NATIONAL COUNCIL LICENSING EXAMINATIONS LEADING TO

REGISTRATION AS A GENERAL NURSE

Candidate Registration No.

Date of examination :
Signature :

PAPER 1: MEDICAL ASPECTS

Medico-pathology
Medico-Nursing care
Pharmacology
Infectious diseases
Medico-psychology
Mental health and psychiatry
Anatomy & physiology
Nursing care plan
Ethics

Duration: 2 Hours
Total marks: noo

Instructions:
Please write clearly. Please, respect the order of questions
The examination comprises only one section of 75 multiple choice questions.
Ansvver all questions.

Choose and circle the letter corresponding to the right answer (0.5 mark each)

N.B. : Veuillez voir la Version Frangaise la fin du questionnaire anglais !

 PAPER 1: MEDICAL ASPECTS
CHOOSE AND CIRCLE THE LETTER CORRESPOND[NG TO THE RIGHT ANSWER.

l. The following are the examples of nurses obligations in ethical decisions Except one:
a. Maximized patient wellbeing

b. Carry out hospital policies

c. Respond to all patient's needs

d. Protect the nurse's own standards of care

2. You are a nurse at the Health center X and you receive a 30 years old male patient
accompanied by his fiancée. After curative consultation, tuberculosis and HIV are
confirmed. The patient hides his HIV status from his fiancée who finally decided to
seek information from the nurse. As a nurse, give two most appropriate
responsesamong the following options

i. The nurse should advise to the patient's fiancée that she has to wait for the patient to
disclose his HIV status himself

ii. The nurse should teach the patient on the importance of disclosing his HIV status
to her future wife.

Iii. The nurse should disclose HIV status to the fiancée in order to protect her

IV. The nurse should advise the patient's fiancée to be tested for HIV herself before
being informed about her fiancé HIV status.

a. i and ii

b. ii and iii

c. i and iv

d. iii and iv
While teaching a client with hypertension concerning caring and controlling his
condition, the nurse should consider one Inos•t important statement among the
following:

All clients with elevated blood pressure require medications

2
 2. It is not necessary to limit salt in the diet if taking a diuretic

3. Obese persons must achieve a normal weight in order to lower blood pressure

4. Life style modifications are indicated for all persons with elevated blood pressure

4. Mrs. Agabe, a 26 years old woman, is admitted to the medical department of her nearest
hospital. She presents with pale skin and mucus membranes, fatigue, dizziness, loss of
weight and irritability. The laboratory examinations show hemoglobin of 7 mg / dl. What
is the best immediate nursing intervention for Mrs. Agabe'?

a. Teach client about taking food high in proteins, calories and iron

b. Monitor hemoglobin as a guide for planning nursing activities

c. Transfuse with blood products as prescribed

d. To administer folic acid as prescribed

5. The following are statements made by the nurse while taking a nursing history. Which of
them would best help her to obtain the greatest amount of client's data?

a. You said the pain started yesterday?

b. Can you tell me more about how the pain began?
c. The pain isn't bad right now, is it?
d. Did your pain begin recently?
6. You are working in medical ward and you have a client who has recently undergone a
bronchoscopy and is requesting for a glass of water. As a nurse what should be your initial
assessment prior to meeting this request'?

a. Determine if the client is able to swallow without difficulty

b. To make sure that the water is slightly warm.
c. Ensure that the patient is not coughing and vomiting.
d. Determine if the client received a local anesthetic during the procedure

3
7. A client is scheduled for a colonoscopy and asks the nurse what will be determined from
the test. What would be the nurse's best response?
a. It will evaluate tumor or other problem in the large intestine
b. It will determine whether there is any blood in the abdominal cavity
c. It will evaluate the presence of varices and provide opportunity to sclerose them
d. It will assess the effectiveness of the treatment you had for the peptic ulcer

8. Which of the following actions by the nurse would be contraindicated when performing
mouth care of an unconscious client?
a. Give oral care using a small swab
b. Brush the teeth with a small(child-size) toothbrush
c. Position the client head to one side or the other during the procedure
d. Use an alcohol-based product for most effective cleansing

9. The nurse is planning to teach the client with acute glomerulonephritis about dietary.

Which of the following is dietary information that the Nurse would mostly include in the

plan?

a. Limit fluid intake to 500ml per day

b. Restrict protein intake by limiting meats and other high-protein foods
c. Increase intake of high-fiber foods, such as cereal
d. Increase intake of sodium-rich foods such as salt preserved fishes
10. Which of the following drugs should a nurse advise a client with liver disease to avoid in
regard to over-the-counter medications?
a. Cimetidine
b. Benzyl penicillin
c. Ascorbic acid
t. Paracetamol
11. Direct intravenous injection is mostly indicated in the following conditions, Except one:
a. Very sick patients that need quick intervention
b. Unconscious patients

4
 c. The drug to be administered for long period and when the drug is painfull for other
routes, and if the drug must particulary be given by this route.

d.' The patient who is able to take the medicines through the other ways
12. Among the usages of enemas indicate the most appropriate group as shown in the answers
below:
Cleansing the lower bowel prior to a surgical procedure such as sigmoidoscopy or
colonoscopy.
ii. used to relieve constipation and fecal impaction
iii. Used to treat intestinal occlusion because of constipation
iv. Used to administer medications into the rectum, such as corticosteroids and
mesalazine used in the treatment of inflammatory bowel disease
1. i, ii and iii
2. i, iii and iv
3. ii, iii and iv
i, ii, iv
13. What is the best position for a patient in a state of lacking normal awareness of self and
unresponsive to the environment?
a. Sim's position
b. Knee-Chest position
c. Orthopneic position
d. Trendelenburg position
14. The nurse teaches the female client who has frequent urinary tract infection that she
should:

a. Urinate after sexual intercourse

b. Take tub baths with bubbles bath

c. Take prophylactic sulfonamides for the rest of her life

d. Restrict fluid intake to prevent the need for frequent voiding

15. A nurse who focuses attention on the strengths and abilities of his patients rather than
their problems is helping them to achieve which of Maslow's basic human needs?

5
 a. Self-actualization

b. Self-esteem

c. Love and belonging

d. Safety and security

16. Which of the following indicate better the need for suctioning :
b. Restlessness

c. Gurgling sounds during respiration

d. Rate and pattern of respirations

e. Skin color

f. Hyperthermia resulting from accumulated secretions :

1. l, 11, 111, and V

2. 1, 111, IV, and V

3. 11, 111, IV, and V

4. l, 11, 111, and IV

17. The purpose of administering oxygen by Pace mask is:

5. To deliver a relatively low concentration of oxygen when only minimal oxygen

support is required

6.To allow un interrupted delivery of oxygen while the patient ingests foods or
fluids

7.To provide moderate oxygen support and a high concentration of oxygen and / or humidity

8. To avoid the presence of clinical signs of oxygen toxicity such as tracheal

irritation, cough and dyspnoea

18. An elderlyclient who recently had a stroke is exhibiting the signs of severe dysphagia.The
optimal form of nutrition support at this time would be :
a. Total parenteral nutrition

6
 b. Regular diet
c. Nasogastric tube feeding
d. Nothing by mouth until dysphasia resolves

