Medicine May 2021

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SECTION A: MULTIPLE CHOICE QUESTIONS

IN EACH OF THE FOLLOWING QUESTIONS, ENCIRCLE THE LETTER CORRESPONDING WITH THE MOST
APPROPRIATE ANSWER.

ONE (1) MARK EACH

1. A type of wound that occurs when the skin is broken by an instrument with uneven edges is called:-

a) Incised wound

b) Lacerated wound

c) Punctured wound

d) Contused wound

2. Mechanical friction on the wound delays wound healing by:

a) Destroying granulation tissue and preventing apposition of wound edges

b) Slowing collagen synthesis by fibroblasts, maintaining circulation, requiring long time for
epithelialization of the skin.

c) Increasing inflammatory response and tissue destruction.

d) Decreasing blood supply to the area in fatty tissue

3. An artificial opening made into the major portion of the small bowel in order to divert enteral content
to the exterior is called:-

a) Colostomy

b) A stoma

c) Anastomosis

d) Ileostomy
4. One of the following condition can predispose a person to colorectal cancer:

a) Chronic diarrhea disease

b) Acute abdomen

c) Ulcerative colitis

d) Impacted worms

5. A patient with malignancy of the larynx may require emergence surgery if:

a) There is a complete obstruction of food passage.

b) There is a complete obstruction of the airway.

c) There is a complete obstruction of the bowel.

d) There is metastasis.

6. Which of the following is NOT a principle of surgery?

a) All the procedures must be done immediately after cleaning the operating environment.

b) Make sure that all equipment to be used in a surgical procedure is sterilized or high level disinfected.

c) Start with clean procedures and end with dirt ones

d) Always begin with serious cases then proceed to the non-urgent ones.

7. A surgical incision for tracheostomy is made between:

a) 1st and 2nd tracheal cartilage.

b) 2nd and 4th tracheal cartilage

c) 3rd and 4th tracheal cartilage

d) 4th and 5th tracheal cartilage


8. Which one of the following is NOT a possible outcome of Inflammation?

a) Resolution

b) Sepsis

c) Anaphylaxis

d) Oedema

9. Which of the following is NOT an Indication for underwater seal drainage

a) Pneumothorax

b) Ascites

c) Heamothorax

d) Lobectomy

10. The nurse notices that the patient has difficulties in breathing during sleep and uses three pillows for
relief. The patient may be experiencing:

a) Ventricular Claudication

b) Hyperventilation

c) Nocturnal Orthopnea

d) Paroxysmal nocturnal dyspnea

11. Which one of the following statements is correct regarding eye swabbing?

a) Swab from the nasal canthus to the temporal canthus

b) Swab from temporal canthus to the nasal canthus

c) Start with the affected eye

d) Start with the unaffected eye


12. The most critical care in the first two days for a patient who has undergone transurethral resection
of the prostate is:

a) Pain management

b) Adequate nutrition

c) Bladder irrigation

d) Positioning of the patient

13. Risk factors for rheumatoid arthritis include most of the following EXCEPT:

a) Genetic/family history of the disease

b) Sex/Gender

c) Aging

0) Blood group

14. Which one of the following is NOT a bacterial cause of septic arthritis?

a) Staphylococcus aureus

b) Haemophylus influenza

c) Neisseria Gonorrhoea

d) Influenza type 1 and2

15. An injury to the soft issue, ligaments or around a joint usually caused by a wrenching or twisting
motion is called:

a) Strain

b) Sprain

c) Subluxation

d) Fracture
16. A fracture that involves the break across the entire section of the bone and frequently displaced
from its normal position is called:

a) Complete

b) Green stick

c) Transverse

d) Stable

17. Partial foot amputation is also known as:

a) Syme

b) Pyrogoff

c) Chopart

d) Transfemoral

18. The confirmatory diagnostic test for Benign Prostatic Hypertrophy is:

a) Prostate ultra sound scan

b) Digital Rectal Examination

c) Prostate-specific antigen

d) Visibly large prostate

19. The type of gangrene that result from reduced or blocked arterial blood flow is referred to as:-

a) Wet

b) Dry

c) Gas

d) Tissue
20. Which of the following sites is most common in spinal injuries?

