State five (5) nursing actions for a patient post gastrectomy. (5marks)
Describe the pathophysiology of liver cirrhosis. (5marks)
A client has been admitted with a diagnosis of acute pancreatitis. The nurse would assess this client for pain that is:-
a) Severe and unrelenting, located in the epigastric area, radiating to the back, relieved by positioning in recumbent position.
b) Severe and unrelenting, located in the left quadrant radiating to the back, relieved by vomiting and knee-chest positioning
c) Severe and unrelenting, located in the medipigastrium, radiating to the back, relieved by knee chest positioning and not relieved by vomiting
d) Severe and unrelenting, located in the left lower quadrant radiating to the hip, relieved by eating and sitting up position
Instructions prescribed for the patient following gastrectomy with regard to dumping syndrome include:-
a) Large dry feedings high in carbohydrates, take fluids with meals, plan rest periods of at least 30 minutes after each meal.
b) Small dry feedings low in carbohydrates, take fluids between meals, rest periods of at least 2 hours after each meal.
c) Eat normal meals twice a day, rest 30 minutes after meals, in semifowlers’ position take fluids after meals
d) Small dry feeding, low in carbohydrates, take fluids between meals, plan rest periods of at least 30 minutes after each meal in recumbent position
State two(2) interventions to manage impaired swallowing in a patient (2 marks)
List four (4) nursing interventions to alleviate diarrhea (2 marks)
Ms Betty, a 60 year old lady is admitted in the ward with diverticulosis.
a. State the clinical manifestations of diverticulosis (4 marks)
b. Explain the management of Ms Joyce in the ward (14 marks)
c. List four (4) complications of diverticulosis. (2 marks).
State five (5) signs and symptoms of liver cirrhosis. 5 marks
Differentiate between peptic and gastric ulcers. 4 marks
Describe briefly the specific pre-operative management of a patient with intestinal obstruction. 6 marks
Outline five (5) specific nursing diagnosis a nurse would obtain while assessing a patient suffering from gastro-intestinal tract conditions. 5 marks
Mrs Gekonge is admitted to surgical ward and a surgeon has made a diagnosis of appendicitis.
(a) Explain the pathophysiology of appendicitis. 5 marks
(b) State five (5) clinical manifestation of appendicitis. 5 marks
(c) Describe the specific nursing management of Mrs Gekonge. 10 marks
Miss Lolwe aged 25 years old is admitted to your ward with dental abscess and is for tooth extraction.
(a) Define dentistry. 1 mark
(b) Draw and label the structure of a molar tooth. 3 marks
(c) State any four (4) clinical features that Miss Lolwe will present with. 4 marks
(d) Describe the management of Miss Lolwe from admission till discharge.12 marks
State three (3) nursing interventions for a patient with dental abscess. 3 marks
Describe the medical management of a patient with oral thrush. 5 marks
Draw and label a diagram showing a structure of a molar tooth. 5 marks
Explain five (5) preventive measures that can be used in the preventive of dental disorders.
Ms Poppy aged 32 years a patient has been diagnosed with dental cavity. You are a nurse allocated to take care of this patient after admission to your ward.
(a) Define dental cavity. 1 mark
(b) Explain three (3) investigations that may have aided this diagnosis. 6 marks
(c) Draw a nursing care plan for Ms Poppy in the first 24 hours of admission that will meet her priority needs. 13 marks
Using a nursing care plan, briefly manage a patient suffering from gingivitis.10 marks
Define the following terms:
(a) Peptic ulcer diseases (PUD). 1 mark
(b) Acute gastritis. 1 mark
(c) Ulcerative colitis. 1 mark
(d) Hernia. 1 mark
Draw and label a diagram of the alimentary canal. 6 marks
(a) Explain the pathophysiology of ulcerative colitis. 5 marks
(b) Explain what you understand by the term ‘nutritional therapy’ In ulcerative colitis. 4 marks
(c) List eight (8) interventions in the management of ulcerative colitis. 4 marks
(a) State five (5) clinical features of peptic ulcer disease (PUD). 5 marks
(b) State five (5) risk factors of peptic ulcer disease. 5 marks
(c) Explain the post-operative management of patient who has undergone partial gastrorectomy. 10 marks
Compare and contrast acute gastritis and chronic gastritis. 6 marks
(a) State six (6) mechanical causes of intestinal obstruction. 6 marks
(b) State six (6) clinical features of small bowel obstruction. 6 marks
(c) List five (5) complications of appendicitis. 2½ mark
1. Explain briefly the pathophysiology of Ascitis. 5 Marks
2. Outline specific nursing management of a patient with appendicitis. 6 Marks
3. Differentiate between duodenal and gastric ulcers. 4 Marks
4. State Four (4) complication of porta hypertension. 5 Marks
1. Mr Zoe is admitted into a ward with a diagnosis of upper gastrointestinal bleeding due to oesophageal varices. He looks pale anxious and has a cold clammy skin.
