B.Sc. (Nursing) Degree Examination
Fourth semester
(Revised/Modified Regulations)
Paper I - Principles and Practice of Adult Nursing/Medical Surgical Nursing

        Section C

SECTION -C  (15 x 1 = 20 marks)
    (Multiple Choice Questions)


Select the most appropriate response.
1.    The following factors predispose the oncologic patients to infection except
a)    Chemotherapy
b)    Radiation therapy        
c)    Malnutrition
d)    Over nutrition

2.    An indication for an elective surgery is  
a)    Intestinal obstruction
b)    Ureteral stone
c)    Extensive burns
d)    Simple hernia

3.    The temperature of the post anaesthesia recovery room should be
a)    20 - 22 C
b)    30 - 35 C
c)    10 - 12 C
d)    5 - 10 C

4.    The classic signs of shock include the fllowing except           
a)    Pallor, cool moist skin
b)    Shallow breathing with high BP
c)    Rapid breathing and ? pulse pressure
d)    Rapid weak thready pulse and low BP

5.    In phlebothrombosis, the patient with knee flexed may complain of pain in the calf muscle on dorsiflexion of foot the sign elicited is called
a)    Kernig's sign
b)    Brudzinski sign
c)    Homan's sign          https://www.youtube.com/watch?v=eI5c3PxFgm8
d)    Chvostek's sign      - https://www.youtube.com/watch?v=2tV4J2DxjNM

6.    In pericarditis while auscultating the type of sound heard during systole and diastole is
a)    Gallop sound
b)    Friction rub  - https://www.youtube.com/watch?v=jh8Zs7H3zjw
c)    Murmurs  
d)    Clicks 

7.    Cardiac specific CK isoenzyme is
a)    CK-MM                
b)    CK-BB
c)    CK-MB
d)    LDH

8.    Manifestations of left sided heart failure include the following except
a)    Orthopnoea
b)    Paroxysmal nocturnal dyspnoea
c)    Cough 
d)    Dependent oedema

9.    Reduction in all cellular elements of the blood is called 
a)    Hemophilia
b)    Anemia
c)    Thrombocytopenia
d)    Pancytopenia

10.    Nursing considerations in preparing a patient for fiberoptic sigmoidoscopy include the following except
a)    Administer warm tap water enema
b)    Put the patient nil orally
c)    Explain the procedure to patient
d)    Assist the patient to assume knee chest position

11.    Thyroid deficiency present is referred to as
a)    Myxoedema
b)    Cretinism 
c)    Goitre      
d)    Hypothyroidism

12.    An immediate observation of a burn patient would most importantly include
a)    Physical development 
b)    Head circumference  
c)    Height and weight   
d)    Quality of respirations

13.    A condition in which a bone fragment is pulled away by a ligament or tendon is known as
a)    Depressed fracture
b)    Strain
c)    Avulsion fracture
d)    Closed fracture

14.    The volume of air that is measured during a slow maximal expiration after a maximal inspiration is called as
a)    Forced inspiratory capacity
b)    Minute ventilation
c)    Vital capacity
d)    Residual volume

15.    The nursing considerations for a client on thiazide diuretic include the following except
a)    Watch for postural hypertension
b)    Administer supplementary potassium
c)    Measure blood pressure in three positions
d)    Caution the patient to rise slowly
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The Chvostek sign is a clinical sign of existing nerve hyperexcitability (tetany) seen in hypocalcemia. It refers to an abnormal reaction to the stimulation of the facial nerve. When the facial nerve is tapped in front of tragus the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of hypocalcemia (i.e. from hypoparathyroidism, pseudohypoparathyroidism, hypovitaminosis D) with resultant hyperexcitability of nerves. Though classically described in hypocalcemia, this sign may also be encountered in respiratory alkalosis, such as that seen in hyperventilation, which causes decreased serum Ca2+ with a normal calcium level due to a shift of Ca2+ from the blood to albumin

