FINAL EXAMINATION FOR REGISTERED NURSES MAY 2004 PAPER II: SURGICAL ASPECTS

WEDNESDAY 5TH MAY 2004 ANSWER ALL QUESTIONS TIME: 9:00AM 12:00 NOON TIME ALLOWED 3 HOURS

Examination number
IMPORTANT Read the questions carefully and answer ONLY what is asked in the section indicated as no credit will be given for irrelevant matter. NO MARKS can be given if a candidate wrongly numbers answers. DO NOT put your name on the paper, only put your index number. SECTION A (Objective questions nos 1 50 to be done on the question paper) NUMBERS 1 20 circle the correct answer only. Qn 1. The hyaline cartilage is found a. Between the bodies of the vertebrae (intervertebral discs) b. Between the articulating surfaces of the knee joint. c. Between the ribs and the sternum. d. On the rim of the body sockets of the hip and shoulder joint Qn 2. The mucous membranes line the a. Genital urinary tract. b. Cardiovascular system c. Central nervous system d. lymphatic vessels Qn 3. Which of the following cranial nerve is not a motor nerve? a. Trochlear b. Abducent c. Auditory Qn 4. The following are the branches of coeliac artery except a. Right gastric artery b. splenic artery c. Hepatic artery d. Hypoglossal d. left gastric artery

Qn 5. The following are paranasal sinuses except a. Maxillary sinus b. Mastoid sinus c. Frontal sinus d. Sphenoid sinus Qn 6. Which of the following is not a postoperative procedure? a. 24 hour collection specimen b. Relief of pain c. Breathing exercises d. care of wound and drainage Qn 7. The following are radiological examinations except a. Cholecystogram b. Hysterosalpingogram c. Bronchoscopy d. Intravenous pyelogram Qn 8. Clinical examination of the patient is carried out in the following order a. Palpation, inspection, auscultation and percussion b. Inspection, palpation, percussion and auscultation c. Auscultation, percussion, palpation and inspection d. Inspection, percussion, palpation and auscultation. Qn 9. The following preoperative care may be done on the eve of operation for a patient due for laparatomy except a. X-ray of the chest b. Administration of Premedication c. Rectal washouts d. Urine testing for sugar, protein, chlorides

Qn 10. If a patient experienced any symptom of glaucoma, it would most likely be a. Decreasing peripheral vision b. excessive lacrimation c. Coloured light flashes d. eye pain Qn 11. What advice would you give to someone whose clothes have caught fire? a. Take off his clothes immediately b. Fall on the ground and roll c. Stand still and call for help d. Spray his clothes with fire extinguisher. Qn12. A 25-year-old man sustains burns of the right arm, right leg and anterior trunk. The total percentage of the burnt body surface would be a. 18% b. 45% c. 27% d. 64% Qn 13. Which of the following positions would permit the best assessment of the patient with inguinal hernia? a. Sitting up b. Left side lying c. Standing up d. Right side lying Qn 14. Which of the following signs would indicate that the child has some dehydration? a. Eager to drink, skin pinch goes back slowly b. Drinks poorly, pinch of skin goes back immediately c. Drinks normally, dry lips, pinch of skin goes back immediately d. Drinks poorly, pinch of skin goes back slowly Qn 15. Which of the following is not a general danger sign in a child of 18months a. Fast breathing b. convulsions c. Not able to drink d. Lethargy or unconsciousness Qn 16. Anaemia in a 2 year old can be detected by a. Paleness of the conjunctiva b. paleness of the tongue c. Palmer pallor d. paleness of the gum Qn 17. The earliest symptom of malignant growth of the larynx is a. Sore throat b. pain radiating to the ear c. Difficulty in swallowing d. persistent hoarseness of the voice Qn 18. Which of the following family planning methods would be ideal for a 38-year-old client with 8 children who does not want to use a permanent method a. Condom b. Depo-Provera c. Norplant d. fertility awareness method

Qn 19. Salpingo oophoritis means a. Inflammation of the ovarian ligaments and fallopian tubes b. Inflammation of the fallopian tube and ovaries c. Inflammation of the ovaries and fimbriae d. Inflammation of the fallopian tube and uterine fundus Qn 20. Normal growth of a long bone is facilitated by a. Osteoclasts b. cancellous bone c. Epiphyseal cartilage d. Yellow bone marrow

TRUE / FALSE Nos 21 30 place TRUE or FALSE against each statement in the space provided 21. Muscle relaxation is necessary for many operations especially upper abdominal procedures.

22. Difficulty with micturition is not a common complication in patients confined to bed.. 23. Older women who smoke can use pills for emergency contraception. 24. Sodium thiopentone can be given intramuscularly as general anaesthesia 25. Impacted fracture is one in which bone fragments are jammed into another 26. A Premedication is a drug administered 1-2 hours before operation to induce sleep.. 27. Job description specifies the title, duties and responsibility of the job owner. 28. Bronchiectasis can be relieved by postural drainage and injection of streptokinase in the pleural cavity 29. In atresia of the oesophagus the upper part of the oesophagus ends in a blind sac and the lower communicates with the trachea.. 30. Retrolental fibroplasia is one of the causes of morbidity in neonates of low birth weight. Numbers 31 40 match items in column A with those corresponding in column B using corresponding letters A 31. Urethral stricture 32. Atelectasis B a. chronic inflammation of ileum b. Blood group

33. Congenital dislocation of the hip . C. Congenital abnormality of male urethra 34. Oesophageal varices 35. Crohns disease 36. Hypospadias 37. Osteoma 38. Coagulation of blood 39. Gangrene 40. Rhesus factor d. Catheterization e. Partial lung collapse f. Haematemesis g. Tissue necrosis

h. Acquired at birth i. Fibrinogen j. Benign bone tumour K. Shallow acetebulum

Nos 41 50 Fill in the Blank spaces

41. is when a person freely makes a thought out decision based on accurate useful information. 42. The six steps of counseling process is known as.. 43. Lactation amenorrhoea method is the best method of contraception for a breast-feeding mother before.. 44. is the simplest method of observing infection prevention. 45. is a temporary loss of motor tone in the smooth muscle of the gut. 46. Assessment and analysis of the patients need and problems is known as 47. The tubes cut during vasectomy operation are called... 48. Radical mastectomy means 49. Infant mortality means.. 50. Maternal mortality rate means. Section B and C (to be answered in the answer books)

Section B 2. You are a Registered Nurse incharge of health center III, explain your responsibility regarding the following a. Record keeping b. Team work c. Delegation of duty d. Meetings e. Out reach 2marks 2marks 2maks 2 marks 2 marks

Section C 3. A 25-year-old schoolteacher is admitted in your ward having sustained head injury in a motor accident a. List five clinical features that the patient will present with 5 marks b. Describe the nursing management of this patient in the first 72 hours of admission c. List 5 complications of head injury 4. A 2-year-old child is brought to you at the health unit complaining of the following Fever and cough for three days and diarrhoea for 2 days use IMCI approach to manage this child in the health unit END 20 marks 10 marks 5 marks