WELCOME TO NOSIKUREVISIONS IN MEDICINE

PAMPHLET

CONTENTS OF THE PAMPHLET

 400+ ONE WORD ANSWERS
 200 CROSS MATCHING
 4 PHRASED ESSAY QUESTIONS

AIM
THIS IS TO IMPACT KNOWLWDGE AND SKILL BY APPLYING CREATIVITY
AND INOVATION IN ANSWERING QUESTIONS
1. Capillary refill test is also known as ____________________________________

Ans: Blanching test

2. A broad, painless, pink-gray, wart like infectious lesions may develop on the vulva, premium or anus in
syphilis is called __________________________________

Ans: Chancre

3. In suspected syphilis infection the term RPR stands for ________________________________

Ans: Rapid Plasma Reagin

4. The recommended dosage of Benzathine Penicillin in an adult in Zambia is ___________________

Ans: 2.4 mu im stat or 8tmls-10mla

5. The recommended drug tor treatment of gonorrhea when using syndromic management is called
______________________________

Ans: Ciprofloxacin

6. The causative organism for Chancroid is called ___________________________

Ans: Haemophilus Ducreyi

7. The commonest type of HIV is _______________________

Ans: Type 1

8. The assertive, problem solving approach to identification and treatment of the patient’s problem is
called ______________________________

Ans: Nursing process

9. A tumour arising from the cells producing melanin is also known as ________________________

Ans: Melanoma

10. The type of sound described as drum like, loud, empty quality felt over gas filled stomach, intestine
or pneumothorax which is heard during percussion as called ____________________________

Ans: Tympanic percussion/sound

11. The insertion of the needle through the chest wall into the pleural space to obtain a specimen or
remove fluids is called ______________________________

Ans: Thoracentesis / Thoracocentesis

12. The increased production of Red Blood Cells is called __________________________

Ans: Polycythemia
13. EFV is an abbreviation for which antiretroviral drug ___________________________

Ans: Efavirenz

14. The third stage in the clinical progression of acute renal failure 15 termed as _____________
stage/phase.

Ans: Diuretic

15. In renal failure, urea is excreted in sweat and crystallizes on the skin to form ______________

Ans: Uremic frost

16. In renal failure, the bitter metallic taste in the mouth is due to accumulation of ______________- in
the mouth.

Ans: Urea

17. The drug of choice for treatment of Filariasis is _________________

Ans: Diethylcarbamazine

18. ____________________ is a branch of Medicine that deals with the study of skin diseases

Ans: Dermatology

19. Cheilitis is the inflammation of the ___________________________

Ans: Lips

20. Diabetes caused by lack of ADH is called ___________

Ans: Diabetes Insipidus

21. The irreversible widening (dilation) of the portion of the bronchi resulting from damage to bronchial
wall is called ________________

Ans: Bronchiectasis

22. An instrument that is used to determine the degree of flexion or extension of the joint is
___________________

Ans: Patella hammer

23. The position which is suitable for examination of the rectum and vagina is __________________

Ans: Dorsal position

24. During health assessment, data that is obtained through observations and physical examination is
called _________________

Ans: Objective data

25. The test used for diagnosis of liver conditions and monitoring the toxic effects of some drugs is called
___________________________

Ans: Liver Function Test

26. A chronic non-specific inflammatory bowel disorder of unknown origin that can affect any part of the
gastro intestinal tract is known as ___________________

Ans: Crohn's disease

27. The causative organism of Paratyphoid fever is called ___________________

Ans: Salmonella paratyphi

28. The inflammation of the tonsils is known as ___________________

Ans: Tonsillitis

29. A period from the time of infection until an antibody test is positive is known as _____________

Ans: Window period

30. A situation when treatment regimen is no longer able to sustain viral suppression and consequently
is unable to control the HIV disease is called ___________drug _____________________

Ans: Treatment failure

31. What test is done to detect the presence of specific DNA and RNA that indicates presence of HIV? __

Ans: Polymerase chain reaction (PCR)

32. Chronic granulomatous disease affecting the skin and the peripheral nervous system is called ______

Ans: Leprosy

33. Production of Red Blood cells is referred to as ____________

Ans: Erythropoiesis

34. Resistance to flexion of the neck due to meningeal irritation is called ________________

Ans: Nuchal Rigidity

35. Periodic episodes of red blood cell sickling with sudden severe pain are called ______________

Ans: Pain crisis

36. Pyogenic meningitis is the same as ____________________

Ans: Bacterial meningitis

37. The general term for lung diseases caused by inhalation and retention of dust particles _________

Ans: Pneumoconiosis
38. Obstruction of a blood vessel caused by a traveling blood clot, particle or matter is referred to as
___________

Ans: Embolism

39. The factor missing in Hemophilia B is _________________

Ans: IX

40. A disease in which white blood cells are not properly formed and start increasing in number in a
malignant way is known as ______________

Ans: Leukemia

41. In malaria, the form of plasmodia that is transmitted from mosquito to human is _________

Ans: Sporozoites

42. A substance that is found in tobacco and contributes to vasoconstriction and consequently
hypertension is ___________________

Ans: Nicotine

43. Inability to breathe easily except in an upright position is called ______________

Ans: Orthopnea

44. A bluish coloring of the skin and mucus membrane indicates _______________

Ans: Cyanosis

45. The type of pneumonia which is due to inhalation of fluid, foods or vomitus into the airway is called
__________________

Ans: Aspiration pneumonia

46. The organism that is implicated in cryptococcal meningitis is called _________

Ans: Cryptococco neoformas

47. The type of Filariasis associated with Blindness is ________________________

Ans: Onchocerca volvulus

48. Fluid present between the brain/spinal cord and the meninges is called ________________

Ans: Cerebral spinal Fluids

49. The amount of fluid filtered from the blood into the capsule per minute is called _______________

Ans: Glomerular Filtration rate

50. What is the intermediate host for the schistosomes? ____________________-

Ans: Snail
51. What does the kidney secrete for the purpose of stimulating bone marrow activity __________

Ans: Erythropoietin.

52. With regard to urine formation, most reabsorption of Substances from the glomerular filtrate occurs
in the _____________________

Ans: Proximal convoluted tube

53. Antidiuretic hormone regulates the reabsorption of _______________

Ans: Water

54. The microscopic larval stage of lymphatic Filariasis parasites that circulates in the blood and is
transmitted by mosquitoes is the ___________________-

Ans: Microfilariae

55. The thickening, hardening and loss of elasticity of the walls of arteries is called ________________

Ans: Atherosclerosis

56. Obstruction of a blood vessel caused by a travelling blood clot, particle or matter is referred to as
_________

Ans: Embolism

57. The term used to describe low oxygen levels in the blood is _______________-

Ans: Hypoxemia

58. Sudden impairment of cerebral circulation in one or more of the blood vessels supplying the brain is
called _______________________

Ans: Cerebral vascular accident

59. The process of restoring a disabled client to the highest levels of functioning possible is ___________

Ans: Rehabilitation

60. The heart is enclosed in a protective covering called ___________________

Ans: Pericardium

61. An inappropriately high urine volume of greater than 3 liters/ per day is called _______

Ans: Polyuria
62. The appearance of blood in urine is known as _______________________

Ans: Hematuria

63. An inflammation of the glomerular capillaries is known as ___________

Ans: Glomerulonephritis

64. Infestation involving beef and pork worms are commonly called ___________

Ans: Taeniasis

65. Diphyllobothirium latum is called ______________________

Ans: Fish tape worm

66. Production of RBCS is referred to as _______________________

Ans: Erythropoiesis

67. Valvular heart disease is sometimes referred to as _____________----

Ans: Rheumatic heart disease

68. The single most important investigation in every patient suspected of a chest disorder is called ____

Ans: Chest X-ray

69. An x-ray taken after opaque fluid has been instilled into the trachea, so outlining the clarity the
bronchi and bronchioles is known as _______________________

Ans: Chest Fluoroscopy

70. Consistent heart rate greater than 100 beats/minutes is called ______________

Ans: tachycardia

71. ________________ is the amount of air involved in one normal inhalation and exhalation

Ans: Tidal Volume

72. The name of the buccal cavity is called

Ans: Mouth

73. The potential space between the two layers of pleura called _______________

Ans: Pleural cavity

74. The hormone that increases the reabsorption of water by the kidney tubules and decreases the
amount of urine is called _________________

Ans: Antidiuretic hormone or Vasopressin

75. The number of lobes on the left lung is _____________

Ans: Two (2) lobes

76. A micro-organism which can live or thrive in the presence of oxygen is called __________

Ans: Aerobic

77. Examination of the chest using stethoscope is termed as ________________

Ans: Auscultation

78. Ankylostoma duodanale and nector americanus are collectively known as _______

Ans: Hookworm

79. The infective stage for Trichuris Trichiura is called the __________________

Ans: Embryonated egg

80. Excessive eating is an anornmally in Diabetes mellitus which is referred to as ___________-

Ans: Polyphagia

81. A protozoa infection caused by trichomonas vaginalis is called ____________

Ans: Trichomoniasis

82. The STI associated with thick cud like discharge is ________________

Ans: Candidiasis

83. The causative organism for syphilis is called _______________

Ans: Candidiasis

84. Infection with entamoeba hystolica can lead to _____________________

Ans: Amoebiasis

85. Hookworm infestation is caused by two (2) hook worm species namely ____________________ and
___________________

Ans: Ankylostoma and Necater Americanus

86. Infestation involving beef and pork worms are commonly called _____________________

Ans: Taeniasis

87. Fish tape worm is called _______________

Ans: Diphyllobothirium

88. With regard to secondary lesions ______________ is the thinning of skin surface at site of disorder.

Ans: Atrophy
89. The most superficial layer of the skin and is composed of stratified keratinized squamous epithelium
is the ___________________

Ans: Epidermis

90. The other name for genital warts is ______________

Ans: Codylomata acuminata

91. An inflammatory disease of the skin glands and hair follicles characterized by comedones, pustules
and nodular lesions is______________

Ans: Acne vulgaris

92. The primary ulcerative lesion in syphilitic infection is known as______________

Ans: Chancre

93. _________________ is a superficial skin infection that usually causes scaring.

Ans: Ecthyma

94. Genital ulcers preceded by vesicles are typical for _________________

Ans: Genital herpes

95. Ascariasis is a human disease caused by the parasitic roundworm known as __________________

Ans: Ascaris Lumbricoides

96. The other name for Hook worm disease is _______________

Ans: Uncinariasis

97. The medical condition caused by pinworm infestation is known as ______________

Ans: Enterobiasis

98. Complication of Malaria arising due to the leakage of haemoglobin from lysed red blood cells into
urine is called ____________________

Ans: Black water fever

99. With regard to the treatment of Trypanosomiasis due to T. b. Rhodesiense, which drug is used in the
treatment of the second stage disease ________________

Ans: Melarsoprol

100. The thickening of prominent skin markings caused by constant rubbing is called
_________________

Ans: Lichenification
101: What do you call a state in which eosinophil’s accumulate in the lung in response to a parasitic
infection ________________

Ans: Loffler’s syndrome

102. A condition that arises as taenia larvae migrate to the brain causing severe headaches, seizures and
other neurological problems is called _______________

Ans: Neurocysticercosis

103. The protozoa that causes Human African Trypanosomiasis is called ______________

Ans: Trypanosoma Brucei

104. The microscopic larval stage of lymphatic filariasis parasites that circulates in the blood and is
transmitted by mosquitoes is the ______________

Ans: Microfilariae

105. The erythematous rashes which forms on the mucosal surface in secondary stage of syphilis is
called __________________

Ans: Condylomata lata

106. The protozoa that cause American Trypanosomiasis is called _______________

Ans: Trypanosoma Cruzi

107. With regard to malaria, which plasmodium is not responsible for the chronic carrier state
_______________?

Ans: Plasmodium Falciparum

108. The causative organism of gonorrhea is ___________________

Ans: Neisseria gonorrhoea

109. A fibrous tissue caused by trauma, deep inflammation or surgical incision is called ______________

Ans: Scar

110. An elevated solid lesion lager than 2cm in diameter that extends into the dermal and subcutaneous
layers is called______________

Ans: Tumour

111. The tsetse fly that transmits Trypanosoma brucei rhodesiense is _________________

Ans: Glossina Morsitan

112. With regard to the treatment of Trypanosomiasis due to T. b. Rhodesiense what is the name of the
drug used to treat the first stage of the disease ___________________

Ans: Suramin
113. The necrotic lesion of varying size that appears the skin, testis, liver and bones in tertiary syphilis
are called _______________

Ans: Gamma

114. The vector responsible for the transmission of malaria is the ________________

Ans. Anopheles Mosquitoes

115. Coartem is a combination of __________________________

Ans: Artemeter and Lumefantrine

116. Round worm infestation is also known as _______________________

Ans: Ascariasis

117. Abnormal low white blood cell count is called ________________

Ans: Leukopenia

118. The other name for hook worm disease is _________________

Ans: Ancylostomitasis or Uncinariasis

119. A substance that is found in tobacco and contributes to vasoconstriction consequently by

hypertension is called __________________-

Ans: Nicotine

120. A condition in which the three (3) types of blood cells are in abnormally low is called ____________

Ans: Pancytopenia

121. Rabies is also known as __________________________

Ans: Hydrophobia

122. Leprosy is also known as __________________

Ans: Hansen's disease

123. Vomiting of blood is referred to as _____________

Ans: Hematemesis

124. Difficulty speaking and understanding speech is termed as ________________

Ans: Aphasia

125. In diabetes mellitus, excessive thirst is known as _________________

Ans: Polydipsia
126. With regard to malaria, plasmodium ________________ is responsible for chronic carrier state

Ans: Plasmodium Falciparum

127. The type of hemophilia due to deficiency in clotting factor XI is known as _____________

Ans: Hemophilia C or Rosenthal Syndrome

128. The number of (copies/ml) RNA particles in the blood is known as ________________

Ans: Viral load

129. CD4 stand for ______________________

Ans: Cluster of Differentiation 4 (CD4)

130. A grayish blue or ashen colour on nail bed seen on physical examination is an indication of _______

Ans: Cyanosis

131. The permanent and abnormal dilatation in one or more large bronchi is called _____________

Ans: Bronchiectasis

132. The term used to describe low oxygen levels in the blood is ________________

Ans: Hypoxemia

133. The drug of choice for treatment of severe malaria is _____________________

Ans: Artesunate

134. The assessment tool that is used to determine the patient level of consciousness is called ________

Ans: Glascow Coma Seale

135. Sputum containing blood is called

Ans: Hemoptysis

136. The type of asthma which occurs where there is no causative agent and is usually secondary to
respiratory tract infections is _______________

Ans: Intrinsic Asthma

137. Administration of drugs into the bones is called ___________________

Ans: Intraosseeous

138. Oxygen is transported in the hlo0d as chemical compound called _____________

Ans: Oxyhemoglobin

139. With regard to Syphilis, in which stage of infection is the chancre found ____________

Ans: Primary Stage

140. The Virus that causes cervical cancer is ________________

Ans: Human Papilloma virus

141. The identification of consistent groups of symptoms and easily recognizable signs and the provision
of treatment that will deal with the majority of organisms responsible for each syndrome is referred to
as _____________

Ans: Syndromic management

142. The most common causes of scrotal swelling _____________

Ans: Hydrocele

143. Which parasite infection is are more common within families with school-aged children, in primary
caregivers of infected children, and in institutionalized children ________________

Ans: Pin worm

144. The study of the skin, including its structure, functions and treatment is known as _____________

Ans: Dermatology

145. A chronic, recurrent, inherited, and occasionally acute inflammatory disease characterized by well-
defined papules, or plaques of varying size is called _____________

Ans: Psoriasis

146. What do you call a condition in which there are patches of depigmentation of the skin due to loss of
melanocytes ___________?

