PAPER 1 :

1. Mr GATARE is suffering from glomerulonephritis since seven days. He has been diagnosed and
treated for acute glomerulonephritis. The main goal for treatment for acute glomerulonephritis is to:

a) Encourage high protein intake

b) Educate for intermittent urinary catheterization

c) Maintain the body fluid balance

d) Encourage the client daily activities

2. During daily activities of a nurse, he establishes client nursing diagnosis. Nursing diagnoses mostly
differ from medical diagnoses in that they are:

a) Dependent upon medical diagnoses for the direction of appropriate interventions

b) Primarily concerned with caring while medical diagnoses are primarily concerned with curing

c) Primarily concerned with human response while medical diagnoses are primarily concerned with
physiology

d) Primarily concerned with psychosocial parameters while medical diagnoses are primarily concerned
with physiologic

3) Mr Kwizera is suffering from cerebral cancer and has no longer time to survive. The patient’s family
does not know the end of life care preferences but assumes that they know what the best is for the
patient under these circumstances. This assumption reflects:

a) The client’s justice

b) Paternalism

c)Pragmatism

d) Veracity

4) The nursing process as it is done by a nurse has stages which must be covered in caring a client,
which action occurs primarily during the evaluation phase of the nursing process?

a) Decision making and judgement

b) Collection of all needed data

c) Priority setting and expected outcomes

d) Reassessment of the client and audit

5) Mr Remy is admitted in the hospital for chest pain and dyspnea lasting for four days. After
investigations, the physician concludes on myocardial infarction. The nursing diagnosis for the patient is
activity intolerance. The plan of care includes the following patient outcome criteria:

a) Experiencing no dyspnea on exertion

b) Ambulating fifty feet without experiencing dyspnea

c)Agreeing to discontinue with smoking

d) Well tolerance of activities

6) After completing neurological and physical assessment of a patient who is admitted for a suspected
stroke, the nurse anticipated the next step in the immediate care of this patient include :

a) Administering activator of plasminogen tissue

b) Obtaining a CT scan of the head without contrast

c) Obtaining a neurosurgical consultation

d) Preparing for carotid Doppler ultrasonography

7 ) A 42 years old mother consults the hospital for headache, general fatigue drinks intake and polyuria.
After a thoroughly assessment and laboratory investigations has shown that serum ketones and serum
glucose levels are above 200mg / dl. What condition would be diagnosed to the patient?

a) Diabetes ketoacidosis

b) Diabetes insipidus

c) Somogyi phenomenon

d) Low level of glycemia

8) Mr Kaduma, 52 years old and police officer was brought to the hospital for chest pain and dry cough,
the diagnosis of angina pectoris was established. He states that his angina pain increases after activity.
The nurse should know that the angina pectoris is a symptom of:

a) Mitral insufficiency

b) Coronary thrombosis

c) Myocardial infarction

d) Myocardial ischemia

9. The nurse needs to carefully assess the complaint of pain of the elderly because older people
a. Are expected to experience chronic pain
b. have a decreased pain threshold
c. Experience reduced sensory perception
d. Have altered mental function
10.Mr. Karisa Patrice is in continuous pain from gastric cancer that has metastasized to the
bone. Pain medication provides little relief and he refuses to move. The nurse should plan to:
a. Reassure him that the nurses will not hurt him
b. Let him perform his own activities of daily living
c. Handle him gently when assisting with required care
d. Complete Patrice care quickly as possible when necessary
11. A client from the emergency room and admitted in medical unit at 9AM alert and oriented,
with an IV infusion of normal saline. His pulse is 82, blood pressure is 120/80, respirations rate
is 20mvts/ minute, and all are within normal range. At 10 am and at 11 am, his vital signs are
stable. At noon, however, his pulse rate is 94, blood pressure is 116/74, and respirations are 24.
What nursing action is most appropriate?

a) Notify his physician.

b) Take his vital signs again in 15 minutes.
c) Take his vital signs again in an hour.
d) Place the patient in shock position.

12. A patient with angina pectoris is being discharged home with nitroglycerine tablets. Which of
the following instructions does the nurse include in the teaching?

a. When your chest pain begins, lie down, and place one tablet under your tongue. If the pain
continues, take another tablet in 5 minutes.
b. Place one tablet under your tongue. If the pain is not relieved in 15 minutes, go to the hospital.
c. Continue your activity, and if the pain does not go away in 10 minutes, begin taking
the nitro tablets one every 5 minutes for 15 minutes, and then go lie down.
d. Place one Nitroglycerine tablet under the tongue every five minutes for three doses then
go to the hospital if the pain is unrelieved

13. A student nurse is assigned to a client who has a diagnosis of thrombophlebitis.

Which action by this team member is most appropriate?
a. Apply a heating pad to the involved site.
b. Elevate the client's legs 90 degrees.
c. Instruct the client about the need for bed rest.
d. Provide active range-of-motion exercises to both legs at least twice every shift.

14. A client receiving heparin sodium asks the nurse how the drug works. Which of the
following points would the nurse include in the explanation to the client?
a. It dissolves existing thrombi.
b. It prevents conversion of prothrombin to thrombin
c. It inactivates thrombin that forms and dissolves existing thrombi.
d. It interferes with vitamin K absorption.

15. A client is admitted in medical ward for chronic obstructive pulmonary disease (COPD). He
is instructor and would like to have information about oxygen administration. Among the
following, which is the most relevant information about oxygen administration to this client?
a. Oxygen at 1-2L/min is given to maintain the hypoxic stimulus for breathing.
b. Hypoxia stimulates the central chemoreceptor in the medulla that makes the client breath.
c. Oxygen is administered best using a non-rebreeding mask
d. Blood gases are monitored using a pulse oximeter.

16. Kakunde is a nurse affected in emergency room. She has to clear respiratory airway for a new
client .When suctioning mucus from a client's lungs, which nursing action would be least
appropriate?
A. Lubricate the catheter tip with sterile saline before insertion.
B. Use sterile technique with a two-gloved approach
C. Suction until the client indicates to stop or no longer than 20 second
D. Hyperoxygenate the client before and after suctioning
d

17. A client with chronic obstructive pulmonary disease is being prepared for discharge.
The following are relevant instructions to the client regarding the use of an oral inhaler
EXCEPT
A. Breath in and out as fully as possible before placing the mouthpiece inside the mouth.
B. Inhale slowly through the mouth as the canister is pressed down
C. Hold his breath for about 10 seconds before exhaling
D. Slowly breathe out through the mouth with pursed lips after inhaling the
drug.

18. The nurse enters the room of a client with chronic obstructive pulmonary disease.
The client's nasal cannula oxygen is running at a rate of 6 L per minute, the skin color is
pink, and the respirations are 9 per minute and shallow. What is the nurse’s best initial
action?

a. Take heart rate and blood pressure.

b. Call the physician.
c. Lower the oxygen rate.
d. Position the client in a Fowler's position.
19. The nurse enters the room of a client with chronic obstructive pulmonary disease. The client's
nasal cannula oxygen is running at a rate of 6 L per minute, the skin color is pink, and the
respirations are 9 per minute and shallow. What is the nurse’s best initial action?
a. Take heart rate and blood pressure.
b. Call the physician.
c. Lower the oxygen rate.
d. Position the client in a Fowler's position.

