Exam No— 20. This is a type of burns in which the nerve endings, the epidermis and dermis are destroyed? a) Second degree burns b) Third degree burns ) Fourth degree burns d) Fifth degree burns 21.Using the rules of nine , the anterior portion of the chest and abdomen make percentages a) 7% b) 9% ©) 18% 4) 19% 22. Professor Mitti had undergone nasal surgery with posterior packing in place, which assessment data would alert the nurse to the possibility of active bleeding? 2) Appearance of anxiety b) Discoloration around the eyes ) Frequent swallowing d) Black, tarry stool 23.An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of a pneumothorax in this client? 2) A low respiratory rate 5) Diminished breath sounds ) The presence of a barrel chest ¢) Asucking sound at the site of injury 24.The presence of serous fluid in the pleural cavity is known as 2) Hydrothorax ») Haemothorax ©) Pyothorax 2) ChylothoraxExam No~ 25.4 condition in which there are multiple rib fractures, with or without fracture of sternum is known as 2) Fractured ribs b) Cardiac tamponade ¢) Pulmonary injury 4) Fiail chest 26.Which of the following is NOT an Indication for underwater seal drainage 2) Pleural effusion b) Atelectatasis ©) Chest surgery d) Emphysema 27.Which of the following is NOT an indication for cardiac surgery? 2) Cardiac Arrest b) Pulmonary regurgitation ¢) Mitral stenosis 4d) Patent Ductus Arteriosus 28. Which intervention is most important to include in a nursing care plan for a patient with atelectasis? 2) Give oxygen continuously at 3 L/minute. ») Have the patient cough and deep-breathe every 4 hours. ) Have the patient use an incentive spirometer every hour. 4) Get the patient out of bed to a chair every day. 29.Chest tubes can be removed when 2) There is fluctuation of fiuid in the glass rod ) X-ray films confirm re expansion of the lungs ) There is persistent air space in the apex of the lungs ) The tubes have been in situ for 12hours post operatively 30.During the removal of the chest tubes, the patient is asked to 2) Exhale deeply and the tube is removed ») Inhale deeply and the tube is removed ©) Swallow as the tube is being removed @) Hold a breath as tube is being removed Pill QUALIFYING EXAMINATION - NOVEMBER/DECEMBER 2016Exam No-—~ 51.Which of the following clostridium genus does NOT cause gas gangrene? 2) clostridium Cl. Novyi b) clostridium Listeria ©) clostridium Histolyticum ¢) clostridium Welchi 32. Which of the following is NOT a type of brain haematoma 2) Epidural haematoma b) Meningeal Haematoma ¢) Subdural haematoma d) Intracerebral haematoma 33. Prognosis of head injury is best given by 2) Patient's age b) CT head ) Mode of injury ¢) Glasgow coma scale 34,Which of the following sites is most common in spinal injuries? 2) Sacral spine ») Upper cervical spine ¢) Thoraco-lumber segment ) Lower cervical spine 35.4 small number of spinal tumors which occur in the nerves of the spinal cord itself are called 2) Myeloma ») Ependymomas ¢) Lymphoma @ Leukemia 36.4 37-year-old patient is admitted to the Emergency Department with ysonee, tachypnea and pink frothy sputum. The nurse determines that the patient is experiencing: 2) Lung abscess b) Neck trauma ©) Cor pulmonale@) Pulmonary embolism 37-The nurse is suctioning a patient with an endotracheal tube. Which of the following is @ correct technique for this procedure? 2) Suction for 5 seconds ») Apply suction during insertion ¢) Suction the mouth before suctioning the airway ©) Hyperoxygenate before and after suctioning 38.,ll of the following statement indicates that the patient understands tracheostomy care EXCEPT? 2) "Iwill reduce the humidity in my home." b) "Ican no longer have showers anymore." ) "Before suctioning, I should wash my hands." ¢) "If I stick a large cotton ball in the airway, I won't be able to breathe." 39.The marked cerebral injury in which the brain is bruised with possible surface haemorrhage is called: 2) Cerebral contusion b) Cerebral concunsion ©) Cerebral haematoma @) Cerebral haemorrhage <0.In epidural hematoma, the bleeding is located between 2) Subdural mater and the Pia mater ») Arachnoid mater and the skull ¢) Pia mater and the dura mater @) Dural mater and the skull £1.To prevent leakage of fluid in the thoracic cavity, how will you position the lent after thoracentesis? 2) Place flat in bed 5) Turn on the unaffected side ©) Tum on the affected side ) Place in supine position Pill QUALIFYING EXAMINATION - NOVEMBER/DECEMBER 2016 Page 10Exam Ni 42.A post-CVA patient who has weakness on the right side and impaired reasoning has had the CVA in the: 2) Left hemisphere of the cerebrum b) Right hemisphere of the cerebrum. ©) Left cerebellum. d) Right cerebellum. 