19. In planning nursing interventions to increase bladder control in client with urinary
incontinence, the nurse includes all of the following, except:

l . Restricting fluids to diminish the risk of urinary leakage

2. Counseling the client concerning the choice of incontinence

containment device

3. Clamping and releasing a catheter to increase bladder tone

4. Teaching the client biofeedback mechanisms to suppress the

urge void
20. The nursing measure that is indicated to reduce the potential for seizures and increased
intracranial pressure in the client with bacterial meningitis is:

l . Administering codeine for relief of head and neck pain

2.Controlling fever with prescribed drugs and cooling techniques

3. Keeping room darkened and quiet to minimize environmental stimulations

4. Maintaining the client on strict bed rest with the head of the bed slightly
elevated

21. Important nursing roles related to prevention and detection of cancer include:

a. Health promotion in relation to eating low fiber,refined carbohydrate diets

b. Teaching about cancer risk factors

c. Encouraging the public to participate in regular screening tests for all

detectable cancer sites

d. Using people's natural fear of cancer to motivate changes in unhealthy life

style

22. An important nursing responsibility related to pain is to:

7
 a. Encourage the client to stay in bed

b. Help the client appear to not be in pain

c. Believe what the client says about the pain

d. Assume responsibility for eliminating the client's pain

23. In severely anemic client, the nurse would expect to find:

l. Dyspnea and tachycardia

2. Cyanosis and pulmonary edema

3. Cardiomegaly and pulmonary fibrosis

4. Ventricular arrthymias and wheezing

24. Asthma is best characterized as:
l. An inflammatory disease
2. A steady progression of bronchoconstriction
3. An obstructive disease with loss of alveolar walls
4. A chronic obstructive disorder characterized by mucus production
25. An appropriate nursing intervention for a client with pneumonia with the nursing
diagnosis of ineffective air way clearance related to thick secretions and
fatigue would be to:
l. Perform postural drainage every hour
2. Provide analgesics as ordered to promote client comfort
3. Administer oxygen as prescribed to maintain optimal oxygen levels
4. Teach the client how to cough effectively to bring secretions to the mouth
26. Very early signs and symptoms of inadequate oxygenation include:
l . Dyspnea and hypotension
2. Apprehension and restlessness
3. Cyanosis and cool, clammy skin
4. Increased urine output and diaphoresis

27. A hospitalized client with Angina tells the nurse that she is having chest pain. The nurse
bases her actions on the knowledge that Anginal pain:
l Will be relieved by rest, nitroglycerin or both
2. Is less severe than pain of myocardial infarction
3. Indicate that a reversible cellular damage is occurring
4. Is frequently associated with vomiting and extreme fatigue

8
28. Prophylactic antibiotics are indicated to prevent infective endocarditis for at risk
individuals who:
l Are undergoing any dental procedure
2. Are entering the third trimester of pregnancy
3. Have acquired viral respiratory tract infections
4. Are exposed to human immune deficiency virus
29. A 78 years old man has conlüsion and temperature of 400 c. He is diabetic with purulent
drainage from his right great toe. His hemodynamic findings are: blood pressure of 84 / 40
mmHg, heart rate of 1 10 beats / min, and his respiration rate is 42 cycles / min and
shallow and he presents cold sweat. These client's symptoms are most likely indicative of:
l Sepsis
2. Septic shock
3. Multiple organs dysfunction syndrome
4. Systemic inflammatory response syndrome
30. Mrs. Kampire calls to tell you that her mother aged of 80 years has been presenting nausea
all day, and has vomited twice. What should you instruct Mrs. Kampire while she is still
waiting for the bus to bring her mother to the health facility?
l To administer antispasmodic drugs and observe skin turgor
2. To give her mother the water to drink and elevate the head of her bed to
prevent aspiration.
3. To offer her mother a higher protein liquid supplement to drink in order to
maintain her nutritional needs
4. To offer her mother large quantity of yoghurt to drink because elderly
people are at risk for calcium depletion
31. You are teaching your client and her family about possible causative factors for peptic
ulcers. You explain that ulcer formation is mostly:
l Caused by a stressful life style and other acid producing factors
2. Inherited within families reinforced by bacterial spread of
staphylococcus aureus in child hood
3. Promoted by factors that tend to cause over secretions of acid such as
excess dietary fats, smoking

9
 4. Promoted by a combination of possible factors that may result in erosion
of the gastric mucosa including certain drugs and alcohol
32. A client with hepatitis B is being discharged in 2 days. Which instruction should the nurse
include in the discharge teaching plan?
l. Avoid alcohol tör 3 weeks
2. Use a condom during sexual intercourse
3. Have family members get an injection of Immunoglobulin
4. Follow a low protein, moderate carbohydrates, moderate fats diet
33. The client with advanced cirrhosis asks the nurse why his abdomen is so swollen. The
nurse's response to the client is based on the knowledge that:

l . A lack of clotting factors promote the collection of blood in the

abdominal cavity
2. Portal hypertension and hypo-albuminemia cause a fluid shift
into the peritoneal space
D. Decreased peristalsis in the gastrointestinal tract contribute to
gas formation and distension of the bowel
4. Bile salts in the blood irritate the peritoneal membranes,
causing edema and pocketing of the fluids
34. A 58 years old patient comes into consultation room complaining of sudden onset of
epigastric pain radiating to the back, anorexia, Nausea, and Vomiting two days ago.
During clinical examination you find temperature of 38.5 0 c, pulse of 99 heart beats /
min.and blood pressure of 70/50 mmHg. On palpation you notice epigastric tenderness,
with localized guarding and rebound. What is the most probable diagnosis?

l . Gastro-duodenal ulcer
2. Gastritis
3. Acute pancreatitis
4. Pancreatic cancer
35. The number one risk factor for stroke is:
l . History of high blood pressure
2. History of diabetes mellitus

10
 3. History of smoking
4. History of physical inactivity
36. The nurse plan care for the patient with migraine headache based on the knowledge that
during migraine the client is most likely to:
a. Withdraw from the stimuli
b. Act out with bizarre behaviors
c. Seek out the company of others
d. Experience painful facial spasm and tearing
37. During health assessment of Mrs. Berwa a comatose female patient, you find out that she
only open eyes when pinched and She is able to localize pain with her arm, but unable to
use appropriate words while responding to your questions. Which of the following options
corresponds better to Berwa Glasgow coma scale?
1. Glasgow coma scale of 3 over 15
2. Glasgow coma scale of 10 over 15
3. Glasgow coma scale of 9 over 15
4. Glasgow coma scale of 7 over 15
38. A client with diabetes has a serum glucose level of 36 mmol / I (648 mg/dl) and is
unresponsive: Following assessment of the client, the nurse suspects diabetic ketoacidosis
rather than hyperosmolar hyperglycemic non ketotic syndrome based on the findings of:
l . Polyuria
2. Severe dehydration
3. Rapid and deep respiration
4. Decreased serum potacium
39. An appropriate teaching measure for the client with diabetes mellitus related to care of feet
is to:

l . Use heat to increase blood supply

2. Avoid softening lotions and creams
3. Inspect all surfaces of the feet daily
4. Use iodine to disinfect cuts and abrasions
40. The appropriate collaborative therapy of client with acute diarrhea caused by rotavirus is
to:

11
 Increase fluids intake

2. Administer an antibiotic
D. Administer anti-Inotility drug
4. Quarantine the client to prevent spread of the virus

41. An abnormal finding by the nurse during an endocrine assessment would be:
l. A blood pressure of 100/70 mm hg
2. Soft, formed stool every other day
3. Excessive facial hair on Woman
4. A 2.2 kg weight gain over the last 6 months
42. A client has been receiving high dose corticosteroids and broad spectrum antibiotics for
treatment of serious trauma and infection. The nurse plans care for the client knowing that
the client is most susceptible to
a. Candidiasis
b. Aspergillosis
c. Histoplasmosis
d. Coccidioidomycosis
43. ALDOMET is useful in case of:
a. Hypertension
b. Hypotension
c. Heart failure
d. Fungal infection
44. The followings drug's effects are attributed to Aspirine EXCEPT:
a. antiplatelet effect
b. Non Steroid Anti-Inflammatory effect
c. a diuretic effect
d. an antipyretic effect

