which of the following is NOT a typical characteristic of Chronic Obstructive Pulmonary Disease (COPD)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "copd",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "spirometry",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Spirometry measures lung volumes and airflow, which are essential for diagnosing respiratory conditions.",
      "format": "mcq",
      "id": 426,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Blood gas levels",
        "B) Lung volumes and airflow",
        "C) Oxygen saturation",
        "D) Respiratory rate"
      ],
      "question": "What does spirometry primarily measure?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "spirometry",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "pulmonary_embolism",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Sudden onset of dyspnea is a classic symptom of pulmonary embolism, indicating a blockage in the pulmonary artery.",
      "format": "mcq",
      "id": 427,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Elevated blood pressure",
        "B) Sudden onset of dyspnea",
        "C) Fever and chills",
        "D) Productive cough"
      ],
      "question": "Which of the following findings is most indicative of a pulmonary embolism?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pulmonary_embolism",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pleural_effusion",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Shortness of breath is the primary clinical manifestation of pleural effusion due to restricted lung expansion.",
      "format": "mcq",
      "id": 428,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Chest pain",
        "B) Hemoptysis",
        "C) Shortness of breath",
        "D) Stridor"
      ],
      "question": "What is the primary clinical manifestation of pleural effusion?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pleural_effusion",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "lung_cancer",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Exposure to asbestos is a significant risk factor for developing lung cancer, particularly in occupational settings.",
      "format": "mcq",
      "id": 429,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Low-fat diet",
        "B) Non-smoker",
        "C) Exposure to asbestos",
        "D) Regular exercise"
      ],
      "question": "Which of the following is a common risk factor for lung cancer?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "lung_cancer",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "ventilation",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The primary purpose of mechanical ventilation is to ensure adequate gas exchange for patients with respiratory failure.",
      "format": "mcq",
      "id": 430,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Increase blood pressure",
        "B) Ensure adequate gas exchange",
        "C) Decrease heart rate",
        "D) Promote gastric emptying"
      ],
      "question": "What is the primary purpose of mechanical ventilation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ventilation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "medical_surgical",
      "telugu_hint": null,
      "topic_id": "ms_respiratory",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_standards",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The Indian Nursing Council\u0027s main function is to establish uniform standards of nursing education for nursing personnel.",
      "format": "mcq",
      "id": 431,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Provide patient care",
        "B) Establish uniform standards of nursing education",
        "C) Conduct nursing examinations",
        "D) Provide financial support to nursing schools"
      ],
      "question": "What is the primary function of the Indian Nursing Council?",
      "source": "Indian Nursing Council GNM Syllabus",
      "source_section": "nursing_standards",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "curriculum_changes",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The revised curriculum reduced the duration of the GNM program from 3 \u00bd years to 3 years.",
      "format": "mcq",
      "id": 432,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Increased to 4 years",
        "B) Remained the same at 3 \u00bd years",
        "C) Reduced to 3 years",
        "D) Extended to 5 years"
      ],
      "question": "What significant change was made to the duration of the GNM program in the revised curriculum?",
      "source": "Indian Nursing Council GNM Syllabus",
      "source_section": "curriculum_changes",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "curriculum_structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The curriculum facilitates teachers by integrating theory and practical components, which helps guide the implementation of the course.",
      "format": "mcq",
      "id": 433,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) By reducing the number of hours required",
        "B) By integrating theory and practical components",
        "C) By allowing more flexibility in teaching methods",
        "D) By eliminating assessments"
      ],
      "question": "How does the revised GNM curriculum facilitate teachers in implementing the course?",
      "source": "Indian Nursing Council GNM Syllabus",
      "source_section": "curriculum_structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "nursing_practice",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Community health nursing practical components focus on the assessment of community needs to provide appropriate care.",
      "format": "mcq",
      "id": 434,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Hospital-based care",
        "B) Home care only",
        "C) Assessment of community needs",
        "D) Administrative tasks"
      ],
      "question": "Which of the following best describes the focus during the community health nursing practical components?",
      "source": "Indian Nursing Council GNM Syllabus",
      "source_section": "nursing_practice",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_foundations",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The nursing foundations course includes fundamentals of nursing and first aid, which are essential for nursing practice.",
      "format": "mcq",
      "id": 435,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Advanced surgical techniques",
        "B) Fundamentals of nursing and first aid",
        "C) Social media management",
        "D) Marketing strategies"
      ],
      "question": "What is included in the nursing foundations course of the GNM program?",
      "source": "Indian Nursing Council GNM Syllabus",
      "source_section": "nursing_foundations",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "practical_requirements",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Detailing practical requirements in the syllabus helps streamline the teaching process and ensures all necessary skills are covered.",
      "format": "mcq",
      "id": 436,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To confuse students",
        "B) To streamline the teaching process",
        "C) To limit hands-on experience",
        "D) To reduce course content"
      ],
      "question": "What is the purpose of detailing practical requirements in the GNM syllabus?",
      "source": "Indian Nursing Council GNM Syllabus",
      "source_section": "practical_requirements",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "assessment_methods",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The revised curriculum incorporates diverse evaluation strategies to assess students\u0027 understanding and skills effectively.",
      "format": "mcq",
      "id": 437,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) By removing all written assessments",
        "B) By incorporating diverse evaluation strategies",
        "C) By allowing only practical exams",
        "D) By standardizing all assessments to one format"
      ],
      "question": "How does the revised GNM curriculum improve assessment methods for nursing students?",
      "source": "Indian Nursing Council GNM Syllabus",
      "source_section": "assessment_methods",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "objectives_of_nursing",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The primary objective in a community health setting is to promote overall health and well-being of the community members.",
      "format": "mcq",
      "id": 438,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Focus solely on medical treatment",
        "B) Promote overall health and well-being",
        "C) Limit patient interaction",
        "D) Conduct only assessments"
      ],
      "question": "What should be a nurse\u0027s primary objective during patient care in a community health setting?",
      "source": "Indian Nursing Council GNM Syllabus",
      "source_section": "objectives_of_nursing",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_concepts",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "anxiety",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Muscle tension is a common physical symptom associated with anxiety disorders.",
      "format": "mcq",
      "id": 439,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Weight gain",
        "B) Muscle tension",
        "C) Increased energy",
        "D) Euphoria"
      ],
      "question": "What is a common physical manifestation of anxiety disorders?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "anxiety",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "bipolar_disorder",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Euphoric mood is a hallmark of the manic episodes seen in bipolar disorder.",
      "format": "mcq",
      "id": 440,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Persistent sadness",
        "B) Euphoric mood",
        "C) Total lack of energy",
        "D) Avoidance of social situations"
      ],
      "question": "Which of the following episodes is characteristic of bipolar disorder?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bipolar_disorder",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "ptsd",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Avoidance of reminders of the traumatic event is a significant symptom of PTSD.",
      "format": "mcq",
      "id": 441,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Hallucinations",
        "B) Avoidance of reminders of the trauma",
        "C) Compulsive behavior",
        "D) Elevated mood"
      ],
      "question": "What is a key symptom of Post-Traumatic Stress Disorder (PTSD)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ptsd",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "ocd",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Excessive cleanliness is a typical compulsive behavior experienced by individuals with OCD.",
      "format": "mcq",
      "id": 442,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Excessive cleanliness",
        "B) Constant talking",
        "C) Social withdrawal",
        "D) Memory loss"
      ],
      "question": "Which of the following is a common compulsive behavior in Obsessive-Compulsive Disorder (OCD)?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ocd",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "eating_disorders",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Excessive exercise is a common behavior among individuals with Anorexia Nervosa, often to lose weight.",
      "format": "mcq",
      "id": 443,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Binge eating",
        "B) Self-induced vomiting",
        "C) Excessive exercise",
        "D) Frequent snacking"
      ],
