NURSING COUNCIL OF KENYA EXAMINATION FOR ADMISSION TO THE REGISTER OF COMMUNITY HEALTH NURSE — KRCHN (BASIC) PAPER ONE DATE: WEDNESDAY 20™ SEPTEMBER 2017 TIME ALLOWED: 3 HOURS 9.00 AM to 12.00 PM L 7 INSTRUCTIONS TO CANDIDATES: Read the questions carefully and answer only what is asked. ENTER YOUR EXAMINATION NUMBER AND QUESTION NUMBER ON THE space provided in the answer booklet. All the questions are compulsory. For Part I (M.C.Q’s) Write your answers in capital letters on the space provided in the answer booklet. Each M.C.Q. is 1 mark. For Part II (SHORT ANSWER QUESTIONS). Answers to these questions should follow each other on the space provided in the answer booklet. For Part IIT (ESSAY/LONG ANSWER QUESTIONS) Answers to each question must be written on the specified page(s) in the answer booklet, Omission of or wrong numbering of examination papers, questions or parts of the question will result in 10% deduction of the marks scored from the relevant part. Each candidate MUST sign the examination return form after handing in ALL the scripts. 10, No candidate shall leave the examination room until all the examination scripts have been submitted and sealed in an envelope by the invigilators.KRCHN (BASIC) EXAMINATION: PAPER ONE: SEPTEMBER 2017 PART I: MULTIPLE CHOICE QUESTIONS: - Ql: The following are the membranes that cover the brain from inside out:- a) Dura, arachnoid, pia. b) Dura, pia, arachnoid. c) Pia, arachnoid, dura. 4) Pia, dura, arachnoid. Q2: Food poisoning is often caused by :- a) Dysentery bacilli. b) Salmonella bacilli” ©) Coliform bacilli.cfs @) Influenza bacilli. The following observations are noted on the patient on underwater seal drainage:~ a) Vital signs, patient conneétions, colour of draining, b) Vital signs, colour of drainage, amount of drainage. ©) Vital signs, patient understandig of the procedure, amount of drainage. 4) Vital signs, patient understanding of the procedure, cyanosis. Q4: Fractures of the base of the skull will manifest with:- 2) Heamorrhage from the nose, the pharynx or the ears. b) Cerebrospinal fluid leakage from the ears. ©) Bloody spinal fluid. 4) Persistent localized pain on swelling Q:5: Which cranial nerve is involved when the patient presents with facial pain, diminished comeal ceflex-end chewing dysfunction:-* a) by eI ov. 4d VL Q6: After liver biopsy the patient should be nursed:- a) On abdomen for 4 ~6 hours. b) Flat on his back for 6 — 8 hours. c) On the right side with a small pillow on thé site for 4— 6 hours. 4) Onthe left side with a small pillow on the site for 4 —6 hours. Q:7: Inthe management of impetigo, antibiotics are used to:- a) Treat deep sitted infection. b) Prevent reinfection. ©) Reduce contagious spread. d) Reduce sensitivity.Q:10: Qi: ua Quis: Match the type of procedure in column A with correet description in column B. Column A a) Vagotomy. b) —Anterectomy. Column B I. Removal of % -% of the stomach. 2. Removal of the lower portion of the stomach and portion of the duodenum. s Severing the vagus nerve. gud 4, Incision made to enlarge the outlet and relax pyloric muscle One major immediate complication following Cystoscopy procedure is:~ a) Burning upon voiding. b) Blood tinged urine. ©) Frequency of micturation. d) Urine retention. Following renal trauma, in order to priority the nurse monitors the patient for:~ a) Signs of infection, urine output, heamaturia, b) _Heamaturia, urine output, sings of infection. ©) Urine output, signs of infection, heamaturia. 