STUDENT iO NUMBER: ............................................................

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UNIVERSITY OF GHANA
(All rights reserved)

SCHOOL OF NURSING AND MIDWIFERY

COLLEGE OF HEALTH SCIENCES
UNIVERSITY OF GHANA
BSC NURSING, FIRST SEMESTER EXAMINATIONS: 2017/2018
NURS 111: TRAUMA AND EMERGENCY NURSING (2 CREDITS)
TIME ALLOWED: TWO (2) HOURS

INSTRUCTION: ANSWER ALL QUESTIONS IN SECTION A& B

SECTION A

INSTRUCTION: CIRCLE THE CORRECT ANSWER ON THE

OUESTION PAPER PROVIDED

1. A 29 year old man sustained third degree burns on the front part of his trunk, both arms
and the perineum. Using Wallace's rule of nine, calculate the total body surface area of
the bum.
a. 27%
b. 37%
c. 36%
d. 39%
2. The following are signs of basilarlbasal skull fractures EXCEPT;
a. Cerebrospinal fluid (CSF) leak from the nose or ears
b. Battle's sign
c. Raccoon eyes
d. Hemoptysis

EXAMINERS:MRS G.ACHEMPIM·ANSONG & MS L NORMAN 10F 10

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3. All are first aid treatment for burns EXCEPT:

.a. Cool the area with cold liquid for at least 10 minutes.
b. Do not touch the injured area.
c. Do not burst blisters
d. Remove anything sticking to the burn.

4. Which of the following is the correct order when performing an abdominal examination? .:.

a. Inspection, palpation, percussion, auscultation

b. Inspection, percussion, palpation, auscultation'
c. Inspection, auscultation, palpation, percussion
d. Inspection, auscultation, percussion, palpation

5. Mr. Ansah (30 years) underwent an abdominal surgery (hernia repair). Post-operative
assessment revealed he was severely dehydrated. Which type of shock is he likely to
develop?
a. Distributive shock
b. Cardiogenic shock
c. Hypovolemic shock
d. Septic shock
6. A type of head injury that occurs on the opposite side of the impact is known as;
a. Coup injury
b. Closed injury
c. Contrecoup injury
d. Concussion
7. A child was reported to have been burn by electrical shock. On assessment at the hospital
using the rule of the palms. The nurse realizes the size of the burnt area is equivalent to 5
palms. The total body burnt area is equal to ................. .
a. 20% j

b. 10% I
c. 5%
d. 1%
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EXAMINERS:MRS G.ACHEMPIM·ANSONG & MS L NORMAN 2 OF 10

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Nurse Titi found a 17 year old girl lying unconscious. Report from onlookers suggests she was
drowned. Nurse Titi performed CPR and placed her in the recovery position after she regained
consciousness. Use this scenario to answer questions 8 and 9.

8. Which of the following best describes recovery position?

a. Placing client on her back
b. Placing client on her side
c. Placing client with head facing down
d. Placing client on her side with head slightly tilted up

9. What is the essence of placing the client in this position?

a_ To enhance circulation
b. To maintain an open airway and drain secretions
c. To facilitate recovery
d. To prevent onlookers from staring at client

10. Miss Dango was involved in an RTA. You were at ilie scene giving fust aid to her and
noticed straw-colored bleeding from the ear and nose. Which of the following is
indicative of this?
a. Skull fracture
b. Brain abscess
c. Concussion
d. Hematoma
11_ A patient is brought to your clinic with burns on his back after spending sometime on the
beach. The site of the burn is red, painful, and dry with no blisters_ This patient is likely
to have suffered from .............. _... .
a. 4th Degree burn
b. 3,d degree burn
c. 2 nd degree burn
d. 1Sl degree burn

