INDEX NO: ………………………CENTER…………………SIGNATURE………………….

KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY

COLLEGE OF HEALTH SCIENCES

FACULTY OF ALLIED HEALTH SCIENCES

DEPARTMENT OF NURSING

TERMINAL EXAMINATION FOR DIPLOMA NURSING – NOVEMBER 2021

PAPER GENERAL PAPER

DURATION
2 HOURS
1. DO NOT OPEN THE QUESTION PAPERS UNTIL YOU ARE TOLD TO DO SO.
INSTRUCTIONS
2. YOU ARE ADVICED TO SPEND 2 HOURS ON THIS PAPER
3. FOR SECTION ‘A’, CIRCLE THE LETTER THAT CORRESPONDS TO YOUR
PREFERRED ANSWER ON THE QUESTION PAPER IN INK AND ALSO SHADE
ACCORDINGLY ON THE SCANNABLE FORM PROVIDED.
4. INDICATE YOUR INDEX NUMBER ON EACH PAGE OF THIS SET OF QUESTIONS.
5. NO PART OF THIS SET OF QUESTION PAPERS SHOULD BE TAKEN OUT OF THE
EXAMINATION HALL BY THE CANDIDATE.
6. ATTEMPT ALL QUESTIONS.
INDEX NO: ………………...CENTER……………. SIGNATURE……………………………...

1. During physical assessment of a patient with breathing difficulty, the patient assumed a
sitting up position with arms thrust forward and laterally unto the edge of the bed tripod
position he is likely to suffering from.
a. Asthma
b. Atelectasis
c. Obstructive Pulmonary Disease
d. Pneumothorax

2. In assessing a patient for psychosocial genetic health, the patient understands that the
following areas will be assessed the nurse.
I. ability to make informed decision
II. educational level
III. past coping mechanism
IV. social support
a. i and ii
b. i,ii and iv
c. ii, iii, and iv
d. i, ii, iii, and iv.

3. A nurse at the Outpatient Department was asked to do genetic counselling for couple who
wants to get married. what will be the role of the nurse in genetic counseling
I. Coordinating genetic relation healthcare with relevant community resources.
II. Gathers relevant data about the family
III. Offer support to patient and family only at the beginning of the counseling process
IV. Provide appropriate genetic information
a. i and ii
b. ii and iii
c. I, ii and iv
d. I, ii, iii, and iv

4. Patient who reported with vomiting and diarrhea had a nursing diagnosis of fluid volume
deficit. Which of the following statement describe this diagnosis.
i. Loss of extracellular fluid volume exceeds the intake fluid.
ii. Loss of water alone with increased serum level
iii. Ratio of serum electrolyte to water remains the same
iv. Water and electrolyte are lost in the same proportion as they exist in the normal
body fluids.
A. i and ii
 B. ii and iii
C. I, ii and iv
D. Ii, iii and iv
5. A patient on the ward is been manage for severe dehydration. The nurse in planning care for
this patient should be alert for the following risk factors .
i. Diabetes insipidus
ii. Excessive vomiting
iii. Gastrointestinal suctioning
iv. Osmotic diuresis
A. i and ii
B. I, ii and iii
C. I, ii and iv
D. Ii, iii and iv

6. A patient reported to a health facility of with the complain of diarrhea, muscle spasms and
laryngo spasms. Under assessment patient was observe to have positive chvostek’s signs.
What other cardinal signs would the patient exhibit.
A. Hypercalcimea
B. Hypocalcaemia
C. Hypermagesmia
D. Hypomagnesmia
7. Madam Ageni Boya, a 41 year old who has vomited severally is likely to be diagnosed of.
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory alkalosis
d. Respiratory acidosis

8. Awurama dadzi developed hypoalbuminaemia, which of the following could be the causes
of awurama’s condition.

I damaged gastrointestinal tract

Ii infection
Iii stress

a. I and ii
b. I and iii
c. ii and iii
d. I , ii, and iii
9. Awo kumi reported at the outpatient department with complaint of rash on the whole body.
She was assessed and diagnosed of chicken pox, awo kumi understands that her condition is
caused by …..
a. Cytomegalovirus
b. Epstein-barr virus
c. Herpes simplex virus
d. Varicella- zoster virus.

