Zagazig University
Faculty of Nursing
Medical Surgical Nursing, Part four 2nd Year
Midterm Exam
Date: 17 /4/2012
Time: 2 hours
Total Mark: 60 degrees
Answer all Questions
I- Multiple-Choice Questions:
(15 degrees)
1. What is the appropriate treatment for a suspected broken collarbone or
shoulder?
a- Apply a simple sling. Bind the sling to the chest with a cravat
b- Use the cross your heart padded chest support method
c- Use the flail chest protection system
d- Apply a modified “Johnson Traction Splint
2. Signals of head and spine injuries are:
a- Blood or other fluids in the ears or nose.
b- Unusual bumps or depressions on the head or over the spine.
c- Has seizures, severe headaches, or slurred speech.
d- Both a and b
e- All of the above
3. In general a splint should be….
a- Loose, so that the victim can still move the injured limb.
b- Snug, but not so tight that it slows circulation.
c- Tied with cravats over the injured area.
d- None of the above
4. A female patient postoperative is diagnosed with deep-vein thrombosis. Which
nursing diagnosis should receive the highest priority at this time?
a. Impaired gas exchange related to increased blood flow
b. Fluid volume excess related to peripheral vascular disease
c. Risk for injury related to edema
d. Altered peripheral tissue perfusion related to venous congestion
5. Researchers think the cause of rheumatoid arthritis may be:
a- Genetic
b- Environmental
c- Hormonal
d- All of the above
6. A client in the hospital has an indwelling urinary catheter, and the nurse is
instructing the nursing assistant in the appropriate care to provide. The nurse
teaches the assistant to:
a. Empty the drainage bag at least q8h
b. Cleanse up the length of the catheter to the perineum
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c. Use clean technique to obtain a specimen for culture and sensitivity
d. Place the drainage bag on the client’s lap while transporting the client to testing
7. One side of the bone is broken and the other is bent with this type of fracture
a- Greenstick Fracture
b- Closed Fracture
c- Spiral Fracture
d- Open Fracture
8. What makes bones so strong?
a- Silica.
b- Cartilage
c- Blood and marrow
d- Calcium and phosphorous.
9. What is the function of a tendon?
a- To link bones to bones
b- To link muscles to bones
c- To link muscles to ligaments
d- To bind the cells in compact bone closer together.
10. Which of the following may contribute to causing cancer?
a- A mutation in a gene that slows the cell cycle
b- Faulty DNA repair
c- Loss of control over telomere length
d- All of the above
11. A patient has a new cast on his right arm. While caring for him, it is important
to FIRST observe for
a- pulse above the cast.
b- Color and hardness of the cast.
c- warmth and color of fingers.
d- Signs of crumbling at the cast end.
12. The nurse on a postoperative care unit is assessing the quality of the client’s
pain. To obtain this specific information about the pain experience from the client,
the nurse should ask:
a. “What does your discomfort feel like?”
b. “What activities make the pain worse?”
c. “How much does it hurt on a scale of measuring the intensity of pain?”
d. “How much discomfort are you able to tolerate?”
13. A female client who received general anesthesia returns from surgery.
Postoperatively, which nursing diagnosis takes highest priority for this client?
a. Acute pain R/T surgery
b. Deficient fluid volume R/T blood and fluid loss from surgery
c. Impaired physical mobility R/T surgery
d. Risk for aspiration R/T anesthesia
14. More extensive means to diagnose a problem; usually involves a body cavity or
use of scope insertion through small incisions Name the type of surgery
a. Diagnostic
b. Exploratory
c. curative
d. palliative
e. cosmetic
15. Potential complications of very young during surgery
a. Respiratory obstruction and dehydration
b. Respiratory obstruction and fluid overload
c. Respiratory obstruction, fluid overload and dehydration
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d. Respiratory obstruction, fluid overload, infection and hypothermia
II- Put (T) if the statement is true or (F) if the statement is False and
correct the false one.
(10 Degrees)
1. People with rheumatoid arthritis are generally encouraged to reduce their physical
activity to relieve stress on their joints.
( )
2. Cartilage is a firm, dense type of connective tissue that consists of cells embedded in
a substance called the Bursae
( )
3. An arthrogram is a radiographic examination of a joint, usually the knee or shoulder
( )
4. The aims of cancer surgeries is; Diagnostic, Treatment, Prophylactic, Palliative
Surgery and Reconstructive
( )
5. Radiation is the use of anticancer drugs to treat cancerous cells
( )
6. The nurse identifies human responses preoperative to actual or potential health
problems during the nursing Assessing step of the nursing process
( )
7. The client who has a history of gout also is diagnosed with urolithisis and the stones
are determined to be of uric acid type. The nurse gives the client instructions in which
foods to limit, including liver
( )
8. The client arrives at the emergency department with complaints of low abdominal
pain and hematuria. The client is afebrile. The nurse next assesses the client to
determine a history of: pyelonephritis
( )
9. The urinary system is a highly efficient mechanism for removing waste products
from the urine
( )
10. A possible complication of cystoscopy is bladder infection
( )
III. Short answer for the following:
12345678-
(20 Degrees)
List three guidelines for applying a cast
List four risk factors of osteoarthritis
List the purpose of traction
Mention Seven Primary National Patient Safety Goals
Role of Scrub Nurse includes
List four steps for Cancer prevention strategies
Postoperative assessment recovery room includes
Causes of Urinary Retention includes
IV. Read the following situation carefully and answer the related questions:
(15marks)
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Situation: Mrs. Halla is 55 years old, she complaining of breast cancer and
undergoing mastectomy then treatment with radio and chemotherapy.
Questions from 1 & 2 related to the situation:
1. According to the previously mentioned situation.
a. Define cancer
b. Warning signs of cancer
c. Preoperative Nursing Intervention
d. Side effect of radio and chemotherapy
2. Apply nursing care plan for Mrs. Halla, to avoid the potential health problem as
a result of cancer and side effect of the receiving intervention.
Good luck
Dr. Nadia M Taha
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