20. The nurse is preparing her plan of care for her patient diagnosed with pneumonia. Which is
the most appropriate nursing diagnosis for this patient?
a. Fluid volume deficit
b. Decreased tissue perfusion.
c. Impaired gas exchange.
d. Risk for infection
21. Which statement by the client indicates understanding of the possible side effects of
Prednisone therapy?
a. I should limit my potassium intake because hyperkalemia is a side-effect of this drug.
b.I must take this medicine exactly as my doctor ordered it. I shouldn’t skip doses.
c.This medicine will protect me from getting any colds or infection.
d. My incision will heal much faster because of this drug.
22. A nurse is giving instructions to a diabetic client about insulin injection. What is the best
reason for the nurse in instructing the client to rotate injection sites for insulin?
a. Lipodystrophy can result and is extremely painful
b. Poor rotation technique can cause superficial hemorrhaging
c. Lipodystrophic areas can result, causing erratic insulin absorption rates from these
d. Injection sites can never be reused
23. The laboratory of a male patient with Peptic ulcer revealed an elevated titer of Helicobacter
pylori. Which of the following statements indicates an understanding of this data?
A. Treatment will include Ranitidine and Antibiotics
B. No treatment is necessary at this time
C. This result indicates gastric cancer caused by the microorganism
D. Surgical treatment is necessary to cure this cancer

24. A Sengstaken-Blakemore tube is inserted in the effort to stop the bleeding esophageal varices
in a patient with complicated liver cirrhosis. Upon insertion of the tube, the client complains of
difficulty of breathing. The first action of the nurse is to:

a. Deflate the esophageal balloon

b. Monitor vital signs
c. Encourage him to take deep breaths
d. Notify the medical doctor

25. The client presents with severe rectal bleeding, 16 diarrheal stools a day, severe abdominal
pain, tenesmus and dehydration. Because of these symptoms, the nurse should be alert for other
problems associated with what disease?
a. Chrohn,s disease
b. Ulcerative colitis
c. Diverticulitis
d. Peritonitis

26. A client is being evaluated for cancer of the colon. In preparing the client for barium enema,
the nurse should:
a. Give laxative the night before and a cleansing enema in the morning before the test
b. Render an oil retention enema and give laxative the night before
c. Instruct the client to swallow 6 radiopaque tablets the evening before the study
d. Place the client on strict diet a day before the study

27. Roxy is admitted to the hospital with a possible diagnosis of appendicitis. On physical
examination, the nurse should be looking for tenderness on palpation at McBurney’s point,
which is located in the
a. left lower quadrant
b. left upper quadrant
c. right lower quadrant
d. right upper quadrant

28. A nurse is directed to administer a hypotonic intravenous solution to a client admitted

recently in medical ward. Looking at the following labeled solutions, she should choose
a. 0.45% NaCl
b. 0.9% NaCl
c. D5W
d. D5NSS
29. A chemotherapeutic agent 5FU is ordered as an adjunct measure to surgery for an old man
suffering for colon cancer. Which of the statements about chemotherapy is true?
a. it is a local treatment affecting only tumor cells
b. it affects both normal and tumor cells
c. it has been proven as a complete cure for cancer
d. it is often used as a palliative measure.
30. RWEGO is admitted in emergency for difficult of breathing with nasal flaring and
wheezing. An asthmatic crisis is diagnosed and an emergency treatment for an acute asthmatic
attack is Adrenaline 1:1000 given hypodermically. This is given to:

a. Increase the blood pressure which is low

b. Decrease mucosal swelling and mucus production
c. Relax the bronchial smooth muscle
d. Decrease bronchial inflammation and secretions
31. Which is irrelevant in the pharmacologic management of a client with cerebral vascular
accident?
a. Osmotic diuretics and corticosteroids are given to decrease cerebral edema
b. Anticonvulsants are given to prevent seizures
c. Thrombolytics are most useful within three hours of an occlusive CVA
d. Aspirin is used in the acute management of a completed stroke.

32. The nurse is assisting in planning care for a client with a diagnosis of immune deficiency.
The nurse would incorporate which of the following as a priority in the plan of care?

a. Providing emotional support to decrease fear

b. Protecting the client from infection
c. Encouraging discussion about lifestyle changes
d. Identifying factors that decreased the immune function
33. In the evaluation of a client’s response to fluid replacement therapy, the observation that
indicates adequate tissue perfusion to vital organs is:

a. Urinary output is 30 ml in an hour

b. Central venous pressure reading of 2 cm H2O
c. Pulse rates of 120 and 110 in a 15 minute period
d. Blood pressure readings of 50/30 and 70/40 within 30 minutes

34. Dennis receives a blood transfusion and develops flank pain, chills, fever and hematuria. The
nurse recognizes that Dennis is probably experiencing:

a. An anaphylactic transfusion reaction

b. An allergic transfusion reaction
c. A hemolytic transfusion reaction
d. A pyrogenic transfusion reaction
35. In dealing with a dying client who is in the denial stage of grief, the best nursing approach is
to:
a. Agree with and encourage the client’s denial
b. Reassure the client that everything will be okay
c. Allow the denial but be available to discuss death
d. Leave the client alone to discuss the loss
36. A client attends the district hospital for abdominal pain. A diagnostic of acute gastritis is
made. The following factors cause acute gastritis EXCEPT

a) Exposure to gastrointestinal irritants

b) Overproduction of hydrochloric acid

c) High production of prostaglandins

d) Stimulation of vagal nerve

37. KABAKA is treated for peptic ulcer. A peptic ulcer disease which is known as:

a) A permanent painful sensation localized at the epigastric pit

b)A painful erosion localized on the gastrointestinal tract

c)A submalignant lesion localized to the wall of the stomach

d) An infection of the gastric mucosal lining by bacteria

38. A client suffering from liver cirrhosis may present the following signs and symptoms
EXCEPT;

a)Skin jaundice

b)Itchying skin

c) Abdomen distension

d) Gastro esophageal varices

39. Mm KAKUZE, 53 years old attends the nearest health centre for loss of appetite, weight
gain , abdominal pain and malaise. On observation, the abdomen has increased volume with
inverted umbilicus. Her last born has 15 years old. The measurement of fundus height and
palpation are difficult. The most likely diagnosis is:

a)Liver cirrhosis

b)Liver failure

c)Ascitis disease

d)Splenomegaly

40. Mr GATERA, 25 years old attends the health centre complaining for diarrhea with steatorrhoea,
vomiting, weight loss and abdominal bloating for 5 days. The client is suffering for:

a) Chronic pancreatitis

b) Malabsorption syndrome

c) Chronic diarrhea

d) Caeliac disease

41. Which of the following nursing interventions would be most important for
determining fluid balance in a client with end-stage of renal failure?
a) Monitor urine specific gravity
b ) Measure fluid intake and output
c.) Weight daily
d. Record frequency of bowel movements

