AMREF VIRTUAL TRAINING SCHOOL (AVTS)
END MODULE ONE SPECIAL/SUPPLEMENTARY EXAM
E-LEARNING PROGRAMME SEPT 2013 CLASS
GENERAL NURSING PAPER E/CH/N/M-KRCHN CLASS
DATE: THUR 3rd APRIL 2014 TIME; 8:00am to 11:00am
INSTRUCTIONS TO CANDIDATES
1. ALL QUESTIONS ARE COMPULSORY
2. ANSWER THE MCQs IN THE ANSWER SHEET PROVIDED. ANSWER IN CAPITAL LETTERS (UPPER CASE LETTERS)
3. FOR PART B AND C WRITE YOUR ANSWERS ON RULED PAPER PROVIDED. FOR PART B (SHORT ANSWER QUESTIONS), ANSWER QUESTIONS FOLLOWING EACH OTHER. FOR PART C (LONG ANSWER QUESTIONS, ANSWER EACH QUESTION SEPARATELY)
4. 10% OF THE MARKS WILL BE DEDUCTED FOR INFORMATION NOT ASKED FOR, SPELLING MISTAKES AND POOR GRAMATICAL EXPRESSIONS.
PART A MCQS 20 MARKS
1. Passive range of motion exercises;
a) Are performed to prevent nosocomial infections.
b) Helps to prevent joints rigidity and contractures.
c) Is a collaborative intervention that requires a surgeon and a nurse.
d) Are repeated 5-6 times a day to enhance quick recovery.
2. For a patient with a nasogastric feeding tube the nurse should ;
a) Perform oral care once a day and avoid hanging the tube below the level of the stomach
b) Avoid aspirating any gastric fluid from the tube
c) Ensure the patient lies flat for 30min after every feeding to prevent dumping syndrome
d) Irrigate the tube with small amount of water before and after each feeding
3. The appropriate distribution of nutrients for a diabetic patient might be,
a) 30% carbohydrates, 30% fat, 40% protein.
b) 60% carbohydrates,20% fat,20% protein
c) 60% carbohydrates,30% fat, 10% protein
d) 40% carbohydrates, 40% fat, 20% protein
4. To prevent recurrent cystitis, a nurse should advise a patient to,
a) Increase fluid intake to 2500 -3000ml/day and urine acidifying agents.
b) Reduce intake of urine acidifiers and increase intake of urine alkalinising agents
c) Avoid wearing tight clothes and public showers.
d) Avoid citrus fruits and increase intake of bicarbonate drinks
5. After a barium enema a nurse should,
a) Keep the patient NPO for 8 hours to rest the bowel
b) Advise the patient that his/her stool will be radioactive
c) Encourage the patient to increase his fluid intake
d) Advise the patient to avoid abdominal exercises for at least 1 week
6. When removing sutures, it is a good practice to,
a) Use sterile gloves during the procedure
b) Refrain from pulling an exposed suture through the wound
c) Administer a topical local anaesthetic agent before suture removal
d) Remove all sutures at once 3-5 days after surgery
7. Indicate whether the following statements are true (T) or false (F) in the answer sheet provided
a) Kussmaul’s respirations are seen in patients with DKA and renal failure
b) Morphine is contra-indicated for patients who have pain due to pancreatitis
8. Anaphylactic shock is;
a) Associated with excessive blood loss
b) Caused by systemic antigen-antibody reaction
c) Associated with effects of adrenaline and nor-adrenaline
d) Usually common in patients on antibiotics
9. Appropriate nursing interventions for a patient with “Risk for infection related to altered immunity response” include;
a. Barrier nursing, avoiding invasive procedures and inspection of entry port sites for pathogens
b. Reverse barrier nursing, monitor SPO2 hourly and serve high protein diet
c. Isolation nursing, obtaining cultures & sensitivities daily and administration of antibiotics
d. Reverse barrier nursing, avoiding invasive procedures & daily assessment of intravenous sites
10. The Korotkoff sounds heard while measuring blood pressure present in the order of,
a. Tapping, Swishing,Knocking, muffling and silence
b. Swishing, Tapping, Silence, muffling and knocking
c. Knocking, Tapping, Swishing, muffling, silence
d. Silence, Tapping, Knocking, Swishing and Muffling
11. In sickle cell anaemia patients,
a. The structure of haemoglobin molecule is not affected.
