MINISTRY OF HEALTH
CHIPATA SCHOOLS OF NURSING & MIDWIFERY
REGISTERED NURSING REGULAR/E-LEARNING 2015
INTAKES
HOSPITAL FINAL EXAMINATIONS
CANDIDATE’S NO: ……………
PAPER: ………………………….
DATE: ……………………………
WRITE No. OF QUESTIONS ANSWERED/
ATTEMPTED
No. No. No. No. No.
END OF FIRST YEAR RE-SIT EXAMINATION FOR REGISTERED
NURSING REGULAR/E-LEARNING 2015 INTAKES
NAME OF PAPER: SURGERY AND SURGICAL NURSING
DURATION: 3 HOURS
TIME: 09:00 HRS TO 12:00 HRS
DATE: 19. 02. 2018
INSTRUCTIONS TO CANDIDATES
1. Write your Exam number on each page of the question paper and answer booklet, both of
which must be returned.
2. This paper has section A, B, C and D. Answer all the questions in section A, B and C. For
section D, answer ONLY TWO (2) questions. Question ONE is compulsory.
3. Make sure all the pages inside the booklet are correct
4. Write on both sides of the paper using CLEAR HANDWRITING
5. DO NOT write on the margins, EXCEPT for question numbers
6. Start each question on a new page for essay questions.
7. DO NOT detach examination booklet
8. DO NOT leave the examination room in the 1st 30 minutes and the last 30 minutes of the
examination until you witness the ceiling of the examination papers
9. DO NOT TURN THE QUESTION PAPER UNTIL YOU ARE TOLD TO DO SO
10. FAILURE to abide to the above stated instructions will warrant disqualification of the
examination script
SECTION A
Multiple choice questions. Circle the letter with the most appropriate answer.
1. The type of surgery that occurs in the first 24 hours after an operation is:-
a) Arterial haemorrhage
b) Reactionary haemorrhage
c) Capillary haemorrhage
d) Venous haemorrhage
2. Sterilization where you use chemicals such as Cidex or Formalin is termed as:-
a) Cold sterilization
b) Dry sterilization
c) Autoclaving
d) Heat sterilization
3. The primary function of the thyroid gland is to synthesis and secrete:-
a) Thyroid stimulating hormone
b) Thyroid stimulating releasing hormone
c) Thyroxin
d) Tri-idothyronin
4. Contributing factors to breast cancer including one of the following:-
a) Smoking
b) Sexual active
c) Social class
d) Gender
5. The discharge from the ear due to a perforated ear drum is;-
a) Rhinorrhea
b) Otorrhea
c) Otitis media
d) Labyrinthitis
6. An increase in the number of cells of tissue is termed as;-
a) Hyperplasia
b) Dysplasia
c) Metaplasia
d) Neoplasia
7. ……………………… is the type of surgery whose purpose is beautification or alteration
in the natural make up of individuals.
a) Palliative
b) Optional
c) Cosmetic
d) Reparative
8. Which one of the following is a type of nasal polyps?
a) Spenoidal polyps
b) Vomer polyps
c) Ethmoidal polyps
d) Frontal polyps
9. The type of conjunctivitis that is caused by irritants is known as;-
a) Chemical conjunctivitis
b) Viral conjunctivitis
c) Bacterial conjunctivitis
d) Ophthalmic conjunctivitis
10. …………….. is deafness caused by a defect of the cochlear or its connecting nerves.
a) Conductive loss
b) Sensory hearing loss
c) Mixed hearing loss
d) Psychogenic hearing loss
11. According to WHO staging of trachoma, presence of scarring in tarsal conjunctiva is
stage:-
a) Stage I
b) Stage II
c) Stage III
d) Stage IV
12. One of the following is the function of the spleen:-
a) Production of red blood cells
b) Formation of lymph
c) Synthesis of vitamin K
d) Removal of abnormal red blood cells
13. ………….. is the type of pneumothorax where there is rapid accumulation of air in the
pleural space causing severe high intrapleural pressure.
