1. During khilafat movement an excited mob set fire to a police station at chauri chaura village where about 22 policemen burnt alive in:
a. February 1922
b. February 1923
c. February 1920
d. February 1921
e. February 1924
2. Who presented the resolution for the formation of All India Muslim League:
a. Nawab Salimullah Khan
b. M. Ali Johar
e. Sir Agha Khan
3. Which of the following was commonly known as the ’Father of idea of Pakistan’?
a. Sir Muhammad Shafi
b. Choudhary Rehmat Ali
c. M A Jinnah
d. Allama Iqbal
4. When India cut off Pakistan’s water supply without notice?
a. June 1948
b. April 1949
c. May 1948
d. May 1949
e. April 1948
5. Mahmood Ghaznavi who ruled Ghani from 997-1030 A.D. raided India for:
a. 17 times
b. 15 times
c. 16 times
d. 19 times
e. 18 times
6. Historical wars of Paniput are very famous ; this battle field is located in Indian Punjab. How many major wars were fought in this field?
7. The 3rd June plan was announced on 3rd June by:
a. Lord Mounbatten
b. Jawahar Lal Nehru
c. Loord Wavell
d. Moti Lal Nehru
e. M.A. Jinnah
8. Quaid-e-Azam inaugurated the State Bank of Pakistan on:
a. 14th August, 1948
b. 1st July, 1949
c. 14th July, 1948
d. 1st July, 1948
e. 1st June, 1948
9. Who was the chairman of two boundary commissions between India and Pakistan?
a. Sir Cyril Radcliff
b. Tej sinjh
c. Muhammad Muneer
d. Din Muhammad
e. Mehar Chand
10. Name the Viceroy of India who made an offer in August 1940, on the behalf of British Government to Indian people:
a. Lord Wavel
b. Lord Mount Batten
c. Lord Irwin
d. Lord Linlithgow
e. Lord Hardinge
11. Who was appointed as the caretaker prime minister of Pakistan after the first dismissal of Benazeer Bhutto:
a. Aftab Ahmed Sherpao
b. Muhammad Khan Junejo
c. Moen Qureshi
d. Meraj Khalid
e. Ghulam Mustafa Jatoi
12. The Muslims of Sub-continent launched the Khilafat movement in the year of:
13. Which of the following was the first Muslim of India who placed Two Nation Theory?
a. Sir Syed Ahmed Khan
b. Sir Agha Khan
c. M. Ali Jinnah
d. M. Ali Johar
e. Sir Muhammad Shafi
14. Quaid-e-Azam Muhammad Ali Jinnah joined All India Muslim League in the year of:
15. All India Muslim League was established in:
a. September 1905
b. December 1906
c. September 1906
d. December 1907
e. December 1905
16. The Mughal emperor who promulgated a new faith entitled Din-e-Elahi in 1581 A.D. was:
17. Who was the first prime minister of Pakistan?
a. Kwaja Nazim-ud-din
b. M. Ali Jinnah
c. Liaquat Ali Khan
d. Muhammad Ali Bogra
18. The Muslim Deputation met the Viceroy Minto in 1906 at:
19. Who was the founder of Mughal dynasty?
a. Sher Shah
e. Zaheer-ud-din Baber
20. In 712 A.D a Muslim expedition to conquer Sindh was sent by Hajjaj Bin Yousuf who was:
a. Governer of Iraq
b. Governer of Makran
c. Emperor of Egypt
d. King of Persia
e. Governer of Syria
21. The Simla Deputation led by Agha Khan was consisted of:
a. 25 members
b. 35 members
c. 30 members
d. 32 members
e. 40 members
22. When 3rd Martial law was imposed?
a. 5th July, 1980
b. 5th July, 1978
c. 5th July, 1976
d. 5th July, 1979
e. 5th July, 1977
23. Who coined the name Pakistan?
a. Maulana Muhammad Ali Johar
b. Choudhary Khaliq-uz-zama
c. M,A. Jinnah
d. Choudhary Rehmat Ali
e. Allama Iqbal
24. Select correct chronological order:
a. Akber, Shah Jahan, Humayun, Jahangir
b. Shah Jahan, Jahangir, Akber, Humayun
c. Akber, Humayun, Jahangir, Shah Jahan
d. Jahangir, Shah Jahan, Humayun, Akber
e. Humayun, Akber, Jahangir, Shah Jahan
25. On 23rd March, 1940, the famous resolution which came to be known as Pakistan Resolution was moved by:
a. Choudhary Khaliq-uz-zama
b. Moulvi Fazal-ul-Haq
c. Sardar Auranzeb
d. Moulana Zafar Ali Khan
e. M.Ali Johar
26. Sindh Provincial Muslim League Conference was held at Karachi and passed a resolution adopting Two-Nation Theory on:
a. 10th October, 1938
b. 10th October, 1941
c. 10th October, 1937
d. 10th October, 1939
e. 10th October, 1940
27. The British Government appointed Simon Commission for the recommendation for the new constitution in the year of:
28. The largest political forum of the Islamic countries in the world is:
b. Gulf Countries
e. Arab League
29. With the resignation of Congress Ministries, the Quaid-e-Azam appealed to the people to observe Day of Deliverance on:
a. 22 December, 1938
b. 22 January, 1940
c. 22 January, 1939
d. 22 December, 1939
e. 22 December, 1940
30. Under the Vidya Mandir scheme, the students were asked to pay respect and homage to Gandhi’s picture every day in their assemblies in the schools. The author of this scheme was.
