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HEALTH SCIENCES FACULTY

GENERAL NURSING AND MIDWIFERY DEPARTMENT

PRE-COUNCIL EXAMINATION

LEVEL THREE: GENERAL NURSING

CANDIDATE REGISTRATION:……………………………………….

PAPER THREE: GENERAL ASPECTS

NORMAL OBSTETRICS

PAEDIATRICS

REPRODUCTIVE HEALTH

GYNAECOLOGY

COMMUNITY HEALTH

NEONATOLOGY

LEADERSHIP AND MANAGEMENT

INSTRUCTIONS : All questions are multiple choices

Each question is scored on one mark

Write clearly and avoid cross out( erasure)

Choose and circle the letter corresponding to the BEST answer

Respond On Questionnaire Paper

Duration: 3 hours
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ENCERCLE THE GOOD RESPONSE

1. The following signs are the signs of fetal respiratory distress except

a. Grunting, retractions

b. Deep sighing

c. Apnea more than 15 seconds

d. Respiration: 30-60 breaths/minute

e. Nasal flaring,

2. Those are the abnormal findings for the examination of head of newborn except:

a. Cephalhematoma

b. Hydrocephalus

c. Sutures can be felt with a small separation between each.

d. Craniosynostosis

3. These are the normal range of the parameters for the term newborn except

a. Respiratory rate : 40-70 cycles per minute

b. Heart rate: 110-160 beats/min

c. Head circumference: 33-35cm

d. Weight: 2-3.5 kg

e. Height: 48-53cm

f. Temperature: 36.5-37.5 .c

4. Matching the abnormal findings from inspection of the skin of the newborn with their
clinical significance for each one

a Jaundice y x. damage of the brain due high bilirubin

b. Acrocyanosis q y. high bilirubin in the blood

c. Circumoral cyanosis z z. Bluish color of the mouth between feedings

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d. Kernicterus x q. blue hand and feet

5. Choose among the following heart diseases which is not congenital:

A. Ventricular Septal Defect; VSD
B. Atrial Septal Defect
C. Patent Ductus Arteriosus
D. Pulmonic Stenosis
E. Aortic Stenosis
F. Coarctation of the Aorta
G. Tetralogy of Fallot
H. Congestive Heart Failure
I. Tricuspid Atresia
6. All of the following statements are true about Family Centered Care except
A. Family centered care is a mandated approach for public health MCH services.
B. It is based on positive research outcomes, but there is the need for much more
research to really understand how best to incorporate families into practice.
C. Put health care decisions back into the hands of patients and families and less into
third party payers and physicians
D. Health care professionals should be centered on care system of disease rather than
trained in building a patient-centered.
7. All of the following statements are false about advantages/ benefits of Family
Centered Care except
A. Time Management
B. Schedule
C. Take good care of yourself.
D. Development of a strong alliance with families
8. Choose among the following statement which is not among the coping mechanisms
of stress in children.
A. Stop negative thoughts.
B. Keep Quiet
C. Focus on the present.
D. Ask for help.
E. Do something you enjoy. .
F. Keep a journal.
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9. Among the Strategies used to Reduce Stress in Children/Helping to Manage Stress,

one is not correct:
A. Acknowledge the feelings of children.

B. Promote a positive environment

C. Help children through stories

D. Promote maladaptive coping

E. Set a good example

10. All of the following statements are true about Preparation for Procedures in pediatric
Nursing except
A. Psychological preparation

B. Establish trust

C. Parental support
D. Explanation to the child
E. Always think “traumatic care”
11 . All of the following statements are true about Performing Procedures in pediatric
Nursing except

A. Benefits of using special treatment room for procedures

B. Expect success

C. Praise the child

D. Distract the child; use play if appropriate
E. Allow expression of feelings – during but not after procedure
12. Respiratory Distress Syndrome is characterized by different signs below except
A. Tachypnea (60 BPM or >)