Ans: Vitiligo

147. A group of inherited conditions in which there is lack of melanin in the skin, hair and eyes is ______

Ans: Albinism

148. Which of the layers of skin does not contain any blood vessels ________________

Ans: Epidermis

149. Which layer of the epidermis sheds keratin cells that are constantly replaced _____________

Ans: Stratum corneum

150. The Sebaceous glands, sensory nerve endings, blood vessels erector Pilli muscles and a major
portion of each hair follicle are found in which layer of the ________

Ans: Dermis

151. What substance does the sebaceous gland produce ________________?

Ans: Sebum
152. What protects the skin from harmful ultraviolet rays ___________

Ans: Melanin

153. Which disorder is caused by excessive secretion of the sebaceous glands?

Ans: Seborrhea

154. The lack of perspiration caused by fever or disease is called __________

Ans: Anhidrosis

154. An acute eruption of intensely itchy papules or wheals is called ___________

Ans: Anhidrosis

155. Moles with the potential to develop into malignant melanoma are called ________

Ans: Urticaria

156. Moles with the potential to develop into malignant melanoma are called _______

Ans: Dysplastic Nevi

157. Excessive hair on the face or body especially in women is called ________

Ans: Hirsutism

158. Chronic dermatitis of unknown etiology patients with history of allergy is called _____

Ans: Atopic dermatitis

159. The skin, hair, nails and glands all make up this system of the body _________

Ans: integumentary system

160. A small elevation of skin containing purulent material is called _________

Ans: Pustule

161. The other name for herpes zoster infection is ________________

Ans: Shingles

162. An acute abscess formation in adjacent hair follicles is called a _____________

Ans: Wheal

163. A comprehensive papule or plaque of dermal edema is called ________________

Ans: Wheal

164. With regard to the different plasmodium causing malaria, which organism causes the most
dangerous form of malaria ____________?

Ans: Plasmodium Falciparum

165. What helminthic is responsible for causing the greatest number of worm infections worldwide ____

Ans: Ascaris Lumbricoides

166. What helminthic infection results in elephantiasis ____________?

Ans: Bancroft Filariasis

167. What is the intermediate host for the schistosomes’ ______________?

Ans: Snails

168. With regard to Schistosomiasis, which specific schistosoma causes urinary Schistosomiasis
_________?

Ans: Schistosoma Hematobium

169. The type of sound described as drum like, laud empty quality felt over gas filled stomach, intestine
or pneumothorax which is heard during percussion is called ___________

Ans: Tympanic percussion

170. A condition of the lung characterized by collapsed, airless, alveoli is called ___________

Ans: Atelectasis

171. __________ is a sexual phase in the life cycle of malaria parasite taking place in the mosquito

Ans: Sporogony

172. The dosage for praziquantel in adult is _____________

Ans: 40mg/kg body weight

173. The nursing measure you should take before giving digitalis is __________

Ans: check pulse rate

174. The test used to diagnose liver conditions and also monitoring the toxic effect of some drug is
called _____________________

Ans: Liver Function Test

175. A chronic non-specific bowel disorder of unknown origin that can affect any part of the gastro
intestinal _______________

Ans: Crohn's Disease

176. The Causative organism for paratyphoid fever is _______________

Ans: Salmonella paratyphi

177. Coughing of bloody sputum I called _____________________

Ans: Hemoptysis
178. The seizures that persists for at least 30 minutes, or is repeated so frequently that recovery
between attacks does not occur is called _________________-

Ans: Status Epilepticus

179. The heart disease that comes about due to long standing lung disease is called ________

Ans: Pulmonary heart disease or Cor Pulmonale

180. Cholecystography is the radiological examination of the _________________

Ans: Gall bladder

181. The drug of choice for shigellosis treatment is ________________

Ans: Nalidixic acid

182. An examination of the body tissues to and organ using the sense of touch is called _________

Ans: Palpation

183. With regard to skin lesions, a circumscribed, superficial collection of serous fluid is called ____

Ans: Vesicle

184. With regard to skin lesions, an elevated, firm circumscribed >1cm in diameter is called _____

Ans: Nodule

185. With regard to skin lesions, a circumscribed elevated superficial solid is called ________

Ans: Plaque

186. A greyish blue or ashen-grey colour on nail beds seen on physical examination is an indication of
________

Ans: Cyanosis

187. A state of bruising and bleeding under the skin is called ____________

Ans: Ecchymosis

188. With regard to skin lesions, an area of skin from which the whole of the epidermis and part of
dermis has been lost is called _________________________

Ans: Ulcer

189. With regard to skin lesions, damage to skin as a result of scratching resulting in a linear ulcer is
called ________________

Ans: Excoriation
190. With regard to skin lesions, a plug of keratin and sebum wedged in a dilated pilosebaceous orifice is
called ___________________

Ans: A Comedone

191. With regard to skin lesions, a streak-like linear darkish lesion due to changes in connective tissue is
called ________________

Ans: a Stria

192. With regard to skin lesions, a group of small papule which can be palpable is called _____________

Ans: Rash

193. With regard to skin lesions, a flat, irregular shaped macule > 1cm is called __________________

Ans: A Patch

194. With regard to skin lesions, a vesicle of greater than 1cm is called __________________

Ans: A Bulla

195. In which type of psoriasis do you find eruptions in drop-sized plaques over the trunk and arms and
legs ___________________?

Ans: Guttate Psoriasis

196. In which type of psoriasis do you find smooth, dry red plaques in skin folds which fissure easily
________________?

Ans: Inverse Psoriasis

197. In which type of psoriasis do you find dot like lesions that gradually enlarge and produce dry silvery
scales ______________

Ans: Psoriasis Vulgaris

198. What is the causative organism of Genital warts _____________?

Ans: Human Papilloma Virus

199. What causes Threadworm infestation _____________?

Ans: Strongyloides Stercoralis

200. What is the causative organism of Chancroid ____________?

Ans: Haemophilus Ducreyi

201. What is thee causative organism of Chlamydia infection_________________

Ans: Chlamydia Trachomatis

202. What causes Whipworm infection _________________?

Ans: Trichuris Trichiura

203. The causative organism for meningococcal meningitis is called __________________

Ans: Neisseria Meningitidis

204. The hormone that regulates the production of red blood cell production is called ______________

Ans: Erythropoietin

205. The intra cutaneous test in which the tubercle bacillus extract is injured into the intradermal layer
of the inner aspect of the forearm is called ___________________

Ans: Mantoux Tuberculin test

206. The entry point of the causative organism of bacillary is through the _________________

Ans: Faecal oral route

207. A record of electrical activity generated in the brain and obtained through electrodes applied on
the scalp surface or through the microelectrodes placed within the brain tissue is called _______

Ans: Electroencephalography

208. A disorder affecting the neuromuscular transmission of involuntary muscles of the body
characterized by weakness and fatigability is called _____________

Ans: Epilepsy

209. An imagine procedure which uses a narrow beam of x-rays to scan the head in successive layers is
called ___________________

Ans: Computer Tomography scans (CT scans)

210. The secondary skin lesion in which there is extravasation of blood cells into tissue secondary to
trauma such as a bruise is called _________________

Ans: Eccymosis

211. An investigation that allows visualization of the kidney, ureter and bladder by use of a radio opaque
contrast medium administered intravenously is called __________________

Ans: Intravenous Pyelogram or intravenous urogram

212. Involuntary voiding during sleep is also referred to as ______________

Ans: Enuresis

213. The presence of proteins in urine is called _________________

Ans: Proteinuria
214. A disorder of the posterior lobe of the pituitary gland due to a deficiency of vasopressin
characterized by excessive thirst and large volumes of urine is called _____________

Ans: Diabetes Insipidus

215. __________________ is as a result of profound liver failure due to accumulation of ammonia and
toxic metabolites as a result of damaged liver cells

Ans: Hepatic Encephalopathy or Hepatic Coma

216. The type of goiter that represents a compensatory hypertrophy of the thyroid gland due to
stimulation of the pituitary gland is called ______________

Ans: Simple Goiter

217. A condition in which there is a marked inadequate amount of insulin resulting in metabolic
disorders such as dehydration, electrolyte loss and acidosis is called _____________

Ans: Diabetes Ketoacidosis

218. A stimulant drug given to patient who are constipated which acts by irritating the colon epithelium,
stimulating the sensory nerve endings and increasing mucosal secretion is called ___________

Ans: Bisacodyl

219. A condition in which there are white patches with rough hair like projections found the lateral
boarder of the tongue is called __________________

Ans: Oral hairy Leukoplakia

220. The investigation done to visualize the oesophagus, gastric mucosa and the duodenum by use of a
lighted endoscope is called __________________

Ans: Esophagogastroduodenoscopy (EGD)

221. An increased concentration of red blood cells is called ___________________

Ans: Polycythemia

222. A severe hemolytic anemia resulting from a defective hemoglobin molecule associated with severe
attacks of pain is called _______________

Ans: Sickle cell anemia

223. A disorder of the heart beat in which there is a disturbance in the rate, rhythm or both is called
________________

Ans: Heart Arrhythmias

224. The vessels that supply blood to the heart muscle which has large metabolic requirements for
oxygen and nutrients is called ________________

Ans: Coronary arteries

225. A chronic pulmonary disease caused by inhalation of dust especially that from the mines is called _

Ans: Silicosis

226. An acute inflammation of the mucous membrane of the trachea and bronchial tree that often
follows infection of the upper respiratory tract is called _______________

Ans: Acute bronchitis

227. The obstruction of one or more pulmonary arteries by a blood clot from the venous system of the
right side of the heart, becomes dislodged and is carried by the lung is called _____________

Ans: Pulmonary embolism

228. The excessive calcium levels in the plasma is referred to as _____________

Ans: Hypercalcemia

229. The bluish discouration of the skin which is as a result of hypoxia is called _____________

Ans: Cyanosis

230. The high pitched sound heard on expiration in a patient with bronchoconstriction or airway
narrowing is called _____________

Ans: Wheezing

231. A bacterial infection of the renal pelvis, tubules and interstitial tissue of the one or more kidneys is
called __________________

Ans: Pyelonephritis

232. _________________ refers to increased levels of thyroid hormones

Ans: Thyrotoxicosis

233. ______________________ is the direct inspection and examination of the larynx, trachea and
bronchial tree using a flexible fiber optic tube

Ans: Laryngoscopy

234. _________________ is the recommended approach to management of sexually transmitted

infections in a resource constrained settings such as a rural health center

Ans: Syndromic approach

235. Infestation of the body with larva stages of a non-biting fly is called _________________

Ans: Myiasis

236. The malignancy of the white blood cell that is characterized by hyperplasia of the white blood cells
and their precursors is called ________________

Ans: Leukemia
237. _____________________ is an infection of the lining of the heart chambers and heart valves,
caused by bacteria, fungi or other infection agents

Ans: Infective Endocarditis

238. __________________refers to difficulty to micturition

Ans: Dysuria

239. Lack of Blood supply to the tissue is known as ______________________

Ans: Hypoxia

240. __________________ is a viral disease of the nervous system that is usually transmitted to man by
an infected animal such as fox or cut or dog

Ans: Rabies

241. The radiological examination of the oesophagus after ingestion of a radio-opaque contrast medium
is called __________________________-

Ans: Barium swallow

242. Urine Output of less than 100mls is called __________________________-

Ans: Oliguria

243. ___________________ is an artificial process of removing waste products and excess water from
the body which relates to renal concept

Ans: Dialysis

244. ____________________ is the type of diabetes which is attributed to impaired utilization of insulin
by the body

Ans: Type 1

245. ______________________is laboratory techniques is mostly commonly used to identify bacilli in

sputum

Ans: Acid fast Staining

246. The main plasma protein made by the liver which circulates in the blood stream is called _________

Ans: Albumin

247. The Widal test is a diagnostic test for ____________________

Ans: Typhoid fever

248. Taenia solium refers to ______________________

Ans: Fish tapeworm

249. Rose spots rash is a characteristic of which diarrheal condition __________________

Ans: Typhoid fever

250. The procedure in which fluid is withdrawn from the abdominal cavity is called ___________

Ans: Paracentesis

251. _________________ is a condition which arises due to reduced hydrochloric acid secretion

