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Medical Surgical Nursing Ii Question Paper
Medical Surgical Nursing Ii
Course:Bachelor Of Science In Nursing And Public Health
Institution: Kenyatta University question papers
Exam Year:2009
KENYATTA UNIVERSITY
UNIVERSITY EXAMINATIONS 2008/2009
SECOND SEMESTER EXAMINATION FOR THE DEGREE OF BACHELOR
SCIENCE (NURSING AND PUBLIC HEALTH)
HNS 209: MEDICAL SURGICAL NURSING II
DATE: Thursday 2nd April, 2009
TIME: 2.00 p.m. – 4.00 p.m.
INSTRUCTIONS
i)
Answer ALL questions.
ii)
For part A MCQs, answer in the question paper.
iii)
For part B and C answer in the answer booklet provided.
PART A:
MCQs
1.
One of the following events occurs in response to a low serum calcium level.
a)
The parathyroid gland releases parathyroid hormone.
b)
The negative feedback system “shuts off”
c)
Calcitonin is released from the pituitary.
d)
The thyroid is stimulated to release TSH
2.
One of the following statement is true regarding type I diabetes mellitus
a)
There is no genetic or hereditary pattern
b)
There is a strong familial link
c)
There is a strong autoimmune basis
d)
There is no environmental link
3.
The focus of the short-term goals for the management of Diabetes Mellitus is to:
a)
Cure the disease
2
b)
Prevent the disease
c)
Control
the
disease
d)
Recognize for complications
4.
Realizing that liver function declines with age, it is essential that the nurse closely
monitor all elderly patients for
a)
Hematuria
b)
Ascites
c)
Jaundice
d)
Drug
toxicity
5.
Which one of the following nursing diagnosis would apply for a patient with liver
cirrhosis?
a)
Pain/itching related to impaired bilirubin metabolism.
b)
Ineffective breathing related to abdominal ascites.
c)
Risk for impaired skin integrity related to scratching, pruritus
d)
Fatigue related to increased metabolic needs and/or anorexia.
6.
In assessment of the abdomen, the sequence should be;
a)
Inspection, palpation, percussion, auscultation
b)
Inspection,
auscultation, palpation, percussion
c)
Inspection, percussion, auscultation, palpation
d)
Inspection,
palpation,
auscultation, percussion
7.
One of the following is True about the pathogenesis of Achalasia
a)
Non-adrenergic non-cholinergic inhibitory neurones are affected more
than cholinergic nerves.
b)
Cholinergic nerves are affected more than the non-adrenergic non-
cholinergic
inhibitory
nerves.
c)
Degenerative lesions are found on the hypoglossal nerve.
d)
There are increased levels of nitric oxide.
8.
The late clinical manifestations of cancer of the oesophagus include:
3
a)
Dysphagia
b)
Painful
swallowing
c)
Substernal
fullness
d)
Hiccups
9.
Severe acute gastritis may be caused by:
a)
Helico-bacter
pylori
b)
Ingestion of a strong alkali
c)
Chronic reflux of pancreatic secretions
d)
Respiratory
failure.
10.
Eradication of H-Pylori entails use of
a)
Two antibiotics and aH2 – receptor antagonist
b)
Two antibiotics and a bismulth salt
c)
Two
antibiotics
and
a proton-pump inhibitor
d)
Two antibiotics and a H1 – receptor antagonist.
11.
The majority of patients who suffer bowel obstructions have obstructions of the
a)
Large
intestine
b)
Ascending
colon
c)
Descending
colon
d)
Small
intestine
12. Classic
clinical
manifestations
of symptomatic gallstones include;
a)
severe, steady right quadrant pain with nausea and vomiting
b)
Low-grade fever with abdominal cramping which is intermittent
c)
Acute, spasmodic pain that is relieved by walking or bending forward.
d)
High fever, mid-epigastric pain and rigid, tender abdomen.
4
13.
24 year old man is brought to the emergency department with a head injury,
which one of the following signs and symptoms is an early indicator of altered
level of consciousness
a)
Localises to painful stimulus
b)
Inability to state the day
c)
Dilatation of pupils
d)
Difficulty
pronouncing
words
14.
The nursing diagnosis that would apply to all patients with parkinson’s disease is;
a)
Risk for injury related to propulsive gait, postural instability
b)
Altered thought process related to neurochemical imbalance
c)
Impaired communication related to dimentia
d)
Impaired
social
interaction related to neurone degeneration
15.
The primary difference in the pathophysiology of myasthenia gravis and multiple
sclerosis, is that myasthenia gravis
a)
Occurs from atrophy of lower motor neurons
b)
Involves destruction of acetylcholine receptors
c)
Involves
destruction
of myelin in the CNS
d)
Occurs because of hardening of the spinal cord.
16.
Nursing care of a client with gastro-enteritis should include which of the
following
interventions:
a)
Encourage optimal nutritional intake
b)
Alleviate abdominal pain and cramping
c)
Administer an oral enti-emetic
d)
Monitor fluid intake and output and electrolyte levels.
17.
In planning for home care of a client with Hepatitis A, which of the following
preventive measures should the nurse emphasize to protect the client’s family?
a)
Completely isolate the client
5
b)
Use good sanitation with dishes and shared bathroom.
c)
Avoid contact with blood-soiled clothings or dressings.
d)
Forbid sharing of needles or syringes.
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