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MAHARASHTRA STATE BOARD OF NURSING AND

PARAMEDICAL EDUCATION, MUMBAI

EXAMINATION IN GENERAL NURSING AND MIDWIFERY

FIRST YEAR (PAPER III)

NURSING FOUNDATION

(Including Fundamental of Nursing, First Aid)

THURSDAY, 11TH JULY 2019

 

Duration: 3 Hours                                                                              Max.Marks:75

 

       I.            Select the most appropriate answer from the following and complete the sentence:                                                                                                                                    1x5=5

(i) World T.B. day is on……………

(a) 7th April     (b) 24th March            (c) 12th Mav               (d) 11th July.

(ii) SOS means……………….

(a) Four times a dav    (b) At bed time.           (c) Before meal           (d) If necessary.

 

(iii) Pus in the urine is called……………………….

(a) Hematuria             (b) Glycosuria              (c) Pyuria         (d) Hyperthermia.

(iv) Ratio of pulse to respiration is………………

(a) 1:4              (b) 4:1              (c) 1:6              (d) 6:1.

(v) Lice in the head is called………………..

(a) Pediculus   (b) Pediculus Capitus  (c) Pediculus Pubis      (d) Pediculus Corporis.

Here are the correct answers:

(i) World T.B. Day is on (b) 24th March.

(ii) SOS means (d) If necessary.

(iii) Pus in the urine is called (c) Pyuria.

(iv) Ratio of pulse to respiration is (a) 1:4.

(v) Lice in the head is called (b) Pediculus Capitus.

 

     II.            Match the following:                                                                                                       1x5=5

A'Section	B'Section
(i) Malena	(a) Sterilization
(ii) Hyperpyrexia	(b) Sitz Bath
(iii) Piles	(c) Presence of blood in sputum
(iv) Hemoptysis	(d) Presence of blood in stool
(v) Ethiline oxide	(e) Cold sponging.

 

A' Section	B' Section
(i) Malena	(d) Presence of blood in stool
(ii) Hyperpyrexia	(e) Cold sponging
(iii) Piles	(b) Sitz Bath
(iv) Hemoptysis	(c) Presence of blood in sputum
(v) Ethylene oxide	(a) Sterilization

 

  III.            State true or false :                                                                                                          1x5=5

(i) Bottle containing poisonous drugs can have ordinary lag.e

(ii) Dyspnea patients are given Fowler's position.

(iii) Rigor Mortis is stiffening of body after death.

(iv) 1 gm. protien provides 8 calories.

(v) Dry dusting is avoided in sick room.

Here are the correct answers:

(i) Bottle containing poisonous drugs can have ordinary label – False

(ii) Dyspnea patients are given Fowler's position – True

(iii) Rigor Mortis is stiffening of the body after death – True

(iv) 1 gm protein provides 8 calories – False (1 gm of protein provides 4 calories)

(v) Dry dusting is avoided in a sick room – True

 

  IV.            Give scientific reasons (any five)                                                                                5x2=10

(i) Diuretics should not be given at night.

(ii) Nurse should keep her finger nails short.

(iii) Patient is kept nil by mouth before operation.

(iv) Smoking prohibited near oxygen cylinder.

(v) Clinical thermometer should not be washed in hot water.

Here are the scientific reasons:

(i) Diuretics should not be given at night – Diuretics increase urine production, which can lead to frequent urination at night, disturbing the patient's sleep and causing inconvenience.

(ii) Nurse should keep her fingernails short – Short nails prevent the accumulation of dirt and bacteria, reducing the risk of infections and ensuring proper hand hygiene during patient care.

(iii) Patient is kept nil by mouth before operation – This prevents aspiration (inhalation of food or liquid into the lungs) during anesthesia, which can lead to serious complications such as pneumonia or choking.

(iv) Smoking prohibited near oxygen cylinder – Oxygen supports combustion, and smoking near an oxygen cylinder can lead to fire hazards or explosions.

(v) Clinical thermometer should not be washed in hot water – Hot water can cause the mercury or alcohol inside the thermometer to expand rapidly, leading to breakage and rendering the thermometer unusable.

 

    V.            Define the following terms (any five)                                                                                   1x5=5

(i) First Aid

(ii) Hospital

(iii) AIDS

(iv) Blood pressure

(v) Bland diet

(vi) Cross infection.

Here are the definitions:

(i) First Aid – The immediate care given to an injured or sick person before professional medical help arrives to prevent the condition from worsening.

(ii) Hospital – A healthcare facility where patients receive medical treatment, diagnosis, and care from doctors, nurses, and other healthcare professionals.

(iii) AIDS – Acquired Immunodeficiency Syndrome, a life-threatening condition caused by the Human Immunodeficiency Virus (HIV) that weakens the immune system, making the body susceptible to infections and diseases.

