Ministry of Health and Indigenous Medical Services
Final Year Examination of 2016 A Student Nurses Batch
PAPER - III
TOTAL MARKS: 100 INDEX NO:
TIME : 02 HOURS DATE :
Answer all questions
01 Encircle the most suitable answer.
1.1 The nurses’ responsibility during perioperative care is to
I. Assist the surgery, controls environment and coordinate the use of supplies and
equipment
Ii . Assist for recovery of the patient
Iii . Prepare the patient for surgery and transportation to the theatre
Iv . All of the above
1.2 the characteristic sign of paralytic ileus is
I Abdominal tightness
ii. Abdominal distension
iii. Increase abdominal growth
iv Absence of peristalsis
1.3 A female patient who has breast cancer, receives Chemotherapy. A nursing Diagnosis for
this condition is kept as fluid and electrolyte imbalance due to chemotherapy. Which
assessment finding will confirm the Nursing diagnosis?
i. Urine output of 400 ml in 8 hours
ii. Serum K level of 3.6 mEq/l
Iii Blood pressure 130/72 mmHg
Iv Dry oral mucus membrane and cracked lip
1.4 55 years old male patient has bowel Carcinoma. What would be the most suitable
investigation to confirm the cancer of the patient
i. Abdominal ultrasound scan
ii. MRI Scanning
Iii. Computerized tomography scan
iii. Biopsy of the tumor
1.5 What is the false statement regarding cataract?
I. A Cataract is a clouding or opacity within the crystalline lens
ii. A nurse will instill non-steroidal anti-inflammatory eye drops to dilate pupils before
surgery.
iii. Slit lamp will be used to diagnose the cataract
iv. None of the above
1.6 Which type of medication would be administered after surgery for patient who have been
undergone Craniotomy.
i. Diuretics
ii. Antihypertensive Drugs
ii. Steroids
iii. anticonvulsants
1.7 A patient has undergone laryngectomy. The immediate nursing priority would be
i. Keep trachea free of secretions
Ii Monitor for signs of infection
ii. Provide emotional support
iii. Promote means of communication
1.8 Most common complications of peptic ulcer are
i. Hemorrhage, peritonitis, Infection
ii Hemorrhage, Perforation, Pyloric obstruction
iii Hemorrhage, perforation, Infection
iv. Hemorrhage, Peritonitis, Perforation
1.9 Which of the incorrect answer about Laparoscopic cholecystectomy?
i. Treatment of choice for cholelithiasis
ii. Less invasive and thus less chance of wound infection
iii. Less pain and rapid return to normal activities
iv. No morbidity & mortality when compared to traditional cholecystectomy
1.10 What is the most important factors nurses should include in her discharge plan of a
patient undergone pyelolithotomy
i. Increase of daily intake of fluid more than 3L to prevent recurrence of UTL
ii. Prescribed medication regime, name, dose and side effects
iii. Importance of mobilization
iv. Need report of signs & Symptoms of recurrence of calculi
1.10 Which is the most effective equipment should be kept ready at bed side, when patient
is on mechanical ventilation.
i. Water seal chest drainage set iii O2 apparatus
ii. Manual resuscitation bag iv Tracheostomy Set
1.11 The most important nursing goal during nursing care of a patient having tracheostomy
surgery is to
i. Relief of pain
ii. Prevention of infection
iii. Maintenance of patient airway
iv. Encourage communication
1.12 Mr X, a diagnosed patient with peptic ulcer has been prescribed small frequent diet,
antacid and famotidine. The eff ect of famotidine is to
i. Help the formation of protective covering on the ulcer and thus promote healing
ii. Helps in neutralizing the excessive gastric acid production
iii. Reduce HC1 Secretion by blocking vagal stimulation
iv. Reduces HC1 secretion by blocking the action of histamine on the H 2 receptors and
decrease conversion of pepsinogen to pepsin
1.13 A Client with varicose veins commonly complains of
i. Muscle ache, cramps and fatigue
ii. Sharp pain in leg during walking
iii. Fatigue & Cool feet
iv. Pallor and numbness of feet
1.14 The nurse is taking care of patient who has undergone ligation & stripping for varicose
veins. Which of the following intervention is not recommended?
