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100+ Free Charge Nurse Series (主管护师 368-374) Practice Questions

Prepare for the National Health Professional Technical Qualification Examination (Intermediate) — Charge Nurse Series (全国卫生专业技术资格考试（中级）主管护师 368-374) exam with instant access — no signup required.

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2026 Statistics

Key Facts: Charge Nurse Series (主管护师 368-374) Exam

4 Subjects

Exam Paper Structure (基础、相关专业、专业、专业实践)

NHC Talent Exchange Center (21wecan)

90 mins

Official Duration per Subject Paper

National Health Commission Examination Regulations

60 / 100

National Passing Benchmark per Subject

National Health Professional Qualification Assessment

2 Years

Rolling Score Validity Cycle (2年滚动管理)

NHC Talent Exchange Center Regulations

Codes 368-374

Intermediate Specialty Classifications

National Health Professional Qualification Directory

100

Practice Questions in this OpenExamPrep Bank

OpenExamPrep

This 100-question practice module is a rigorous dual-language study adaptation for China's National Charge Nurse Qualification Examination (中级主管护师 368-374). It covers the official 4-subject syllabus across Advanced Pathophysiology & Pharmacotherapy (20%), Nursing Leadership & Hospital Infection Control (25%), Advanced Medical-Surgical Clinical Nursing (35%), and Health Education & Clinical Research (20%), featuring authentic clinical scenarios, standard Chinese clinical terminology, and exhaustive distractor rationales.