12
47. A 56 years old male patient reports to you at emergency department of a certain
hospital. He presents wheezing, dyspne•a, Cough, and Chest tightness. What is the
most appropriate option among the medications proposed by the Medical student?
a. Oxygen therapy
b. Salbutamol
c. Hydrocortisone
d. Ciprofloxacin
1. 1, 11, and IV
2. 1, 11 and Ill
3. 11, 111 and IV
4. 1, 111 and IV
48. A client with Tuberculosis has nursing diagnosis of non compliance. The nurse
recognizes that the most common etiological factor for this diagnosis in client with
Tuberculosis is :
a. Fatigue and lack of energy to manage self care
b. Lack of knowledge about how the disease is transmitted
c. Little or no motivation to adhere to a long term drug regimen
d. Fillings of shame and response to the social stigma associated with
Tuberculosis
49. Among the diseases listed below, which is most characterized by the following signs
and symptoms: Sudden explosive watery diarrhea, excessive vomiting and fever, no
colic pain, Rapid onset of dehydration and asthenia?
a. Cholera
b. Bacterial dysentery
c. Food poisoning
d. Amoebiasis
50. The following are different factors to base on while deciding the time to start
antiretrovirus treatment. What is the most important factor?
a. Viral load
b. CD 4 cell count
c. The readiness of the patient to start ART
d. The clinical condition of the patient
51. Mr. Mukire a 40 years old patient is admitted at the health facility. His chief
complaints are: headache, weakness, loss of appetite, chills; vomiting, joint pain and
muscular aches, and he had passed liquid stools four times a day since two days ago.
The clinical examination revealed temperature of 37.8 o
c and Stiffness. Among the
following options, which ones describe better the most probable diagnosis and
management of the case of Mr. Mukire?
l . Simple malaria to be treated with coartem tablets +
paracetamol tablets + Metoclopramide IV.
2. Simple malaria with minor digestive symptoms to be
treated with Aspegic IV +Artesunate IV which may be
followed by coartem tablets
D. Severe malaria to be treated with Quinine IV + Glucose 5%
IV+ Aspegic
4. Typhoid fever to be treated with Aspegic IV and Ciprofloxacin IV
followed by oral tablets

52. You examine Mrs. Kawera aged 32 years old and a known case of HIV. She is
complaining of moderate unexplained weight loss of around 10% of body weight in the
last 6months and recurrent cough, sinusitis and tonsillitis. On physical examination, she
has ulceration of oral mucosa, papular pruritic eruptions and onycomycosis. In which
clinical stage should you classify Mrs. Kawera according to
World Health Organization?
I. Clinical stage I
2. Clinical stage Il
3. Clinical stage Ill
4. Clinical stage IV
16
NATIONAL COUNCIL LICENSING EXAMINATIONS LEADING TO
REGISTRATION AS A GENERAL NURSE

Candidate Registration N •

Date of examination :
Signature :

PAPER 2 : SURGICAL ASPECTS

Surgical pathology
Surgical nursing care
Applied pharmacology
First Aid
Anesthesia and resuscitation
Applied anatatomy
Sensory pathology
Nursing care plan

Duration: 2 Hours Total

marks: noo

Instructions:
Please write clearly. Please, respect the order of questions
The examination comprises only one section of 75 multiple choice questions.
Answer all questions.
Choose and circle the letter corresponding to the right answer (0.5 mark each)

N.B. : Veuillez voir la Version Frangaise å la fin du questionnaire anglais !

PAPER 2 : SURGICAL ASPECTS
CHOOSE AND CIRCLE THE LETTER CORRESPONDING TO THE RIGHT
ANSWER
1. The following are the diagnostic measures for hiatal hernia except:
a) Gastro intestinal endoscopy
b) Chest X-ray examination
c) Barium swallow
d) Esophageal motility studies

2. The following include the signs and symptoms of peritonitis except:

a) Abdominal rigidity
b) Hiccough
c) Dry mucous membranes
d) Severe diarrhea

3. From The statements below describing the clinical manifestation of spinal cord
injuries located on Cl -C4; identify the most appropriate answer.
a) Quadriplegia with total loss of respiratory function
b) Quadriplegia with possible phrenic nerve involvement. Owing to
edema resulting in loss of respiratory function
c) Quadriplegia with gross arm movement; sparing of diaphragm leads to
diaphragmatic breathing
d) Paraplegia with loss of varying amounts of inters costal and abdominal
muscle

4. The pathologies listed below require emergency surgery when diagnosed EXCEPT:
a) Diverticulitis
b) Appendicitis
c) Strangulated hernia
d) Gastrointestinal obstruction

2
5. Signs and symptoms of raised intracranial pressure (ICP) include the following
EXCEPT:

a) Early- confusion, restlessness, lethargy and disorientation,

b) Late -- comatose
 c) Strains, footboard push

d) Pupillary dysfunction - sluggish response to light to fixed pupils

6. The following are clinical manifestations of fractures EXCEPT:

a) Swelling around the injured area,

b) Loss of function in the injured area,

c) Bruising around the injured area, deformity of a limb,

d) No localized pain at the injured site

7. The following are clinical manifestations of Compartment syndrome EXCEPT:

a) Paresthesia

b) Distal pain to the injury that is not relieved by narcotics

c) Pressure of the compartment increases

d) Pressure of compartment decreases

8. Osteomyelitis is likely to occur among the following groups of people EXCEPT:

a) Diabetics people
b) Patients receiving hemodialysis
c) Young people
d) People with weakened immune systems

3
9. During a football match two players struck each other's head while running for the
ball, and one of them sustained head injury. The mechanism of occurrence of the
injury is described by one of the terms below:
a) Deceleration
b) Acceleration
c) Acceleration- Deceleration (coup contre coup)
d) Compression
 10. The investigations listed below are commonly recommended for head injuries
diagnosis EXCEPT:

a) Radiologic — CT scan skull films

b) Cerebral angiogram

c) EEG and X- ray

d) Echography

11. Most of the investigations listed below are indicated in case of urinary tract lithiasis
EXCEPT:

a) CT Scan and Kidney MRI

b) Abdominal x-ray and intravenous pyelogram (IVP)

c) Echography and Kidney ultrasound

d) Retrograde pyelogram and abdominal X-ray

12. Benign prostate hypertrophy (BPH) is characterized by the following symptoms

EXCEPT:
a) Inability to urinate (urinary retention)
b) Incomplete emptying of the bladder
c) Urine incontinence
d) Painful ejaculation
4

Read (he scenario and answer the questions INO 13 to 16.

r.s Esperance 60 year old and and 62 kg transferred from Kabuye health centre with
severe burns ,destruction of skin cells followed by generalised oedema formation due
to petrol flame of their house. The casualty was evacuated by her neighbours after 30
minutes in the flame. On assessment the physician noticed 45% of total body surface
area was burnt (burns on face, 2 arms, abdomen and genital organs) with flame
inhalation, hypervolemia, cellular shock and acute pain. Then the physician decided to
start fluid resuscitation immediately, his preference was Ringer lactate, IV antibiotics
and close monitoring. Mrs Esperance had been diagnosed with hypertension, hepatic
diseases two years before, she was known of cigarettes smoking for more than 5
years .
13. From the following items identify two other causes of bums:

a) Chemicals and water

b) Cold steam and frost

c) Chemicals and hot fluids

Cold sand and radiation

14. From the given list of factors determining severity of burns identify the incorrect:

a) Age of patient and body part involved

b) Size of burn and its depth

c) Mechanism of injury and history of cardiac, pulmonary and renal diseases

d) Young age and size.