      "question": "Which behavior is commonly associated with Anorexia Nervosa?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "eating_disorders",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "schizophrenia",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Avolition, or lack of motivation, is a negative symptom often seen in schizophrenia.",
      "format": "mcq",
      "id": 444,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Hallucinations",
        "B) Delusions",
        "C) Avolition",
        "D) Disorganized speech"
      ],
      "question": "What is a common negative symptom of schizophrenia?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "schizophrenia",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "personality_disorders",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Intense emotional swings are a hallmark of Borderline Personality Disorder.",
      "format": "mcq",
      "id": 445,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Stable relationships",
        "B) Intense emotional swings",
        "C) Consistent self-image",
        "D) Lack of impulsivity"
      ],
      "question": "Which of the following is a characteristic of Borderline Personality Disorder?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "personality_disorders",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "substance_use",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Long-term substance abuse can lead to an increased risk of anxiety disorders.",
      "format": "mcq",
      "id": 446,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Heightened concentration",
        "B) Improved mood",
        "C) Increased risk of anxiety disorders",
        "D) Enhanced memory retention"
      ],
      "question": "What is a potential psychological effect of long-term substance abuse?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "substance_use",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "gambling_disorder",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Lying about gambling habits is a common sign of gambling disorder, indicating a lack of honesty about the addiction.",
      "format": "mcq",
      "id": 447,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Playing without financial consequences",
        "B) Frequent social gatherings",
        "C) Lying about gambling habits",
        "D) Enjoying the thrill of winning"
      ],
      "question": "Which of the following is a sign of gambling disorder?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "gambling_disorder",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_disorders",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "mental_health_introduction",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "The Indian Nursing Council (INC) is the statutory body for establishing standards of nursing education in India.",
      "format": "mcq",
      "id": 448,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Indian Nursing Council",
        "B) World Health Organization",
        "C) Ministry of Health and Family Welfare",
        "D) National Nursing Association"
      ],
      "question": "Which body is responsible for establishing uniform standards of nursing education in India?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "mental_health_introduction",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "program_duration",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The duration of the General Nursing and Midwifery training programme has been revised to 3 years.",
      "format": "mcq",
      "id": 449,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) 2 years",
        "B) 3 years",
        "C) 3 \u00bd years",
        "D) 4 years"
      ],
      "question": "What is the new duration of the General Nursing and Midwifery training programme as per the revised syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "program_duration",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "curriculum_format",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The revised curriculum format now includes detailed course descriptions and learning objectives.",
      "format": "mcq",
      "id": 450,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Elimination of practical training",
        "B) Inclusion of course description and objectives",
        "C) Extension of course duration",
        "D) No changes were made"
      ],
      "question": "What was a significant change in the format of the revised nursing curriculum?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum_format",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "practical_requirements",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The integration of internships within the 3-year course allows for practical experience, contributing to effective teaching.",
      "format": "mcq",
      "id": 451,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) By eliminating practical components",
        "B) By integrating internship within the course",
        "C) By reducing theoretical hours",
        "D) By increasing the number of examinations"
      ],
      "question": "How does the revised nursing curriculum ensure effective teaching?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "practical_requirements",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_objectives",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The revised syllabus aims to prepare nurses to provide qualitative nursing care in hospitals and communities.",
      "format": "mcq",
      "id": 452,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) To increase the teaching staff",
        "B) To prepare nurses for qualitative nursing care",
        "C) To shorten the internship duration",
        "D) To reduce the number of subjects"
      ],
      "question": "What is one of the main objectives of the revised nursing syllabus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_objectives",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "clinical_facilities",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "The curriculum emphasizes clinical facilities through detailed descriptions, aiding in practical skill development.",
      "format": "mcq",
      "id": 453,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Clinical facilities",
        "B) Theoretical knowledge only",
        "C) Extracurricular activities",
        "D) Online learning modules"
      ],
      "question": "What aspect of nursing education does the curriculum emphasize through clear descriptions?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "clinical_facilities",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nursing_regulations",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The guidelines and minimum requirements are established to ensure uniform standards of nursing education across institutions.",
      "format": "mcq",
      "id": 454,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) To reduce student enrollment",
        "B) To ensure uniformity in nursing education",
        "C) To minimize teaching resources",
        "D) To eliminate practical training"
      ],
      "question": "What is the purpose of the guidelines and minimum requirements established by the INC?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_regulations",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "anti_ragging",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The syllabus includes an anti-ragging policy to protect students and ensure a safe educational environment.",
      "format": "mcq",
      "id": 455,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Grading system",
        "B) Anti-ragging",
        "C) Attendance requirements",
        "D) Uniform policy"
      ],
      "question": "What policy has been addressed in the nursing syllabus to ensure student safety?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "anti_ragging",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nursing_faculty",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The nursing teaching faculty is required to have higher education and relevant experience in the field of nursing.",
      "format": "mcq",
      "id": 456,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) No specific qualifications",
        "B) Higher education and experience in nursing",
        "C) Only part-time instructors allowed",
        "D) No need for practical experience"
      ],
      "question": "What is a requirement for the nursing teaching faculty as per the curriculum?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nursing_faculty",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "admissions",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The curriculum outlines specific admission terms and conditions that are based on academic performance.",
      "format": "mcq",
      "id": 457,
      "last_reviewed": "2023-10-09",
      "options": [
        "A) Open admissions for everyone",
        "B) Selective criteria based on academic performance",
        "C) No admissions allowed",
        "D) Admissions based only on financial status"
      ],
      "question": "What does the nursing curriculum specify regarding admission terms?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "admissions",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "mental_health",
      "telugu_hint": null,
      "topic_id": "mh_psychiatric",
      "verification_status": "reviewed",
      "verified_at": "2023-10-09",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "microbial_growth",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Temperature is a critical factor affecting microbial metabolism and reproduction.",
      "format": "mcq",
      "id": 458,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Light",
        "B) Temperature",
        "C) Pressure",
        "D) Sound"
      ],
      "question": "What is the primary factor that influences microbial growth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "microbial_growth",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "antiseptics",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Penicillin is an antibiotic, not an antiseptic, as it specifically targets bacteria rather than acting on all microbes on the skin.",
      "format": "mcq",
      "id": 459,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Iodine",
        "B) Ethanol",
        "C) Hydrogen Peroxide",
        "D) Penicillin"
      ],
      "question": "Which of the following is not considered an antiseptic?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antiseptics",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "infection_control",
      "context": "scenario",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Cleaning hands with soap and water is the most effective practice in infection control prior to any procedure.",
      "format": "mcq",
      "id": 460,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Using antiseptic wipes on surfaces",
        "B) Wearing gloves during the procedure",
        "C) Cleaning hands with soap and water",
        "D) Using a mask"
      ],
      "question": "A nurse is preparing an area for a surgical procedure. Which practice is most effective in controlling potential infection?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "infection_control",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "disinfection_techniques",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Sodium Hypochlorite is widely used as a disinfectant due to its effectiveness against a broad spectrum of pathogens.",
      "format": "mcq",
      "id": 461,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Vinegar",
        "B) Sodium Hypochlorite",
        "C) Rubbing Alcohol",
        "D) Glycerin"
      ],
