COLLEGE OF NURSING, IHIALA.

PRE PROFESSIONAL EXAMINATION FOR GENERAL NURSES

COVERING ALL ASPECT OF NURSING CARE AND TREATMENT OF PATIENTS

JULY, 2022.
PAPER 11

TIME ALLOWED: 3 HOURS FOR SECTION A & B.

INSTRUCTIONS: This paper consist of sections A & B. Please read the INSTRUCTIONS for each
section CAREFULLY. Any candidate who makes an unauthorized writing/appeal on the answer booklet
shall be DISQUALIFIED. Candidates NUMBER and NOT name is to be entered at the top right hand
corner of each sheet.

SECTION A: ESSAY QUESTIONS 60% (ANSWER ALL QUESTIONS)

1. Mrs Akintola 45 years old trader came into the out-patient department with the history of excessive
thirst, increased frequency in output of urine, loss of weight from 70kg to 60kg within a period of
12weeks. On urine testing the urine was positive +++ for sugar and a diagnosis of Diabetes Mellitus.

a) With the aid of a large well labeled diagram, describe the pancreas.
Diagram 1 mark, Labeling 1 mark, Description 3 marks
b) Mention four (4) other investigations that must be conducted to confirm Mrs Akintola’s diagnosis.
(1mark)
c) Utilizing the Nursing Care Plan, identify and solve in order of priority, three (3) nursing diagnosis of
Mrs Akintola (9Marks)
d) Outline the salient points in the management of Mrs. Akintola that you will teach her before
discharge. (5mks)

2. Mary a 9month-old baby is to receive 16mg of Gentamycin IM 8hrly for 5 days. The
pharmacy supply is 80mg/2m/. Show clearly how you arrive at the answers:
a) Calculate the volume of the drug you will give to Mary per dose 4mks
b) How many ampoules of gentamycin will be needed for Mary’s total treatment 4mks

c) Mary is to receive I litre of Hartman’s solution for 8hours. The infusion set delivers 15 drops
per minute calculate the rate of drops per minute (4marks)
d) Write briefly on the following drugs under the headings; Group, Action, Indication, Dosage,
Side effect, Contra indication and Nursing responsibilities.
i. Methyldopa (Aldomet)
ii. Haloperidol
(4 marks each)
3. You have been asked by the Chief Nursing Officer-in-charge of the Antenatal clinic to teach a
group of pregnant women in the clinic about management of resources
a. Explain the term management (3 marks)
b. I. List five (5) functions. II. Enumerate any five (5) qualities of a manager (5 marks)
c. Differentiate between teaching and learning (3mks)
d. state the principle of learning (4marks)
e. List (10) teaching/instructional methods (5 marks)
 COLLEGE OF NURSING, IHIALA.

PRE PROFESSIONAL EXAMINATION FOR GENERAL NURSES

COVERING ALL ASPECT OF NURSING CARE AND TREATMENT OF PATIENTS

JULY, 2022.
PAPER 11
MARKING SCHEME FOR SECTION A
Question 1
1a

Diagram 1mk and labelling (2marks)

Description
 The pancreas is a pale grey gland weighing about 60 grams.
 It is about 12-15 cm long and is situated in the epigastric and left hypochondriac regions of
the abdominal cavity.
 It consists of a broad head, a body and a narrow tail.
 The head lies in the curve of the duodenum, the body behind the stomach and the tail lies in
front of the left kidney and just reaches the spleen.
 The abdominal aorta and the inferior vena cava lie behind the gland.
 The pancreas is both an exocrine and endocrine gland.
 This consists of a large number of lobules made up of small acini, the walls of which consist
of secretory cells.
  Each lobule is drained by tiny duct and these unite eventually to form the pancreatic duct,
which extends along the whole length of the gland and opens into the duodenum.
 Just before entering the duodenum the pancreatic duct joins the common bile duct to form
the hepatopancreatic ampulla.
 The duodenal opening of the ampulla is controlled by the hepatopancreatic sphincter (of
Oddi) at the duodenal papilla.
 The function of the exocrine pancreas is to produce pancreatic juice containing enzymes,
some in the form of inactive precursors that digest carbohydrates, proteins and fats.
 As in the alimentary tract, parasympathetic stimulation increases the secretion of pancreatic
juice and sympathetic stimulation depresses it.

The Endocrine Pancreas

 Distributed throughout the gland are groups of specialized cells the pancreatic islets (of
Langerhans).
 The islets have ducts so the hormones diffuse directly into the blood.
 The endocrine pancreas secretes the hormone Insulin and glucagon, which are principally
concerned with control of blood glucose levels.

The blood supply

The splenic and mesenteric arteries supply the pancreas and venous drainage is by veins of
the same names that join other veins to form the portal vein.