5
18. The surgical team is composed of the following persons EXCEPT:
a) Surgeon
b) Anesthetist
C) Patient
d) Cardiologist

19. The general rules of nursing for a patient with a tracheotomy includes all of the töllowing
EXCEPT:
a) Provide a warm and humid, to prevent infection and the development of muco purulent plugs.
b) Keep at hand a complete additional tracheal cannula and sterile for use in emergencies and
maintain the vacuum in good working order and keep the aspirations of sterile probes always
available.
c) Keep the tracheobronchial tree free and frequently check the site of tracheotomy tor signs of
bleeding, infection.

d) Do not give frequent mouth care day and night.

2(). The goals of tracheotomy are the following EXCEPT:

a) Establish and maintain airway fonction well and help the patient who can no longer tolerate
an endotracheal tube.
b) Remove the secretion of tracheobronchial airway when the patient is unable to cough properly.
c) To relieve the patient who has no special breathing problems
d) To prevent aspiration of oral secretions or stomach secretion in unconscious patient

21. During sternal puncture procedure, monitoring includes the following elements EXCEPT:
a) Monitor the reactions of the patient and the flow at the puncture site,
b) Measurement of blood pressure and pulse,
c) Monitor all vital signs tor the patient,
d) Massage/compression on the puncture site for a minute.

22. Lumbar puncture is performed for the following reasons EXCEPT:

a) To analyze the cerebrospinal fluid in order to detect signs of infection or disease.
b) Measure the pressure of the cerebrospinal fluid;
c) Administration of the anesthetic (for pain) or medicines
d) To analyze the abnormal cells

23. Impaired physical mobility related to pain as manifested by limitation and movement of upper
extremities on surgical side is another nursing diagnosis for a patient post mastectomy. Select the
appropriate nurse's role in the rehabilitation phase of the patient among the following statements.

7
 a) The nurse should treat pain in order to facilitate easy exercises.

b) The nurse should encourage the patient to do passive exercises

c) The nurse should not allow the patient to exercise by herself

d) The nurse should provide enough passive exercise

24. The following are criteria used as general indicators for surgical interventions in case of peptic
ulcers EXCEPT:

a) Multiple ulcer sites

b) Fåilure of ulcer to heål

c) Failure to take food by mouth

d) Possible existence of maligriancy

25. The following aye surgical procedureS used for theatrnerit Of peptic Ulcers EXCEPT:

a) Vagotorny
b) Pyloroplasty
c) Gastroduedoctomy
d) Partial gastrostomy With ariastomosis to the transverse cölon

Readfollowing scenario and answer the related questions (26-29)

Mr. Christopher 57 years old was admitted on your ward just on the previous day of his operation
appointment for partial gastrostomy. He has been sick for a period of ten (10) years and is worried
that he may not survive anesthesia.

26. For the success of Mr. Christopher's operation, the nurse in the surgical ward will have to play a
big role as follows:

a) Preparation of the bed for the patient pre operatively

b) Preparation of the teaching plan which involves answering the patient's and family's questions
that may play a great role in allaying the anxiety.

c) Showing the patient all the pictures related to his disease

d) Keeping the patient silent on the ward in order to be ready for the operation.

8
27. Post operatively, Mr. Christopher has to be closely monitored so as to prevent complications by:

a)Checking vital signs as necessary

a) The NGT drainage should be efficient

b) NGT is used for aspiration in order to decompress the stomach thus reduce pressure on
sutures

c) Nasogastric suction should be done so that the patient may not vomit gastric contents

28. The statements bellow are records from observations of gastric aspirates from patient post partial
gastrectomy immediately. In relation to time and color, identify the correct answer.
a) It is expected to be yellow green within 36- 72hours
b) Is red after operation and is expected to be darkening within 24 hours
c) It is expected to be yellow green 24-36 hours
d) It is expected to be dark black within 48 hours

e)

29. As a nurse, in recovery room, what do you have to do in order to prevent rupture of the remaining
stomach to a patient post gastrostomy with NGT in position?

a) Continue aspiration of stomach content

b) Avoid any blockage of the NGT by irrigation

c) Keep the patient in semi siting up position so that the patient does not vomit.

d) Keep the patient on IV line only.

30. The following statements are complications of gastrectomy EXCEPT:

a) Peritonitis and abscess

b) Hemorrhage and shock

9
 c) Increased peristaltic movement and intestinal obstruction

d) Pyloric stenosis

31. Which of the following element is not among surgical procedures purpose?

a) Diagnostic

b) Palliative

c) Constructive

d) Nutritive

32. The Period in which a decision to have a surgery is made and ending when the patient is
transferred to the operating table is called.
a) Post- operative phase
b) Intra- operative phase
c) Pre- operative phase
d) Peri- operative phase
33. The section of the operating room where we must wear the surgical gowns, and the mask, is
called:

a) Unrestricted access area

b) Restricted Zone

c) Semi restricted zone

d) Access area

34. From the statements below identify the best explaining the purpose of an informed consent form.

a) Patient right of knowing the anaesthetics' drug to be used in the theatre

b) Authorization by the patient or a family member for the procedure

c) Ensure that the client is not undergoing a procedure without an informed consent and helps
protect the team from liability
10
 d) Dictate the treatment or a care which is going to be done for the patient

35. The following are measures to prevent the post-operative infections in surgical ward EXCEPT:

a) Clean and keep the skin dry

b) Use aseptic technique during dressing change and remove drains on time

c) Avoid touching the wound and early mobilization

d) Proper and effective hand washing by the staffs, patient and visitors
36. A systematic approach that applies knowledge from the biological, physical and social sciences to
unique client situations is:

a) Nursing diagnosis
b) Nursing assessment
c) Nursing process
d) Nursing Theory

37. An active, organized, cognitive process used to examine one's thinking and the thinking of others
is:

a) Critical thinking
b) Holistic care
c) Nursing care plan
d) Nursing diagnosis

38. Choose the correct answer testifying the human being dimensions:

a) Physical/biological, social, emotional/psychological and spiritual.

b) Physical/biological, social/economic, and spiritual.

c) Physical/biological, emotional/psychological and physiological.

d) Physical/biological, social, emotional/psychological and developmental

11
Read following scenario and answer the related questions (39-42)

Mr. X 38 years , while working on his plantation injured himself by his panger and sustained a big
wound on the leg. Immediately after the injury he called for help, the neighbor treated him with
green herbs to stop bleeding because he could not go to the health center as he had not paid the
health insurance due to poverty.

After two weeks the wound was smelling, leg very much swollen and dark in colour. Mr. X could not
eat and sleep because of severe pain. Later he was transferred to hospital by the local authorities. The
patient assessment revealed a temperature of 39.9 0 C, moderate dehydration and poor hygiene.

39. Basing on the given statements below which one describes the appropriate formulation of a
nursing diagnosis?

a) The client has poor body hygiene as it was indicated by bathing him on arrival.

b) Patient has altered body temperature related wound infection as manifested by high
temperature39.9 0 C

c) Insufficient body function as indicated by lack of opening bowels

d) Loss of intact skin as indicated by a wound

40. As a nurse your nursing interventions to Mr. X, would be the following EXCEPT:

a) To administer antipyretics so as to lower temperature to normal.

b) To improve general body hygiene by bathing the patient

c) To care for the wound by inspection ,cleaning and dressing.

d) Treat the dehydration by prescribing the intravenous fluid.