      "question": "Which chemical is commonly used as a disinfectant in healthcare settings?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "disinfection_techniques",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "biosafety",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The primary goal of biosafety is to prevent the spread of infections to both healthcare workers and patients.",
      "format": "mcq",
      "id": 462,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To protect the environment",
        "B) To ensure staff safety",
        "C) To prevent infection spread",
        "D) To minimize costs"
      ],
      "question": "What is the primary goal of biosafety in a healthcare facility?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "biosafety",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "antibiotics",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Ceftriaxone is a broad-spectrum antibiotic effective against many Gram-negative bacteria.",
      "format": "mcq",
      "id": 463,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Penicillin",
        "B) Vancomycin",
        "C) Ceftriaxone",
        "D) Bacitracin"
      ],
      "question": "Which of the following antibiotics is effective against Gram-negative bacteria?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antibiotics",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "infection_prevention",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Isolation of confirmed cases is critical in preventing further spread during a pandemic.",
      "format": "mcq",
      "id": 464,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Isolation of confirmed cases",
        "B) Increased patient visitation",
        "C) Relaxation of hand hygiene protocols",
        "D) Routine cleaning of all surfaces"
      ],
      "question": "During a pandemic, which infection prevention strategy should be prioritized in a healthcare setting?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "infection_prevention",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "sanitation",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 1,
      "explanation": "Sanitation encompasses cleaning, waste disposal, and measures to prevent disease transmission.",
      "format": "mcq",
      "id": 465,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Cleaning with soap and water",
        "B) Disposal of waste",
        "C) Prevention of disease transmission",
        "D) All of the above"
      ],
      "question": "What is the meaning of sanitation in the context of healthcare?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sanitation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "sterilization_techniques",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Autoclaving is the most effective sterilization method for surgical instruments, utilizing steam under pressure.",
      "format": "mcq",
      "id": 466,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Dry heat",
        "B) Autoclaving",
        "C) Ethylene oxide gas",
        "D) Boiling water"
      ],
      "question": "What is the most effective method of sterilization for surgical instruments?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sterilization_techniques",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_control",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "live_attentuated",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Live attenuated vaccines closely mimic natural infections, eliciting a strong immune response.",
      "format": "mcq",
      "id": 467,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) They contain killed pathogens",
        "B) They require multiple doses for immunity",
        "C) They stimulate a strong immune response similar to natural infection",
        "D) They are safe for immunocompromised individuals"
      ],
      "question": "What is a characteristic of live attenuated vaccines?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "live_attentuated",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "inactivated_vaccines",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "The polio vaccine is an example of an inactivated (killed) vaccine.",
      "format": "mcq",
      "id": 468,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Polio vaccine",
        "B) MMR vaccine",
        "C) Varicella vaccine",
        "D) Yellow fever vaccine"
      ],
      "question": "Which of the following is an example of an inactivated vaccine?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "inactivated_vaccines",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "herd_immunity",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Herd immunity occurs when a sufficient portion of the population is immune, reducing disease spread and protecting those who are unvaccinated.",
      "format": "mcq",
      "id": 469,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) By ensuring everyone gets vaccinated",
        "B) By decreasing the overall presence of the disease in the community",
        "C) By providing lifetime immunity to the unvaccinated",
        "D) By allowing the disease to spread more easily"
      ],
      "question": "How does herd immunity protect unvaccinated individuals?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "herd_immunity",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "vaccine_storage",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Most vaccines should be stored within the 0\u00b0C to 5\u00b0C range to maintain their efficacy.",
      "format": "mcq",
      "id": 470,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) -20\u00b0C to -10\u00b0C",
        "B) 0\u00b0C to 5\u00b0C",
        "C) 10\u00b0C to 15\u00b0C",
        "D) 20\u00b0C to 25\u00b0C"
      ],
      "question": "What is the recommended storage temperature range for most vaccines?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vaccine_storage",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "adverse_effects",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Injection site pain is a common and mild adverse effect following vaccination.",
      "format": "mcq",
      "id": 471,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) High fever",
        "B) Injection site pain",
        "C) Anaphylaxis",
        "D) Severe headache"
      ],
      "question": "What is a common mild adverse effect of vaccination?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "adverse_effects",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "vaccine_schedule",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Following the recommended vaccine schedule ensures that individuals develop immunity at the appropriate time to protect against diseases.",
      "format": "mcq",
      "id": 472,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) To reduce healthcare costs",
        "B) To ensure timely immunity development",
        "C) To allow for natural exposure to diseases",
        "D) To increase the number of vaccinations"
      ],
      "question": "Why is it important to follow the recommended vaccine schedule?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vaccine_schedule",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "post_exposure_prophylaxis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Post-exposure prophylaxis is used to reduce the risk of disease after exposure to a pathogen.",
      "format": "mcq",
      "id": 473,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) To treat existing infections",
        "B) To reduce the risk of disease after exposure",
        "C) To enhance immune response to a vaccine",
        "D) To replace the need for vaccination"
      ],
      "question": "What is the purpose of post-exposure prophylaxis in vaccination?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "post_exposure_prophylaxis",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "vaccine_immunity",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Vaccination aims to provide long-term immunity against specific infections.",
      "format": "mcq",
      "id": 474,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Immediate treatment of diseases",
        "B) Long-term immunity against specific infections",
        "C) Reducing the healthcare workforce",
        "D) Preventing all diseases"
      ],
      "question": "What does vaccination primarily aim to achieve?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vaccine_immunity",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "vaccine_contraindications",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Individuals with a known allergy to a component of a vaccine should avoid vaccination due to the risk of severe allergic reactions.",
      "format": "mcq",
      "id": 475,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Individuals with mild fever",
        "B) Individuals allergic to a vaccine component",
        "C) Individuals who recently had a cold",
        "D) Individuals with a family history of vaccination"
      ],
      "question": "Which of the following individuals should typically avoid vaccination?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vaccine_contraindications",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "vaccine_therapeutics",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Vaccination is not used to treat active infections; it is primarily preventive.",
      "format": "mcq",
      "id": 476,
      "last_reviewed": "2023-10-06",
      "options": [
        "A) Preventing disease in healthy individuals",
        "B) Treating an active infection",
        "C) Providing immunity in outbreak situations",
        "D) Reducing the spread of infectious diseases"
      ],
      "question": "In which scenario would vaccination not be considered a therapeutic approach?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vaccine_therapeutics",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_immunization",
      "verification_status": "reviewed",
      "verified_at": "2023-10-06",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pathogenicity",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Pathogenicity refers to the ability of a microorganism to cause disease in a host.",
      "format": "mcq",
      "id": 477,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) The ability to survive outside a host",
        "B) The ability to cause disease",
        "C) The ability to replicate rapidly",
        "D) The ability to resist antibiotics"
      ],
      "question": "What is pathogenicity in microorganisms?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pathogenicity",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "fungi",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Candida is a genus of fungi known to cause infections in humans.",
      "format": "mcq",
      "id": 478,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) E. coli",
        "B) Candida",
        "C) Streptococcus",
        "D) Mycobacterium"
      ],
      "question": "Which of the following is a type of fungus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fungi",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "parasites",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Plasmodium is a genus of protozoan parasites that includes species responsible for malaria.",
      "format": "mcq",
      "id": 479,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Plasmodium",
        "B) Salmonella",
        "C) Staphylococcus",
        "D) Clostridium"
      ],
      "question": "Which of the following is considered a protozoan parasite?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "parasites",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "bacteria growth",
      "context": "scenario",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Bacterial growth requires optimal conditions including temperature, pH, and in some cases, the presence of oxygen.",