¼ for any correct 12 points (total 3marks)

1b. Four (4) other investigations (1 marks)

 Fasting blood sugar

 Random blood sugar
 2 hours post-prondial blood sugar
 Glucose tolerance test
1/4 for correct 4 points (total 1marks

1c. Nursing Care Plan of Mrs Akintola with Diabetes Mellitus

DATE S/ NURSING NURSING NURSING ORDERS SCIENTIFIC EVALUATION

N DIAGNOSIS OBJECTIVE PRINCIPLE/
RATIONALE
1. Deficient Client will 1. Monitor intake & 1. Monitoring helps Client expressed
fluid volume verbalize output closely. to assess fluid less thirst, had
related to less thirst 2. Administer iv fluid as balance. moist mucous
polyturia as within 48 prescribed. 2. Fluid membrane, good
evidence by hours of 3. Encouraged oral administration skin tugor and fluid
excessive nursing intake of fluid if not enhances balance in 24 hours
thirst intervention nauseated. replacement of fluid of nursing
4. Monitor hydration loss. intervention.
status 4 hourly twice 3. Oral intake of
 then 6 hourly for 24 fluid improves
hours. hydration status.
5. Monitor vital signs 4 4. Monitoring
hourly. promotes assessment
6. Document care & of effect of
client’s progress. intervention.
5. Dehydration can
be manifested by
alteration in vital
signs e.g. high
temperature,
tachycardia.
6. Documentation
provides evidence of
intervention and
progress of care.
2. Anxiety Client will 1. Assess level of 1. Assessment Client was less
related to demonstrate anxiety. enhances anxious in 48 hours
disease less anxiety, 2. Encourage quantification of evidenced by
prognosis ask less verbalization of concern level of anxiety. calmness and
evidenced by questions and fears. 2. Verbalization reduction in level of
apprehension, 3. Reassure client helps client to focus apprehension/anxiet
patient asking 4. Show client others on the problem. y.
question. with similar conditions. 3. Reassurance
5. Answer client’s relieves tension.
questions tactfully and 4. Raises client’s
honestly hope of recovering.
6. Clarify 5. Providing factual
misconceptions. information
promotes
understanding of
disease process and
relieves anxiety.
6. Clarification
enhances client’s
belief about the
illness.
3. Deficient Client will 1. Determine client’s 1. Knowledge Client demonstrated
knowledge of demonstrate level of knowledge about assessment helps to understanding of
diabetes improved illness and treatment determine client’s illness and actively
mellitus understandi regimen. need for information participated in his
management ng of illness 2. Teach client about and extent required. care in one week of
and self care and illness and therapeutic 2. Knowledge nursing intervention
skills related willingness regimen. promotes client’s
to frequent to learn 3. Teach health self-confidence and
questioning necessary maintenance activities co-operation with
self-care e.g. diet planning, care.
 skills within exercise, foot care and 3. Acquisition of
one week of drug administration these care abilities.
intervention 4 Graduate teaching from 4. Graduated
simple to complex tasks. teaching promotes
5. Encourage client to understanding and
provide feedback. prevents confusion
6. Encourage client’s as a result of
input (participation) in information
care. overload.
5. Feedback
provision facilitates
assessment of
client’s
understanding of
information and
development of self.
6. Patients
participation
promotes client’s
satisfaction and
understanding of
teaching.
4. Imbalanced Client will 1. Plan meal with 1. Meal planning Client gained 3kg in
nutrition: less achieve required calorie and ensures adequacy of two weeks of
than body optimum nutrients as prescribed nutrients & calorie intervention
requirement control of 2. Explore client’s intake.
related to blood cultural food preferences. 2. Culturally
impaired glucose 3. Encourage client to eat acceptable
carbohydrate, level within full meals and in between intervention
fat and one week & snacks as prescribed promotes client
protein gain 4kg 4. Administer prescribed cooperation with
metabolism within 2 insulin 30mins before treatment
evidenced by weeks of food 3. Eating full meal
loss of intervention 5. Give food rich in provides optimum
weight vitamins and minerals nutrition, necessary
(e.g. fruits and vegetable) to achieve and
low in calorie maintain the desired
6. Monitor weight twice weight & blood
weekly glucose control.
4. Insulin promotes
uptake/utilization of
glucose by the body
tissues
5. Vitamins and
minerals enhance
intake of required
nutrient for optimum
 health.
6. Weight
assessment is a
baseline for further
nursing intervention

Diagnosis- ½ mark if correct

Objectives- ½ mark if correct
Interventions- ¼ mark (for any correct 3points)
Rationale – ¼ mark for any correct 3 points
Evaluation – ½ mark if correct
3marks for each care plan -Total 9 marks

1d. Salient points in Management.

