QUESTION PAPER- MEDICAL SURGICAL NURSING- II

3RD YEAR BSc.

Duration- 3 hrs.

Marks- 75

Date- 23/2/13

SECTION A- MCQ (30* ½ = 15 MARKS)

1. Human papilloma virus is known to be associated with:

A. cervical cancer

B. lymphoma

C. hepatocellular cancer

D. gastric cancer
2. Discharge planning for the burn patient begins
A. After grafting
B. On admission
C. After the emergent phase
D. Atleast 1 week before the discharge

3. The physician has prescribed pantoprazole for a client with burns which will help prevent the development
of:
A. Curling’s ulcer
B. Myoglobinuria
C. Hyperkalemia
D. Paralytic ileus

4. ___________ is a therapeutic agent used to promote recovery of neutrophils after

chemotherapy.

A. Filgrastim

B. L-Asparaginase

C. Levamisole

D. Hydroxyurea

5. Which laboratory result would be expected during the emergent phase of a burn injury?
A. Glucose 100 mg/dl
B. Potassium 3.5 mEq/l
C. Sodium 142 mEq/l
D. Albumin 4.2 gm/dl

6. The rationale for placing a patient with pelvic inflammatory disease in semi
fowler’s position is to:

A. Relieve pain

B. Prevent complication of sterility

C.Promote drainage to prevent abscess

D. Improve circulation and promote healing

7. Preoperative and postoperative nursing care for a woman with a gynaecological fistula includes:
A. Ambulation
B. Bladder training
C. Fluid restriction
D. Perineal hygiene
8. Stomatitis is a common side effect of chemotherapeutic agents, occurs because the
a. Site of malignancy is near the oral cavity
b. General health of the patient with cancer is poor
c. Chemotherapeutic drugs have an external, local and irritating effect
d. Rapidly dividing cells of the mucus membrane of the mouth are being destroyed

9. Thick white and curd like vaginal discharge and vulvar pruritis is most consistent
with:
a. Trichomoniasis
b. Monilial vaginitis
c. Bacterial vaginosis
d. Chlamydial cervicitis
10. The nurse has just completed the dressing change for a client with burns to the lower legs and
ankles. The nurse should place the client’s ankles in which position?
A. Internal rotation
B. Abduction
C. Dorsiflexion
D. Hyperextension

11. Helicobacter pylori is believed to be associated with:

A. Prostate cancer
B. Lung cancer

C. Vaginal cancer

D. Gastric cancer

12. On the third post-burn day, the nurse finds that the client’s hourly urine output is 26 ml. The nurse
should continue to assess the client and notify the doctor for an order to:
A. Decrease the rate of the intravenous infusion.
B. Change the type of intravenous fluid being administered.
C. Change the urinary catheter.
D. Increase the rate of the intravenous infusion.

13. Graft taken from different species is called as:

A. Homograft
B. Autograft
C. Heterograft
D. Biobrane
14. The injury that is least likely to cause full thickness burns is
a) Sun burn
b) Chemical injury
c) Scald injury
d) Electrical injury
15. The most effective method of administering a chemotherapeutic agent that is vesicant is to:
a. Give it orally
b. Give it through a scalp vein
c. Give it through a peripheral insyte
d. Give it through a central venous access device
16. According to the rule of nine a person with burns on his head and neck, perineum and right
leg is
a. 20%
b. 24%
c. 26%
d. 28%
17. Gas used in filling the balloon of the IABP is
a. Oxygen
b. Hydrogen
c. Helium
 d. Carbon dioxide
18. The commonest cause for rectovaginal fistula is:
A. Obstructed labour
B. Complete perineal tear
C. Malignancy of the vagina
D. Radiation

19. Zero reference point is identified via

a. Longitudinal axis
b. Horizontal axis
c. Phlebostatic axis
d. Sternal axis
20. Chemotherapy dosage is frequently based on total body surface area so one must do which
of the following before administering chemotherapy:
a. Measure abdominal girth
b. Calculate body mass index
c. Ask the client about his or her height and weight
d. Weigh and measure the client on the day of drug administration

21. Endotracheal cuff pressure should be maintained within

a. 10-15 mmHg
b. 15-20 mmHg
c. 20-25 mmHg
d. 25-30 mmHg
22. Site for bone marrow aspiration is
a. Radius
b. Ulnar
c. Femur
d. Sternum
23. Suctioning time at a stretch must be limited to:
A. 1 minute
B. 3 minutes
C. 5 sec.
D. 30 sec.

24. The normal physiologic change of ageing that places an elderly client at an
increased risk for digitalis toxicity is decreased:
a) Gastrointestinal motility
b) Bone density
c) Vital capacity
d) Glomerular filtration

25. The best predictor of an elderly person falling is:

a) A history of previous falls
b) Use of multiple medication
c) Sensory deficits
d) Alterations in balance

26. Most appropriate food to facilitate sleep would be:

a) Crackers, banana and milk
b) Cheese, toast and hot chocolate
c) Slice of cake and hot tea
d) Fruit, chees and a glass of wine
27. No hair on the legs of a 80- year old man are physiologic changes affecting the:
a) Integumentary system
b) Circulatory system
c) Endocrine system
d) nervous system
28. Abnormal finding that needs to be reported when assessing the skin of an elderly
client is:
a) Increased patches of dark pigmentation on exposed skin
b) A dark, elevated patch that bleeds on touch
c) Deep wrinkles and frown lines around the mouth and eyes
d) Numerous brown or flesh coloured skin tags around the neck
29. The nurse would instruct the independent older person to:
a) Take most medications with milk or antacids to avoid stomach upset
b) Avoid drinking alcohol if taking acetoaminophen
c) Keep daily medications in kitchen cabinet near the sink
d) Save prescription drugs in case the physician orders them again
30. A factor that contributes to the development of hypothermia in older adults is
decreased:
a) Activity level
b) Sensory perception of cold
c) Percentage of body fat
d) Nutritional and fluid intake
SECTION B

Answer the following ( any 5 out of 6) (5*3= 15)

1 Fluid replacement formulas in burns

2. Warning signs of cancer

3. Hospice care

4.Enumerate age related changes in elderly

5. Types of hysterectomy

6. Degrees of uterine prolapse

SECTION C

Answer the following ( any three out of four) (3*5= 15)

1. PAP smear
2. Classify burns
3. Side effects of chemotherapy and nursing care
4. Health education for a client with a pacemaker

SECTION D

Answer ANY TWO LAQ (2*15= 30 )

1. Mrs. Sunita, weighing 50 kgs is brought to the burns care unit with 60 % burns
involving chest, abdomen and lower extremities
a. Briefly describe the fluid resuscitation for Mrs. Sunita during the emergent
phase (6)
b. Explain nurses role in wound management ad infection control for this
patient (6)
c. How will you prevent contracture (3)
2. A 35 year old unmarried lady is admitted with breast cancer and is posted
for radical mastectomy
a. Enumerate etiological factors for breast cancer (3)
b. How will you diagnose a case of breast cancer (4)
c. Discuss self care after mastectomy (8)
 3. A)Define cardiac arrest (2)
b) Discuss the steps in cardiopulmonary resuscitation intervention (8)
c) State specific medications used in cardiopulmonary resuscitation (5)