      "format": "mcq",
      "id": 480,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Presence of oxygen",
        "B) Temperature",
        "C) pH level",
        "D) All of the above"
      ],
      "question": "What environmental factor is most critical for bacterial growth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bacteria growth",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "virus structure",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Viruses are composed of a protein coat called a capsid and do not have cellular structures like a cell wall or nucleus.",
      "format": "mcq",
      "id": 481,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Cell wall",
        "B) Nucleus",
        "C) Capsid",
        "D) Cytoplasm"
      ],
      "question": "Which of the following structures is found in viruses?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "virus structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "antibiotics",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Antibiotics are designed to kill or inhibit the growth of bacteria, not viruses or other microorganisms.",
      "format": "mcq",
      "id": 482,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To promote growth in livestock",
        "B) To kill or inhibit the growth of bacteria",
        "C) To treat viral infections",
        "D) To enhance immune response"
      ],
      "question": "What is the primary purpose of antibiotics?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antibiotics",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "infection control",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Handwashing is recognized as the most effective method for preventing the transmission of infections in healthcare settings.",
      "format": "mcq",
      "id": 483,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Handwashing",
        "B) Wearing gloves",
        "C) Isolation of patients",
        "D) Disinfecting surfaces"
      ],
      "question": "In a hospital setting, which of the following practices is the most effective for preventing the spread of infection?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "infection control",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "bacterial diseases",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Cholera is a bacterial infection caused by Vibrio cholerae.",
      "format": "mcq",
      "id": 484,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Influenza",
        "B) Cholera",
        "C) HIV/AIDS",
        "D) Malaria"
      ],
      "question": "Which disease is primarily caused by bacteria?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "bacterial diseases",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "viral diseases",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Hepatitis B is a viral infection caused by the Hepatitis B virus.",
      "format": "mcq",
      "id": 485,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Hepatitis B",
        "B) Tuberculosis",
        "C) Syphilis",
        "D) Typhoid"
      ],
      "question": "Which of the following diseases is caused by a virus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "viral diseases",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "microbiology",
      "telugu_hint": null,
      "topic_id": "micro_organisms",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "uterine_structure",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The uterine wall is primarily composed of smooth muscle, which allows for contractions during labor.",
      "format": "mcq",
      "id": 486,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Skeletal muscle",
        "B) Smooth muscle",
        "C) Cardiac muscle",
        "D) Striated muscle"
      ],
      "question": "What is the primary muscle type that makes up the uterine wall?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "uterine_structure",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "placenta",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "The placenta performs multiple functions including hormone production, providing a barrier, and facilitating gas and nutrient exchange.",
      "format": "mcq",
      "id": 487,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Producing hormones",
        "B) Providing a protective barrier",
        "C) Facilitating gas exchange",
        "D) All of the above"
      ],
      "question": "Which of the following is a primary function of the placenta during pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "placenta",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "ovarian_cycle",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "Luteinizing hormone (LH) surges to trigger ovulation during the ovarian cycle.",
      "format": "mcq",
      "id": 488,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Estrogen",
        "B) Progesterone",
        "C) Luteinizing hormone (LH)",
        "D) Follicle-stimulating hormone (FSH)"
      ],
      "question": "Which hormone is primarily responsible for triggering ovulation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "ovarian_cycle",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "fallopian_tubes",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The fallopian tubes serve as the site of fertilization where the sperm meets the egg.",
      "format": "mcq",
      "id": 489,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Hormone production",
        "B) Site of fertilization",
        "C) Nutrient absorption",
        "D) Menstrual fluid passage"
      ],
      "question": "What is the primary function of the fallopian tubes?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fallopian_tubes",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "perineum",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "The pelvic diaphragm is crucial during childbirth as it supports the pelvic organs and aids in the delivery process.",
      "format": "mcq",
      "id": 490,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Superficial perineal layer",
        "B) Deep perineal layer",
        "C) Perineal fascia",
        "D) Pelvic diaphragm"
      ],
      "question": "Which layer of the perineum is primarily involved in childbirth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "perineum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "fetal_positions",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "The fetal position greatly affects the ease of delivery, as certain positions facilitate a smoother labor process.",
      "format": "mcq",
      "id": 491,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) It determines the pain level during contractions",
        "B) It affects the ease of delivery",
        "C) It does not influence labor",
        "D) It only affects the mother\u0027s comfort"
      ],
      "question": "What is the significance of the fetal position during labor?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fetal_positions",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "breast_anatomy",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The alveoli are the milk-producing glands located in the breast.",
      "format": "mcq",
      "id": 492,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Lactiferous ducts",
        "B) Alveoli",
        "C) Nipple",
        "D) Areola"
      ],
      "question": "Which structure is responsible for milk production in the breast?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "breast_anatomy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "cervix",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The cervix acts as a protective barrier to keep the fetus safe within the uterus during pregnancy.",
      "format": "mcq",
      "id": 493,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Hormonal regulation",
        "B) Protection of the fetus",
        "C) Facilitating contractions",
        "D) Providing nourishment"
      ],
      "question": "What is the primary role of the cervix during pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cervix",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "amniotic_fluid",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Amniotic fluid cushions the fetus, providing a protective environment during development.",
      "format": "mcq",
      "id": 494,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Provide nutrients",
        "B) Cushion the fetus",
        "C) Facilitate breathing",
        "D) Assist in hormone regulation"
      ],
      "question": "What is the primary function of amniotic fluid during pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "amniotic_fluid",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pubic_symphysis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The pubic symphysis allows slight movement during childbirth to facilitate the passage of the baby.",
      "format": "mcq",
      "id": 495,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) It restricts movement",
        "B) It allows slight movement for delivery",
        "C) It protects the fetus",
        "D) It does not play a role"
      ],
      "question": "What is the role of the pubic symphysis during childbirth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pubic_symphysis",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_anatomy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "obstructed_labour",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Obstructed labor can lead to increased risk of vaginal tears due to the prolonged pressure and difficulty in delivery.",
      "format": "mcq",
      "id": 496,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Increased risk of vaginal tears",
        "B) Decreased fetal heart rate",
        "C) Enhanced uterine contractions",
        "D) Improved maternal well-being"
      ],
      "question": "What is a common consequence of obstructed labor?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "obstructed_labour",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "gestational_diabetes",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "All listed factors\u2014age over 25, family history of diabetes, and obesity\u2014are significant risk factors for developing gestational diabetes.",
      "format": "mcq",
      "id": 497,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Age over 25",
        "B) Family history of diabetes",
        "C) Obesity",
        "D) All of the above"
      ],
      "question": "What is the primary risk factor for developing gestational diabetes?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "gestational_diabetes",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "hyperemesis_gravidarum",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Hyperemesis gravidarum can lead to severe dehydration due to excessive vomiting, which can be hazardous to both mother and fetus.",
      "format": "mcq",
      "id": 498,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Dehydration",
        "B) Increased appetite",
        "C) Elevated energy levels",
        "D) Low blood pressure"
      ],
      "question": "Which of the following is a severe complication of hyperemesis gravidarum?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hyperemesis_gravidarum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "placenta_accreta",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Women with placenta accreta are at an increased risk for cesarean delivery due to the abnormal attachment of the placenta to the uterine wall.",
      "format": "mcq",
      "id": 499,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Increased likelihood of cesarean delivery",
        "B) Placental abruption",
