With Important Theory [Based on Baba Faridkot University, Punjab]Naina Bhardwaj Post Basic BSc Nursing Indo American College of Nursing (Moga) Rattan Professional Education College of Nursing (Mohali) Punjab India
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Nursing Solved Question Papers for General Nursing and Midwifery IIIrd Year
First Edition: 2012
Printed atDedicated to
My parents mother, Neelam Bhardwaj and in loving memory of my father Dr Lajpat Rai Bhardwaj Who taught me to always love Care and be the best that I could bePreface
I am sure, this book will prove beneficial to student by enabling them to prepare well for their examination.
It is a matter of great pride to present ‘Nursing Solved Question Paper's for General Nursing and Midwifery’ the third year students of general nursing and midwifery [GNM] as a student, I found difficulty in getting an authentic questions bank during my exams. However, there were a few book available in the market but they were not having the authentic questions with relevant answers so, I have complied this questions bank which appeared in Baba Faridkot University of Punjab as per INC regulations.
The book is written with great attention and concentration keeping in mind the basic requirement of IIIrd year nursing students. It contains solved question paper pediatric nursing, midwifery and gynecology and community health nursing with detailed explanation and important theory given at the beginning of every subject.
I am thankful to the God, who strengthens me in each second in all my work by showing his blessing abundantly through various resources, which helped me in the accomplishment of the entire task in my life.
I want to acknowledge my parents who opened my door of opportunity in education. I thank my mother, Neelam Bhardwaj, for all of her love, support, and assistance as I continuously worked to achieve my professional goals, I thank my father Dr Lajpat Rai Bhardwaj, who always provided insightful word and of encouragement. My memories of his love and support will always remain in my heart. I am certain that he would be very proud of my professional accomplishments.
It gives me immense pleasure in bringing out 1st edition of this book. This book written with great attention and concentration Keeping in mind the basic requirement of the nursing students. The book is general contains “Solved paper for all subject of GNM IIIrd year” students with some Important theory. This book will prove really beneficial to nursing students and will enable the students to prepare well for their examination. Sincere appreciation and warmest thanks are extended to many Individual who in their own mays have contributed to the publication of this book.
My heartfelt thanks to my husband Rohit, my brother Monu Bhardwaj and Sonu Bhardwaj for their great support.
My sincere thanks goes to Jaypee Brother's Medical Publishers (Pvt) Ltd for publishing this book.INC Syllabus
Unit – I Introduction
- Concept in child health care.
- Trends in paediatric nursing.
- Role of paediatric nurse in child care.
- Child care in India.
- Emerging challenges, nursing process related to paediatric nursing
- Concept of preventive paediatics.
- Vital statistics.
Unit – II The Newborn
- Characteristics of New Born and Physiological status of the new born:
- Assessment of the new born: head to toe assessment (physical assessment), neurological assessment.
- Nursing care of the normal/healthy new born including home care.
- Breast feeding-concept of Baby friendly hospital initiative.
- Common health problems–medical and nursing management of:
- Hyperbilirubinaemia, haemolytic disorder neonatal hypoglycaemia, sepsis, oral thrush, impetigo, erythema toxicum, hypothermia, neonatal convulsions.
- Birth injuries; injuries of muscles and peripheral nerves, injuries of bones, sort tissue injury and injury of nervous system.
- High Risk New born
- Definition: small for dates, Low birth weight
- Common health problems of pre-term, post term and low birth weight infants and their nursing management.
- High risk to new born of HIV +ve mother, diabetic mother, its medical and nursing care.
Unit – III The Healthy Child
- Growth and development: Definition, principles, factors affecting growth and development, techniques of assessment of growth and development, importance of learning about growth and development.
Growth and development during Infancy.
Health Promotion during Infancy
- Nutrition counseling and weaning, immunization.
- Safety and security including prevention of accidents, play and toys.
- Growth and development of Toddler.
- Health promotion during toddler hood, nutrition counseling, toilet training, immunization, safety and prevention of accidents, guidance to parent on toddler's care, play and toys.
- Health promotion during pre-school years, nutritional guidance, safety and security, day care centers/nursery school, play, role of parents in sex education of child.
The School Ager
- Physical, psychological and moral development during school age years.
- Health promotion during school years, nutritional guidance, sleep and rest, physical exercise and activity, dental health, sex education, play, role of parents in reproductive child health.
