A.

The common cause of blindness in HIV (Human Immunodeficiency virus is

A. Cotton wool spots
B. Cytomegalovirus retinitis
C. Karposis Sarcoma
D. HIV microangiography

2 Age related Macular degeneration ( ARMD is responsible for the following visual field defects

A. Central
B. Peripheral
C. Bitemporal Hemianopia
D. Binasal Hemianopia

3. In the international classification of diseases,”Visual Impairement” is a visual acuity of

A. 6/6
B. 6/36
C. 6/60
D. 6/18

4 .The first clinical feature of Vitamin A deficiency is

A. Night blindness
B. Bitot’s spots
C. Keratomalacia
D. Conjunctival Xerosis

5. Direct ophthalmoscopy project

A. Virtual, erect and magnified image

B. Real ,inverted and magnified image
C. Real ,erect and magnified image,
D. Virtual, inverted and condensed image

6. Retinoscopy is

A. Visualization of the retina alone

B. Visualization of the retina and other posterior segment contents
C. Objective measurement of the refractive error of a patient
D. Subjective measurement of the refractive error of the patient

7. Proliferative diabetic retinopathy is characterized by

A. Microaneurysms
B. Cotton wool spots
C. Neovascularization
D. Retinal detachment

8. According to Kenya Essential Package for Health (KEPH| Tiers of care county and sub county Hospitals
belong to
 A. Level 1
B. Level 2
C. Level 3
D. Level 4

9. The following are functions of community Health workers

A. Treating common eye ailments and minor injuries

B. Supportive supervision
C. Reviewing and developing health sector policies
D. Mobilizing and allocation of resources in the community

10. The type of immunity that is passed onto a bady during breastfeeding is called

A. Natural Active immunity

B. Natural Passive immunity
C. Artificial Active Immunity
D. Artificial Passive Immunity

11.The following Immunoglobulin is correctly matched with it’s function

A. Ig M………………..Most abundant immunoglobulin in blood

B. Ig A………………….Found on the surface of B Lymphocytes
C. Ig D………………….Present in people with allergies and drug sensitivity
D. Ig E………………….Found in secretions like mucous ,tears and saliva

12.A Nursing Research is

A. Lab experiment
B. Systematic and scientific inquiry
C. Report
D. Hypothesis

13.On the basis of information sought there are two types of research which are

A. Explorative and Explanatory Research

B. Descriptive and Correlation Research
C. Basic and applied Research
D. Qualitative and Quantitative Research

14.A mscientific study and Research that seeks to solve practical problems is

A. Basic Research
B. Applied Research
C. Explanatory Research
D. Descriptive Research

15. The sampling technique used in Research when the population under study id heterogeneous is
 A. Simple Random sampling
B. Systematic Random sampling
C. Stratified Random sampling
D. Snow balling

16. The appropriation of another person’s ideas, processes, results or words without giving appropriate
credit is

A. Falsification
B. Fabrication
C. Jurisdiction
D. Plagiarism

17 .Measurement of visual Acuity to class 7 students during school health and recording as
6/6,6/18,6,36….. is an example of

A. Applied Research
B. Descriptive Research
C. Qualitative Research
D. Quantitative Research

18. The authenticity of research findings is it’s

A. Originality
B. Validity
C. Objectivity
D. Reliability

19.The following is the first step in research process

A. Searching sources of information to locate the problem

B. Survey of related literature
C. Identification of the problem
D. Searching for a solution

20.A Hypothesis in Research is

A. A conclusion drawn from data analysis

B. A summary of the research findings
C. A measurement of data accuracy
D. A statement of predicted relationship between variables

21.An example of primary source of data in research is

A. Research article
B. Text book
C. Meta-analysis
D. Interview report

22. Random sampling in Research is

 A. A sample that is selected by chance
B. A sample that is selected from a population in a systematic way
C. A sample that is selected based on convenience
D. A sample that is selected based on a specific criteria