B. Retractions

C. Nasal flaring
D. Inspiratory grunting
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13. Characteristics of Learning Disorders in Infant, Childhood, and Adolescent Disorders

are listed below except one
A. Inadequate development of specific academic skills, such as reading, writing, and math.
B. Specific academic skills are substantially below expected for age, intelligence, and education
C. Significantly interferes with aspects of life requiring those skills.
D. characterized by multiple motor tics and one or more vocal tics (involuntary, sudden, rapid,
nonrhythmic,
14 . Attention Deficit/Hyperactivity Disorder includes two major syndromes except:

A) Inattention

B) Hypoactivity-impulsivity

C) Hyperactivity-Impulsivity

15. These symptoms listed below are responsible of which pathology:

Cyanosis

Severe respiratory distress with retractions and nasal flaring

Bowel sounds in chest

Uneven chest expansion

Decreased breath sounds on affected side

profound hypoxemia with combined acidosis

CXR – loops of bowel in chest with shift of thoracic structures towards unaffected
side, eg dextrocardia

A. Diaphragmatic Hernia
B. Congenital heart defects
C. Meconium Aspiration Syndrome

16. These symptoms listed below are responsible of which pathology:

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 Abdominal pain
 Nausea/vomiting
 Diarrhea
 General malaise & weakness
 Intestinal obstruction
 Anemia
 Retarded physical growth & development in children
A. Diarrhoea
B. Vomiting
C. Constipation
D. Acute abdominal pain
E. Pica
F. Worm infestation
G. Cleft Lip and Cleft Palate
H. GERD
I. Esophageal Atresia/ Tracheoesophageal fistula
J. Appendicitis
K. Intussuception
L. Hirschsprung’s Disease
M. Failure to Thrive (FTH

18. Hepatitis A in children is from:

A. Eating food or drinking water that is contaminated with feces

B. Coming into contact with contaminated blood
C. spread through contaminated blood
D. Contaminated medical instruments, sexual contact with infected person, needles

19 . These Symptoms below are responsible of which pathology:

◦ A common cold, including nasal congestion, runny nose, sneezing, red and
watery eyes, mild fever, and a dry cough.

◦ After about 1 to 2 weeks, the dry cough becomes a wet cough that brings up
thick, stringy mucus.

◦ At the same time, coughing begins to occur in long spells that may last for
over a minute, sometimes causing a child to turn red from effort or blue from
lack of oxygen.

A. Pertussis (Whooping Cough)

B. Pneumocystis carinii
C. Legionnaire’s Disease (Legionellosis)
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D. Pneumonia
E. Mycobacterium tuberculosis

20. The IMNCI case management process includes all the following steps except one

A. Assessment
B. Classification.
C. Identify treatment and treat
D. Follow-up care.
E. Orientation

21. Among the Objectives and Advantages of IMNCI Strategy one is not correct

A. to reduce mortality and morbidity associated with the major causes of disease in children
less than five years of age, and
B. to contribute to the healthy growth and development of children
C. To facilitate exchange between two health professionals

22. All of the following statements are true about classification based on a colour-coded
triage system in IMNCI except

A. Red/pink- urgent pre-referral treatments and referral: Child needs inpatient care
B. Yellow - specific medical treatment and advice: Child needs specific treatment, provide it
at home
C. Green - simple advice on home management: Child needs medicine, advise home care

23. True or False

1. Leadership is the process of influencing the behavior of others. TRUE

2. Management is a process of organized activities. TRUE
3. Quality is doing the right thing, right, the first time and doing it better the next time
TRUE
4. The significant feature of consultative/democratic leadership style is that the leader
confers with giving order to group members and taking decision. FALSE
5. Free Rein style or laissez-faire means giving freedom to subordinates. TRUE