Sample Charge Nurse Series (主管护师 368-374) Practice Questions

Try these sample questions to test your Charge Nurse Series (主管护师 368-374) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient with severe acute pancreatitis develops hypovolemic shock (低血容量性休克). During the ischemic compensatory phase of microcirculation (微循环缺血期 / 痉挛期), which pathophysiological change occurs in the capillary bed?
A.Extensive microvascular dilation and blood pooling in the capillary network
B.Precapillary sphincter and metarteriole constriction leading to decreased capillary inflow and arteriovenous shunt opening
C.Disseminated microthrombus formation and depletion of coagulation factors
D.Paralysis of postcapillary venules resulting in massive plasma fluid extravasation
Explanation: During the ischemic compensatory phase (微循环缺血期/代偿期) of shock, sympathoadrenal activation triggers massive catecholamine release. This causes intense constriction of precapillary sphincters (毛细血管前括约肌) and metarterioles (微动脉), reducing capillary perfusion ('less in, less out') while opening arteriovenous shunts (动静脉短路开放) to divert blood to vital organs (brain and heart).
2A critically ill patient with septic shock (脓毒性休克) has arterial blood gas (ABG) results: pH 7.28, PaCO2 28 mmHg, HCO3- 13 mmol/L, PaO2 85 mmHg, Base Excess (BE) -12 mmol/L. How should the Charge Nurse (主管护师) interpret this acid-base imbalance?
A.Uncompensated respiratory acidosis (失代偿性呼吸性酸中毒)
B.Partially compensated metabolic acidosis (部分代偿性代谢性酸中毒)
C.Primary metabolic alkalosis with respiratory compensation (代谢性碱中毒合并呼吸代偿)
D.Mixed respiratory acidosis and metabolic acidosis (呼酸合并代酸)
Explanation: The pH is 7.28 (< 7.35, acidemia). Primary reduction of HCO3- to 13 mmol/L (< 22 mmol/L) and negative BE (-12 mmol/L) indicate primary metabolic acidosis due to lactic acidosis from hypoperfusion. PaCO2 is 28 mmHg (< 35 mmHg), indicating compensatory hyperventilation (respiratory compensation). Because pH remains outside the normal range (7.35–7.45), it is classified as partially compensated metabolic acidosis (部分代偿性代谢性酸中毒).
3Anuric acute kidney injury patient presents with serum potassium (K+) 6.9 mmol/L. The ECG shows tall, peaked T waves, PR interval prolongation, and QRS widening. Which medication must be administered FIRST to rapidly counteract myocardial toxicity and prevent fatal ventricular arrhythmias?
A.5% Sodium bicarbonate (5% 碳酸氢钠) 100 mL IV infusion
B.10% Calcium gluconate (10% 葡萄糖酸钙) 10–20 mL slow IV injection
C.Regular insulin 10 U in 50% glucose (50% 葡萄糖加胰岛素) IV drip
D.Sodium polystyrene sulfonate (聚苯乙烯磺酸钠) oral suspension
Explanation: In severe hyperkalemia (高钾血症, K+ > 6.5 mmol/L) with ECG changes, the immediate first-line intervention is intravenous 10% calcium gluconate (10% 葡萄糖酸钙) 10–20 mL slowly over 2–5 minutes. Calcium ion directly stabilizes the cardiac resting membrane potential by shifting the threshold potential, immediately antagonizing potassium's cardiotoxicity without altering serum potassium concentration.
4During continuous infusion of norepinephrine (去甲肾上腺素) via a peripheral intravenous line, the nurse notes severe local blanching, coolness, and swelling around the puncture site. Which emergency action should be taken FIRST?
A.Apply a hot wet compress at 60°C to promote peripheral vasodilation
B.Stop the infusion immediately, aspirate residual drug, and infiltrate phentolamine (酚妥拉明) locally
C.Elevate the limb and increase the infusion rate to flush through the constricted vessel
D.Apply topical 0.5% iodophor and leave the intravenous catheter in place for 24 hours
Explanation: Norepinephrine extravasation (去甲肾上腺素外渗) causes intense alpha-1 adrenergic vasoconstriction leading to ischemic tissue necrosis. The infusion must be discontinued immediately. Residual medication should be aspirated, followed by local subcutaneous infiltration of the alpha-receptor antagonist phentolamine (酚妥拉明, 5–10 mg diluted in 10–15 mL normal saline) into the blanched area to restore capillary blood flow.
5In the early hypercoagulable phase (高凝期) of Disseminated Intravascular Coagulation (DIC / 弥散性血管内凝血) secondary to severe sepsis, which laboratory finding and clinical nursing consideration are most characteristic?
A.Microvascular thrombosis and organ dysfunction may occur early; management prioritizes the cause, with anticoagulation considered only for selected thrombotic-predominant cases under specialist direction
B.Severely prolonged PT/APTT with spontaneous mucosal hemorrhage; tranexamic acid (氨甲环酸) is the first choice
C.Marked thrombocytopenia with elevated FDP; platelet concentrate transfusion is the sole required treatment
D.Marked elevation of fibrinogen (> 6.0 g/L) with absence of D-dimer elevation
Explanation: DIC produces systemic coagulation activation, microvascular thrombosis, factor and platelet consumption, and potentially both organ ischemia and bleeding. The central treatment is rapid control of the underlying cause plus supportive blood-component therapy when clinically indicated. Heparin is not an automatic treatment for every early septic DIC case; it may be considered in selected patients in whom thrombosis predominates and bleeding risk is acceptable, under specialist direction.