1
41. Identify the reason why Mr. X did not go to health services
12
 a) The social economic background of the patient

b) The religion of the patient

c) Marital status of the patient

d) Age of the patient

42. The main cause of wound infection of Mr. X would be:

a) Bacteria

b) Delay in care

c) Poor wound care

d) Poverty

43. For a nurse to make an effective nursing care plan she needs to do the following EXCEPT:

a) Take history of the patient and subjective data

b) To read the notes

c) To get objective data

d) To make a right nursing diagnosis

44. Components of the nursing process are arranged in the following order.

a) Nursing diagnosis, evaluation, planning, assessment and implementation

b) Nursing assessment, nursing diagnosis, implementation , planning and evaluation

c ) Evaluation, Planning ,Nursing diagnosis ,Nursing assessment and implementation

d ) Nursing assessment, Nursing diagnosis , planning ,implementation and evaluation

45. Objectivity of a good nursing care plan is indicated by the following statements, choose the
incorrect.

13
 a) Good assessment

b) Good communication

c) Good prioritization

d) Good planning

Read the scenario below and respond to questions 46-47

Mr.Serugendo was cycling going to town as he entered the main road, he was nocked by a lorry.
Immediately the police came and the causality was taken to hospital by ambulance. According to the
medical personnel it was observed that Mr Serugendo had a wound on left side of the head, was
profusely bleeding on the left leg which was shorter than the right leg. The casualty could not speak
but was breathing through open mouth.

Read the scenario and answer the following questions related to it.

46. If you as a nurse arrived at the site before the police, your priority activity would have been:

a) To lift the casualty from the road

b) To stop traffic

c) To send away the people

d) To check whether the causality was alive or dead

47. Which of the first aid interventions listed below is correct in respect to CAB
(circulation,Airway,Breathing)

a) To ensure good circulation by putting the casualty in supine position

b) To ensure normal breathing by turning the head on the side

c) To ensure good perfusion

d) To position the casualty in supine position and elevate the legs

14
48.' If a casualty's behavior threatens your safety while you are attempting to provide first-aid, what
should you do?
a) Try to retrain the casualty and prevent harm to yourself and others
b) Attempt to calm the casualty by gently touching his or her arm and talking softly
c) Withdraw from the immediate area and wait for Emergency Medical System personnel
d) Try speaking forcefully and authoritatively to the casualty to gain cooperation

49. Why is it necessary to complete a primary survey in every emergency situation?

a) To check for minor injuries
b) To determine if there is any life threatening Conditions that needs immediate care
c) To get consent from the casualty before providing care
d) To ask for information about the cause of the illness or injury

5(). Choose the best order to assess the three elements of a primary survey
a) Airway, circulation, breathing
b) Breathing, airway, circulation
c) Circulation, airway, breathing
d) Airway, breathing, circulation

51. You have decided to give rescue breathing to a casualty of respiratory arrest. Which technique
should you use to keep the airway open when there is no suspected head or spinal injury?
a) Chin lift
b) Head tilt/neck lift
c) Jaw thrust without head tilt
d) Head tilt/chin lift

52. Choose the incorrect answer among the following alert signs of side effects of general anesthesia
after two (2) weeks:

a) Severe headache

b) Pain in stomach or abdomen

c) Increased or decreased amount of urine

d) Heart attack

53. The triad of general anaesthetic include the following element except:

15
 a) Analgesic- muscle relaxant-Hyponotic

b) Hyponotic- Analgesic- Muscle relaxant.C) Analgesic- -}dyponotic- Muscle relaxant

d) Analgesic- Muscle relaxant- Induction

54. A series of acts and means to support the vital chain is:

a) Local anesthesia

b) General anesthesia

c) Resuscitation

d) Spinal anesthesia

55. Failure of blood oxygenation or an obstacle to gaseous exchange due to hypoventilation

is:

a) Anaemic hypoxia

b) Diffusion hypoxia

c) Hypoxemic hypoxia

d) Cytotoxic hypoxia

56. The föllowing medications are analgesics except:

a) Thiopental
b) Fentanyl
c) Ketamine
d) Propofol

57. Antihistamines are used to control the symptoms of allergies. Which of the drugs bellow
are in this group?

a) Chlorpheriramine

b) Chlorpromazine

c) Ephedrine

16
 d) Adrenaline

58. Antihistamines are contra indicated in case of:

b) upper respiratory infection

C) acute asthma

d )Acute laryngitis

59. Antipyretics act on the CNS to control fever and also inhibit prostaglandin production.

Indicate one example from the list below.

a) Acetaminophen

b) Acetic. acid

c) Loxapine

d) Lactone

60. Identify the side effects of cardiac glycosides from the listed answers bellow:

a) H ypoten.sien

c) i achecardia

d) Dizziness and blurred vision

Il

17
61. From the list of drugs below indicate any of them that belongs to the group of corticosteroids.

a) Bumetamide
b) Betamethasone
c) Furosemide
d) Captopril

62. In case of convulsive disorders of the adult dose of Diazepam by oral route is:

a) ) 5-10 mg twice a day

b) 2- 10 rng twice a day
c) 2 -- 20 mg once a day
d) 5-20 mg once a day

63. Nystatin belongs to the group of:

a) Antibacterial

b) Antiviral

c) Antifungal

d) Bactericidal

64. The following are types of tonsillitis EXCEPT

a) Acute tonsillitis

b) Chronic tonsillitis

c) Sub acute tonsillitis

d) Sub chronic tonsillitis

65. Which of the following statements is not an indication for tonsillectomy?

a) In case of atrophied tonsils

b) In case of chronic tonsillitis

18
 c ) In case of hypertrophy of the tonsils

d ) in case of acute tonsillitis

66. Among the following causes, choose one which is not a cause of retinopathy:

a) Diabete

b) Obesity

c) Hypertension

d) Heredity

67. Cataract is a common eye condition of the elderly identifies one of the types from the following
given responses:

a) Sub capsular cataract

b) Intra capsular cataract

c) Cortical cataract

d)Nuclear cataract

68. From the following items select the most appropriate answer which describes the effect of
malnutrition on the development of bones.

a) Malnutrition during the time of bone growth can cause a person to be shorter than he can or
she should have been.

b) Malnutrition during the time of bone growth can cause a person to be extraordinarily tall.

c) For a bone tissue to grow calcium is needed for the synthesis of Vitamin D in the body.

d) For a bone tissue to grow vitamin D is synthesized in the body.

19
69. The following items are types of bones EXCEPT

a) Long bones

b) Short bones

c) Irregular bones

d) Regular bones

70. The following items indicate the functions of the skeletal system EXCEPT.

a) To support the body

b) To facilitate body movement
c) To protect the body organs
d) To maintain the body size
71. Given these blood vessels.

Choose the arrangement that lists the blood vessels in the order red blood cell passes through
them as it leaves heart, travels to a tissue, and returns to the heart.