i. Elevate the foot of the bed
ii. Apply compression stockings
iii. Encourage deep breathing
iv. Encourage sitting beside the bed and hang down the leg
1.15 Most important risk factor for lung cancer is
i. Cigarette smoking
ii. Working in Asbestos industry
iii. Genetic Predisposition
v. Exposure to low level radiation
1.17 Atelectasis is a post-operative complication of abdominal and thoracic surgery. Which
intervention is risk for atelectasis
i. Frequent positioning
ii. Steam inhalation
iii. Use of an incentive spirometer
iv. Coughing exercise
1.18 What is the most appropriate position for the pts who have undergone a
knee Amputation?
i. Supine with the stump flat on the bed
ii. Supine with the stump supported with pillows
iii. Reverse Trendelenburg position
iv. Prone position
1.19 The patient complains of having hoarseness and weak voice after
thyroidectomy. Which nursing action is most appropriate?
i. Notify the Physician immediately
ii. Reassure the patient
iii. Check for signs of bleeding
iv. Administer Calcium Gluconate
1.20 After cataract surgery, a patient should be encouraged to
i. Maintain bed rest for a week
ii. Lift weight to increase muscle strength
iii. Lie on his stomach while sleeping
iv. Avoid bending his head below waist
1.21 During the immediate postoperative period of the client’s stoma. The
nurse evaluates which of the following observation should be reported
immediately to the doctor?
i. Stoma is dark red to purple
ii. Stoma oozes a small amount of blood
iii. Stoma is lightly edematous
iv. Stoma does not expel stool
1.22 Diagnosed patient with hiatus hernia complains of sleeplessness.
Appropriate nursing action is to
i. Provide 2-3 pillows to support the head and help to sleep
ii. Provide antacid to the patient
iii. After a glass of milk before going to bed
iv. Avoid giving carbohydrate rich diet
1.23 Dumping syndrome occurs as a complication of
i. Mastectomy iii Colostomy
ii. Esophagectomy iv Gastrostomy
1.24 Administration of Sclerosing agent is an effective treatment for
i. Internal hemorrhoids
ii. Fibrosis hemorrhoids
iii. First degree hemorrhoids
iv. Third degree hemorrhoids
1.25 The nurse administer neomycin sulphate to a patient prior to colon
surgery to
i. Decrease the possibility of post-operative urinary tract infection
ii. Increase the production of Vitamin K.
iii. Destroy intestinal bacteria
iv. Increase defecation
1.26 A test that would be performed to diagnosis varicose vein is
i. Romberg test
ii. Doppler ultrasound
iii. Trendelenburg test
iv. Kernig’s test
1.27 A main complaint of patient having enlarged prostate gland is
i. Hesitancy
ii. Dysuria
iii. Polyurea
iv. Hematuria
1.28 Intussusception is
i. Twisting a making a bowel loop
ii. Movement of one segment of bowel in to another segment
iv. Adhering bowels and internal organs
iii. Protrusion of a bowel segment through abdominal wall
1.29 In the recovery room, while caring for a patient who have received
general Anesthesia, the nurse should inform the Physician if
i. Patient pushes out the airway
ii. The Patient has snoring
iii. Respiration are regular but shallow
iv. SBP reduces from 130 to 100mmHg
1.30 When turning the patient who has undergone right pneumonectomy ,
the nurse should plan to position the client in:
i. Right Side – lying position or supine
ii. High fowlers
iii. Right or left side lying position
iv. Low fowler’s position [30 Marks]
02 Filling the blanks using most appropriate words or phrases:
2.1 Gallstones are composed of primarily from……………………………………
……………………………………
2.2 ………………………………………………..is a collection of fluid in the pleural space.
2.3 Carpel tunnel syndrome would be caused by compression of ……………………………………………….
Nerve
2.4 …………………………………………………Disease may occur due to excessive accumulation of
endolymph in the membranous labyrinth
2.5 The formula for fluid resuscitation of burn patient is termed
as……………………………………………………………………….
2.6 The phases of wound healing are …………………………………… …………………………………&
………………………………………………………..
2.7 Resus sardonicus is a main feature of………………………………… …………………………….
2.8……………………………………………………….is a chronic idiopathic diffuse inflammatory disease of
the mucosa of the colon.
2.9 A Common complication after mastectomy is ……………………………………………………. in which
condition there is an obstruction to the lymph flow in the arm of the operated side.
