PART I: MULTIPLE CHOICE QUESTIONS (MCQs) 20 MARKS
1. A patient who is receiving hemodialysis for chronic renal failure is especially prone to develop:
a. Peritonitis
b. Hepatitis C
c. Renal calculi
d. Bladder tumor
2. Which of the following symptoms indicate acute rejection of a transplanted kidney?
a. Fever, weight loss, oliguria, high blood pressure, pain at the graft site
b. Fever, weight gain, poliuria, low blood pressure
c. Fever, weight gain, oliguria, high blood pressure, pain at the graft site
d. Fever, weight loss, polyuria, low blood pressure, pain at the graft site
3. In the diuretic phase of renal failure, which electrolyte imbalances the nurse should monitor?
a. Hypernatremia, hypokalemia
b. Hyponatremia, hypokalemia
c. Hypocalcemia, hypophosphatemia
d. Hypercalcemia, hypophosphatemia
4. Which of the following conditions may cause prerenal form of acute renal failure?
a. Benign prostatic hyperplasia
b. Myocardial infarction
c. Hemolytic blood transfusion reaction
d. Septic shock and nephrotoxic injury from radiocontrast agents
5. The two most common complications of urethral trauma are:
a. Urethral strictures and impotence in men
b. Bladder strictures and impotence ureters
c. Impotence among men and ectopic uterus
d. Impotence among men and megaureters
6. Which of the following types of renal calculi is radiolucent?
a. Calcium oxalate
b. Calcium phosphate
c. Uric acid
d. Struvite
7. Which of the following palliative procedures is usually performed when the ureters are obstructed by a tumor?
a. Transurethral resection
b. Cuteneous ureterostomy
c. Pyelostomy
d. Percuteneous nephrostomy
8. The two major problems caused by bladder diverticula are:
a. Distended bladder and urinary tract infections
b. Urinary tract infections and ureter stricture
c. Malignancies and obstruction
d. Urinary tract infections and malignancies
9. A post operative patient has developed urinary retention. To relieve the patient from retention the nurse carries out all of the following except:
a. Place the patient in a sitting position
b. Administer a diuretic
c. Place a hot water bottle over the perineum
d. Get an order for inserting a catheter in to bladder
10. Which one of the following statements best describes pulmonary embolism?
a. It is a thrombus originating from arterial circulation that has occluded a bronchiole
b. It is a thrombus originating from arterial circulation that has occluded a pulmonary vessel
c. It is a thrombus originating from venous circulation that has occluded a pulmonary vessel
d. It is a blood clot that has developed in the pulmonary vessel
11. Which of the following symptoms would suggest a tension pneumothorax?
a. Haemoptysis
b. Sucking sounds made on inspiration
c. Collapsed neck vein
d. Deviation of the trachea
12. Which of the following nursing interventions can prevent or reduce the risk of atelectasis in a post operative patient?
a. Frequent turning
b. Steam inhalation
c. Use of an incentive spirometer
d. Coughing exercise
13. Which of the following treatments would the nurse recommend for a patient with spontaneous pneumothorax?
a. Insertion of chest tube
b. Thoracentesis
c. Antibiotic
d. Mechanical ventilation
14. Pleural effusion is defined as:-
a. The collapse of alveoli
b. The inflammation of pleura
c. The accumulation of fluid in the alveoli
d. The accumulation of fluid in the pleural space
15. Which one of the following methods is employed for removal of pleural fluid in pleural effusion?
a. Insertion of a chest tube in the pleural space
b. Perform paracentesis
c. Perform thoracentesis
d. Diuretic therapy
16. Which of the following diagnostic procedures most accurately confirms diagnosis of lung cancer?
a. Chest X-Ray
b. Bronchoscopy
c. Cytologic studies of early morning sputum specimen
d. Surgical biopsy
17. The primary reason for peripheral arterial disease includes:-
a. Atherosclerosis’
b. Embolism
c. Thrombosis
d. Vasospasm
18. The reason for furosemide (lasix) administration in the treatment of hypertension is:-
a. It blocks the sympathetic stimulation of the heart
b. It controls blood volume by inhibiting reabsorption of sodium and water in the kidney tubule
c. It helps in reabsorption of sodium and excretion of potassium
d. It dilates peripheral blood vessels
19. Which of the following types of angina is most likely to progress into Myocardial Infarction (MI)?
a. Stable angina
b. Unstable angina
c. Prinzmetal’s angina
d. Nocturnal angina
20. The pain medication of choice in acute myocardial infarction is:-
a. Pethidine hydrochloride
b. Diclophenac sodium
c. Codeine sulfate
d. Morphine sulfate
PART II: SHORT ANSWER QUESTIONS (SAQs) 40 MARKS
1. Differentiate between acute renal failure and chronic renal failure (6 marks)
2. Explain the pathophysiological changes that occur in pulmonary embolism (5 marks)
3. Outline five (5) priority nursing diagnoses that can be in a patient with acute renal failure (5 marks)
4. Outline the rationale for performing the following investigation tests in a TB patient: (4 marks)
a. Sputum culture
b. Blood culture
c. Chest X-Ray Study
d. Arterial Blood Gas (ABG) analysis
5. Explain the three (3) most important warning signs that signal lung cancer. (6 marks)
6. Outline the goals of nursing care of a patient with congestive heart failure (6 marks)
7. Explain the role of beta-blockers (drugs) in the management of a patient with myocardial infarction (MI). (4 marks)
8. Explain ischemia as a primary cause of acute tubular necrosis (4 marks)
PART III: LONG ANSWER QUESTIONS (LAQs) 40 MARKS
1. A patient with emphysema is admitted in the medical unit of a Hospital with resting hypoxemia
a. Formulate four (4) priority nursing diagnoses for this condition (8 marks)
b. Discuss the interventions for each nursing diagnosis formulated in question (a) above (12 marks)
2. Ms Jael is admitted in a female medical-surgical ward with a diagnosis of chronic constrictive pericarditis.
a. Describe the pathophysiology of this disease. (8 marks)
b. Discuss the nursing care for this patient.