1 . Arteriole
2. Capillary
3. Elastic artery
4. Muscular artery
5. Vein

6. venules

b) 3,4,1,2,6,5

d )4.3.2,
72. Given these blood vessels. Which vessels carry oxygen- rich blood?
20
 l . Aorta
2. Inferior Venacava

3. Pulmonary arteries

4. Pulmonary Vein

a) 1,3
b) 1,4
c) 2,3
d) 2,4

73. The alveolar Ventilation is the:

a) ) Total volume times the respiratory rate

b )Minute ventilation plus the dead space

c ) Amount of air available for gas exchange in the lung

d ) Vital capacity divided by the respiratory rate

74. The larynx a body structure, it:

a) Connects the oral pharynx with the trachea

b) Has three paired and six unpaired cartridges

c) Contains the vocal folds

d) Contains the vestibular folds

75. Which of the following medicine is vagolytics inhibitor or parasympathetic inhibitor

a) Atropine

21
b) Diazepam

c) Promethazine

d) Ketamine

22
16
NATIONAL COUNCIL LICENSING EXAMINATIONS LEADING TO REGISTRATION
AS A GENERAL NURSE

Candidate Registration N

Date of examination :
Signature :

PAPER 3: GENERAL PAPER

Pediatrics
Normal obstetric
Neonatology
Gynecology
Reproductive Health
Community health
Primary Health care
Health promotion
Management Duration: 2 Hours
Total marks: noo

Instructions:
Please write clearly. Please, respect the order of questions
The examination comprises only one section of 75 multiple choice questions. Answer all questions.
Choose and circle the letter corresponding to the right answer (0.5 mark each)

N.B. : Veuillez voir la Version Francaise å la fin du questionnaire anglais !

PAPER 3: GENERAL PAPER
CHOOSE AND CIRCLE THE LETTER CORRESPONDING TO 'THE RIGHT ANSWER
 l . Which of the following groups of hormones increase during pregnancy?
a. Gonadotrophin, Prolactin and progesterone.
b. Relaxin, estrogen and LH.
c. Testosterone and progesterone
d. Anti-diuretic and and FSH

2. Mrs Aline has a pregnancy of 10 weeks, she is complaining for morning sickness (nausea and
vomiting). As nurse working in health center, antenatal service you might provide the following
advices, except:
a. Toasted bread
b. Four large meals with antacid
c. Bland foods
d. Frequent small meals

The breasts enlargement associated with pregnancy, is seen associated with which Gestational age?
a. 0 to 12 weeks
b. 13 to 24 weeks
c. 25 to 36 weeks
d. 37 to 40 weeks.

4. A partograph can best be defined as:

a. A chart for recording cervical dilation
b. An observation chart to record the clinical findings during ANC period
c. A systematic graph used to record fetal movement during labor
d. A chart on which all observations and progress of labor together with foetal and maternal
conditions are plotted on.

5. The Leopold maneuvers are intended to:

a. Estimate the weight of the fetus
b. Rotate a fetus from breech to cephalic presentation
c. Determine the fetus position and engagement of the presenting part
d. Determine if the baby is in breech or cephalic position
6. The most frequent position of the baby at term is:
a. Cephalic with back right posterior
b. Cephalic with back left posterior
c. Cephalic with back left anterior
d. Cephalic with back right anterior

7. The most effective method to reduce pain during labor, when one has to choose from the list below is:
a. Pethedine 100 mg 1M
b. Continuous support by a trained nurse/ midwife
c. Phenergan 25 mg 1M

2
 d. Paracetamol 100 mg IR

8. The duration of labor in a nulliparous woman is approximately:

a. 2-4 hours
b. 5- 6 hours
c. 6-10 hours

d. 12- 18 hours

90 The stability of the uterus is ensured by the following ligaments except:

a. Broad ligaments
b. Utero Sacro ligaments
c. Ligarnententum venosum
d. Round ligaments

10.Which of the following anatomical relation of the uterus is not correct:

b. Posterior---------— The Vagina

c. Lateral— The broad ligaments , Fallopian tubes & ovaries
d. Superior- ———-The intestines

I I. The last menstrual period of Mrs Angelina was on 12/04/2015. What is her expected
date of delivery?
a. 19/01/2016
b. 31/01/2016
c. 21/01/2016
d. 23/01/2016
12. The third stage of labor is best described as the:
a. Complete dilatation of the cervix to the delivery of the neonate
b. Delivery of the neonate to the delivery of the placenta
c. Onset of labor to full cervical dilatation
d. Two hours after delivery of the placenta
13. Low back pain is commonly associated with:
a. True labor
b. False labor
c. Both true labor and false labor
d. Neither true nor false labor
14. Intrapartum period extends from:
a. The beginning of contractions to the first 2 hours after delivery of the newborn and placenta
b. The beginning of contractions to the expulsion of fetus
c. The beginning of contractions to the expulsion of the placenta

3
 d. The beginning of contractions to the first 6 hours after delivery of the newborn and placenta

15. The following are the features of true labor, except:

a. Regular contractions
b. Increased frequency and intensity of contractions.
c. Longer interval between contractions.
d. Activity increases contractions

16. While assessing uterine involution immediately after delivery, the uterus is:
a. Midway between symphysis and umbilicus
b. One cm above the umbilicus
c. At the level of the umbilicus
d. One cm below the umbilicus

17. One of the following is not a presumptive sign of pregnancy:

a. Amenorrhea
b. Fatigue
c. Osiander's sign
d. Presence of Human chorionic gonadotrophin (HCG) in urine

18. During the second stage of labor in the absence of electronic fetal monitoring, the fetal heart auscultation
should be performed after:
a. Each uterine contraction
b. Every 2 uterine contractions
c. Every 3 uterine contractions

d. Every 5 uterine contractions

19. Which of the following statements is correct regarding the proper use of Apgar Score:
a. It is used to define birth asphyxia
b. It indicates the cause of newborn's depression
c. The I-minute Apgar score identifies newborns requiring special attention
d. The 5-minute Apgar score predicts neurologic injury.

20. Moderate fetal depression is defined as Apgar score of:

a. Less than 2
b. 2 t0 4
c. 4 to 7
d. 8 to 9

21. Which of the following is the correct management of the umbilical cord stump in the
newborn:

4
 a. Keep it covered with Vaseline
b. Apply antiseptic solution daily
c. Keep it uncovered to expose it to air
d. Apply antiseptic solution twice / day.

22. The common practice of giving supplemental Vitamin K to newborn is a response to:
a. The relative deficiency of maternal Vitamin K
b. Maternal liver dysfunction in pregnancy
c. ,Fetal liver immaturity in the immediate newborn period
d. Lack of Vitamin K absorption

23. The Apgar score incorporates five components. These include:

a. Temperature, grimace, heart rate ,respiratory effort, muscle tone
b. Color, grimace, heart rate, respiratory effort, muscle tone
c. Color, grimace, temperature, heart rate, respiratory effort
d. Respiratory effort, age muscle tone, weight, color, temperature

24. Obtaining a history when carrying out the assessment of the newborn is important. The following
elements are relevant, except:

a. The position of mother during delivery (Lithotomy, lateral

b. Gestational age and weight of baby
c. Was any resuscitation required?
d. Was there meconium stained liquor present at birth?
25. What is the primary mechanism of action of intra-uterine contraceptive device (IUD)?
a. Inhibit the development and release of the egg
b. Impose a barrier between the sperm and the egg
c. Alter the ability of the fertilized egg to implant and grow
d. Make the cervical mucus inappropriate for sperm survival

26. The synthetic estrogen most frequently found in oral contraceptive is:
a. Ethinyl estradiol
b. ß- estradiol
c. Levonorgestrel
d. Norethindrone

27. Aline, a 25 years old, Gravida 0, moderately obese consults you about the use of oral contraceptives. Her
menarche was at age 16 and her menstrual period comes every 30 t 45 days and lasts 2 to 4days. If Aline
wishes to use an oral contraceptive agent she would be at great risk of :
a. Post-pills amenorrhea

5
 b. Endometrial cancer
c. Ectopic pregnancy
d. Acne

28. The following family planning methods are fertility awareness- based methods, except:
a. Calendar rhythm method
b. Symptothermal method
c. Basal body temperature
d. Withdrawal

29. The most common reason for pregnancy following a vasectomy is :

a. Operative hematoma formation
b. Ligation of the tunica albicans
c. Sexual activity too soon after surgery
d. Recanalization

