2nd Year GNM Nursing KARNATAKA MEDICAL SURGICAL NURSING - II FEBRUARY 2025
KARNATAKA
STATE DIPLOMA IN NURSING EXAMINATION BOARD
GNM
THEORY EXAMINATION – FEBRUARY 2025
2nd
YEAR – PAPER II - MEDICAL SURGICAL NURSING - II
I. Give the meaning of the following
Answer :
- Photophobia
This means intolerance or heightened sensitivity to light — the eyes (or head) are uncomfortable or even in pain when exposed to bright or normal light.
(Note: The word literally means “fear of light”, but medically it refers to sensitivity rather than a psychological fear.) - Alopecia
This is the absence or loss of hair from places where hair normally grows. It may be localized (in one area) or diffuse (many areas), temporary or permanent. - Pott’s spine
Also known as spinal tuberculosis (tuberculous spondylitis) — an infection of the vertebrae by Tuberculosis bacteria which can destroy vertebrae, cause deformity (like kyphosis) and even neurological complications. - Oncology Nursing
A specialty branch of nursing concerned with the care of patients who have cancer (neoplasms/tumours) — this includes screening, prevention, treatment support, symptom/side-effect management, patient/family education, palliative and end-of-life care.
II. Fill in the blanks
Answer :
- Dengue is caused by Aedes
mosquito
- Increased discharge from ear
is called as Otorrhoea
- Presence of albumin in the
urine is known as Albuminuria
- Surgical removal of kidney is termed as Nephrectomy
III. Write short notes for any FOUR of the following
Answer :
9. Antihypertensive drugs
·
These are medicines used to lower high blood
pressure (Hypertension).
·
Common classes: Diuretics (ex:
Hydrochlorothiazide), ACE inhibitors (ex: Enalapril), Beta-blockers (ex:
Atenolol), Calcium channel blockers (ex: Amlodipine).
·
They reduce BP by decreasing cardiac output,
decreasing peripheral vascular resistance or reducing blood volume.
·
Nursing care: Monitor BP regularly, advise
low-salt diet, watch for side effects like dizziness, hypotension, electrolyte
imbalance.
10. Diphtheria
·
It is an acute infectious disease caused by Corynebacterium
diphtheriae.
·
It affects throat, tonsils, nose and produces a
greyish membrane in throat.
·
Spread by droplet infection; symptoms include
fever, sore throat, hoarseness, difficulty in breathing.
·
Treatment: Diphtheria antitoxin + antibiotics
(Penicillin/Erythromycin), isolation of patient, immunization with DPT vaccine
for prevention.
11. Frost bite
·
Local injury caused by exposure to extreme cold
temperature — tissues freeze (mostly fingers, toes, ears, nose).
·
Skin becomes pale, numb, cold, hard and later
blisters may form after rewarming.
·
Management: Gradual rewarming (37–39°C warm
water immersion), avoid rubbing, sterile dressing and adequate hydration.
·
Complications: Necrosis, gangrene → may require
amputation if severe.
12. Disaster cycle
·
It is a continuous process of managing disasters
which has phases before, during and after disaster.
·
Major phases include: Mitigation,
Preparedness, Response, and Recovery.
·
Mitigation/Preparedness: risk assessment,
training, mock drill, planning.
·
Response/Recovery: rescue, triage, treatment,
rehabilitation and restoring community back to normal.
13. Rabies Management
·
Rabies is a fatal viral disease transmitted by
bite/scratch from infected animals (dog mainly).
·
Immediate management: Wash wound 10–15 min with
soap & running water, apply antiseptic.
·
Post-exposure prophylaxis: rabies vaccine
schedule + Rabies Immunoglobulin (in category III wounds).
·
Prevention: Dog vaccination, avoid stray
animals, early reporting of bites, public health education.
IV. Answer the following
14. Define Tonsillitis (1 mark)
Tonsillitis is an inflammation and infection of the tonsils (usually the
palatine tonsils) commonly caused by viral or bacterial organisms.
15. Clinical features of Tonsillitis (2 marks)
·
Sore throat and painful swallowing
·
Fever and malaise
·
Enlarged, red swollen tonsils ± white exudates
·
Cervical lymph node enlargement and tenderness
·
Bad breath (halitosis), voice change (“hot
potato voice”)
16. Surgical and Nursing management of Tonsillitis (5
marks)
Surgical Management:
·
Tonsillectomy is indicated in repeated/chronic
tonsillitis, airway obstruction due to enlarged tonsils, peritonsillar abscess
etc.
·
Performed under general anaesthesia.
Nursing Management:
·
Pre-operative:
• Assess vitals, bleeding history, allergies
• Explain procedure and reduce anxiety
• Maintain NPO status before surgery
·
Post-operative:
• Position in side-lying to drain saliva and prevent aspiration
• Monitor for bleeding (frequent swallowing = danger sign)
• Provide cold fluids/ice chips, avoid hot & spicy foods
• Pain relief and throat care
• Observe airway patency and oxygen saturation
• Educate to avoid coughing, throat clearing, and strenuous activity
17. Define Amputation (1 mark)
Amputation is the surgical removal of a limb or part of a limb (e.g. leg,
foot, arm, fingers) because of disease, trauma or severe infection.
18. Surgical and Nursing management of amputee patient
(5 marks)
Surgical Management:
·
Amputation is done when limb is non-viable due
to gangrene, severe trauma, malignancy or vascular disease.
·
Surgical aims: remove diseased part, shape stump
for prosthesis, preserve maximum healthy tissue.