 Stress the importance of exercise in weight and glucose control
 Patient should adhere to dietary prescription
 Encourage compliance with treatments
 Teach foot care and prevention of injury
 Teach about prevention of hypoglycaemia and its management.
 Teach self monitoring of blood glucose
 Teach necessary skills to self medicate and observe for desired effects and side effects
 Educate patient on the relevance of carrying diabetic identification label
 Teach the importance of follow-up
 Advise patient to observe adequate rest and sleep daily
 To follow prescribed dietary regimen. Eat three or more measured meal daily
 Do not omit food following calculated diet.
 Use house hold measures to know value of food taken
 Avoid concentrated carbohydrate, sugar, ice cream and mineral
 Weigh weekly and keep weight at optimal level, if on insulin, get extra calorie.
 Test urine for glucose and acetone daily
 Test freshly voided urine
 Adjust insulin dosage according to the result of the urine
 Sterilize needle and syringe by boiling
 Rotate site of insulin injection
 Avoid cold insulin because of tissue reaction
 Measure of insulin and give only prescribed dose and know the reaction of insulin
 Carry diabetes identification card and a cube of sugar in case of signs and symptoms of
hypoglycemia
 Proper foot ware to prevent trauma and infection, ischemia which may necessitate amputation
 Prevent bruises, cuts, moisture on the feet
 Wear well fitted cover shoe
 Report acute reactions to the doctor immediately
 Take only prescribed medication
 Avoid smoking, coffee as nicotine in them constricts blood vessels causing reduction in blood
flow to the feet.
  Know signs of diabetic coma or insulin coma and teach the patient what to do when sign and
symptoms appear
 Encourage patient to go for regular checkup
 If patient operates machines, they may be need for a change of occupation since even transient
confusion can be dangerous.
 To join the “Diabetic association”.

1/2 mark each for any correct 10 points (total 5marks)

Question 2
(2a) Gentamycin comes in 80/mg/2ml and prescription = 16mg

So baby Mary in each dose will receive

Meanwhile Gentamycin for baby is always reconstituted with, 6ml of distil H20

So given 16mg to baby Mary will be 80mg/8ml 1.6

1.6 x 8 = 1.6ml per dose 128 =

1.6

80mg 80 (4mks)

2b) To calculate the number of ampules to baby for 5 days you will;

First = calculate daily dose for baby Mary

1.6ml x t ds (8 hourly)

1.6ml x 3

4.8mls for a day

24ml for 5days ie 4.8 x5.

Baby Mary for the complete treatment will consume 3 ampoules of gentamycin which is
24omg of gentamycin (4mks)

2c) 1000 x 15 100 x 15 = 31.25 drops/m = approx 31d/m

meanwhile, here is the full working

Hartman’s infusion 1 litre = 1000mg

drop factor = 15

for 8hrs = 6
 1000mg x 15

60. x 8

= 1000 x 15 5
+500
500 31.25 d/r

480 48 168 84

Approximately 31drops/m (4mks)

(2d)i Methyldopa (Aldomet)

Group: Antihypertensive agent (1/4mk)

Action: It inhibits dopa carboxylase and depletes tissues of norepinephrine, thereby reducing
blood pressure. (1/2mk)

Indication: Mild, Moderate and severe hypertension.

Dose Adult: Usual starting dose is 250mg two or three times a day in the first 48hours. Dose
can be adjusted until an adequate response is achieved. Maximum recommended daily dosage
is 3g.

Children: Initial dosage is based on 10mg/kg body weight daily in two to four doses.
Maximum dosage is 65mg/kg or 3g daily (1/2mk).

Route: Orally (1/4mk).

Side effect: Sedation may occur during the initial period of therapy or when dose is
increased. Headache, asthenia, weakness, paresthesia, impaired mental acuity, depression,
dizziness, light- headedness, oedema, nausea, vomiting, rashes, hepatitis, jaundice. (1point =
1/4mk, total = 1mk).

Contra indication: Acute hepatitis, active cirrhosis, hypersensitivity, therapy (1 point =

1/4mk) with monoamine oxidase inhibitors (MAO).

Nursing Responsibilities

 Observe patient for signs of side effects.

 Advice patient not to take methyldopa along with iron as (ferrous gluconate or ferrous
sulphate) as it decreases bioavailability (quantity of drug present for absorption)
 When increasing dose, administer the increased dose in the evening first as many
patients experience sedation when dose is increased.
 If there is sign of increasing oedema or heart facture, do not administer the drug. Total
marks= 4mks

(ii) Haloperidol
Group: Antipsychotic (1/4 mark)

Action: Blocks postsynaptic dopamine receptors in the brain thereby decreasing psychotic
behaviour. (1/2mark)

Indication: Schizophrenia, Mania, Short-term adjunctive management of psychomotor

agitation, violent behaviour, severe anxiety (1/2 mark)

Dose: Adult 1.5-3mg 2-3 times daily or 3-5mg 2-3 times in severely or resistant patients.
(1/2mark).