a) Traumatic pneumothorax
b) Open pneumothorax
c) Tension pneumothorax
d) Simple/closed pneumothorax
14. The type of shock that occurs as a result of extreme or excruciating pain is:-
a) Anaphylactic shock
b) Cardiogenic shock
c) Neurogenic shock
d) Toxic shock
15. The stage in inflammation where there is vasodilatation resulting into hyperraemia or
redness is:-
a) Cellular response
b) Cellular healing
c) Exudate formation
d) Vascular response
16. The type of a wound which results from vigorous shaking of the head causing brain
function derangement without structural damage is;-
a) Concussion
b) Contusion
c) Abrasion
d) Incision
17. The organisms that mostly cause wet gangrene is:-
a) Clostridium tetani
b) Clostridium perfringes
c) Clostridium welchi
d) Clostridium septicum
18. Predisposing factors to haemorrhoids include the following:-
a) Fruity diet
b) Adequate intake of water
c) Vegetable diet
d) Sedentary occupation
19. ………………………… is a transparent tissue that forms the front part of the eye ball
covering the iris and pupil.
a) Conjunctiva
b) Lens
c) Cornea
d) Retina
20. A wound where there are irregular tear-like tissues caused by some blunt trauma is
known as:-
a) Abrasions
b) Penetrated
c) Punctured
d) Lacerated
21. Which factors does not influence wound healing positively?
a) Presence of nutrients
b) Presence of infection
c) Presence of blood supply
d) Absence of Diabetes Mellitus
22. An injury to a joint in which the normally adjacent joint surfaces become completely
separated from one another or it pops out of its socket is known as:-
a) Sprain
b) Strain
c) Dislocation
d) Fracture
23. A short or long leg cast with a rubber or metal walking device attached to the foot is
known as:-
a) Body cast
b) Shoulder spica cast
c) Hip spica cast
d) Walking cast
24. A fracture in which the break of a bone occurs at an angle across the bone is known as:-
a) Oblique Fracture
b) Depressed Fracture
c) Green Stick Fracture
d) Complicated Fracture
25. ………………………………………………… is the inflammation of the eyelid margins
a) Conjunctivitis
b) Blepharitis
c) Iritis
d) Rhinitis
26. The grade in which the haemorrhoids prolapses out of the anus with defecation or
straining but spontaneously returns to is normal anatomic position is:-
a) First degree
b) Second degree
c) Third degree
d) Fourth degree
27. The intraoperative phase begins:-
a) When the patient is diagnosed to have a surgical condition
b) When the patient is transferred into the operating room
c) When the patient is operated on and transferred to the ward
d) When the patient is admitted waiting the operation to be performed
28. The molecular weight of a fluid within a column is called:-
a) Electrical force
b) Active transport
c) Hydrostatic pressure
d) Osmotic pressure
29. An abnormal opening two epithelial tissues is known as:-
a) Sinus
b) Defect
c) Fistula
d) Aneurysm
30. The acquiring of large irregular shapes of nuclei of cancer cells is termed as:-
a) Carcinogensis
b) Pleomorphism
c) Anaplasia
d) Neoplasia
31. The type of operating rooms that consists of operating rooms, scrub up rooms, anesthetic
room and has storage space and changing room is known as:-
a) Single theatre suite
b) Twin theatre suite
c) Multiple theatre suite
d) Combined theatre suite
32. A test used to assess the conduction of sound through TONE is known as:-
a) Rinne test
b) Romberg test
c) Audiometry
d) Weber test
33. The stage of shock in which organ damage is so severe that the patient does not respond
to treatment and cannot survive is called:-
a) Compensatory stage
b) Recovery stage
c) Irreversible stage
d) Progressive stage
34. The type of splenomegaly in which there is portal hypertension and splenic vein
occlusion is called:-
a) Inflammatory splenomegaly
b) Congestive splenomegaly
c) Infectious splenomegaly
d) Hyperplasia splenomegaly
35. The examination that is done to examine the filtering angle and drainage of the eye is
called:-
a) Gonioscopy
b) Patchymetry
c) Tonometry
d) Visual field testing
36. The condition which results when there is an interference with the pumping of the heart is
known as:-
a) Anaphylactic shock
b) Vaso vagal shock
c) Cardiogenic shock
d) Hypovolaemic shock
37. A condition in which there is a fine white mat topped black spheres in the ear is called:-
a) Otitis externa
b) Otitis media
c) Otomycosis
d) Eczematoid
38. The endocrine hormones produced by the pancrease are:-