10. Syndromic management of sexually transmitted infections has both advantages and
disadvantages. The following are some disadvantages except.

A. Problem with partner notification

B. Only symptomatic STIs are treated
C. Over treatment especially in women.
D. Treatment is given at first visit.

11. Afeto kwamevi Ametor has been on your ward for the past seven days with the diagnosis of
coronary artery disease [CAD]. What are some of the non₋modifiable risk factors of the
above conditionsˀ

i. Family history of CAD

ii. Hypertension
iii. Increasing Age
iv. Obesity

A. I and ii
B. I and iii
C. ii and iv
D. iii and iv.

12. Mr kwabena Ankama, a 65 year old driver has been admitted to the male medical ward with
dysrhythmia. The nursing diagnosis for the above patient may include the followingː

I Anxiety related to fear of the unknown

ii. Decrease cardiac output
iii. Deficient knowledge about dysrhythmia and it treatment
iv.Family history of the disease
 A. I and ii
B. I and iv
C. I ,ii and iii
D. Ii, iii and iv

13. During a class room teaching on cardiac conditions, the tutor made mention of pericarditis as
one of the conditions of the heart. The lesson was understood that pericarditis can be caused
by ………….
I. Aneurysm
ii. Brain injury
iii. Infections
iv. Renal failure

A. I and ii
B. Ii and iii
C. I, ii and iv
D. I, iii and iv

14. Mr. Kwame Nyamekye has been on the ward with the diagnosis of Anaemia. His discharge
teaching to maintain nutritional status at home includes;
I. Eat well balanced diet
II. Drink adequate fluids
III. Avoid processed foods
IV. Avoid foods high in fat
A. I and II
B. I,II and IV
C. I, II, III and IV
D. II, III and IV

15. Alhaji Koo Baba, a 52 year old mechanic reported to the hospital with the complaints of
headache, dizziness and palpitations. His body mass index was calculated to be 50kg/m3. The
probable diagnosis will be ….

A. Morbidly obese

B. Normal weight

C. Obese

D. Overweight
16. A patient was rushed to the hospital with a complaints of sudden abdominal pains. On arrival
at the hospital, the pain lasted a relatively short time and was self-limiting. This pain could be
described as……..

A. Acute

B. Chronic

C. Referred

D. Throbbing

17. Madam Alepa Doda, 26years was admitted into the medical ward and treated for pneumonia.
Before she was discharged, she was again diagnosed as having malaria. Acquiring infections or
diseases other than the one patient was admitted with is described as ……….

A. chronic infection

B. contact infection

C. nosocomial infection

D. Patient to patient infection

18. The amount of blood pumped by the ventricles in 1 minute is known as;

A. Cardiac output

B. Heart rate

C. Stroke volume

D. ventricular contraction

19.Which of the following cardiac makers is first detected in blood after a patient with
myocardial infarction is assessed

A. Cardioglobin
B. Hemoglobin
C. Myoglobin
D. Xyloglobin
 20. The Apical and Radial pulse of a cardiac patient was checked. What will be the
difference between the Apical and Radial pulse?
A. Bradycardia
B. Pulse deficit
C. Rhythm deficit
D. Tachycadia.

21. A patient complains of severe abnormal pain. The nurse in assessing the pain should note the
following.

i. Degree of pain
ii. Duration
iii. Intervals without pain
iv. Time of onset.

A. I and ii
B. I and iii
C. I, ii and iv
D. I, ii, iii and iv

22. The nurse asked the patient to closed the eye and identify mild aromas such as coffee,
vanilla, pea nut butter, chocolate or orange. What cranial nerve is the nurse assessing?

