NCK Exam Revision Questions & Answers 2026 (Free MCQs)

Preparing for the NCK exam is no small feat. Whether you are a BScN degree candidate, the pressure to pass this licensure exam is real. It is also significant if you are a KRCHN diploma student. It’s crucial to succeed on your first attempt. One highly effective strategy involves answering NCK exam revision questions consistently. You should do this across all tested subjects. Provide detailed rationales to understand the ‘why’ behind every answer.

In this post, ReviQuiz provides you with 20 free NCK exam MCQs. These include full answers and rationales. They cover the six core subjects tested in the NCK exam. These questions are not from random internet sources. They are carefully written to reflect the style, difficulty, and subject coverage of the actual NCK exam.

At the end of this post, you will find links to our full NCK revision question banks. These banks include 1,000+ more MCQs and rationales.

What Subjects Are Covered in NCK Exam Revision Questions?

The NCK exam tests you across six major subject areas. Your revision questions should cover all of them proportionally. Here is what to expect:

• Medical-Surgical Nursing — diseases, nursing interventions, pharmacology in clinical settings
• Community Health Nursing — public health, disease prevention, environmental health
• Midwifery Nursing — antenatal care, labour, postnatal care, newborn care
• Paediatric Nursing — child health, immunization, growth and development, paediatric conditions
• Mental Health Nursing — psychiatric disorders, therapeutic communication, mental health law
• Anatomy & Physiology — body systems, pathophysiology relevant to clinical nursing

The free MCQs below are spread across these subjects. This ensures you get a balanced warm-up. You can then dive into our full question banks.

20 Free NCK Exam Revision Questions with Answers & Rationales

Instructions: Read each question carefully and choose the best answer before checking the rationale below.

Question 1 | Medical-Surgical Nursing

A patient with Type 2 Diabetes Mellitus presents with fasting blood glucose of 14 mmol/L. Which of the following is the PRIORITY nursing intervention?A. Administer oral hypoglycaemic as prescribedB. Encourage oral fluid intakeC. Notify the physician immediatelyD. Recheck blood glucose in 30 minutes

Correct Answer: C. Notify the physician immediatelyRationale: A fasting blood glucose of 14 mmol/L is significantly above the normal range (3.9–5.6 mmol/L) and indicates uncontrolled hyperglycaemia. The priority action follows the nursing process — assessment has been done, and the next step is to communicate a critical finding to the physician before initiating treatment. Independent nursing actions like encouraging fluids are supportive but not the priority here.

Question 2 | Medical-Surgical Nursing

A nurse is caring for a post-operative patient 8 hours after abdominal surgery. The patient reports increasing pain at the surgical site, has a temperature of 38.8°C, and the wound appears red and warm. What should the nurse suspect?A. Normal post-operative inflammationB. Wound dehiscenceC. Surgical site infection (SSI)D. Deep vein thrombosis (DVT)

Correct Answer: C. Surgical site infection (SSI)Rationale: The triad of increasing pain, fever (>38°C), and localised redness and warmth at the surgical site are classic signs of surgical site infection (SSI). Normal post-operative inflammation typically resolves within 24–48 hours and does not present with fever this high. Wound dehiscence involves wound separation, not infection signs. DVT presents with calf pain and swelling, not wound symptoms.

Question 3 | Pharmacology / Med-Surg

A nurse is administering Furosemide (Lasix) 40mg IV to a patient with heart failure. Which of the following electrolyte imbalances should the nurse monitor for MOST closely?A. HypernatraemiaB. HypokalaemiaC. HypercalcaemiaD. Hypermagnesaemia

Correct Answer: B. HypokalaemiaRationale: Furosemide is a loop diuretic that works on the loop of Henle to inhibit reabsorption of sodium, chloride, and potassium. The most common and clinically significant electrolyte imbalance associated with loop diuretics is hypokalaemia (low potassium). Hypokalaemia can cause dangerous cardiac arrhythmias, muscle weakness, and fatigue. The nurse should monitor potassium levels closely and report values below 3.5 mmol/L.