Ans: Achlohydria

252. The endoscopic examination of the colon referred to ______________

Ans: Colonoscopy

253. _______________________ is the hormone which is responsible for regulation of glucose levels in
the blood

Ans: Insulin

254. In diabetes mellitus the characteristic im which the patient complains of excessive hunger is called
______________________

Ans: Polyphagia

255. ___________________ is the presence of stones in the salivary glands

Ans: Sialolith

256. ______________________ is the typical pattern of fever in typhoid

Ans: Intermittent fever

257. ____________________________ is the drug of choice for treatment of amoebic dysentery

Ans: Tinidazole

258. The layer of the stomach consisting of loose connective tissue and a thin layer of smooth muscle is
__________________

Ans: Mucosa

259. In liver function test AST stands for ________________________

Ans: Aspartate Amino Transferase

260. ___________________________ factors influencing the occurrence of the disease

Ans: Predisposing

261. Inflammation of the mucosa of the rectum is known as _________________________

Ans: Proctitis
262. A verbal interaction with a goal of acquiring information from a patient is referred to as _________

Ans: Interview

263. ________________ is a chief complaint focused on history taking

Ans: Problem Solving

264. Diarrhea resulting from disordered water and electrolyte transport in the small intestine is called __

Ans: Secretory Diarrhea

265. _________________ is a group of signs and symptoms resulting in defects in absorption of

nutrients

Ans: Malabsorption

266. _____________________ are painful cracks that develop in folds of tissue at the corners of the
mouth

Ans: Angular Cheilitis

267. The causative organism for Vincent Stomatitis is ___________________

Ans: Fusiform bacillus

268. In ancylostomiasis the infective form is called ________________

Ans: Filariform Larvae

269. _________________ is the infection responsible for cytercecosis encephalitis

Ans: Taenia Solium

270. The incubation period for typhoid fever is _______________________

Ans: 1-3 weeks

271. Enterobius vermicularis is also known as ________________

Ans: Pin worm

272. Forecast of the probable outcome of a disease is known as ________________

Ans: Prognosis

273. A congenital anornmally in which there is narrowing or blockage of the Oesophagus is called _____

Ans: Achalasia

274. _______________________ is the chronic inflammation of the mucosa of the colon and rectum

Ans: Ulcerative Colitis

275. Toxic mega colon s also known as _____________________

Ans: Fulminating Colitis

276. A condition in which the lining of the oesophagus is replaced by tissue similar to intestinal lining is
called __________________

Ans: Barrett's Oesophagus

277. _________________ is the series of events/process which occurs in a disease

Ans: Pathogenesis

278. _________________________ is the type of stomatitis which occurs in children

Ans: Simple Catarrhal stomatitis

279. Monilia stomatitis is also known as ___________________

Ans: Oral thrush

280. A condition characterized by lack of peristaltic movement in the esophagus and failure of the lower
esophagus sphincter is called _____________

Ans: Achalasia

281. The incubation period of dysentery is __________________

Ans: 1-7days

282. Inflammation of the gall bladder is called ___________________-

Ans: Cholecystitis

283. The thick layer of loose connective tissue of the gastro intestinal tract that contains blood,
lymphatic vessels, nerves and glands is _______________

Ans: Sub mucosa layer

284. The hydrochloric acid of the stomach is produced by cells called _________________

Ans: Parietal cells

285. An enzyme found in saliva that hydrolyses starch and maltose is ___________________

Ans: Amylase

286. The bulky, foul smelling, yellow- gray, greasy stool that float in water is called _________________

Ans: Steartorrhoea

287. The causative organism of typhoid fever is __________________

Ans: Salmonella Typhi

288. Clusters of cells found in the intestinal wall composed of macrophages are essential to kill any
bacteria ________________

Ans: Payers Patches

289. The removal of a sample of tissue from the body for examination is called ______________

Ans: Biopsy

290. A human disease caused by a parasitic round worm called _________________

Ans: Ascaris Lumbricoides

291. The beet type worm is called ________________

Ans: Taenia Saginata

292. An infection of man with the larva stage of the pork tape worm (Taenia Solium) is called _________

Ans: Cytercecosis

293. The Causative organism of peptic ulcer disease is _______________

Ans: Helicobacter Pylori

294. The toxin produced by vibrio cholera is called _______________

Ans: Choleragen

295. An investigation done in typhoid fever which reveals antibodies against salmonella typhi which
raise early quickly is called _________________

Ans: Widal test

296. The drug of choice for shigellosis treatment is _________________

Ans: Nalidixic Acid

297. The causative organism for Amoebiasis is _____________________

Ans: Enteromoeba Hystolitica

298. The presence of entamoeba Hystolitiea with ingested red blood is called ________________

Ans: Erythrophagocytosis

299. The sphincter that controls the flow of contents from the pancreatic duct to the duodenum is
______

Ans: Sphincter of Odd

300. The endocrine functions of the pancreas are carried out by specialized cells called _________

Ans: lslets of Langerhans

301. A Test done to determine lactose intolerance on the presence of an infection in stool is called ___

Ans: Fecal Pit test

302. The inflammation of the oral mucosa that may extend to the buccal mucosa, lips and palate is
called _________________

Ans: Stomatitis

303. The type of stomatitis which is common in poorly nourished children is called ______

Ans: Simple Catarrhal stomatitis

304. Inflammation of the salivary gland is called _________________

Ans: Parotitis

305. A disease of the muscle of the lower oesophageal body and the lower oesophageal sphincter is
called ________________

Ans: Achalasia

306. The replacement of the tissue lining of the oesophagus by the tissue that is similar to the intestinal
lining is called ____________

Ans: Barrett’s oesophagus

307. An esophageal contraction of the diaphragm that repeats several times per minute is called

Ans: Hiccup or Hiccough

308. The observations or measurements made by the data collector are called _________________

Ans: Objective data

309. The data collection technique that is performed by concentrating on what the client is saying and
the message being conveyed is called __________________

Ans: Active listening

310. The type of palpation which is used to determine freely mobile masses beneath the abdominal wall
is called __________________

Ans: Ballottement

311. An examination of boy tissues and organs using the sense of touch is called _______________

Ans: Palpation

312. An instrument which is used to tap the tendons during a neurological examination is ____________

Ans: Tendon hummer or Patella hammer or Patella Reflex

313. Death of myocardial cells is called _________________

Ans: Myocardial Infarction

314. A genetic defect that results from a deficient or detective clothing factor VIII causes a condition
called ______________

Ans: Hemophilia A

315._________________________ is the sickle cell crisis that results from blood vessels obstructions by
the suckled red blood cell causing tissue ischemia and necrosis

Ans: Vaso Occlusive crisis

316. How many minutes should blood be started after leaving the blood bank ____________

Ans: 30minutes

317. Megaloblastic anaemia is caused by deficiency of __________________ and ______________

Ans: Folic acid and Vitamin B12

318. A sudden interruption of cerebral circulation in one or more of the blood vessels supplying the
brain is called __________________

Ans: Cerebral vascular accident

319. The causative organism of leprosy is called ____________

Ans: Mycobacterium Leprae

320. ____________ is the type leprosy seen in people with good resistance to mycobacterium

Ans: Tuberculoid Leprosy

321. Low circulating platelet levels is called _____________

Ans: Thrombocytopenia

322. Congestive cardiac failure is also referred to as ___________________

Ans: Right sided failure

323. Hansen’s disease is also known as __________________

Ans: Leprosy

324. ________________________ is a localized dilatation of a cerebral artery that results from a

weakness in the arterial wall

Ans: Cerebral Aneurism

325. Bleeding within the brain tissue parenchymal itself is referred to as ________________

Ans: Intracerebral haemorrhage

326. A severe asthmatic attack which cannot be controlled with usual medications is called ________.

Ans: Status asthmaticus

327. The organism that is implicated in cryptococcal meningitis is called ____________

Ans: Cryptococcal neoformas

328. The type of pneumonia which is due to inhalation of fluid, foods or vomitus into the airway is called
________________

Ans: Aspirational Pneumonia

329. The fluid part of blood is known as _________________

Ans: Plasma

330. An area of tissue that has died because of lack of oxygenated blood is _________

Ans: Infarct

331. A bluish coloring of the skin, mucus membrane indicates __________

Ans: Cyanosis

332. Abnormal local dilatations of arteries is ___________________

Ans: Aneurism

333. Group of lung diseases caused by inhaling organic or inorganic atmospheric pollutants is _______

Ans: Pneumoconiosis

334. The potential space that separates the dura and arachnoid maters is called __________

Ans: Sub-arachnoid space

335. A condition of the lung characterized by collapsed, airless alveoli is called _______

Ans: Atelectasis

336. _______________________ is a bleeding disorder caused by a reduction in the number of

circulating platelets

Ans: Thrombocytopenic Purpura

337. ______________________ is the iron-containing in red corpuscles in blood plasma

Ans: Haemoglobin

338. _____________________________ is the medical term describing thyroid gland

Ans: Goitre
339. The method of physical examination in which the body surface is struck to elicit sound is called ___

Ans: Percussion

340. The HIV enzyme that incorporates the viral DNA into the host genome DNA is known as _________

Ans: Integrase

341. Indigestion is also known as _________________

Ans: Dyspepsia

342. The inflammation of the skin, clinically characterized by polymorphous lesions is called __________

Ans: Dermatitis

343. The drug of choice for treatment of tapeworm is __________________

Ans: Niclosamide

344. ___________________ is the time when the patient is asymptomatic, organism multiplies and host
defences are triggered to encounter the infection

Ans: incubation

345. _________________________ is a planned communication for a purpose of establishing the health

needs and health problems of the client

Ans: Nursing diagnosis

346. ______________ is referred to as a test which measures the amounts of oxygen, carbon dioxide
and acidity of the blood

Ans: Arterial blood gas analysis

347. _______________ is the thickening and hardening of the arterial wall

Ans: Arteriosclerosis

348. ____________________ occurs when the HIV infected individual tests positive to HIV antibody best

Ans: Sero-conversion

349. ___________________ is the gastrointestinal tract condition which is characterized with lack of
peristaltic movement in the oesophagus and failure of relaxation of water oesophagus sphincter

Ans: Achalasia

350. A condition in which there is failure of the small intestines to absorb the product of digestion is
known as _________________

Ans: Malabsorption
351. The medications used for the treatment of pinworms are ___________ pyrantel pamaoate and
albendazole

Ans: Mebendazole

352. ___________________ is a procedure which is performed to obtain a sample of fluid from the
pleural cavity. The sample obtained can be used for diagnostic or therapeutic purposes where the fluid is
drained to relieve shortness of breath

Ans: Thoracentesis

353. An unpleasant sensory and emotional experience associated with actual or potential tissue damage
is called _________________

Ans: Pain

354. ____________ refers to pain on swallowing

Ans: Odynophagia

355. Herpes Zoster is also known as ____________________

Ans: Shingles

356. The STI associated with cloudy like discharge is called ________________

Ans: Candidiasis

357. _______________ is the type of pain which is localized, of short duration and with a sharp
sensation

Ans: Superficial pain

358. A long duration, diffuse, dull and aching relates to which type of pain _____________

Ans: Deep pain

359. The other name for vitamin B12 deficiency anaemia is called ______________

Ans: Pernicious Anemia

360. _________________ is a substance which enable the body to produce antibodies

Ans: Antigen

361. The degree of pathogenicity of a pathogen is known as ________________

Ans: Virulence

362. __________________ is a protein produced by the body in response to the introduction of a

foreign substance

Ans: Antibody
363. _______________________ is the accumulation of blood in the pleural cavity

Ans: Heamothorax

364. A condition known as goiter results from a deficiency of ________________

Ans: Iodine

365. A state of condition of passing an abnormally large output of urine due to either to an excessive
intake of liquid or disease often diabetes is known as _____________

Ans: Diabetes Insipidus

366. Medically the fainting is also known as _____________

Ans: Syncope

367. Pain originating from abdominal organs like kidneys is called _____________

Ans: Visceral Pain

368. Steatorrhea is due to absence of __________________

Ans: Stercobilin

369. _______________ is the process used to destroy all microorganism including spore forming ones

Ans: Sterilization

370. ________________________________ is a syndrome of inappropriate high levels of corticosteroids

Ans: Cushing Syndrome

371. The two most common forms of Filariasis are __________ and _________________

Ans: Lymphatic and Subcutaneous

372. The body of the tape worm is made up of successive segments called _______________

Ans: Proglottids

373. If untreated Filariasis involving the eyes can cause what type of blindness called ________

Ans: Onchocercasis or River blindness

374. The drug of choice for Filariasis is called ______________________

Ans: Diethylcarbamazine

375. ______________________ is a chronic liver condition characterized by diffuse inflammation and

fibrosis resulting in drastic structural changes and significant loss of function

Ans: Liver Cirrhosis

376. _________________ data is obtained through observations and physical examination

Ans: Objective

377. Chronic lymphatic Filariasis leads to disease called ___________________________

Ans: Elephantitis

378. ________________ is the presence of pus within the pleural cavity

Ans: Empyema

379. Hypothrombinaemia is also referred to as _____________ deficiency

Ans: Vitamin K

380. Stable angina is also known as __________________

Ans: Effort Angina

381. _____________________ is a recessive X-linked genetic disorder involving a lack of functional

clotting factor

Ans: Hemophilia A

382. A severe asthmatic attack which cannot be controlled with usual medications is called __________

Ans: Status Asthmaticus

383. The organism that is implicated in cryptococcal meningitis is called _________________

Ans: Cryptococco meningitis

384. An area of tissue that has died because of lack of oxygenated blood is called _______________

Ans: Infarction

385. A condition of the lung characterized by collapsed and airless alveoli is called ____________

Ans: Atelectasis

386. The assessment tool that is used to determine the patient's level of consciousness (LOC) is called
_________________