24. Choose the right answers ( encircle)

One of the following assertions is not right; find it.
a) Autocratic helps in emergency situation
b) Democracy is consultative before making decision
c) Free rein or laissez faire is used to put the followers under pressure for high
performance
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25. According to MOH 2012 (Ministry of Health in Rwanda), quality definition

is:
a. Health interventions
b. Procedures
c. Standards
d. All of the above

26. Dimensions of quality are:

a. Competence
b. Effectiveness
c. Efficiency
d. a, b and c
27. One activity is not a responsibility of a head nurse/midwife of department:
a. Dressing change
b. Drug distribution
c. To invite a quality meeting
d. Doing c-section technique
e. Requisition of materials

28. Quality improvement refers to:

a. Quality definition
b. Quality measuring
c. Quality improvement
d. All of the above

29. True or False /

a) Leadership is the process of influencing the behavior of others. TRUE

b) Management is a process of organized activities. TRUE
c) Quality is doing the right thing, right, the first time and doing it better the
next time TRUE
d) The significant feature of consultative/democratic leadership style is that the
leader confers with giving order to group members and taking decision.
FALSE
e) Free Rein style or laissez-faire means giving freedom to subordinates. TRUE

30. Choose the right answers /

One of the following assertions is not right; find it.
a) Autocratic helps in emergency situation
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b) Democracy is consultative before making decision

c) Free rein or laissez faire is used to put the followers under pressure for
high performance

31. According to MOH 2012 (Ministry of Health in Rwanda), quality

definition is:
a) Health interventions
b) Procedures
c) Standards
d) All of the above

32. Dimensions of quality are:

a) Competence
b) Effectiveness
c) Efficiency
d) a, b and c
33. One activity is not a responsibility of a head nurse/midwife of
department:
a) Dressing change
b) Drug distribution
c) To invite a quality meeting
d) Doing c-section technique
e) Requisition of materials

34. Quality improvement refers to:

e. Quality definition
f. Quality measuring
g. Quality improvement
h. All of the above
Choose the good respnse
35.The family needs assessment for:

A- Physical environmental data

B- Family decision making pattern
C- Family problem solving pattern
D- Family values and beliefs

36. Which of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined in the hospital.
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B. Services are provided free of charge to people within the catchment area.
C. The public health nurse functions as part of a team providing a public health nursing services.
D. Public health nursing focuses on preventive, not curative, services.

37 .The most common disposal methods are:

A- Damping
B- Burning
C- Burying
D- Dumping
38 .The role of community health nurse for community assessment includes:
A- Using mass media to advance healthy public policy
B- Using measures to impede population's health
C- Using appropriate public & illness care services
D- Using mass media hindered the public health issue
39. .Factors affecting community health are
A.- Physical factors
B- Economic factor
C- Technology factors
D- Secio- culture factor
40. Community under development characterized by the following:
A- Insanitary environment
B- Lack of health opportunities
C- Inadequate health services
D- Inadequate crisis
41. .The goal of establish health promotion practice of community are
A- Increase the span of healthy life for all population
B- Achieve access to preventive services for every one
C- Develop of health policy and planning
D- Encourage of physical fitness programs for all ages

42.Development of community health nursing should be determined by:

A- Promote client responsibility and self care.
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B- Progress in causal thinking

C- Use organizational theory
D- Change in socio cultural status.

43. Well functional of community health nursing through:

A - Assessing community needs
B- Developing policy
C- Treating disorder of individual
D- Rehabilitating disabled person
44.The community health nurse should observe the community for:
A- Economic recourses
B- Rehabilitation program
C- Methods of prevent health problems
D- Strategy of policy
E- Treating disorder of individual
45. The community health nurse should be focused on:
A- Wellness for every individual
B- Economic forces of community
C- Advanced technology
D- Evaluation of the practice

46. A multiparous client who has been in labor for 2 hours states that she feels the urge to move
her bowels. How should the nurse respond?