Question 4 | Community Health Nursing

During a community health assessment, a nurse identifies that a majority of under-5 children in a village have stunted growth. What is the MOST likely underlying cause the nurse should investigate?A. Malaria prevalenceB. Chronic malnutritionC. Inadequate immunisation coverageD. Poor sanitation and water quality

Correct Answer: B. Chronic malnutritionRationale: Stunting (low height-for-age) is the classic indicator of chronic malnutrition — specifically long-term inadequate intake of calories, proteins, and micronutrients during the first 1,000 days of life. While malaria, poor sanitation, and low immunisation coverage all contribute to child health problems, they primarily cause acute illness (wasting, diarrhoeal diseases, vaccine-preventable diseases) rather than stunting. The nurse should assess dietary practices, food security, and maternal nutrition.

Question 5 | Community Health Nursing

A public health nurse is planning a health education session on malaria prevention for a rural community in Kenya. Which of the following is the MOST cost-effective and evidence-based intervention to recommend?A. Indoor residual spraying (IRS) monthlyB. Distribution of Long-Lasting Insecticidal Nets (LLINs)C. Mass drug administration with Artemether-LumefantrineD. Draining all stagnant water in the community

Correct Answer: B. Distribution of Long-Lasting Insecticidal Nets (LLINs)Rationale: Long-Lasting Insecticidal Nets (LLINs) are the most cost-effective, evidence-based primary prevention strategy for malaria at the community level, strongly supported by WHO and Kenya’s National Malaria Control Programme. They provide direct protection during sleeping hours when mosquito bites are most common. IRS is effective but expensive and requires trained personnel for monthly application. Mass drug administration is a treatment, not a prevention strategy. Draining stagnant water is beneficial but not feasible as a standalone community-wide solution.

Question 6 | Midwifery Nursing

A primigravida at 38 weeks gestation presents to the antenatal clinic with blood pressure of 158/104 mmHg, proteinuria 2+ on dipstick, and reports severe headache. What is the CORRECT diagnosis?A. Gestational hypertensionB. Mild pre-eclampsiaC. Severe pre-eclampsiaD. Chronic hypertension with superimposed pre-eclampsia

Correct Answer: C. Severe pre-eclampsiaRationale: Severe pre-eclampsia is diagnosed when BP is ≥160/110 mmHg OR there is significant proteinuria (2+ or more) WITH severe symptoms such as severe headache, visual disturbances, epigastric pain, or thrombocytopaenia. This patient has BP of 158/104 (borderline severe), proteinuria 2+, and severe headache — the combination of these features, especially the severe headache indicating possible cerebral involvement, classifies this as severe pre-eclampsia requiring urgent intervention. Gestational hypertension has no proteinuria. Mild pre-eclampsia has BP <160/110 and no severe features.

Question 7 | Midwifery Nursing

A woman in active labour has a partograph that shows the cervical dilation line has crossed the action line. What is the MOST appropriate immediate nursing action?A. Prepare the mother for emergency Caesarean sectionB. Administer oxytocin infusion immediatelyC. Notify the doctor or midwife in charge urgentlyD. Encourage the mother to push harder

Correct Answer: C. Notify the doctor or midwife in charge urgentlyRationale: When the partograph dilation line crosses the action line, it indicates prolonged/obstructed labour — progress is slower than expected. The nurse’s immediate action is to notify the doctor or senior midwife in charge so that a medical assessment can determine the cause and appropriate management (which may include augmentation, assisted delivery, or C-section). The nurse does NOT independently decide to start oxytocin or prepare for C-section — these are medical decisions. The treatment depends on the cause of delay.

Question 8 | Paediatric Nursing

A 9-month-old infant is brought to the clinic. According to Kenya’s immunisation schedule (KEPI), which vaccines should this child receive at this visit?A. BCG and OPV 0B. DPT-HepB-Hib 3, OPV 3, and PCV 3C. Measles-Rubella (MR) vaccine onlyD. Yellow Fever vaccine

Correct Answer: B. DPT-HepB-Hib 3, OPV 3, and PCV 3Rationale: According to the Kenya Expanded Programme on Immunisation (KEPI), at 9 months a child receives the third doses of DPT-HepB-Hib, OPV, and PCV. BCG and OPV 0 are given at birth. The Measles-Rubella vaccine is given at 9 months as well in some schedules — note that this may vary slightly with updated KEPI guidelines, and the nurse should always refer to the current national immunisation schedule. Yellow Fever is given in endemic areas only.