Side effects: Extra pyramidal reactions, sedation, dizziness, insomnia, headache, confusion,
blurred vision, transient leucopenia, leukocytosis, urine retention, menstrual irregularities,
gynecomastia, pigmentation, photosensitivity. (1point= ¼ mk, total = 1/2 mark)

Contraindications: Impaired consciousness, bone marrow depression, phaeochromocytoma,

porphyria, basal ganglia disease, breastfeeding, pregnancy, history of seizure or EGG
abnormalities, glaucoma, urine retention, anticonvulsant, anticoagulant, antiparkinsonian or
lithium medications. (1 point= ¼ marks; total points- ½ marks.

Nursing Responsibilities

 Give oral drug with food or milk.

 Give IM injection into large muscle, patient should lie down at least 30 minutes after
injection.
 Supervise ambulation till patient is stabilized on medication.
 Avoid strenuous activities
 Patient should not stand for long periods at a time
 Increase fluid intake to prevent constipation, give sips of water for dry mouth.
 Do not withdraw the drug abruptly
 Observe patient for side effects
 Warn patient to avoid hazardous activities that require mental alertness. (1 point = 1/2
mark; = total I mark)

QUESTION 3
a. Management is a means of using human and material resources to accomplish set
organizational goals and objectives. The resources utilized include man, labour and
capital (3 marks)
b. i. 5 functions of a manager
 Planning
 Organizing
 Staffing
 Co-ordinating
 Controlling
  Communicating
 Directing
 Reporting
 Budgeting
 Representing
(1/2 mark each for any correct 5 answers)
ii. 5 qualities of a manager
 Energetic
 Emotional stability
 Exemplary conduct
 Honesty
 Objectivity
 Competence
 Empathy
 Good communication ability
 Fore sight (visionary)
 Courage
(1/2 mark each for any correct 5 answers)

3c

S/ Teaching Learning
N
1 It involves impartation of knowledge and It involves acquisition of knowledge
Skills to learners and skills
2 It is a social phenomenon It involves psychological and
psychomotor activities
3 It involves actions designed and intended to It is a change in behaviour as a result
bring about learning of experiences
(1/2 mark each)
3d. principles of learning
 Readiness – learners should be interested and willing to learn
 Participation – learners should be actively involved
 Effect – learning strengthens or weakens the connections, depending on whether the
outcome is satisfying
 Practice – it improves skills and perfection
 Reinforcement – learning should be reinforced and appraised through incentives,
rewards and correction
 Use of punishment should be minimized
 There should be a clear goal for learning
 Feedback – at the end of learning session, the learner should be evaluated
 Learning should be from simple to complex
 (1 mark each for any correct 4 points)

3e. Teaching/instructional methods

 Lecture/expository method
 Demonstration/ illustration
 Discussion
 Role play
 Case studies
 Field trip
 Project/discovery
 Drama
 Tutorial
 Experimentation
 Story telling/narration
 Questioning/ answering (Socratic)
 seminar
 quiz/ debate
 assignment
 brainstorming
(1/2 mark each for any correct 10 answers)
 College of Nursing, Ihiala
Pre-Professional Examination for Nursing Students
Date: Julu, 2022.
PAPER 11

Candidates’ No:

Section B: Objective Questions (40%).