23. An example of a non-experimental research design is

A. Randomized controlled trial

B. Quasi experimental Research
C. Case study
D. Cross sectional study

24. The ideal fluid for irrigation during Extracapsular cataract extraction is

A. Normal saline to dextrose

B. Balanced salt solution
C. Normal saline
D. Balanced salt solution and glutathione

25. A 60 year old male patient operated for cataract 6 months back now complains of floaters and
sudden loss of vision .The probable diagnosis is

A. Vitreous hemorrhage
B. Retinal detachment
C. Central retinal artery occlusion
D. Cystoids macular oedema

26. A common complication of anterior chamber intraocular lens is

A. Glaucoma
B. Hyphema
C. Sub luxation
D. Retinal detachment

27 .Leaving the posterior capsule behind during cataract surgery is advantageous because it

A. Prevents cystoid macular oedema

B. Decreased endothelial damage
C. Progressively improves vision
D. Decrease chance of retinal detachment

28.Schwalbe’s line corresponds to

A. Corneal endothelium
B. Descement’s membrane
C. Schlemm canal
D. Ciliary body

30.The normal cup disc ratio is

A. Below 0.5
 B. Elow 1.0
C. Below 1.5
D. Below 0.1

31 .A patient comes to the casualty with and acute bronchial asthma after treatment for glaucoma.The
probable drug may be

A. Timolol
B. Betaxolol
C. Latoprost
D. Anticholinesterase

32.A 55 year old female patient comes to the casualty with history of severe eye pain,redness and
diminution of vision.On examination the visual acuity is 6/60,there is corneal congestion,corneal
oedema and a shollow anterior chamber.The drug of choice is

A. Atropine ointment
B. I.V Mannitol
C. Ciprofloxacin eye drops
D. Betamethasone eye drops

33.The most sensitive part of the Retina is

A. Optic disc
B. Fovea centralis
C. Macular Lutea
D. Peripheral retina

34.A patient is on follow up following enucleation of a painful blind eye.A Proper sized prosthetic eye is
advised after a post operative period of

A. 10 days
B. 20 days
C. 6..8 weeks
D. 12…24 weeks

35.Bitemporal hemianopia field defect is characteristic of

A. Glaucoma
B. Optic neuritis
C. Pituitary tumour
D. Retinal detachment

36 .A female patient ,20 years old presents with complaints of difficulty in reading near print.On
examination ther is ptosis and diplopia when looking in all directions. The probable diagnosis

A. Lateral rectus palsy

B. Oculomotor palsy
C. Presbyopia
D. Myasthenia gravis
37.The common cause of eye discharge in a 2 month old infant is

A. Ectropion
B. Congenital nasolacrimal duct blockage
C. Ophthalmia neonatorum
D. Vernal catarrh

38.Mucin layer deficiency occurs in

A. Keratoconjunctivitis
B. Lacrimal gland removal
C. Canaliculi blockage
D. Herpetic keratitis

39.Adhesions of margins of two eyelids is called

A. Symblepharon
B. Ankyloblepharon
C. Blepharophimosisi
D. Ectropion

40. The commonest malignant tumour of the eyelid is

A. Squamous cell carcinoma

B. Basal cell carcinoma
C. Malignant melanoma
D. Sebaceous cell carcinoma

41.The orbital wall often fractured in a blow out fracture due to fist cuff injury is

A. Superior wall
B. Inferior wall
C. Medial wall
D. Lateral wall

42. Following a road traffic accident a patient develops proptosis and pain over the right eye on the 4 th
day .On examination there is a bruise on the eye and the forehead. The diagnosis is

A. Fracture sphenoid
B. Cavernous sinus thrombosis
C. Internal carotid artery aneurysm
D. Carotid cavernous fistula

43.A young man aged 30 years presents to hospital with poor vision for the last 10 days.He is a farmer
and gives a history of trauma with a vegetative matter.On examination there is a corneal ulceration
whose base has raised soft creamy infiltrates.The most probable aetiological agent is

A. Acantamoeba
B. Fusarium
C. Corynebacterium diptheriaea
 D. Streptococcus pneumoniae

44.The following is a correct definition of ‘Chain of command’

A. Hierarchy of authority and responsibility

B. Relationship without authority
C. Activity directed through linear authority
D. The tendency f0r people to perform as expected