b. Imam Ali
c. Zakir Hussain
e. Dr. Abdul Kalam
31. Name the historians who visited India in 1001 A.D. gave earliest account of distinction between the Hindus and Muslims:
a. Mahmood Ghaznavi
32. The Indian National Congress passed the ‘Quit India Resolution’ in Bombay on:
a. 30th August, 1942
b. 31st August, 1942
c. 28th August, 1942
d. 18th August, 1942
e. 8th August, 1942
33. Where Quaid-e-Azam taken to in the last months of his life:
34. India exploded five nuclear tests on 11th and 13th May 1998. Pakistan replied with atomic explosions on:
a. 27th May, 1998
b. 28th May, 1998
c. 26th May, 1998
d. 25th May, 1998
e. 24th May, 1998
35. The Quran and Sunnah declared as the supreme law of Pakistan in________ of constitution of 1973.
a. 9th amendment
b. 10th amendment
c. 7th amendment
d. 8th amendment
e. 11th amendment
36. Kashmir is located in the ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬________ of Pakistan.
b. North East
37. When East Pakistan separated from Pakistan?
a. 8th December, 1971
b. 18th December, 1971
c. 10th December, 1971
d. 16th December, 1971
e. 20th December, 1971
38. The famous Congress-League Scheme was signed in Lucknow in the year of:
39. Which significant step of Bhutto Government in 1974 was a great satisfaction for religious parties?
a. Qadianis were declared as non-Muslims
b. Friday was declared weekly holiday
c. Pakistan was declared Islamic state
d. Separate Electorate were announced
At the end of presentation learners will be able to:
Discuss the terminologies related to pharmacology
Discuss the history of pharmacology briefly
Identify the purposes of medication
Identify the source of medication
Discuss the classification of drugs
Describe the three type of drug supply system.
Discuss the drugs standards and legislation.
Identify resource to collect and utilize drug information.
Learn to prepare drugs cards
Definition: Pharmacology is the science that deals with the study of drugs and their interaction with the living systems.
The word Pharmacology is derived from Greek – pharmakon means drug and logos means study.
In actual use, however, its meaning is limited to the study of the actions of drugs.
Pharmacology has been defined as “an experimental science which has for its purpose the study of changes brought about in living organisms by chemically acting substances (with the exception of foods), whether used for therapeutic purposes or not.”
Pharmacology studies the effects of drugs and how they exert their effects.
There is a distinction between what a drug does and how it acts.
Thus, amoxicillin cures a strep throat, and cimetidine promotes the healing of duodenal ulcers.
Pharmacology asks “How”? Amoxicillin inhibits the synthesis of cell wall mucopeptide by the bacteria that cause the infection, and cimetidine inhibits gastric acid secretion by its antagonist action on histamine H2 receptors
Scope Of Pharmacology
The scope of Pharmacology is rapidly expanding and Provides the rational bases for therapeutic use of drug.
On the basis of study of drug it is divided into two branches .
Branches of Pharmacology
Basic Pharmacology : the study of drugs in isolated tissues animals and other related living beings such as bacteria and viruses for experimental work is called basic Pharmacology.
The study of drugs in human beings is called clinical pharmacology.
The study of drugs in animals for treatment of diseases is also called clinical pharmacology.
General Definition of Drug
Any chemical agent that is used for diagnosis, prevention, treatment and curement of disease is called drug.
This disease oriented definition of drug is not applicable to some drugs such as oral contraceptives and general anesthetics etc.
WHO definition of drug
In 1966 WHO define drug as: “Any agent that is used or intended to be used for the treatment of disease or modifying pathological/physiological condition or to explore pathological/physiological condition is called drug”.
Drug means any substance which change the physiology of cell tissue, organ, or organism.
Medicine: Whenever, a drug is formulated into a suitable dosage form for prevention, cure, and diagnose of a disease in a proper dose.
Dose means the amount of medicine taken
Dosage form means the physical form of the medicines (solids, liquids, gas etc.)
Therapeutics: Therapeutics deals with the use of drugs in the prevention and treatment of disease.
Toxicology: Toxicology deals with the adverse effect of the drug and also the study of poisons, i.e detection ,prevention and treatment of poisoning. (Toxicon =poison in greek.
Pharmacodynamics means the mechanism by which the drug exerts its effect. For example, how aspirin work as analgesic. What the drug does to the body.
Pharmacokinetics means the movement of drugs within the body (absorption, distribution, biotransformation, and excretion). What the body does to the drug.
Over the counter (OTC) medicine: those medicines for which the physician prescription is not required. For examples, analgesics, antacids.
Analgesic means those medicines which are used for pain
Antipyretics means those drugs which are used for fever
Idiosyncratic means unexpected drug reaction
Teratogenic means harmful effects of drugs on the fetus
Synergism means when the combination of drugs increase the effect
Antagonism means when the combination of drugs decreases the effects
Patient compliance: The extent to which the patient follows
the clinical prescription
Pharmacopoeia is an official publication, containing a list of medicinal drugs with their effects and directions for their use.
BP: British Pharmacopoeia.
USP: United States Pharmacopeia
Active ingredient means biologically active substance which produce effect
An excipient is a pharmacologically inactive substance formulated alongside the active pharmaceutical ingredient of a medication e.g.. Cellulose derivatives
Purposes served by excipients:
Provide bulk to the formulation.
Facilitate drug absorption or solubility and other pharmacokinetic considerations.
Provide stability and prevent from denaturation.
Efficacy means maximum effect that a drug can produce regardless of dose.
Potency means amount of a drug that is needed to produce a given effect
Bioavailability is the degree to which or the proportion of the drug that is available to the site of action or target tissue to produce the desired effect.
Half-life (t1/2) is the time taken by the plasma concentration of the drug to decrease by 50%, or reach half of the original concentration. Initially, If a drug has plasma concentration of100 mg/ml and after passing 2 hours it reduces to 50 mg/ml, then the half life would be????..
Prophylactic agent is any drug that prevents a disease or illness from occurring (vaccines)
A brief history of pharmacology
Originating in the 19th century, the discipline makes drug development possible.
Pharmacology is one of the cornerstones of the drug discovery process.
The birth date of pharmacology is not as clear-cut.
In the early 19thcentury, physiologists performed many pharmacologic studies.
François Magendie studied the action of nux vomica (a strychnine-containing plant drug) on dogs, and showed that the spinal cord was the site of its convulsant action. His work was presented to the Paris Academy in 1809.
In1842, Claude Bernard discovered that the arrow poison curare acts at the neuromuscular junction to interrupt the stimulation of muscle by nerve impulses.
Pharmacology was held to have emerged as a separate science in 1847, when Rudolf Buchheim was appointed professor of pharmacology at the University of Dorpat in Estonia (then a part of Russia).