Instruction: Circle the right answers on the question papers. Write your Examination
Number on the space provided and on every page of the question papers.
1. A nurse is inserting an indwelling urinary catheter in a male client. As the nurse
inflates the balloon, the client complains of discomfort, the most appropriate nursing
action is to:
a. Aspirate the fluid, advance the catheter farther and reinflate the balloon
b. Remove the syringe from the balloon, discomfort is normal and temporary
c. Aspirate the fluid, withdraw the catheter slightly and reinflate the balloon
d. Aspirate the fluid, remove the catheter and insert a new catheter.
2. The fetal circulation consists of:
a. Two umbilical veins and one umbilical veins and one umbilical artery
b. Two umbilical arteries and one umbilical vein
c. Arteries carrying blood of the fetus
d. Veins carrying deoxygenated blood in the fetus
3. A nurse is performing an admission assessment on a 6month old infant with a
diagnosis of hydrocephalus when the nurse:
a. Tests the urine for protein
b. Takes the apical pulse
c. Measures the head circumference
d. Takes the blood pressure
4. Which is the early sign of congestive heart failure in an infant with congenital heart
disease?
a. Cough
b. Pedal edema
c. Pallor
d. Tachycardia
5. Which body area will provide the best result for assessment of cyanosis in a black
skinned client?
a. Backs of the hands
b. Earlobe
c. Palms of the hands
 d. Sacrum
6. Which equipment should be used by the nurse to feed a 3months infant after surgical
repair of cleft lip?
a. Single hole nipple
b. Plastic spoon
c. Rubber straw
d. Rubber dropper
7. The nurse should closely monitor which of these in a client with acute renal failure
a. Enuresis
b. Lethargy
c. Drug toxicity
d. Insomnia
8. Which intervention should the nurse include in the care plan of a catatonic
schizophrenic client?
a. Administering lithium carbonate as prescribed
b. Giving the client an opportunity to express concern
c. Providing a quite environment where the client can be alone
d. Meeting all the client’s physical needs
9. The following are ligaments of the knee joint Except
a. Patella ligament
b. Oblique popliteal ligament
c. Pubofemoral ligament
d. Tibia collateral ligament
10. Which of these is Not a muscle of the neck?
a. Trapezius muscle
b. Sternocleidomastoid muscle
c. Longissimus muscle
d. Sterohyoid muscle
11. The major landmark for the anterior neck muscles is
a. Sternocleidomastoid muscle
b. Platysma muscle
c. Hyoid bone
d. Thyroid cartilage
12. Functions of muscous include all Except
a. Discharge of pus in goblet cells
b. Protection of membrane from chemical and mechanical injury
c. Traps foreign bodies in the respiratory tract
d. Acts as lubricant wherever it is secreted
13. One of the following is Not a function of the spleen
a. Synthesis of hormones
b. Phagozytoxis
c. Storage of blood
d. Immune response
14. Functional psychosis can be classified as
 a. Schizophrenia
b. Organic psychoses
c. Affective psychoses
d. A and B only
15. An expression of existence of two opposing feelings or emotion at the same time is
referred to as
a. Mutism
b. Ecstasy
c. Ambivalence
d. Elation
16. The nurse should be aware that cardiac arrest in a previously healthy infant may be
precipitated by________________
a. Ventricular arrhythmias
b. Respiratory failure
c. Generalized seizures
d. Distributive shock
17. A six weeks old infant is admitted with dehydration and possible pyloric stenosis.
Which observation might assist the nurse practitioner in making a differential
diagnosis
a. Loose stools
b. Hiccoughs
c. Projectile vomiting
d. Distended abdomen
18. A two year old baby presented at the emergency department with generalized body
swelling. Which of the following lab results will confirm a diagnosis of nephritic
syndrome?
a. Massive protein in urine
b. Blood in urine
c. Increased urinary sodium
d. Increased urinary potassium
19. In assessing a client with hyperthyroidism, the nurse expects to find which of the
following signs
a. Weight gain, constipation and lethargy
b. Weight loss, nervousness, and tachycardia
c. Exophthalmoses, diarrhea and cold intolerance
d. Diaphoresis, fever, and decreased sweating
20. The nurse observes constant bubbling in the water seal chamber of a closed chest
drainage system. What should the nurse conclude?
a. The system is functioning correctly
b. The system has an air leak
c. The client has a pneumothorax
d. the chest tube is obstructed
21. When caring for a client with acute respiratory failure, the nurse should expect to
focus on resolving which set of problems?
a. Hypotension, hyperoxaemia and hypercapnia
b. Hyperventilation, hypertension and hypoxia
c. Hyperoxaemia, hypocapnia, and hyperventilation
d. Hypercapnia, hyperventilation and hyperaemia
22. A client in your ward has a tumour of the posterior pituitary gland. Interventions in
his care plan should include all of these Except
a. Check weight daily
b. Restrict fluids
c. Assess urine specific gravity
d. Monitor fluid intake and output
23. A psychotic client in your ward reports to you that the previous shift nurse put
something suspicious in his water with his medication. If your reply was “he is
worried about his medication”, the reply will be considered as
a. An example of presenting reality
b. Reinforcing the client’s delusions
c. Focusing on emotional content
d. A non-therapeutic technique called mind reading.
24. When teaching a client with peripheral vascular disease about foot care, the nurse
should include
a. Avoid using cornstarch on the feet
b. Avoid wearing canvas shoes
c. Avoid using a nail clipper to cut toe nails
d. Avoid wearing cotton socks
25. When developing a care plan for an adolescent, the nurse considers the psychosocial
needs. During adolescent, psychosocial development focuses on
a. becoming industrious
b. establishing an identity
c. achieving intimacy
d. developing initiative
26. Sources of surveillance data could be from all Except
a. assessment of socio-economic status
b. case researchers
c. existing report on communicable disease
d. on-going monitoring on village level
27. An immune-compromised patient requires reverse isolation technique. This means
that
a. patient is highly infectious
b. patient requires protection from others with infection
c. all formites used by the patient must be sterile
d. patient should be nursed in a special room
28. During assessment of a client who sustained blunt injury to the chest wall, one of the
following signs will indicate the presence of pneumothorax
 a. diminished breath
b. sucking sound of the site of injury
c. low respiratory rate
d. presence of a barrel chest
29. An employer establishes physical exercise in the workplace and encourages all
employees to use it. This is an example of which level of health promotion
a. primary prevention
b. secondary prevention
c. tertiary prevention
d. passive prevention
30. When caring for a 2year old child, the nurse should offer choices when appropriate
about some aspects of care. According to Erikson, doing this helps the child achieve
a. trust
b. autonomy
c. industry
d. initiative
31. A business man loses an important contract, and gets a flat tire while driving home.
That evening, he begins to find fault with everyone. What defense mechanism is he
using?
a. projection
b. displacement
c. regression
d. sublimation
32. The nurse is caring for a client with cholelithiasis. Which sign is NOT indicative of
obstructive jaundice?
a. clay-coloured stools
b. Body itching
c. reduced haematocrit
d. elevated bilirubin in the urine