45.Hawthorn Effect explains that the relationship between people and productivity is enhanced by the
following

A. Special attention
B. Organizations
C. Special attention
D. Creativity

46.The following is a major difference between managers and leaders

A. Leaders usually have legitimate power

B. Managers are seldom leaders
C. Leaders do not make good managers
D. Managers always have legitimate power

47.A staff nurse describes their unit manager as a” born leader” .The nurse ascribes to the following
theory of leadership

A. Traits theory
B. Formal leadership theory
C. Behavioral theory
D. Democratic leadership theory

48.The unit manager of a 32 bed eye ward unit allows the staff nurses to do self governance for
scheduling,client care assignments and committee work.The manager would be considered which type
of leader

A. Autocratic
B. Democratic
C. Bureaucratic
D. Laissez faire

49.A Multiple car accident has occurred with multiple trauma clients being sent to an emergency
department. The unit manager is preparing the staff for the arrival of the trauma victims. The type of
leadership style effective in this situation is

A. Democratic
B. Autocratic
C. Bureaucratic
D. Laissez faire
50. When trying to facilitate change in the staffs it is necessary to build trust and recognize the need for
change. According to Lewin’s Force field model this is

A. Moving the system to a new level

B. Refreezing the system
C. Unfreezing of the system
D. Institutionalization

51.How does decision making differ from problem solving

A. Decision making always involves selecting from a set of alternatives

B. Problem solving always involves selecting one of several alternatives
C. Problem solving never involves decision making
D. Decision making always involves solving a problem

52. The staff of a surgical eye unit is in conflict with the occupational therapy department.The type of
communication that will be used to discuss the problem is

A. Downward communication
B. Lateral communication
C. Distorted communication
D. Upward communication

53.The following is an important principle of delegation

A. When delegating you must transfer authority

B. No transfer of authority exists when delegating
C. Responsibility is not transferred with delegation
D. Delegation is the same as work allocation

54. The first process in the delegation process is

A. Decide to delegate
B. Determine the task
C. Define the task
D. Reach agreement

55.The nurse manager has two employees with a longstanding conflict that is affecting productivity and
cohesiveness.She decides to meet with the two in private and bring the conflict out into the open,and to
attempt to resolve it through knowledge and reason.The conflict management strategy involved is

A. Confrontational
B. Collaboration
C. Suppression
D. Intervention

56. Matching a job with an experienced Registered Nurse first requires a selection process.The first step
in the selection process is

A. Job analysis
 B. Selection techniques
C. Methods of recruiting
D. Assurance of legal requirements

57.According to Maslow’sTheory of Human needs,the level needs to be met first are

A. Self actualization needs

B. Safety needs
C. Esteem needs
D. Physiological needs

58.The Theory that views motivation as Learning is

A. Reinforcement
B. Operant
C. Process
D. Conditioning

59.A technique used to eliminate a negative behavior by ignoring the behavior is known as

A. Punishment
B. Shaping
C. Extinction
D. Equity

60.The four majour concepts uin nursing theory are

A. Person,Environment,Nursing Health
B. Promotive,Environment Nursing,Health
C. Promotive preventive,Curative Rehabilitative
D. Person Environment,Theory Health

61.Licencing Examinations for Registered Nurses in Kenya are administererd by

A. National Nurses Association of Kenya

B. American Nurses Association
C. Kenya National Nurses Union
D. The Nursing Council of Kenya

62.To implement nursing care interventions the nurse must be competent in three areas which are

A. Leadership,Autonomy and Skills

B. Experience,Advanced education,Skills
C. Skills,Leadership,Finances
D. Knowledge,Function and specific skills

63.The purpose of assessment is

A. Implement nursing care

B. Delegate nursing responsibility
C. Establish a data base concerning the client
 D. Teach client about his/her problems

64. As an art, Nursing relies on knowledge gained from practice and reflection of past experiences.As a
science Nursing draws on