42. These are possible nursing diagnosis in case of pneumonia apart from:

a) Hypothermia

b) Acute pain

c) Fatigue

d) Ineffective breathing pattern

2.The following are not possible nursing diagnosis in case of affected need of move and maintain
a desirable posture except:

a) Disturbed body image

b) Impaired physical mobility

c)hyperthermia

d)fear

3. These are benefits of Nursing process excluding:

a. Facilitation in nursing care documentation

b .it is expensive

c. it increases the quality of care

d. facilitates the continuity of care

42. A 40 year old female client is admitted for abdominal discomfort, fever and myalgia. The physician
has prescribed nasogastric intubation. This procedure has the following purpose EXCEPT:

a.To relieve distention of the stomach or intestine

b.To decompress the stomach by aspiration of gastric content

c. To measure fluid capacity of the stomach

d.To feed unconcious patient

43. A client a naso gastric tube for feeding 15 days ago The following complication s may arise from this
situation EXCEPT one:

a.Oral infection

b.Oesophageal tracheal fistula formation

c.Higher risk of aspiration

d.Respiratory infection

44. One of the following signs and symptoms is not related to hypoglycemia :
a.Quiet normal breathing

B.Evidence of dehydration

C.Palpitations with trembling

d.Free sugar from urine

45. A 56-year-old reports reduced exercise tolerance over the past 5 years. In the past year, he
has noted chest pain after ascending a flight of stairs. He smokes 2 packs of cigarettes per day.
On examination he has a blood pressure of 155/95 mm Hg. His body mass index is 30.
Laboratory findings include total serum cholesterol of 245 mg/dL. Which of the following
vascular abnormalities is he most likely to have?

a.Hyperplastic arteriolosclerosis

b.Lymphedema

c.Medial calcific sclerosis

d.Atherosclerosis

46. A 54-year-old previously healthy woman is hospitalized for pneumonia. On the 10th hospital
day she is found to have swelling and tenderness of her right leg, which has developed over the
past 48 hours. Raising the leg elicits pain. An ultrasound examination reveals findings suggestive
of femoral vein thrombosis. Which of the following conditions is the patient most likely to have?

a.Protein C deficiency

b.Prolonged immobilization

c.Chronic alcohol abuse

d.Essential hypertension

47.A 61-year-old man has had increasing exercise intolerance for the past 3 years , he now
becomes short of breathe upon climbing a single flight of stairs and numbness of right leg . The
fasting blood glucose measurements is 145 to 210 mg/dL for the past 15 years, but he has not
sought medical treatment. If he dies suddenly, which of the following is most likely to be the
immediate cause of death?

a.Myocardial infarction

b.Nodular glomerulosclerosis

c. Cerebral hemorrhage
d. Deep venus thrombosis

48. One of the following indications is not true in relation with Lactate Ringer’s

fluid:

a)Patient with liver disease

b)Fluid replacement for acute and mild blood loss

c) Patients with severe burns and vomiting

d)Mild hemoacidosis

49. In preventing phlebitis which occurs during intravenous therapy, the health care provider is
requested to:

a) Administer intravenous drug slowly

b) Change the infusion site every 72 hours

c.Dilute the drugs to administer with a few amount of solvent

d. Observe the facial patient reaction during injection

50. Severe hemophilia has the following manifestations EXCEPT one:

a)Severe joint damage

b) Severe cephalic pain

c) Spontaneous bleeding

d) Severe hematuria

51. A senior 6 student is diagnosed a severe migraine.One of the following manifestations is

aroused by this health problem:

a) Upper abdominal pain

b) Photophobia and photopsia

c) Irradiation of pain in the shoulder

d) Mild chest tingling sensation

52. One of the following conditions is not included among below risk factors of developing a
primary high blood pressure.

a) Genetic predisposition

b) Over activity of the sympathetic nervous system

c) Primigravidae

c) Inhibition of sodium-potassium transport across cell wall

53. One of the following conditions is not included among below risk factors for developing
seizures in young adults

a) Brain tumor or trauma

b) Alcohol withdrawal

c) Illicit drug abuse

d) Coolness of weather

54.A client has been treated in district hospital for heavy proteinuria, pitting oedema,
hypoalbuminemia, hypercholesterolemia and Low hematuria. At the beginning, he has
unexplicable weight gain, oedema of the face. Which of the following condition is most likely to
have ?

a) Chronic glomerulonephritis

b) Acute glomerulonephritis

c) Nephrotic syndrome

c) Pyelonephritis

55. A client consults the health institution for inability to completely empty the bladder dysuria ,
pain with ejaculation. The diagnosis done is prostatitis. One of the following is not the common
causes of this condition
 a) Escherchia coli
b) Clamydia trachomatis
c) Staphylococcus aureus
d) Streptococcus hemolytic

56. The following element constitute a risk factor of DIC

a) Extensive burns

b) Tissues necrosis

c) Dead foetus syndrome

d) All these elements

12. The treatment of acute glomerulonephritis is mainly based on :

a) Antihypertensive drugs

b) Antibiotics drugs

c) Salt restriction

d) Combination of the aboves

13. The urinary retention during prostatitis condition is caused by :

a) Swollen prostate pressing on urethra

b) Perineal pain in upright position

c) Severe pain with urination

d) Prostate stones
14. The management of renal failure has the following objective:

a) Maintain good nutrition

b) Treat related infection

c) Fight electrolytes imbalance

d) All the objectives

15. The important factors for developing ascites include TWO of the following:

a) An Increased total body water

b) Increased rate of renin production
c) Long lasting condition
d) Increased portal pressure

16. The complication of asthma include the following EXCEPT one:

a.Pneumothorax

b.Atelectasis

c.Gastric backward

d. Thorax diformity

17. The following are the cause of pleural effusion EXCEPT ONE:

a. Liver cirrhosis

b.Congestive heart failure

c.Pneumonia

d.Tuberculosis

18. The following are the symptoms or signs of severe anemia EXCEPT ONE:

a) Chest pain or angina

b) Low blood pressure

c) Slow heart rate

d) Fainting or passing out

19. A high blood pressure is often manifested by the following signs and symptoms
EXCEPT ONE:

a) Intermittent and deep headache

b) Low back pain with anorexia
c) Dizziness and blurred vision

d) Nausea and vomiting,

20. If a person has epilepsy, a seizure can be caused by:

a)Missed medication

b)Sleep deprivation

c) Excessive stress

d) All the above

A 53-year-old woman is found on a routine physical examination to have vital signs with T
37°C, P 78/minute, RR 16/minute, and BP 165/110 mm Hg. There are no other significant
findings. She has an abdominal ultrasound examination that shows the right kidney to be
atrophic. Which of the following pathologies is most likely suffering from?