A. Abducens
B. Auditory
C. Hypoglossal
D. Olfactory

23. Mamle Dzata diagnosised of malaria with a temperature of 40˚c. The temperature
reduced to 39.6˚c after tepid sponging. Which of the following organs controls the body
temperature?

A. Adrenal gland
B. Hypothalamus
C. Pituitary
D. Thyroid gland

24. A patient with restlessness, agitations, twitching, convulsion and serum sodium greater than
145Eq/L can be said to be suffering from……………
A. Hypercalcaemia
B. Hypernatraemia
C. Hypokalaemia
D. Hyponatraemia

25. A nurse planning care for Brenya who is suffering from hyperc

alcaemia would make the following relevant nursing diagnosis except

A. Activity intolerance related to neuromuscular weakness

B. Decreased cardiac output related to dysrhythmias

C. Fluid volume deficit related diarrhea

D. Ineffective breathing pattern related to respiratory muscle weakness

26. Mr. Moore has been diagnosed of thyroid disease due to inadequate intake of iodine. His
condition could lead to……………….

I. increased production of thyroid hormone

II. increased production of thyroid stimulating hormone (TSH)

III. reduced production of thyroid hormone

IV.reduced production of thyroid stimulating hormone

A.I and II

B.II and III

C. I, II, and III

D. I, II, III and IV

27. Mrs. Aduke Fume a 26 year old who weighs 85kg has been on the ward for 4 days. In
planning care for Mrs. Fume, the following nursing diagnosis were made except;

A. Anxiety related to change in lifestyle

B. Imbalanced nutrition more than body requirement

C. Imbalanced nutrition less than body requirement

D. Risk for imbalanced nutrition, more than body requirement

28.A Hepatitis B patient on your ward reported of passing light colored stools this could be as a
result of the liver ………

A. Becoming enlarged and tender

B. Converting glucose to glycogen

C. Not being able to produce bile

D. Secreting a lot of bile salt

29. Pulmonary tuberculosis [TB] is on the increase. The main principles in preventing the
transmission of this disease is ̸ are………
i. Early identification and treatment of people with active TB
ii. Performing a physical examination on patient
iii. Prevention of spread of infectious droplet
iv. Surveillance of TB transmission

A. I and iv
B. I,ii and iii
C. I, iii and iv
D. Iv only

30. Aku Botwe reported at the hospital with itchy and whitish vagina discharge. The
laboratory result confirmed candidiasis. Which of the following medication is most
appropriate for treating this condition.

A. Clindamycin
B. Doxycycline
C. Famciclovir
D. Nystatin (antifungi)

31. Asibi Bawa was diagnosed with syphilis. Which of the following organisms will be
isolated after a culture and sensitivity test is done.

A. Candida albicans
B. Chlamydia trachomatis
C. Streptococcus syphilis
D. Treponema pallidum

32. During a code response in the intensive care unit, a nursing student was inadvertently
pricked with a needle used on a homeless patient who had just arrived at the unit. What
kind of treatment will the student receive?

A. Post exposure prophylaxis after laboratory test

B. Immediate pre exposure prophylaxis
C. Post exposure prophylaxis
D. Pre exposure prophylaxis

33. Henry peters a hypertensive patient has developed ascites associated with right sided
heart failure. The condition of this patient may be due to ………

A. Congestion in the peripheral tissue and viscera

B. Decreased in ejected ventricular volume
C. Increased pulmonary pressure
D. Venous engorgement of the lungs

34. Adiza, a 13year old student was brought to your ward with the diagnosis of glucose 6
phosphate dehydrogenase deficiency. Which of the under listed will you stress on during
discharge education? The patient should ……………..

A. Avoid oxidant medications

B. Reduced exercise
C. Reduced water intake
D. Refused blood transfusion

35. Mama Ashie, a 28 year old known Asthmatic patient was rushed to the OPD with an
asthmatic attack. The physician Assistance ordered Theophylline which will……….

