MERU UNIVERSITY OF SCIENCE AND TECHNOLOGY

P.O. Box 972-60200 – Meru-Kenya.

Tel: +254 (0) 799 529 958, +254 (0) 799 529 959, +254 (0) 712 524 293
Website: www.must.ac.ke Email: info@must.ac.ke

University Examinations 2017/2018

FIRST YEAR, SECOND SEMESTER EXAMINATION FOR THE DEGREE OF BACHELOR

OF SCIENCE CLINICAL MEDICINE AND COMMUNITY HEALTH

CCM 3124: NURSING SKILLS AND CRITICAL CARE NURSING

DATE: SEPTEMBER 2018 TIME: 3 HOURS

INSTRUCTIONS:
1. This examination consists of Three sections
2. Section one Short answer Questions
3. Section two long answer Questions
4. Section three True/False Multiple choice questions
5. All questions are compulsory.

SECTION ONE: SHORT ANSWER QUESTIONS (20MARKS)

1. State five steps of the nursing process. (5 Marks)
2. State four indicators for insertion of a nasogastric tube (4 Marks)
3. State three factors that promote wound healing. (3 Marks)
4. Explain four blood transfusion reactions. (8 Marks)

SECTION TWO: LONG ANSWER QUESTIONS. 30 (MARKS)

INSTRUCTIONS: Answer all questions in this section on the answer booklet provided.
1. Describe how to prevent infection in the hospital setting. (15 Marks)
2. Explain the steps followed while performing intravenous cannulation. (15 Marks)

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SECTION THREE: MULTIPLE CHOICE QUESTIONS. (100 MARKS)

INSTRUCTIONS: Answer TRUE or FALSE to each of the answers given in this section,
answer booklet provided.
1. While taking the client’s pulse the clinician would:
(i) Document techypnea as above normal.
(ii) Use the brachial artery to verify a radial pulse measure.
(iii)Use the apex of the heart to verify a radial pulse measure.
(iv) Document tachycardia as above normal.
(v) A weak and slow pulse would best indicate imminent death.
2. The best way to collect and handle specimens is by:
(i) Collecting urine specimen for culture and sensitivity using a clean container.
(ii) Discard the first flow of urine to ensure that the urine is not contaminate when collecting
urine specimen for culture and sensitivity.
(iii)Specimens should be sent to the laboratory immediately to ensure accurate and efficient
results.
(iv) Using the speculum to facilitate high vaginal swab.
(v) Collecting throat specimen by swabbing the throat and the tongue.
3. When collecting a 24-hour urine specimen for creatinine clearance, it is important to:
(i) Insert a urinary catheter to obtain the specimen.
(ii) Obtain the client’s weight prior to beginning the urine collection.
(iii)Discard the last voided specimen prior to ending the collection.
(iv) Discard the first voided specimen prior to starting the collection.
(v) All subsequent specimen collected should be passed into the urine jug before emptying
into the specimen bottle/container..
4. When removing gloves, the medical personnel should NOT:
(i) Wash hands.
(ii) Pee off gloves inside out.
(iii)Use glove to glove, skin to skin technology.
(iv) Remove mask and gown before removing gloves.
(v) Remove the gloves then the mask and the gown.
5. Rigor mortis refers to:
(i) Discolouration of dependent parts of the body after death.
(ii) Cooling of the body after death.
(iii)Stiffening of the body after death.
(iv) Procedures performed to the dead body.
(v) Sets in after two hours.
6. In mobility and body mechanics:

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 (i) The center of gravity is located within the pelvis.
(ii) The base of gravity should pass through the centre of gravity.
(iii)You should turn at the waist when lifting heavy weights.
(iv) Leg and arms muscles should be used to lift an object.
(v) You should place one foot slightly ahead of the other.
7. The qualities that are relevant in documenting patient care are:
(i) Accuracy and conciseness.
(ii) Thoroughness.
(iii)Current information.
(iv) Organization.
(v) All of the above.
8. Blood pressure measurement is an important part of the patient’s database. It is considered to
be:
(i) The basis of the nursing diagnosis
(ii) Objective data.
(iii)An indicator of patient complaint.
(iv) Subjective data.
(v) Routine check-up
9. During bed making, the main purpose for mitering corners if the sheet is flat it to:
(i) Secure the bottom sheets.
(ii) Make the corner look neat.
(iii)Keep the bed linen tight.
(iv) Follow nursing procedure manual.
(v) Keep the bed linen wrinkle free.
10. When positioning the clients:
(i) Fowlers position would have the head of the bed is elevated to 600.
(ii) Fowlers position would have the head of the bed is elevated to 450
(iii)Sims position puts the client to lie in extreme lateral position.
(iv) Supine position would place the client lying in the abdomen with the head turned to
either side.
11. The following intervention is appropriate when an IV infusion infiltrates:
(i) Elevate the site
(ii) Attempt to flush the line.
(iii)Discontinued the infusion.
(iv) Apply a warm compression.
(v) Apply cold compression.

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12. The process of removing all viable micro-organisms from an inanimate object including
spores is termed as:
(i) Disinfection is the process of removing micro-organisms from an inanimate object
including spores.
(ii) Sterilization is the process of removing micro-organisms from an inanimate object
including spores.
(iii)Sterilization is the process of removing micro-organisms from an inanimate object and
not spores.
(iv) Disinfection is the process of removing micro-organisms from an inanimate object and
not spores.
(v) Decontamination is the process of rendering objects safe to handle.
13. Discharge planning should be:
(i) Initiated after surgery and successful recovery.
(ii) Initiated after the patient is less anxious.
(iii)Initiated immediately before discharge.
(iv) Initiated oadmission to the hospital.
(v) Done with the involvement of the patient.
14. A patient who decides to leave the hospital against medical advice must a sign a form to:
(i) Indicate the patient’s wish.
(ii) Be used in the event of admission.
(iii)Release hospital from legal responsibility for the patient’s health status.
(iv) Ethically illustrate that the patient has control of his/her own care and treatment.
(v) Protect the doctor from legal suits.
15. The patient complaints about feeling nauseated after lung. This is an example of:
(i) Subjective data.
(ii) Objective data.
(iii)Signs and symptoms.
(iv) Data obtained during physical examination.
(v) Data obtained during history taking.
16. An elevation of the body temperature above normal is labeled as:
(i) Hypothermia.
(ii) Hyperthermia.
(iii)Hypertension.
(iv) Afebrile.
(v) Febrile.
17. When caring for patient who is dyspnoeic:
(i) Remove pillows from the head.
(ii) Elevate the head of the bed.
(iii)Elevate the foot of the bed.
(iv) Take the blood pressure.

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 (v) Monitor oxygen saturation.
18. The purpose of assessment is to:
(i) Make a diagnostic conclusion.
(ii) Delegate a nursing responsibility.
(iii)Teach the client about his/her health.
(iv) Establish a database.
(v) To use information in decision making.
19. If a client develops tenderness, warmth, Erythema and pain at the intravenous site, you
should suspect:
(i) Sepsis.
(ii) Phlebitis.
(iii)Infiltration.
(iv) Bleeding.
20. Maintaining a urinary catheter drainage bag in the dependent position prevents:
(i) Urinary reflux.
(ii) Contamination.
(iii)Urinary retention.
(iv) Reflex incontinence.
(v) Urinary incontinence.

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