a) Sacral spine

b) Upper cervical spine

c) Thoraco-lumbar segment

d) Lower cervical spine

21. Which of the following develops when venous return from the anal canal is impaired?

a) Anal fissure

b) Anal fistula

c) Piles

d) Anal abscess

22. The most common cause of bacterial prostatitis is:

a) Klebsiella

b) Enterobacter

c) E. Coli

d) Staphylococcus

23. Which of the following is the direct cause of liver cirrhosis?

a) Prehepatic

b) Intrahepatic

c) Posthepatic

d) Biliary obstruction.
24. Which of the following is an ideal bed for a patient with burns on the abdomen?

a) Divided bed

b) Plaster bed

c) Post-operative bed

d) Cardiac bed

25. The type of anaesthesia which is administered directly into the nerve that supplies the operated area
is termed:

a) Infiltration anaesthesia

b) Spinal anaesthesia

c) Epidural anaesthesia

d) General Anaesthesia

26. The metallic bone disorder in which the rate of resorption accelerates, and the rate of bone
formation decelerates resulting into decreased bone mass is called:

a) Osteosarcoma

b) Fracture

c) Osteomyelitis

d) Osteoporosis

27. Which of the following bone is found superior to the patella and inferior to the ischium?

a) Femur

b) Calcaneus

c) Symphysis pubis

d) Tibia
28. Hypopyon is:

a) Blood in the anterior chamber of the eye

b) Pus in the ear

c) Pus in the anterior chamber of the eye

d) Pus in the pleural cavity

29. During removal of underwater seal drainage tubes, the patient is asked to take a deep breath and
hold it in order and hold it in order to:

a) Prevent collection of blood from the injury site in pleural cavity

b) Prevent a rush of air into the puncture site

c) Prevent backflow of aspirate into the chest

d) Facilitate full lung expansion

30. The type of brain injury where there is bruising of brain tissue is called:

a) Concussion

b) Contusion

c) Epidural hematoma

d) Subdural hematoma

31. Hematoma caused by bleeding between the skull and the dura is called:

a) Epidural hematoma

b) Subdural hematoma

c) Subarachnoid hematoma

d) entra-cerebral hematoma
32. Which one of the following explains why skin traction is preferred to provide immobility and
alignment of fractured bone(s) of the lower limb in children and elderly patients?

a) To reduce pain

b) To prevent further damage to the bone tissue

c) To prevent further damage to the neuro-muscular tissue

d) Children and elderly patient do not easily cooperate

33. Malignant tumours differ from benign tumours in that malignant tumours:

a) Are encapsulated

b) Remain localized

c) Infiltrate surrounding tissue

d) Always require radiation therapy

34. Closure of the canal of schlemn results in:

a) Infection of the choroids and retina

b) Conjunctivitis

c) Increased intraocular pressure

d) Tearing

35. The pinna is also known as:

a) Outer ear

b) Auricle

c) Malleus

d) Stapes
36. The ear receives its nerve supply from:

a) Vestibulocochlear nerve

b) Tympanic nerve

c) 2nd cranial nerve

d) Eustachian nerve

37. Deafness caused by impaired transmission of sound through the outer or middle ear to the fluid in
the cochlea is known as:

a) Sensorineural deafness

b) Conductive deafness

c) Psychogenic deafness

d) Mixed deafness

38. Abnormal dilatation of the pupil of the eye is called:

a) Myopia

b) Miosis

c) Mydriasis

d) Aphakia

39. Acuteness or clearness of vision is measured by:

a) Snellen chart

b) Perimetry

c) Slit lamp examination

d) Ophthalmoscope
40. Cholesteatoma is best defined as a:-

a) Brownish-grey mass of impacted epithelial tissue, pus, and fatty substances

b) Reddish-grey mass of impacted epithelial tissue, pus, and fatty substances

c) Whitish-grey mass of impacted epithelial tissue, pus, and fatty substances

d) Yellowish-grey mass of impacted epithelial tissue, pus, and fatty substances

41. The pathological alteration in the sire, shape, and organization of differentiated cells is known as:

a) Dysplasia

b) Hyperplasia

c) Metaplasia

d) Degeneration

42. Which one of the following is a form of cancers that occur in supportive structures, such as bone,
muscle, cartilage, fat, or fibrous tissue

a) Adenocarcinomas

b) Carcinomas

c) Sarcomas

d) Blastomas

43. Which of the following nursing advice to the patient with peptic ulcer on discharge is

NOT important?

