EDUCATION INSTITUTE
\nQ I . Explain the etiology and outline at least TWO (2) clinical features for each the following acute health problems.
\na) Acute Kidney Injury
\nb) Acute gastrointestinal disorders
\nc) Ischemic stroke
\nd) Complex regional pain syndrome (CRPS)
\ne) Asthma
\n) Acute unconscious state
\ng) Angina Pectoris
\nh) Cellulitis
\ni) Dehydration
\nj) Haernorrhagic Shock
\nk) Concussion
\nI) Myocardial infarction
\nm) Nephrolithiasis
\nn) Bacterial Sepsis
\nQ2 a. List the eight (8) key principles of surgical nursing.
\nb. Explain briefly the following surgical procedures using correct surgical terminology. (30-40 words each)
\na) Elective\/emergency surgery
\nb) General, local, epidural and spinal anaesthetic and peripheral nerve block
\nc) Amputation
\nd) Open reduction
\ne) Hip replacement
\n1) Craniotomy
\ng) Tonsillectomy
\nh) Appendectomy
\ni) Laparotomy
\nj) Hysterectomy
\nk) Prostatectomy
\nI) Cataract extraction
\nm) Internal bleeding due to trauma.
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\nQ3 Too Too Wadadi is a 16-year-old Maori boy from New Zealand who was rushed to the Emergency department this morning with testicular torsion. After an initial blood work he was shifted to the operating room. The surgical procedure completed at 12 noon and the patient was shifted to the post operative ICU.
\n\u2022 What is the significance of holistic nursing care ?
\nOutline the application of holistic nursing in the treatment of Too Too Wadadi considering his age, gender and specific culture.
\nQ4 Mrs. Kabita Kandel , a 55 year old female was admitted in the female general ward. She was diagnosed with bilateral osteoarthritis of the hip and has been posted for a Total hip replacement. She has a family history of type 2 Diabetes Mellitus and also coronary artery disease. The anaesthetist reviewed the blood work and after consultation with the patient, gave the clearance for surgery. The surgery took place at 9 am the next day and the patient was shifted to the post operative room at I2 noon. The doctors have ordered to commence patient mobilization at 8 pm today.
\nName any two (2) Risk Assessments that are required to be performed to ensure patient’s stability on feet before mobilization.
\nQ5A Briefly outline the purpose, complications and nursing management of the following procedures:
\n\u2022 IN Intravenous fluid intake
\n\u2022 Central venous catheter (CVC)
\nQ5 B
\nWhat is Total Parenteral Nutrition ?
\nOutline at least three (3) indications of Total Parenteral Nutrition.
\nWhat is the composition of a Standard TPN solution
\nQ6 What is the rationale for undertaking the following pre and post anesthetic observations in a patient who has been admitted for surgery?
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\na. List two (2) functions and two (2) complications associated with Peripherally inserted central catheter (PICC).
\nb. Outline the Nursing Management of a patient prior and post PICC insertion procedure
\nQ8 Outline any three (3) strategies a Nurse can use for pain management in a patient after surgery with the exception of using analgesics.
\nQ9
\nA. In terms of a patient who is not regaining consciousness, how would you assess their level of consciousness
\nB. What signs and symptoms of deterioration you need to monitor?
\nQ10
\nDraw a neatly labelled diagrammatic flow chart representation of the management of a case of pediatric Cardio Pulmonary Resuscitation for a 5 year old male in a hospital where 2 certified CPR givers are available
\nQ I I Explain the physiology behind the progression of a respiratory arrest into a cardiac arrest.
\nQ12
\nA. Excluding Deep Vein Thrombosis, outline at least four (4) complications associated with bed rest
\nB. Describe in brief the complex nursing management of a patient who was recently diagnosed with DVT.
\nQI3 List five (5) clinical manifestations and five (5) complex nursing interventions of Acute Pancreatitis
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\nQ14
\na.List three (3) indications of tracheostomy suctioning.
\nb.Briefly outline the nursing management involved in tracheostomy suctioning.
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\n015. Read the scenario and the nursing diagnosis given below and outline at least four (4) complex nursing interventions.
