RÉPUBLIC DU CAMEROUN REPUBLIC OF CAMEROUN
Paix-Travail-Patrie Peace-Work-Fatherland
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MINISTÈRE DE L’ENSEIGNEMENT SUPERIÉUR MINISTRY OF HIGHER EDUCATION
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COMMISSION NATIONALE D’ORGANISATION NATIONAL COMMISSION FOR THE
DE L’EXAMEN ORGANISAITON OF HIGHER NATIONAL
HIGHER NATIONAL DIPLOMA EXAM (HND) DIPLOMA EXAM (HND)
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Higher National Diploma (HND) Examination Session
Specialty/Option: Nursing
Paper: Case study
Duration: 5 Hours
Credits: 10
INSTRUCTIONS: Make sure you answer the questions neatly and orderly. Start each
section on a new page.
SECTION A: MULTIPLE CHOICE QUESTIONS (25MARKS)
Write the letter corresponding to the correct answer in your answer booklets.
1) What is the first intervention for a client experiencing myocardial infarction?
a. Administer morphine
b. Administer oxygen
c. Administer sublingual nitroglycerin
d. Obtain an electrocardiogram
2) A pulsating abdominal mass usually indicates which of the following conditions?
a. Abdominal aortic aneurysm
b. Enlarged spleen
c. Gastric distention
d. Gastritis
3) Which of the following classes of medications protects the ischemic myocardium by
blocking catecholamines and sympathetic nerve stimulation?
a. Beta-adrenergic blockers
b. Calcium channel blockers
c. Narcotics
d. Nitrate
4) Mr. T. has chest pain that radiates to his left arm. He is pale and perspiring profusely. An
ECG reveals necrosed heart tissue. His diagnosis is
a) Fibrillations
b) MI
c) Palpitations
d) CAD
5) This drug dilates blood vessels thereby increasing blood and oxygen supply to
myocardium
a) Nitrates
b) Beta blockers
c) ACE inhibitors
d) Calcium channel blocker
6) A congenital defect in which there is communication between the pulmonary artery and
the aorta is called:
a. Coarctation of the aorta
b. Tetralogy of fallot
c. Patent ductusarteriosus
d. Atrial septal defect
7) A congestive heart failure patient has been assessed with having pulmonary oedema and
peripheral oedema. He is place on a loop diuretic, beta blocker and digoxin. Which of the
following below is a loop diuretic?
a. Hydrochlorothiazide
b. Furosemides
c. Aldactone
d. Spironolactone
8) This patient admitted in your ward has type 1 diabetes mellitus. Laboratory examinations
indicate ketones in blood and on examinations his breath gives a “fruity” smell. What
will you suspect?
a. Hypoglycaemia
b. Hyperglycaemia
c. Diabetic ketoacidosis
d. Metabolic acidosis
9) It is a drug to treat vaginal candidiasis
a. Doxycycline
b. Penicillin
c. Ciprofloxacin
d. Fluconazole
10) A client who is having a mastectomy expresses sadness about losing her breast. Based on
this information the nurse would identify that the client is at risk for which nursing
diagnosis?
a. Body image disturbance
b. Anticipatory grieving
c. Fear
d. Ineffective coping
e. All of the above
11) Some critically ill patients quite often not psychotic but appear to suffer from delirium.
What can predispose these patients to delirium?
a. Anxiety and sleep deprivation
b. Haemodynamic instability and electrolyte disturbances
c. Hypoxemia and immobilization
d. All of the above
e. Only b and c are correct
12) The clinical sign of pre-eclampsia is
a. Proteinuria
b. Hypotension
c. Morning sickness
d. Hyperglycaemia
13) Prophylactic injection of Vitamin K is usually given to new-borns to prevents
a. Jaundice
b. Haemorrhage
c. Cyanosis
d. Night blindness
14) A client present to the emergency department complaining of decrease in urine out.
Monitoring the patient for the day, he is able to pass out just about 100ml of urine. He is
given 1000mls of normal saline, urine output after 2hours is 25ml. Lab results show a
blood urea level of 445ml/dl and creatinine of 2.2mg/dl. Based the finding the nurse
would anticipate that the client is at risk of
a. Urinary retention
b. Renal failure
c. Glomerulonephritis
d. Urinary tract infection
15) A physician orders 150mg of quinine for 6 years old child to be given as an infusion.