33. An 18months old child is NOT expected to perform one of the following

a. Scribble on paper
b. Say “dada”
c. Hop on one leg
d. Feed self
34. A right-handed 30yrs old man had head trauma following road traffic accident. During
nursing assessment you found that he is unable to comprehend language and also had
diminished hearing. Which lobe of the brain is most likely affected?

a. Occipital
b. Parietal
c. Frontal
d. Temporal
35. One of these clients is at risk of dehydration

a. Client with chronic kidney disease

b. Client with colostomy
c. Client with liver failure
d. Client with congestive cardiac failure
36. The anatomy of Patent ductus arteriosus can be described as abnormal connection
between

a. Aorta and superior vene cava

b. Aorta and brachiocephalic trunk
c. Aorta and pulmonary artery
d. Aorta and inferior vene cava
37. A client with right 7th cranial nerve damage will most likely report which of the following
symptom

a. Impaired vision
b. Difficulty chewing food
c. Difficulty closing the right eye
d. difficulty closing the left eye
38. An increased erythrocyte sedimentation rate may be found in

a. Tuberculosis
b. Hyperkalemia
c. Hypokalemia
d. Polycythemia
39. Kussmaul breathing is typically found in

a. Head injury
b. Hypoglycemia
c. Diabetic ketoacidosis
d. Severe anemia
40. One of these is NOT a vector born disease

a. Yellow fever
b. Malaria
c. Filariasis
d. Hepatitis
41. The Angle of Louis lie between

a. T1-T2 intervertebral disc

b. T2-T3 intervertebral disc
c. T4-T5 intervertebral disc
d. T6-T7 intervertebral disc
42. As a nurse on ward duty, a mother calls you to attend to a 2yr old child with a diagnosis
of tetralogy of fallot who suddenly became dyspneic and severely cyanosed. What immediate
action will you take to reduce the child’s symptoms?

a. Give intranasal oxygen

b. Position the child in a squatting posture
c. Call the doctor on call
d. Counsel mother that it is not a serious event
43. One of these is a Non-modifiable risk factor for type 2 diabetes mellitus

a. Obesity
b. Sedentary lifestyle
c. family history of diabetes
d. smoking
44. Which diet will you recommend preoperatively, for a patient billed for
haemorrhoidectomy

a. Low residue diet

b. Plain fluid
c. higher fiber diet
d. None of the above
45. Steps in obtaining a consent for a surgical procedure include all Except

a. Explain the procedure and the risks involved

b. Evaluate client’s knowledge level
c. Explain alternative treatments if any
d. Advice client on best treatment option
46. During physical examination of an infant, a nurse notes a mongoloid facies, low set ears
and poor activity. These findings are in keeping with

a. Trisomy 18
b. Trisomy 13
c. Trisomy 21
d. Trisomy 19
47. The following reflex is abnormal in a 6month old infant

a. Planter grasp
b. Tonic neck reflex
c. Babinski reflex
d. Rooting
48. The purpose of palliative surgery is to

a. Restore function to malfunctioning body part

b. Reduce intensity of disease symptoms
c. Allow for definitive diagnosis
d. None of the above
49. The following congenital heart defects will produce an audible murmur on auscultation
Except

a. Large ventricular septal defect (VSD)

b. Small ventricular septal defect (VSD)
c. Patent ductus arteriosus
d. Atrioventricular septal defect
50. The commonest complication of insulin therapy in diabetes is

a. Hypoglycemia
b. Hyperglycemia
c. Weight loss
d. Obesity
51. One of this is NOT a primary function of the female pelvis
a. Enhances movement of the body
b. Permits sitting and kneeling
c. It houses the Pelvic organs
d. It is a primary haemopoietic organ
52. The primary site of spermatogenesis is

a. Epididymis
b. Seminiferous tubules
c. Ductus deferens
d. Seminal vesicles
53. Which of the following will manifest with fecal incontinence?

a. Spinal cord injury

b. Head injury
c. Hip arthritis
d. Anal fissure
54. Haemophilia is a clotting disorder inherited in what pattern?