2. Blood transported by the pulmonary veins returns to the

left atrium.
right atrium.
right ventricle.
left ventricle.
3. The valve between the left ventricle and the blood vessel leaving the left ventricle is the
bicuspid valve.
tricuspid valve.
pulmonary semilunar valve.
aortic semilunar valve.

. The valve located between the right atrium and the right ventricle is the
tricuspid valve.
bicuspid valve.
mitral valve.
semilunar valve.

Which of the following increase(s) blood pressure?

increased cardiac rate
increased peripheral resistance
increased blood volume
Decreased central resistance

A 25 year old male was brought to the ER. It was not possible to obtain a history from the
patient, however a bystander said that he was struck by a motor vehicle. On performing the
Glasgow coma scale the findings in response to pain the findings were: no response to eye
opening, flexion of upper extremities at elbows but extension of lower extremities and
incomprehensible sounds. Which of the following level of brain injury this patient has

a) Severe brain injury

b) Mild brain injury
c) Moderate brain injury
d) No brain injury
During the nasogatric intubation procedure prescribed to Mm Kwizera, the nurse have to use the
Sengstaken-Blakemore Tube . This kind of nasogastric tube is indicated for :

a) Evacuation of the stomach content for laboratory tests

b) Treatment of bleeding esophageal varices
c) Decompression and irrigation of the stomach.
d) Administration of drugs after stomach surgery

1. Acute gastritis is due to the following factors EXCEPT

A. Exposure to gastrointestinal irritants

B. Overproduction of hydrochloric acid
 C. High production of prostaglandins
D. Stimulation of vagal nerve

2. Peptic ulcer disease is known as:

A. A permanent painful sensation localized at the epigastric pit

B. A painful erosion localized on the gastrointestinal tract
C. A submalignant lesion localized to the wall of the stomach
D. An infection of the gastric mucosal lining by a bacteria

3.A client suffering from liver cirrhosis may present the following signs and symptoms EXCEPT;

A. Skin jaundice
B. Itchy skin
C. Abdomen distension
D. Gastroesophageal varices

4. Mm KAKUZE, 53 years old consults the nearest health centre for loss of appetite, weight gain,
abdominal pain and fullness, malaise, shortness of breath since 30 days. On observation, the abdomen
has increased volume with inverted umbilicus. Her last born has 15 years old. The abdominal palpation is
difficult. The most likely diagnosis is :

A. Liver cirrhosis
B. Liver failure
C. Ascitis
D. Splenomegaly

5. Mr GATERA , 25 years old attends the health centre complaining for diarrhea with steatorrhoea,
vomiting, weight loss and abdominal bloating for 5 days. The client is suffering for :

A. Chronic pancreatitis
B. Malabsorption syndrome
C. Chronic diarrhea
D. Caeliac disease
6. Type II diabetes Mellitus was previously called

A. Non-insulin dependant diabetes

B. Insulin dependant diabetes
C. Juvenile onset diabetes
D. Diabetes insipidus

7. Which of the following nursing interventions would be most important for

determining fluid balance in a client with end-stage renal failure?
A. Monitor urine specific gravity
B. Measure fluid intake and output
C. Weight daily
D. Record frequency of bowel movements

8. The nasogastric intubation has the following purpose :

A. To relieve distention of the stomach or intestine

B. To decompress the stomach by aspiration of gastric content
C. To feed unconcious patient
D. All above responses

9. A long term naso gastric tube may lead to the following complications

except one:

A. Oral infection
B. Oesophageal tracheal fistula formation
C. Higher risk of aspiration
D. Respiratory infection

10.One of the following signs and symptoms is not related to hypoglycemia :

A. Quiet normal breathing

B. Evidence of dehydration
C. Palpitations with trembling
 D. Free sugar from urine

1. Which of the following benefits is not true in relation with oxygen absorption?

a) Retards the aging of human cells

b) Prevents the immune diseases

c) Alleviates tiredness

d) Helps to relieve headache

5. The use of oxygen therapy is recommended in the following case:

a) Congenital musculoskeletal abnormalities

b) Left ventricular failure

c) Weakness of respiratory muscles due to neurological problems

d) All the above

The following elements are incidents of intravenous injection except one:

a )Throat dryness and swallowing reflex

b) Swelling and pain

c) Air embolism

d)Venous irritation

In order to admnister the fluids prescribed, the health care provider use the

following mean:

a) Performing a veni puncture

b) Add a solution to a continuous infusion line

c) Use an existing intravenous system

d) All the above

10. During insulin treatment, the health care provider must pay attention

especially to:

a) Dosage and food intake types and timing

b) Appropriate insulin speed of onset and duration of action

c) The increased stress factors of illness

d) All the above

11.The nasogastric intubation has the following purpose (s) :

a) To relieve distention of the stomach or intestine

b) To decompress the stomach by aspiration of gastric content
c) To feed unconcious patient
d) All above responses

. One of the following indications is not true in relation with Lactate Ringer’s

fluid:

a)Patient with liver disease

b)Fluid replacement for acute and mild blood loss

c)Patients with severe burns and vomiting

d)Mild hemoacidosis

. In preventing phlebitis which occur during intravenous therapy, the health care
provider is requested to:

a) Use proper vein puncture material and technique

b) Change the infusion site every 72 hours

c) Dilute correctly the drugs to administer

d) All the above

 SECTION2: SHORT ANSWER QUESTIONS / 15 marks

1. State four contra-indications of urinary catheter? 2 marks

2. List four complications of Diabetic mellitus. 2 marks
3. Enumerate four complications of pancreatitis. 2 marks
4. State four clinical manifestations of Cushing syndrome? 2 marks

5. Explain 2 difficulties which may occur during insertion of nasogastric tube and how to manage
them. 2 marks

6. Explain the pathophysiology of portal hypertension. 2 marks

7. Explain briefly the difference between cholelithiasis and cholecystitis. 3marks

SECTION C : ESSAY QUESTIONS/ 20 marks

1) Akariza is a 19-year old female with a history of having been treated 4 months ago with oral
Ampicillin. Five days before reporting to the health center, she experienced nausea and vomiting On
arrival she complained of lower abdominal pain, discomfort in the pelvic area fever and frequent
micturition with cloudy or strong-smelling urine

a)What medical condition may she be suffering from? 2marks

b)List the investigations that may be carried out /2 marks

c) Discuss the curative treatment and preventive measures of this condition. 4marks

d) State the possible complications that Akariza might get / 2 marks

2) Mr KARAKIRE, a 59-year-old man with a history of having headache, fever and vomiting two days ago.
He is admitted in hospital in status of coma. He presents right hemiplegia and rigidity of left site .Vital
signs are: BP 178/112mmhg, pulse 78bpm, temperature 39.3 oc, RR22mvt/min, weight 98kg, he can’t
open the eyes, and he has incomprehensible speech.

a)What medical condition may Karakire be suffering from? 3marks

b) Identify risk factors of the medical condition mentioned above? 2marks

c)Using Glasgow coma scale, calculate Glasgow score of that client and interpret it. 5marks