Ans: Glascow Coma Scale

387. The anemia that occurs when the overall hemoglobin level is decreased, but the red blood cell size
remains normal is called ___________________

Ans: Normocytic Anemia

388. Sudden impairment of cerebral circulation on one or more of the blood vessels supplying the brain
is called _________________________

Ans: Cerebral vascular accident

389. Inflammation of the spinal cord is called ________________________

Ans: Myelitis

390. The vector responsible for the transmission of malaria is the ___________________

Ans: Anopheles mosquito

391. The identification of consistent groups of symptoms and easily recognizable signs and the provision
of treatment that deal with the majority of organisms responsible for each syndrome is referred to as
________

Ans: Syndromic management

392. A chronic disease in which the kidney becomes greatly distended with fluid is known as _________

Ans: Hydronephrosis

393. When performing physical examination in order to determine freely mobile structures such as
some masses, the procedure that is done is called ______________________

Ans: Ballottement

394. An examination done by striking or taping the body are with finger tips to evaluate character (size,
boarders, and consistence) of internal parts and discover fluids by the sound produced is known as
______

Ans: Percussion

395. A comprehensive, specialized care provided by an interdisciplinary team to patients and families
living with a life-threatening severe advanced illness is known as ___________

Ans: Palliative care

396. An infection with group A hemolytic streptococcus of the throat may proceed to which condition in
2 to 3 weeks ________________

Ans: Rheumatic fever

397. The presence of pus in urine is known as _____________________

Ans: Pyuria

398. The total absence of urine is known as ________________________

Ans: Anuresis
399. The inflammation of the pelvis of the kidney is referred to as ____________

Ans: Pyelonephritis

400. Expiratory reserve volume is the largest volume of air expired from the lungs during __________

Ans: Forceful breath

401. ___________________ is the difference between systolic and diastolic pressure

Ans: Pulse pressure

MATCH THE ITEMS IN COLUMN I WITH THEIR MEANING IN COLUMN II

COLUMN I COLUMN II

1_Polyuria A. Increased appetite

Ans: B

2._Polydipsia B. Frequent urination

Ans: D

3._Polyphagia C. Presence of glucose in urine

Ans: A

4._Glucosuria D. Increased thirst and fluid intake

Ans: C

5._Oliguria E. Raised blood glucose

Ans: G

F. Increased blood pressure

G. Reduced urine out put

H. Ketones in urine

MATCH THE DISEASES IN COLUMN I WITH THEIR APPROPRIATE CAUSES IN COLUMN II

COLUMN I COLUMN II

6._Genital warts A. Wuchereria Bancroft

Ans: D

7._Filariasis B. Taenia Saginata

Ans: A

8._Lymph granuloma Venereum C. Varicella Zoster

Ans: F

9._Pork tape worm D. Human papilloma virus

Ans: G

10._Herpes Zoster E. Ascarias Lumbricoides

Ans: C

F. Haemophilus Ducreyi

G. Taenia solium
 MATCH THE FOLLOWING DRUGS IN COLUMN I WITH THEIR APPROPRIATE CONDITION IN COLUMN II

COLUMN I COLUMN II

11._Artesunate A. Intestinal worms

Ans: D

12._Valium B. Asthma

Ans: G

13._Mebendazole C. Risk of coagulation

Ans: A

14._Pyrazinamide D. Severe malaria

Ans: H

15._Acetyl salicylic acid E. Meningitis

Ans: C

F. Hypertension

G. Anxiety

H. Tuberculosis

MATCH THE DRUGS IN COLUMN I WITH THEIR TOXICITY LE IN COLUMN II

COLUMN I COLUMN II

16._Abacavir (ABC) A. Heart failure

Ans: H

17._Atazanavir (ATV-r) B. Severe Anemia

Ans: D

18._Nevirapine (NVP) C. Renal toxicity

Ans: E

19._Tenofovir Disoproxil Fumarate (TDF) D. Hyperbilibinaemia

Ans: C

20._Azidothymidine (AZT) E. Ascites

Ans: B

F. Hyperlipidemia
G. Steven Johnson’s syndrome
H. Hypersensitivity reaction
MATCH THE FOLLOWING IN COLUMN I WITH THEIR CORRESPONDING CONCEPTS IN COLUMN II
COLUMN I COLUMN II
21._Crescendo A. Irreversible necrosis of the heart muscle
Ans: G
22._Quarantine B. Stable angina
Ans: F
23._Christmas factor C. Inherited blood coagulation disorder
Ans: D
24._Myocardial infarction D. Clotting factor IX
Ans: A
25._Hemophilia E. Clotting factor VIII
Ans: C
F. Enforced Isolation
G. Unstable Angina

MATCH THE FOLLOWING IN COLUMN I WITH THEIR CORRESPONDING DESCRIPTION IN COLUMN II

COLUMN I COLUMN II
26._Anti-hemophilic factor A. Reed-Sternberg cell absent
Ans: E
27._Constructive pericarditis B. Hodgikin’s lymphoma with prognosis
Ans: C
28._Constrictive pericarditis C. Chronic pericarditis
Ans: D
29._Non Hodgikin’s Lymphoma D. Reed Sternberg present
Ans: A
30._Nodular Sclerosis E. Clotting factor VIII
Ans: B
F. Clotting factor IX
G. Acute pericarditis

MATCH THE FOLLOWING IN COLUMN I WITH THEIR CORRESPONDING DESCRIPTION IN COLUMN II

COLUMN I COLUMN II
31._Ascariasis A. Caused by beef tapeworm
Ans: E
32._Filariasis B. Caused by schistosomes
Ans: D
33._Snail fever C. Caused by pinworms
Ans: B
34._Enterobiasis D. Caused by filarial nematodes
Ans: C
35._Taenia Saginata E. Caused by round worms
Ans: A
F. Caused by pork tape worms
G. Caused by inhalation of bauxite du
MATCH THE FOLLOWING PNEUMONIOSIS IN COLUMN I WITH THEIR CORRESPONDING DESCRIPTION
IN COLUMN II
COLUMN I COLUMN II
36._Silicosis A. Caused by inhalation of dust containing silica and iron
Ans: B
37._Byssinosis B. Caused by silica inhalation
Ans: F C. Caused by inhalation of asbestos
38._Silicosiderosis
Ans: A D. Caused by inhalation of beryllium
39. _Asbestosis
Ans: C E. Caused by inhalation of iron dust
40._Siderosi
Ans: E F. Caused by inhalation of cotton dust
G. Caused by inhalation of dirty sand

MATCH THE FOLLOWING ANTI-TB DRUGS IN COLUMN I WITH THEIR COMMON SIDE EFFECTS IN
COLUMN II

COLUMN I COLUMN II
41._Streptomycin A. Arthralgia/joint pain
Ans: C
42._Ethambuto B. Orange/red urine
Ans: D
43._Pyrazinamide C. Peripheral Neuritis
Ans: A
44._Isoniazid D. Optic neuritis/blindness
Ans: B
45._Rifampicin E. Tremors
Ans: G
F. Parasthesia
G. Bloody stool

MATCH THE FOLLOWING CONDITIONS IN COLUMN I WITH THEIR CAUSATIVE AGENTS IN COLUMN II

COLUMN I COLUMN II
46._Bacillary Dysentery A. Vibro-cholera
Ans: D
47._Cholera B. Salmonella paratyphi
Ans: A
48._Typhiod fever C. Salmonella typhi
Ans: C
49._Hepatitis B D. Shigella
Ans: E
50._Amoebic Dysentery E. Hepatitis B virus
Ans: F
F. Entamoeba Hystolitica
 G. Candida albicans

MATCH THE TERMS IN COLUMN l WITH THEIR DESCRIPTION IN COLUMN II

COLUMN I COLUMN II
51._Wheal A. Elevated solid lesion <1cm diameter
Ans: B
52._Vesicle B. Firm edematous irregular shaped area
Ans: C
53._Plaque C. Circumscribe, superficial collection of serous fluid
Ans: D
54._Papule D. Circumscribed elevated superficial solid lesions
Ans: A
55._Nodule E. Elevated superficial lesion filled with purulem
Ans: F fluid
F. Elevated, firm circumscribed >1cm in diameter
G. A vesicle of greater than 1 cm

MATCH THE FOLLOWING TECHBIQUES IN PHYSICAL EXAMINATION IN COLUMN I WITH THEIR

EXPLANATIONS IN COLUMN II
COLUMN I COLUMN II
56._Palpation A. The techniques that uses senses such as vision, hearing and smell
Ans: E
57._Ballottment B. The technique that determines the quality of sounds obtained depending
On the density of the underlying tissue using fingers
Ans: D
58._Inspection C. The techniques embraces listening to sounds present in body cavities or
Body organs using stethoscope
Ans: A
59._Percussion D. The technique used to determine freely mobile asses beneath the
Abdominal wall
Ans: B
60._Auscultation E. The technique used to examine the characteristics of tissues and organs
Using sense of touch
Ans: C
F. The technique used to determine patient condition by comparing the
Stated age and general
G. The technique used to assess the weight of the patient with general
Appearance
MATCH THE FOLLOWING ORGANS OF THE GASTRO INTESTINAL TRACT IN COLUMN I WITH THEIR
FUNCTIONS IN COLUMMN II
COLUMN I COLUMN II
61._Stomach A. Facilitates peristalsis of the bolus
Ans: B
62._Gall bladder B. Serves as a reservoir and to digest the food substance
Ans: D
63._Pancreas C. Contains enzymes responsible for breaking down of proteins
Ans: C
64._Oesophagus D. Stores and concentrate bile for emulsification of fats
Ans: A
65._Intestines E. Contains enzymes amylase which hydrolyses starch and maltose
Ans: F
F. Facilitates the absorption of nutrients
G. Mechanically breakdown and lubricate the food

MATCH THE FOLLOWING TECHNIQUES USED DATA COLLECTION IN COLUMN I WITH THEIR
DESCRIPTION IN COLUMN II
COLUMN I COLUMN II
66._Confrontation A. A technique used when a health want to share with the client the
Conclusion drawn from his or her data
Ans: E
67._Restatement B. The technique that involves repeating what the client says and the health
Provider use different words to confirm statement by a client
Ans: B
68._Clarification C. The technique where the health provider uses phrases to encourage the
The client to continue talking
Ans: F
69._Facilitation D. Technique where the health concentrate on what the client saying to
Understand the message being conveyed to him
Ans: C
70._Interpretation E. The technique used by a health provider when he notices inconsistence
Between what the client reports and the observations or other data about
The client
Ans: A
F. The technique used by a health provider to get more specific information
About the vague conflict statement
G. The technique used by the health provider where she or he avoid
Formulating the next question while client is talking
MATCH THE FOLLOWING TERMS IN COLUMN I WITH THEIR CORRECT DEFINITION IN COLUMN II
COLUMN I COLUMN II
71._Ataxia A. Fainting
Ans: E
72._Aphasia B. Brain injury opposite the impact
Ans: C
73._Flaccid C. Inability to speak
Ans: D
74._Syncope D. Weak, soft, lax
Ans: A
75._Comatose E. Failure of muscle coordination
Ans: F
F. Deep stupor
G. Ceasation of breathing

MATCH THE FOLLOWING TERMS IN COLUMN I WITH THEIR CORRECT DEFINITION IN COLUMN II
COLUMN I COLUMN II
76._Patella Hammer A. Examination of the ear drum
Ans: D
77._Stethoscope B. Checking the temperature
Ans: C
78._Autoscope C. Detection of heart and respiratory sounds
Ans: A
79._Spatula D. Detection of reflexes
Ans: E
80. Laryngoscope E. Examination of the tongue and palatal movement
Ans: G
F. Measure the size of the body organs of the skin
Lesions
G. Examination of the throat
H. Examination of the rectum

MATCH THE TERMINOLOGIES IN COLUMN I WITH THEIR MEANING IN COLUMN II

COLUMN I COLUMN II
81._Xerostomia A. Loss of voice
Ans: C
82._Apnea B. Excessive salivation
Ans: D
83._Rhinorrhea C. Dryness of the mouth
Ans: H
84._Aphonia D. Temporal loss of breathing
Ans: A
85._Hyperhidrosis E. Rebound nasal congestion
Ans: G
F. Difficulties in breathing
G. Excessive perspiration
H. Excessive discharge from the nose
MATCH THE ITEMS IN COLUMN I WITH THEIR APPROPRIATE DEFINITION IN COLUMN II
COLUMN I COLUMN II
86._Morphine A. Peptic ulcer
Ans: D
87._Losartan B. Asthma
Ans: G
88._Salbutamol C. Meningitis
Ans: B
89._Chloramphenicol D. Severe pain
Ans: C
90._Tagament E. Severe malaria
Ans: A
F. Schistosomiasis
G. Hypertension

MATCH THE FOLLOWING NAME IN COLUMN I WITH THEIR PROPER NAME OF THE FOLLOWING
WORMS IN COLUMN II
COLUMN I COLUMN II
91._Tapeworm A. Ancylostomia duodenale
Ans: E
92._Hookworm B. Strongyloides Stercoralis
Ans: A
93._Whipworm C. Trichuris Trichiura
Ans: C
94._Pinworm D. Enterobius vermicularis
Ans: D
95._Threadworm E. Taenia Saginata
Ans: B
F. Ascarias lubricoid
G. Filarine

MATCH THE FOLLOWING CONDITIONS OF THE SKIN IN COLUMN I WITH THEIR CAUSES IN COLUMN II
COLUMN I COLUMN II
96._Herpes Zoster A. Bacteria
Ans: C
97._Impetigo B. Infestation
Ans: A
98._Tinea C. Viral
Ans: D
99._Myiasis D. Fungi
Ans: B
100._Eezema E. Antigen anti body reaction
Ans: E
F. Helminth
G. Foreign bodies
MATCH THE FOLLOWING INFECTIONS IN COLUMN I WITH THEIR CAUSATIVE ORGANISM IN COLUMN II
COLUMN I COLUMN II
101._Genital warts A. Treponema palladium
Ans: E
102._Chancroid B. Herpes simplex virus type 2
Ans: C
103._Gonorrhea C. Haemophilus Ducreyi
Ans: G
104._Chlamydia D. Klebsiella granulomatis
Ans: F
105._Syphilis E. Human papilloma virus
Ans: A
F. Chlamydia trachomatis
G. Neisseria gonorrhea

