Instructions: Short Answer Questions (120 marks, 1200 words maximum)
Question 1 – Respiratory
A. Compare the differences between pleural effusion and pulmonary oedema and then describe one (1) nursing and one (1) medical management for each condition.(10 marks)
B. Identify two respiratory conditions classified under the term chronic obstructive pulmonary disease (COPD). Compare the main similarities and difference between both respiratory conditions.(10 marks)
C. Discuss the nursing and medical interventions for COPD.(10 marks)
D. Name one (1) common organism that causes pneumonia. Discuss the pathophysiology of pneumonia and identify the best treat for viral pneumonia.(10 Marks)
Question 2 – Cardiovascular
Stephen is a fifty-four (54) year old man who is admitted to the ward with central chest pain radiating down his left arm.
A. Name the three (3) main categories of acute coronary syndrome and outline the similarities and differences for each condition.(10 marks)
B. Unstable angina is usually diagnosed on the patient history, clinical findings, and response to treatment. Identify four (4) clinical indications of acute myocardial infarction and briefly discuss the reason for each indication (10 marks)
C. Discuss and describe the pharmacological and non-pharmacological intervention of acute coronary syndrome. (10 marks)
D. Following a medical assessment, the doctor orders beta blockers for Stephen. Explain the mechanism of action of beta blockers in managing acute angina. What are the nursing considerations when administering a beta blocker? (10 marks)
Question 3 – Immune Disorders
Peter is 26 years old and is allergic to penicillin. When he was a child; he developed a rash over his entire body after taking penicillin. He has just been admitted to ED after a crush injury at work and required surgery. His notes clearly state that he is allergic to penicillin. He is prescribed cefazolin, which is a cephalosporin antibiotic with similar properties to penicillin. Shortly after the first dose, he experiences a rash, audible wheeze, angio-oedema and pale skin. His BP is low, HR elevated and breathing shallow and rapid. A MET call is made, and Peter is successfully resuscitated using adrenaline.
A. Compare allergic and anaphylactic reactions. Outline the treatment for anaphylaxis.(10 marks)
B. Discuss the likely allergic reaction that Peter experienced. Explain why Peter did not experience the same drug allergic reaction as he experienced in the hospital when he had penicillin for the first time as a child.(10 marks)
C. Describe the clinical manifestation and explain why the systemic signs and symptoms manifest following infusion of the antibiotic. (10 marks)
D. Discuss the mechanism of action of adrenaline and why it was administered to Peter. (10 marks)