Lacking outside funding, Buchheim built a laboratory at his own expense in the basement of his home. Although Buchheim is credited with turning the purely descriptive and empirical study of medicines into an experimental science, his reputation is overshadowed by that of his student, Oswald Schmiedeberg.
Oswald Schmiedeberg (1838–1921)
Oswald Schmiedeberg is generally recognized as the founder of modern pharmacology.
Schmiedeberg obtained his medical doctorate in 1866 with a thesis on the measurement of chloroform in blood.
In 1872, he became professor of pharmacology at the University of Strassburg, receiving generous government support in the form of a magnificent institute of pharmacology.
He studied the pharmacology of chloroform and chloralhydrate.
In 1869, Schmiedeberg showed that muscarine evoked the same effect on the heart as electrical stimulation of the vagus nerve.
In 1878, he published a classic text, Outline of Pharmacology
In 1885, he introduced urethane as a hypnotic.
In the United States, the first chair in pharmacology was established at the University of Michigan in 1890 under John Jacob Abel, an American who had trained under Schmiedeberg.
In 1893, Abel joined Johns Hopkins University in Baltimore.
His major accomplishments include the isolation of epinephrine from adrenal gland extracts (1897–1898), isolation of histamine from pituitary extract (1919), and preparation of pure crystalline insulin (1926). His student Reid Hunt discovered acetylcholine in adrenal extracts in 1906.
Today, there is a pharmacology department in every college of medicine or pharmacy.
Purposes of Medication
Medications can be administered for the following purposes
Diagnostic Purpose: to identify any disease
Prophylaxis: to prevent the occurrence of disease e.g. heparin to prevent thrombosis and antibiotics to prevent infections
Therapeutic Purpose: to treat or cure disease / decrease symptoms, restore normal function or maintain normal function
Essentials of medication order
The drug order, written by the physician, has 7 essential parts for administration of drugs safely. The nurse should know how to read a drug order. It should have the following components:
Patients full name.
Date and time.
Route of administration.
Time and frequency of administration.
Signature of physician.
Types of Medication Orders
STAT order: needed immediately
Single order: given only once
PRN order: given as needed
Routine orders: given within 2 hours of being written and carried out on schedule
Standing order: written in advance carried out under specific circumstances
Basic principles (Safety) in medication administration3 checks and 7 Rights:
Sources of Drugs
Primitive Medicine: observing the reaction of some animals to particular herbs. Through primitive medicine quinine was discovered from Africa; used for malaria and lime juice for Ascorbic acid/Vitamin C and this is used for scurvy and gum bleeding.
Plants; Roots, bark, sap, leaves, flowers, seeds were sources for drugs e.g. Digitalis from foxglove, opium from the poppy plant.
Animal sources; gave us hormones for replacement in times of deficiencies e.g. Insulin from the pancreases of pigs and cattle, Liver extracts for anemia etc
Minerals; including acids, bases and salts like potassium chloride
Natural; OCCURRING SUBSTANCES like proteins
Happy Chance; Discovery is by chance not by any premeditated effort.
Synthesis of Substances; from natural products in the laboratory.
Mathematics is a group of related sciences, including algebra, geometry, and calculus, concerned with the study of number, quantity, shape and space and their interrelationships by using a specialized notations.
(Mathematical notations include relatively simple symbolic representations, such as the numbers 0, 1 and 2; variables such as x, y and z; function symbols such as sin; operator symbols such as “+, -, x etc relational symbols such as “<“,)
Nursing Mathematics/Importance of Mathematics in Nursing
Nursing mathematics reviews and practices basic mathematical skills that are tailored to the needs of a professional nurse.
Nurses, in their daily practices, deal with many problems in which there is use of mathematical knowledge.
It is truth that math is incorporated into the daily lives of the health care professionals. Doctors and nurses use math when they write prescriptions or administer medications.
Mathematics plays a vital role in medicine. Since people’s lives are involved, it is crucial that nurses and doctors be really accurate with their mathematical calculations.
If we have to give 2/3 tablet to a child, as in each country as a nurse we deal with different people and all of them do not understand the meaning of 2/3. A nurse should know that what does 2/3 means?
If we have to infuse an IV infusion in some particular time, what should be the speed of drip i.e. how many drops/minutes? For example, according to the client’s need and his condition, a different flow rate is used.
Conversion of one system into the others. If a nurse does not know conversion factors between different quantities, then how can he/she be able to convert these? For example, if a nurse does not know that how many kilograms in a pound and also the use of multiplication and division (mathematical operations), then it is not possible to convert pound into kilogram or kilogram into pound.
Medication dosage calculations etc are some such problems, which can be solved by nursing mathematics. Especially in pediatric nursing and intensive care unit nursing, it becomes more important than other areas.
It’s easy to figure out how to calculate the correct dose in your hand if the physician order calls for 25 milligrams, but the tablet comes in a 50 milligram. You simply give half the tablet. However, if the medication to be given is based on the patient’s weight in milligrams per kilogram, then you’d need to multiply in order to find out the correct dose.
The reason understanding math is so important is because the wrong dose could mean death of the patient. According to All Experts, that is why it’s so important nurses know how to calculate the correct dose. Normally, it’s the pharmacist who does the calculations. However, if the pharmacy is unavailable to do the calculating, then the nurse would have to know how to do it.
A number that expresses the relationship of one or more equal parts to the total number of equal parts in one unit (or one group) is called a fraction.
The common fraction consists of two numerals, one above the other, separated by a fraction bar.
For example, 2/3, 4/6, ½, ¾ etc are fractions.
The meaning of common fraction
A common fraction is:
PART OF A WHOLE NUMBER
The fraction 2/3 (two-thirds) means that 2 out of 3 equal parts of one whole are being considered.
ONE NUMBER DIVIDED BY THE ANOTHER
The fraction 2/3 (two-thirds), read from top to bottom, means 2 divided by 3, 2 ÷ 3, or 3∫2.
A PRODUCT OF MULTIPLICATION
The fraction 2/3 (two-thirds) means that there are 2 of the thirds, or (2 X 1/3).
Example – 1 (while —- unit)
¾ of the square is shaded
¼ of the square is unshaded
4/4 is one whole square.