Trousseau sign of latent tetany : This sign may be positive before other manifestations of hypocalcemia such as hyperreflexia and tetany, more sensitive test than the Chvostek sign for hypocalcemia.
To elicit the sign, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. Neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and metacarpophalangeal joints flex, the DIP and PIP joints extend, and the fingers adduct. The sign is also known as main d'accoucheur (French for "hand of the obstetrician") because it supposedly resembles the position of an obstetrician's hand in delivering a baby.
https://www.youtube.com/watch?v=2tV4J2DxjNM
Hemophilia A, also called factor VIII (FVIII) deficiency or classic hemophilia, is a genetic bleeding disorder caused by missing or defective factor VIII, a clotting protein. Although it is passed down from parents to children, about 1/3 of cases are caused by a spontaneous mutation, a change in a gene.
Hemophilia A is four times as common as hemophilia B while more than half of patients with hemophilia A have the severe form of hemophilia.
Genetics
The X and Y chromosomes are called sex chromosomes. The gene for hemophilia is carried on the X chromosome. Hemophilia is inherited in an X-linked recessive manner.  Females inherit two X chromosomes, one from their mother and one from their father (XX). Males inherit an X chromosome from their mother and a Y chromosome from their father (XY). That means if a son inherits an X chromosome carrying hemophilia from his mother, he will have hemophilia. It also means that fathers cannot pass hemophilia on to their sons.
But because daughters have two X chromosomes, even if they inherit the hemophilia gene from their mother, most likely they will inherit a healthy X chromosome from their father and not have hemophilia. A daughter who inherits an X chromosome that contains the gene for hemophilia is called a carrier. She can pass the gene on to her children. Hemophilia can occur in daughters, but is rare.
For a female carrier, there are four possible outcomes for each pregnancy:
A girl who is not a carrier
A girl who is a carrier
A boy without hemophilia
A boy with hemophilia

Myxedema or myxoedema is a term used synonymously with severe hypothyroidism. However, the term is also used to describe a dermatological change that can occur in hypothyroidism and some forms of hyperthyroidism.
In this context, myxedema refers to deposition of mucopolysaccharides in the dermis, which results in swelling of the affected area. One manifestation of myxedema occurring in the lower limb is pretibial myxedema, a hallmark of Graves disease, an autoimmune form of hyperthyroidism. Myxedema can also occur in Hashimoto's thyroiditis and other long-standing forms of hypothyroidism

Cretinism :  http://www.examnnotes.com/Cretinism%20short%20note.html
Goitre - enlargement of the thyroid gland
May be in euthyroid status/hypothyroid status/hyperthyroid status
Avulsion Fractures
Depressed Fracture of skull
Lungvolumes Updated.png
TLC    Total lung capacity: the volume in the lungs at maximal inflation, the sum of VC and RV.
TV    Tidal volume: that volume of air moved into or out of the lungs during quiet breathing (TV indicates a subdivision of the lung; when tidal volume is precisely measured, as in gas exchange calculation, the symbol TV or VT is used.)
RV    Residual volume: the volume of air remaining in the lungs after a maximal exhalation
ERV    Expiratory reserve volume: the maximal volume of air that can be exhaled from the end-expiratory position
IRV    Inspiratory reserve volume: the maximal volume that can be inhaled from the end-inspiratory level
IC    Inspiratory capacity: the sum of IRV and TV
IVC    Inspiratory vital capacity: the maximum volume of air inhaled from the point of maximum expiration
VC    Vital capacity: the volume of air breathed out after the deepest inhalation.
VT    Tidal volume: that volume of air moved into or out of the lungs during quiet breathing (VT indicates a subdivision of the lung; when tidal volume is precisely measured, as in gas exchange calculation, the symbol TV or VT is used.)
FRC    Functional residual capacity: the volume in the lungs at the end-expiratory position
RV/TLC%    Residual volume expressed as percent of TLC
VA    Alveolar gas volume
VL    Actual volume of the lung including the volume of the conducting airway.
FVC    Forced vital capacity: the determination of the vital capacity from a maximally forced expiratory effort
FEVt    Forced expiratory volume (time): a generic term indicating the volume of air exhaled under forced conditions in the first t seconds
FEV1    Volume that has been exhaled at the end of the first second of forced expiration
FEFx    Forced expiratory flow related to some portion of the FVC curve; modifiers refer to amount of FVC already exhaled
FEFmax    The maximum instantaneous flow achieved during a FVC maneuver
FIF    Forced inspiratory flow: (Specific measurement of the forced inspiratory curve is denoted by nomenclature analogous to that for the forced expiratory curve. For example, maximum inspiratory flow is denoted FIFmax. Unless otherwise specified, volume qualifiers indicate the volume inspired from RV at the point of measurement.)
PEF    Peak expiratory flow: The highest forced expiratory flow measured with a peak flow meter
MVV    Maximal voluntary ventilation: volume of air expired in a specified period during repetitive maximal effort