43. The nurse counsels that the patient at the greatest risk for a CVA is a: 2) 20-year-old obese Latin woman on birth control pills. b) 40-year-old athletic white man with a family history of CVA. ) 60-year-old Asian woman who smokes occasionally. d) 65-year-old African-American man with hypertension. 44. Which of the following treatments would be most appropriate to relieve the pain of a patient admitted with DVT? 2) Applying heat ») Bed rest c) Exercise d) Leg elevation 45.You have received a victim of RTA with some lacerations on the scalp. What will be your nursing actions 2) Admit the patient for 24 hours to observe ») Dress the wound and discharge ©) Ask if He is to go home ¢) Do vital signs if stable discharge 46.A condition in which the urethral meatus is located on the ventral surface of the penis anywhere from the corona of the perineum is called; 2) Epispadiasis ©) Hyperspadiasis <) Epospadiasis 2) Hypospadiasis (> mit OTIALIFYING EXAMINATION - NOVEMBER /DECEMBER 2016 Page 11ExatiNo————— ~A surgical approach to removing an enlarged prostate using a cystoscope passed through the urethra to the prostate gland is called; +2) Transurethral incision of the prostate ») Transurethral resection of the prostate <) Trensversicle prostatectomy @) Retropubic prostatectomy 48.An incision made in the urinary bladder without a drainage tube is called; 2) Cystectomy ») Cystotomy ©) Cystostomy @) Cystoscopy 42. Which one among the following investigations is diagnostic for prostatic cancer? 2) Digital Rectal Examination ©) Prostate Specific Antigen <) Serum creatinine levels 2) Urine Microscopy Culture and Sensitivity 50.Cancer of the bladder that is located in the upper part of the bladder well ‘2bove the urethral orifice is best treated by; 2) Partial cystectomy ») Total cystectomy ©) Megavoltage radiotherapy 2) Cystodiathermy Pil QUALIFYING EXAMINATION - NOVEMBER/DECEMBER 2016,MATCHING ITEMS. etch the types of surgery that may be carried out on the stomach in column I with their descriptions in column II. Responses in Column IT should be used once only. Column I Column II -----Vagotomy A. Surgical procedure involving the anastomosis of the inferior part of the oesophagus to the jejunum. ~----Antrectomy B. Surgical removal of the antrum of the stomach. Pyloroplasty C. Surgical removal of the entire stomach Gastroduodenostomy _D. Surgical removal of 60 ~ 80% of the stomach. Gastrojejunostomy —_E, Surgical removal of the stomach antrum and its distal portion and duodenum with anastomosis of the remaining stomach portion to the jejunum. F, Surgical removal of the lower portion ‘of the stomach and anastomosis of its remaining portion to the duodenum. G. Surgical dilatation of the pyloric sphincter to increase the rate of gastric emptying. H . Surgical ligation of the vagus nerve to decrease the secretion of gastric acid.Exam No—- ‘Match each investigation in Column I with the appropriate condition in ‘Column II. Responses in Column II should be used once only. ‘Column I Column 11 36.——Weber’S Test A. Ear infections 57.———-Otoscopy B. Fractures 58.——~X-Ray Imaging C. Hearing disorders 59.——Ultrasound scan D. Visual disorders 60.—-~Snellen chart E. Cognitive disorders F. Speech disorders G. Internal hemorrhage H. Retinal detatchment the type of fracture in Column I with its description in Column Responses in Column II should be used only once. Column I Column IT ‘A. Break across the entire section of the bone . A fragment of the bone is pulled off by a ligament or tendon <3.—-Avulsion . The fracture occurs at the site of disease <.—Oblique .. The fracture line runs in spiral shape 5. —Pathological . Bone is splinted into several fragments One side of the bone is broken and the other side is bent . A fracture occurs at an angle across the bone |. The fracture extends through the skinExam No ‘Match the operation in Colum I with the organs involved in Column II. Responses in Column I should be used once only. ‘Column I Column IT 66.—-Gastrectomy A Tleum 67.-——-Oophrectomy B Testicles 68.-—--Appendicectomy c Colon 69.——-Pyloroplasty D Pylorus 70.