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Adult Nursing I (Nrsg 224) Question Paper

Adult Nursing I (Nrsg 224)

Course:Nursing Sciences

Institution: Kenya Methodist University question papers

Exam Year:2013

TIME : 3 HOURS

Instructions:
Answer all questions
SECTION A: Multiple Choice Questions (20 marks)
Question One
A nurse is preparing to admit a client with a diagnosis of congestive heat failure. Which of the following medications would the nurse ensure that it is readily available for use?
Propranolol
Walfarin
Digoxin
Amlodipine

Question Two
A community nurse is instructing a client about the use of a respiratory inhaler. Which action by the client indicates a need for further instruction?
Removes the cap and shakes the inhaler well before use.
Inhales the mist and quickly exhales
Presses the canister down with finger as he inhales.
Waits 1 to 2 minutes between puffs if more than one puff has been prescribed.

Question Three
A client has experienced pulmonary embolism. A nurse assesses for which symptom, which is most commonly reported?
Sudden chills and fever
Chest pain that occurs suddenly
Dyspnea when deep breaths are taken
Crackles as auscultation

Question Four
The clinic nurse administers a mantoux skin test to a client. The nurse tells the client to return to the clinic for reading the results in:
48 to 72 hours
Within 24 hours
36 to 48 hours
24 to 48 hours

Question Five
A 16 year old boy is brought to the emergency department with a bloody nose. What is the initial nursing action?
Place the boy in a supine position in the examination coach.
Assist the boy in a sitting position with the head tilted forward.
Instruct the boy to swallow blood until the bleeding can be controlled.
Prepare to transfuse the client.

Question Six
A nurse is preparing a client for lumbar puncture. The nurse would place the client in which position for the procedure?
Side-lying with a pillow under the hip
Prone, with a pillow under the abdomen
Prone, in slight – Trendelenburg’s position
Side-lying, with legs pulled up and head bent down onto chest.

Question Seven
Which of the following is the best route to administer pain medication in a client with extensive burns?
Oral
Intravenous
Intramuscular
Subcutaneous

Question Eight
A group of emergency room nurse is administering intravenous fluids to clients with partial thickness burn injuries. In evaluating the adequacy of fluid resuscitation which of the following will provide the most reliable method?
Vital signs
Urine output
Mental status
Peripheral pulses

Question Nine
A surgical nurse is assessing the motor function of an unconscious client. Which of the following would be best used to test the client’s peripheral response to pain?
Nail bed pressure
Pressure on the eye
Pressure on the sternum
Squeezing the leg muscles

Question Ten
A client with HIV infection is prescribed daily cotrimoxazole (septrin) as part of the disease management. The nurse plans to monitor which of the following significant adverse reactions associated with this drug?
Anemia
Skin rashes
Nausea and vomiting
Diarrhea

Question Eleven
What is the primary role/purpose of neutrophilis in the inflammatory response?
Dilate blood vessels
Increase fluid at the site of injury
Produce permeability of the blood cells
Phagocytes any potentially harmful agents

Question Twelve
A 20 year old female client is scheduled for escharatomy procedure due to third-degree circumferential aim burn. The primary nurse understands that the anticipated therapeutic outcome of the escharatomy is
Return of distal pulses
Decrease edema formation
Decrease loss of body fluids
Decrease bleeding from the site

Question Thirteen
Nurse Hasha teaches a patient with heart failure to take doses of furosemide in the morning. The reason for this is to help
Prevent electrolyte imbalance
Prevent sleep disturbances during night
Prevent rapid drug absorption
Excrete the excessive amounts of fluids that accumulated at night.

Question Fourteen
Ms Ince is admitted with a diagnosis of congestive cardiac failure (CCF). The nurse expects to hear what type of sound an auscultation, indicative of CCF?
Crackles
Wheezes
Stridor
Friction mbs

Question Fifteen
Which of the following clinical findings indicates a positive Homan’s sing?
Surgical incision pain
Absent bowel sounds
Pain with dorsiflexion of the foot
Crackles on auscultation of the lungs

Question Sixteen
A client has received a transfusion of platelets. A nurse evaluates whether the client benefitted from platelet therapy if the client exhibits which of the following?
Decreased blood oozing from the injection sites
Increased hemoglobin level
Increased packed cell volume
Decreased hematocrit level

Question Seventeen
Theophylline is prescribed for a client with acute bronchitis. A nurse administers the medication knowing that the primary action of this mediation is
Suppress cough
Promote expectoration
Relax smooth muscles of the bronchial airway
Prevent infection

Question Eighteen
An orthopedic nurse is evaluating the pin sites for a client in skeletal traction. The nurse would be least concerned with which of the following findings?
Serous drainage
Inflammation
Purulent discharge
Pain at the pin site

Question Nineteen
A clinical nurse instructor is performing an admission assessment for an adult client with a diagnosis of tuberculosis. Which of the following diagnostic test results would confirm the diagnosis?
Chest X-ray
Tuberculin skin test
Sputum culture
Complete blood count

Question Twenty
A client is suspected to be having a myocardial infarction (MI). The nurse assesses for elevation in which of the following isoenzyme values reported with the creatine kinase level?
MM
MB
BB
MK

SECTION B: Short Answer Questions. (40 marks)
Question One
Explain the goals of intravenous therapy. (5 marks)

Question Two
Pain is the most common symptom associated with cancer.
What are the causes of pain among cancer patients?
(2 marks)
Describe the pharmacologic management of cancer pain
(6 marks)

Question Three
State four nursing diagnoses for a client with pneumonia. (4 marks)

Question Four
Explain the surgical/risk factors and appropriate preventive strategies under the following clinical conditions:
Poor nutrition.
(4 marks)
Fluid and electrolyte imbalance
(4 marks)

Question Five
List four indications for endotracheal intubation.
(2 marks)
Describe the nursing care of clients with artificial airways.
(4 marks)

Question Six
Hypertension is a disease named the "Silent Killer."
What is the difference between essential hypertension and secondary hypertension?
(2 marks)
Explain the risk factors for hypertension.
(3 marks)
State the non pharmacologic management of hypertension.
(4 marks)

SECTION C: Long Answer Questions. (40 marks)
Question One
A middle aged unknown African man is brought to the emergency department, following a road traffic accident. After preliminary investigations, he is found to be having an open pneumothorax secondary to chest trauma.
Explain the clinical manifestations of open pneumothorax.
(4 marks)
Describe the collaborative management of the client with open pneumothorax.
(12 marks)
What instructions would a nurse give to the community members on strategies to preventive automotive or road traffic accidents?
(4 marks)

Question Two
Describe the pathophysiology of coronary artery disease.
(6 marks)
Discuss the collaborative management of the client with coronary artery disease.
(12 marks)
List four complications of the coronary artery disease.
(2 marks)

Adult Nursing I (Nrsg 224) Question Paper

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