EXAMINERS:MRS G.ACHEMPIM-ANSONG & MS L NORMAN 3 OF 10

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12. The part of the spine which usually not assoCiated with spinal cord injuries is
.......... region.
eli,
a. Cervical
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b. Thoracic
c. Lumber
d. Sacral
13. A burnt victim on admission suddenly develops rigors, mental confusion, apathy and
oliguria. On assessment she had fever, sudden fall in blood pressure and hypotension.
The patient is likely to be suffering from
a. Contractures
b. Dehydration
c. Renal failure
d. Septic shock
14. In Ghana the leading causes of abdominal injuries are
a. falls and road traffic acCidents
b. gunshot injuries
c. injuries following procedures
d. stab injuries
15. The cervical vertebrae consist of ................. ..
a. 5
b. 7
c. 9
d. 11
16. A pregnant woman in the third trimester has an abdominal injury. It is likely that the
............ may be injured.
a. Uterus
b. Kidney
c. Diaphragm
d. Aorta
17. In massive hemothorax more than .. """ .. ,, ...... milliliters of blood is loss
a.1.0
b.1.5
c.2.0
d.2.5
18. A common spinal injury in people who carry loads on the heads is usually referred to
as" .. " ....... neck
a. Babies
b. Cow
c. Crow's
d. Porter's

EXAMINERS:MRS G.ACHEMPIM-ANSONG & MS l NORMAN 40F 10

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• 19. In complete tetraplegia, the injury is located below ............ cervical vertebrae
a. C4
b. C5
c. C6
d. C7
20. Entry ofbolod and air into the pleural space is termed ................ ..
a. Hemothorax
b. Hemopneumothorax
c. Pneumothorax
d. Tension pneumothorax
21. The motor cortex is responsible for .................... ..
a. Hearing
b. Movement
c. Smell
d. Speech
22. A bleeding bruise to the brain caused by a direct impact to the head is known as ......... ..
a. Concession
b. Concussion
c. Confusion
d. Contusion
23. Hypoxaemia refers to as .................. in the blood.
a. Low oxygen
b. Low carbon dioxide
c. High oxygen
d. High carbon dioxide
24. The hand, wrist and ankle is bandage using .................. turn
a. Circular
a. Figure of eight
b. Recurrent
c. Spiral
25. A person goes into shock after hearing bad news. This is an example of............ shock.
a. Anaphylactic
b. Cardiogenic
c. Hypovolemic
d. Neurogenic ~
.t- 26. The following are all risk factors }lead injuries EXCEPT
a. Alcohol addiction
b. Colour blindness
c. Females
d. Males

EXAMINERS:MRS G.ACHEMPIM·ANSONG & MS L NORMAN 5 OF 10

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27. When there is crushing of the skin and muscle resulting in rough tears ofa wound is
referred to as ............ wound.
a. Abrasion
b. Contusion
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c. Laceration
d. Punctured
28. A patient with head injury is assessed using the Glasgow. Coma Scale (GCS).The score
on the scale is 6. This patient is'suffering from ............. Head injury.
a. Mild
b. Moderate
c. Severe
d. Very severe
29. The Cushing's response involves ................ ..
1. Bradycardia
II. Bradypnea
m. .Hypertension
IV. Hypotension
a. I,II&IV
b. I, II & III
c. I ,III& IV
d. II ,III,IV
30. All of the following can be used in dislodging an obstruction in the throat EXCEPT:
a. Coughing
b. Heimlich Maneuver
c. CPR
d. Chest thrust
31. Forcing a limb beyond the normal range of a joint is known as .................... .
a. Dislocation
b. Fracture
c. Strain
d. Sprain
32. Disaster management entails different activities. Temporal housing, claims processing
and long- term medical care are done during which phase of the disaster management?
a. Mitigation
b. Preparedness
c. Recovery
d. Response

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EXAMINERS:MRS G.ACHEMPIM·ANSONG & MS L NORMAN 60F 10
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• ~ 33. Two methods used in immobilizing an injured parUs ................ and ................ .
a. Splinting and tying the fracture part to the chest
b. Splinting and bandaging to the lower limbs
c. Tying the injured part and padding
d. Padding and holding the injured part
34. You are in a restaurant and you observe someone clutching the throat. The best thing to
do is ....
a. Assess the airway
b. Give the person some water to drink
c. Perform Heimlich maneuver
d. Assist the person into a recovery position
35. The chain of survival involves all of the following EXCEPT:
a. Recognition and call for help
b. Shock
c. CPR
d. Defibrillation
36. During a disaster casualties are group based on the surgeon's grouping for easy
identification and prompt treatment. People with minimal injuries or ambulatory are
identified with which color?
a. Red
b. Yellow
c. Green
d. Black
37. The following are signs of shock EXCEPT;
a. Hyperventilation
b. Increased blood pressure
c. Weak, tready pulse
d. Vomiting
38. A curious child drunk an amount of hot liquid and had serious blisters on the lips and
chest area. This type of injury can be termed as ........................... ..
a. Corrosive burns
b. Electrical burns
c. Radiation
d. Scald