Question 9 | Paediatric Nursing

A nurse is assessing a 3-year-old child using the IMCI guidelines. The child has a temperature of 38.5°C, no stiff neck, no bulging fontanelle, and petechiae are absent. According to IMCI, how should this child be classified?A. Very Severe Febrile DiseaseB. Severe Malaria or Very Severe Febrile DiseaseC. Malaria (or fever — no severe signs)D. No malaria risk

Correct Answer: C. Malaria (or fever — no severe signs)Rationale: According to IMCI (Integrated Management of Childhood Illness) guidelines, a child with fever but NO general danger signs (no convulsions, not lethargic, able to drink) and NO signs of very severe febrile disease (no stiff neck, no petechiae, no bulging fontanelle) is classified as ‘Malaria’ or ‘Fever — no severe signs’ in malaria-risk areas. The classification directs the nurse to perform a malaria RDT/microscopy test and treat accordingly. Severe classifications require danger signs to be present.

Question 10 | Mental Health Nursing

A patient on the psychiatric ward approaches the nurse, agitated, and says ‘I hear voices telling me to hurt myself.’ What is the nurse’s PRIORITY action?A. Document the statement in the patient’s notesB. Reassure the patient the voices are not realC. Ensure the patient’s immediate safety and remove harmful objects from the environmentD. Administer PRN sedation as prescribed

Correct Answer: C. Ensure the patient’s immediate safety and remove harmful objects from the environmentRationale: The priority in psychiatric nursing, as in all nursing, is patient safety (Maslow’s hierarchy — safety before other needs). When a patient expresses active auditory command hallucinations directing self-harm, the immediate action is to ensure the patient is safe by staying with them and removing any objects that could be used for self-harm. Documentation is important but is done after ensuring safety. Telling the patient the voices are not real is non-therapeutic and can damage the therapeutic relationship. Sedation may be necessary but is a secondary action after safety measures are in place.

Question 11 | Anatomy & Physiology

The sinoatrial (SA) node is considered the natural pacemaker of the heart. At what rate does the SA node normally fire, and where is it located?A. 40–60 beats per minute; located in the left atriumB. 60–100 beats per minute; located in the right atrium near the superior vena cavaC. 100–150 beats per minute; located in the interventricular septumD. 20–40 beats per minute; located in the bundle of His

Correct Answer: B. 60–100 beats per minute; located in the right atrium near the superior vena cavaRationale: The SA node is located in the posterior wall of the right atrium, near the junction of the superior vena cava. It spontaneously depolarises at a rate of 60–100 beats per minute, which is the normal resting heart rate. It is called the natural pacemaker because it has the highest intrinsic firing rate in the cardiac conduction system. The AV node fires at 40–60 bpm (secondary pacemaker), and the Purkinje fibres fire at 20–40 bpm if all other pacemakers fail.

Question 12 | Anatomy & Physiology

A patient with chronic renal failure has a serum potassium of 6.8 mmol/L. Which of the following ECG changes would the nurse MOST likely observe?A. Flattened P waves and U wavesB. ST elevation and wide QRSC. Tall, peaked T waves and widened QRS complexD. Prolonged PR interval and delta waves

Correct Answer: C. Tall, peaked T waves and widened QRS complexRationale: Hyperkalaemia (high serum potassium, >5.5 mmol/L) causes characteristic ECG changes that progress with severity: early changes include tall, peaked (tent-shaped) T waves; moderate hyperkalaemia causes PR prolongation and QRS widening; severe hyperkalaemia can lead to sine wave pattern and cardiac arrest. Flattened T waves and U waves are signs of hypokalaemia. ST elevation with wide QRS is seen in severe hyperkalaemia near arrest, but peaked T waves appear first. Delta waves indicate Wolff-Parkinson-White syndrome.