6According to Chinese hospital high-alert medication safety guidelines (高危药品管理规范), what is the MAXIMUM allowable concentration of 10% potassium chloride (10% 氯化钾) in peripheral intravenous maintenance fluids?
A.0.15% (15 mmol/L)
B.0.30% (40 mmol/L)
C.0.60% (80 mmol/L)
D.1.00% (134 mmol/L)
Explanation: According to national high-alert drug safety standards and clinical pharmacology guidelines, the maximum permissible concentration of potassium chloride in intravenous maintenance fluids administered via peripheral veins is 0.3% (0.3 g/100 mL, corresponding to approx. 40 mmol/L or 15 mL of 10% KCl added to 500 mL infusion solution). Direct intravenous push (静脉推注) is strictly banned due to the risk of instantaneous cardiac arrest.
7A patient receiving intravenous doxorubicin (多柔比星, an anthracycline vesicant) reports severe burning pain at the infusion site with subcutaneous edema. Following immediate cessation of infusion and aspiration, which local physical measure is correct?
A.Apply hot moist compresses at 50–55°C continuously for 24 hours
B.Apply intermittent local ice packs / cold compresses (局部冷敷) for 24–48 hours
C.Perform vigorous local circular massage to disperse the drug into surrounding tissue
D.Infuse 100 mL of 5% sodium bicarbonate directly into the subcutaneous tissue
Explanation: Doxorubicin (多柔比星) is an anthracycline DNA-binding vesicant (发疱性化疗药). Local cold compresses (局部冰敷/冷敷) cause vasoconstriction, slow cellular drug uptake, reduce local metabolic activity, and restrict drug spread. In contrast, plant alkaloids (e.g., vincristine 长春新碱) require warm compresses (热敷) to facilitate systemic dilution.
8A patient with decompensated hepatitis B cirrhosis develops lethargy, flapping tremor (扑翼样震颤), and disorientation. Why are soap-and-water enemas (肥皂水灌肠) strictly contraindicated in this hepatic encephalopathy (肝性脑病) patient?
A.Soap solution is acidic and precipitates gut mucosal bleeding
B.Soap solution is alkaline, increasing intestinal pH and converting ionized NH4+ into absorbable non-ionized NH3
C.Soap solution stimulates intense vagal reflexes causing profound bradycardia
D.Soap solution binds to lactulose and neutralizes its osmotic laxative effect
Explanation: In hepatic encephalopathy (肝性脑病), ammonia toxicity (血氨增高) is a primary pathophysiological mechanism. Soap solution (肥皂水) is alkaline (pH > 7.0). In an alkaline intestinal lumen, ionized ammonium (NH4+) is deprotonated into toxic, lipid-soluble, un-ionized ammonia (NH3), which readily diffuses across the intestinal mucosa into the portal and systemic circulation, crossing the blood-brain barrier to precipitate hepatic coma. Acidic solutions (e.g., lactulose or weak vinegar enemas) maintain an acidic environment to trap ammonia as NH4+ for excretion.
9When titrating intravenous nitroglycerin (硝酸甘油) for a patient with acute decompensated left heart failure and pulmonary edema, which nursing consideration is essential regarding infusion equipment and hemodynamic monitoring?
A.Standard PVC infusion tubing must be used to ensure uniform chemical binding
B.Non-PVC / glass administration sets (专用非PVC输液器) should be utilized, and blood pressure must be monitored frequently to prevent hypotension
C.The infusion rate should be increased rapidly until systolic blood pressure drops below 85 mmHg
D.Nitroglycerin should be infused strictly through the same central lumen as dopamine without dedicated access
Explanation: Nitroglycerin (硝酸甘油) is highly lipophilic and readily adsorbs to polyvinyl chloride (PVC) plastic tubing, causing up to 40–80% drug loss. Therefore, dedicated low-adsorption non-PVC (e.g., polyethylene PE) tubing or glass infusion bottles must be used. Nitroglycerin predominantly reduces venous return (preload reduction) and at higher doses reduces afterload; close arterial blood pressure monitoring is mandatory to prevent coronary hypoperfusion.
10A patient with severe chronic hyponatremia (serum Na+ 112 mmol/L) is admitted with somnolence. What is the MAXIMUM safe rate of serum sodium correction during the first 24 hours to prevent osmotic demyelination syndrome (脑桥中央髓鞘溶解症 / ODS)?
A.Not exceeding 4–6 mmol/L in 24 hours
B.Not exceeding 8–10 mmol/L in 24 hours (or <= 0.5 mmol/L/h)
C.Rapid elevation of 15–20 mmol/L within the first 6 hours
D.Normalizing serum sodium to 140 mmol/L within 12 hours
Explanation: Overly rapid correction of chronic hyponatremia causes rapid brain cell dehydration and shrinkage, leading to osmotic demyelination syndrome (脑桥中央髓鞘溶解症 / Central Pontine Myelinolysis), resulting in spastic quadriparesis, pseudobulbar palsy, and coma. Clinical guidelines mandate that the increase in serum sodium should not exceed 8–10 mmol/L in the first 24 hours (and <= 18 mmol/L in 48 hours).