Example –2 (while —- group)
3/5 of the group is shaded
2/5 of the group is unshaded
5/5 is one whole group.
Express each of the following in three different ways
B. Write fractions to express the shaded and unshaded portions of each unit or group
Denominator, Numerator, and Fraction Bar
A common fraction has a denominator, numerator, and a fraction bar. The denominator and numerator are called the terms of the fraction. The fraction bar represents the operation of the division.
The DENOMINATOR tells:
The TOTAL number of EQUAL parts in ONE whole the SIZE of each equal part in one whole
In fraction/ 2/3, the denominator of 3 means 3 equal parts in one whole the size of each part is one-third (1/3).
If the denominator is 1, it means that one whole has one equal part, and that part has the size of one whole. Then 2/1 is read as “two wholes”.
The denominator of a fraction cannot be zero. It is impossible for zero parts to make one whole and it is impossible to divide by zero.
A number (up above the fraction bar) gives an important piece of information.
The NUMERATOR tells the NUMBER of EQUAL parts being used, talked about, or considered.
In fraction 2/3, numerator 2 means 2 equal parts are being talked about (out of total of 3 equal parts in one whole).
In mathematics, the symbol ÷ means “divided by”. Read a fraction from top to bottom when reading as an expression of division.
7/8 = 7 divided by 8 = 7÷ 8 = 8∫7
Fill in the blanks about each fraction.
Look at the fraction.
What is the total number of equal parts in whole? __________
What is the size of each part? __________
How many parts are being talked about? __________
The numerator is __________
The denominator is __________
TYPES/KINDS OF FRACTION
1. PROPER FRACTIONS
A fraction is called proper fraction if the numerator is smaller than the denominator. The value of proper fraction is less than one.
For example: ¾, ¼, 4/5.
2. IMPROPER FRACTION
A fraction is called improper fraction if the numerator is larger than or equal to the denominator. The value of the fraction is equal to one or more than one.
For example: 4/4, 5/1, 7/4.
Note: Every natural number can be written as a fraction in which 1 isitss denominator. For example, 2 = 2/1, 25 = 25/1, 53 = 53/1, etc. So, every natural number is an improper fraction.
A combination of a proper fraction and a whole number is called a mixed fraction.
2 1/3, 4 5/2, 11 1/10 and 7 5/11 are examples of mixed fractions.
In other words:
A fraction which contains two parts: (i) a natural number and (ii) a proper fraction, is called a mixed fraction, e.g., 3 2, 7 3 etc.
In 3 2/5, 3 is the natural number part and 2/5 is the proper fraction part.
In Fact, 3 2/5 means 3 + 2/5.
Fractions, which have the same value but look different, are called equivalent (equal) fractions. The written form of the fraction changes, but the value of the fraction remains the same.
½, 2/4, 4/8, 8/16 are equivalent fractions.
When comparing fractions, these symbols are used
= is equal to 7/8 = 14/16
> is greater than 1/3 > 3/14
< is less than 3/10 < 7/8.
If the denominators are the same, the fraction with larger numerator has the greater value.
For example, in the following fractions 5 is greater numerator so the fraction 5/8 has greater value than 3/8. Its mean 5/8 > 3/8.
Another method for comparison fractions:
For example, we have to compare 5/8 and 3/8
Step I Write 0 after numerators in both fractions. These will be 50/8 and 30/8
Step II simplify these two up to one time only, answers will be 6 and 3 respectively so first is larger value that’s why 5/8 > 3/8
If the numerators are the same, the fraction with the smaller denominator has the greater value.
For example: 2/4 > 2/ 8, ½ > ¼.
Another method for comparison fractions:
For above fractions 2/4 and 2/8
Step I Write 0 after numerators in both fractions. These will be 20/4 and 20 /8
Step II simplify these two upto one time only, answers will be 5 and 2 respectively so first is larger value that’s why 2/4 > 2/8
To compare 2/3 and ¾, a common denominator for both fractions must be found. Rewrite each fraction as an equivalent fraction using the common denominator.
2 X 4 = 8 3 X 3 = 9
——- — ——– —–
3 X 4 = 12 4 X 3 = 12
Now comparing 2/3 and ¾ is the same as 8/12 and 9/12.
Therefore 2/3 < ¾ because 8/12 < 9/12.
Another method for comparison fractions:
For example we have to compare 2/3 and 3/4
Step I Write 0 after numerators in both fractions. These will be 20/3 and 30/4
Step II simplify these two upto one time only, answers will be 6 and 7 respectively so second is larger value that’s why 3/4 > 2/3 OR 2/3 < 3/4
1.2 Decimal or Decimal Fraction
Decimal is a fraction that has an unwritten denominator of a power of 10. It is indicated by a decimal point to the left of the numerator; .2 = 2/10 (Collins Concise Dictionary)
Decimal fractions represent common fractions that have denominators of 10, 100, 1000, or some power of 10. To the left of decimal points are whole numbers and to the right of the decimal points are fractional parts.
1.75, 1 is the whole number which is to the left of the decimal point while 75 is the fractional part as it is to the right of decimal point.
In decimal fractions, a zero is written to the left of the decimal point to indicate clearly that there are no whole numbers in the decimal, just fractional parts, for example, 0.75 (not .75).
First look at the fractional parts. Let’s add a zero to the right of the decimal point.
Notice here that adding zeroes after the last digit to the right of the decimal point does not change the value.
Let’s put the zero in different position:
Adding zeroes between the decimal point and the first number to the right of the decimal point does change the value.
Division of Decimals
Dividend = Quotient
Remember: Quotient is another name for Answer. They’re one and the same.
1.2.1 Division of Whole by Decimal
If the divisor is not a whole number, move the decimal point the same number of places to the right in the divisor and the dividend so that the divisor becomes a whole number. Place the decimal point in the quotient directly above the new decimal point in the dividend. Then divide.
A. 7 ÷ 1.75 = 7 / 1.75
Make the divisor (1.75) a whole number by multiplying 100 times.
Multiplying the dividend (7) by the same number, 100
Place the decimal point in the quotient (your answer).
