EXAMINATION

FACULTY OF HEALTH SCIENCES

PROGRAMME(S): BNT
SESSION: WEEKEND

MODULE CODE AND TITLE: LEVEL:

2220 FHS- MEDICAL NURSING 2 1.3

DATE: TIME:
AUGUST, 2023

DURATION: TOTAL MARKS:

6 HOURS 100

EXAMINER/ LECTURER: MODERATOR:

MS. ATUHAIRE EVAS

INSTRUCTIONS TO THE CANDIDATE/ STUDENT

1. V-class is the ONLY official examination platform.
2. Questions must be attempted in the answer booklet/sheet provided on V-class.
3. All queries should be directed to the examiner, Head of Department, or Dean.
4. You have SIX HOURS to complete this paper. No exam answer sheet shall be accepted
after the 6 hours (the system has closed).
5. This is an OPEN BOOK (Online) examination.
6. Read each question carefully before beginning to type/write your answers.
 7. Review the grades assigned to each question of the examination and allocate your
time accordingly.
8. Review your answers carefully before submitting your examination.
9. After submitting your exam answer sheet, Cross-Check to ensure your examination was
attached and sent to V-class and received a confirmation message

Attempt ALL the Questions

QUESTION ONE:
A 50-year-old man presented to your hypertensive clinic for a hypertensive review. He had been
seen in clinic 3 months previously and had high blood pressure readings average of 145-
155mmHg systolic and 86-96mmHg diastolic and Body Mass Index (BMI) was 35 kg/m 2. He
was advised to lose weight and reduce his salt intake. He reports reduction of weight and salt
intake as he was advised previously. As a nurse on the hypertension clinic, you examine the
patient and his BMI is 33 kg/m2 and his Blood pressure 158/92mmHg.

a) As a BNT student nurse on hypertensive clinic, what other information would you like to
know from this patient that will guide management? (10 MARKS)
b) Explain with rationale the key investigations would you like to do for this patient? (15
MARKS)

QUESTION TWO:
A 53-year-old woman was found to have a random blood glucose level of 227 mg/dL (12.6
mmol/L) at Mpigi hospital. Three days later, her fasting blood glucose value was 147 mg/dL (8.2
mmol/L). She has no previous history of diabetes and is alarmed by the possibility of having this
disorder. As a result, she seeks for your advice. The patient has been treated for hypertension for
10 years, currently with amlodipine 10 mg by mouth daily. She was once told that her cholesterol
value was "borderline high" but does not know the value. No family medical history is available
because she was adopted. On examination, blood pressure is 140/85 mmHg supine and 140/90
mmHg upright with a regular heart rate of 76 beats/minute. She weighs 78kg, with a body mass
index (BMI) of 30.9 kg/m2.
 a) Describe what could be the diagnosis of this patient? (10 MARKS)
b) How would you advise the patient on her condition if you are a nurse at Mpigi hospital?
(15 MARKS)

QUESTION THREE:
Ms. Annex is a 30-year-old woman who presents to medical ward with a dry, hacking cough
after recovering from bronchitis. The cough is worse at night and associated with shortness of
breath (SOB). In the past she has experienced coughing spells after running and when cold. Both
of her children and her maternal grand-mother have asthma.

a) As a nurse working in the medical ward, what routine information would you want to
obtain from Ms. Annex? (10 MARKS)
b) On further assessment Ms. Annex is in acute respiratory distress. Vital signs (VS) were
respiratory rate 40 per minute and SPO2 89%. On admission, her pulse is 175bpm and
irregular. Her blood pressure is 80/50 mmHg. Her nasal mucosa was pale, no cervical
adenopathy, lungs were clear to auscultation, but forced expiration using the peak flow
meter seemed to generate a cough. Abdomen was soft and no tenderness. Using the
nursing process, describe how you would manage Ms. Annex? (15 MARKS)

QUESTION FOUR:
A 48-year-old woman presents to the Medical Emergency with a 2days history of diarrhea and
vomiting. She believes this was caused by a take away from a hotel she had a day before
developing symptoms. She has been unable to keep anything down including water and now
feels very poorly. The patient has a history of hypertension, and diabetes controlled with oral
drugs. O/E: she appears very dry and has reduced skin turgor. BP is 88/55mmHg and heart rate
105beats per minute with 0.3ml/kg/hr urine output.

a) As a BNT student nurse, suggest the possible investigations with a rationale that you
would request for this patient? (10 MARKS)
b) Formulate four possible nursing diagnoses for the patient? (15 MARKS)

GOOD LUCK