A. Let the client to get up and use the potty

B. Allow the client to use bedpan
C. Perform a pelvic exam
D. Check the fetal heart rate

47. A nurse in the delivery room is assisting with the delivery of a newborn infant. After the
delivery of the newborn, the nurse assists in delivering the placenta. Which observation would
indicate that the placenta has separated from the uterine wall and is ready for delivery?
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A. the umbilical cord shortens

B. a soft and boggy uterus
C. maternal complain of severe uterine cramping
D. change in the shapes of uterus

48. A nurse is caring for a client in labor. The nurse determines that the client is beginning in
the 2nd stage of labor when which of the following assessments is noted?

A. The client begins to expel clear vaginal fluids

B. The contractions are regular
C. The membranes have ruptured
D. The cervix is fully dilated

49. A nurse is developing a plan of care for a client experiencing dystocia and includes
several nursing interventions in the plan of care. The nurse prioritizes the plan of care and
selects which of the following nursing interventions as the highest priority?

A. Keeping the significant other informed of the progress of labor

B. Providing comfort measures
C. Monitoring fetal heart rate
D. Changing the clients positions frequently

50. Which of the following anatomical relation of the uterus is not correct
A. Anterior ………..bladder
B. Posterior……….the vagina
C. Lateral ………….the broad ligaments ,F.T&ovaries
D. Superior ………..the intestines
51. Which of the following statements characterize well the normal positions of the uterus:

A. anteverted and slightly antiflexed

B. antiflexed and slightly anteverted
C. retroverted and slightly anteverted
D. Slightly retroverted and anteverted

52.The normal PH of the vagina is which protects vagina against infections.

a. 3
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b.4.9

c.4.5

53. A client is admitted to the birthing suite in early active labor. The priority nursing
intervention on admission of this client would be:

A. Auscultation the fetal heart rate

B. Taking an obstetric history
C. Asking the client when she last ate
D. Explorer whether the membranes has been ruptured

54. Uterine contraction that commonly occur in third trimester and do not occur at regular
interval , do not get stronger over time and do not last longer over time are called .

A. premature contractions
B.follicular contractions
C.irritable contractions
D. Braxton hicks contractions

55. The three stages of labor are :

A. full cervical dilatation, infant delivery, placenta delivery

B .latent phase, active phase, deceleration phase

C. cervical dilatation to 6cm,cervical dilation to 10 cm,infant delivery
D. rupture of membranes, full cervical dilation ,infant delivery

56. Effect of GBV on women’s Reproductive Health includes all except:

A. Unwanted pregnancies
B. Unsafe abortions
C. Tumors
D. HIV/STIs

57. Lactation amenorrhea method is related to:

A. Mechanical contraception
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B Chemical contraception
C. Natural contraception
D. Emergency contraception

58. There are several indicators for monitoring the reproductive health status globally, however
the most used indicator as base line is:

A: infertility rate

B: mortality rate

C: contraceptive rate

D: fertility rate

59. Which of the following is the importance of HTSP (Health timing and spacing of
pregnancy?)
A. Social norm & quality FP services support- girl’s, women’s & couple’s desires to delay, space
and limit pregnancies
B. Facilitate dialogue on family planning in challenging environments by focusing on the health
of mother and child
C. Referral networks that include organizations known to be “youth friendly.”
D. Monitoring and Evaluation

60. Which contraceptive method can be used within 10 minutes of placenta delivery/ within 48
hours of delivery if not wait one month?
A. Jadelle
B. Implanon
C. IUD
D. Depo prvera

61. The woman who chooses to have sterilization should be counselled about:
A. Health benefit and risks, advantages and disadvantages as well as side effects and
complications of the method.
B. The possibility to need other children in future and availability of other long-term reversible
methods.
C. Irreversibility of the method and it is the only one that fits her condition.
D. a and b.

CASE: A young girl comes in your consultation and is requesting your help one hour after doing
unprotected sexual intercourse and she think that she is in ovulation.