MENTAL HEALTH NURSING

1. Medically speaking, mania is defined as...

a) Low deflated mood
b) Anger followed by sleepness
c) Alternating high and low mood
d) Abnormally elevated mood

2. The most common hallucination in schizophrenia is..

a) Hearing voices
b) Visual of images
c) Smelling odors
d) Sexual hallucination

3. Less severe symptoms that precede the more debilitating symptoms are called:
a) Early symptoms
b) Warning signs

4. Which of the following is not a common type of depressive disorder?

a) Dysthymia
b) Bipolar
c) Panic
d) Major depression

5. Schizophrenia is a mental disorder that affect

a) Thoughts
b) Mood
c) Judgment
d) a and c are correct
6. Paranoid delusions are belief that indicates:
a) Someone is trying to harm the individual
b) The person has special powers and abilities
c) Something is wrong with a particular body part
d) All of the above

7. Social withdraws is:

a) Is a significant decrease in unprompted speech
b) Loss of interest in mixing with other people
c) Lack of emotional expression
d) b and c are correct

8. Anxiety disorders are caused by:

a) Imbalance of neurotransmitters
b) Hereditary traits
c) Certain life experiences such as traumatic events
d) a,b,c are correct
e)Only b is correct

9. Symptoms of panic attack include:

a) Shortness of breath, heart palpitations and a sense of terror or impending doom
b) Anxiety about performance situations, feelings of guilt, nervousness
c) Irrational fear, recurring thoughts, losing interest in activities that were enjoyable previously
d) All of the above

10. Reliving the trauma, bad dreams, feeling emotionally numb or strong guilt, being easily
startled and having angry outbursts are the symptoms of:
a) Generalized anxiety disorder
b)Post Traumatic Stress Disorder
c) Obsessive Compulsive Disorder
d) All above

11. If you have excessive fear of staying home alone and repeatedly feel the need to check if
the door is locked, you may have
a) Generalized Anxiety Disorder
b) Obsessive Compulsive Disorder
c) Post-traumatic Stress Disorder (PTSD)
d) All of above

12. To be diagnosed with schizophrenia:

a) A person must claim to hear voices in their head
b) Blood work must be positive
c) A person experiences a sudden appearance of psychotic symptoms
d) Psychotic or loss of reality symptoms are observed for at least six months

13. Positive symptoms of schizophrenia include:

a) Delusions and hallucinations
b) Social withdraw
c) Lack of interest in daily activities
d) All of above

14. The two main treatment of anxiety disorders are:

a) Medication and psychotherapy

b)Medications and aerobic exercises
C) Lifestyle change and quitting smoking

15. Which of the following is the treatment of depression?

a) Selective serotonin reuptake inhibitors
b) Psychotherapy
c) All of above

1.DSM-IV classified PTSD as a type of disorder classified in which of the following disorder :
a) Anger
b) Depressive
c) Anxiety
d) Phobia

COMMUNICABLE DISEASES
COMMUNICABLE DISEASES

MULTIPLE CHOICE QUESTIONS

1. You are in maternity at health center and you admit a woman living with HIV who had
given birth at home in 10 previous hours, she is on ART since 2009 and the Community
health worker (CHW) who have help her during delivery has cut the umbilical cord using
the teeth. In the following answer what is the best one are you going to take for this case?
a. Clean the baby and start prophylaxis for baby and CHW.
b. Clean the baby and start prophylaxis for the baby.
c. Start prophylaxis for the community health worker.

What is the best prophylaxis for a baby born on HIV positive woman?

a. Nevirapine (NVP) syrup since birth for the first six months of life and cotrimoxazole
syrup since the age of six months.
b. Take daily NVP syrup since birth until one week after the cessation of breastfeeding
c. Nevirapine (NVP) syrup since birth for the first six weeks of life and cotrimoxazole
 syrup since the age of six weeks.
d. Take daily NVP syrup and cotrimoxazole syrup since birth until one week after the
cessation of breastfeeding.

2. In the importance of communicable disease in Africa include the following, except:

a. Many of them are very common
b. Some of them are very serious and cause death and disability
c. Some of them cause widespread outbreaks of disease (i.e epidemics)
d. Many are particularly serious and more common in infants and children
e. None above

3. A baby girl was born in a sero-discordant couple (HIV- mother) after three months of
breastfeeding the mother turns HIV positive. What is the best decision for this case?
a. Put the mother on ART and the baby takes NVP and cotrimoxazole for six weeks
after the initiation of the mother’s ART.
b. Put the mother on ART and the baby should continue taking NVP for six weeks
after the initiation of the mother’s ART.
c. Put the mother on ART and the baby should continue taking NVP for six
weeks after the initiation of the mother’s ART and will start cotrimoxazole
after six weeks.

What is the best answer of follow up in discordant couples?

a. All HIV positive partners in discordant couples will be started on lifelong ART
regardless any eligibility criteria
b. All HIV positive partners in discordant couples will be started on lifelong ART regarding
CD4 cells count.
c. All HIV positive partners in discordant couples will not be started ART until the mother
give birth.

4. Which is the most severe and life threatening type of meningitis?

a. Bacterial
b. Viral
c. Protozoa
d. Fungal

5. Mrs MUKAMANA is on TDF + 3TC + EFV since 2014 and she decide to limit the birth
by using Ethinyl- Estradiol, based on the effect of ART on plasma concentration of
 contraception, what is the best answer in the following?
a. To increase 30μg ethinyl – estradiol on the contraceptive she use.
b. To decrease 15 or 20 μg ethinyl – estradiol on the contraceptive she use
c. To decrease >30μg ethinyl – estradiol on the contraceptive she use.
d. To increase >30μg ethinyl – estradiol on the contraceptive she use
6. Which indicates that the patient with meningitis is having positive Brudzinski’s
sign?

a. Passive flexion of the neck causes bilateral flexion of hips and knees
b. When the patient cannot fully extend his knee while the hip is flexed at 90 degrees.
c. Passive flexion of one thigh causes passive flexion of the opposite thigh
d. None of the above is correct

7. The species of plasmodium that cause the relapse for malaria are:

a. P. vivax and P.malaria

b. P.ovale and P. falciparum
c. P.vivax and P.falciparum
d. P.vivax and P.ovale

8. Which of the following diseases are caused by Varicella-Zoster Virus (VZV)?

a. Chicken pox and herpes labialis
b. Herpes zoster and genital herpes
c. Shingles and chicken pox
d. Varicella and cytomegalovirus disease

9. The treatment of choice for schistosomiasis is:

a. Praziquantel
b. Metronidazole
c. Niclosamide
d. Mebendazole

10. Which of the following is the certitude test for diagnosing typhoid fever?
a. Widal test
b. Full Blood Count (FBC)
c. Clinical diagnosis and Widal test
d. Culture

11. The most effective treatment in case of cholera is:

a. Antibiotherapy
 b. Treatment with antidiarrheic drugs
c. Replacing fluid and salt losses
d.Metronidazole

12. The germ which is responsible for an epidemic meningitis is called:

a. Staphylococcus aureus
b. Neisseria meningitis
c. Streptococcus pneumonia
d.Listeria monocytogene

