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Nrsg 226:Adult Health Nursing Question Paper

Nrsg 226:Adult Health Nursing

Course:Nursing

Institution: Kenya Methodist University question papers

Exam Year:2013

KENYA METHODIST UNIVERSITY

END OF 1''ST ''TRIMESTER 2013 (EVENING) EXAMINATION
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : NURSING
UNIT CODE : NRSG 226
UNIT TITLE : ADULT HEALTH NURSING
TIME : 3HOURS

INSTRUCTIONS: Answer ALL Questions

SECTION A (Multiple Choice Questions; Choose the most appropriate response, Each correct response earns you 1mark)

Question 1

A focused examination is performed when;

The patient denies a health problem
A baseline health maintenance examination is required
A specific problem is identified during physical examination
The medical diagnosis directs attention to a specific problem area.

Question 2

The nurse would place information that a patient revealed about his concern that his illness is threatening his job security in which of the following functional health pattern?

Role-relationship
Cognitive- perceptual
Coping – stress tolerance
Health perception- health management

Question 3

When planning teaching with consideration of Adult learning principles, the nurse would;

Present material in an efficient lecture format
Recognize that adults enjoy learning regardless of relevance to their personal lives
Provide opportunities for the patient to learn from other adults with similar experiences
Postpone practice of new skills until the patient can independently practice the skill at home

Question 4

A patient is admitted to the medical ward with chronic kidney disease (CKD). The nurse understands that this condition is characterized by:

Progressive irreversible destruction of the kidneys
A rapid decrease in urinary output with an elevated blood urea and nitrogen (BUN)
An increasing creatinine clearance with a decrease in uritary output.
Prostration, somnolence and confusion with coma and imminent death

Question 5

The polydipsia and polyuria related to diabetes mellitus are primarily caused by:

The release of ketories from cells during fat metabolism
Fluid shifts resulting from the osmotic effect of hyperglycemia
Damage to the kidneys from exposure to high levels of glucose
Changes in Red Blood cells (RBC`s) resulting from attachment of excessive glucose to haemoglobin.

Question 6

The nurse assists the patient with nutritional therapy of diabetes with the knowledge that a "diabetic diet" is designed:-

To be used only for Type 1 diabetes
For use during periods of high stress
To normalize blood glucose by elimination of sugar
To help normalize blood glucose through a balance diet.

Question 7

A nurse is instructing a client on how to perform a testicular self examination (TSE). The nurse tells the client.

To examine the testicles while lying down
That the best time for the examination is after a warm shower/bath.
To gently feel the testicle with one finger to feel for a growth
The testicular exams should be done at least every 6 months

Question 8

A client suspected of having an ovarian tumor is scheduled for a pelvic ultrasound. Which pre-procedure instructions with the nurse to provide to the patient?

Maintain an NPO status prior to the procedure
Eat a light breakfast only
Drink six to eight glasses of water without voiding prior to the test
Wear comfortable clothing and shoes for the procedure.

Question 9

A nurse is caring for a client 4 days after a pelvic surgery who has been NPO, now instructed to start on clear fluids/liquids. Which priority assessment will the nurse make before administering the diet.

Ability to ambulate
Urine specific gravity and total urine output in 24 hours
Incision appearance
Bowel sounds

Question 10

Which of the following nursing intervention would prevent lymphedema of the affected over on a client after a radical mastectomy?

Placing cool compresses on the affected arm
Elevating the affected arm on a pillow above heart level
Maintaining an IV site below the antecubital area on the affected side
Avoiding arm exercises in the immediate post-operative period.

Question 11

Pre-renal causes of acute renal failure (ARF) include:

Prostate cancer and calculi formation
Hyporolemia and myocardial infarction
Acute glomerulthephritis and neoplasm
Septic shock and nephrotoxic injury from drugs.

Question 12

A nurse notes that a client with type 1 diabetes mellitus-has lipodystrophy on both upper thighs. The nurse would appropriately inquire if the client:

Cleanses the skin with alcohol before each injection
Rotates sits for injection
Aspirates for blood prior to injection into the subcutaneous tissue
Administers the insulin at a 45-degree angle.

Question 13

Which of the following nursing diagnoses would the nurse include in the plan of core for a patient post cucation of colostomy?

Altered nutrition: More than body requirements
Body image disturbance
Fear related to poor prognosis
Sexual dysfunction

Question 14

A client with ascities is scheduled for a paracentesis which of the following positions will the nurse assist the client to assume for this procedure?

Supine
Left-side-lying
Right- side lying
Upright position

Question 15

Which of the following is an example of a correctly written learning objective?

The patient will lose 2.5kgs in 6 weeks
The patient should understand the implication of the condition
The patient will read two pamphlets on the subject of breast self-examination.
The patient`s spouse will demonstrate to the nurse how to correctly change a gastrostomy bag before discharge.

Question 16

An important nursing responsibility related to pain is to

Leave the patient alone to rest
Help the patient appear to not be in pain
Believes what the patient says about the pain
Assume responsibility for eliminating the patients pain.

TRUE and FALSE Questions 1/2 a mark each)

Question 17

Regarding HIV/AIDS

The progression of HIV disease is predictable
HIV disease is diagnosed when the CD4+ cell count is 200cells/mm3 or fewer.
HIV disease in men who have sex with men is decreasing
Ninety-nine percent seroconversion of exposed individuals occurs within 6 months of the exposure.
An HIV- infected person may appear to be healthy.
The nurse instructs the HIV patient to have a diet high in calorie. High in protein and low in residue.
On HIV transmission and prevention, condoms may not provide 100% protection but when used correctly and consistently they reduce the risk of getting infected.
Condoms do not provide 100% protection but when used with a spermicidal one can be assure of complete protection against HIV.

SECTION B (Short Answer Questions 40marks)

Question 1
a) Define critical thinking. (1mark)
b) State THREE characteristics of critical thinking in relation to the nursing
process. (3marks)

Question 2

Describe FOUR factors that influence an individual`s ability to tolerate surgery.

(8marks)

Question 3
Describe the role of the nurse in caring for a patient undergoing a lumber punture test. (5marks)

Question 4
Describe the THREE types of shock. (9marks)

Question 5
State FOUR warning signings of cerebral vascular accident. (4marks)

Question 6

Describe nursing interventions in the management of a patient with cerebral

Vascular accident within 48 hours of admission to a medical ward. (8marks)

Question 7

Describe THREE components of teaching for a patient with tuberculosis.
(3marks)

SECTION C

Question 1

Mr. Adam a 65year old man is admitted to the medical ward with complaints of increasing shortness of breath, he has been on treatment for congestive cardiac failure and a chest x-ray confirms pulmonary edema.
a) Describe the pathophysiology of pulmonary edema in a patient with
congestive cardic failure. (5marks)
b) List other TWO clinical manifestations that Mr Adam will present with.
(1mark)
c) Using the nursing process, describe the management that Mr. Adam will
receive till discharge. (14marks)

Question 2

Ms Janny is a known epileptic on treatment and has been admitted with history of recurrent seizures and complains of headache and muscle aches.
a) Describe the TWO major classification if seizures giving an example in
each case. (5marks)
b) Discuss the FOUR stages of a tonic-clonic seizure. (8marks)
c) describe the nursing interventions for Ms. Janny while in the ward till
discharge. (7marks)

Nrsg 226:Adult Health Nursing Question Paper

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