- Physical changes, physiological and reproductive changes, reaction of adolescents to puberty.
- Health promotion during adolescence.
- Nutritional guidance, personal care, reproductive health / sex education, role of parents in health promotion of adolescents.
Unit – IV The Sick Child
- Child's reaction to hospitalization.
- Effects of hospitalization on the family of the child.
- Role of nurse in helping child and family in coping with stress of hospitalization and illness.
Nursing Interventions Adaptations in Nursing Care of Sick Child
- Examination, principles of safety observed in paediatric techniques.
- Preparation of child for diagnostic tests, collection of specimens.
- Calculation and administration of oral and parenteral medications.
- Procedures related to feeding: formula preparation, gavage, gastrostomy feeding.
- Procedures related to elimination: enema, colostomy irrigation.
- Use of play as nursing intervention.
- Care of child in incubator.
- Administration and analysis of oxygen concentration.
- Surgical dressing
- Stea tent inhalation.
- Immobilised child
Unit – V Behavioral Disorders and common Health Problems during Childhood, their Prevention, Medical and Nursing Management.
Nutritional disturbances, allergies, dermatitis, vomiting, diarrhea, failure to thrive, resistance to feeding, colic anxiety.
Communicable diseases, poisoning, tonsillitis, otitis, media, urinary tract infections, diarrhea, child abuse, breath holding spells, bed wetting, thump sucking, nail biting, temper tantrums, masturbation.
Helminthic infestations, common skin infections, animal and insect bites, stuttering, pica, tics, antisocial behaviour, enuresis.
Problems of puberatal development: Precocious puberty, tall stature, gynaecomastia, acne, amenorrhoea, dysmenorrhoea, sexually transmitted diseases, accidents, sports injuries, juvenile delinquency, anorexia nervosa, obesity.
Unit – VI Children with Congenital Defects / Mal Formations
- Malformations, of the central nervous system-cranial deformities, defects of spinabifida, meningocele, hydrocephalus, cerebral palsy, neural tube closure.
- Skeletal defects-cleft lip and palate.
- Defects of Gastro-intestinal tract: Oesophageal atresia and distula, anorectal malformations, hernia, congenital hypertrophied pyloric stenosis.
- Defects of Genitourinay tract: Hpospadiasis, epispadiasis, extrophy of bladder, phimosis, cryptrochidism, polycystic kidney.
- Sexual abnormalities – ambiguous genitalia, hermaphroditism.
- Defects of cardio-vascular system – Congenital heart diseases, major acyanotic and cyanotic defects.
- Orthopeadic Abnormalities – Club foot, developmetal abnormalities of extremities.
Unit – VII Children with Various Disorders and Diseases
Etilogy, signs, symptoms, complications, prevention, medical, surgical and nursing management of:
- Disturbances of fluid and electrolyte balance: Imbalance, burns, disturbances pf renal function, acute and chronic glomerulonephritis, acute and chronic renal failure.
- Disturbed respiratory functions: Acute infections of upper and lower respiratory tract, acute inflammation of lungs.
- Gastro-intestinal disorders: Malabsorption syndromes (celiac diseases) and obstructive disorders (intestinal obstruction, Hirschsprugn's disease) inflammatory conditions (appendicitis, Meckel's diverticulum's, ulcerative colitis), worm infestations.
- Problems related to production and circulation of blood: Acquired heart diseases, congestive cardiac failure, infective endicarditis, rheumatic fever.
- Problems related to the elements of blood: Anaemias, sickle cell anaemia, thalassemia, defects of haemostasis, haemophilia, Immune deficiency diseases, HIV infection (AIDS) leukemias, thrombocytopaenia, purpura.
- Disturbances of regulatory mechanism: Disturbances of cerebral functions – altered state of consciousness, craniocerebral trauma.
- Intracranial infections: Meningitis, encephalitis, convulsive disorders.
- Endocrine dysfunctions: Disorder of pituitary functions, disorders of thyroid and parathyroid function, disorders of adrenal cortex, disorders of pancreatic hormone secretion.
- Problems that interfere with locomotion: Polimyelitis, osteomyelitis, kyphosis, lordosis and scoliosil, rheumatoid arthritis.
- Children with development problems: Handicapped children, multiple handicapped children, mental retardation.
- Communication disorders: Hearing, vision impairment, deaf and blind children.
Unit – VIII Welfare of Children
- Child welfare services, agencies, balwadi, anganwadi, day care centers, midday meal programme.