4) Urine output, heamaturia, signs of infection. Bucks’s extension traction is indicated for fractures of:- a) Humerous. b) Radius. ©) Tibia, 4) Cervical spine. Osteoarthritis may be defined as:- a) Degenerative disease of the joint. b) Infection of the joint. ©) Metabolic disease of the joint. d) Systematic disease of the joint. The main reason superficial burns are more painful is that:- a) edema causes pressure on the blood vessels. b) Superficial nerves become hypersensitive due to impaired circulation. ©) Sensory nerve ending have been exposed. 4) The motor nerve ending have been destroyed. BQ4: Qs: Q16: Qs: Qs: Q20: Long term complications of burn: a) b) °) d) \clude:- Scaring, contracture, deep venous thrombosis, infection Scaring, contracture, deep venous thrombosis, hypovoluthia. Scaring, contracture, disfigurement, psychological trauma. Scaring, infection, contracture, hypovolumiiye Indicate whether the following statements are true or false:- a) Culdoscopy is a procedure used to investigate infertility or ectopic pregnancy. b) —_ Colposoepy is a procedure used to visualize fallopian tubes. ‘The main long-term complication folloing radical mastectomy is: a) Phantom pain. b) Tingling and numbness. c) _Lymphoedema. d) Paralysis. The following are sequential steps undertaken by the nurse if anaphylactic reaction occurs during management of status asthmaticus:- a) b) °) d) Establish airway, give epinephrine, apply a tourniquet above injection site. Establish airway, apply tourniquet above injection site, give epinephrine. Give epinephrine, establish airway, apply tourniquet above injection site. Apply tourniquet above injection site, establish airway, give epinephrine. Following management of nose fractures, swelling can be reduced by: a) b) 2) a) Use of anti-inflammatory drugs. Use of warm (hot) compression. Use of cold (ice) compression. Use of anti-biotics. Uveitis is the inflammation of the:~ a) b) ° d) Iris, cilliary body, choroid, Vitreous body, iris, choroid. Iris, retina, sclera. Cilliary body, sclera, choroid Terminal cleaning in the operating theatre refers to:~ a) d) °) d) Cleaning and preparation of operating theatre between cases in preparation for the next patient. Cleaning and disinfecting operating theatre when a patient dies in theatre, Cleaning and disinfecting of theatre at the completion of the days schedule. Preparation of the operating theatre before arrival of the next patient. 4PART. Qh: Q2: Q3: Qa: Qs: Q6: QT: Q8: SHORT ANSWER QUESTION: lor Explain the first four (4) steps in the ‘nursing process ie - ie Write short notes on benzyl penicillin under the following heading:~ alha€ opt a) Classification. 1/0" b) Mode of action. ) Two (2) side effects. d ‘Two (2) nursing considerations. Eaplain thes 3) spesfc nursing management of a patient diagnosed with ascitis, Woe AT REaA if Karan’ CONN i List the (4) types of jaundice. State methods of waste segregation in hospitals in infect seprgaion tose ra nigh\y 1 Charts bu state five (5) specific health messages on exercise precautions 1 diabetic - patient. State five (5) clinical manifestations of pleural effusion ae Draw and label a diagram illustrating common possible sites of ectopic pregnancy. 6PART II: ESSAY/LONG ANSWER QUESTIONS Q:l: Mrs. Jay aged 35 years is admitted to the ward and a diagnosis of status - asthmaticus is made. 2) _ Explain the pathophysiology of asthma. 5 b) Describe the specific nursing management of Mrs. Jay turing)an ul attack. ©) Formulate four (4) health messages to be shared to Mrs. Jay on 4 discharge. Q:2: Mrs. X 48 years old who had been diagnosed with cancer of the colon is admitted for surgery and a colostomy is made. a) Outline five (5) nursing diagnosis that the nurse may come up with while managing Mrs. X. 0 » c) State three (3) complications that Mrs. X may develop after the 3 2 4 colostomy_- 4 elo" ; efi x0 : Lntingrpy faclors / Troue *& reachan