Faculty OF Nursing
Benha University
Medical Surgical Nursing
Final semester Exam
Second Year
Date: 16/1/2011
Time: 3 hours
Total Marks: 80
I- MCQ:-
(30 Marks )
Please circle the correct answer only:
1- Physical response in acute pain all of the following Except:a- Tachycardia
B- Slow and deep respiration
c- Dilated pupils
d- Increase blood pressure
2- Hypertension is generally defined as persistent elevation of systolic
blood pressure of
a- 140 mmhg
b- 140 mmhg or below
c- 140 mmhg or above
d- all of above
3- The following investigations are used to diagnose the pneumonia
Except:
a- Chest X-ray
b- Blood picture
c- Sputum culture examination
d- Serum creatinine
4- The main cause of primary emphysema is:
a- water pollution
b- Sinusitis
c- Sarcoidosis
d- Definency of serum alpha one antitrypsin
5- Chronic pain is:
1
a- Temporary pain
b- Range from severe to mild
c- Prolonged pain
d- Lasts less than 6 months
6- Malignant hypertension is an emergency condition that
characterized by:a- Systolic blood pressure above 140 mmhg
b- Diastolic blood pressure above 90mmhg
c- Systolic blood pressure above 160mmhg
d- Diastolic blood pressure above 120mmhg
7-Patient complain from renal vasoconstriction may be due:a- Obstruction in collecting ducts
b- Decrease vascular volume
c- Ischemia stimulates renin real ease
d- Intravascular pooling of blood
8- All of the following occur to patient with renal failure Except one:
a- Metabolic acidosis
b- Oliguria
c- Proteninuria
d- Colitis and weight loss
9- To correct the bleeding tendencies for patient with acute renal
failure we must: a- Correct specific gravity for urine
b- Correct Vita K deficiency and decrease BUN level
c- Increase level of fluid volume
d- Put dialysis in the recommendation
10- When the nurse tale the vital signs to patient with COPD, she
finds:
a- Tachycardia and tachypnea
b- Puffiness of eye and clubbing finger
C-Absent of cardiac pulsation and rhonchi
11 - The most common post operative discomforts all of the following
Except:
a- Pain
b- Urinary retention
c- Constipation and abdominal distention
d- Deep vein thrombosis
2
12- Hernia is located in the inguinal canal in the groin area is defined
as:
a- Umbilical hernia
b- Inguinal hernia
c- Femoral hernia
d- Incision hernia
13- One of the following is invasive interventions used to treat pain:a- Acupuncture
b- Heat therapy
c- Therapeutic touch
d- Vibration
14- Hypertensive manifested by:a- No clinical manifestations
b- Morning occipital headache
c- Epistaxsis
d- Restlessness, change in level of consciousness and blurred vision
15- Pain that occurs in an area of the body that is an remote from the
affected organ is called:
a- Phantom pain
b- Deep visceral pain
c- Superficial pain
d- Referred pain
16- Post operative complications of hernia all of the following Except
a- Edema of the scrotum
b- Hernioplasty
c- Urinary retention
d- Infection
17- From the causes of cholecyctitis all of the following Except one: a- Cholelithiasis
b- Secondary infection by gut organisms, predominantly E. coli
c- Endocrinopathies
d- Liver damage
18- Spider like blood vessels on the skin is:a- Symptoms of renal failure
b- Symptoms of cirrhosis
c- Symptoms of diabetes
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d- Complications of cirrhosis
19- From pharmacological therapy of hypertension:a- Angiotensin converting enzyme inhibitors
b- Beta blockers
c- Loop diuretics
d- All of above
20- From prevention of cirrhosis:a- Avoid alcohol consumption
b- Immunization for hepatitis
c- Following infection control measure to prevention viral hepatitis
d- All of the above
21- Severity of cirrhosis is measured by:a- (MELD) score
b- Glascow score
c- Cirrhosis score
d- Non of the above
22- When the patient taking capoten, the patient must be perform:a- Daily measuring blood pressure
b- Weekly blood analysis
c- Monthly urine analysis with leukocytic
d- Complete blood count analysis
23- A liver transplant indicated for cirrhosis:a- Is considered when complications of cirrhosis can not be
controlled by treatment
b- Is an option treatment
c- For prevention complication
d- All of the above
24- When the heart is converts to anaerobic metabolism, these means:a- Less oxygen
b- Less carbon monoxide
c-Less ATP and more lactic acid
d- All of the above
25- Directional coronary atherectomy ( DCA) Is:a- A balloon tipped catheter that inflated in to coronary artery to
cracking the a atherosclerotic lesion
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b- A catheter with rotating blade to shaves off atherosclerotic
region
c- A mechanical scaffold to reopen the blocked artery
a- Non of the above
26- From nursing care of cirrhotic patient all of the following Except
a-Promote activity intolerance
b- Improve nutritional status
c- Protect skin integrity
d- Prevent injury
27- Angina decubitis is chest pain that occur when the person is In:a- High fowler's position
b- At rest
c- Lying down
d- All of above
28- From classification of hypertension all of the following Except:a- Systolic and diastolic hypertension
b- Primary and secondary hypertension
c- Isolated systolic hypertension
d- Isolated diastolic hypertension
29- From loop diuretics:a- Lasix
b- Aldactone
c- Capoten
d- All of above
30 – Chronic renal failure is:a- A clinical syndrome characterized by a rapid decline in renal
function
b- A progressive, irreversible destruction of both kidneys
c- Adiminshed in renal reserve
d- All of above
II- Put circle around (T) if the statement is true and (F) if statement
is false: ( 16 Marks )
5
1- Hernia is decrease in size by coughing, straining, or constipation.