About the Charge Nurse Series (主管护师 368-374) Exam

The National Health Professional Technical Qualification Examination (Intermediate) — Charge Nurse Series (全国卫生专业技术资格考试（中级）主管护师，专业代码 368-374) is China's official intermediate professional licensing credential for senior clinical nurses, head nurses, and nursing managers across tertiary, secondary, and community health institutions. Administered annually by the National Health Commission Talent Exchange Center (21wecan), achieving the Charge Nurse (主管护师) title is an essential statutory career milestone required for advanced clinical practice leadership, nursing administration, clinical teaching, and appointment to Head Nurse (护士长) or Deputy Director Nurse (副主任护师) tracks. The exam rigorously assesses deep competence across 4 unified domains: Basic Knowledge (pathophysiology, etiology, laboratory investigations), Related Professional Knowledge (nursing leadership, infection control, health education), Professional Knowledge (clinical manifestations, diagnostic reasoning, treatment principles), and Professional Practice Competency (nursing process execution, clinical care pathways, emergency rescue techniques, and patient safety protocols).

Assessment

National computer-based examination (人机对话机考) administered across 4 separate 90-minute testing sessions: (1) Basic Knowledge (基础知识), (2) Related Professional Knowledge (相关专业知识), (3) Professional Knowledge (专业知识), and (4) Professional Practice Competency (专业实践能力), totaling 400 points (100 points per paper).

Time Limit

90 minutes per subject paper (360 minutes total across 4 examination papers)

Passing Score

60 out of 100 points per subject (fixed 60% national standard passing score)

Exam Fee

Set provincially; Hunan's 2026 notice charges RMB 70 per subject (National Health Commission Talent Exchange Center (国家卫生健康委人才交流服务中心 / 21wecan))

Charge Nurse Series (主管护师 368-374) Exam Content Outline

20%

advanced-pathophysiology-and-pharmacotherapy

Mechanisms of acute organ dysfunction, systemic inflammatory response syndrome (SIRS), sepsis pathophysiology, acid-base and electrolyte disorders (metabolic acidosis, hyperkalemia, hypokalemia), hemodynamics in circulatory shock, cardiac arrhythmia mechanisms, neuroendocrine stress responses, pharmacokinetics/pharmacodynamics of critical care drugs, vasoactive inotropes/pressors, antiarrhythmics, emergency toxicology, chemotherapy safe handling, and high-alert drug safety protocols.

25%

nursing-leadership-quality-and-infection-control

Nursing administration principles, nursing staffing and tier management (能级对应与分层管理), clinical pathways, patient safety adverse event reporting (不良事件上报制度), healthcare quality management tools (PDCA, RCA, 5S), medical record management, nosocomial infection surveillance, standard precautions, isolation protocols for MDROs (MRSA, CRE, CRAB), sterilization and disinfection standards (WS/T 367), healthcare-associated infection bundles (VAP, CLABSI, CAUTI, SSI), and medical waste management.

35%

advanced-med-surg-and-specialty-nursing

Comprehensive assessment and care of complex medical-surgical disorders: acute coronary syndromes (STEMI/NSTEMI), acute decompensated heart failure, acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD) exacerbations, acute stroke (ischemic/hemorrhagic), gastrointestinal hemorrhage, hepatic encephalopathy, acute pancreatitis, polytrauma, closed chest drainage, intracranial pressure (ICP) management, post-operative complications, obstetric emergencies (postpartum hemorrhage, preeclampsia), and pediatric respiratory/neurological emergencies.

20%

health-education-community-and-research

Health education behavior change models (Health Belief Model, PRECEDE-PROCEED), patient communication and counseling techniques, community chronic disease management protocols, home care and palliative hospice nursing, epidemiology and community health assessment, clinical nursing research methodology, literature evaluation, evidence-based nursing practice (EBNP) formulation, research ethics, and statistical concept interpretation.

How to Pass the Charge Nurse Series (主管护师 368-374) Exam

What You Need to Know

  • Passing score: 60 out of 100 points per subject (fixed 60% national standard passing score)
  • Assessment: National computer-based examination (人机对话机考) administered across 4 separate 90-minute testing sessions: (1) Basic Knowledge (基础知识), (2) Related Professional Knowledge (相关专业知识), (3) Professional Knowledge (专业知识), and (4) Professional Practice Competency (专业实践能力), totaling 400 points (100 points per paper).
  • Time limit: 90 minutes per subject paper (360 minutes total across 4 examination papers)
  • Exam fee: Set provincially; Hunan's 2026 notice charges RMB 70 per subject

Keys to Passing

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Charge Nurse Series (主管护师 368-374) Study Tips from Top Performers