A. Scientifically tested knowledge that is applied in the practicesetting

B. Physician generated research
C. Experimental research
D. Non experimental research

65.Clients perceptions about their health problems are

A. Objective data
B. Observational recordings
C. Aucilliary reports from the data collector
D. Subjective data

66.The relevance of the Nurses Code of Ethics for nurses

A. Improves nursing in Universal Health

B. Provide identical care to all
C. Defines the principles by which nurses provide care to their clients
D. Protects the desires of the nurse

67. The first step in establishing a database is to collect subjective information from the client by
interviewing the client. An interview is

A. An organized conversation with the client

B. Implementation of physician orders
C. Delegation to personnel providing care
D. Determining specific nursing actions

68. A Theory is a set of concepts ,definitions,relationships and assumptions that

A. Explain a phenomena
B. Formulate Legislation
C. Measure nursing functions
D. Reflect the domain of nursing practice

69 .Health is a state of complete physical ,mental and social wellbeing and not merely the absence of
disease or infirmity

A. World Diabetes Federation

B. International Council of Nursin
C. American Nurses Association
D. World Health Organization

70.The following is an example of health promotion activity by the Nurse

A. Administering Immunizations
B. Giving a bed bath
 C. Preventing complicatioins sfter an accident
D. Performing diagnostic procedures

71.The most important skill needed to obtain accurate information from your client is/are

A. Teaching and assessment

B. Good communicationand critical thinking
C. Cognitiveand teaching experience
D. Psychomotor

72. Systemic ocular medications are

A. Injections in the eye

B. Drugs taken orally to treat certain eye conditions
C. Are eye drops
D. Medications that has ocular side effects

73.The following medication is contraindicated in patients with sulfa allergy

A. Acetazolamide
B. Scopolamine
C. Physostigmine
D. Pilocarpine

74 The drug of choice for cytomegalovirus retinitis in HIV patients is

A. Acyclovir
B. Ribavarin
C. Ganciclovir
D. Vidarabine

75 A 21 old student attends then university clinic with complaints of slowly worsening vision over the
last year and she is now unable to see the front of the lecture theatre.However her near vision is
perfect.The examination most likely to diagnose the cause of the problem is

A. Pupil reaction testing

B. Ocular motility testing
C. Confrontational visual field testing
D. Refraction

76.A 54 year old woman had had type 1 diabetes for 30 years and presents to the ophthalmic clinic for
retinopathy screening.On dilated fundus examinationthe doctor notes the following scattered
microaneurysms,several dot haemorrhages and a small area of new blood vessels.The doctor is likely to

A. Diagnose no retinopathy and follow up the patient for a year

B. Diagnose background diabetic retinopathy and follow up the patient for one year
C. Diagnose clinically significant macula oedema
D. Diagnose proliferative diabetic retinopathy
77.A 45 year old man hads worn thick glasses since childhood presents to the clinic complaining of
flashing lights in his right eye with no history of trauma.The most likely cause is

A. Retinal detachment
B. Temporal arteritis
C. Subarachnoid haemorrhage
D. Uveatis

78. A patient presents with severe eye pain followingcataract extraction.On examination with a torch
the eye is red and inflamed with ciliary injection and a layer of pus in the anterior chamber.The likely
diagnosis is

A. Normal post operative inflammation

B. HLA associated uveitis
C. Adenoviral conjunctivitis
D. Endophthalmitis

79.A 64 year old woman complains of photophobia,foreign body sensation and bluured vision in her
right eye.The probable diagnosis is

A. Acute angle closure glaucoma

B. Blepharitis
C. Uveatis
D. Keratitis

80.The first line treatment in a chemical injury is

A. Admission if severe
B. Topical antibiotics
C. Topical cycloplegia
D. Neutrilization of the PH by irrigation

81.In a blow out fracture the commonest bone to be fractured is

A. The maxillary bone

B. The zygomatic bone
C. Frontal bone
D. Ethmoid bone

82,Features of orbital floor fractures include

A. Diplopia on upgaze and down gaze

B. Damage to the supraorbital nerve
C. Numbness of lateral canthus
D. Haemoptysis

83.The commonest cause of proptosis is

A. Orbital infection
B. Orbital haemorrhage
 C. Thyroid ophthalmoscopy
D. Orbital tumour

84.Phaco emulsification can be done in the following except

A. Immature cataract
B. Mature cataract
C. Congenital cataract
D. Dislocated cataract

85.In Myopia

A. The length of the eyeball is short

B. Corneal radius of the curvature is less
C. The lens is less spherical
D. Images form infront of the retina when the patient accommodates