13. Which of the following is the most frequent complication of herpes zoster (ZONA)?
a. Zoster sine herpete
b. Deafness
c. Secondary bacterial infection
d. Post herpetic neuralgia
14. Which of the following is the most commonly implicated virus in common cold?
a. Coronavirus
b. Influenza virus
c. Rhinovirus
d. Human respiratory syncytial virus

15. The expected laboratory result from Full Blood Count for a patient with typhoid
fever is:

a. Increased neutrophils in blood

b. Increased lymphocytes in blood
c. Decreased neutrophils in blood
d. All are incorrect

16. Some infectious diseases affect a human and make him to develop immunity. This
immunity developed by a human after being exposed to an infectious disease is
called:

a. Naturally acquired active immunity

b. Artificially acquired active immunity
c. Naturally acquired passive immunity
d. Artificially acquired passive immunity
17. The nurse knows that the analysis of the cerebrospinal fluid (CSF) of a patient with
tubercular meningitis will show :

a. Increasead neutrophils in the fluid

b. Increased lymphocytes in the fluid
c. Increased basophils in the fluid
d. Increased eosinophils in the fluid

18. The following forms of Leprosy are NOT infectious:

a. Borderline and Lepromatous leprosy

b. Lepromatous and Tuberculoid leprosy
c. Borderline and Indeterminate leprosy
d. Indeterminate and Tuberculoid leprosy

19. Which of the following is the most appropriate HIV test to be used for a 1 year old
baby born to HIV- positive mother?
a. ELISA
b. WESTERN BLOT
c. PCR
d. Determine
20. Of the viruses listed below, the most lethal is:
a. Influenza virus
b. Ebola virus
c. Zona responsible virus
d. Epstein -Barr virus
21. Which of the following theories explaining how HIV took place in humans is
considered as the most commonly accepted?
a. The oral polio vaccine theory
b. The hunter theory
c. The conspiracy (or man-made) theory
d. The contaminated needle theory

22. The nurse knows that P. Falciparum is responsible for tertian fever because:
 a. It causes the fever that occurs after 3 days
b. It causes the fever that occurs at every 3rd day
c. It causes the fever that occurs at every 2nd day
d. It causes the fever that occurs after 72 hours
23. Which of the following germs are responsible for dysentery?:
a. Shigella spp, Entamoeba coli and Schistosoma mansoni
b. Entamoeba histolytica, Schistosoma mansoni and Shigella spp
c. Shigella spp, Schistosoma haematobium and Entamoeba histolytica
d. No correct answer

24. Mr. KAREKEZI is an adult leprous patient aged 48 years old. There is 4 months
taking drugs for leprosy. Now, he consults the Health Centre complaining the
sudden onset of widespread severe pain; warm, tenderness and redness in the
existing lesions (existing skin patches). This case will be considered as:
a. A relapse
b. Type II reaction or Erythema Nodosum Leprosum of leprosy
c. Treatment failure
d. Type I reaction or reversal reaction of leprosy

25. Emile Gatete took the primotreatment of tuberculosis in 2004 and was recovered.
Now, he consults the Health Centre with fever and cough. The 3 sputum exams
show the following: ++/+. Gatete’s case should be classified as:
a. NTPM+
b. Failure of primotreatment
c. Relapse
d. NTPM-
26. The most important physiological problem and most serious that is precipitated by
the use of high doses of Chloramphenical at the beginning of Typhoid fever
treatment is:
a. Herxheimer reaction or endotoxinic septic shock
b. Lyell syndrome
c. Anaphylactic shock
d. Besiredika reaction

17. In Tuberculosis management; Direct Observed therapy or treatment (DOT strategy) help to
reduce the risk of Multidrug-resistant TB (MDR-TB) which is defined as:
a. bacterium resistant to isoniazid and rifampicin
b. bacterium resistant to either rifampicin or kanamycin
c. positive Mantoux skin test
d. positive sputum test after 2 months of treatment
e. bacterium resistant to three therapy
18. Hepatitis viruses’ types A, B, C, D and E are responsible for viral hepatitis. The following
viruses are transmitted through ingestion of contaminated food or water.

a. hepatitis viruses’ types A and B

b. hepatitis viruses’ types A and E
c. hepatitis viruses’ types B and D
d. hepatitis viruses’ types C and D
e. hepatitis viruses’ types D and A

19. Gonzaga is a young boy diagnosed with simple malaria with minor digestive syndrome. He
weight 30 kg and treated by intravenous artesunate.
Give the dose in milliliters that Gonzaga is receiving once bearing in mind that the final
preparation of artesunate is 60mg/10ml
a. 5 ml
b. 12 ml
c. 10 ml
d. 6 ml
e. 13 ml

27. Mrs. NYIRAMANA is a 34 years old, married with 37weeks of amenorrhea. She
consulted Kigoma Health centre complaining of fever, headache, physical asthenia,
nausea, arthralgia and lombalgia. During history taking, she told to the nurse that the
previous day was having chills and then sweating. She also told the nurse that it was the
2nd day without eating because of vomiting which prevented her to take food by mouth.
The nurse took the vital signs and found that the temperature was 38.7oC, pulse: 116
beats/ min, blood pressure: 99/ 65 mmHg, respiration: 20 breaths/ min. After vital signs,
the nurse reacted quickly to decrease the fever. She administered paracetamol tablet but
unfortunately the patient directly vomited the tablet. After complete assessment the blood
smear was taken, examined and became positive. The nurse took a decision to admit the
patient for follow up.
Answer the following questions concerning the case study:

1. What was the medical diagnosis for Mrs. NYIRAMANA?

a)Simple malaria with minor digestive symptoms
b)Simple malaria
c)Typhoid fever
 2. Which treatment in the following is the best for Mrs. NYIRAMANA after confirming the
diagnosis?
a. Artesunate 2.4 mg/ kg IV and if improvement in 24 hours, continue with
Coartem tablets 4 tablets twice a day/ 3 days
b. Athemether IM, if improvement coartem tablets 4 tablets twice a day/ 3 days
c. Quinine IV in glucose 5%, if improvement continue with quinine tablets

MEDICAL PSYCHOLOGY

Jimmy cannot pick between two girls who he would like to go to promenade with. Which type of
conflict is Jimmy experiencing?
A. Approach-approach
B. Approach-avoidance
C
Multiple approach-avoidance
.
D. Avoidance-Avoidance
E. Single avoidance-approach

During periods of prolonged stress the hypothalamus triggers the

A
Endorphins
.
B. ACTH hormone
C. Sypathetic nervous system
D. Pituitary gland
E. Adrenal gland

Mr Sixbert is a young man of 26 years old, married to Sabine of 22 years old. They have one
child under five . Sixbert is a carpenter and Sabine a sewer. In January 2011, Sixbert was very
sick and admitted in Internal Medicine Male during 3 months. The test of HIV was positive and
he is on antituberculosis and antiretrovirus drugs.He has developed bed sores and muscular
atrophy. Despite this situation, he is kind to everybody,openminded and follows advices for
health care providers.

a) How do you call Mr Sixbert ‘s attitude?

b) Explain three advantages or disadvantages of that attitude to the wellbeing of the client
himself and his family.

c)Identify two worst reactions often expected from Sixbert’s situation.