a. Autosomal recessive
b. Autosomal dorminant
c. X-linked recessive
d. X-linked dorminant
55. Immature germ cells in the testis that will eventually form the sperm cells at puberty are
called

a. Spermatocytes
b. Spermatids
c. Spermatogonia
d. Spermatogen
56. One of the following is Not indicated in the post-operative care of a patient that had
thoracic surgery

a. Nursing in upright position

b. Oxygen therapy
c. Deep breathing exercises
d. Regular vital signs monitoring
57. The most persistent adverse effect of electroconvulsive therapy is

a. Prolonged seizures
b. Severe persistent headache
c. Anterograde amnesia
d. Retrograde amnesia
58. The confirmatory investigation for chronic obstructive pulmonary disease is

a. Arterial blood gas

b. Sputum microscopy and culture
c. Lung function test
d. Pulmonary MRI scan
59. One of the following is NOT a posterior relation of the vagina

a. Rectum
b. Perineal body
c. Pouch of Douglas
d. Bladder
60. All are vaccines given under the National Programme on Immunization Except

a. Oral polio vaccine (OPV)

b. Haemophilus influenza typeB (HiB)
c. Pneumococcal conjugate vaccine (PCV)
d. Mumps, measles and rubella vaccine (MMR)
61. Routes of administration of vaccines include all Except

a. Intravenous
b. Intradermal
c. Subcutaneous
d. Intramuscular
62. One of the following is Not a known adverse reaction following COVID-19 vaccination

a. Blood clotting disorder

b. Local reaction with pain
c. Dizziness
d. Convulsions
63. Emergency care for an actively convulsing infant brought into the emergency room Does
Not include

a. Give rectal diazepam

 b. Loosen tight clothings
c. Hold firmly to restrict movement
d. Keep the child away from harmful objects
64. The following actions are appropriate for the nurse who is starting an intravenous fluid
Except

a. Clean the skin at the site of the I.V line with antiseptic swab
b. Use client’s non-dependent arm, unless contraindicated
c. Obtain a verbal consent for the procedure
d. Completely fill the drip chamber with solution
65. Immunoglobulin responsible for allergic reactions is

a. IgA
b. IgG
c. IgE
d. IgD
66. The nurses TPR chart contains the following clinical data Except

a. Pulse rate trend

b. Blood pressure trend
c. Core temperature trend
d. Peripheral Temperature trend
67. Part of the sperm that penetrate the egg membrane during fertilization is called

a. Acrosome
b. Allosome
c. Telosome
d. Autosome
68. The drug of choice in the management of severe pre-eclampsia and eclampsia is

a. Hydralazine
b. Magnesium sulphate
c. Calcium gluconate
d. Syntocinon
69. Example of a mechanical barrier contraceptive is

a. Loop
b. Diaphragm
c. Copper
d. progestin
70. The substance responsible for the oncotic pressure that keeps fluid within the
intravascular compartment is

a. Plasma protein
b. Inorganic solutes
c. Idiogenic osmoles
 d. Plasma sodium
71. Patient monitoring in intensive care involves the use of

a. Manual recordings only

b. Automated recordings
c. Manual and automated recordings
d. Pulse rated recording
72. The following activities are classified as primary prevention Except

a. Routine vaccination
b. Screening for cervical cancer
c. Community distribution of insecticide treated nets
d. Iron supplementation in school children
73. Active immunity can be conferred on a child by which of the following

a. Taking chloroquine for malaria

b. Suffering from tetanus infection
c. Recovering from measles infection
d. Having active hepatitis B infection
74. One of these is an emergency care for a toddler with accidental ingestion of caustic soda

a. Induce vomiting immediately

b. Give diluted acidic juice to counter its effect
c. Maintain Nil per os (NPO) for at least 24hrs
d. Give plenty of water
75. Which of these blood products will be ideal for treatment of a bleeding child being
managed for disseminated intravascular coagulopathy (DIC)

a. Sedimented red cells

b. Fresh whole blood
c. Fresh frozen plasma
d. Platelet concentrate
76. Oxygenated blood goes to the fetus by means of the

a. Umbilical arteries
b. Umbilical vein
c. Great umbilical vessels
d. Aorta
77. A 65yr old woman with advanced cervical cancer and acute urinary retention is scheduled
for emergency surgery. The patient cannot sign the consent form due to sedation from
narcotic analgesics administered to her. The most appropriate action to be taken by the nurse
caring for this patient is

a. Obtain a court order for the surgery

b. Obtain a telephone consent from a family member and have the consent witnessed by
two persons
 c. Have the hospital chaplain sign the informed consent immediately
d. Send the patient to surgery without the consent form since it is an emergency
78. One of these is Not a child survival strategy

a. Immunization
b. Family planning
c. Girl child education
d. Hospitalization
79. Every cell in the body has a nucleus Except

a. Mature white blood cells

b. Mature red blood cells
c. Mature ovum
d. Mature spermatozoa
80. One of these is Not a contraindication to breastfeeding

a. Mother receiving chemotherapy for cervical cancer

b. Mother on anti-thyroid medication for graves’ disease
c. HIV infected mother on HAART
d. Mother with open pulmonary tuberculosis
81. A 5day old newborn was found to have cyanosis of the lips and tongue. What is the likely
diagnosis?