Question 13 | Medical-Surgical Nursing

A nurse is educating a patient newly diagnosed with Pulmonary Tuberculosis (PTB) on their treatment regimen. The patient will be started on the standard 2HRZE/4HR regimen. What does the ‘Z’ represent?A. Zithromax (Azithromycin)B. PyrazinamideC. EthambutolD. Zinc supplement

Correct Answer: B. PyrazinamideRationale: In TB drug abbreviations: H = Isoniazid, R = Rifampicin, Z = Pyrazinamide, E = Ethambutol, S = Streptomycin. The 2HRZE/4HR regimen means 2 months of intensive phase (Isoniazid + Rifampicin + Pyrazinamide + Ethambutol) followed by 4 months of continuation phase (Isoniazid + Rifampicin). This is the standard first-line regimen for new PTB cases in Kenya. Patient education on adherence is critical to prevent drug resistance.

Question 14 | Community Health Nursing

A health worker is conducting a home visit and finds a mother exclusively breastfeeding her 4-month-old infant. The mother asks when she should introduce complementary foods. What is the CORRECT advice?A. At 3 months when the baby shows interest in foodB. At 4 months to ensure adequate nutritionC. At 6 months while continuing to breastfeedD. At 12 months when the baby has teeth

Correct Answer: C. At 6 months while continuing to breastfeedRationale: WHO and Kenya MOH guidelines recommend exclusive breastfeeding for the first 6 months of life, followed by the introduction of appropriate complementary foods at 6 months while continuing breastfeeding up to 2 years and beyond. Introducing complementary foods before 6 months increases the risk of gastrointestinal infections, allergies, and displaces breastmilk. Waiting until 12 months is too late and puts the infant at risk of micronutrient deficiencies. The health worker should also advise on appropriate complementary food textures and frequencies by age.

Question 15 | Midwifery Nursing

A midwife is conducting a newborn assessment immediately after delivery. Which of the following APGAR score findings at 5 minutes would require immediate resuscitation?A. APGAR score of 8B. APGAR score of 6C. APGAR score of 3D. APGAR score of 10

Correct Answer: C. APGAR score of 3Rationale: The APGAR score (Appearance, Pulse, Grimace, Activity, Respiration) is scored 0–10. Interpretation: 7–10 = Normal (routine care); 4–6 = Moderate distress (stimulation and oxygen); 0–3 = Severe distress (immediate resuscitation required). An APGAR of 3 at 5 minutes indicates severe neonatal depression and requires immediate resuscitation including bag-mask ventilation, warmth, and possible chest compressions. An APGAR of 8 or 10 requires only routine care.

Question 16 | Pharmacology

A nurse is preparing to administer Digoxin 0.25mg to a patient with atrial fibrillation. Before administration, the nurse checks the patient’s apical pulse and finds it is 52 beats per minute. What should the nurse do NEXT?A. Administer the dose as prescribed — the heart rate is acceptableB. Hold the medication and notify the physicianC. Administer half the prescribed doseD. Increase the IV drip rate first before giving Digoxin

Correct Answer: B. Hold the medication and notify the physicianRationale: Digoxin is a cardiac glycoside used to slow heart rate in atrial fibrillation. A key nursing responsibility before administering Digoxin is to check the apical pulse for a full minute. The safe threshold is: if the heart rate is below 60 bpm in adults, HOLD the dose and notify the physician. This patient’s HR of 52 bpm is below the threshold. Administering Digoxin at this rate would further slow the heart and risk serious bradycardia or heart block. This is a critical safety intervention every nurse must know.

Question 17 | Medical-Surgical Nursing

A patient with a closed fracture of the right tibia has a plaster of Paris (POP) cast applied. Four hours later, the patient reports severe pain, numbness, and the toes of the right foot appear pale and cold. What complication should the nurse suspect?A. Normal post-casting discomfortB. Compartment syndromeC. Deep vein thrombosisD. Fat embolism

Correct Answer: B. Compartment syndromeRationale: The 5 Ps of compartment syndrome are: Pain (severe, disproportionate, worsening with passive stretch), Pallor, Pulselessness, Paraesthesia (numbness/tingling), and Paralysis. This patient demonstrates pain, pallor, and numbness — early signs of compartment syndrome, which is a surgical emergency. The cast may need to be split or removed immediately. It is critical to distinguish from normal post-casting discomfort, which should be mild and improving. Compartment syndrome left untreated leads to permanent nerve and muscle damage within 6–8 hours.