2.10 A tumor usually of the adrenal medulla that produces excess quantities of catecholamine is
………………………………………………………… [10 Marks]
03 Select the most suitable terms from the column B & match with the column A in the given
spaces
Column A Column B
1. Gastro Jejunostomy [ [ ] a. Tonometer
2. Flail chest [ ] b. Slit lamp
3. Mac-Burney’s point [ ] c. exophthalmos
4. Whipple resection [ ] d. Appendicitis
5. Phantom Sensation [ ] e. Peritonitis
6. Paget’s disease [ ] f. Cancer Rectum
7. Pyloric Stenosis [ ] g. Conductive deafness
8. Glaucoma [ ] h. Bill Roth – I
9. Weber test [ ] i. Bill Roth – 11
10. Hyperthyroidism [ ] j. Pancreatic Tumor
k. Tumors in large intestine
l. Projectile vomiting
m. Pathologic fracture
n. Rib Fractures due to
accidental trauma
o. Amputation of an arm or
leg
[10marks]
01] 60 years old male patient was admitted to the surgical ward due to nausea, abdominal
pain, distention and tenderness. After seen by the doctor, the patient was managed as acute
abdomen.
1.1 what are the causes for the acute abdomen?
i.
ii.
iii.
iv. [2marks]
1.2 Mention the emergency nursing management for this patient.
i.
ii.
iv.
iv. [4marks]
1.3 The investigation reveals the patient’s condition as intestinal obstruction and plans to do
Exploratory Laparotomy
State the specific nursing interventions during preoperative phase under sub headings.
physical preparation.
i.
ii.
iii.
iv [2marks]
Psychological preparation
i.
ii.
iii
[1.5marks]
1.4 Describe the role of the nurse during post – operative phase.
Nursing diagnosis 01 nursing intervention
ii
[marks 1.5]
Nursing diagnosis 02 interventions
i
ii [marks 1.5]
02] 55 years old male patient was admitted to cancer ward complaining of dysphagia and LOA
Pt was diagnosed as oral cancer
2.1 Mention the possible causes for oral cancer
i.
ii.
iii.
iv. [2 marks]
2.2 write down the specific clinical manifestation of disease condition except LOA and
dysphagia
i.
ii.
iii.
iv. [2marks]
2.3 List down most relevant investigations to confirm the diagnosis
i.
ii. [1marks]
2.4 What would be the most relevant treatment method for the oral cancer.
i.
ii.
iii. [1.5marks]
2.5 Chemotherapy is the one of best method of treatment to promote tumor cell destruction of
cancers. Name the frequently used chemotherapeutic drugs.
i.
ii.
iii. [2marks]
2.6 State the safety measures in handling chemotherapy.
i.
ii.
iii.
iv. [2marks]
2.7 Pain is the most common symptoms associated with carcinoma.
Mention the non pharmacological nursing interventions of pain relief.
i.
ii.
iii.
iv. [2marks]
03] 50 years old Mr P was admitted to the surgical ward due to accidental flame burn injury to
face, neck, chest abdomen and both hands.
3.1 Calculate the percentage of burn surface area A/C to the rule of nine .
[1marks]
3.2 What would be the other signs and symptoms nurse found during assessment phase of the
patient.
Signs
i.
ii.
iii. [1.5marks]
Symptoms
i.
ii.
iii. [1.5marks]
3.3 List down the factors determining the severity of burns.
i.
ii.
iii.
iv. [2 marks]
3.4 What are the objective of planning nursing care for the patient during emergent phase.
i.
ii.
iii.
iv. [2marks]
3.5 State three immediate nursing diagnosis and two nursing interventions for each one
Nursing Diagnosis Nursing Interventions
1. i.
ii.
2. i.
ii.
3. i.
ii.
[4.5marks]
04] Hip fracture causes functional disability and negatively affects quality of life in older people
and is an important health problem with high morbidity and mortality.
4.1 List down possible risk factors of hip joint fractures in elderly women.
i.
ii.
iii.
iv. [2marks]
4.2 An elderly married women was admitted to orthopedic ward after hip fracture. Patient
seen by the surgeon and plans to immobilize the affected limb.
What should be the most common methods of immobilization of the limb.
i.
ii. [2marks]
4.3 What are the nurse’s role in maintaining safety of the patient having skin traction.
i.
ii.
iii.
iv. [2marks]
4.4 Orthopedic Surgeon plans to do total hip replacement surgery for this pt.
Describe the nursing interventions during pre op care for this patient
I,
ii.
iii.
iv. [2marks]
4.5 Pre – op teaching is a most effective role of a nurse. Describe the facts included in the
teaching session for this patient.
i.
ii.
iii.
iv.
v. [2.5marks]
4.6 List down the possible complications for patient having joint fracture.
i.
ii.
ii i.
iv. [2marks]