30. Women who become pregnant after undergoing female sterilization are at higher risk ft.
a. Spontaneous abortion
b. Pelvic inflammatory disease ( PID)
c. Ectopic pregnancy
d. Fetal congenital anomalies
31. A 24 year old woman had an intra-uterine device (IUD) inserted two months ago. She is
complaining of spotting almost every day. How would you BEST counsel this patient?

a. Reassure the client and explain to her that she has to take the acetaminophen
b. Reassure the client and explain to her that she probably has an STI and the IUD should be
removed
c. Reassure the client and explain to her that the bleeding would get heavier during her menses
d. Reassure the client and explain to her that irregular bleeding is common on the first months
after IUD insertion, and will subside generally after 3 months

32. The first stage of the human sexual response according to Masters and Johnson is:
a. Orgasm phase
b. Plateau phase
c. Resolution phase
d. Excitement phase

33. Among the assertions bellow which one is correctly related to the rape trauma syndrome?
a. Has a common presentation in all victims
b. Has a predicted onset
c. Is involuntary in nature

6
 d. Is typically of short duration

34. Which of the following statements about the physical examination of a sexual assault victim is
incorrect:
a. A general complete physical examination is not required as it would be traumatic for the client
b. Forensic specimens should be collected and cultures sent to test for sexually transmitted
infections
c. Forensic specimens should kept in health professional's possession or control.
d. Genital and rectal evaluation are mandatory in evaluation of sexual assault victim

35. Mrs. Joyce visits the nurse who provided her with contraceptive pills last time. She tells the nurse
that she missed three pills in the last three days because she was away for her small scale trade. What
will be your advice to Mrs. Joyce?
a. To continue the rest of the pills as usual
b. To stop taking the pills and use a backup contraceptive method until menses has occurred
c. To take the missed pills and continue to take the rest as usual
d. To give injectable contraceptives
36. The most common cause of increased vaginal discharge is:

a. Candidiasis
b. Trichomoniasis
c. Bacterial vaginosis
d. Human papillomavirus

37. Which of the following is the most appropriate initial test for infertility in the c ofa 25 year old,
Gravida l, Parity l, who wishes to increase her chance of preg by the timing of sexual intercourse?
a. Basal body temperature record
b. Semen analysis
c. Urinary luteinizing hormone test
d. Hysteroscopy

38. A 17-year-old client comes to your office with primary amenorrhea. She has nol breast and pubic
hair development, but the uterus and vagina are absent. The po: diagnosis includes:
a. Gonadal dysgenesis
b. Mullerian agenesis (rokitanski-kuster —hauser syndrome)
c. Klinefelter syndrome
d. Turner syndrome

39. What is the common cause of dysmenorrhea in 19-year old client?

a. Anovulation
b. Excess prostaglandin production

7
 c. Adenomyosis
d. Pelvic congestion syndrome

40. A 28-year —old GO, PO client complains of increasing pelvic heaviness, and cyclic lower abdominal
pain that begins one day before her menstrual flow, and lasts for 5days. Periods are regular, but are
heavy with clots. She has been attempting pregl for the past 3 years. Which of the following is not a
likely diagnosis for this client'
a. Primary dysmenorrhea
b. Adenomyosis
c. Uterine myomas
d. Endometriosis

41. Which of the following is not a sign or symptom of uterine myomata?

a. Bladder irritability with urinary frequency
b. Heavy periods
c. Amenorrhea
d. A palpable pelvic mass
42. Uterine carcinoma may originate from all the following tissues except:
a. Blood vessels
b. Endometrium
c. Nerve fibers
d. Myometriurn

43. Ganza, 15 years old was transferred from a health center to district hospital. She was transferred
because of periodic lower abdominal pain for four months, fullness of the breast, heaviness in the
lower abdomen; vital signs in the normal range, and sub-pubic swelling. The vulvar inspection
revealed a bulging membrane. Among the following pathologies suspected by the nurse in the
health center, what would be the right diagnosis?
a. Ovarian cysts
b. Threatened abortion
c. Imperforated hymen
d. Uterine myoma

44. The following are the predisposing factors of cervical cancer except:
a. Repeated cervical trauma
b. Smoking
c. Multiple sexual partners
d. Nullpara

45. Children need special care. The following statements support this concept, except:
a. *Children are anatomically and physiologically identical to adults
b. Children are more vulnerable to the diseases.
c. Improving the health of children is improving the future of nations, and the world in general.

8
 d. Children are more prone to accidents

46. The following reflex of newborn has been elicited by the examiner by stroking the cheeks or comers
of the newborn's mouth. The newborn's head turns toward the stimulus and opens its mouth for
sucking. That is:
a. Moro reflex
b. Babinski reflex
c. Rooting reflex
d. Sucking reflex
47. You are a 3rd year nurse student, and you have been posted in community for I month. One day, you have been
called to prepare and provide health education 10 the citizens after Umuganda about infants and children
feeding ernphasizing on the benefits of adequate breastfeeding and weaning. After learning that inadequate
inthnts and children feeding can cause several growth and development disorders including the delay in the
closure of children's föntanels, one participant called Mukamusoni asks you a question about the clo.sure of her
son's breema (anterior fontanel) who is I I months old. In your response, you have to explain that in normal
conditions, the bregma closes at:
a. 0 to 2 months after birth.
b. 6 months of life
c. I I months of life.
d. 18 months of lifé

48. Which of the following statements about artificial feeding is NOT true'?
a. Infants that are fed artificially are not protected against infections
b. Artificial feeding does not provide nutrients in the right form for an infant to digest and may
result in the infant's growth being delayed or stunted
c. Infants that are artificially fed are more likely to develop allergies, behavioral problems and
suffer from diarrhea and/or anemia.
d. In society, artificial feeding is energy saving, money saving and time saving.

49. An 8 year old child named Mugisha is admitted in pediatrics ward with body temperature of 40 oc,
inability to drink, convulsions, unconsciousness, and vomiting (leaving nothing in stomach). The
laboratory investigations revealed malaria parasites Tropho +++. Mugisha is in the same room with
another child who has a contagious infection. Mugisha's mother is a single mother and she is very
anxious because she left other children at home without someone else to care for them.
Among the following nursing diagnoses formulated for Mugisha and his family, which one is not
appropriate?
a. Hyperthermia related to malaria manifested by high body temperature
b. Deficiency fluid volume related to vomiting manifested by sunken eyes
c. Anxiety related to hospitalization stay manifested by mother' s complains
d. Risk for infection related to the fact of being in the same room with another child who has a
contagious infection.

50. Basing on the information given in question No 70, the physician prescribes different medications for
Mugisha whose body weight is 26kg. Artesunate intravenous 2.4 mg /kg (every 12 hours) is among

9
 the prescribed medications. A vial of artesunate is 6Gmo/10ml. Calculate the starting dose of
artesunate to be administered to Mugisha.
a. 45mg / 7.5 ml
b. 45.6 mg/ 7.6 ml
c. 62.4 mg / 10.4 ml
d. 65 mg/ 10.8 ml
51Umulisa, 2 years old weighing 12kg is admitted in a district hospital. Her mother gives a history of fever.
vomiting all feeds and body weakness for one day. On general examination, the child is severely dehydrated,
temperature is 400 C, respiration 32 movements per minute. You undress the baby, you do tepid sponging, and
you give ringer lactate meanwhile send for the pediatrician. The pediatrician ordered for laboratory
investigation and the diagnosis is severe malaria. He prescribes quinine loading dose (20mg/kg in
10ml/kg of glucose 5%) as Umulisa has a history of allergy on artesunate. Quinine will be infused
using a drop factor of 20 to flow for 4 hours. The flow rate will be:

a. 8 drops / min
b. 10 drops / min
c. 12 drops / min
d. 15 drops / min

52. Koplik's spots are observed before the body skin rash appears in case of:
a. Tetanus
b. Measles
c. Typhiod fever
d. Varicella (Chicken pox)

53. Kwashiorkor is a type of protein-energy malnutrition, in which:

a. Both proteins and calories are deficient but the lack of proteins is more predominant.
b. Both proteins and calories are deficient, but the lack of calories is more predominant.
c. Only proteins are deficient.
d. Only calories are deficient.