1Master Shock Hemodynamics & Vasoactive Titration: Differentiate hypovolemic, cardiogenic, and septic shock parameters (CVP, MAP, SVR, ScvO2). Review precise dosing and titration rules for norepinephrine, epinephrine, dopamine, and nitroglycerin, including central line infusion and extravasation prevention.
2Understand Infection Control Bundles & MDRO Protocols: Memorize the evidence-based components of CLABSI bundles (chlorhexidine skin prep, maximal barrier precautions, daily need review), CAUTI bundles (aseptic insertion, dependent drainage, prompt removal), and VAP bundles (head-of-bed elevation 30–45°, daily sedation holiday, subglottic suctioning, oral chlorhexidine hygiene).
3Apply Quality Improvement & Nursing Leadership Tools: Learn how to construct and interpret PDCA cycles, Root Cause Analysis (RCA fishbone diagrams), clinical pathway variances, adverse event classification (Level I to IV), and nurse staffing tier allocations (能级对应原则).
4Prioritize Medical-Surgical Emergencies & High-Risk Interventions: Focus on acute myocardial infarction emergency nursing (MONA/Fibrinolysis/PCI window), acute stroke thrombolysis nursing (rt-PA inclusion/exclusion and BP management), closed chest tube drainage safety (water seal oscillation, clamping protocols), and acute pancreatitis early fluid resuscitation.
5Consolidate Health Education Models & Research Methodology: Differentiate the Health Belief Model (perceived susceptibility, severity, benefits, barriers) from the Transtheoretical Stages of Change Model. Review randomized controlled trial (RCT) design fundamentals, blinding techniques, PICO evidence-based search frameworks, and basic biostatistical interpretations (p-values, odds ratios).

Frequently Asked Questions

What is the China National Charge Nurse (主管护师) examination?

The Charge Nurse (主管护师) examination is the national intermediate professional qualification test (中级卫生专业技术资格考试) administered annually by the National Health Commission Talent Exchange Center (国家卫生健康委人才交流服务中心 / 21wecan). Passing this examination confers the intermediate professional title of Charge Nurse (主管护师), which is mandatory for career advancement, clinical nurse specialist roles, head nurse appointments, and subsequent promotion to Senior Nursing titles (副主任护师 / 主任护师).

What are the four official examination subjects and their passing standards?

The examination comprises 4 subjects: (1) Basic Knowledge (基础知识 - clinical etiology, pathophysiology, diagnostics), (2) Related Professional Knowledge (相关专业知识 - health education, infection control, nursing management), (3) Professional Knowledge (专业知识 - disease manifestations and clinical therapy), and (4) Professional Practice Competency (专业实践能力 - nursing assessment, clinical nursing pathways, and procedure execution). Each subject is scored out of 100 points, with a nationwide passing cutoff fixed at 60 points.

How does the two-year rolling score management system work?

Under the National Health Commission's 2-year rolling score rule (2年为一个周期的滚动管理办法), candidates must pass all 4 examination subjects within two consecutive calendar years. Passing scores achieved in Year 1 carry over to Year 2; if any subject is not passed after Year 2, the earliest passed subjects expire and must be retaken.

What are the specialty codes under the Charge Nurse series?

The Charge Nurse series includes 7 specialized sub-codes: 368 Nursing Practice (护理学), 369 Internal Medicine Nursing (内科护理学), 370 Surgical Nursing (外科护理学), 371 Obstetrics & Gynecology Nursing (妇产科护理学), 372 Pediatric Nursing (儿科护理学), 373 Community Nursing (社区护理学), and 374 Traditional Chinese Medicine Nursing (中医护理学). All specialties share identical Basic Knowledge and Related Professional Knowledge exams, while Professional Knowledge and Practice Competency focus on their respective specialty domains.

What educational and clinical experience prerequisites are required?

Candidates must hold a valid Nurse Practice Certificate (护士执业证书) and have served as a Junior Nurse Practitioner (护师) for: (1) 7 years with a secondary vocational diploma (中专); (2) 6 years with a college diploma (大学专科); (3) 4 years with a bachelor's degree (大学本科); (4) 2 years with a master's degree (硕士学位); or (5) direct eligibility upon graduation with a doctoral degree (博士学位). In rural/community health stations, eligibility requirements may be shortened by 1 year.

Why is this practice bank structured with 100 dual-language questions?

While the official examination is conducted in Simplified Chinese via computer-based test terminals, this 100-question study bank provides an advanced dual-language MCQ format designed for clinical nursing professionals, bilingual charge nurses, hospital quality coordinators, and nursing scholars. Each question integrates authentic Chinese clinical terms (in parentheses) alongside clear scenario stems and exhaustive distractor analyses.