86.The pupil in acute anterior uveitis is

A. Miosed and regular with poor reaction

B. Miosed and irregular with poor reaction
C. Dilated and irregular with good reaction
D. Dilated and regular with poor reaction

87. A young male of 22 years presents with gradual ecrease of visual acuity in both eyes and change of
refractive error on examinationwith retinoscope there is high astigmatism.The likely diagnosis is

A. Keratoglobus
B. Keratoconus
C. Buphthalmos
D. Megalocornea

88.When the eye is medially rotated the prime depresser muscle of the eyeball is

A. Inferior rectus
B. Inferior oblique
C. Superior oblique
D. Lateral rectus

89. A patient presented with photophobia and watering of the left eye.On examination with fluorescein
staining revealed a dendritic ulcer.This ulcer is usually caused by

A. Streptococcus pyogenes
B. Candida albicans
C. Herpes simplex virus
D. Herpes zoster virus

90.The nasolacrimal duct opens in the

A. Superior meatus
B. Inferior meatus
 C. Middle meatus
D. Nasopharynx

91.Regarding probing and syringing test the following statement ids true

A. Recommended for acute dacryocystitis

B. Regurgitation is positive
C. Congenital nasolacrimal duct block
D. Chronic dacrryocystitis

92. A major risk factor for the progression of maculopathy is

A. Anaemia
B. Hypercholesteroaemia
C. Hypertension
D. Smoking

93. The nerve which has the longest intracranial course is

A. Fourth cranial nerve

B. Third cranial nerve
C. Sixth cranial nerve
D. Fifth cranial nerve

94. Swimming pool conjunctivitis is caused by

A. Clamydia trachomatis
B. Adenovirus type 8
C. Gonococcus
D. Klebsiella

95,The following nursing action should be given highest priority when admitting a patient into the
operating room

A. Level of consciousness
B. Vital signs and gowning
C. Patient identification and correct operative consent
D. Positioning and skin preparation

96. The following nursing actions would help the patient decrease anxiety during the post operative
period

A. Explaining all procedures thoroughly in a chronological order

B. Spending time listening to the patient and answering questions
C. Reassuring the patient that the surgical staff are competent professional
D. Encouraging sleep and limiting interruptions

97.The most important factor in the prevention of post operative infection in the eye theatre is

A. Proper administration of antibiotics

B. Adequate fluid intake at least 2 litres per day
 C. Practice strict asceptic technique
D. Frequent change of wound dressings

98. A with shock following post operative haemorrhge should be placed in the

A. High fowlers position

B. Sims position
C. Modified Trendelenberg
D. Prone position

99.The type of shock that a patient can experience following a severe drug reaction

A. Hypovolemic shock
B. Anaphylactic shock
C. Septic shock
D. Neurogenic shock

100.The most abundant electrolyte in the extracellular fluid compartment is

A. Potassium
B. Sodium
C. Magesium
D. Calcium

101.The hormone that regulated water and sodium concentrations in blood is

A. Insulin
B. Aldosterone
C. Adrenocorticotrophic hormone
D. Growth hormone

102. The following is an immediate complication of a burn injury

A. Sepsis
B. Hypovolemia
C. Contractures
D. Anaemia

103.A 69 year old woman presented with a history of pain ,tingling of the skin and erythema. This was
followed 18 hours later by a vesicular rash. Over the next 2 days the vesicles became pastules. The
pastules dried out over the next 7 days and by day 12 most had crusted.Most of the crustshad fallen by
week 3

The cranial nerve involved in this presentation

A. Oculomotor
B. Trigeminal nerve
C. Facial nerve
D. Optic nerve

104.The following corneal conditions is autosomal recessive

 A. Macular corneal dystrophy
B. Granular corneal dystrophy
C. Meesmannn’s corneal dystrophy
D. Fuchs’ corneal endothelial dystrophy