a) Pancreatic juice and Glucagon
b) Cystokinines and Insulin
c) Insulin and Glucagon
d) Pancreatic juice and Insulin
39. Intracellular fluid accounts to what percentage in a normal human body?
a) 60%
b) 45%
c) 40%
d) 55%
40. The largest lymph1atic tissue in the body is the;-
a) Spleen
b) Thymus
c) Liver
d) Appendix
41. Dislocation does not occur at one of the following points:-
a) Thumb
b) Hip
c) Wrist
d) Elbow
42. The second stage in the process of wound healing is …………….
a) Phase of traumatic inflammation
b) Proliferative phase
c) Maturation phase
d) Destructive phase
43. The type of prostatectomy where an incision is made into the lower abdomen and the
bladder is opened is known as :-
a) Retropubic
b) Perineal
c) Suprapubic
d) Transurethral
44. ………………………………….. is a type of chest injury where three or more adjacent
ribs are fractured in two or more parts on the same side.
a) Flail chest
b) Pneumothorax
c) Haemothorax
d) Pulmonary contusion
45. An injury to a joint in which the normally adjacent joint surfaces become completely
separated from one another is
a) Fracture
b) Dislocation
c) Sprain
d) Strain
46. The third stage in the bone healing process is the :-
a) Granulation tissue
b) Callus
c) Consolidation
d) Remodeling
47. One of the following is not a means of fracture immobilization
a) Plaster of Paris
b) External fixation
c) Internal fixation
d) Clutches
48. According to Roman Numeral staging of cancer. In stage 0, the cancer is:-
a) Locally advanced
b) Localized to one part of the body
c) In situ
d) Spread to other parts of the body
49. The branch of medicine dealing with the care of the elderly is known as
a) Pediatric
b) Geriatric
c) Forensic
d) Obstetric
50. The drug of choice in a patient with increased intracranial pressure is
a) Phenytoin
b) Normal saline
c) Phenobarbitone
d) Mannitol
SECTION B
Match the following terms in Column I with their appropriate definitions in Column II.
Responses in Column II should only be used once.
COLUMN I COLUMN II
51. .......... Halos a. Inability to maintain a clear image as objects
are moved closer
52. .......... Myopia b. Pupillary dilation
53. .......... Strabismus c. Rings around light due to optical imperfections in
front of the eye
54. ……… Presbyopia d. Inability to see distant objects as clearly as near
objects
55. ……… Mydriasis e. Muscles of the eye do not align properly and
binocular vision is not present
f. Degree of vision distortion
g. Single objects are is perceived as two
Match the signs and symptoms of inflammation in Column I with the possible causes in Column
II. Response in Column II should only be used once.
COLUMN I COLUMN II
56. ………Redness a. Due to reflex inhibition of muscular movement
57. ………Pain b. Due to local oedema caused by accumulation of
fluid exudates in the extravascular spaces
58. ………Swelling c. Due to a rise in tissue tension within the
inflamed area
59. ……….Heat/warmth d. Due to gross and persistent dilatation of small
vessels within the area of injury
60. ……….Loss of function e. Due central part of the body and the circulating
blood to the peripheral
f. Due to the toxins irritating the tissues
g. Due to fulminating organisms on the edges
Match the types of chest injuries in column I with their appropriate definitions in Column II.
Responses in column II should only be used once.
COLUMN I COLUMN II
61. …….. Flail chest a. Presence of air in the pleural cavity
62. …….. Chylothorax b. Presence of blood in the pleural cavity
63. ………Pleural effusion c. Presence of pus in the pleural cavity
64. ……….Haemothorax d. Three or more adjacent ribs are fractured in two
more parts on the same side
65. ……… Empyema e. Presence of water in the pleural cavity
f. Presence of milky substances in the pleural space
g. Presence of micro-organisms in the pleural space
Match the types of wounds in Column I with their causes in Column II. Responses in column II
should only be used once.
COLUMN I COLUMN II
66. ……… Contused a. A clean, sharp-edged object such as a razor
67. ……… Alvusion b. Blunt objects such as barbed wire
68. ……… Abrasion c. An object puncturing the skin, such as a nail or needle.
69. ………. Laceration d. Removal of part of a tissue such as dog bite
70. ……….. Punctured e. Friction to the superficial layer such as pulling on floor
f. Object like a knife entering and coming out from the skin
g. Blunt force trauma that damages tissue under the skin.