- Welfare of delinquent and destitute children.
- Programme and policies for welfare of working children.
- National child labour policy.
- Child Act, Juvenile Justice Act.
- Internationally accepted rights of the child.
COMMUNITY HEALTH NURSING – II
Unit – I Health system in India (Organizational set-up)
- Central level
- State level
- District level
Unit – II Health Care Services in India
- Health care concept and trends.
- Health care delivery system.
- Public sector: Rural areas, urban areas, health insurance, scheme, other agencies (defence, Railways etc.)
- Voluntary health agencies.
- Indigenous system of medicine.
- Nurse's role in health care services.
Unit – III Health Planning in India
- National Health policy
- National Health planning
- Fiver years plans
- Health committees and reports.
Unit – IV Specialized Community Health Services and Nurse's Role
- MCH (Reproductive health and child care).
- School health services.
- Industrial nursing.
- Geriatric nursing.
- Care of the handicapped: physically and mentally challenged.
- Rehabilitation nursing.
Unit – V Nurse's Role in National Health Programmes
- Major health problems in India.
- National control and development programmes.
- National eradication programmes.
- Nurse's role in national health programmes.
Unit – VI Demography and Family Welfare Demography
- Trends in India and its implications.
- Concept of fertility and infertility.
- Small family norms.
- Aims and planning methods
- Family welfare policy
- National programme
- Nurse's role in family welfare programme.
Unit – VII Health Team
Role of Nursing Personnel at Various Levels
- Multipurpose health worker: male and female
- Lady health visitor / Health supervisor
- Public heath nurse
- Public health nurse supervisor
Unit – VIII Vital Health Statistics
- Important rates and indices
- Vital health records and their utility.
MIDWIFERY AND GYNAECOLOGY
form these disorders and diseases.
Unit – I Introduction
- Definition: Midwifery, obstetrical nursing.
- Historical review.
- Development of maternity services in India
Unit – II Reproductive System
- Review of genitor-urinary system of male and female organs structure, physiology.
- Menstrual cycle.
- Internal and external organs of reproduction.
- Female pelvis: structure, diameters and type.
Unit – III Embryology and Foetal Development
- Ovum, sperm, maturation, fertilization and implantation.
- Development of fertilized ovum, morula, blastocyst, embryo.
- Development of pacenta: structure of full term placenta, functions and abnormalities, anatomical variations.
- Formation of foetal sac, membranes, amnion and chorionand their functions.
- Formation of liquor amni, its functions and abnormalities.
- Development of umbilical cord: structure, functions and abnormalities.
- Foetal skull: diameters, frontanelles, sutures and their importance.
- Foetal circulation.
Unit – IV Nursing Management of Pregnant Women
- Reproductive health.
- Genetic counseling.
- Physiological changes in pregnancy.
- Diagnosis of pregnancy: History, signs and symptoms and investigations.
- Influence of homones.
- Prenatal care: Objectives, history taking, calculation of expected date of delivery, routine examinations.
- Health education: Breast care, diet in pregnancy antenatal exercises.
- Preparation for hospital/ home delivery.
- Minor disorders of pregnancy and its management.
Unit – V Nursing Management of Women in Labour
- Definition, stage and duration.
- Causes of onset of labour.
A. First Stage of Labour
- Signs of onset of labour.
- Physiological changes in first stage of labour.
- Management – preparation of labour room.
- Preparation of women in labour: Physical and psychological.
- Equipments for normal delivery.
- Care: physical, psychological, monitoring of maternal and foetal condition.
- Vaginal examination; indication, articles, technique.
B. Second Stage of Labour
- Signs of second stage.
- Mechanism of labour.
- Monitoring of maternal and foetal condition.
- Physical and psychological care.
- Procedure for conduct of normal delivery.
- Prevention of perineal tear.
- Episiotomy, suturing and care.
C. Third Stage of Labour
- Signs, physiological changes.
- Management: immediate baby care, technique of placental expulsion, monitoring maternal condition examination of placements and its membranes, blood loss.
- Immediate postnatal care / fourth stage of labour.
D. Conduct of Home Delivery
Unit – VI Nursing Management of Baby at Birth
- Review of physiology of new born
- Apgar scoring, examination for defects (head to foot examination)
- Infant feeding: breast feeding, artificial feeding.
- Care of skin, eyes, cord, buttocks.