7 x 100 = 700 = 4.
1.75 100 175
Solve the following:
A. 19 ÷ 1.2 (15.83)
B. 15 ÷ 0.7 (21.42)
On the Job practice
Q1. How many 0.5-gram doses can be obtained from a 4-gram vial of medication? (8 doses)
Q2. How many 0.25-gram doses can be obtained from a 2-gram vial of medication? (8 doses)
1.2.2 Division of decimal by whole
If the divisor is a whole number, place the decimal point in the quotient directly above the decimal point in the dividend. Then divide. Look at the following example:
1.26 ÷ 6 = 1.26 / 6 6∫1.26(0.21
Solve the following:
A. 0.19 ÷ 12 (0.015)
B. 8.89 ÷ 7 (1.27)
On the Job practice
Q. A total of 270.9 grams of meat is to be served in three meals. How many grams of meat should be served in each meal? (90.3 gram)
Q. A total of 1.50-grams of medication is given in 3 doses. How many grams should be given per dose? (0.50 gram per dose)
1.2.3 Division of Decimal by Decimal
A. 14.48 ÷ 0.4 = 14.48 / 0.4
Make the divisor (0.4) a whole number by multiplying by 10.
Multiply the dividend (14.48) by the same number, 10.
Place the decimal point in the quotient.
Solve the following:
12.24 ÷ 0.6 (20.4)
15.5 ÷ 1.5 (10.33)
On the Job practice
A container holds 16.25 milliliters of medication. How many 1.25 milliliter doses can be administered from the container? (13 doses)
The total prescribed dosage of medication is 4.5 grams. How many 1.5-gram tablets need to be administered? (3 tablets)
Percent or percentage is another kind of fraction that always has a denominator of 100.
1.3.1 The Meaning of Percentage: –
Percent means “per 100” or “÷ 100”.
Remember that the fraction bar means “divided by”.
6% = 6 percent = 6 per 100 = 6 / 100 6 divided by 100
25% = 25 percent = 25 per 100 = 25 / 100
100% = 100 percent = 100 per 100 = 100 / 100
Dividing by 100 results in “hundredths” as can be seen. Another way of saying percent is hundredths.
1% = 1 percent = 1/ 100 = 1 hundredths
50% = 50 percent = 50/ 100 = 50 hundredths
75% = 75percent = 75/ 100 = 75 hundredths
Common fractions can be equal to one (7/7), less than one (1/7), more than one (15/7). Similarly, decimals can be equal to one (1), less than one (0.5), more than one (1.5).
And percentage too, can be equal to one (100% = 100/100), less than one (30% = 30/100), more than one (150% = 150/100).
1.3.2 Conversion of percent to fractions:
25% = 25/100 = ¼
50% = 50/100 = ½
75% = 75/100 = 3/4
125% = 125/100 = 1 25/100 = 1 ¼
1.3.3 Conversion of percent to decimals:
4% = 4/100 = 0.04
35% = 35/100 = 0.35
100% = 100/100 = 1.
125% = 125/100 = 1.25
1.3.4 Conversion of Fraction to Percentage
A common fraction is converted to percentage in TWO STEPS
Step -1. Express the fraction as decimal (divide the numerator by the denominator)
Step -2. Change the decimal to a percent by multiplying by 100 and add a percent sign (%)
¼ = 1÷ 4 = 0.25 x 100 = 25 %
3/8 = 3 ÷ 8 = 0.375 x 100 = 37.5 %
2/5 = 2 ÷ 5 = 0.4 x 100 = 40 %
Change the common fraction to its equivalent percentage
a. ½ (50%)
b. 5/8 (62.5%)
c. ¾ (75%)
1.3.5 Conversion of Decimal to Percentage:
To convert a decimal to a percent, multiply by 100. Move the decimal point two places to the right and add a percent sign.
0.125 = 0.125 x 100 = 12.5 %
3.9 = 3.9 x100 = 390 %
0.75 = 0.75 x 100 = 75 %
Express the following as an equivalent percent:
1.4 Formula of Percentage:
Percent (%) = Numerator X 100
1.4.1 How to calculate percentage
Suppose we have to know the percentage of ½
Suppose the percent of ½ is A % then
A = ½ X 100 = 0.5 X100 = 50%
1. Suppose you got 740 marks out of 850 in your SSC. What is your percentage in SSC?
Using above formula
A = 740/850 X 100 = 0.87 X 100 = 87%.
2. What is the percentage of the solution if you have 50 gram of solute in 1000 mL of solution? (Answer 5%)
Solve it yourself using the same method.
Solution Strength as Percent:
Percent strength describes the amount that was dissolved in a liquid to form the solution.
A 5% solution made with pure drug (liquid form) means 5 ml (solute) of pure drug in 100 ml (Solvent) of solution.
5% Solution = 5ml/100 ml
A 5% solution made with pure drug (dry form) means 5 gm(solute) of pure drug in 100 ml (Solvent)of solution.
5% Solution = 5 gm/100 ml
In clinical life we use iv fluids like Inj:5% D/W 1000 cc, or Inj:10% D/W 1000 cc
Its mean in Inj: 5% D/W, there are 5 grams of dextrose i.e. glucose in 100 mL of Distilled water so there will be 50 gram of glucose in 1000 cc of distilled water or there is 50gram of glucose in 1000 cc in this drip, similarly in 10% D/W, there is 100gram of glucose in 1000 cc in this drip.
Conversion of Decimal to Fraction
Decimal fractions can be converted into common fractions by dropping the decimal point to find numerator and using the correct denominator.
A. 0.15 Drop the decimal point to find numerator 15. The proper denominator (100) will have as many zeroes as there are decimal places to the right of the decimal point. 0.15 = 15/100
B.0.2 Drop the decimal point to find numerator 2. The proper denominator (10) will have as many zeroes as there are decimal places to the right of the decimal point. 0.2 = 2/10
C. 0.005 Drop the decimal point to find the numerator 5. The proper denominator (1000) will have as many as zeroes as there are decimal places to the right of the decimal point. 0.005 = 5/1000
2. Apply four fundamental operations on fraction, decimal and percentage:
Addition, Subtraction, Multiplication and Division of Fractions
Addition of Fractions:
Add 3/8 + 2/8 + 5/8
Solution: first of all we take Least Common multiple (LCM), as denominator is same then this is the LCM
3/8 + 2/8 + 5/8
3 + 2 + 5 = 10/8 = 5/4 = 1 ¼ Answer
as this is not a proper fraction and Answer should have proper fraction so we convert it into mixed fraction.
