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Q I . Explain the etiology and outline at least TWO (2) clinical features for each the following acute health problems.
a) Acute Kidney Injury
b) Acute gastrointestinal disorders
c) Ischemic stroke
d) Complex regional pain syndrome (CRPS)
e) Asthma
) Acute unconscious state
g) Angina Pectoris
h) Cellulitis
i) Dehydration
j) Haernorrhagic Shock
k) Concussion
I) Myocardial infarction
m) Nephrolithiasis
n) Bacterial Sepsis
Q2 a. List the eight (8) key principles of surgical nursing.
b. Explain briefly the following surgical procedures using correct surgical terminology. (30-40 words each)
a) Elective/emergency surgery
b) General, local, epidural and spinal anaesthetic and peripheral nerve block
c) Amputation
d) Open reduction
e) Hip replacement
1) Craniotomy
g) Tonsillectomy
h) Appendectomy
i) Laparotomy
j) Hysterectomy
k) Prostatectomy
I) Cataract extraction
m) Internal bleeding due to trauma.
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Q3 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.
• What is the significance of holistic nursing care ?
Outline the application of holistic nursing in the treatment of Too Too Wadadi considering his age, gender and specific culture.
Q4 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.
Name any two (2) Risk Assessments that are required to be performed to ensure patient's stability on feet before mobilization.
Q5A Briefly outline the purpose, complications and nursing management of the following procedures:
• IN Intravenous fluid intake
• Central venous catheter (CVC)
Q5 B
What is Total Parenteral Nutrition ?
Outline at least three (3) indications of Total Parenteral Nutrition.
What is the composition of a Standard TPN solution
Q6 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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a. List two (2) functions and two (2) complications associated with Peripherally inserted central catheter (PICC).
b. Outline the Nursing Management of a patient prior and post PICC insertion procedure
Q8 Outline any three (3) strategies a Nurse can use for pain management in a patient after surgery with the exception of using analgesics.
Q9
A. In terms of a patient who is not regaining consciousness, how would you assess their level of consciousness
B. What signs and symptoms of deterioration you need to monitor?
Q10
Draw 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
Q I I Explain the physiology behind the progression of a respiratory arrest into a cardiac arrest.
Q12
A. Excluding Deep Vein Thrombosis, outline at least four (4) complications associated with bed rest
B. Describe in brief the complex nursing management of a patient who was recently diagnosed with DVT.
QI3 List five (5) clinical manifestations and five (5) complex nursing interventions of Acute Pancreatitis
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Q14
a.List three (3) indications of tracheostomy suctioning.
b.Briefly outline the nursing management involved in tracheostomy suctioning.
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015. Read the scenario and the nursing diagnosis given below and outline at least four (4) complex nursing interventions.
Scenario Nursing Diagnosis Complex Nursing interventions required
Mrs Fernando is an 83-year-old Mr. Harris develops the
widow who lives with her two following nursing diagnoses for
adult sons. Over the past 15 years, Mrs. Fernando:
she 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
• Impaired gas exchange
and acute exacerbation of COPD, related to acute and chronic lung disease
- Risk for impaired spontaneous ventilation related to loss of hypoxemic respiratory drive and respiratory muscle fatigue
- Impaired home maintenance related to activity intolerance
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Q16 Describe in detail the nursing management of a patient with an intercostal catheter and an underwater chest drainage tube (UWSD)?
QI7 Outline the nursing management of a patient on B1PAP and CPAP
018. Outline the function of each of the following equipment that is present in an Acute care environment.
Item Function
Bad and Mask,
Endotracheal tube,
Laryngoscope
Pulse oximetry
Vaccum pump and suction catheter
Electrocardiograph
Defibrillator
Standard IV fluids and administration sets
Infusion pumps
Large bore IV catheters
Supplies for throacostomy
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Nasal gastric/oral gastric tubes
Hard Cervical collars
Thermal contral far patients and fluids/blood
Q I 9 Classify burns based on causative factors. Describe the 4 degrees of burns as a result of fire with
clinical features.
Q20.
• What is Venous thromboembolism (VTE)?
• Outline the types of VTE.
• Mention at least two (2) clinical features for each type of VTE.
Q21.
a. Outline at least TWO (2) extrinsic and TWO (2) intrinsic causes of fractures.
b. What is a green stick fracture? What age group does it affect?
e. Outline three (3) clinical features of green stick fractures.
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Q22. Write the indications of use for the following emergency medications that are used in acute situations.
DRUG INDICATION
Adrenaline
(1000 microgram in I mL injection
equivalent to 1:1000)
1000 microgram = I mg
Atropine
(0.6 mg in I mL injection)
Benztropine
(2 mg in 2 mL injection)
Benzylpenicillin
(600 mg or 3 g powder, dissolve in
water for injections)
Chlorpromazine
(50 mg in 2 mL injection)
Dexamethasone sodium phosphate
(4 mg in 1 mL injection)
Diazepam
(10 mg in 2 mL injection)
Dihydroergotamine
(1 ring in I mL injection)
Diphtheria and tetanus booster vaccine
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(0.5 mL pre-filled syringe)
Frusemide
(20 mg in 2 mL injection)
Glucagon
(injection kit containing I mg glucagon and I mL solvent in syringe)
Glyceryl trinitrate
(400 microgram per dose, 200 doses as sublingual spray)
Haloperidol
(5 mg in I mL injection)
Hydrocortisone sodium succinate
(100 mg or 250 mg with
2 mL solvent for injection)
Lignocaine
(100 mg in 5 mL injection)
Metodopramide
(10 mg in 2 mL injection)
Methoxyflurane
(3 mL plus inhaler)
Morphine sulfate
(15 mg or 30 mg in I mL injection)
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Naloxone
(2 mg in 5 mL injection)
Procaine penicillin
(1.5 g in 3.4 mL injection)
This should read
(1.5 g in 3.4 mL injection)
Corrected May 2013
Prochlorperazine
(12.5 mg in 1 mL injection)
Promethazine hydrochloride
(50 mg in 2 mL injection)
Salbutamol inhaler
(100 microgram per dose,
200 doses)
Salbutamol nebuliser solution
(2.5 mg or 5 mg in 2.5 mL per dose, 30 doses)
Terbutaline
(500 microgram in I mL injection)
Tramadol
(100 mg in 2 mL injection)
Verapamil
(5 mg in 2 mL injection)
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Q23.
a. What are the clinical manifestations of Acute Myocardial Infarction?
b. Outline the complex steps involved in its nursing management.
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