(iv) Blood Pressure – The force exerted by circulating blood against the walls of the arteries, measured in systolic (maximum) and diastolic (minimum) pressure.

(v) Bland Diet – A diet consisting of easily digestible, low-spice, non-irritating foods, often prescribed for patients with gastrointestinal issues.

(vi) Cross Infection – The transmission of infections between patients, healthcare workers, or between patients and healthcare environments due to improper hygiene or contamination.

 

  VI.            Write short notes (any three):                                                                                     3x5=15

(a) Biomedical Waste Management

(b) Nursing Ethics

(c) Care of rubber Articles

(d) Principles of Bandaging

(e) Bed Sore.

(a) Biomedical Waste Management

Biomedical waste includes infectious and hazardous waste from healthcare facilities. Proper disposal prevents infections and environmental pollution. Waste is managed using color-coded bins, incineration, autoclaving, and chemical treatment. Healthcare workers must follow strict safety protocols to handle biomedical waste.

(b) Nursing Ethics

Nursing ethics guide nurses in providing safe and effective patient care. Key principles include autonomy (respecting patient decisions), beneficence (acting in the best interest of the patient), non-maleficence (avoiding harm), justice (fair treatment), and confidentiality (protecting patient information).

(c) Care of Rubber Articles

Rubber articles (like catheters, gloves, and tubes) need proper care to maintain hygiene and functionality. They should be washed with antiseptic solutions, dried completely, stored properly, and sterilized using boiling or chemical disinfectants before reuse.

(d) Principles of Bandaging

Bandaging is done to support an injured part, reduce swelling, and protect wounds. Key principles include applying even pressure, ensuring comfort, securing firmly but not too tight, covering the wound properly, and using an appropriate bandage type (e.g., roller, triangular, or tubular bandages).

(e) Bed Sore

Bed sores (pressure ulcers) occur due to prolonged pressure on the skin, especially in bedridden patients. Prevention includes frequent repositioning, using pressure-relieving mattresses, keeping the skin dry, and maintaining good nutrition.

VII.            Mrs. Sakshi, 55 years old admitted in female medical ward having constipation since 2 days :                                                                                                          5+3+4+3=15

(a) Define Enema and write purposes of Enema.

(b) Write the classification of Enema.

(c) Write scientific principles applied in simple Enema.

(d) What health education you will give to prevent constipation?

                                                            OR                                                                  5+5+5=15

(a) Write role of a Nurse in Disaster Management.

(b) Care of unconcious patient.

(c) Write difference between Dog bite and Snake bite.

 (a) Definition of Enema and Its Purposes

Enema: It is the introduction of a liquid solution into the rectum through the anus to stimulate bowel movement or administer medication.

Purposes of Enema:

1. Relieve Constipation – Helps in softening stool and easing defecation.
2. Cleanse the Bowel – Prepares the bowel for surgery or diagnostic procedures like colonoscopy.
3. Administer Medications – Some drugs are given rectally for rapid absorption.
4. Expel Gas – Helps relieve bloating and gaseous distension.
5. Stimulate Peristalsis – Encourages bowel movements in patients with weak intestinal motility.

(b) Classification of Enema

1. According to Purpose:
• Evacuant Enema – Used for constipation (e.g., soap suds enema).
• Retention Enema – Held in the rectum for absorption (e.g., oil enema).
• Medicated Enema – Administers drugs rectally (e.g., steroid enema).
• Carminative Enema – Relieves gas and bloating (e.g., peppermint enema).
• Nutritive Enema – Provides nutrition when oral intake is not possible.
2. According to Solution Used:
• Oil-based Enema – Lubricates and softens stool.
• Saline Enema – Used in electrolyte imbalances.
• Soap Suds Enema – Stimulates peristalsis.

(c) Scientific Principles Applied in Simple Enema

1. Gravity helps in the flow of enema solution – The enema bag should be placed at an appropriate height (12-18 inches above the patient).
2. Warm solution prevents abdominal cramping – The enema solution should be at body temperature (37°C).
3. Lubrication reduces discomfort – Lubricating the rectal tube prevents mucosal injury.
4. Left lateral position facilitates flow – This position allows easy passage of the fluid into the rectum.
5. Slow administration prevents irritation – A steady flow ensures comfort and effectiveness.

(d) Health Education to Prevent Constipation

1. Increase fiber intake – Consume fruits, vegetables, and whole grains.
2. Drink plenty of water – At least 8 glasses per day.
3. Exercise regularly – Walking and yoga promote bowel movements.
4. Establish a routine – Try to have a fixed time for bowel movements daily.
5. Avoid excessive use of laxatives – Dependence can reduce natural bowel function.
6. Manage stress – Stress can affect bowel habits.