Add 2/3 + ¾ + 1/6
Solution: first of all, we take Least Common multiple (LCM), as denominators are different then we use the following method.
2 3,2,3 3 3,1,3
Hence 2x2x3=12 is LCM, each of 3,4, and 6 can multiply 12 completely without remainder.
2/3 + ¾ + 1/6
8 + 9 + 2 = 19/12 = 1 7_ Answer.
Add 3 3 + 4 5
Note: Mixed numbers are first written as improper fraction (6 ½ = 13/2). Whole numbers are written as fraction by putting whole number over the denominator 1. Whether there is any of four operations.
Solution: 3 3 + 4 5
Make improper fraction
3 ¾ Multiply 4 and 3, it wl be 12 now add 3(numerator) it will be 15. Now rewrite it as 15/4
similarly change 4 5/6 and write as 29/6
Now add 15/4 and 29/6, same as Q. No.2.
Subtraction of Fractions:
Subtract 1/8 from 7/8
Solution: first of all we take Least Common multiple (LCM), as denominator is same then this is the LCM.
7/8 – 1/8
7 – 1 = 6/8 = ¾ Answer (answer should in minimum fraction)
Similarly do the following yourself
Subtract 9/16 from ¾
Subtract 7 7 _ 3
Multiplication of Fractions
Multiply 15/8 and 7/30
15 X 7 = 7 Answer
8 30 2 16
Multiply ½ and ¼
Multiply 3, 2/9, and 9/10.
Division of Fractions:
Division involves the use of a reciprocal (or inverse). The reciprocal of a fraction is its “flip.” Change mixed numbers and whole numbers to their equivalent improper fractions first. Then find the reciprocal of the divisor by inverting (flipping) it.
Divide 2 ½ by ¼ or 2 ½ ÷ ¼
Or 5/2 ÷ ¼
5 X 4 = 5 X 2 = 10 Answer
Divide ¾ by ¼
Divide 8 by 4 1
Addition, Subtraction, Multiplication and Division of Decimal
Addition of Decimal Numbers:
To add any decimal numbers, line up the decimal points. To avoid confusion, add zeroes after the last digit to make all of the decimal fractions’ same length. This does not change the value of the decimal fraction.
Find the sum of the following
(keep in mind that you have to keep the numbers according to digit place i.e. unit, 10th, 100th etc as kept in Q.No. below)
8.45 + 7.98
6.94 + 0.5 + 17.102 + 8
Subtraction of Decimal Numbers:
8.4 – 0.7
7.8 – 3.92
6 – 3.45
On the Job
A patient receives the following doses of medication: 1.75 milliliters, 2.5 milliliters, and 2 milliliters. What is the total dosage? (6.25 mL)
A vial contains 3.5 milliliters of medication. An injection of 2.25 milliliters is withdrawn from the vial into a syringe. How much medication remains in the vial? (1.25 mL)
Patient Ali weighed 65.95 kilograms (kg) 2 months ago. His weight then increased by 0.9 kg one month, and 1.58 kg the next month. What is his current weight? (68.43 Kg)
A patient is to receive a dosage of 2.5 milligrams (mg) and has been given 1.75 mg. What additional amount of medication must be administered? (0.75mg)
Multiplication of Decimals
Observe the names given to the parts of a multiplication problem.
Factor X Factor = Product
0.2 X 0.4 = 0.08
A. 6.51 (2 decimal places)
X .2 (1 decimal place)
1.302 (3 decimal place)
Multiply 30.7 and 1.6 (49.12)
Multiply 7.9 and 12 (94.8)
On the JOB
A patient is given 0.09 kilogram of meat for each meal. How many kilograms of meat are served in nine meals? (0.81 kg)
A container holds 10.75 liters of ethyl alcohol. How much alcohol is in six of these containers? (64.5 liters)
Divisions of Decimals:
Already done previously
Apply the percentage formula in different word problems:
1 out of 45 patient received insulin. —— %
Using the formula for percent = numerator/denominator X 100
1/ 45 X 100 = 2.22 % patients received insulin.
75 out of 125 patients required follow up visits ——– % (60 %)
1 out of 110 patients received a blood transfusion. —– % (0.90 %)