a) Avoid bland diet

b) Encourage adequate rest

c) Reduce stress

d) Take medication as prescribed


44. Mrs. Kanda Kanda complained of pain and difficulty in swallowing. This term is referred as:

a) Dyspepsia

b) Dysphagia

c) Odynophagia

d) Pyrosis

45. A male patient has a sucking stab wound to the chest. Which action should the nurse take first?

a) Drawing blood for a hematocrit and hemoglobin level

b) Applying airtight dressing over the wound

c) Preparing a chest tube insertion tray

d) Preparing to start an intravenous line

46. Topical glucocorticosteroids are used for treating:-

a) Iridocylitis

b) Keratitis

c) Conjunctivitis

d) Uveitis

47. Which of the following is NOT a sign and symptom of pleural effusion

a) Shortness of breath

b) Chest pains

c) Haemoptysis

d) Fever
48. A nurse calls a physician with the concern that a patient has developed a pulmonary embolism.
Which of the following symptoms has the nurse most likely observed?

a) The patient is somnolent with decreased response to the family.

b) The patient suddenly complains of chest pain and shortness of breath,

c) The patient has developed a wet cough and the nurse hears crackles on auscultation of the lungs.

d) The patient has a fever, chills, and loss of appetite

49. The physician makes an order for the nurse to discontinue a patient's nasogastric tube following
abdominal surgery. Before removing the tube, the nurse should:

a) Aspirate gastric contents to make sure that the residual volume is less than 50 ml

b) Assess for client's bowel sounds

c) Make sure that the client is able to swallow and chew food

d) Determine the integrity of the taste buds

50. The Glasgow coma scale is used to evaluate the level of consciousness in the patients with
neurological condition. The three assessment factors included in this scale are:

a) Pupil size, response to pain, motor responses

b) Pupil size, verbal response, motor response

c) Eye opening, verbal response, motor response

d) Eye opening, response to pain, motor response


SECTION B: MATCHING ITEMS

RESPONSES IN COLUMN II SHOULD BE USED ONLY ONCE

Match the types of surgical procedures in Column I with their description in Column II

Column I Column II

51._Simple Mastoidectomy A. Myringoplasty is combined with ossicular

Reconstruction

52._Radical Mastoidectomy B. The surgeon opens the mastoid bone and

Removes the infected air cells.

53._Myringotomy C. Repair of the perforation of the

Tympanic membrane alone

54._Tympanoplasty D. Surgical incision of the tympanic membrane to

Allow drainage and relieve pressure

55._Myringoplasty E. A narrow tube called an endoscope is passed

Into the nose

F. Involves removal of the mastoid bone, excision

Of the posterior wall of the ear canal, remnants

Of the tympanic

G. Removal of some ear part to prevent the brain

From receiving signals


Match the following terms in Column I to their definitions in Column II

Column I Column II

56._Cystitis A. Inflammation of the gall bladder

57._Cystoscopy B. Inflammation of the urinary bladder

58._Cystostomy C. Narrowing of the urethral lumen

59._Urethreal stricture D. Visualization of the urinary bladder via an endoscope

60._Cystectomy E. An incision made into the urinary bladder

F. Surgical removal of the gall bladder

G. Surgical removal of the urinary bladder

Match the types of casts in Column I with their best descriptions in Column II

Column I Column II

61._Long arm cast A. Encases the trunk

62._Thumb spica B. A body cast that encases the trunk, shoulder and elbow

63._Shoulder spica C. Extends from axilla to palm, with the elbow normally

64._Walking cast D. Extends from below the elbow to the palm and includes the thumb

65._Body cast E. A short or long leg cast with a rubber or metal walking device

Attached to the foot

F. A body cast that encases the trunk and one or both lower extremities

G. Encases the neck


Match the medicines in Column I with the group they belong to in Column II

Column I Column II

66._Kanamycin A. Cephaslosporin

67._Cefotaxime B. Oral hypoglycaemic-biguanide

68._Metformin C. Schistosomicide

69._Sulphadoxine D. Calcium channel blocker

70._Apresoline HCL E. Antimalaria

F. Oral hypoglycaemic - sulphonylurea

G. Aminoglycoside
SECTIONC: COMPLETION

COMPLETE THE FOLLOWING SENTENCES WITH THE MISSING WORD(S).