        "C) Preterm labor",
        "D) Fetal growth restriction"
      ],
      "question": "What is a primary risk associated with placenta accreta?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "placenta_accreta",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "cord_prolapse",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The immediate priority in the case of cord prolapse is to relieve pressure on the cord to prevent fetal distress.",
      "format": "mcq",
      "id": 500,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Administer pain relief",
        "B) Perform a vaginal examination",
        "C) Relieve pressure on the cord",
        "D) Monitor fetal heart rate"
      ],
      "question": "What is the immediate priority if a cord prolapse is detected during labor?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "cord_prolapse",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "amniotic_f fluid_embolism",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Sudden hypotension is a hallmark symptom of amniotic fluid embolism, indicating a critical and life-threatening condition.",
      "format": "mcq",
      "id": 501,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Severe headache",
        "B) Sudden hypotension",
        "C) Excessive bleeding",
        "D) Persistent fever"
      ],
      "question": "What is the hallmark symptom of amniotic fluid embolism?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "amniotic_fluid_embolism",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "uterine_inversion",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Manually replacing the uterus is critical in managing uterine inversion to restore normal anatomy and prevent severe complications.",
      "format": "mcq",
      "id": 502,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Administering intravenous antibiotics",
        "B) Replacing the uterus manually",
        "C) Performing a hysterectomy",
        "D) Monitoring vital signs closely"
      ],
      "question": "Which intervention is critical in managing uterine inversion?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "uterine_inversion",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "thrombosis",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Prolonged immobility during pregnancy is a significant risk factor for venous thrombosis, leading to potential complications.",
      "format": "mcq",
      "id": 503,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Frequent exercise",
        "B) Prolonged immobility",
        "C) Decreased blood volume",
        "D) Low body mass index (BMI)"
      ],
      "question": "What is a common risk factor for venous thrombosis during pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "thrombosis",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "preterm_birth",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "All listed factors, including maternal age over 35, poor prenatal care, and a history of preterm birth, increase the risk of preterm birth.",
      "format": "mcq",
      "id": 504,
      "last_reviewed": "2023-10-01",
      "options": [
        "A) Maternal age over 35",
        "B) Poor prenatal care",
        "C) History of preterm birth",
        "D) All of the above"
      ],
      "question": "What is a primary risk factor for preterm birth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "preterm_birth",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_complications",
      "verification_status": "reviewed",
      "verified_at": "2023-10-01",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "pregnancy",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "A full-term pregnancy typically lasts about 40 weeks from the last menstrual period.",
      "format": "mcq",
      "id": 505,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) 28 weeks",
        "B) 36 weeks",
        "C) 40 weeks",
        "D) 44 weeks"
      ],
      "question": "What is the typical duration of a full-term pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pregnancy",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "menopause",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Menopause is characterized by the cessation of menstruation and marks the end of a woman\u0027s reproductive years.",
      "format": "mcq",
      "id": 506,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Increase in menstrual flow",
        "B) Cessation of menstruation",
        "C) Irregular menstrual cycles",
        "D) Increased fertility"
      ],
      "question": "What is menopause characterized by?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "menopause",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "gynecological_terms",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Hysterectomy is the surgical procedure for the removal of the uterus.",
      "format": "mcq",
      "id": 507,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Removal of the ovaries",
        "B) Removal of the uterus",
        "C) Removal of the fallopian tubes",
        "D) Surgical repair of the vulva"
      ],
      "question": "What does the term \u0027hysterectomy\u0027 refer to?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "gynecological_terms",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "sexual_health",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Endometriosis is a condition where endometrial-like tissue grows outside the uterus, often leading to pain and fertility issues.",
      "format": "mcq",
      "id": 508,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Ovarian cyst",
        "B) Endometriosis",
        "C) Fibroids",
        "D) Pelvic inflammatory disease"
      ],
      "question": "Which condition is characterized by the presence of endometrial tissue outside the uterus?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sexual_health",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "contraception_methods",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Tubal ligation is a surgical procedure that permanently prevents pregnancy by blocking the fallopian tubes.",
      "format": "mcq",
      "id": 509,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Male condom",
        "B) Tubal ligation",
        "C) Birth control pills",
        "D) Copper IUD"
      ],
      "question": "Which contraceptive method is permanent?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "contraception_methods",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "gynecological_exams",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "A Pap smear is primarily used to screen for cervical cancer by detecting precancerous changes in cervical cells.",
      "format": "mcq",
      "id": 510,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) To detect pregnancy",
        "B) To screen for cervical cancer",
        "C) To assess ovulation",
        "D) To diagnose STIs"
      ],
      "question": "What is the purpose of a Pap smear?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "gynecological_exams",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "infertility",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Ovulatory disorders are one of the most common causes of infertility in women, affecting their ability to conceive.",
      "format": "mcq",
      "id": 511,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) High blood pressure",
        "B) Ovulatory disorders",
        "C) Anemia",
        "D) Diabetes"
      ],
      "question": "Which of the following is a common cause of infertility in women?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "infertility",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "vaginal_health",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The normal pH range of the vagina is typically between 4.0 and 4.5, which helps maintain a healthy flora.",
      "format": "mcq",
      "id": 512,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) 2.5 - 3.5",
        "B) 4.0 - 4.5",
        "C) 5.0 - 5.5",
        "D) 7.0 - 8.0"
      ],
      "question": "What is the normal pH range of the vagina?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vaginal_health",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "STI",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Human Papillomavirus (HPV) is a viral infection that can lead to cervical cancer, along with other health issues.",
      "format": "mcq",
      "id": 513,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Gonorrhea",
        "B) Chlamydia",
        "C) Human Papillomavirus (HPV)",
        "D) Syphilis"
      ],
      "question": "Which sexually transmitted infection is caused by a virus and can lead to cervical cancer?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "STI",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "gynecological_conditions",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Menorrhagia refers to abnormally heavy or prolonged menstrual bleeding.",
      "format": "mcq",
      "id": 514,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Amenorrhea",
        "B) Menorrhagia",
        "C) Oligomenorrhea",
        "D) Dysmenorrhea"
      ],
      "question": "Which condition is characterized by heavy menstrual bleeding?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "gynecological_conditions",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_gynecology",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "fetal_position",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "The term \u0027presentation\u0027 refers to the part of the fetus that is presenting at the cervix during labor.",
      "format": "mcq",
      "id": 515,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Presentation",
        "B) Station",
        "C) Engagement",
        "D) Position"
      ],
      "question": "What is the term for the position of the fetus in the uterus during labor?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fetal_position",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pain_management",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Epidural anesthesia is one of the most effective methods of pain relief during labor.",
      "format": "mcq",
      "id": 516,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) General anesthesia",
        "B) Epidural anesthesia",
        "C) Oral analgesics",
        "D) Local anesthesia"
      ],
      "question": "Which method is commonly used for pain relief during labor?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pain_management",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "labour_signs",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "The \u0027bloody show\u0027 is often the first sign of labor, indicating cervical changes.",
      "format": "mcq",
      "id": 517,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Rupture of membranes",
        "B) Regular contractions",
        "C) Bloody show",
        "D) Nesting instinct"
      ],
      "question": "What is the first sign of labor that many women may experience?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "labour_signs",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "labour_stages",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The second stage of labor is when the baby is delivered.",
      "format": "mcq",
      "id": 518,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) First stage",
        "B) Second stage",
        "C) Third stage",
        "D) Fourth stage"
      ],
      "question": "During which stage of labor does the delivery of the baby occur?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "labour_stages",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "postpartum_care",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Monitoring vital signs is critical in the immediate postpartum period to detect any complications.",