- Psychology and perception of new born.
- Minor disorders of new born: birth marks, rashes, skin infections, sore buttocks, infections of eyes.
- Jaundice of new born.
- Major disorders: Birth asphyxia, resuscitation measures, haemolytic disease (RH factor).
- Infections and birth injuries.
Unit – VII Nursing Management of Mother during Puerperium
- Definition, objectives of care
- Immediate postnatal care (care during 4th stage of labour)
- Physiological changes during puerperium.
- Psychosocial aspects of care.
- Diet during puerperium.
- Establishment of lactation and breast care.
- Perineal care.
- Postnatal exercises.
- Postnatal examination, follow-up, family welfare.
- Minor ailments and its management.
Unit – VIII Complications of Pregnancy and its Management
- Bleeding in early pregnancy.
- Bleeding in late pregnancy.
- Hydramnios, oligohydramnios.
- Hydatidiform mole.
- Pelvic inflammatory disease.
- Intrauterine growth retardation, intrauterine death.
- Post maturity.
Unit – IX High Risk Pregnancy and its Management
- Concept, factors.
- Anaemia, Jaundice, Viral infections.
- Urinary tract infection, Heart Diseases, Diabetes Mellitus, Ostemalacia, Sexually Transmitted Diseases, AIDS.
- Teenage pregnancy, Elderly primigravida, Multipara,
- Multiple pregnancy.
Unit – X High Risk Labour and its Management
- Malpositions, Malpresentations: Occipitoposterior position face, brow, shulder and breech presentation.
- Contracted pelvis: Definition, causes, diagnosis, management and trial of labour.
- Abnormal uterine action: Hypotonic and hypertonic action, bandl's ring, contraction ring, precipitate labour.
- Cervical dystocia.
- Early rupture of membranes, prolonged labour, Induction of labour.
- Obstructed labour rupture of uterus.
- Obstetrical emergencies: Cord presentation, cord prolapse, amniotic fluid embolism, obstetric shock.
- Complications of third stage: Post partum haemorrhage, atonic uterus, retained placenta and membranes, inversion of uterus.
Unit – XI Complications of Puerperium and its Management
- Puerperal pyrexia, Puerperal sepsis, Thrombophlebitis, Embolis, Puerperal psychosis.
- Mastitis, Breast abscess.
Unit – XII Obstetric Operations
- Manual removal of placenta.
- Version: internal, external.
- Forceps delivery.
- Vacuum extraction.
- Caesarean section.
- Medical termination of pregnancy.
- Laproscopic sterilization.
Unit – XIII Drugs used in Obstetrics
Unit – XIV Ethical and Legal Aspects Related to Midwifery and Gynecological Nursing
- During this period of training each student shall.
- Conduct thirty antenatal examinations.
- Witness fifteen deliveries before conducting one herself.
- Make five vaginal examinations.
- Conduct twenty deliveries.
- Perform and suture five episiotomies, five first degree tears.
- Give post natal care to thirty lying-in-mothers and to their new born babies.
- Carry out ten health teachings for antenatal and lactating mothers.
Unit – I Introduction
- Definition related to gynecological nursing.
- Gynecological history taking, examination and investigations.
Unit – II Puberty
- Definition development of sex organs in females.
- Menstrual cycle.
- Disorders of menstruation: amenorrhoea, dysmenorrhoea, cryptomenorrhoea.
Unit – III Fertility and Infertility
Definition, causes both in male and female investigation and management.
Unit – IV Pelvic Infections
- Vulva: Vulvitis, bartholinitis.
- Vagina: Vaginitis, trichomonas vaginalis, moniliasis.
- Metritis, salpingitis, oopthoritis, pelvic abscess.
- Chronic infections, cervical erosion.
Unit – V Uterine Displacement and Descent
- Retroversion, retroflexion.
- Decent of the uterus: First degree, second degree, completed procedentia.
Unit – VI Sexually Transmitted Diseases and their Prevention
- Syphilis, gonorrhoea, warts.
- Acquired Immuno Deficiency Syndrome (AIDS) / HIV.
Unit – VII Breast Disorders
- Breast abscess
Unit – VIII Benign and Malignant Neoplasms of Reproductive Organs
- Uterine polyps, uterine fibroids.
- Cancer: Cervix, uterus.
- Ovarian cyst: Benign, malignant.
- Cancer: Chemotherapy, radiotherapy.
- Palliative care.