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OR: Disaster Management, Unconscious Patient Care, and Bites

(a) Role of a Nurse in Disaster Management

1. Preparedness – Participate in disaster drills, maintain emergency kits.
2. Triage and Assessment – Prioritize care based on severity of injuries.
3. First Aid and Medical Assistance – Provide life-saving interventions.
4. Psychosocial Support – Counsel survivors and reduce trauma impact.
5. Infection Control – Prevent outbreaks in disaster-affected areas.
6. Documentation – Maintain records of patients and resources used.

(b) Care of an Unconscious Patient

1. Airway Management – Ensure open airway, suction if needed.
2. Positioning – Place in lateral position to prevent aspiration.
3. Monitoring Vitals – Regularly check pulse, BP, and respiration.
4. Skin Care – Prevent bedsores by repositioning every 2 hours.
5. Nutritional Support – Provide tube feeding if required.
6. Eye Care – Use artificial tears to prevent dryness.

(c) Difference Between Dog Bite and Snake Bite

Aspect	Dog Bite	Snake Bite
Cause	Bite from a rabid or non-rabid dog	Venomous or non-venomous snake bite
Symptoms	Pain, swelling, bleeding, risk of rabies	Pain, swelling, necrosis, shock
Immediate Care	Wash with soap, apply antiseptic, get rabies vaccine	Immobilize limb, keep calm, seek anti-venom
Prevention	Avoid stray dogs, vaccinate pets	Wear protective boots in snake-prone areas
Treatment	Rabies shots, antibiotics if infected	Anti-venom, supportive care

 

VIII.            Mr. Nitin, 62 years old admitted in male medical ward with severe hypertension. He is unconcious due to CVA (stroke) :                                                         3+3+6+3=15

(a) List the needs of Mr. Nitin.

(b) Write purposes of sponge bath.

(c) Write procedure of sponge bath.

(d) Write common problem caused due to negligence of oral hygiene.

Case Study: Mr. Nitin (Hypertension & Stroke Case)

(a) List the Needs of Mr. Nitin (3 Marks)

Since Mr. Nitin is unconscious due to a stroke (CVA) and has severe hypertension, his needs include:

1. Airway Maintenance – Ensure a clear airway to prevent aspiration.
2. Monitoring Vital Signs – Regularly check BP, pulse, respiration, and oxygen levels.
3. Positioning – Keep him in a semi-Fowler’s position to reduce intracranial pressure.
4. Nutrition & Hydration – Administer IV fluids or nasogastric feeding if required.
5. Skin Care & Hygiene – Prevent bed sores and infections by providing sponge baths and repositioning him every 2 hours.
6. Elimination Care – Use a catheter if necessary and monitor urine output.
7. Emotional Support for Family – Educate them about his condition and care needs.

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(b) Purposes of Sponge Bath (3 Marks)

A sponge bath is given to maintain hygiene, prevent infections, and provide comfort.

1. Cleans the body – Removes sweat, dirt, and bacteria.
2. Prevents infections – Reduces risk of skin infections and bed sores.
3. Maintains body temperature – Can be given with warm water for comfort or cold water to reduce fever.
4. Improves circulation – Massaging during the bath promotes blood flow.
5. Relaxes the patient – Provides comfort and relieves stress.
6. Promotes dignity – Maintains hygiene and self-respect for unconscious patients.

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(c) Procedure of Sponge Bath (6 Marks)

Preparation:

• Gather supplies: Warm water, towel, soap, washcloth, gloves, clean gown, and lotion.
• Explain the procedure to the family (if present).
• Maintain privacy by closing curtains.

Steps:

1. Position the Patient: Place Mr. Nitin in a semi-Fowler’s position if possible or keep him in a lateral position.
2. Protect the Bed: Place a waterproof sheet under him.
3. Start with the Face & Neck: Use a damp washcloth to clean his face and neck without soap.
4. Clean the Upper Body: Wipe one area at a time (arms, chest, abdomen), using gentle strokes. Dry immediately.
5. Clean the Lower Body: Wash legs and feet carefully.
6. Perineal Care: Clean the genital area gently with a fresh washcloth.
7. Back & Massage: Clean the back and give a light massage to improve circulation.
8. Dress the Patient: Change into a clean gown and remove wet linens.
9. Dispose of Materials: Properly discard used water and linens.
10. Record Observations: Note any rashes, sores, or skin issues.

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(d) Common Problems Due to Negligence of Oral Hygiene (3 Marks)

Poor oral hygiene can cause various complications, especially in unconscious patients:

1. Bad Breath (Halitosis) – Due to bacterial buildup.
2. Oral Infections – Risk of thrush (fungal infection) or gingivitis.
3. Dry Mouth (Xerostomia) – Lack of saliva increases bacterial growth.
4. Tooth Decay & Gum Disease – Plaque buildup can cause cavities and bleeding gums.
5. Aspiration Pneumonia – Bacteria from the mouth can enter the lungs, leading to serious lung infections.
6. Difficulty in Feeding – Poor oral health can cause mouth pain, affecting nutrition intake.