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Faculty OF Nursing
Benha University
Emergency Nursing
Model Answer of Final semester Exam
First Year
Date: 18/6/2011
Time: 3 hours
Total Marks: 80
I- MCQ:-
‫هيئةالتهي التد‬
‫هيئةالتدرر‬
‫االلتدريس‬
(20 Marks )
Put circle around the letter corresponds to the best answer:
1- Substance that alters physiologic function, with the potential for
affecting health is called:
a) Medication.
b) Drug.
c) Pharmacognosy.
2- Injury to the skin that result from direct contact or exposure to
any thermal, chemical, electrical, or radiation source are termed:
a) Epiderms.
b) Subcutaneous layer.
c) Burns.
3- Sudden illness or injury that is perceived by the client or
significant other as requiring immediate intervention defined as:
a) Emergency.
b) Emergency nurse.
c) Service providers.
4- Ways in which poisoning may occur all of the following except:
a) Ingestion-by mouth.
b) Absorption-by skin contact.
c) Ingestion-by breathing.
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5- Clinical signs for patient with hemorrhage are the following
except:
a) Rapid, weak pulse.
b) Hot and clammy skin.
c) Drop in blood pressure.
6- Break in the continuity of tissues of the body either internal or
external usually caused by an accident is called:
a) Wound.
b) Closed wound.
c) Open wound.
7- Abnormal condition characterized by decreased cardiac out put
and arterial blood pressure leading to decreased blood flow to the
tissue and tissue ischemia results is defined as:
a) Hemorrhage.
b) Shock.
c) Burns.
8- Hypovolemic (Oligaemic) shock it is a condition characterized by:
a) Hypotension, restlessness or mental dullness.
b) Rapid pulse and respiration.
c) All of the above.
9) Disruption or break in the continuity of the structure of a bone is
called::
a) Open fracture.
b) Fracture.
c) Closed fracture.
10) Clinical manifestation of the fracture all of the following except:
a) Mild pain.
b) Difficulty in movement.
c) Swelling, bruising and bleeding.
11) Signs and symptoms of fracture ribs all of the following except:
a) Pain at site.
b) Bruising and deformity.
c) Normal breathing.
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12- All of the following are signs and symptoms of collapsed lung
except:
a) Normal skin color.
b) Severe breathing difficulties.
c) Enlarge neck vein.
13- General term used to describe any trauma to the head, and most
specifically to the brain itself is called:
a) Depressed fractures.
b) Head injury.
c) Basilar skull fracture.
14- Causes of life threatening conditions:
a) Flail chest and head injury.
b) Shock and stroke.
c) All of the above.
15- The scientific study of origin, chemistry, effects and use of drugs
is called:
a) Pharmacology.
b) Pharmacodynamics.
c) Medications.
16- Common household poisons are:
a) Kerosene and fume.
b) Sleeping pills and pain relievers.
c) All of the above.
17- Poison that enters the body through the skin known as:
a) Injected poison.
b) Absorbed or contact poison.
c) Inhaled poison.
18- The edges are severely damaged and highly irregular is called:
a) Lacerated wound.
b) Incised wound.
c) Stab puncture wound.
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19- The type of burn injuries caused by hot liquids or steam is known
as:
a) Electrical burn.
b) Chemical burn.
c) Thermal burn.
20- Possible causes of Cardiogenic shock all of the following except:
a) Acute myocardial infarction or chest trauma.
b) Bacterial toxins.
c) Cardiac surgery and cardiac failure.
II- Put circle around (T) if the statement is true and (F) if statement
is false: ( 15 Marks )
1- Transfer to definitive care is one of the purpose of emergency
medical services
T
F
2- Depressed skull fractures is a fracture of the bones that from the
base of the skull and results from severe blunt head trauma of
significant force
T
F
3- Dry burn as scald injury. It is caused by hot liquids or steam
T
F
4- Blurring of vision is one of the signs and symptoms of the severe
blunt head trauma
T
F
5- Cardiogenic shock is the inability of the heart to pump enough
blood to supply all parts of the body
T
F
6- Bone infection is one of the direct complications of fractures
T
F
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7- Loss of consciousness lasting from several minutes to many days or
longer is one of the signs and symptoms of severe blunt head
trauma
T
F
8- Bandages used on wounds to prevent healing
T
F
10- Injected poison is a poison that enters the body through a bite,
sting, or syringe
T
F
11- Intraparenchymal hemorrhage occurs when blood accumulates
in the space beneath the arachnoid layer that surrounds the
brain
T
F
12- Pharmacodynamics are the study of poisons, including the
adverse effects of drugs on living organisms
T
F
13- Direct pressure is one of the first aids for external bleeding
T
F
14- Alcohol be used on open skin
T
F
15- Subcutaneous layer is the deepest part of the skin and it is
consists of connective tissue and fats
T
F
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III- Matching : (10 Marks)
1- haematemsis
2- haematuria
3- hemoptysis
4- toxicology
5- pharmacognosy
6- Vasogenic shock
7- anaphylactic shock
8- septic shock
9- cardiopulmonary
resuscitation
10- cardiac arrest
3 coughing blood.