-----Orchidectomy E Appendix - Caecum G ‘Stomach H Ovary Se cvinie EVAMINATIAN ~ NOVEMRER /NFCEMRER 2016 Page 15Exam No- : COMPLETION THE FOLLOWING SENTENCES USING ONE OR TWO WORDS ‘7 The ends of the bones are covered by 72.The complication of surgery of the stomach in which there is presence of undigested fat in food is called- 73. The complication that designates an unpleasant set of vasomotor and gastrointestinal symptoms that occur after meals in about 10 - 50% of patients who have had gastrectomy surgery or form of vagotomy is called 74.The cutting and rejoining of intestines Is known as 75.4 legal document that protects the patient, surgeon, hospital and other employees from legal implications is called--- 76.A patient undergoing surgery must be Nil by mouth for a period of ~ 77. The equipment used to clear secretion from the patients airway is called ---- is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants 79-.An injury to a joint in which the normally adjacent joint surfaces become completely separated from one another is---- = ‘80. Bleeding which occurs inside the body cavities and cannot be seen is referred to as is the solution used to clean the colon of fecal material preoperatively. QUALIFYING EXAMINATION - NOVEMBER/DECEMBER 2016Exam No—— ‘2 Peivic fioor exercises which help to reduce postoperative dribbling following prostatectomy are called-~ ‘=3.A type of radiation therapy in which radioactive seeds are placed inside the patient is called —-—- ‘The drug of choice for pain management in the first 48 hours following urinary bladder surgery is 8s. is the excision of a portion or whole of the colon. ‘86. Bulging of the urethra and bladder into the vaginal wall is referred to as ------ is the recurrent ulcerative and inflammatory disease of the mucosal and sub mucosal layers of the colon and rectum. -- is a tear or ulcer in the lining of the anus. ----is inflammation of the joint. is used to test for visual acuity. is a branch of medicine that deals with cancer -- is a vein which is elongated, tortuous and dilated. is a procedure that involves withdrawing a sample of synovial fluid from the joint with a needle and syringe for testing. SA- ~ is an artificial limb or organ. '25.An injury where there is break in the continuity of the skin is a— - 96. The type of traction used for treatment of fractures of lower limbs in children is— - is accumulation of pus in the posterior chamber of an eye. = il QUALIFYING EXAMINATION - NOVEMBER/DECEMBER 2016. Page 17Exam No 'S8.The stage where the tumour has grown into the inner wall of the colon or rectum and the tumor has not grown through the wall is---------- 92. Haemorrhoids that occur outside and below the external anal sphincter and they are covered by the skin are called —~ 100. The investigations that involves the insertion of the fingers in the anus examination to diagnose haemarrhoids is called - Snr lial 1FVING FYAMINATION - NOVFMRFR/NFCEMRER 2016 Page 18[ON D: ESSAY QUESTIONS R TWO QUESTIONS ONLY. QUESTION ONE (1) IS COMPULSORY. 1. Mr. Marron Zulu, aged 36 years is admitted to surgical ward with a diagnosis of strangulated inguinal hernia. He is scheduled for herniorrhaphy. 2) Define strangulated hernia 5% 5) Outline any four (4) types of hernia other than the one mentioned in the stem ¢) Discuss the pre-operative care of Mr. Zulu from the time of admission until he is taken for operation 50% ©) Explain five (5) complications of herniorrhaphy and indicate how they can be prevented 20% 25% 2 Mr. Collins Banda a 30 year old man is admitted to male surgical ward following a road traffic accident. Upon examination, he is unconscious and Giagnosed with head injury. a) Define the following terms: Concussion 5% | ii. Contusion 5% | ) Uist five (5) clinical manifestations of head injury 10% ©) Discuss in detail the management of Mr. Banda while in hospital under the following headings i, Medical and Surgical management 25% il, Nursing care 35% ¢) Outline five (5) complications that may arise and how they can be managed “ml OUALIFYING EXAMINATION - NOVEMBER/DECEMBER 2016Exam No = Mr. Yoram Phiri a 75 years old man is admitted in 2 male surgical ward with a agnosis of Rheumatoid arthritis of the left knee joint. Buck's extension (skin traction) has been applied on his leg. 5% 2) (i) Define Rheumatoid arthritis? 10% (ii) Draw a well labeled diagram of the synovial joint ») Mention three (3) drugs, their dose and three (3) side effects of each that may be used in the treatment of Mr. Phiri. 15% ) Using the nursing care plan identify five (5) problems and indicate the care you would give to Mr. Phiri. ¢) Outline five (5) points that may be included in the Information, Education and Communication (TEC) to Mr. Phiri 50% 20%