A. Decreased air way inflammation

B. Dilate the airway
C. Reduced irritation in the airway
D. Reduced the constriction of the bronchioles
36. Which of the following assessment techniques will be the best for determining fluid in
the pleural cavity?
A. Auscultation
B. Inspection
C. Palpation
D. Percussion

37. A hypertensive patient was placed on furosemide a loop diuretic. The mechanism of
action of this medication is to………….

A. Block reabsorption of sodium and water in the kidneys

B. Block the effect of angiotensin ii
C. Impair synthesis of norepinephrine
D. Inhibit calcium iron influx

38. To elicit appropriate responses from a 17 year old about his sexual health and practices,
the nurse will ask ……….questions.

A. Closed ended
B. Guiding
C. Leading
D. Open ended

39. Mr. Abam , age 45 reported to your unit with complains of muscular weakness,
constipation, anorexia, bradycardia and heart block. Which of the following conditions is
the patient suffering from?

A. Hyperkalemia
B. Hyperkalemia
C. Hypocalcaemia
D. Hypokalemia

40. In nursing Mr. Anum, a 40 year old vegetarian with malnutrition, what will be the nurse’s
great concern?

A. Intake of foods rich in folate

B. Intake of foods rich in iron.
C. Intake of vitamin A rich food
D. Intake of vitamin B rich foods

41. Madam Besiwaa aged 50, came to your unit hypovolemic shock. What will be the nurse’s
first action to take during the compensatory stage of shock?

A. Administer prescribed IV fluids

B. Administer prescribed medication
C. Assist in identifying and treating the underlying causes
D. Monitor the patient’s hemodynamic status

42. Mr. Lee, a patient on your ward has been scheduled for ECG examination. Patient is
anxious and eager to know the reason for the ECG. Which of the following will be the
best response from the nurse?

A. Determines the patient potential target heart rate.

B. Shows how the heart performs when at rest
C. Shows the presence of myocardial infarction
D. Will predict whether the patient will have heart attack.

43. Madam Esi has been diagnosed of acute coronary syndrome and is on admission on the
medical ward. To identify nervous system involvement of patient condition, the nurse
assesses for ……….

A. Anxiety, restlessness, decrease muscle contractility

B. Anxiety, restlessness, palpitations, heart murmurs
C. Anxiety, restlessness, shortness of breath, crackles
D. Anxiety, restlessness, feeling of impending doom

44. What will be the most effective way to increase the probability that a patient will
implement a self-care regime at home after been diagnosed and treated for Angina

A. Identify patient coping mechanism at home

B. Provide adequate education on heart healthy living
C. Provide patient with a 24₋hour diet plan
D. Refer patient to a public health nurse in his community.

45. Mr. Hush Moro has pleural effusion. Which of the following adventitious sounds indicate
that this patient has a fluid fill lung?
A. Bronchial
B. Crackles
C. Vesicular
D. Wheezes

46. The major goal of the nurse in managing a patient with pneumonia include……..

I. Improve airway patency

II. Institute suctioning therapy
III. Maintain proper fluid volume
IV. Provide enough rest to conserve energy

A. I and ii
B. I,ii and iii
C. I,ii and iv
D. I, iii and iv

47. Alhaji Bashiru has been diagnosed of peptic ulcer and is on admission at your ward.
Which of the following clinical manifestations confirms that he has a duodenal ulcer .ˀ
pain occursː
A. 2 to 3 hours after meals
B. 30 minutes to 1 hour after meals
C. 2 to 3 hours before meals
D. 30 minutes to 1 hour before meals

48. Mr. Fordjour a 65 year old patient on admission at your ward report of having urgency
and frequency of micturition and dysuria. Patient may possibly have……..