      "format": "mcq",
      "id": 519,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Assessing for lacerations",
        "B) Monitoring vital signs",
        "C) Checking the baby\u0027s weight",
        "D) Providing breastfeeding support"
      ],
      "question": "A nurse is providing care to a woman after delivery. Which assessment is the priority in the immediate postpartum period?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "postpartum_care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "labour_complications",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Prolonged labor is defined as labor lasting more than 20 hours for primiparas.",
      "format": "mcq",
      "id": 520,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Precipitate labor",
        "B) Prolonged labor",
        "C) Dystocia",
        "D) Breech presentation"
      ],
      "question": "Which complication of labor is characterized by a prolonged labor lasting more than 20 hours?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "labour_complications",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "labour_assessment",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Electronic fetal monitoring provides accurate information regarding the frequency and duration of contractions.",
      "format": "mcq",
      "id": 521,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Palpation of the abdomen",
        "B) Electronic fetal monitoring",
        "C) Vaginal examination",
        "D) Maternal report"
      ],
      "question": "A nurse is assessing a laboring woman. What is the best method to determine the frequency of contractions?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "labour_assessment",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "labour_progress",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Dilation refers specifically to the gradual opening of the cervix during labor.",
      "format": "mcq",
      "id": 522,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Effacement",
        "B) Dilation",
        "C) Descent",
        "D) Engagement"
      ],
      "question": "What is the term used for the gradual opening of the cervix during labor?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "labour_progress",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_labour",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "physiological_changes",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "During pregnancy, there is an increase in blood volume to support the growing fetus and placenta.",
      "format": "mcq",
      "id": 523,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Decreased heart rate",
        "B) Increased blood volume",
        "C) Decreased respiratory rate",
        "D) Increased platelet count"
      ],
      "question": "Which of the following is a common physiological change during pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "physiological_changes",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "nutrition",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Folate is crucial for the development of the neural tube and helps prevent neural tube defects.",
      "format": "mcq",
      "id": 524,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Vitamin C",
        "B) Folate",
        "C) Protein",
        "D) Iron"
      ],
      "question": "A pregnant woman is seeking advice on her diet. Which nutrient is particularly important for neural tube development?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "labour_signs",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Lightening, or the baby dropping into the pelvis, is a primary sign that labor may begin soon.",
      "format": "mcq",
      "id": 525,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Lightening",
        "B) Increased appetite",
        "C) Fatigue",
        "D) Pelvic discomfort"
      ],
      "question": "Which of the following is a primary sign of labor onset?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "labour_signs",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "risk_factors",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Pre-existing diabetes is a significant high-risk factor that can lead to complications during pregnancy.",
      "format": "mcq",
      "id": 526,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Age 25",
        "B) Pre-existing diabetes",
        "C) Non-smoker",
        "D) Healthy BMI"
      ],
      "question": "Which of the following factors is considered a high-risk factor during pregnancy?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "risk_factors",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "fetal_development",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The fetal heart typically begins to beat around 6 to 7 weeks of gestation.",
      "format": "mcq",
      "id": 527,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) 4-5 weeks",
        "B) 6-7 weeks",
        "C) 8-10 weeks",
        "D) 12 weeks"
      ],
      "question": "At what week of gestation does the fetal heart typically begin to beat?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fetal_development",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "complications",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Gestational diabetes can increase the risk of developing preeclampsia during pregnancy.",
      "format": "mcq",
      "id": 528,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Low birth weight",
        "B) Preeclampsia",
        "C) Hyperemesis gravidarum",
        "D) Premature rupture of membranes"
      ],
      "question": "Which of the following is a common complication associated with gestational diabetes?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "complications",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "antenatal_care",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Antenatal care primarily focuses on monitoring the mother\u0027s health throughout the pregnancy.",
      "format": "mcq",
      "id": 529,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To provide education on labor",
        "B) To monitor the mother\u0027s health",
        "C) To schedule delivery dates",
        "D) To assess newborn viability"
      ],
      "question": "What is the primary purpose of antenatal care?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antenatal_care",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "postpartum",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Uterine involution is the process by which the uterus returns to its pre-pregnant size following delivery.",
      "format": "mcq",
      "id": 530,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Increased energy levels",
        "B) Uterine involution",
        "C) Decreased appetite",
        "D) Enhanced immune response"
      ],
      "question": "Which of the following is a common physical change during the postpartum period?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "postpartum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "pregnancy_symptoms",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Hyperemesis gravidarum is characterized by severe nausea and vomiting during pregnancy, particularly in the first trimester.",
      "format": "mcq",
      "id": 531,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Ectopic pregnancy",
        "B) Hyperemesis gravidarum",
        "C) Gestational hypertension",
        "D) Premature labor"
      ],
      "question": "A woman in her first trimester reports fatigue and nausea. Which condition should the nurse assess for?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pregnancy_symptoms",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "exercise",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Yoga and swimming are low-impact exercises that are generally recommended for pregnant women to maintain fitness.",
      "format": "mcq",
      "id": 532,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) High-intensity interval training",
        "B) Yoga and swimming",
        "C) Heavy weightlifting",
        "D) Contact sports"
      ],
      "question": "What type of exercise is generally recommended for pregnant women?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "exercise",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_pregnancy",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "physical_changes",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 1,
      "explanation": "Uterine involution, or the return of the uterus to its pre-pregnancy size, is a common physical change during the puerperium.",
      "format": "mcq",
      "id": 533,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Increase in breast size",
        "B) Decrease in body weight",
        "C) Return of menstruation immediately",
        "D) Uterine involution"
      ],
      "question": "Which of the following is a common physical change during the puerperium?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "physical_changes",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "emotional_changes",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Postpartum blues, characterized by mood swings and emotional instability, is a common emotional change during this period.",
      "format": "mcq",
      "id": 534,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Increased self-confidence",
        "B) Postpartum blues",
        "C) Constant happiness",
        "D) Withdrawal from social interactions"
      ],
      "question": "What is a common emotional change experienced by mothers during the puerperium?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "emotional_changes",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "infection_risks",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Retained placental fragments can lead to postpartum infections due to the presence of necrotic tissue.",
      "format": "mcq",
      "id": 535,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Proper hand hygiene",
        "B) Vaginal delivery",
        "C) Retained placental fragments",
        "D) Adequate rest"
      ],
      "question": "During the puerperium, which factor significantly increases the risk of infection?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "infection_risks",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "breastfeeding",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Skin-to-skin contact is recommended to stimulate breastfeeding and enhance mother-infant bonding.",
      "format": "mcq",
      "id": 536,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Formula feeding",
        "B) Skin-to-skin contact",
        "C) Avoiding colostrum",
        "D) Pumping milk exclusively"
      ],
      "question": "What is recommended for mothers to promote breastfeeding during the puerperium?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "breastfeeding",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "nutrition",
      "context": "scenario",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Vitamin C is vital for tissue repair and immune function, making it essential during the healing period.",
      "format": "mcq",
      "id": 537,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Vitamin C",
        "B) Carbohydrates",
        "C) Fats",
        "D) Fiber"
      ],
      "question": "A nurse is educating a postpartum mother about nutrition. Which nutrient is most important for healing during the puerperium?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "postpartum_exercises",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Kegel exercises are specifically designed to strengthen pelvic floor muscles, which can be weakened during childbirth.",