Quinine comes in 600mg/2ml. How many ml will the nurse need to constitute the
infusion?
a. 1ml
b. 1.5ml
c. 0.5ml
d. 0.75ml
16) A medication order reads “Amoxicillin suspension 250mg PO.” The pharmacist delivers
100ml/bottle with labelling stating “5ml contains 125mg of Amoxicillin” the nurse will
administer
a. 7.5ml
b. 10ml
c. 12ml
d. 15ml
17) A priority nursing action before a client receives blood transfusion is?
a. Obtain baseline vital signs
b. Discuss with the patient
c. Administer anti histamine
d. None of the above
18) When informed consent is obtained from the patient, the explanation of the surgical
procedure, possible risk, complications and alterations is the responsibility of the
a. Nurse
b. Surgeon
c. Anaesthetist
d. Admission clerk
19) Impotence is a disorder that indicates a problem with
a. Erection
b. Urination
c. Conception
d. Ejaculation
20) Epispadia affects the
a. Prostate
b. Epididymis
c. Scrotum
d. Urethra
21) A 35 year old complains of pains when having sexual intercourse with her partner. Which
term can be used to describe this?
a. Dysparaghia
b. Dysuria
c. Dyspareunia
d. None of the above
22) Removal of stones form the bladder is known as
a. Pyelolithotomy
b. Cystolithotomy
c. Nephrectomy
d. Ureterolithotomy
23) A patient is presenting with signs and symptoms of diabetes insipidus. Which is of the
following is not symptom of diabetes insipidus?
a. Polyuria
b. Polydipsia
c. Polyphagia
d. Weight loss
24) Tonsillitis is a common upper respiratory tract infections. Which of these may be a
symptom of tonsillitis?
a. Sore throat
b. Bad breath
c. Fever
d. Swollen lymph nodes
e. All of the above
25) Along with a sore throat and fever, which of these can be a symptom of an adenoid
infection in children?
a. Snoring during sleep
b. Recurrent ear infections
c. Breathing mostly with mouth open
d. Voice impairment
e. All of the above
SECTION B: SHORT ANSWER QUESTIONS (25MARKS)
1) Mr. L. has dizziness, confusion, and weakness on the left side of his body. Ultrasound of
his carotid artery shows blockage by fatty plaque.
a. Identify the condition (1mark)
b. Risk factors. (2marks)
c. Surgical treatment method (2marks)
2) A 5year school going child presents with a contagious viral infection characterised by
fever, conjunctivitis, coryza, cough and koplik’s spots and distinctive maculopapular rash.
a. What will you suspect? (1mark)
b. What is the incubation period? (1mark)
c. What are the predisposing factors? (3marks)
3) An elderly man has been warded in the surgical ward with the diagnosis of malignant
prostatic hypertrophy.
a. Identify the clinical manifestations of the condition (2marks)
b. What are the diagnostic procedures? (2marks)
c. What surgical interventions will be needed? (1mark)
d. Outline nursing care of this patient. (5marks)
4) A 60 year old female present with bleeding for more than a month. Physical examinations
and ultrasound result showed a uterine growth which is benign. She is programed for a
hysterectomy. How can you differentiate this tumour from a malignant tumour? (5marks)
SECTION C: ESSAY QUESTIONS (50MARKS).
Ensure proper presentation of nursing care plans following all key headings
1. Congestive heart failure will occur with respect to other heart disease.
a) Outline five (5) signs and symptoms of right heart failure (2.5marks)
b) Outline five (5) signs and symptoms of left heart failure (2.5marks)
c) State the nursing care of a patient with CHF (5marks)
d) Identify one nursing diagnosis and draw a nursing care plan. (5marks)
2. A 30 year old female presents to the hospital with swelling and bulging near the navel,
abdominal discomfort. It was reducible but has been irreducible for past 2days.
Ultrasound results indicated an incarcerated umbilical hernia.
a) What do you understand by hernia being incarcerated? (1mark)
b) Identify three (6) risk factors to the development of umbilical hernias? (3marks)
c) Key management procedure is surgically. Briefly outline the preoperative and
postoperative care given to the patient. (10marks)
d) What is this surgical procedure known as? (1mark)
3. This new born is diagnosed with convulsion (seizures) and has been admitted to the
neonatal ward for care and follow up.
a. Briefly explain the 2 types convulsions. (4mark)
b. Medical management of seizures (3marks)
c. What immediate first aid measures will you give to a convulsive child? (3marks)
d. Draw a nursing care plan for 3 priority needs of this child. (10marks)