MATCH THE SYNDROME IN COLUMN I WITH ACCOMPANYING SIGN SYMPTOM IN COLUMN II

COLUMN I COLUMN II
106._Vaginal discharge A. Failure to open eyes
Ans: F
107._Urethral discharge B. Scrotal pain
Ans: E
108._Genital Ulceration C. Growth
Ans: D
109._Neonatal conjunctivitis D. Sore present
Ans: A
110._Inguinal bubo E. Frequent Micturition
Ans: H
F. Dyspareunia
G. Lower abdominal pain
H. Enlarged lymph node

MATCH THE FOLLOWING TYPES OF ANAEMIA IN COLUMN I WITH THEIR CAUSES IN COLUMN II
COLUMN I COLUMN II
111._Heamolytic anaemia A. Chloramphenicol
Ans: D
112._Heamorrhagic anaemia B. Pneumonia
Ans: C
113._Aplastic anaemia C. Hemorrhoids
Ans: A
114._Pernicious anaemia D. Malaria
Ans: E
115._Sickle cell anemia E. Gastrectomy
Ans: G
F. Blood compatibility
 G. Inherited condition

MATCH THE FOLLOWING TERMS IN COLUMN I WITH THE DESCRIPTION IN COLUMN II

COLUMN I COLUMN II
116._Fissure A. A streak-like linear darkish lesion due to changes in connectivity tissue
Ans: C
117._Stria B. Normal structure permanently replaced by fibrous tissue
Ans: A
118._Comedone C. A slit-shaped deep ulcer
Ans: D
119._Burrow D. A plug of keratin and sebum wedged in a dilated pilosebaceous orifice
Ans: F
120._Scar E. A flake arising from the stratum corneum
Ans: B
F. A linear or curvilinear papule caused by scabies mite
G. Meibomian glands of the skin inflamed

MATCH THE TYPES OF PSORIAIS IN COLUMN I WITH THE CORRECT DESCRIPTION IN COLUMN II
COLUMN I COLUMN II
121._Erythrodermic A. There is an eruption of local small raised pus filled plaques
Ans: B
122._Guttate psoriasis B. There is extensive flushing all over the body with or without scaling
Ans: C
123._Inverse psoriasis C. There are eruption in dropped size plaques over the trunk and arms
And legs
Ans: D
124._Psoriasis Vulgaris D. There are smooth, dry red plaques in the skin folds which fissure
Easily
Ans: E
125._Pustular Psoriasis E. There are dot-like lesion that gradually enlarge and produce dry
Silvery scales
Ans: A
F. There are erythematous small oozing vesicles
G. There is erythema, scaling and hair loss
H. Superficial pus forming and toned skin
MATCH THE FOLLOWING UPPER RESPIRATORY INFECTIONS IN COLUMN I WITH THEIR CAUSATIVE
ORGANISMS IN COLUMN II
COLUMN I COLUMN II
126._Hay Fever A. Influenza (HINI)
Ans: C
127._Coryza B. Corona virus
Ans: D
128._Swine flu C. Pollen
Ans: F
129._SARS D. Rhinovirus
Ans: B
130._Laryngitis E. Helicobacter pylori
Ans: A
F. Haemophilus influenza
G. Mycobacterium Tuberculosis

MATCH THE FOLLOWING TERMS IN COLUMN I WITH THEIR DESCRIPTION IN COLUMN II

COLUMN I COLUMN II
131._Wheal A. Elevated solid lesion less <1cm diameter
Ans: B
132._Vesicle B. Firm edematous irregularly shaped area
Ans: C
133._Plaque C. Circumscribed, superficial collection of serous fluid
Ans: D
134._Papule D. Circumscribed elevated superficial solid lesion
Ans: A
135._Nodule E. Elevated superficial lesion filled with purulent fluid
Ans: F
F. Elevated, firm circumscribed >1cm in diameter
G. A vesicle of greater than 1 cm

MATCH THE FOLLOWING PART OF THE BODY AFFECTED IN COLUMN I WITH THE NAME OF TINEA
INFECTION IN COLUMN II
COLUMN I COLUMN II
136._Scalp A. Tinea corporis
Ans: D
137._Groin B. Tinea cruris
Ans: B
138._Trunk C. Tinea mauum
Ans: A
139._Hand D. Tinea capitis
Ans: C
140._Beard E. Tinea faciei
Ans: F
F. Tinea barbae
G. Tinea fokotalia
MATCH THE FOLLOWING TERMS IN COLUMN I WITH THEIR DESCRIPTION IN COLUMN II
COLUMN I COLUMN II
141._Ecchymosis A. Grayish blue or ashen-gray colour on nail beds
Ans: B
142._Erythema B. Bruise and bleeding under the skin
Ans: C
143._Jaundice C. Reddish tone with evidence of increased skin temperature
Ans: D
144._Cyanosis D. Yellowish/greenish descolourization
Ans: A
145._Petechiae E. Small reddish purple pin points difficulty to see in the dark
People
Ans: E
F. Thickening of the skin over the feet, hands and elbow
G. Intracranial contusion

MATCH THE FOLLOWING TERMS IN COLUMN I WITH THEIR DESCRIPTION IN COLUMN II

COLUMN I COLUMN II
146._Eroision A. Damage to skin as a result of scratching in a linear ulcer
Ans: C
147._Crust B. An area of skin from which the whole of the epidermis and part of the
Dermis has been lost
Ans: D
148._Ulcer C. An area of the skin denuded by complete loss of the epidermis
Ans: B
149._Excoriation D. Exudate of blood or serous fluid
Ans: A
150._Scale E. A slit-shaped deep ulcer
Ans: F
F. A flake arising from the stratum corneum
G. A toned brain tissue

MATCH THE FOLLOWING ITEMS IN COLUMN I WITH THE DISEASE THEY CAUSE IN COLUMN II
COLUMN I COLUMN II
151._Arachnoid Granulation A. Parkinson’s
Ans: C
152._Deficiency of clotting factor 8 B. Formation of CSF
Ans: A
153._Deficiency of intrinsic factor C. Absorption of CSF
Ans: E
154._Deficiency of dopamine D. Hemophilia B
Ans: A
155._Deficiency of Plasma protein E. Pernicious anaemia
Ans: F
F. Generalized anaemia
G. Hemophilia A
MATCH THE FOLLOWING CELL ADAPTATION AND MALADAPTATION IN COLUMN I WITH THEIR
DEFINITION IN COLUMN II
COLUMN I COLUMN II
156._Hypertrophy A. Decrease in size or number of cells
Ans: G
157._Hyperplasia B. Maintenance of the size and shape of cells
Ans: E
158._ Dysplasia C. Cells in a more embryonic form
Ans: D
159._ Metaplasia D. Change in size, shape and appearance of the cells
Ans: F
160._Hypotrophy E. Increase in number of cells
Ans: A
F. Transformation of one cell type to the other
G. Increase in size of the cell

MATCH THE FOLLOWING ITEMS IN COLUMN I WITH THEIR EFFECTS IN COLUMN II

COLUMN I COLUMN II
161._Hyperparathyroidism A. Myxoedema
Ans: F
162._Anterior pituitary hypo-secretion B. Addison’s disease
Ans: E
163._Adrenal insufficiency C. Gigantism
Ans: B
164._Hypothyroidism D. Tetany
Ans: A
165._Acromegaly E. Diabetes Insipidus
Ans: C
F. Thyrotoxicosis

G. Anencephaly

MATCH THE FOLLOWING ITEMS IN COLUMN I WITH THEIR DESCRIPTION IN COLUMN II

COLUMN I COLUMN II
166._Haematochezia A. Accumulation of nitrogenous wastes in blood
Ans: G
167._Maleana B. Ammonium smell on patent’s body
Ans: D
168._Uremic fetor C. Bitter metallic test in the mouth due to ammonia
Ans: B
169._Anarsaca D. Black, tarry stool due to bleeding from the upper GIT
Ans: F
170._Azotemia E. Chemical waste generated from muscle metabolism
Ans: A
F. Generalized Oedema

G. Passage of fresh blood through the anus

MATCH THE FOLLOWING TYPES OF PAIN IN COLUMN I WITH THEIR CORRECT DESCRIPTION IN
COLUMN II

COLUMN I COLUMN II
171._Viscera pain A. Pain is felt at the site of origin
Ans: D
172._Deep pain B. Pain is felt at a distance from the site of origin
Ans: E
173._Neuropathic pain C. Pain felt due to tension or pressure on viscera
Ans: G
174._Referred pain D. Pain felt from the internal organs e.g. kidneys
Ans: B
175._Local pain E. Pain is has long duration, diffuse, dull and aching
Ans: A
F. Pain is localized, of short duration and with a sharp
Sensation
G. Pain from healed herpes-zoster or phantom limb

MATCH THE FOLLOWING PRINCIPLES OF MEDICINE AND MEDICAL NURSING IN COLUMN I WITH THEIR
CORRECT DESCRIPTION IN COLUMN II

COLUMN I COLUMN II
176._Autonomy A. This stipulates that the information obtained from an
Individual should not be disclosed to another without the
Consent of patient
Ans: B
177. _Beneficence B. Each person has individual rights, privacy and choice
Ans: E
178._Veracity C. The duty to become faithful to one’s promise
Ans: G
179._Fidelity D. All patients should be treated alike
Ans: C
180._Sancity of life E. Action that promote the wellbeing of others e.g. taking
Actions that serves the best interest of patients
Ans: F
F. Life should take precedence in all practice
G. The obligation to tell the truth and not to lie or deceive
Others
MATCH THE FOLLOWING INVESTIGATIONS AND PROCEDURESIN COLUMN I WITH THEIR CORRECT
DESCRIPTION IN COLUMN II
COLUMN I COLUMN II
181._Endoscopy A. Procedure in which fluids are withdrawn from the abdominal cavity
Ans: D
182._Liver Biopsy B. A procedure used to examine the brain tissue
Ans: G
183.-Barium swallow C. A medical procedure that diagnoses the lower GIT Abnormalities
Ans: E
184._Barium meal D. The direct visualization of the body structures through a lighted
Fiber optic instrument
Ans: F
185._Barium enema E. This is the radiological visualization of the oesophagus
Ans: C
F. It is a fluoroscopic X-ray that study that uses contrast medium to
Diagnosis the structure abnormalities of the stomach and
Duodenum
G. Is a diagnostic procedure which is done to obtain a liver tissue for
Examination

MATCH THE FOLLOWING DIARRHEAOL DISEASES IN COLUMN I WITH THEIR COUSETIVE ORGANISM IN
COLUMN II
COLUMN I COLUMN II
186._Paratyphoid fever A. External hemorrhage streptococcus
Ans: D
187._Amoebiasis B. Shigella boydii, dysenteriae, sonnei, flexneri
Ans: C
188._Cholera C. Entamoeba Hystolitica
Ans: E
189._Bacillary Dysentery D. Salmonella paratyphi A, B, C
Ans: B
190._Typhoid fever E. Vibrio cholera
Ans: F
F. Salmonella typhi
G. Toxoplasmosis gondii
MATCH THE FOLLOWING TERMS USED IN MEDICINE IN COLUMN I WITH THEIR MEANING IN COLUMN
II
COLUMN I COLUMN II
191._Pathopysiology A. A disease state, disability or poor health due to any cause
Ans: G
192._Disease B. Refers to the cause of the disease
Ans: E
193._Syndrome C. The recognition of a particular ailment from symptoms, physical signs and
Test which may have been performed
Ans: F
194._Morbidity D. A search into the problem so that one comes up with the diagnosis
Ans: A
195._Diagnosis E. A pathological process having a characteristic set of signs and symptoms
Ans: C
F. A set of symptoms and signs which occur together and constitute the
Manifestation of some special condition
G. An alteration in functioning of the body as a result of disease

MATCH THE FOLLOWING OPPROTUNISTIC INFECTIONS IN COLUMN I WITH THEIR COUSATIVE

ORGANISM IN COLUMN II
COLUMN I COLUMN II
196._Toxoplasmosis A. C. belli
Ans: C
197._Isoporiasis B. Cryptosporidium
Ans: A
198._Campylobacteriosis C. Toxoplasma gondii
Ans: G
199._Giardiasis D. Histoplama
Ans: E
200._Histoplamosis E. G. lambia
Ans: D
F. Blastomyces
G. C. jejuni
 GNC PHRASED ESSAY QUESTIONS

QUESTION 1: ANAEMIA

MRS. VASELINE CHAMBA IS A 46 YEAR OLD HOUSE WIFE WITH THREE (3) CHILDREN IS ADMITTED TO
FEMALE MEDICAL WARD WITH IRON DEFICIENCY ANAEMIA

a) State five (5) causes of iron deficiency anaemia 15%

b) List five (5) signs and symptoms that Mrs. Chamba is present with 15%

c) Discuss in detail the management of Mrs. Chamba under the following headings;

i. Medical management 15%

ii. Nursing management 35%

d) State five complications of anemia 20%

______________________________________________________________________________

SOLUTIONS/ANSWERS

a) State five (5) causes of iron deficiency anaemia 15%

1) Dietary deficiency of iron containing foods such as meat, liver and eggs

2) Achlohydria- lack of hydrochloric acid

3) Malabsorption due to chronic pancreatitis or intestinal diseases

4) Frequent pregnancies (fetus takes maternal iron). There is increased demand for iron during
pregnancy and lactation