a. List Four (4) diagnostic tests that can be done to diagnose upper gastrointestinal bleeding. 2 Marks
b. Describe the pathophysiology of oesophageal varices. 5 Marks
c. State Five (5) nursing diagnosis for Mr. Zoe. 5 Marks
d. Briefly explain the Nursing care for Mr. Zoe from admitted until discharge. 8 Marks
State five (5) nursing diagnosis for patient with cholelithiasis. 5 marks
Outline three (3) types of jaundice. 3 marks
State five (5) contributing factors to bleeding of eosophageal varices. 5 marks
Briefly explain the pathophysiology of liver abscess. 5 marks
List four (4) clinical manifestations of hepatic dysfunction. 2 marks
Draw and label a diagram of biliary system. 4 marks
Differentiate between duodenal ulcer and gastric ulcer. 4 marks
State four (4) predisposing causes of cholelithiasis. 4 marks
State four (4) nursing diagnosis of a patient suffering from acute pancreatitis. 4 marks
Describe the pathophysiology of appendicitis. 4 marks
Mrs J has been admitted to female adult ward with history of not passing stool for 3 days and projected vomiting with faecal stained vomitus. On investigation a diagnosis of intestinal obstruction was made.
(a) State five (5) mechanical causes of intestinal obstruction. 5 marks
(b) Describe the pathophysiology of small intestine obstruction. 5 marks
(c) Describe the immediate and subsequent management of Mrs J for the first 48 hours. 10 marks
State five (5) clinical features of duodenal ulcer. 5 mks
State the five causes of chronic gastritis. 5 mks
State the five clinical manifestations of cancer of the stomach. 5 mks
State five precipitating factors to the occurrence of hemorrhoids. 5 mks
Mr. Walunge who is a cyclist, is brought in male surgical ward with complain of severe abdominal pain, tenderness and inability to open the bowels for the last two days. He is diagnosed of having intestinal obstruction.
(a) Define intestinal obstruction. 2 mks
(b) State five clinical features of intestinal obstruction. 5 mks
(c) Mr. Walunge is to be taken to theatre for emergency laparatomy. Discuss pre- and post operative management of Mr. Walunge under the following:-
(i) Investigations
(ii) Treatment
(iii) Nursing diagnosis
(iv) Nursing planning and intervention
(v) Health massages to be shared with him 13 mks
List four (4) predisposing factors for hiatal hernia. 2 marks
Briefly outline the management of acute gastritis. 3 marks
Briefly describe the pathophysiology of intestinal obstruction. 5 marks
Differentiate between acute and chronic gastritis. 2 marks
List six (6) clinical presentation of decompensated liver cirrhosis. 3 marks
Briefly outline the management of a patient with haemorrhoids. 3 marks
Explain how the pancreas acts as an exocrine and endocrine organ. 2 marks
Discuss the various strains of hepatitis virus including their management and prevention. 10 marks
(a) Outline the pathophysiology of peptic ulcer disease. 5 marks
(b) Formulate two (2) nursing diagnoses of a patient suffering from peptic ulcer disease. 2 marks
(c) List six (6) causes of peritonitis. 3 marks
Briefly explain the pathophysiology of acute pancreatitis. 5 marks
State six (6) risk factors for colelithiasis. 3 marks
Explain the pancrease as an endocrine and exocrine gland. 2 marks
Briefly explain the three (3) types of liver cirrhosis. 4 ½ mark
List four (4) predisposing factors to hiatal hernia. 2 marks
State the two (2) classifications of haemorrhoids. 2 marks
List three (3) complications of peritonitis. 1 ½ mark
Mr X is admitted into a department where you are an in-charge with a diagnosis of peptic ulcer disease. Using nursing process, manage Mr X for the first 24 hours. 10 marks
A child 7 years is admitted into a paediatric ward with intestinal obstruction.
(a) Define intestinal obstruction. 1 mark
(b) Explain two (2) major causes of intestinal obstruction. 4 marks
(c) With an aid of well labelled diagram, show the common site for gastric cancer.5 marks
Give four factors that contribute to gastroesophageal reflex disease. 2 marks
Outline the clinical manifestation of hiatal hernia. 5 marks
Explain the pathophysiology of peritonitis. 5 marks
List ten (10) complications of the cancer of the stomach. 5 marks
Define dumping syndrome and discuss its manifestations. 3 marks
Draw a well labelled diagram showing the stomach, common sites of gastric and duodenal ulcers. 5 marks
Mr Momanyi 56 years in admitted to male surgical ward with a diagnosis of cancer of the oesophagus. Manage Mr Momanyi using nursing process for the first 24 hours.
State five (5) clinical features of duodenal ulcer. (5 mks)
State the five causes of chronic gastritis. (5 mks)
State the five clinical manifestations of cancer of the stomach. (5 mks)
State five precipitating factors to the occurrence of hemorrhoids. (5 mks)
Mr. Walunge who is a cyclist, is brought in male surgical ward with complain of severe abdominal pain, tenderness and inability to open the bowels for the last two days. He is diagnosed of having intestinal obstruction.
(a) Define intestinal obstruction. (2 mks)
(b) State five clinical features of intestinal obstruction. (5 mks)
(c) Mr. Walunge is to be taken to theatre for emergency laparatomy. Discuss pre- and post operative management of Mr. Walunge under the following:-
(i) Investigations
(ii) Treatment
(iii) Nursing diagnosis
(iv) Nursing planning and intervention
(v) Health massages to be shared with him (13 mks)