7.During your next clinical placement in Medical ward of KABUTARE hospital, you provide care
to two mothers , Kankindi and Namahoro.They are suffering respectively from Diabete and
breast cancer. They are coming from the farest district of South Province and they haven’t been
at school.

a)Identify four most problems encountered by these clients during hospitalization and in the
general life.

b) Describe 4 suitable attitudes of the caregiver to decrease the occurrence of these problems
and promote their health status.

NCP

One of the following is not a characteristic of the Nursing Process:

a) Based on knowledge-requiring critical thinking

b) Planned,organized and systematic
c) Client-centered with agreement
d) Goal-directed
c) Prioritized
f) Dynamic

1) One of the following assertion is true in the context of components of Nursing Process :

a.assessment ,nursing diagnosis,and the evaluation

b.problem statement, the etiology and the evaluation

c.Expected outcome and interventions.

d)a and c are true

e)a and b are true

2). these are benefits of Nursing process excluding:

a. Facilitation in nursing care documentation

b .it is expensive
c. it increases the quality of care

NURSING PROCESS UNIT

 A. Multiple choice questions/10 marks

4 multiple choice questions, circle the best answer

1.The following are the characteristics of Nursing process except:

a .systematic and dynamic

b. goal-directed and limited
c. universally applicable and interpersonal
d) Organized and prioritized

2. These are benefits of Nursing process excluding:

a. Facilitation in nursing care documentation

b .It is expensive in time and means

c.It increases the quality of care

d. Treat human response to health

4. Tuzige is a student in nursing school .During the clinical practice; he is establishing nursing
diagnosis, which statements must be included in nursing diagnosis?

a. A problem, its complications and its manifestations

b. A problem, its manifestations and a medical diagnosis

c. A problem, its etiology and its manifestations

d. A problem, its etiology and its repercussions

HEALTH ASSESSMENT
I. choose true answer/5marks

The anamnesis may be defined as is:

a. information gained by a physician/nurse by asking specific questions, either of the patient or
of other people who knows the person and can give appropriate information with the aim of
obtaining information useful in formulating a diagnosis and providing medical care to the
patient.
b. information gained by a physician/nurse by asking specific questions, either of the patient or
of other people who want to know the person, with the aim of obtaining information useful in
formulating a diagnosis and providing medical care to the patient.
c. information gained by a physician/nurse by asking more questions about medical history,
either of the patient or of other people who knows the person and can give suitable information
with the aim of obtaining information useful in formulating a diagnosis and providing medical
care to the patient.

d. No correct answer.

2. Inspection is:
a. seeking physical symptoms by observing the patient.

b. seeking physical signs by observing the patient.

c. seeking physical signs by touching the patient.

d. a and b are true.

e. no correct answer.

3. During physical examination the physician/nurse can put the client in supine position in order
to examine the following parts of the body:
a. Thorax, abdomen and back
b. Thorax, breast and abdomen
c. Thorax, breast and client mood.
d. No true answer

4. One of the following concepts is a common symptom of upper respiratory infection or

bronchitis or pneumonia or tuberculosis.
a. Cough and sputum
b. Hemoptisia and cough
c. Cough and chill
d. Cough and wheezing

5. In health assessment, the nurse should check vital signs for the following reasons except:

a. To identify the existence of an acute medical problem.

b. Because they are a means of rapidly quantifying the magnitude of an illness and how well
the body is coping with the resultant physiologic stress.
c. Because they are a marker of chronic disease states (e.g. hypertension is defined as
chronically elevated blood pressure).
d. A and B are true answers
 NATIONAL COUNCIL OF NURSES AND MIDWIVES

STRUCTURE OF LICENSING EXAMINATIONS

A. General Nursing (Soins Infirmiers)

Paper 1: Medical Aspects

1. Administration of Ringer’s lactate solution is contra-indicated in :

a. Hypovolemia
b. Burns
c. Lactic acidocis
d. Vomiting or Diarrhea
2. The primary purpose of administering potassium chloride infusion to
patient with diabetic ketoacidosis is:
a. To treat Hyperpnea
b. To replac e excessive electrolytes losses
c. To treat cardiac arrhythmia
d. To treat Hypoglycemia
3. During postural drainage the positions should be held for:
a. 3 to 5 minutes
b. 3 to 10 minutes
c. 3 to 15 minutes
d. 5 to 10 minutes
4. The suprapubic catheter should be changed in order to prevent infection:
a. Every 8 weeks
b. Every 4 weeks
c. Every week
d. Each three days
5. The size of Nasogastric tube for adult patients is :
a. From 12 – 18 F
b. From 12-16 F
 c. From 10-14 F
d. From 8-10 F

NCNM MEDICAL NURSING

1. ETHICS
1.1 Different models of ethical decision making represent the various systematic processes or
approaches that a nurse might take in making an ethical decision related to the health and
nursing care of an individual or a population group. These models are useful in helping the
decision maker examine. Except one
a. The values involved and the interests at stake
b. The context within which the decision will be made
c. The kinds of strategies that will need to be employed to achieve a resolution to the
problems identified
d. The nature of nurse’s responsibilities in the situation
e. The patient’ reasoning abilities and life experiences
1.2 Nurses and nursing staff treat everyone in their care considering:
a. Dignity
b. Humanity
c. Compassion
d. Social status
e. Sensitivity
1.3 Nurses and nursing staff provide and promote care that:
a. Puts people at the center
b. Involves patients
c. Involves families
d. Considers careers
e. Puts patients on side during decision making
1.4 Self care theory was developed by:
a. Betty Neumann
b. Virginia Henderson
c. Dorothea Orem
d. Imogene King
1.5 Professional misconduct includes but not limited to the following:
a. Failure to comply with the code of professional conduct
 b. Incompetence
c. Committing harmful act against a client
d. Unethical behavior and failure to fulfill professional duty/obligations
e. Helpful acts to the patients and their family
1.6 The role of National council for nurses and midwives is;
a. To registers nurses
b. To protect the public against harms
c. To teach nurses and midwives
d. To ensure quality of nursing care
e. To take measures to institutions that do not meet educational standards

Enumerate 6 obligations of a nurse applying for admission to nursing profession.

a) The applicant establishes his/her identity.

b) The applicant holds an approved educational qualification.
c) The applicant has a good character.
d) The applicant does not have a physical or mental impairment which prevents them from
practicing nursing safely.
e) The applicant speaks one or more of the official languages of Rwanda.
f) The applicant has practiced nursing or midwifery in the last three years.
g) If applicable, the applicant should hold a current, unconditional license to practice as a nurse
from another country.