      "format": "mcq",
      "id": 538,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Kegel exercises",
        "B) Crunches",
        "C) Aerobics",
        "D) Weight lifting"
      ],
      "question": "Which postpartum exercise is considered beneficial for strengthening pelvic floor muscles?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "postpartum_exercises",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "mental_health",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Postpartum depression is a significant mental health concern that can affect mothers during the puerperium and requires screening.",
      "format": "mcq",
      "id": 539,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Anxiety disorders",
        "B) Postpartum depression",
        "C) Schizophrenia",
        "D) Bipolar disorder"
      ],
      "question": "What mental health condition is crucial to screen for during the puerperium?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "mental_health",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "thermoregulation",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Hormonal changes during the puerperium can affect thermoregulation, leading to temperature fluctuations.",
      "format": "mcq",
      "id": 540,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Hormonal changes",
        "B) Increased metabolism",
        "C) Fluid retention",
        "D) Decreased appetite"
      ],
      "question": "Which physiological mechanism is affected during the puerperium, leading to temperature variations?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "thermoregulation",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "family_support",
      "context": "scenario",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Involving family members in caregiving can enhance support for the mother and improve her confidence and well-being.",
      "format": "mcq",
      "id": 541,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Encourage isolation",
        "B) Involve family members in caregiving",
        "C) Provide only verbal instructions",
        "D) Dismiss concerns and provide no guidance"
      ],
      "question": "During a home visit, a nurse observes a mother struggling with her newborn. What is the best way for the nurse to promote family support?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "family_support",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "maternal_followup",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "A follow-up at 6 weeks postpartum is recommended to assess maternal health and recovery.",
      "format": "mcq",
      "id": 542,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) 1 week",
        "B) 2 weeks",
        "C) 6 weeks",
        "D) 3 months"
      ],
      "question": "What is the recommended follow-up time for mothers after delivery?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "maternal_followup",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "midwifery",
      "telugu_hint": null,
      "topic_id": "mw_puerperium",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "minerals",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Calcium is crucial for the development and maintenance of healthy bones and teeth.",
      "format": "mcq",
      "id": 543,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Iron",
        "B) Calcium",
        "C) Potassium",
        "D) Sodium"
      ],
      "question": "Which mineral is essential for maintaining healthy bones and teeth?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "minerals",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "fats",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Saturated fats can increase levels of LDL (bad) cholesterol in the blood.",
      "format": "mcq",
      "id": 544,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Saturated fat",
        "B) Polyunsaturated fat",
        "C) Monounsaturated fat",
        "D) Omega-3 fatty acids"
      ],
      "question": "What type of fat is considered unhealthy and can raise cholesterol levels?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "fats",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "carbohydrates",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Glucose is a simple carbohydrate, while starch, fiber, and glycogen are complex carbohydrates.",
      "format": "mcq",
      "id": 545,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Glucose",
        "B) Starch",
        "C) Fiber",
        "D) Glycogen"
      ],
      "question": "Which of the following is a simple carbohydrate?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "carbohydrates",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "water",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "Approximately 60% of the human body weight is made up of water, highlighting its importance in bodily functions.",
      "format": "mcq",
      "id": 546,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) 30%",
        "B) 50%",
        "C) 60%",
        "D) 70%"
      ],
      "question": "What percentage of the human body is made up of water?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "water",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "dietary_fiber",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Dietary fiber is known for aiding in digestion and promoting regular bowel movements.",
      "format": "mcq",
      "id": 547,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Helps in weight gain",
        "B) Aids in digestion",
        "C) Provides energy",
        "D) Increases blood sugar"
      ],
      "question": "What is the main benefit of dietary fiber in the diet?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "dietary_fiber",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "vitamin_a",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "Fish oil is one of the richest sources of Vitamin A, contributing significantly to dietary intake.",
      "format": "mcq",
      "id": 548,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Carrots",
        "B) Milk",
        "C) Spinach",
        "D) Fish oil"
      ],
      "question": "Which food source is highest in Vitamin A?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vitamin_a",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nutrition_requirements",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Age and gender are key factors that influence an individual\u0027s daily nutritional needs.",
      "format": "mcq",
      "id": 549,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) Age and gender",
        "B) Favorite food",
        "C) Geographic location",
        "D) Social media trends"
      ],
      "question": "What factor influences the daily nutritional requirements of an individual?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutrition_requirements",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nutrition",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "The body primarily obtains energy by metabolizing carbohydrates and fats, which are broken down during digestion.",
      "format": "mcq",
      "id": 550,
      "last_reviewed": "2023-10-04",
      "options": [
        "A) By converting proteins into carbohydrates",
        "B) By storing fats as energy reserves",
        "C) By metabolizing carbohydrates and fats",
        "D) By absorbing vitamins directly into the bloodstream"
      ],
      "question": "How does the body primarily obtain energy from food?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-04",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "lactation nutrition",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Lactating women require more calories primarily to support the production of breast milk.",
      "format": "mcq",
      "id": 551,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Growth of maternal tissues",
        "B) Production of breast milk",
        "C) Increased physical activity",
        "D) Hormonal changes"
      ],
      "question": "What is the primary reason for increased caloric needs during lactation?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "lactation nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "childhood nutrition",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "Vitamin D is essential for calcium absorption, which is vital for bone health in children.",
      "format": "mcq",
      "id": 552,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Vitamin A",
        "B) Vitamin D",
        "C) Vitamin E",
        "D) Vitamin K"
      ],
      "question": "Which vitamin is crucial for the development of bone health in children?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "childhood nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "elderly nutrition",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 3,
      "explanation": "Elderly individuals often experience decreased metabolic rates and thus have lower caloric requirements.",
      "format": "mcq",
      "id": 553,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Increased protein synthesis",
        "B) Decreased caloric requirements",
        "C) Increased absorption of nutrients",
        "D) Decreased fluid intake"
      ],
      "question": "What change in metabolism is commonly observed in elderly individuals?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "elderly nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "adolescent nutrition",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Adolescents, particularly females, need adequate iron to compensate for blood loss during menstruation and to prevent anemia.",
      "format": "mcq",
      "id": 554,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) To enhance energy levels",
        "B) To prevent anemia during menstruation",
        "C) To support muscle growth",
        "D) To aid in digestion"
      ],
      "question": "Why is iron intake particularly important for adolescents, especially females?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "adolescent nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "pregnancy nutrition",
      "context": "theory",
      "correct_answer": "D",
      "difficulty": 2,
      "explanation": "Folic acid is crucial for fetal development, particularly in preventing neural tube defects.",
      "format": "mcq",
      "id": 555,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Omega-3 fatty acids",
        "B) Fiber",
        "C) High-protein foods",
        "D) Folic acid"
      ],
      "question": "What is the recommended dietary addition for pregnant women to support fetal development?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "pregnancy nutrition",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "nutrient absorption",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "A low-fat diet can impede the absorption of fat-soluble vitamins (A, D, E, K) because these vitamins require fat for absorption.",
      "format": "mcq",
      "id": 556,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Low-fat diet",
        "B) High fiber intake",
        "C) High protein intake",
        "D) Regular exercise"
      ],
      "question": "Which factor can impair the absorption of fat-soluble vitamins?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutrient absorption",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "macro_micronutrients",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Carbohydrates are classified as macronutrients, which are needed in larger amounts in the diet.",
      "format": "mcq",
      "id": 557,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Vitamins",
        "B) Minerals",
        "C) Carbohydrates",
        "D) Antioxidants"
      ],