Nursing Management:
·
Monitor vital signs & bleeding at stump site
·
Maintain stump dressing, aseptic wound care
·
Pain control: manage phantom limb pain
·
Positioning to prevent contractures (avoid
prolonged pillow under stump)
·
Early gentle physiotherapy & ROM exercises
·
Psychological support — accept body image change
·
Prepare stump for prosthesis fitting with
bandaging & shrinker
·
Patient and family education on stump care &
prosthesis use
V. State the following statement is True / False
Answer :
19. Emset is used to prevent vomiting – True
(Emset = Ondansetron → anti-emetic used to control nausea & vomiting)
20. Western blot test is used to diagnose typhoid – False
(Widal test is done for Typhoid. Western Blot is mainly used for HIV
confirmation)
21. Diphtheria is caused by E.coli – False
(Diphtheria is caused by Corynebacterium diphtheriae)
22. Chicken Pox is caused by paramyxo virus – False
(Chickenpox is caused by Varicella Zoster Virus – a herpes
virus)
VI. Write short notes for any THREE of the following
Answer :
23. Thalassemia
·
Thalassemia is a hereditary hemolytic anemia
caused by defective formation of hemoglobin chains (alpha or beta globin).
·
It leads to chronic anemia, bone marrow
expansion, and extramedullary hematopoiesis.
·
Clinical features: pallor, jaundice,
hepatosplenomegaly, growth retardation, bone deformities, recurrent infections.
·
Treatment includes regular blood transfusion,
iron chelation therapy (Desferal / Deferasirox), folic acid, sometimes bone
marrow transplant.
·
Nursing care: monitor Hgb, prevent infection,
encourage nutritional support, psychological support, teach importance of
regular therapy.
24. Mastitis
·
Mastitis is inflammation/infection of the breast
tissue commonly seen in lactating mothers.
·
Caused by stasis of milk and bacterial infection
(commonly Staphylococcus aureus).
·
Symptoms: breast pain, swelling, redness, fever,
malaise.
·
Treatment: antibiotics, analgesics, continue
breastfeeding or milk expression to empty breast (unless abscess).
·
Nursing care: breast support bra, warm compress,
correct breastfeeding techniques, maintain hygiene, rest.
25. Congestive Cardiac Failure (CCF)
·
CCF is the inability of the heart to pump
adequate blood to meet body needs — leads to congestion in systemic &
pulmonary circulation.
·
Causes: hypertension, coronary artery disease,
MI, valvular diseases, cardiomyopathy.
·
Clinical features: dyspnoea, orthopnoea,
fatigue, edema (pedal), weight gain, cough with frothy sputum.
·
Treatment: diuretics (furosemide), ACE
inhibitors, beta-blockers, low salt diet, oxygen therapy.
·
Nursing care: monitor vitals, daily weight,
input–output chart, semi-Fowler’s position, administer medications, fluid
restriction.
26. Nursing management of Psoriasis
·
Psoriasis is a chronic autoimmune skin disorder
with scaly, erythematous plaques.
·
Nursing care includes:
• Maintain skin hydration: frequent moisturizers/emollients
• Topical therapy compliance: corticosteroids, tar preparations, vitamin D
analogues
• Avoid skin trauma → prevents Koebner phenomenon
• Teach stress reduction, avoid triggers (cold weather, infection)
• Psychological support & patient education (long-term chronic nature,
flare-ups expected)
VII. Answer the following
Answer :
27. Define arrhythmia and causes of arrhythmia (2
marks)
Definition:
Arrhythmia is an abnormality in the rate, rhythm or conduction of the
heartbeat. The heart may beat too fast, too slow or irregularly.
Causes:
·
Coronary artery disease / Myocardial infarction
·
Electrolyte imbalance (↓ potassium, ↓ magnesium)
·
Heart failure, hypertension
·
Drug toxicity (digitalis, stimulants)
·
Hyperthyroidism / Stress / Caffeine / Smoking
28. Medical and Nursing management of arrhythmia (5
marks)
Medical Management:
·
Anti-arrhythmic drugs (e.g., Amiodarone, Lidocaine,
Beta-blockers)
·
Correct electrolyte imbalance (K⁺, Mg²⁺)
·
Oxygen therapy if hypoxia present
·
Pacemaker for severe bradyarrhythmias
·
Defibrillation / cardioversion for
life-threatening rhythms (VT / VF / SVT)
Nursing Management:
·
Monitor vital signs & continuous ECG
monitoring
·
Assess chest pain, breathlessness, dizziness
·
Maintain oxygenation, administer O₂ as ordered
·
Administer prescribed drugs & observe side
effects
·
Educate patient to avoid caffeine, smoking,
stress
·
Maintain electrolyte balance, monitor lab values
·
Prepare patient for emergency interventions if
needed
29. Define chemotherapy (2 marks)
Chemotherapy is the use of chemical drugs to destroy or inhibit the growth
of cancer cells. It is a systemic therapy used to treat malignant diseases.
30. Classification of chemotherapy drugs (5 marks)
Common classes of chemotherapeutic agents:
1. Alkylating
agents
– Cyclophosphamide, Ifosfamide
2. Antimetabolites
– Methotrexate, 5-Fluorouracil
3. Antitumor
antibiotics
– Doxorubicin, Bleomycin
4. Plant
alkaloids / Mitotic inhibitors
– Vincristine, Paclitaxel
5. Hormonal
agents
– Tamoxifen, Prednisolone
6. Targeted
therapy
– Imatinib, Trastuzumab
7. Platinum
compounds
– Cisplatin, Carboplatin
Chemotherapy selection depends on cancer type, stage, patient condition and
may be given alone or in combination therapy.