54. Nasal flaring is a sign observed in inspection of child with:

a. Asthma
b. Malaria
c. Pneumonia
d. Tonsillitis

55. The transmission mode of one of the following intestinal parasites is usually by skin
penetration in barefooted persons. That is:
a. Aleebiasis
b. Oxyuriasis

10
 c. Ankylostomiasis
d. Ascariasis
56. The following symptoms: Fever. dy.suria, dribbling, and urine which may be foul-smelling are found
in ease of :
a. Nephrotic syndrome
b. Urinary tractinfection
c. Urinary incontinence.
d. Acute glomerulo - nephritis

57. Diabetes insipidus is the disorders of the pituitary gland due to a deficiency of antidiuretic
hormone (ADH). One of the following statements regarding diabetes insipidus is not
correct.
a. Insulin rate is normal in circulating blood
b. Glucose level is normal in circulating blood
c. To correct diabetes insipidus, the client receives insulin therapy
d. Diabetes insipidus leads to polyuria, and increased thirst.

58. Integrated Management of Childhood Illnesses (IMCI) isa

Comprehensive and timely management of the 5 most common causes of illness and death
among the under-fives year old children
b. Comprehensive and timely management of all causes of illness and death among the under-
fives year old children
c. Comprehensive and timely management of the 5 most common causes of • illness and death
among all children from birth to school age
d. Comprehensive and timely management of all causes of illness and death among all
children from birth to school age.

59. One of the following concepts is recognized as the heart of primary health care in the
Declaration of Alma — Ata and the Ottawa charter:
a. Equitable resources sharing
b. Community participation
c. Sustainable interventions
d. Holistic community health care

60. The primary health care refers to:

a. Primary - level health - services
b. Primary medical care
c. Primary nursing
d. Community based health care
61. Which one ofthe töllowing statements is true regarding the 4th millennium development
goal?

11
a. Under five mortality is an indicator towards the achievement of the 4 th millennium development goal
b. Under five mortality rate is an indicator towards the achievement of the 4th millennium development goal
c. Under-five mortality is lower than infant mortality
d. Under- five mortality (l death per 10,000 per day) is a serious issue of public health

62. Which one of the following statements is the target of the millennium development goals:
a. Reduce maternal mortality rate by 75% by 2015
b. Reduce maternal mortality rate by 80% by 2015
c. Reduce maternal mortality rate by 75% by 2020
d. Reduce maternal mortality rate by 80% by 2020

63. Which one of the following concepts, involves the empowerment of the community in improving
their health through health education, and improvement of the physical, social and economic
environment?
a. Demography
b. Epidemiology
c. Health promotion
d. Environmental health

64. Nosocomial infections known also as hospital-acquired infections are infections that are not present in
the patient at the time of admission to hospital but develop during the course of the stay in hospital.
Infections are considered nosocomial if they first appear:
a. 12 hours or more after hospital admission
b. 24 hours or more after hospital admission
c. 36 hours or more after hospital admission
d. 48 hours or more after hospital admission

65. There are four main forms of hand hygiene. One of them has the main purpose of "cleaning after
patient contact". That form of hand hygiene is called:
a. Ordinal hands washing
b. Careful hands washing
c. Hygtenic hands disinfection
d. Surgical hands disinfection
66. Medical waste products differ according to their type and source. One of them consists of tissue,
organ, body part, blood and body fluid. It is hazardous waste and if exposed can cause diseases. That
is:
a. General waste
b. Pathological waste
c. Sharps
d. Chemical waste

67. The following are key principles of food hygiene, according to WHO, except:
a. Prevent contaminating food with pathogens spreading from people, pets, and pests.
b. Separate raw and cooked foods to prevent contaminating the cooked foods.

12
 c. Cook foods for the appropriate length of time and at the appropriate temperature to kill pathogens.
d. Store food in the refrigerator temperature less than 2QC.

68. The following are the principles that should guide the approach to assessing community in the
primary health care except:

a. Community assessment should involve both formal and informal assessment of needs and
resources
b. Community assessment should be an integral part of health promotion work
c. Community assessment should reflect psychological aspect of individuals
d. The community assessment should recognize the partnership between people themselves and
health workers in determining their needs and resources.

69. According to WHO determinants of health, at every stage of life, health is determined by
complex interactions between social and economic factors, the physical environment and
individual behavior. Some are inborn factors, which play a part in determining lifespan and
likelihood of developing certain illnesses. They are:

a. Age, gender and genetic

b. Individual lifestyle
c. Social and community networks
d. General socio-economic, cultural and environmental conditions
70. Read and analyze the following assertions. One of them is not a characteristic of a high quality
health care. Which one?

a. Safe: avoiding injuries to patients from the care that is intended to help him.
b. Duties oriented: while providing health care, the clients' preferences, needs, and values
should not guide the clinical decisions. Instead, more interest should be put in fulfilling the
health professionals' responsibility, as they are more knowledgeable than the clients in
matter of quality improvement.
c. Timely: reducing waits and sometimes harmful delays in providing health care.
d. Equitable: providing care that does not vary in quality because of personal characteristics such as
gender, ethnicity, geographic location, religion, and socioeconomic status.

71. Among the styles of leadership, there is one, in which leader allows maximum freedom to
subordinates, i.e., they are given a free hand in implementing their own methods. The leader
only provides information, materials and facilities to his subordinates to enable them to
accomplish group objectives. In that style of leadership, someone from outside cannot recognize
in the organization who is the leader, or who are the subordinates. That style of leadership is
called:
a. Dictator
b. Autocratic
c. Democratic

13
 d. Laissez-Faire /Free rein

72. A manager alone cannot perform all the tasks assigned to him. In order to meet the goals, the manager
should delegate authority. The following are guidelines for effective delegation except:
a. Before delegating authority, make the nature and the scope of the task clear. be Assign authority
proportionate to the task
c. Make the subordinate clearly understand the limits of his/her authority.
d. Make the subordinate accountable to more than one superior.

73. The following are the qualities of a good leader except :

a. A leader must possess a high degree of physical and nervous energy
b. A leader should be intelligent enough to examine problems and difficult situations
c. A leader can maintain influence in all situations.
d. A leader must be able to communicate the policies and procedures clearly, precisely and effectively
74. The field of quality assurance is focused on different concepts including performances appraisal
according to standards. While setting the standards, a number of characteristics should be considered.
Some of those features are listed below, and one is wrong. That is:

a. Realistic: the standards can be followed or achieved with existing resources.

b. Valid: the standards are based on scientific evidence or other acceptable expertise.
c. Personal: in organization or institution, each member has to develop her/his own standards to
achieve her / his personal goals.
d. Clear: the standards are understood in the same way by everyone concerned and not subject to
misinterpretation.

75. Among the following functions of manager, one is defined as the systematic thinking by which
managers think about their activities in advance for achieving the desired objectives. That function is
called:

a. Planning
b. Organizing
c. Directing
d. Controlling

14