A. Glomerulonephritis, renal stones

B. Lesions of bladder neck, urinary sphincter injury
C. Renal neuropathy, urinary tract infection
D. Urethra stricture, benign prostatic hyperplasia

49. What explanation will the nurse give to Mr. Atsu, a patient who is enquiring about the
reason for his urine specimen for culture and sensitivity test?

i. Determines the presence of bacterial and their strains

ii. Help in estimating specific gravity of urine
iii. Identifies the antimicrobial therapy best suited for identified microbes
iv. Help with appropriate evaluation of any abnormalities in urine
 A. I and iv
B. Ii and iii
C. I, ii and iii
D. I, ii, iii and iv

50. Madam Asana, a known diabetic patient was rushed to the unit with diabetic
ketoacidosis. Which of the following is the possible cause of client’s condition.
A. Intake of oral glycemic medications
B. Non adherence to insulin regime
C. Over dose of antibiotic therapy
D. Overdose of insulin injection

51. The following clinical assessment findings are indications that the patient has grave’s
disease.

A. Chronic pain and tenderness of the thyroid gland

B. Dysphagia, fever, restlessness
C. Exophthalmos, palpitation, nervousness
D. Firm palpable thyroid gland, neck pain

52. The nurse ’s teaching of Madam Dede Armah diagnosed of hyperparathyroidism will
includeː

A. Avoidance of excessive intake of calcium

B. Avoidance of excessive intake of iron rich foods
C. Encouraging intake of high protein diet
D. Encouraging intake of high sodium diet

53. As a preceptor on the ward, how will you explain vertigo to a second year RGN student?

A. A feeling of dizziness and discomfort

B. A feeling of restlessness and listlessness
C. An abnormal sensation of imbalance movement
D. Having a feeling of light headedness and dizziness
54. To identify a cortical motor abnormality during nervous system assessment, the nurse
instruct patient to do which of the following?

A. Flex the wrist

B. Make a fist
C. Swinging the arm
D. Throw a ball

55. Baby Moses, a 12 month old baby is on admission at the pediatric ward with recurrent
seizures. Describe the nurse’s responsibility after an episode of seizure?

i. Document the event leading to and duration of the seizure

ii. Put patient in the fowlers position after the seizures
iii. Maintain a patent airway to prevent aspiration
iv. Tell mother to breastfeed baby immediately

A. I and ii
B. I and iii
C. Iii and iv
D. Ii and iv

56. Mr. Marfof 76 years been discharged after he was managed for angina pectoris. Which of
the following should the nurse include in his teaching?

A. Avoid alcohol
B. Eat diet high in fiber
C. Eat diet high in saturated diet
D. Reduced smoking

57. The student nurse checks the oxygen saturation of a 60 year old man with pneumonia
who has removed the oxygen catheter and the result is 70 percent. Which of the
following actions should the nurse take?

A. Inform the charge nurse that oxygen saturation Is normal

B. Nebulize patient
C. Put the oxygen catheter back on the patient
D. Takes no action
 58. Mr. Oye a 30 year old man is scheduled for thoracentesis. The nurse’s role will includeː

i. Offer support throughout procedures

ii. Preparing and positioning patient
iii. Suctioning patient during procedure
iv. Teaching deep breathing and coughing exercise
A. I and ii
B. Ii and iii
C. Ii and iv
D. I, ii, iii and iv

59. The nurse is performing an irrigation of the left ear of Madam Akos Boamaah with
impacted cerumen. What be the nurse’s best action?

A. Gentle pull the pinna back and upwards

B. Gentle pull the pinna down and backwards
C. Instruct the patient to tilt the head backwards
D. Place a cotton in the ear

60. Mr. Boateng is diagnosed of the Meniere’s (lesion) of the ear disease and is been
discharged. Which of the following is an appropriate teaching on regarding diet?

A. Avoid excess use of caffeine

B. Avoid sugar substitute
C. Drink at least 2litres of fluid per day
D. Follow a high fiber diet

Pau/ASH/NURS/2021