EXAMINERS:MRS G.ACHEMPIM-ANSONG & MS L NORMAN 7 OF 10

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39. Which of the following is NOT a Principle of first aid treatment?

a. Never give unconscious patients anything by mouth
b. Place unconscious patients in the sitting up position
c. Remove casualty from danger
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d. Treat the most urgent condition first

40. The following are all common causes of trauma EXCEPT;

a. Raptured spleen
b. Road Traffic Accident
c. Falls from a height
d. domestic violence and assault

41.' The immediate assistance or treatment given to someone injured or suddenly taken ill before the
arrival of an ambulance, doctor or transporting the person to hospital is referred to as;

a. Cardiopulmonary resuscitation
b. Emergency management·
c. First aid management
d. Immediate management

42. Which of the following is NOT a Sign or symptom of hyperglycemia?

a. Drowsiness.
b. Profuse sweating
c. Rapid pulse
d. Restlessness

43. The victim presents with signs and symptoms of shock but the skin is warm to touch. What type of
shock is this?
a. Cardiogenic shock
b. Hypovolemic shock
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c. Neurogenic shock
d. Septic shock
44, Types of open wounds include the. following EXCEPT; I
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a. Abrasion I
b. Contused wound
c. Incised wound
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d. Lacerated wound I
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45. Which of the following is a common cause of acute abdomen? !I
a.. Acute pancreatitis
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b.. Intestinal obstruction I
c. Typhoid perforation.
d. All of the above !
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46. Purposes of bandaging include;

EXAMINERS:MRS G.ACHEMPIM-ANSONG & MS L NORMAN 80F 10

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• a. To control bleeding
b. To support and immobilize a limb
. c. To reduce swelling
d. All of the above
47. Which type of bandaging is most appropriate for bandaging the wrist and ankle?
a. Circular tum
b. Figure-of-eight tum
c. Recurrent tum
d. Spiral tum

48. Common chest injuries leading to trauma death include the following EXCEPT;
a. Broken ribs
b. Hemothorax
c. Pneumothorax
d. Spondylosis

49. When.perfonning an abdominal examination, the presence of tenderness, guarding and

rebound tenderness suggests ............................. .

From question SO-52, Match the type of bum with its sign.s or clinical presentation;

Type of burn Signs

50. First degree bum a. Fonnation of blisters

51. Second degree bum b. Presence of eschar
52. Third degree bum c. Red, painful and dry
d. Heals within 10-30 days
53. Types of bandaging include ........... .
a........................................... .
b........................................... .
c. . ............................................ .
d ........................................... . (4marks)
54. The first aid treatment for a client with a soft tissue injury can be tagged with the
acronym 'RICE'. What does 'RICE' stand for?
a................................. .
b................................. .
c ................................. .
d................................. . (4 marks)

EXAMINERS:MRS G.ACHEMPIM-ANSONG & MS L NORMAN 9 OF 10

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SECTlONB
ANSWER ALL THE QUESTIONS IN THE ANSWER BOOKLE! PROVIDED

OUESTION ONE:
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I. You are working at a control Centre for disasters and emergencies. During a real disaster,
there are a number of activities which needs to be put in place to help those involved.
a. Enumerate the response that you will put in place to lessen the effect of the
disaster. (10 marks)
b. Some.)of the casualties brought to the facility have suffered burnt injuries. Describe
the first aid management of burns of a patient with 3rd degree burns. (5marks)
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c. Describe how you would resuscitate a casualty who is unresponsive. (5 marks) !

TOTAL 20 MARKS
OUESTION TWO:
A. Mr Eduam, aged 50 was involved in a road traffic Accident and was rushed to the casualty
unit with severe bleeding. Patient came in a state of shock
1. Mention and describe the type of shock client has(4marks)
\1. Describe the emergency management of Mr. Eduam(6marks)

B.
1. Enumerate 4 principles of first aid (4marks)
\1. Describe the first aid management of the following conditions;
1. Epistaxis(3 marks)
2. Hypoglycemia(3 marks)
TOTAL 20 MARKS

EXAMINERS:MRS G.ACHEMPIM-ANSONG & MS L NORMAN 10 OF 10