Nearly 0.07 of the patients stayed fewer than two days. —— %
0.07 = 7/100 X 100 = 7%
5. Only 0.005 of the patients remained in the hospital for more than two weeks.
Definition: respiratory acidosis is a clinical disorder in which the pH is less than 7.35 and the Pco2 is greater than 42mmHg
It may be either:
Acute respiratory acidosis
Chronic respiratory acidosis
Respiratory acidosis is always due to inadequate excretion of Co2 with inadequate ventilation, resulting in elevated plasma Co2 levels and thus elevated carbonic acid (H2CO3) levels (Epstein and singh 2001)
Acute respiratory acidosis occurs in emergency situations such as acute pulmonary edema, aspiration of foreign object, atelectasis, pneumothorax, over dose of sedatives, sleep apnea syndrome
Reparatory acidosis can also occur in disease that impair respiratory muscles such as: muscular dystrophy, myasthenia gravis and gullian-ballian syndrome
Clinical manifestations in acute and chronic respiratory acidosis vary sudden hypercapnia (PaCO2) can cause increased pulse rate
Increased respiratory rate
Increased blood pressure
Feeling of fullness in the head
An elevated PaCO2
Increased cerebral blood flow particularly when it is higher than 60mmHg
Ventricular fibrillation may be the first sign of respiratory acidosis
If respiratory acidosis is severe, intra cranial pressure may increase, resulting in palpation and dilated conjuctival blood vessels
Chronic respiratory acidosis occurs with pulmonary disease such as:
Chronic emphysema and bronchitis, obstructive sleep apnea and obesity
Cyanosis, ICP, tachypnea, COPD
Assessment and Diagnostic Findings
Arterial blood gas (ABG’s) evaluation reveals a pH less than 7.35 a PaCO2 greater than 42mmHg and variation in the bicarbonate level
Depending on the duration and cause of the acidosis in acute respiratory acidosis
Treatment is directed at improving ventilation
Pharmacological agents are used as indicated e.g bronchodilators, to relieve spasm Antibiotics for infection
Thrombolytics or anti coagulants are used for pulmonary emboli Adequate hydration
Mechanical ventilation use appropriately may improve pulmonary ventilation
Respiratory Alkalosis (carbonic acid deficit)
Definition: respiratory alkalosis is a clinical condition in which the arterial pH is greater than 7.45 and the PaCO2 is less than 38mmHg
As like respiratory acidosis acute and chronic condition can occur
Respiratory alkalosis is always due to hyperventilation which cause excessive blowing off of CO2 and hence a decrease in the plasma carbonic acid concentration
Causes can include”
Inappropriate ventilator setting
Chronic respiratory alkalosis results from chronic hypocapnia and decreased serum bicarbonate levels
Chronic liver insufficiency
Cerebral tumors are predisposing factors
Light headedness – due to vasoconstriction and decreased cerebral blood flow
Inability to concentrate
Tingling due to decreased calcium
Tinnitus and at time loss of consciousness
ABG’s assist in the diagnosis of respiratory alkalosis
In acute state pH is elevated above normal as result of low PaCO2 and normal bicarbonate level
Serum electrolytes analysis decreased Ca+ level
Patient with chronic respiratory alkalosis are usually asymptomatic
Treatment depends on the underlying cause of respiratory alkalosis
If the cause is anxiety – the patient instructed to breath slowly to allow CO2 to accumulate
A sedative may be required to relieve hyperventilation in vary anxious patients
Fluid volume excess (FVE) refers to an isotonic expansion of ECF (Extra cellular fluid) caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exist in the ECF
It is always secondary to an increase in the total body sodium content which lead an increase to total body water, due to there is isotonic retention of body substances the serum sodium concentration remains essentially normal
FVE may be related to simple fluid overload or diminished functions of the homeostatic mechanisms responsible for regulating fluid balance
Contributing factors include
Cirrhosis of liver
Other contributing factors are
Consumption of excessive amount of table or other sodium salts
Administration of excessive sodium containing fluid to patient with impaired regulatory mechanisms (Beck – 2000)
Clinical manifestation of FVE start from expansion of the extra cellular fluid (ECF) and include
Distended Neck Veins
And Crackles (abnormal lung sound) Other manifestations include
Increased blood pressure
Increased pulse pressure
Increased central venous pressure
Increased urine output
Shortness of breath (SOB) and wheezing
Laboratory data useful in diagnosing FVE include BUN and hematocrit level
In both FVE both of these values may be decreased because of plasma dilution
Other causes include low protein intake and anemia
In chronic renal failure both serum osmolality and sodium level are decreased due to excessive retention of water
x- ray chest reveal pulmonary congestion
Treat the cause
If the fluid excess is related to excessive administration of sodium containing fluids, discontinuing the infusion may be all that is needed
Symptomatic treatment consist of diuretics and restriction fluids and sodium
Nutritional therapy – restrict sodium in diet
Pure water may be used
To asses for FVE
The nurse measure intake and output at regular intervals to identify excessive fluid retention
Daily Wt of patient
To assess breath sounds at regular intervals
The nurse monitors degree of edema in most depending parts of body as feet, ankles, sacral region bed ridden patient
Q1) Explain Strategies for managing patient with urinary stress incontinence
Ans :- The nurse instructs the patient to:
1)Avoid bladder irritants, such as caffeine, alcohol, and aspartame (NutraSweet).
2)Avoid taking diuretic agents after 4 pm.
3)increased awareness of the amount and timing of all fluid intake.
4)Perform all pelvic floor muscle exercises as prescribed, every day.
5)Stop smoking (smokers usually cough frequently, which increases incontinence).
6)Take steps to avoid constipation: Drink adequate fluids, eat a well-balanced diet high in fiber, exercise regularly, and take stool softeners if recommended.
7)Void regularly, 5–8 times a day (about every 2–3 hours):
First thing in the morning
Before each meal
Before retiring to bed
Once during the night if necessary
Q2) a) difference between AIDS and HIV
b) explain the prevention of HIV
HIV (Human Immunodeficiency Virus)
HIV is the acronym for human deficiency virus
Virus that invades the immunity system
Patient may suffer minor difficulties; symptoms will be similar to flu
AIDS (acquired immunodeficiency syndrome)
AIDS is the acronym for acquired immune deficiency syndrome
Large stage of spectrum of conditions, initially caused by the infection of (HIV)
Patient will experience severe sign and symptoms, disrupting the quality of life
Prevention of HIV
Individuals can reduce the risk of HIV infection by limiting exposure to risk factors.
1)Male and female condom use before sex
2)Testing and counselling for HIV and STIs
3)Testing and counselling, linkages to tuberculosis (TB) care
4)Avoid sharing contaminated needles, syringes and other injecting equipment and drug solutions when injecting drugs
5)Elimination of mother-to-child transmission of HIV
Q3) enlist types of hypersensitivity and explain management of any one of them And :- Definition
Hypersensitivity is an excessive or aberrant immune response to any type of stimulus
Types of hypersensitivity
1)Anaphylactic (Type I) Hypersensitivity
2)Cytotoxic (Type II) Hypersensitivity
3)Immune Complex (Type III) Hypersensitivity
4)Delayed-Type (Type IV) Hypersensitivity
Anaphylactic (Type I) Hypersensitivity Management
1)Antihistamines actto block the effects of histamine, which reduces vascular permeability and bronchoconstriction.
2)Corticosteroids which can be used to reduce the inflammatory response, as well as epinephrine, which is sometimes given during severe reactions via intramuscular injections through an EpiPen or intravenousinjection.
3)Epinephrinecan help constrict blood vessels and prevent anaphylactic shock.