2. Discuss the importance of legal framework course to a nurse student.

1. To be able to identify

a) Legal responsibilities and obligations in nursing profession

b) Legal principles of the professional code of conduct

c) Legal issues and sanctions

d) Functions and roles of professional Nursing associations

e) Being update on the policy that guide nursing profession

2. Discuss the role of National council of nurses and midwives /2marks

The principal function of the Council is to protect the public from harmful or unprofessional
practices by ensuring that clients receive care from competent and ethically behaved nurses and
midwives.

 The National Council set standards of professional education, practice including

professional conduct of nurses and midwives and determine their scope of practice.
 The National Council ensure that the public receives care from only nurses and midwives
who meet the required qualifications for provision of safe and effective care.

In order to ensure that educational and practice standards are met, the NCNM carries out the
following:

a) Set up educational standards

 Establish pre-requisites for entry to the nursing and midwifery professions

 Set standards for opening and running nursing and midwifery institutions/ programmes
 Approve programme curricula
 Collaborate with relevant educational establishments that have quality of education in
their responsibilities
 Audit and approve nursing and midwifery educational institutions or programmes
 Monitor regularly nursing and midwifery educational institutions to ensure that they
continue to meet the set standards
 Take appropriate measures for the institutions that do not meet the standards

b) Set standards of Practice

 Register and issue certificates to all eligible nurses and midwives

 Issue and renew licenses to only those who continue to meet practice standards
 Withdraw license from anyone who abrogates the code of professional conduct
 Ensure that nurses and midwives continue to demonstrate that their professional
knowledge is updated in relation to areas of their practice
  Issue examinations to foreign trained nurses or midwives who wish to practice in the
country but do not have established requirements for registration
 Update from time to time standards of practice

To take measures to institutions that does not meet educational standards

3. List 5 goals of nursing associations. /2.5 marks

ANSWER:

a) Ensure quality nursing care for all

b) Sound health policies globally
c) The advancement of nursing knowledge
d) The presence worldwide of a respected nursing profession
e) Competent and satisfied nursing workforce.
f) Advancing the profession
MENTAL HEALTH AND PSYCHIATRY
1. List early 5 warning signs of schizophrenia
2. Give 5 risk factors for developing Melancholic depression
3. The role of a nurse in case of melancholic depression
4. Mrs. Betty is a 32 years old woman, G5, in post partum period after caesarian section. On the
fourteenth day after delivery, Betty’s husband bring her at Nyamata Hospital where you are in
clinical practice, after catching her when she tried to put her baby down the toilet, and he said
that his wife Betty does not sleep well, she refuses to eat and breastfeed the baby boy because
he is satan. Betty’s husband tells you that there is conflict between Betty and her mother in low
and they are very poor and the pregnancy was unwanted. The medical diagnosis is:

MEDICAL NURSING

1. A nursing diagnosis can be defined as:

a. A statement of nursing judgment
 b. A statement of a client’s problem
c. A long detailed problem statement
d. Based on objective and subjective data
2. Mr. Obed is normally active but is confined to bed because he had a fractured neck of
femur (left leg). The following nursing diagnosis can be made, Except:
a. Pain due to a fractured neck of femur
b. Risk of constipation as a result of enforced bed rest
c. Risk of pressure sore development from enforced bed rest
d. Risk of a new fracture of fibula as a result of enforced bed rest
3. The sites for intramuscular injections in older children who have been walking for more
than a year are:
a. The deltoid muscle
b. The vastus lateralis muscle
c. The ventro-gluteal muscle
d. The dorsogluteal muscle
4. The sites for intramuscular injection in infants who have not been walking for a year
are:
a. The vastus lateralis muscle
b. The deltoid muscle
c. The mid-anterior thigh muscle
d. The ventrogluteal muscle
5. The nursing care plan can be evaluated using the following methods, except:
a. Patient satisfaction or complaint
b. Reviewing the nursing care plan
c. Medical handover
d. Nursing handover
6. In order for nurses to be able to plan care for their clients, they have to be able to
gather information that will enable them to make informed decisions. The following
information may be collected, except:
a. Physical health information
b. Psychological information
c. Social health information
d. climate conditions information
7. The following criteria should be used to evaluate the quality of hand washing:
a. The use of soap/detergent
b. The use of continuously running water
c. Rubbing the hands together vigorously
d. Rinsing and drying the hands vigorously
e. Rinsing and drying the hands thoroughly
f. Positioning of hands to avoid the contamination of surface areas
8. Edmond needs to increase his mobility. His diet should be assessed and relevant advice
given emphasizing an increase in amount of fruit and vegetables. Fluid intake should
also be assessed. The target is:
a. An intake of 30-35 ml/Kg per day
b. An intake of 20-30 ml/Kg per day
c. An intake of 20-25 ml/Kg per day
d. An intake of 10-20 ml/Kg per day
9. The term “aseptic technique” refers:
a. To the method of carrying out procedures in an environment that is rendered as
free from micro-organisms and contaminant as possible
b. To the method used in microbiological experiments
c. To the method of carrying out procedures in an environment that is rendered as
free from micro-organisms
d. To the method of carrying out procedures in an environment that is rendered as
free from contaminants as possible

PHARMACOLOGY
10. The immune response can be blocked either by interfering with the effects of immunity
or with some aspects of them. Those drugs can be:
a. Antihistamines
b. Anti-inflammatory
c. Antipyretics
d. Corticosteroids
11. A patient named N.D is under Furosemide 40mg per day. The best way to monitor the
efficiency of this drug is:
a. To take pulse and blood pressure daily
b. To weigh the patient regularly
c. To take pulse, temperature and blood pressure
d. To take height, pulse and blood pressure
12. Insulin is a hormone which lowers the concentration of glucose in the blood by:
a. Converting glycogen in the liver to glucose
b. Mobilizing the liver glycogen and thus releases glucose into the blood
c. Converting glucose to glycogen in the liver where it is stored
d. Raising the blood sugar in patients who are hypoglycaemic
13. It is clear that once an ulcer of stomach has developed, acid is largely responsible for
pain, which is the leading symptom, and reduction of acid leads to relief of pain and
probably to healing. A possible method of reducing gastric acidity is:
a. To reduce the secretion with antacids
b. To neutralize the acid within the stomach with frequent foods
c. To reduce the secretion of acid by frequent foods
d. To neutralize the acid within the stomach with antacids and with frequent foods
14. Nurses frequently measure blood pressure. They are often involved in treating
hypertension. They should remember that the position of patient during blood
pressure has an influence on the result The nurse will pay attention to the following
point:
a. The blood pressure should usually be recorded with the patient both lying and
standing
b. The blood pressure should usually be recorded with the patient standing
c. The blood pressure should be recorded with the patient lying on the left side
d. The blood pressure should be recorded with the patient lying on right side

MEDICAL PSYCHOLOGY

15. When a nurse gives care to patient who suffering from a mental
health disorder, she may be a good counselor. A counseling can be
defined as:
a. Getting emotionally involved with client
b. Attempting to sort out the problems of the client
c. The act of helping the client to see things more clearly, possibly
from a different view point
d. Giving advice to the client on his problem