a. Transposition of the great vessels

b. Ventricular septal defect
c. Atrial septal defect
d. Patent ductus arteriosus
82. The difference between the systolic and diastolic blood pressure is called

a. Mean arterial pressure

b. Pulse pressure
c. Pressure discrepancy
d. Peripheral resistance
83. The most effective way to reduce nosocomial infections in hospital wards is

a. Barrier nursing
b. Frequent proper hand washing
c. Liberal use of anti-microbial agents
d. Frequent use of disinfectant on surfaces
84. Following a right mastectomy, which of these is a complication related to the surgery?

a. Severe pain in the incision site

b. Reduced sensation in the incision site
c. Oedema of the right arm
d. Sanguineous drainage from the operation site
85. One of the following is a major cause of neonatal mortality in Nigeria

a. Perinatal asphyxia
b. Haemorrhagic disease of the newborn
c. Erythroblastosis fetalis
d. Congenital heart defects
86. The most appropriate time for breast self-examination is

a. One week after onset of menstruation

b. At the onset of menstruation
c. Weekly at the same time of the day
d. Every month during ovulation
87. A risk factor for cervical cancer according to scientific evidence is

a. Smoking
b. Oral contraceptive pills
c. Multiple sexual partner
d. Frequent vaginal examination
88. The causative agent for monkeypox disease is

a. Virus
b. Protozoa
c. Bacteria
d. Prion
89. Children with congenital heart defects may have the following comorbidities Except

a. Failure to thrive
b. Heart failure
c. Frequent infections
d. Suboptimal intelligence
90. One of these hormones is Not essential in spermatogenesis

a. Follicle stimulating hormone (FSH)

b. Luteinizing hormone (LH)
c. Thyroid stimulating hormone (TSH)
d. Androgens
91. One of these vitamins also functions as a hormone

a. Vitamin A
b. Vitamin B
c. Vitamin C
d. Vitamin D
92. Pain that is felt on a cutaneous site different from where it originates is referred to as

a. Phantom pain
b. Superficial pain
c. Referred pain
 d. Cutaneous pain
93. Lactational amenorrhea is one of the natural birth control methods that functions
effectively with

a. Complimentary breastfeeding
b. Token breastfeeding
c. Exclusive breastfeeding
d. Mixed feeding
94. A 6yr old girl who had vitamin D deficiency may likely suffer the following
complications later in her life Except

a. Short statue
b. Obstructed labour
c. Limb deformities
d. Severe anaemia
95. Nursing care for an unconscious 50yr old man Does not include

a. Nasogastric nutrition
b. Bladder and bowel care
c. Nurse in right lateral position
d. Frequent turning of patient
96. As the nurse on duty, you just observed from the treatment chart that an overdose of
paracetamol was mistakenly administered to a 3yr old child in the previous hour, what will be
your immediate action?

a. Call the attention of the doctor on call

b. Administer appropriate dose of activated charcoal
c. Give maintenance intravenous fluid
d. Erase the charted drug to avoid querries
97. The organ of excretion in the foetus is

a. Kidneys. b. Liver. c. Intestine. d. Placenta

98. Which of the following is Not a component of environmental hygiene?

a. Personal hygiene. b. Portable water supply. c. Good hygiene. d. Food storage

99. Anatomically, the maxillary sinuses is located

a. Below the orbit

b. Within the ethmoid bone
c. In the midline of the frontal bone
d. Within the sphenoid bone
100. The incubation period of Plasmodium falciparium is

a. 5-9days
b. 9-14days
c. 14-19days
d. 19-24day
 College of Nursing, Ihiala.
Pre-Professional Examination for Nursing Students
Date: July, 2022.
Marking Scheme for PAPER 11 Objectives

1. A 32. C 63. C
2. B 33. C 64. D
3. C 34. D 65. C
4. D 35. B 66. C
5. C 36. C 67. A
6. D 37. C 68. B
7. C 38. A 69. B
8. D 39. C 70. A
9. C 40. D 71. C
10. C 41. C 72. B
11. C 42. B 73. C
12. A 43. C 74. C
13. A 44. A 75. B
14. A 45. D 76. B
15. C 46. C 77. A
16. B 47. D 78. D
17. C 48. B 79. B
18. A 49. A 80. C
19. B 50. A 81. A
20. C 51. D 82. B
21. B 52. B 83. B
22. B 53. A 84. C
23. c 54. C 85. A
24. B 55. C 86. A
25. B 56. A 87. C
26. C 57. D 88. A
27. B 58. C 89. D
28. A 59. D 90. C
29. A 60. D 91. D
30. B 61. A 92. C
31. B 62. D 93. C
94. D 97. D 100. B
95. C 98. A
96. B 99. A