105.A 50 year old man has presented with deteriorating vision On examination he has superior
bitemporal hemianopia .The likely site of the lesion is

A. Left occipital lobe

B. Optic chiasma
C. Left optic nerve
D. Right parietal lobe

106.A 64 year old woman is brought to the emergency room after she experienced
dizziness .Neurological examination reveals that the patient is unable to move her right eye medially.The
likely locus of lesion is

A. Cortex
B. Medulla
C. Pons
D. Midbrain

107.The following muscle is supplied by the motor division of the trigeminal nerve

A. Platysma
B. Masseter
C. Orbicularis oculi
D. Orbicularis oris

108.A patient who suffers from acute onset of facial palsy,the first line of treatment is

A. Frequent ocular lubrication

B. Lateral tarsorrhhaphy
C. Topical corticosteroids
D. Levater muscle resection

109. A stye is an acute suppurative inflammation of

A. Meibomian glands
B. Accessory lacrimal glands
C. Zeiss glands of the lash follicles
D. Lid margin

110.The following is a function of a scrub up nurse in the operating theatre

A. Ensuring that the patient brought to theatre is the right patient to undertake surgery
B. Checks the vital signs of the patient
C. Preparatioin of the sterile instruments and equipment
 D. Ensures that the theatre team is available for the operation

111. The main function of the retinal pigment layer is

A. Absorbs light
B. Digests the outer segment of rods and cones
C. Digests outer segment of cones only
D. Stores Vitamin A

112.The antero posterior diameter of a normal eyeball varies between

A. 20……….25mm
B. 18…….22mm
C. 22…….27mm
D. 25………30mm

113In Retinitis pigmentosa the commonest mode of clinical presentation in adults is

A. Night blindness
B. Myopia
C. Hyperopia
D. Central visual field defect

114. Blepharospasms is a condition of the eye in which there is

A. Exaggerated blinking of the eyelids

B. Involuntary contraction of few fibers of the orbicularis oculi
C. Involuntary tonic contraction of the orbicularis oculi muscle
D. Atrophy and loss of elasticity of the muscles and the skin of the lid

115 The following is the most common cause of rubeosis iridis

A. Central Retinal vein occlusion

B. Diabetic eye disease
C. Ocular ischaemic syndromeChronic open angle glaucoma /// apply

116.Laser iridotomy is performed in

A. Open angle glaucoma

B. Inflammatory glaucoma
C. Angle closure glaucoma
D. Chronic open angle glaucoma

117 The following is a favourable indication of Keratoplasty

A. Corneal dystrophy
B. Keratoconus
C. Corneal gegeneration
D. Vascularized corneal opacity

118.A typical retinal appearanceof acute central retinal vein occlusio

 A. Haemorrhage all over the retina
B. Pale optic disc
C. Generalized venous constriction of the retina
D. Vitreoes haemorrhage

119.The tear film consists of

A. Aqueous ,lipid and serous layer

B. Lipid,saline and mucuos layer
C. Mucuos.lipid and aqueous layer
D. Saline lipid and mucuos layer

120.Pappiledema is bilateral optic nerve head swelling due to

A. Hypertension
B. Encephalitis
C. Optic nerve glioma
D. Space occupying lesion in the brain

121.Vernal conjunctivitis typically occurring in young patients is a localized form of anaphylaxis involving

A. Type I hypersensitivity
B. Type ii and iv hypersensitivity
C. Type iv hypersensitivity
D. Type I and iv hypersensitivity

122,A baby one month old is brought to the ophthalmic clinicwith findings of whitish appearance of the
cornea and slightly larger size noted in both of the eyes by the mother.The probable diagnosis is

A. Congenital rubella infection

B. Congenital cataract
C. Congenital glaucoma
D. Retinoblastoma

123.A young boy was brought in the eye clinic with blunt trauma to the left eye.Examination reveals
superficial cornweal ulce.The management will involve

A. Use of antibiotic eyedrops

B. Use of antibiotics and patching
C. Wait for the lesion to settle itself
D. Use an eye pad to cover the eye