Medical info & Nursing council license/loksewa preparation-Nepal

Cyclophosphamide induced hemorrhagic cystitis:
Cyclophosphamide is an alkylating agent metabolized in the liver to its active anticancer form, phosphoramide mustard, and a toxic byproduct, acrolein. While phosphoramide mustard crosslinks DNA to kill cancer cells, acrolein is excreted in urine, where it accumulates in the bladder. Acrolein irritates the bladder mucosa, leading to hemorrhagic cystitis, characterized by hematuria, dysuria, urinary frequency, and urgency. The risk increases with high doses or prolonged therapy.

Management and Role of MESNA:
MESNA (sodium 2-mercaptoethanesulfonate) is a sulfhydryl compound used to prevent cyclophosphamide-induced cystitis. It binds to acrolein in the urine, forming a non-toxic compound that is safely excreted, without affecting the anticancer efficacy of cyclophosphamide. Additional preventive measures include adequate hydration and frequent urination to reduce bladder exposure to acrolein.

Antimicrobial resistance (AMR) is a growing global health threat that occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve to resist the effects of medications designed to kill them or stop their growth. This resistance makes common infections harder to treat, leading to longer illnesses, increased healthcare costs, and a higher risk of severe outcomes or death. Misuse and overuse of antibiotics in humans, animals, and agriculture—such as taking antibiotics without prescription, not completing the full course, or using them for viral infections—are major drivers of AMR. Poor infection prevention, lack of new drug development, and inadequate global surveillance also worsen the problem. Combating AMR requires coordinated action, including responsible use of antimicrobials, public education, improved sanitation, vaccination programs, and investment in research for new treatments.

एन्टिबायोटिक भनेको जीवाणु (ब्याक्टेरिया) बाट हुने संक्रमण उपचार गर्न प्रयोग हुने औषधि हो। यसले भाइरस (जस्तो कि रुघा, खोकी, फ्लू) मा काम गर्दैन। तर हाम्रो समाजमा सानो रोगमा पनि मनपरी एन्टिबायोटिक प्रयोग गर्ने, आफैंले फार्मेसीबाट किन्न जाने, वा डाक्टरको सल्लाहबिना प्रयोग गर्ने प्रवृत्ति छ।
आफूखुशी जथाभाबी एन्टिबायोटिक प्रयोग गर्दा मानव स्वास्थ्यमा पर्ने असरहरु:

१. किटाणुहरुले एन्टिबायोटिक प्रतिरोध क्षमता (Antibiotic Resistance) बिकास गर्छन।

२. भविष्यमा सामान्य रोगको उपचार गर्न गाह्रो पर्छ, महँगो र शक्तिशाली औषधि प्रयोग गर्नुपर्ने हुन्छ।

३. उपचार असफल भइ बिरामीको ज्यानै समेत जान सक्छ।

४. गलत कारणले औषधि प्रयोग गर्दा रोग निको हुँदैन, समय र पैसा दुवै बर्बाद हुन्छ।

५. जथाभाबी एन्टिबायोटि सेवनले हाम्रो शरीरको प्रतिरक्षा प्रणालीमा समेत असर पर्न सक्छ, अर्थात् जुन रोग सामान्य आफै निको हुन्थ्यो सो को लागि समेत औसधि सेवन गर्नुपर्ने स्थिति आउन सक्छ ।

६. अनावश्यक एन्टिबायोटिकले शरीरको राम्रो ब्याक्टेरियालाई पनि मारीदिन्छ, जसले स्वास्थ्यमा नकारात्मक असर पार्छ।

एस्तो अवस्था हुन नदिन के गर्न सकिछ ?
१. डाक्टरको सल्लाहबिना एन्टिबायोटिक सुरु नगर्ने।

२. पूरा डोज (डाक्टरले भनेको दिनसम्म) एन्टिबायोटिक थेरापी लिने । बीचमै रोग ठिक भयो भनेर नरोक्ने ।

३. भाइरसको संक्रमणमा (जस्तै सामान्य रुघाखोकी) एन्टिबायोटिक नखाने।

४. फार्मेसिस्टको निर्देशनअनुसार मात्र औषधि प्रयोग गर्ने।

Q.No. 596) Who is the founder of modern Nursing ?
A. Hildegard Peplau
B. Virginia Henderson
C. Florence Nightingale
D. Jean Watson

Q.no.595) spontaneous abortion is due to the deficiency of
A.Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin E

Q.no.594) Immunity produced by the body after disease attack is;
1
A. Active Natural
B. Passive Natural
C.Active Artificial
D. Passive Artificial

Total marks coverage in Nepal Nursing Council PCL nursing licensure examination

Integrated Science
5%
5
Fundamental of Nursing
25%
38
Community Health Nursing
15%
23
Adult Nursing
20%
30
Child Health Nursing
10%
15
Midwifery and Gynecology
20%
30
Leadership and Management
5%
7

Total
150
Source : Official website of NNC