SECTION C
71. The …………………………….... are type of cells in the eye that are sensitive to light.
72. The condition characterized by the presence of gall stones in the gallbladder is termed as
………………………………………………………………………………………………
73. ………………………………………………… is a clear fluid secreted by the ciliary
body of the eye which prevents retinal detachment.
74. A tonsillar abscess is termed as ……………………………………………………………
75. A new bone tissue that grows on the dead bone is termed as ……………………………...
76. The ………………………………………………..equalizes the pressure between the
inner and outer surfaces of the tympanic membrane
77. The mass of debris of tissues that collects in the middle ear during chronic otitis media is
known as …………………………………………………………………………………..
78. ………………………………………………. is the kind treatment alongside the
treatment for the main primary tumour
79. A severe form of bacterial conjunctivitis that occurs in newborn babies is known as
………………………………………………………………………………………………
80. An ocular disease characterized by raised Intraocular Pressure is termed as
…………………….………………………………………………………………………...
81. A ………………………………………………… is a stretching or tearing of ligaments
82. Dilatation and swelling of veins around the anus or lower rectum is known as
………………………………………………………………………………………………
83. The ischaemic heart disease in which there is chest pain with a sense of strangling and
anxiety which is produced by exercise and emotion is …………………………………….
84. …………………………………………. is a cut or break in the continuity of any tissue
caused by injury or operation.
85. The type of radiotherapy that involves placement of specifically prepared isotopes
directly into the tumour itself is known as …………………………………………………
86. The period during which the patient is in theatre and the procedure is in process is known
as ………………………………………………………………………………………….
87. The medical term for increased sensitivity to pain is ……………………………………...
88. Elective surgeries are also known as non-urgent or …………………………… operations
89. A medical term used to describe the death of an area of the body is ………………………
90. Operations can broadly be divided into two namely emergence and ……………………...
91. A procedure in which a gastroenterologist uses rubber bands to block the blood supply
for varices is called ………………………………………………………………………...
92. The ability of the eye to change its focus between distant objects and near objects is
known as …………………………………………………………………………………...
93. The fluid that people loose through evaporation or from moist surfaces of the skin and
respiration is known as ……………………………………………………………………..
94. …………………………………………… is the separation of all the layers in an
abdominal wound and the protrusion of a loop of the intestines into the surface may
occur.
95. The presence of undigested fat in stool is called ………………………………………….
96. …………………………………….. is a graphic record of the heart’s electrical activities.
97. Glands that have ducts that carry their secretory products to the surface are known as
………………………………………………………………………………………………
98. The medical term used for a normal functioning thyroid id ……………………………….
99. The hormone responsible for raising blood sugar levels when they are low is
………………………………………………………………………………………………
100. …………………………………. is a condition in which there is a startled facial
expression due to excessive fat collection behind the eyeball.
SECTION D
Answer only two essays from this section. Question one (1) is compulsory.
1. Idah Phiri a 25 years old young lady of Nadalisika Compound is admitted to your
surgical ward from theatre after tracheostomy.
i. Define the term tracheostomy 5%
ii. Explain five (5) indications of tracheostomy 20%
iii. Discuss the post operative care of Idah Phiri until discharge 50%
iv. Explain five (5) specific complications of tracheostomy and how they can be
managed 25%
2. Mr. Chanda Mutale a 60 years old farmer is admitted in your surgical ward with history
of constipation and vomiting fecal matter. After thorough investigations, a diagnosis of
intestinal obstruction is made.
i. Define the term Acute abdomen 5%
ii. Explain four (4) types of hernias 20%
iii. Discuss the pre-operative care of Mr. Chanda Mutale 50%
iv. Explain five (5) post-operative exercise you would have taught Mr. Chanda
Mutale pre-operatively to avoid occurrence of complications after surgery
25%
3. Mr. Mukango Lipase a 65 years old man is admitted to your surgical ward with
complaints of dribbling urine and urgency. After thorough investigations a diagnosis of
benign prostate hypertrophy is made.
i. State four (4) signs and symptoms of prostate hypertrophy 20%
ii. Outline four (4) types of prostatic surgery 20%
iii. Discuss the post-operative care of Mr. Mukango Lipase within the first 48 hours
45%
iv. Explain five (5) points you would include in your information, education and
communication to Mr. Mukango Lipase on discharge 15%