T
F
2- Defective carbohydrate metabolism is due to impaired ostrogen
level.
T
F
3- Core pulmonale and right heart failure are most common
complications of chronic obstructive pulmonary disease.
T
F
4-Myocardial infarction is a life threatening condition characterized
by formation of localized necrotic areas within endocardium.
T
F
5- By the end of the week in simulation phase in radiotherapy, the
technologist place permanent dots on patient skin.
T
F
6- Diminished renal reserve is characterized by normal BUN and
serum creatinine.
T
F
7-In blood gases for asthmatic patient, we found paco2 decreased.
T
F
8- Pain of cholecystitis located at the epigastria area. T
F
9-Deep somatic pain originates in muscles, nerves, bones, blood
vessels is dull and poorly localized.
T
F
10- Streptokinase to be effective, it must be given within 3 to 6 hours
after the onset of myocardial chest pain.
T
F
1
F
2
F
3
T
4
F
5
F
6
T
6
7
F
8
F
9
T
10
T
III- Matching
Score: 15
1 Azotemia
a Occur when the kidney can not synthesize
ammonia and ( HCO3) level decrease
2 Metabolic acidosis
b Occur when BUN and serum creatinine
level are elevated
3 Chronic bronchitis c Reversible hyper responsiveness lead to
narrowing of air ways
4 Asthma
d Enlargement of the air spaces duo to
dilation or destruction of alveolar walls
5 Emphysema
e Excessive mucus secretion from bronchial
tree
*** Read carefully the above questions and put
the correct answer in suitable place
1
b
2
a
3
e
4
c
5
d
1 Hyperphosphatemia a Is the use of cytotoxic drugs
2 Chemotherapy
3 Alopecia
b Occur in treatment area and depend
upon the dose and extent of radiation to
the scalp
c Is treated with reduced dietary intake
and phosphate binders such as
aluminum based antacids
4 Percussion
d Is a microscopic identification of
malignant cells from tumor tissue for
diagnosis of cancer
5 Diagnostic surgery
e Rhythematically clapping the chest wall
with cupped hands
*** Read carefully the above questions and put
the correct answer in suitable place
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1
c
2
a
3
b
4
e
1 Radiation therapy
a Bile leak ( biloma)
2 Central pain
b
5
d
State of metabolic dysregulation
characterized by the smell of acetone
3
c
Incisional hernia
Is the use of high energy ionizing particles
to treat cancer
4 Complications of
cholecystectomy
d It is located in an operative score due to
weakness of abdominal wall
5 Diabetic
ketoacidosis
e Is related to a lesion in the brain ,sever,
spontaneous and often continues ,may be
caused by vascular lesion ,tumor , trauma
or inflammation
*** Read carefully the above questions and put
the correct answer in suitable place
1
c
2
e
3
d
4
a
5
b
IV- Complete: (15 Marks )
1- The fibrous plaque that formed on surface of coronary artery
consists from
A-Smooth muscles cell
b- Collagen
c- Accumulated lipid
2- Atherosclerosis is primarily affects Intima of the arterial wall
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3- Enumerate 5 non invasive interventions used to treat pain
1-Cutaneous stimulation.
2-Auditory stimulation
3-Rest and sleep
4- Relaxation
5- Hypnosis
4-coronary artery bypass graft Is the by pass of a blockage in one or
More of the coronary arteries
5-Varina angina is a chest pain commonly happen at early hours of the day
6- When the abdominal cells infiltrate from the original site through lymph or
blood vessels to other areas of the body, this is called Metastasis.
7- Needle biopsy Is the aspiration of acore tissue samples through a
needle
8- Enumerate 5 causes of irreducible hernia:
1adhesion between the sac and the contents
2-over crowding of the contents
3-Narrow neck
4-huge long standing hernia
5-Dhesion between the contents
6- Sliding hernia
7- Omentum in the sac
9-Uremia Is a clinical situation in which a zotemia progresses to asymptomatic
state
10-The angina that precipitated by a heavy meal may last form 15 To 20.
Minutes
IV- Situation
Score: 15
Mrs. Noha , a thirty seven years old . House wife, living
with her husband and four children. She detected amass
in her breast .She is scheduled for right radical
mastectomy to be followed by radiotherapy.
Read carefully this situation and then answer the following
questions:
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1- Write the medical diagnosis to the condition of Mrs .noha?
Cancer
2- List role of nurse in preparing Mrs .noha on day of surgery?
1- Checks medical note
2- Check the consent from has been signed
3-Ensure pre operative assessment has been documented
4- Instruct the patient to remove artificial materials
5- The patient wears a hospital gown
3- Mention three nursing diagnosis for immediately post operative
phase?
1-Ineffective airway clearance related to effects of general
anesthesia
2- Impaired gas exchange related to incisional pain
3- Fluid volume deficit, potential, related to blood loss,
fluid deprivation and vomiting
4- Utilize the nursing care plan format to plan total care for Mrs
.noha?
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