\nScenario Nursing Diagnosis Complex Nursing interventions required
\nMrs Fernando is an 83-year-old Mr. Harris develops the
\nwidow who lives with her two following nursing diagnoses for
\nadult sons. Over the past 15 years, Mrs. Fernando:
\nshe has become increasingly short of breath while gardening and walking, two favorite activities. She also has developed a chronic cough that is particularly bad in the mornings. Ten years ago, her family physician told her that she had emphysema. She is admitted to the hospital with possible pneumonia .Ineffective airway clearance related to pneumonia and COPD
\n\u2022 Impaired gas exchange
\nand acute exacerbation of COPD, related to acute and chronic lung disease
\n– Risk for impaired spontaneous ventilation related to loss of hypoxemic respiratory drive and respiratory muscle fatigue
\n– Impaired home maintenance related to activity intolerance
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\nQ16 Describe in detail the nursing management of a patient with an intercostal catheter and an underwater chest drainage tube (UWSD)?
\nQI7 Outline the nursing management of a patient on B1PAP and CPAP
\n018. Outline the function of each of the following equipment that is present in an Acute care environment.
\nItem Function
\nBad and Mask,
\nEndotracheal tube,
\nLaryngoscope
\nPulse oximetry
\nVaccum pump and suction catheter
\nElectrocardiograph
\nDefibrillator
\nStandard IV fluids and administration sets
\nInfusion pumps
\nLarge bore IV catheters
\nSupplies for throacostomy
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\nNasal gastric\/oral gastric tubes
\nHard Cervical collars
\nThermal contral far patients and fluids\/blood
\nQ I 9 Classify burns based on causative factors. Describe the 4 degrees of burns as a result of fire with
\nclinical features.
\nQ20.
\n\u2022 What is Venous thromboembolism (VTE)?
\n\u2022 Outline the types of VTE.
\n\u2022 Mention at least two (2) clinical features for each type of VTE.
\nQ21.
\na. Outline at least TWO (2) extrinsic and TWO (2) intrinsic causes of fractures.
\nb. What is a green stick fracture? What age group does it affect?
\ne. Outline three (3) clinical features of green stick fractures.
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\nQ22. Write the indications of use for the following emergency medications that are used in acute situations.
\nDRUG INDICATION
\nAdrenaline
\n(1000 microgram in I mL injection
\nequivalent to 1:1000)
\n1000 microgram = I mg
\nAtropine
\n(0.6 mg in I mL injection)
\nBenztropine
\n(2 mg in 2 mL injection)
\nBenzylpenicillin
\n(600 mg or 3 g powder, dissolve in
\nwater for injections)
\nChlorpromazine
\n(50 mg in 2 mL injection)
\nDexamethasone sodium phosphate
\n(4 mg in 1 mL injection)
\nDiazepam
\n(10 mg in 2 mL injection)
\nDihydroergotamine
\n(1 ring in I mL injection)
\nDiphtheria and tetanus booster vaccine
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\n(0.5 mL pre-filled syringe)
\nFrusemide
\n(20 mg in 2 mL injection)
\nGlucagon
\n(injection kit containing I mg glucagon and I mL solvent in syringe)
\nGlyceryl trinitrate
\n(400 microgram per dose, 200 doses as sublingual spray)
\nHaloperidol
\n(5 mg in I mL injection)
\nHydrocortisone sodium succinate
\n(100 mg or 250 mg with
\n2 mL solvent for injection)
\nLignocaine
\n(100 mg in 5 mL injection)
\nMetodopramide
\n(10 mg in 2 mL injection)
\nMethoxyflurane
\n(3 mL plus inhaler)
\nMorphine sulfate
\n(15 mg or 30 mg in I mL injection)
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\nNaloxone
\n(2 mg in 5 mL injection)
\nProcaine penicillin
\n(1.5 g in 3.4 mL injection)
\nThis should read
\n(1.5 g in 3.4 mL injection)
\nCorrected May 2013
\nProchlorperazine
\n(12.5 mg in 1 mL injection)
\nPromethazine hydrochloride
\n(50 mg in 2 mL injection)
\nSalbutamol inhaler
\n(100 microgram per dose,
\n200 doses)
\nSalbutamol nebuliser solution
\n(2.5 mg or 5 mg in 2.5 mL per dose, 30 doses)
\nTerbutaline
\n(500 microgram in I mL injection)
\nTramadol
\n(100 mg in 2 mL injection)
\nVerapamil
\n(5 mg in 2 mL injection)
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\nQ23.
\na. What are the clinical manifestations of Acute Myocardial Infarction?
\nb. Outline the complex steps involved in its nursing management.
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