71. A strand of material used for tie a bleeder is called ________________________

72. The inflammation of the gums is called ________________________________

73. An Incision Into the urinary bladder to drain urine from the bladder is called _______

74. When continuous bladder drainage is needed and a catheter is inserted and stay in the bladder by
means of a self-retaining balloon is called ___________________________

75. An abnormality in which, part of the stomach protrudes through the diaphragm is called
____________ hernia

76. ____________________________is the most common renal cancer that develop in the renal cortex.

77. ______________________ is a cancer of the kidneys that typically occurs in children

78. _______________________ is the delivery of radiation therapy through internal implants.

79 .The ____________________ is a biconvex transparent disc made of proteins called crystallines and it
is located directly behind the iris and focuses light on to the retina.

80. ______________________ is a condition in which the eye does not focus light evenly onto the
retina.

81. __________________ is an age-related condition in which the ability to focus up close becomes
more difficult.

82. Scrub nurses are also known as _______________________

83. In a surgical team, the Runner is also known as ________________________________

84. The procedure of blocking the production of testosterone by use of drugs like Zoladex is called
__________________________

85. ______________________ is a type of fracture that occurs in an area of a diseased bone tissue as
occurs in osteosarcoma.

86. A medical officer who is specialized in the treatment of cancers is called _______________

87. __________________________ is formation of stones (calculi) within the gall bladder or biliary duct
system.

88. Skin care around the cystostomy tube is critical in order to prevent _____________________
89. An incision located at the suprapubic skin crease about 5cm above the pubic symphysis and
commonly used in caesarean section operations is called __________________________

90. The presence of stones in the ureters is called _____________________________

91. __________________ is the condition due to an abnormal proliferation of mesenchymal elements in


the bone marrow, spleen, liver and lymph nodes.

92. A type of surgery that uses effects of freezing to treat tissue disease is called ___________________

93. ___________________ is a reconstructive surgery of a joint or joints to restore motion because of


ankylosis or trauma or to prevent excessive motion.

94. A _________________________ is an injury to the soft tissue around a joint.

95. The space of the spinal cord in which the spinal anaesthetic is injected is the ___________ space

96. The type of forceps that must be available during Intubation is called __________________

97. A process of supporting respiration by manual or mechanical means when normal breathing is
inefficient or has stopped is known as _________________________

98. The other name for Cidex is ______________________

99. An abnormality in which the opening of the urethral meatus lies on the dorsal surface of the penis is
called _______________________________

100. An Increase in the number of cells of a tissue; most often associated with periods of rapid body
growth is called ____________________________
SECTION D: ESSAY QUESTIONS

ANSWER TWO QUESTIONS ONLY. QUESTION ONE (1) IS COMPULSORY.

1. Mr. Moyo, a 45 year-old peasant farmer Is brought to the Emergency Room with history of having
fallen from a tree. He sustained a ruptured spleen and is scheduled for splenectomy.

a) i. Define splenectomy 5%

ii. State five (5) indications of splenectomy, other than the one mentioned above 10%

b) Explain five (5) functions of the spleen in the human body 15%

c) Outline the pre-operative care you are going to give to Mr. Moyo 50%

d) Mention five (5) complications that Mr. Mayo may develop post-operatively and explain how you are
going to prevent each of the mentioned problem 20%

2. Ms. Nyambe, a 25 year old Public Relations Officer, sustains burns of the face and neck after her
house caught fire. She is admitted to your ward.

a) i. Define burns 5%

ii. Using the Wallace's Rule of Nines, calculate the burnt surface Ms. Nyambe may

Have sustained 10%

b) Draw a well labelled diagram of the skin 15%

c) Identify five (5) nursing problems that Ms. Nyambe may have during hospitalization and using the
nursing care plan, outline how you are going to manage them 50%

d) Give five (5) reasons why nurses should study Psychology 20%
3. Mr. Lungu, a 20 year old university student has reported to your Ear, Nose and Throat (ENT) clinic
with complaints of failure to perceive sound in the left ear for six months. On examination, he was
diagnosed to have Hearing Impairment

a) i. Define Hearing Impairment 5%

ii. Mention five (5) causes of hearing impairment 15%

b) Explain four (4) types of hearing loss 20%

c) Outline six (6) ways you would use in the rehabilitation of a deaf client 30%

d) Nurses play a critical role in the provision of a safe environment for the patients. Mention six (6) ways
by which a nurse can provide a safe environment for the patient in a ward set up 30%

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