62 .Choose the best choice for this girl that can help her
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a. Implants(Jadelle)
b. Depo- proveran
c. Combined oral contraceptive pills, Progesterone only pills and IUD
d. Implanon NXT

63.Emergency contraception is effectively if taken:

a. As soon as possible within 72 hours

b. Later between 4 and 5 days
c. After one week

64. In which of the following ways do gender norms typically affect the sexual behavior of
young people? (2marks).

A. Gender norms encourage young women to have sex with multiple partners in order to
improve their reputation among peers.
B. Gender norms encourage young men to respect their female partners’ wishes.
C. Gender norms discourage young women from discussing condoms with their partners.
D. Gender norms encourage young men in same-sex relationships to talk openly about
their sexual relationships with other men and ask for information on how to protect
themselves from HIV.

65. A woman needs to use Standard Day Method If her menstrual cycle is between: 2marks

a. 24-28 days
b. 26-30 days
c. 28-35 days
d. 26-32 days

Choose the best answer

66. Which of the following statement characterize malignant tumours

A. Do not spread by blood or lymphatic system

B. Ulceration and infections are common
C. The increase in size is slow (limited by the capsule)
D. The symptoms result from pressure on adjacent tissues
E. There is no tendency to recur after incision

67. The following statement is not a transmission mode for pelvic inflammatory desease:
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A. Sexual transmission via the vagina & cervix

B. Gynaecological surgical procedures
C. HIV/AIDS in pregnancy
D. A foreign body inside uterus
E. Child birth/ Abortion

68. The following statements are indications of surgery in Pelvic Inflammatory Disease
except:

A. Severe, progressive pelvic pain

B. Good response to medical treatment

C. Bilateral abscesses / > 8 cm. diameter

D. Uncertain diagnosis
E. Repeated exacerbations of PID

69. One of the following statements is true about benign tumours:

A. Are untreated and the patient usually dies.
B. Do not spread by blood or lymphatic system
C. Spread occurs to the other tissues
D. Ulcelation and infections are common
E. It is growing from tissue covered by squamous cell

70.. The following statements characterize Trichomoniasis except:

A. It is caused by a parasite trichomonas vaginalis
B. Trichomonas is almost exclusively sexually transmitted
C. Grayish watery vaginal discharge is characteristic of trichomoniasis
D. Can also be transmitted through shared bath facility
E. Alcohol should be avoided during the treatment of trichomoniasis.
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71. A 24 years old girl is admitted in the gynecology with the history of painful menstruation
periods. On history taking, the bleeding is normal and lasts for four days every month. On
gynecological examination, there is particular problem related. Which type of problem does this
young girl have?

A. Amenorrhea

B. Secondary dysmenorrhea

C. Primary dysmenorrhea

D. Dysmenorrhea

72. Which of the following conditions is not among possible causes of amenorrhea?

A. Endometriosis

B. Excessive exercise

C. Change in climate

D. Rapid in body weight

73. Which of the following is TRUE about secondary infertility?

A. The major cause of secondary infertility is tubal pregnancy

B. The major cause of secondary infertility is taking broad spectrum antibiotics

C. The major cause of secondary infertility is tubal occlusion due to pelvic inflammatory
infections

D. The major cause of secondary infertility is congenital abnormality

Mother ALICE is 62 years old and has never conceived throughout her marriage. She report to
the outpatient department complaining of some irregularities of the size and shape of her right
breast, dimpling and a hard immobile lump on the breast, she became very worried and
decided to come to the hospital for consultations.

74.. Which of the following investigations will be relevant for the diagnosis of ALICE’s
condition?

A. CT scan, MRI, Ultrasound, hemoglobin

B. Mammography, ultrasound, Biopsy, Blood test for metastasis

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C. Biopsy, Mammography, CT scan, ESR

D. Mammography, Blood Test for metastasis

75. What Virus is a pre-requisite for the development of most cervical cancer?

A. Gonorrhea
B. Syphilis
C. Human papilloma virus

D. HIV/AIDs

GOOD LUCKY !!!!!!!!!!!!!!!!!!!!!!!