b. Prophylactic administration of folic acid and pneumococcal vaccine is recommended
c. Administration of IV fluids & immediate blood transfusion are encouraged during sickle cell crisis situations
d. The treatment of choice includes administration of penicillins & NSAIDs
12. The primary causes of acute otitis media are;-
a. Escherichia coli and proteus spp.
b. Streptococcus pneumonia and Haemophilus influenza.
c. Staphylococcus aureus and haemophilus influenza.
d. Proteus spp. and Streptococcus pneumonea.
13. Post intracranial surgery a patient is mainly at risk of;-
a. Hypoxia, paralytic ileus and hypostatic pneumonea
b. Cerebral oedema, hypoxia and seizures.
c. CSF leakage, urine retention and hyperthermia.
d. Hypotension, septicaemia and sensory deprivation.
14. Osteoarthritis;
a. Is inflammatory and autoimmune.
b. Commonly affects weight bearing joints.
c. Mainly affects the synovial membrane tissue.
d. Usually affects small joints of the hands and feet.
15. In management of Asthma,
a. The patient should lie in dorsal recumbent position to enhance breathing
b. Give intravenous aminophylline 250mg over 20min
c. Administer oxygen via nasal prongs at 2l/min for the first 24 hrs.
d. Administer IV hydrocortisone 400mg every 4-6hrs until respiration rate gets normal
16. The early signs of cancer of the posterior-nasal space include;
a. Proptosis, hearing loss.
b. Hearing loss, double vision.
c. Purulent nasal discharge, aphonia.
d. Anosmia, proptosis.
17. Limb traction helps to,
a. Relieve pain, achieve hemostatis and prevent deep venous thrombosis
b. Restore nerves function, maintain bone alignment & correct deformities
c. Rest inflamed joints, restore limb and muscle size, prevent contractures
d. Promote movement with ease, restore blood flow & reduce embolism
18. Hyperkalemia commonly occurs in the following,
a. Burns, pneumonia and congestive cardiac failure.
b. Renal failure, crush injuries and burns.
c. Digitalis toxicity, DKA and hyperthyroidism.
d. Overuse of potassium sparing diuretics, CCF and liver cirrhosis
19. Complications of measles include:-
a) Deafness,encephalitis,contractures
b) Paralysis, rectal prola
c) pse, blindness
d) Malnutrition, umbilical hernia, deafness
e) Blindness, malnutrition, pneumonia
20. The route that achieves the quickest absorption and effects of a drug is the,
a) Subcutaneous
b) Intradermal
c) Intramuscular
d) Oral
PART B SHORT ANSWER QUESTIONS 40 MARKS
1. Outline five (5) specific nursing interventions for a child with meningitis (5mrk)
2. Draw and label a diagram illustrating the conducting system of the heart (5 marks)
3. List four types of intravenous fluids giving an indication for each (4 marks)
4. Describe the role of the kidney in maintaining fluid & electrolyte balance (4mks)
5. Describe the pathosphysiology of burns (5 marks)
6. Outline any four (4) nursing diagnosis for a patient with head injury (4 marks)
7. State five (5) specific nursing responsibilities for a patient with congestive cardiac failure (CCF) – 5 mrks
8. Outline four (4) nursing bowel training interventions for a patient with incontinence (4mrks)
9. List any four (4) classes of antibiotics giving an example for each (4 marks)
PART C LONG ESSAY ANSWER QUESTIONS 40 MARKS
1. Mr. T. 45yrs old is brought to hospital and is diagnosed to have an ischemic stroke
a. Draw a diagram illustrating structures of a neurone (4 mrks)
b. Describe the management for Mr. T. for the first 72 hours (14 mrks)
c. State any two(2) complications associated with ischemic stroke (3 mrks)
2. Master Pizza is admitted in a paediatric ward having been diagnosed to have mechanical intestinal obstruction-:
a. State any four (4) causes that might have led to Master Pizza’s condition (4 mrks)
b. Describe the management for master Pizza from admission till discharge (14 mrks).
c. List any four (4) complications master pizza may develop (2mrks)