5) Chronic hemorrhage due to menorrhagia, peptic ulcer, hemorrhoids, hookworms, carcinoma of the
rectum, colon and stomach

b) State five (5) signs and symptoms that Mrs. Chamba will present with 15%

1) Soreness and inflammation of the mouth and tongue due to reduced production of new cells and
amino acids

2) Changes in fingers nails- brittle, discolored, concave or spoon shaped

3) Dysphagia due to oesophageal atrophy

4) Pica- eating strange things, such as charcoal, earth soil or foods in great excess e.g. tomatoes, greens
due lack of iron
5) Fatigue due to reduced energy und oxy gen since iron is also involved in the conversion of blood sugar
to energy

6) Pallor of the mucus membrane, palm or conjunctiva due to lack of iron which is a blood pigment

7) Tachycardia/ heart palpitations due to increased heart activity in order to adequately circulate oxygen
through-out the body tissues

8) Dizziness due to reduced oxygen supply to the brain

9) Shortness of breath on exertion due to deficient oxygen

c) Discuss in details the management of Mrs. Chamba under the following headings:

MEDICAL MANAGEMENGT

AIMS

1. To identify the cause of the disease

2. To promote adequate formation of blood cells
3. To prevent complications such as renal failure

INVESTIGATIONS

1. HISTORY TAKING
 It will be done to determine the possible cause of the disease and identity the symptoms
experienced by the patient. History will reveal blood loss, low iron foods or worm infestation

2. PHYSICAL EXAMINATION

 It will be done to establish the signs and symptoms of the disease such as pallor

3. LABORATORY AND RADIOLOGICAL TESTS

 Full blood count will show decreased umber of circulating erythrocytes

 serum iron and total iron will be low
 blood film shows Megaloblastic changes in vitamin BI2 deficiency and folic acid deficiency
 HB will reveal low hemoglobin
 Stool for microscopic and occult blood to rule out worm infestation and GIT bleeding
 Blood smear for malaria parasite

4. TREATMENT
 Treatment is according to the cause

i. Ferrous sulphate (FeSO)/oral 200mg 8 hourly for a month

ii. Folic acid 5mg orally/day (OD) for 1 month

iii. Blood transfusion i.e. packed cells when Hb is very low or whole blood if the cause of anaemia is
hemorrhage

iv. Bone marrow transplant for aplastic anemia

v. Oxygen therapy if the patient is hypoxic

NURSING MANAGEMENT

AIMS

1. To increase the oxy gen carrying capacity of blood

2. To reduce demand for oxy gen

3 To alleviate the discomforts experienced by the patient

4. To prevent complications

5. To help the patient to live a life that is as useful and satisfying as his condition will permit when the
disease is chronic

ENVIRONMENT

I will nurse Mrs. Chamba in a medical ward preferably in a side ward to protect her from infection since
her immunity is compromised due to the illness. I will ensure that the room is warm by switching on a
heater to prevent hypothermia since anemic patients has less body heat as a result of reduced amount
of oxygen available for metabolism. I will also ensure that there is good ventilation to promote free
circulation of air. I will ensure that the room is noisy free by telling members of staff to reduce their
voices in the environment to promote rest. I will ensure that the room is clean by dumb dusting to
prevent harboring of infections

RESPIRATORY CARE

Severe anemia causes shortness of breath or dyspnea, I will ensure that Mrs. Chamba is comfortable in
bed by elevating the head of the bed to achieve a semi-fowler's position to promote full lung expansion
and relieve dyspnea. If dyspnea is present with the patient at rest, I will administer supplemental oxygen
by mask to improve tissue oxygenation or perfusion, I will arrange for blood transfusion of packed cells
may be since Mrs. Chamba severe anemia. I will increase the oxygen -carrying capacity of blood and
improve breathing. As the condition improves, I will let the patient adopt to any position of her choice to
promote comfort
 REST

I will put Mrs. Chamba on total bed rest until red blood cells and hemoglobin are increased in order to
reduce the demand for oxygen and conserve her energy. I will promote rest by ensuring that the patient
is comfortable in bed, restricting visitors and doing related nursing procedures at the same time so that
patient is not disturbed unnecessarily. I will ensure that squeaking trolleys are oiled to prevent noise and
there by promote rest. I will provide an explanation about the sauce of fatigue and weakness to create
awareness and gain cooperation. As the patient will be on total bed rest she is likely to have pressure
sores especially on the sacral area, therefore I will do pressure area care and provide an air ring to
prevent the formation of pressure sores

OBSERVATIONS

On admission, I will do vital signs observations of temperature, pulse, respirations and blood pressure to
act as the base line data in order to know if the condition is improving or deteriorating. I will do
subsequent vital signs observations every four hours to monitor the patient’s condition and response to
treatment. A high temperature will indicate presence of infection and I will work hand in hand with the
physician to do further medical investigations to identify the specific infection. I will observe the colour
of the conjunctiva, lips and tongue and other mucus membrane, to assess the degree of pallor whether
it is reducing or not. I will observe for presence of jaundice which may indicate hemolysis of red blood
cells. I will evaluate the patient for presence of edema which may indicate protein deficiency or onset of
complications such as heart failure; I will monitor the hemoglobin on alternate response to treatment. I
will monitor urine out-put hourly, noting changes in colour and volume of out-put. Oliguria will indicate
decreased renal perfusion and I will notify the physician for further investigations to be done

PROMOTING PATIENTS COMFORT

Patients with anaemia frequently experience severe headache and dizziness as a result of the cerebral
hypoxia. I will relieve symptoms by encouraging the patient to remain quiet and inactive. I will reduce
environment stimuli such as bright light and noise to prevent stimulating headache. I will apply cold
compress and give prescribed analgesic such as paracetamol to relieve headache

PSYCHOLOGICAL CARE

I will assess the patient’s level of consciousness and chest tightness and may be worried of the outcome
of his condition. I will assess the patient's level of anxiety so that I can know where to start from. I will
provide adequate information about his condition to increase awareness about the condition and there
by relieve anxiety. I will encourage the patient to ask questions about the condition to correct
misconception and relieve psychological tension and I will answer accordingly and honestly. I will
encourage the significant others to stay with him to promote a sense of belonging and thereby relieve
anxiety. When the condition improves, I will provide diversion therapy such as watching TV, reading
magazines or music if available to divert the patient's mind from thinking too much about his condition

NUTRITION AND FLUIDS

I will assess the nutritional and fluid status of the patient so that I know what interventions to put in
place. I will encourage the patient to eat diet which is high in all nutrients to meet his daily nutritional
demands and prevent of malnutrition. A highly nutritious diet is important in red blood cells formation. I
will ensure that the diet is light easily digestible and selected to provide the protein, iron, vitamins and
other elements necessary needed for production of red blood cells hemoglobin. I will discuss with the
patient the importance of foods increasing the red cells and hemoglobin and to determine his food
preferences. I will offer small but frequent meals to encourage patient to eat. If the patient s mouth,
tongue and oesophagus are sore, rough and hot and spiced foods will be avoided to prevent irritation
and trauma. I will encourage regular mouth washes, serve food in a clean environment in order to
promote appetite. I will encourage the patient to take adequate fluids to prevent constipation

MEDICATION

I will administer prescribed drugs and fluids such as blood to increase the hemoglobin and the oxygen
carrying capacity and promote healing hereby. I will monitor the patient for the effects and side effects
of the medication administered

HYGIEN AND INFECTION PREVENTIONN

In the acute phases of the condition when the patient is on total bed rest will, I will do bed bath to
remove dead epithelial cells and promote the patient's self-self-esteem. As the condition improves and
the patient is free from dyspnea, I will provide assisted baths. I will also encourage frequent oral care to
prevent halitosis and oral infections. Since a patient with iron deficiency anemia have stomatitis and a
sore tongue, I will do nail a soft bristled toothbrush to prevent oral trauma which may predispose the
patient to oral infections. The mouth will be cleansed before and after taking food. I will do nail care to
prevent skin breakdown since the patients skin is edematous tissue is liable to break down and I will do
2 hourly change of positions to prevent prolonged pressure on the bonny prominence. I will not allow
visitors and personnel with any infection, such as cold or sore throat to be in contact with the patient to
prevent cross infection

EXERCISES

Initially patients are on total bed rest, during this time, I will do passive exercises to improve blood
circulation and muscle wasting. I will assist patient with rang of motion to prevent bed rest
complications such as deep vein thrombosis due to vascular congestion. I will introduce actively slowly
as the patient's condition improves to prevent straining the heart
 ELIMINATION

I will monitor the patient's elimination pattern in term of urine and stool to detect any abnormalities
such as reduced urine output, constipation and diarrhea, if the patient is constipated, I will encourage
the patient to increase foods rich in fiber to relieve constipation which may lead to straining of the heart
 ADDITIONAL DATA

NURSING CARE PLAN FOR ANEMIA

Nursing problem Nursing diagnosis Goal/Objective Interventions and Rationale Evaluation

Ineffective Ineffective Mrs. Chamba will I will monitor patient’s Mrs. Chamba had
breathing pattern breathing pattern have normal respiration rate, depth and normal breathing within
related to hypoxia breathing within 2 quality to determine the 1 hour of my nursing
evidenced by hours of degree of ineffective interventions evidenced
dyspnea hospitalization breathing by normal respiration of
14 breaths/minute

I will position Mrs. Chamba

in semi-fowler’s position to
promote full lung expansion

I will administer
supplemental humidified
oxygen at the rate of 4-5
/liters/minute to improve
tissue oxygenation

I will do pulse oximetry to

assess oxygen saturation
and monitor patient’s
responses to oxygen
therapy
Risk for Risk for Mrs. Chamba will I will encourage the patient Patient nutritional status
imbalanced imbalanced have adequate to eat a balanced diet to is maintained within
nutrition less than nutrition less nutrition meet the body daily demand norms throughout the
the body than the body throughout for nutrients hospitalization evidenced
requirement requirements hospitalization by absence of signs of
related to I will involve the patient in malnutrition
anorexia the planning of his food
preferences can be taken
into consideration to
promote appetite

I will do regular mouth

wash, serve food in a clean
environment in order to
promote appetite

I will record intake and

output on a fluid balance
chart to prevent fluid
overload
Anxiety related to Patient will be relieved I will provide adequate information Patient will be
breathlessness evidenced of anxiety within one about his condition to increase relieved of anxiety
by patient being agitated hour of my nursing awareness about the condition and within one hour of my
interventions there by relieve anxiety nursing interventions
evidenced by the
patient being calm
I will reassure her that although her
condition can be controlled by
adhering to treatment and life style
modification

I will encourage the patient to ask

questions to relieve her psychological
tension and I will answer accordingly
and honestly

I will encourage significant others to

stay with her to promote a sense of
belonging and there by relieve
anxiety When the condition
improves, I will provide diversional
therapy such as watching TV, reading
magazines or music to divert the
patient’s mind from thinking too
much about the condition
Risk for pressure Risk for pressure Patient will be I will change the patient’s position Patient was free from
sore sore formation free of pressure 2 hourly to prevent prolonged pressure sores
related to sores formation pressure on the body prominences throughout my
enforcement throughout my nursing interventions
immobility during nursing I will put air ring below the evidenced by an
period of total interventions patient’s buttocks to relieve intact skin
bed rest pressure from the sacrum

I will do pressure area care to

improve blood circulation to bony
prominences

I will change the soiled linen to

maintain skin integrity
Intolerance Activity Patient will have I will put Mrs. Chamba on total bed Patient has improved
intolerance improved activity rest in an acute phase of the activity tolerance within
related to fatigue intolerance within disease to reduce oxygen demand 2 hours of my nursing
evidenced by 2 days of and preserve her energy interventions evidenced
patient’s hospitalization by patient being able to
exhaustion with I will do related nursing perform various activities
minimal activity procedures at the same time to without exhaustion
avoid unnecessary disturbance of
the patient

I will maintain adequately relieve

chest pain by both
pharmacological and non-
pharmacological means in order to
promote rest
d) State five complications of anemia 20%

1. Congestive cardiac failure- due to increased workload of the heart to pump more blood in order to
meet the metabolic needs of the body

2. Paralysis due to deficient of oxygen supply to the nerves

3. Respiratory acidosis due to increased levels of carbon dioxide in the blood

4. Recurrent infections due to lowering of the immunity

5. Respiratory failure due to severe hypoxia

QUESTION 2: ACUTE RENAL FAILURE

MRS KAY ANNIE MUTALE A 43 YEAR OLD INTREPRENUER HAS BEEN ADMITTED TO YOUR FACILITY
WITH A PROVISIONAL DIAGNOSIS OF ACUTE RENAL FAILURE

a)

i. Explain the process of urine formation 10%

ii. Draw a well labeled diagram of a nephron 15%

b) Explain the three (3) main causes of renal failure 15%

c) Discuss in detail the management of Mrs. Mutale throughout hospitalization 45%

d) State five (5) complications of renal failure 15%

____________________________________________________________________________________

ANSWERS/SOLUTIONS

a)

i. Explain the process of urine formation 10%

 Urine is formed in the nephrons through a complex three step process: simple filtration, tubular
reabsorption and tubular secretion

SIMPLE FILTRATION

Filtration takes place through the semipermeable walls of the glomerulus and glomerular capsule. Water
and a large number of small molecules pass through, although some are reabsorbed later. Blood cells,
plasma proteins and other large molecules are an unable to filter through and remain in the capillaries.
The filtrate in the glomerulus is very similar in composition to plasma with important exception of
plasma proteins. Filtration is assisted by the difference between the blood pressure in the glomerulus
and the pressure of the filtrate in the glomerular capsule

SELECTIVE REABSORPTION

Selective reabsorption is the process by which the composition and volume of the glomerular filtrate are
altered during its passage through the convoluted tubules, the medullary loop and the collecting tubule.
The general purpose of the process is to reabsorb into the blood those filtrate constituents needed by
the body to maintain fluid and electrolyte balance and the PH of blood. Active transport is carried out at
carrier sites in the epithelial membrane using chemical energy to transport substances against their
concentration gradients. Some constituents of glomerular filtrate (glucose, amino acids) do not normally
appear in urine because they are completely reabsorbed unless they are present in blood in excessive
quantities