Question 18 | Paediatric Nursing

A 2-year-old child is brought to the emergency department with severe acute malnutrition (SAM). The child is alert, has no oedema, and has a MUAC of 10.5 cm. What is the MOST appropriate initial management step?A. Start F-75 therapeutic milk immediatelyB. Give high-energy biscuits (RUTF)C. Administer IV dextrose for hypoglycaemia prophylaxisD. Refer to inpatient therapeutic care immediately

Correct Answer: A. Start F-75 therapeutic milk immediatelyRationale: In Severe Acute Malnutrition (SAM) management (Kenya MOH guidelines based on WHO protocols), a child who is medically compromised (even if alert, with MUAC <11.5 cm) is admitted to inpatient therapeutic care. The first step in acute phase management is F-75 (stabilisation formula) — low protein, low energy milk given to stabilise the child metabolically without overwhelming a compromised gut and renal function. RUTF (Ready-to-Use Therapeutic Food) is used in the rehabilitation phase, not acute stabilisation. IV dextrose is given only if hypoglycaemia is confirmed by blood glucose <3 mmol/L.

Question 19 | Mental Health Nursing

A nurse is using therapeutic communication with a patient experiencing depression. The patient says, ‘I feel like nothing will ever get better.’ Which response by the nurse is MOST therapeutic?A. ‘Don’t worry, things always get better with time.’B. ‘I understand exactly how you feel, it gets better.’C. ‘It sounds like you’re feeling hopeless right now. Can you tell me more about what’s been happening?’D. ‘You should focus on the positive things in your life.’

Correct Answer: C. ‘It sounds like you’re feeling hopeless right now. Can you tell me more about what’s been happening?’Rationale: This response demonstrates two key therapeutic communication techniques: reflection (acknowledging the patient’s feeling of hopelessness) and an open-ended question (inviting the patient to share more). This validates the patient’s experience without minimising it or offering false reassurance. Options A, B, and D are non-therapeutic: ‘Don’t worry’ and ‘things get better’ are false reassurance; ‘I understand exactly how you feel’ is a cliche; and telling the patient to ‘focus on positives’ is dismissive and can worsen feelings of guilt and inadequacy in depression.

Question 20 | Anatomy & Physiology

A nurse is explaining kidney function to a student nurse. Which of the following CORRECTLY describes the function of the Loop of Henle?A. It filters blood under high pressure to produce the glomerular filtrateB. It reabsorbs glucose and amino acids from the filtrateC. It creates a concentration gradient in the medulla that allows urine concentrationD. It secretes hydrogen ions to regulate acid-base balance

Correct Answer: C. It creates a concentration gradient in the medulla that allows urine concentrationRationale: The Loop of Henle, by means of countercurrent multiplication, creates a hypertonic gradient in the renal medulla. This gradient is what allows the collecting duct (under ADH influence) to reabsorb water and produce concentrated urine. The glomerulus (Bowman’s capsule) performs filtration. The proximal convoluted tubule reabsorbs glucose, amino acids, and most water. The distal tubule and collecting duct handle acid-base regulation through H+ secretion and HCO3- reabsorption. Each segment has distinct functions that the NCK exam regularly tests.

Access Our Full NCK Revision Question Banks

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How to Use These NCK Revision Questions Effectively

Answering MCQs alone is not enough — it is the rationale that builds your exam intelligence. Here is a study strategy that works:

• Attempt the question first without looking at the answer. This activates your critical thinking.
• Read the rationale even if you got it right. Understanding why ensures you can apply the same logic to similar questions.
• Flag difficult questions and revisit them 48 hours later — spaced repetition improves retention.
• Study by subject per day rather than mixing all topics. Cover one subject block before moving to the next.
• Use our 30-day NCK revision calendar to structure your entire revision schedule systematically.

Frequently Asked Questions About NCK Exam Revision Questions

Final Word: Consistent Practice Wins

There is no shortcut to passing the NCK exam — but there is a smarter way to prepare. Consistent practice with high-quality revision questions helps nurses pass on their first attempt. Detailed rationales support their understanding and success.

Use these 20 free NCK exam revision questions as your starting point. Then take your revision to the next level with ReviQuiz’s full question banks. Over 1,000 more questions await you. They are organised by subject, by paper, and by difficulty level.

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