      "question": "Which of the following is considered a macronutrient?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "macro_micronutrients",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nutrition assessment",
      "context": "scenario",
      "correct_answer": "D",
      "difficulty": 3,
      "explanation": "Conducting a dietary recall helps in understanding the patient\u0027s current eating habits, which is crucial for identifying nutritional deficiencies.",
      "format": "mcq",
      "id": 558,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Assess calorie intake",
        "B) Evaluate physical activity levels",
        "C) Review medication list",
        "D) Conduct a dietary recall"
      ],
      "question": "An elderly patient presents with loss of appetite and weight loss. What should be the initial focus of the nutritional assessment?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutrition assessment",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "nutritional needs",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "Eating small, frequent meals can help manage nausea in pregnant women by preventing the stomach from becoming too empty.",
      "format": "mcq",
      "id": 559,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Increase fiber intake",
        "B) Eat small, frequent meals",
        "C) Drink large amounts of water",
        "D) Limit protein intake"
      ],
      "question": "What dietary adjustments might be necessary for a pregnant woman experiencing nausea?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "nutritional needs",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "hydration",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Proper hydration is essential for regulating body temperature and maintaining overall bodily functions throughout all life stages.",
      "format": "mcq",
      "id": 560,
      "last_reviewed": "2023-10-02",
      "options": [
        "A) Regulates body temperature",
        "B) Enhances taste of food",
        "C) Increases appetite",
        "D) Reduces digestive time"
      ],
      "question": "What is the key reason for maintaining proper hydration during all life stages?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "hydration",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "nutrition",
      "telugu_hint": null,
      "topic_id": "nut_lifecycle",
      "verification_status": "reviewed",
      "verified_at": "2023-10-02",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "safety_protocols",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 1,
      "explanation": "The INC\u0027s main function is to establish uniform standards for nursing education and prescribe the syllabus for nursing personnel.",
      "format": "mcq",
      "id": 561,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To conduct clinical trials",
        "B) To establish uniform standards of nursing education",
        "C) To manage hospitals",
        "D) To provide financial support to nurses"
      ],
      "question": "What is the primary purpose of the Indian Nursing Council (INC) in relation to nursing education?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "introduction",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "curriculum_structure",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The duration of the program has been reduced from 3 \u00bd years to 3 years as per the revised curriculum.",
      "format": "mcq",
      "id": 562,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Increased from 3 years to 3 \u00bd years",
        "B) Remained the same at 3 years",
        "C) Decreased from 3 \u00bd years to 3 years",
        "D) Increased from 2 years to 3 years"
      ],
      "question": "How has the duration of the General Nursing and Midwifery program changed in the revised curriculum?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "assessment_methods",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 3,
      "explanation": "The revised curriculum specifies a variety of assessment methods for both practical and theoretical components.",
      "format": "mcq",
      "id": 563,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Only theory tests",
        "B) Practical assessments only",
        "C) A variety of assessment methods including practical and theoretical",
        "D) No assessments are specified"
      ],
      "question": "What does the revised curriculum of the GNM program include regarding assessment methods?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "course_content",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 2,
      "explanation": "The revision integrates internship within the 3-year course to enhance practical learning.",
      "format": "mcq",
      "id": 564,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Additional elective subjects",
        "B) Theoretical exams",
        "C) Internship",
        "D) Extended leave periods"
      ],
      "question": "What is a key component integrated into the 3-year General Nursing program?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "nursing_foundations",
      "context": "theory",
      "correct_answer": "C",
      "difficulty": 1,
      "explanation": "Anatomy and Physiology is one of the subjects included in the first-year curriculum of the GNM program.",
      "format": "mcq",
      "id": 565,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Pharmacology",
        "B) Community Health Nursing",
        "C) Anatomy and Physiology",
        "D) Medical-Surgical Nursing"
      ],
      "question": "Which subject is included in the first-year curriculum of the GNM program?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "curriculum_format",
      "context": "theory",
      "correct_answer": "B",
      "difficulty": 2,
      "explanation": "The revised format includes detailed descriptions for practical areas with objectives and assessment methods.",
      "format": "mcq",
      "id": 566,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Elimination of practical components",
        "B) Inclusion of detailed descriptions for practical areas",
        "C) Focus solely on theoretical knowledge",
        "D) No changes were made to the syllabus format"
      ],
      "question": "What significant change was made to the syllabus format in the revised GNM curriculum?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "curriculum",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "nursing_education",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "The INC\u0027s involvement is crucial to standardize nursing education and ensure that it meets quality benchmarks for future nurses.",
      "format": "mcq",
      "id": 567,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To standardize nursing education and ensure quality",
        "B) To increase the duration of nursing programs",
        "C) To eliminate internship requirements",
        "D) To focus solely on theoretical knowledge"
      ],
      "question": "Why is the Indian Nursing Council\u0027s involvement crucial in the revision of nursing curricula?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "introduction",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_basics",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "analgesics",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Ibuprofen is a widely used nonsteroidal anti-inflammatory drug (NSAID) that acts as an analgesic.",
      "format": "mcq",
      "id": 568,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Ibuprofen",
        "B) Metformin",
        "C) Amlodipine",
        "D) Amoxicillin"
      ],
      "question": "Which of the following is a common analgesic?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "analgesics",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "antihypertensives",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Antihypertensive medications are primarily used to manage and treat high blood pressure.",
      "format": "mcq",
      "id": 569,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To treat high blood pressure",
        "B) To lower blood sugar levels",
        "C) To treat infections",
        "D) To relieve pain"
      ],
      "question": "What is the primary use of antihypertensive medications?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antihypertensives",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "apply",
      "concept_tag": "anticoagulants",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Warfarin is an anticoagulant that helps prevent blood clots.",
      "format": "mcq",
      "id": 570,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Warfarin",
        "B) Furosemide",
        "C) Dexamethasone",
        "D) Metoprolol"
      ],
      "question": "Which of the following medications is classified as an anticoagulant?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "anticoagulants",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "antidepressants",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Selective Serotonin Reuptake Inhibitors (SSRIs) are a common class of antidepressants used to treat depression.",
      "format": "mcq",
      "id": 571,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) SSRIs",
        "B) Beta-blockers",
        "C) NSAIDs",
        "D) Diuretics"
      ],
      "question": "Which class of medications is commonly prescribed for depression?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antidepressants",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "remember",
      "concept_tag": "vaccines",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 1,
      "explanation": "Vaccines are primarily used to prevent diseases by stimulating the immune response.",
      "format": "mcq",
      "id": 572,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) To prevent diseases",
        "B) To treat infections",
        "C) To relieve pain",
        "D) To reduce inflammation"
      ],
      "question": "What is the primary purpose of vaccines?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "vaccines",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "understand",
      "concept_tag": "sedatives",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 2,
      "explanation": "Diazepam is a common sedative that is often prescribed to help patients with sleep issues.",
      "format": "mcq",
      "id": 573,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) Diazepam",
        "B) Amoxicillin",
        "C) Aspirin",
        "D) Levothyroxine"
      ],
      "question": "Which of the following is a common sedative used to induce sleep?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "sedatives",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    },
    {
      "cognitive_level": "analyze",
      "concept_tag": "antimicrobials",
      "context": "theory",
      "correct_answer": "A",
      "difficulty": 3,
      "explanation": "Antimicrobials are agents that inhibit the growth of microorganisms, including bacteria, fungi, and viruses.",
      "format": "mcq",
      "id": 574,
      "last_reviewed": "2023-10-05",
      "options": [
        "A) They inhibit microbial growth.",
        "B) They enhance blood flow.",
        "C) They increase pain perception.",
        "D) They raise blood sugar levels."
      ],
      "question": "Which of the following best describes the action of antimicrobials?",
      "source": "INC GNM Syllabus / Standard Nursing Textbooks",
      "source_section": "antimicrobials",
      "source_url": "https://www.iminursing.in/gnm-syllabus.pdf",
      "subject_id": "pharmacology",
      "telugu_hint": null,
      "topic_id": "pharma_common",
      "verification_status": "reviewed",
      "verified_at": "2023-10-05",
      "verified_by": "agentic-generator"
    }
  ],
  "topic": "Telangana Staff Nurse Recruitment"
}