SECRETION

Filtration occurs as the blood flows through the glomerulus. Substances not required and foreign
materials e.g. drugs including penicillin and aspirin, may not be cleared from the blood by filtration
because of the short time it remains in the glomerulus. Such substances are cleared by secretion into
the convoluted tubules and excreted from the body in urine. Tubular secretion of hydrogen (H+) ions is
important in maintaining homeostasis
ii. Draw a well labeled diagram of a nephron 15%

THE NEPHRONE
b) Explain the three (3) main causes of renal failure 15%

1. PRE-REANL CAUSES

These interfere with renal perfusion; the kidney depends on an adequate delivery of blood to be filtered
by the glomeruli. Therefore, reduced renal blood flow obviously decreases the glomerular filtration rate
(GFR). Conditions that causes renal failure are circulatory volume depletion are pre-renal causes of renal
failure. These include dehydration from diarrhea and vomiting: hemorrhage, burns, excessive use of
diuretics, vascular obstruction, and decreased cardiac output- heart failure

2. INTRA-RENAL CAUSES

Renal failure occurs as a result of damage of the kidneys, parenchymal changes occur from disease or
nephrotoxic substances, causes include acute tubular necrosis, acute pyelonephritis, sickle cell,
eclampsia, septic abortion, metabolic disorders, glomerulonephritis, nephrotoxic drugs e.g.
sulphonamides, uterine hemorrhage, vascular lesions crushed injuries to the kidneys

3. POST RENAL CAUSES

Renal failure results from obstruction of urine flow-arises from obstruction in the urinary tract,
anywhere from the tubules to the urethral meatus. Causes include; Prostatic hypotrophy, renal calculi,
urethral strictures, infection, surgery (accident ligation), tumour, blood clots, anticholinergic drugs,
Oedema or inflammation

c) Discuss in details the management of Mrs. Mutale throughout hospitalization 45%

MEDICAL MANAGEMENT

AIMS

- To identity the possible cause of the disease

- To treat the cause

- To promote normal renal function

 INVESTIGATIONS

1. HISTORY TAKING

 It will be done to identity the possible causes. There will be history of renal disease or a
condition leading to hypervolemia

2. PHYSICAL EXAMINATION

 It will reveal the signs of the disease such as peripheral edema

3. LABORATORY AND RADIOLOGICAL TEST

 Blood, Urea, Nitrogen (BUN), and serum Creatinine levels are high
 Blood potassium: serum electrolyte analysis will show increased levels of potassium due to
decreased GFR and increased phosphate concentration
 Kidney ultrasonography to evaluate the kidney status
 Electrocardiography (ECG) will reveal tall T waves, widening QRS complex and disappearing P
waves if hyperkalemia is present
 Hemoglobin estimation: Hb levels will reduce due to reduced erythropoietin production

4. TREATEMENT

The goal of the treatment is to remove the precipitating factors, maintain homeostatic balance and
prevent complications until the kidneys are able to resume function: treat the cause

 Restrict fluids: replace losses plus 400ml/24hoours. Medications that are handled by the kidney
will require modification of dosage or frequency to prevent medication toxicity
 Diuretics: in oliguric ARF for fluid removal, e.g. furosemide or manitol
 Antihypertensive drugs: to control blood pressure aldoment or Atenolol
 Aluminum hydroxide: an antiacid to control hypophosphatemia
 Sodium bicarbonate: to control acidosis
 Intravenous calcium: to reverse the cardiac effects of life threatening hyperkalemia
 Vitamin B and C: to replace loses if the patient is on dialysis
 Packed cells: for active bleeding or if anemia is poorly tolerated
 Diet: increased carbohydrate, reduce proteins, reduce potassium and reduce sodium intake,
however because of loss K+ during Diuretic phase, K+ may need to be increased during that time
 Peritoneal dialysis or hemodialysis may be done
 NURSING CARE

AIMS

1) To correct fluid and electrolyte imbalance

2) To relieve symptoms

3) To prevent infection

4) To prevent complications

ENVIRONMENT/PREVENTION OF INFECTION

Most patients in the acute stage of Acute Renal Failure will be cared for in the intensive care unit
because of the need for constant monitoring of blood pressure, electrocardiogram, pulmonary status
and mental status. I will keep side rails and use padded rails as necessary assess orientation and reorient
confused patient to prevent injury. I will maintain a quiet environment by controlling ward traffic and
noise to promote rest. I will ensure that there is good ventilation by opening windows to promote free
circulation of air. I will ensure that the environment is clean by doing daily dumb dusting to prevent
harboring of infection. I will put up measures to prevent infection because the patient is highly
susceptible to infection. I will use protective clothing when attending to the patient to prevent her from
contracting the infection. I will restrict visitors from entering the room to prevent the patient from
contracting the disease. I will maintain asepsis for indwelling catheter and when performing invasive
procedures

POSITION

If the patient is unconscious or lethargic, I will nurse the patient in a recumbent position with the head
turned to one side to promote drainage of oral secretions and thereby keep the airway patent. If the
patient is fully conscious and well oriented, I will nurse her in a semi-fowler's position supported by a
backrest or pillows to promote full lung expansion and relieve dyspnea. I will change the patient’s
position 2 hourly to prevent formation of pressure sores in bony prominences

REST AND SLEEP

I will put the patient on total bed rest in the acute phase of the illness until clinical signs disappear to
allow healing of the kidneys. I will promote rest by keeping the patient comfortable in bed. I will restrict
visitors and doing related nursing procedures at the same time so that the patient is not disturbed
unnecessary. I will ensure that squeaking trolleys are oiled to prevent noise and there by promote rest.
While the patient is bed rest, I will encourage passive and active exercises to promote blood and fluid
circulation to all body parts. When the condition improves, I will ambulate the patient to improve blood
circulation and I will allow the patient to resume normal activities gradually as symptoms subside
 OBSERVATIONS

On admission, I will do vital signs observations of temperature, pulse, respiration and blood pressure to
act as the base line data in order to know if the condition is improving or deteriorating. I will do
subsequent vital signs observations every 4 hours to monitor the patient’s condition and response to
treatment high temperature will indicate presence of infection and I will work hand in hand with the
physician to do further medical investigations to identity the specific infection. When the patient is
ambulant, I will assess the motor skills and monitor ambulation, assist patient if necessary. I will assess
the patient for signs of bleeding and prevent patient from bleeding by avoiding unnecessary invasive
procedures and by instructing to use soft tooth brush.

Since the patient is in prone position, I will assess the patient for signs of infection so that infection so
that infection can be detected and treated early. I will assess, the level of consciousness of the patient to
monitor the general condition, if the patient is stuporous state, I will put her recovery position, and tum
him every 2 hours to prevent pressure sores. I will assess pressure areas for any sores or swelling. I will
weigh the patient daily as well as abdominal girth to monitor edema. I will observe for indications of
fluid volume excess, including edema. I will also observe for indicators of volume depletion, including
poor skin turgor

NUTRITION AND FLUIDS

Most patients with Acute Renal Failure are too ill to tolerate oral feedings. Oral intake in worsen nausea
as a result of altered biochemical environment and GIT irritation. I will work hand in hand with dietitian
and physician to institute a diet that provides enough calories to avoid catabolism while preventing a
surplus of nitrogen. Catabolism will lead to an increased blood urea nitrogen levels because of the
breakdown of muscle for protein. I will restrict protein to 0.5g/kg of body weight per day. I will maintain
carbohydrate intake at around 100g/kg per day. Sodium and potassium will be restricted because they
are in excess in the body. I will restrict fluid especially in oliguric phase to prevent further fluid retention.
I will provide fluid in form of ice chips to minimize thirst. I will administer prescribed dietary
supplements to prevent malnutrition

PSYCHOLOGICAL CARE

I will find out level of understanding and knowledge of the disease from the patient to establish the level
of knowledge. I will provide adequate information about her condition to increase awareness about the
condition and their by relieve anxiety. I will reassure the patient and family that mental capacities will
return within recovery of kidney function. I will encourage the patient to ask questions to relieve
psychological tension and I will answer accordingly and honestly. I will encourage the significant others
to stay with her to promote a sense of belonging and thereby relive anxiety. When condition improves, I
will provide diversional therapy such as watching TV, reading magazines or music if available to divert
the patient's mind from thinking too much about his condition.
 HYGIENE/INFECTION PREVENTION

I will maintain a meticulous personal hygiene throughout the patients stay in hospital to promote
patient's comfort and prevent infections. Since the patient's skin is edematous, I will carefully clean it
every day and keep it dry to prevent its breakdown. I will administer antipruritic agent to relive itching
and promote comfort as well as prevent skin break down from scratching. I will wash my hands with
antiseptic soap under running water before and after attending the patient to prevent cross infection. I
will do pressure area care during baths to improve blood circulation and there by prevent pressure sores

ELIMINATION

I will monitor the patient's elimination pattern in terms of urine and stool to monitor bowel and kidney
function. I will monitor and record the quality and number of bowel movements to detect any problems.
I will provide prescribed stool softeners and bulk building supplements as necessary. If the patient is
constipated, I will suggest alternate dietary sources of fiber, such as unsalted popcorns. I will provide
fleet, enemas as prescribed to relieve constipation

PATIENT AND FAMILY TEACHING

I will teach the patient and family about the cause of renal failure and problems with recurrent failure. I
will also talk about identification of preventable environment of health factors contributing to the
illness, such as hypertension and nephrotoxic drugs are taught. I will also teach about medication
regimen, including name of medication, dosage reason for taking and side effects and about prescribed
dietary regimen. I will teach the patient about the signs and symptoms of returning renal failure such as
decreased urine out-put, without decreased fluid intake and signs and symptoms of infections. I will
emphasize the important of follow up care and give information about options for future. I will give
explanation of transplantation of the kidney and dialysis if there are possibilities
d) State five (5) complications of renal failure 15%

1)

2) Electrolyte imbalance

3) Metabolic acidosis

4) Pulmonary edema

5) Hypertension

6) Pneumonia

7) Congestive heart failure

8) Severe anemia

9) Infection

10) Hyperkalemia
QUESTION 3: HYPERIENSION

MR. PORTERFIELD MUNCHINI A WORKER AT PICK 'N' PAY HAS BEING BROUGHT TO THE HOSPITAL
WITH COMPLAINTS OF HEADACHE, BLURRED VISSION AND DIZZINESS. ON EXAMINATION THE
PATIENT HAS BEING DIAGNOSED WITH HYPERTENSION.

a)

i. State five (3) signs and symptoms of hypertension 10%

ii. Outline five (5) risk factors of hypertension 15%

b) Explain two (2) types of hypertension 10%

c) Identify five (5) problems that Mr. Munchini may have and using a nursing care plan, discuss how you
would manage them 50%

d) Outline five (5) complications of hypertension 20%

____________________________________________________________________________________

ANSWERS/SOLUTIONS

a)

i. State five (5) signs and symptoms of hypertension 10%

1. Occipital headache due to reduced oxygen perfusion to the brain resulting from increased
peripheral vascular resistance

2. Visual disturbance due to reduced blood supply to the retina

3. Palpitations due to increased cardiac output

4. Dizziness due to reduced blood supply to the brain

5. Fatigue due to reduced tissue perfusion

 6. Flushing due to increased peripheral resistance

7. Epistaxis as a result of rupture of small blood vessels in the nose due to raised blood pressure

8. Mild edema due to renal insufficiency leading to water retention which indicates renal
complication

9. Shortness of breath due to increased oxygen demand indicate

ii. Outline five (5) risk factors of hypertension 15%

1. Cigarette smoking: t increases chances of cardiovascular diseases and hypertension in one of

them. This is because nicotine is a stimulant to smooth muscles leading to vasoconstriction
causing a rise in blood pressure

2. Stress: This stimulates secretion of adrenaline, which promotes vas-constriction, leading to

increased peripheral resistance and raised blood pressure

3. Eating High fat diet: Elevated serum lipid from diet will cause accumulation of cholesterol that
settles on the wall of the blood vessels causing thickening and elasticity loss. Peripheral
resistance is increased leading to hypertension

4. High Sodium Intake: This cause’s fluid retention which eventually increases due to the increase
in blood volume thus, raises the pressure as there will be increased peripheral resistance due to
the increase in volume that has to flow through the same size of blood vessel lumen

5. Alcohol intake: This has risk association with the development of hypertension. It may have to
do with adrenergic stimulation leading to Vaso-constriction

6. Use of birth control pill: Oral contraceptive increases the risk of developing hypertension in
women, having a family history of hypertension and who, also stroke. They leading to release of
renin and increase fat deposition causing elevation of blood pressure
b) Explain two (2) types of hypertension 10%

1. PRIMARY HYPERTENSION

It is also known as essential or idiopathic hypertension whose causes are not known. It is the most
common type of hypertension which accounts for 90-95% of cases of hypertension. Its onset is usually
between 30-50 years. It is further subdivided into:-

 Benign hypertension: It is essential hypertension running for a consideration long period

of time and being asymptomatic

 Malignant hypertension: It is of sudden onset and produces severe symptoms making

survival to a few months or up to 2 years if not properly managed. It is a very serious
type of hypertension with an unusually sudden increases in blood pressure every high
level. It runs a rapid course damaging the inner linings of the blood vessels, heart,
kidneys, brain and spleen

2. SECONDARY HYPERTENSION

It is a type of hypertension resulting from other diseases and usually the cause is known. It is caused by
a specific disorder of a particular organ or blood vessels, such as the kidneys, adrenal glands or aortic
artery. It accounts for 5% to 10% of hypertensive population and occurs in people below 30 and above
50 years
c) Identify five (5) problems that Mr. Munchini may have, using a nursing care plan, discuss how you
would manage them 50%