5 refers to the study of natural drug
sources, such as plants, animals, and
their products.
1 vomiting blood.
2 blood in urine.
7 occur in severe allergic conditions as a
result of antigen-antibody reaction
after the entry of an antigen to which
the patient is sensitive into the
circulatory system.
4 the study of poisons, including the
adverse effects of drugs on living
organisms
6 occurs as a result of inadequate
peripheral resistance from wide
spread vasodilatation.
9 is an emergency technique used when
a person's heart has stopped beating
and breathing.
10 sudden cessation of breathing and
inadequate circulation of blood by the
heart.
8 it caused by bacterial toxins due to
wide spread infection leading to
vasodilatation and drop of arterial
blood pressure.
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IV- Complete: (20 Marks )
A- List 5 of common treatment used in ICU during cardiopulmonary
resuscitation :
1-Oxygen
2-Adrenaline.
3-Atropine
4-Lidocaine.
The nurse should be alert for signs of toxicity, which may include:
drowsiness, disorientations, tinnitus, parenthesis and seizures. If
toxicity is suspected, the nurse must be stop the drip, hang a normal
saline IV and promptly notify the physician
5-Magnesium sulfate.
6-Sodium bicarbonate
7-Calcium.
8-Amidoarone.
B- List 5 warning signs of shock:
1- Anxiety – restlessness, confusion and disorientation due to:
a- Central nervous system (CNS) response to hypoxia.
b- Inadequate cerebral perfusion.
2- Deep, rapid respirations due to:
a- Low circulatory oxygen.
b- Acidosis.
3- Narrowing of pulse pressure – the difference between systolic and
diastolic pressure due to:
a- Systolic pressure – from reduced cardiac output.
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b- Diastolic pressure – from CNS response.
4- Rapid heart rate, weak thread pulse due to:
a- Stimulation of the heart by CNS.
5- Thirst, dry mouth due to:
a- Shift of fluid from interstitial to intravascular causing tissue
dehydration which stimulates the hypothalamus thirst center.
b- Peripheral circulation which causes saliva production.
c- Mouth breathing during hyperventilation.
6- Decreased urine output (less than 30 ml/hr) due to:
Decreased blood flow to the kidneys.
7- Cool, clammy skin; pale or cyanotic skin and mucous membrane
due to:
a- Increased CNS causing peripheral vasoconstriction.
8- Low body temperature due to:
a- Poor blood flow except in early septic shock, temperature
rises.
9- Muscle weakness, fatigue due to:
a- Anaerobic metabolism causing lactic acid build up.
b- Hyperkalemia.
C- Enumerate 5 parenteral rout for administrating drugs:
1- Subcutaneous injection
2- Intramuscular injection
3- Intrademal injection
4- Intravenous injection
5- Intraarterial injection
6- Intracardiac injection
7- Intraperitoneal injection
8- Intraspinal injection
9- Intraosseous injection
D- Enumerate 5 of the factors that influence burn injury severity:
Factors that influence injury severity include:
1- burn depth.
2- burn size(percentage of TBSA).
3- burn location.
4- age.
5- general health.
6- mechanism of injury.
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V- Essay:
I- Define the following : ( 10 Marks )
A- Pharmacokinetics: Are referring to the absorption, distribution,
metabolism, and excretion of a drug in living
organisms.
B- Flail segment: Ribs and/or sternum is fractured in numerous places
and can result in a section of bone becoming
unattached from the chest wall.
C- Venous bleeding: It is dark blood because it is nonoxygenated and
flows slowly and steadily. This type of bleeding
associated with deeper cuts.
D- Melena: Black stool which indicate bleeding in gastrointestinal
tract(GIT).
E- Abrasions: Are a destruction of the superficial layers of the epidermis
due to pressure or friction by a blunt rough object. Usually
it is above the basal layer of the epidermis, so, it heals
without leaving any scar unless infected or as rarely if it
reaches the dermis.
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II- Give short notes on the factors influencing wound healing?
( 5 Marks)
Factors influencing wound healing:
Age: blood circulation and oxygen delivery to the wound or
inflammatory response are impaired by aging. Risk of infection is
greater. Cell growth and reconstruction are slower.
Nutrition: tissue repair and infection resistance depend on a balanced
diet and good nutrition and malnutrition lead impaired of
tissue repair.
Obesity: fatty tissue don't heal easily, less abundant supply of blood
vessels in fatty tissue. Impair delivery of nutrients and cellular
elements needed for healing, suturing of adipose tissue is more
difficult subsequent infection for major wound is greater.
Therapy with steroids, irradiation: this drugs reduce leukocytes
count and interfere with immune response.
Diabetes mellitus: An elevation of blood glucose impairs phagocytosis
and the risk of infection is increase lead to poor wound
healing.
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