1. What is the effect of McMurphy choking the Big Nurse and ripping off her dress, exposing her? What does it contribute to the story?
Kesey has repeatedly emphasized in Cuckoo's Nest how Ratched attempts to conceal her femininity through her "sexless" uniform. She views the sexual instinct as weak, primal, and uncontrollable, which puts it at ends with her deeply controlling and manipulative nature. Therefore, she attempts to physically conceal all signs of sexuality by covering up her breasts and revealing very little skin. By concealing her sex instinct, she hides any sign of human vulnerability that might maker her appear weak, and establishes herself above the "primality" of other people. Another reason she makes an effort to conceal herself is that her breasts and figure as a whole are the most obvious indicators of her gender. As Harding says, a man can have "power" over a woman, so to speak, by being sexually dominant over her. By hiding all signs of her gender, Nurse Ratched is able to protect herself from potentially being subjugated by the typical hierarchy of male over female and keep herself in control over the men. However, at the end of the book when McMurphy tears off her clothing and exposes her, he undermines both of the barriers that Ratched has created. Revealing her sexuality makes her seem human, thereby making her susceptible to the vulnerabilities that come with being human. It also made her femininity obvious and took away the power she had over the men before.

2. What is the effect of Bromden suffocating McMurphy?
Bromden suffocating McMurphy at the end of the novel isn't done out of maliciousness, but rather to solidify him as the Christ figure whose sacrifice allowed the ward patients to live again. McMurphy's willingness to sacrifice his own freedom to undo the ward's oppressive order makes him as a sort of martyr, and both his "spiritual" death and physical death serve to cement his martyrdom and almost make him like a messiah to the ward.

3. What purpose do Candy and Sandy serve in the novel?
Candy and Sandy are notably the only two women in the story that are not depicted as oppressive and controlling. This is because they are the only women not viewed as "demasculating" by suppressing the men's sexuality and trying to control it. Ratched, Harding's wife, Billy's mother, and the nurse with the birthmark all suppressed male sexuality, shamed it, or tried to control it. Candy, however, openly had relations with Billy, which gave him confidence until Ratched shamed him for it and threatened to tell his mother. The both of them worked as prostitutes, signifying an openness about sexuality that the other women in the story lacked. Candy and Sandy being depicted as "good" ties in with Kesey's theme that sexuality should not be suppressed and that male dominance should not be undermined in favor of female dominance.

4. What is the significance of Bromden's ability to finally resist the fog?
Bromden noted that the fog, induced by his schizophrenia, allowed him to hide from not only the other ward members, but also the aides and the Big Nurse. After being shamed, ignored, and oppressed for much of his life and "shrunk" by Ratched's overwhelming domination of the ward, he attempted to hide himself away from society and take refuge from being hidden within the fog. The fog conceals Bromden's identity and protects him from the oppressive eyes of society. As Bromden becomes more emboldened by McMurphy throughout the story, however, he no longer needs the fog to cling to and hide in. He is free to exist under the observation of others, now that he realizes he is not truly crazy and need not be ashamed of who he is.