Nursing Diagnosis Goal/objective Intervention and rationale Evaluation

Altered comfort Patient will have I will provide emotional to enable Patient has improved
related to headache improved comfort the patient cope up with comfort within 2
evidenced by patient within 2 hours of headache hours of nursing
being restlessness hospitalization interventions
I will administer prescribed evidenced by patient
analgesic to block pain receptors being calm
hence relieve pain

I will use diversional therapy to

divert the patients mind away
from pain

I will administer prescribed muscle

relaxation such as diazepam to
promote rest

Risk of injury related to Patient will be free of I will nurse the patient on the bed Patient was free from
dizziness caused by the injury throughout with side rails and raise the side injury throughout
disease and medication hospitalization raise to prevent falling of the bed hospitalization

I will lower the height of the bed

to reduce risk of falling off the bed

I will advise the patient to remain

in bed until he is free of dizziness
to prevent falling

I will support the patient when

standing and walking to prevent
falling
Anxiety Anxiety related to Patient will be I will orient the patient to the Patient will be
the unfamiliar relieved of anxiety hospital environment and its relieved of
hospital environment within one hour routines to create awareness anxiety within
and outcome of the hospitalization one hour of
condition evidenced I will reassure the patient that his nursing
by patient condition can be controlled interventions
verbalization through strict adherence to evidenced by
treatment and life style patient being
modification to calm the patient calm

I will encourage the patient to ask

questions to relive psychological
tension and I will answer
accordingly and honesty

I will provide diversional therapy

such as watching TV, reading
magazines, or music id available to
divert the patient’s mind from
thinking to-much of the condition

I will explain all the nursing

procedures done on the patient to
gain his cooperation and prevent
unnecessary anxiety
 Activity intolerance Patient will be free I will put Mr. Munchini on total Patient hard
related to fatigue of pressure sores best rest in an acute phase of the improved activity
evidence by patient’s formation disease to reduce oxygen demand tolerance within
exhaustion with throughout my and preserve her energy 2 hours of my
minimal activity nursing nursing
interventions I will do related nursing interventions
procedures at the same time to evidenced by
avoid unnecessary disturbance of patient being
the patient able to perform
various activities
I will maintain a quiet without
environment to promote sleep exhaustion

I will adequately relieve chest pain

by both pharmacological means in
order to promote rest

Knowledge deficit Knowledge deficit Patient will I will provide adequate Patient
about the condition demonstrate information about his condition demonstrated
and how to control it knowledge about and how to control it to increase knowledge about
related to lack of his condition and awareness about the condition the condition and
exposure to how to control it how to control it
information within one hour of I will provide brochures about the within one hour
evidenced by hospitalization condition to create more of hospitalization
patient’s inability to awareness about the condition
demonstrate
knowledge about the I will arrange for patient teaching
condition about the condition to facilitate
exchange of information
d) Outline five (5) complications of hypertension

1. ARTERY DAMAGE AND NARROWING

High blood pressures can damage the cells of the arteries’ inner lining. That begins a series of
events that make artery wall thick and stiff, a disease called arteriosclerosis.
2. HEART FAILURE
This result from the stain on the heart over time caused by high blood pressure. This cases the
muscle of the heart to weaken and work less efficiently. Eventually, the overwhelmed heart
simply begins to wear out and fail to pump adequate blood to all parts of the body.
3. KIDNEY FAILURE
High blood pressure is one of the most common causes of kidney failure, that’s because it can
damage both the large articles leading the kidneys and the tiny blood vessels (glomeruli)
damage within the kidneys. Damages to either make it difficult for the kidneys to effectively
filter waste from blood.
4. CEREBRAL VASCULAR ACCIDENTS
This is sudden disruption of blood supply to the brain. It occurs when the blood pressure
becomes abnormally too high leading to rupture of cerebral blood vessels and celebral
hemorrhage.
5. RETINOPATHY
This is any damage to the eyes, which may cause vision impairment. Results from reduced blood
supply to the retina as are result of Vaso-constriction.
6. ENCEPHALOPATHY
Is a term that means brain, damage or malfunction? It is caused by reduced blood flow to the
brain because of reduced blood flow.
 QUESTION 4: CEREBRA VASCULAR ACCIDENT

MR. CHOCOLET NYONDO IS A FARMER IN CHINBULIYA VILLAGE AGED 49 YEARS HAS BEEN
BROUGHT TO YOUR WARD IN UNCONSCIOUS STATE WITH HISTORY OF HYPERTENTION, MR.
NYONDO HAS BEEN DIAGOSED WITH CEREBRAL VASCULAR ACCIDENT.

a) Define cerebral vascular accident 5%

b)

i. Draw well labeled diagram of circle of Willis 15%

ii. State five (5) signs and symptoms of cerebral vascular accident 10%
iii. Outline two (2) types of cerebral vascular accident 10%

c) Explain the three causes of cerebral vascular accident 15%

d) Identify five (5) nursing problems that Mr. Nyondo may have and using a nursing care plan,
discuss how you would manage them 45%

SOLUTION/ANSWER

a) Define cerebral vascular accident 5%

 This is a sudden interruption of blood supply to the brain caused by obstruction or
rupture in one or more of blood vessels that supply the brain resulting in permanent
or temporary neurological dysfunction lasting longer than 24hours.
b)
i. Draw a well labeled diagram of circle of Willis 15%
CIRCLE OF WILLIS
 ii. State five (5) signs and symptoms of cerebral vascular accident 10%

1. Dysphagia: swallowing reflex may also be impaired

2. Aphasia: difficulty or inability to express self verbally
3. Agraphia: inability to express self in writing
4. Frequent, urgency and urinary incontinency
5. Alexia: inability to understand written words
6. Numbness: unable to feel or have sensations on the part of the body which should covey
sensation to the affected nerve center in the brain
7. Parasthesia: this is an abnormal tingling sensation (pin or needles)
8. Facial drooping: this is where the face bend or hang down limply
9. Paralysis: this can be of the face, leg or arm or entire side of the body such as hemiplegia,
quadriplegia, paraplegia
10. There may be loss of consciousness
11. Impaired breathing: due to dysfunction of one of the muscles that helps with breathing
12. Seizures: due to increase excitation of the nerve impulses within the brain
13. Nausea and vomiting: when the muscles of the GIT are affected
14. Neck stiffness and rigidity: when the muscles of the neck are affected

iii. Outline two (2) types of cerebral vascular accident 10%

1. ISCHEAMIC STROKE/HAEMORRHAGIC STROKE

In this type of stroke, there is no cerebral hemorrhage. However, stroke is caused by ischemia
(deficiency of blood supply to area of the brain). This ischemia can come about several ways, for
instance when there is cerebral thrombosis (this is where blood clots from within the blood
vessels of the brain). Ischemia can also be caused by cerebral embolism (detached clot from
somewhere e.g. the heart lodges in the brain). It can also occur when a fat embolus from the
marrow of the broken bone lodges in the brain.
2. HEAMORRHAGIC STROKE
This type of stroke can occur when there is rupture of blood vessels which causes hemorrhage
into the brain tissue or in a space for instance epidural/extradural (bleeding between the inner
skull and the dura mater compressing the brain underneath), subdural (bleeding between the
dura mater and arachnoid mater) and also the subarachnoid mater (bleeding between the
arachnoid mater and the pia mater).
 c) Three (3) causes of cerebral vascular accident 15%

1. CEREBRAL EMBOLISM
Cerebral vascular accident or stroke is caused by an emboli or detached clot which may lodge in
one of the cerebral arteries and produce a stroke. This kind of stroke is seen in diseases where a
clot forms on the left side of the heart and is carried up in the blood stream to lodge in one of
the cerebral vessels. The disease which most frequently causes a clot in the left side of the heart
are:- mitral stenosis with atrial fibrillation, myocardial infarction and sub-acute bacterial
endocarditis.
2. CEREBRAL THROMBOSIS
A blood clot forms in one of the arteries supplying the brain which blocks the artery and
deprives part of the brain of its supply. This is common in elderly people whose cerebral arteries
become thickened and roughened. The flow of blood is obstructed and clotting occurs.
3. CEREBRAL HAEMORRHAGE
This results from rupture of a cerebral blood vessel which produces hemorrhage into the brain.
This interrupts blood supply to the brain resulting in neurological dysfunction. This event is more
common in case of hypertension where the blood pressure rise too high and causes rupture of a
cerebral blood vessel.

d) Identify five (5) problems that Mr. Nyondo may have and using a nursing care plan, discuss
in detail how you are going them 45%
 NURSING CARE PLAN FOR MR. NYONDO

NURSING NURSING DIAGNOSIS GOAL/OBJECTIVE INTERVENTION AND EVALUATION ON

PROBLEM RATIONABLE
Ineffective Infective breathing Mr. Nyondo will I will monitor patient’s Mr. Nyondo had
breathing pattern related to have normal respiration rate, depth normal breathing
problem compression of the breathing within 1 and quality to within 1 hour of
respiratory center hour of my nursing determine the degree nursing interventions
evidenced by rapid interventions of ineffective evidenced by normal
respirations of 23 during breathing. respirations of 14
breaths/minute hospitalization breath/minutes
I will position Mr.
Nyondo in lateral
position d drainage of
oral secretions

I will insert an oral

pharyngeal air way to
prevent the tongue
from failing back ward

I will administer
supplemental
humidified oxygen at
the rate of
4-5/liters/minute to
improve tissue
oxygenation

I will do pulse oximetry

to assess oxygen
saturation and monitor
patient’s responses to
oxygen therapy
Risked for imbalanced Mr. Nyondo will I will insert a Mr. Nyondo nutrition
nutrition less than the have adequate nasogastric tube to status was
body requirements nutrition provide an alternative maintained within
related to decreased throughout way of feeding normal throughout
e body alertness, chewing hospitalization hospitalization and
requirements and swallowing I will provide nutritious evidenced by
difficulties resulting fluids based feeds to absence of signs of
from altered level of meet the patients daily malnutrition
consciousness nutrition requirements

I will administer
prescribed intravenous
fluids and electrolytes

I will record intake and

output on a fluid
balance chart to
prevent fluid overload
which may worsen
cerebral edema and
rise the intracranial
pressure
Self-care deficit Self-care deficit Mr. Nyondo will I will bath the patient in
related to altered have improved bed to improve dead
consciousness comfort epithelial
evidenced by throughout
patient’s inability hospitalization I will do oral care to
to do self-care prevent halitosis
activities
I will do nail care to
prevent harboring of
bacteria in the nails

I will change the soiled

linen to promote patient’s
comfort

I will do hair care to

prevent perdiculosis

Risk of pressure Risk of pressure Mr. Nyondo will be I will change the patient’s Patient was
sore formation sore formation prevented of position 2 hourly to prevented from
related to having pressure prevent prolonged developing
prolonged sores throughout pressure on the bony pressure sore
immobility hospitalization prominences throughout
hospitalization n
I will put air ring below the evidence by
patient’s buttocks to intact skin
relieve pressure from the
sacrum

I will do pressure area care

to improve blood
circulation to body
prominences

I will do pressure area care

to improve blood
circulation to bony
prominences

I will change the soiled

linen to maintain skin
integrity
Risk of hypostatic Risk of hypostatic Mr. Nyondo will be I will turn the patient every Patient was
pneumonia pneumonia related prevented from 2 hours to prevent stasis of prevented from
to prolonged developing tracheobronchial secretions developing
immobility hypostatic hypostatic
pneumonia I will involve the pneumonia
throughout physiotherapist in throughout
hospitalization performing chest exercises hospitalization
to immobilize trachea
bronchial secretions for
suction

I will gently suction out

bronchial secretions to
prevent their accumulation

ADDITIONAL DATA

PREDISPOSING FACTORS OF CVA OR STROKE

1. HYPERTENSION
This is a major risk factor for stroke, particularly in combination with atherosclerosis.
Hypertension can cause rupture of blood vessels supplying the brain due to high blood
pressure.
2. AGE
60-75% of all strokes occur in person over 65 years of age due to arteriosclerosis.
3. SEX
Men have a slightly increased incidence of stroke due to risk factors associated with
hypertension such as smoking.
4. HEART DISEASES
In some heart diseases, a clot can form due to the heart beating irregularly. For example a
clot can form on the left side of the side of the heart e.g. in mitral stenosis, atrial fibrillation
and myocardial infarction and sub-acute bacterial endocarditis. Also were the heart is not
able to pump enough blood to the brain causing.
5. REPEATED USE OF COAGULANTS
These promote clotting. Clotting can occur in the cerebral arteries or elsewhere in the body.
6. SMOKING
This can cause arteriosclerosis (hardening of the blood vessels).
7. OBESITY
Causes narrowing of the blood vessels due to accumulation of fats.
8. ALCOHOL
 It causes accumulation of fats in the blood vessels reducing the capacity carrying blood to
the brain.

9. DIABETES MELISTUS
If blood glucose levels are not controlled, there could be accumulation of glucose in the
blood vessels narrowing the lumen and reducing the amount of blood flow to the brain.
10. USE OF ORAL CONTRACEPTIVES
This is because of the fat cholesterol a steroid that is found in estrogen and progesterone.
Cholesterol is a precursor of these hormones and taking oral contraceptives can lead to
deposition of the cholesterol in the cerebral arteries narrowing the lining

COMPLICATIONS FOR CVA

1. CONTACTURE DISBILITY
They result from lack of exercises which lead to stiffening of the muscles causing
permanent shortening of the affected
2. SPEECH DEFECTS
This is because the center that controls speech on the brain is damaged leading poor
coordination of speech or total failure to speak
3. PERMANENT PARLYSIS
This may affect the limbs or face and occurs due to severe neurological deficit leading to
poor nerve stimulation to muscles
4. PRESSURE SORES
They may occur due to prolonged immobility and lack of exercises which lead to poor
blood circulation and prolonged pressure on bony prominences
5. HYPOSTATIC PNEUMONIA
This occurs due to prolonged immobility and lack of chest exercises which lead to
accumulation of trachea-bronchial secretions