Q4) enlist complication of chemotherapy
Ans :- Complication of chemotherapy
Easy bruising and bleeding.
Anemia (low red blood cell counts)
Nausea and vomiting.
Q5) explain immediate post operative care of patient after appendectomy Ans :-
Post Operative care
1)Monitor vital sign.
2)Assess level of consciousness.
3)Assess bleeding at wound site.
4)Give clear fluid for first POD.
5)Monitor for infection and any complication at the wound incision.
6)Administer IV prophylaxis antibiotics as ordered.
7)Maintain aseptic technique during dressing.
8)Encourage patient to do ROM exercise.
Q6) English types of abortion and explain management of any one Ans :- Definition
Interruption of pregnancy or expulsion of the product of conception before the fetus is viable is called abortion. The fetus is generally considered to be viable any time after the fifth to sixth month of gestation.
Types of abortion
The term threatened abortion is used when a pregnancy is complicated by vaginal bleeding before the 20th week. Pain may not be a prominent feature of threatened abortion, although a lower abdominal dull ache sometimes accompanies the bleeding. Vaginal examination at this stage usually reveals a closed cervix. 25% to 50% of threatened abortion eventually result in loss of the pregnancy.
The patient is kept at rest in bed until 2 days after blood loss has ceased. Intercourse is forbidden. As soon as the initial bleeding has stopped an ultrasound scan is performed. This will reveal whether or not the pregnancy is intact. The prognosis is good when all abnormal signs and symptoms disappear and when the resumption of the progress of pregnancy is apparent.
In case of inevitable abortion, a clinical pregnancy is complicated by both vaginal bleeding and cramp-like lower abdominal pain . The cervix is frequently partially dilated, attesting to the inevitability of the process.
The uterus usually expels its contents unaided , and examination must be made with strict aseptic technique. If the abortion is not quickly completed, or if hemorrhage becomes severe, the contents of the uterus are removed with a suction curettege.
In addition to vaginal bleeding, cramp-like pain, and cervical dilatation , an incomplete abortion involves the passage of products of conception , often described by the women as looking like pieces of skin or liver.
Patients require admission to the hospital. Treatment is aimed at preventing infection, controlling bleeding and obtaining an empty and involuting uterus. The chief risks associated with retained products are hemorrhage and sepsis.
4)Missed Abortion: –
The term missed abortion is used when the fetus has died but is retained in the uterus, usually for some weeks. After 16 weeks’ gestation, dilatation and curettage may become a problem. Fibrinogen levels should be checked weekly until the fetus and placenta are expelled.
Once the diagnosis has been made the uterus should be emptied. Early in gestation evacuation of the uterus is usually accomplished by suction curettage. The prognosis for the mother is good. Serious complications are uncommon.
5) Recurrent Abortion: –
Recurrent abortion refers to any case in which there have been three consecutive spontaneous abortions. Possible causes are known to be genetic error, anatomic abnormalities of the genital tract, hormonal abnormalities, infection, immunologic factors, or systemic disease.
Paternal and maternal chromosomes should be evaluated. The mother should be ruled out the presence of systemic disorders such as DM, SLE, and thyroid disease. It should rule out the presence of Mycoplasma, Listeria, Toxoplasma etc. infectious disease. Pelvic examination
Q7) English types of abortion and explain management of them
Cirrhosis of the liver is a chronic, progressive disease characterized by widespread fibrosis(scarring) and nodule formation.
The development of cirrhosis is an insidious, prolonged course, usually after decades of chronic liver disease.
b) enlist its signs and symptoms
Some of the more common symptoms and signs of cirrhosis include:
Yellowing of the skin (jaundice) due to the accumulation of bilirubin in the blood
Loss of appetite
Easy bruising from decreased production of blood clotting factors by the diseased liver.
list 10 points of nursing intervention
Promoting rest to conserve energy
Improving nutritional status
Providing skin care
Reducing risk of injury
Monitoring & managing Potential complication
Bleeding & hemorrhage
Fluid Volume excess
Promoting home & self care
Client teaching like deep breathing techniques.
Provide adequate nutrition and education, encourage lifestyle changes
Provide a quiet and calm environment.
Provide comfort measures such as back rubbing and changing position to relieve pain.
Q2) a) define intestinal obstruction and its types
This obstruction can involve only the small intestine (small bowel obstruction), the large intestine (large bowel obstruction), or via systemic alterations, involving both the small and large intestine (generalized ileus). The “obstruction” can involve a mechanical obstruction or, in contrast, may be related to ineffective motility without any physical obstruction, so-called functional obstruction, “pseudo-obstruction,” or paralytic ileus
There are two main types
It is caused by physical barrier
Cause Tissue and organ stick together
Lack or absence of peristalsis
Lack of muscular contractions to move food contents
b) describe its management and nursing care
a. Relieving pressure and obstruction
b. Supportive care
a. Treatment with nasogastric or long intestinal tube provides bowel rest and removal of air and fluid
b. Successfully relieves many partial small bowel obstructions
a. Treatment for complete mechanical obstructions, strangulated or incarcerated obstructions of small bowel, persistent incomplete mechanical obstructions
b. Preoperative care
1.Insertion of nasogastric tube to relieve vomiting, abdominal distention, and to prevent aspiration of intestinal contents
2.Restore fluid and electrolyte balance; correct acid and alkaline imbalances
3.Laparotomy: inspection of intestine and removal of infarcted or gangrenous tissue
4.Removal of cause of obstruction: adhesions, tumours, foreign bodies, gangrenous portion of intestines and anastomosis or creation of colostomy depending on individual case
a. Prevention includes healthy diet, uid intake
b. Exercise, especially in clients with recurrent small bowel obstructions
Q3) a) define renal failure and its causes
A condition in which the kidneysstop working and are not able to remove waste and extra water from the blood or keep body chemicals in balance. Acute or severe renal failurehappens suddenly (for example, after an injury) and may be treated and cured.
The most common causes are:
high blood pressure
chronic glomerulonephritis (kidney damage)
high blood sugar (diabetes)
polycystic kidney disease
blocked urinary tract
describe acute renal failure along with nursing care
Acute kidney failurehappens when your kidneyssuddenly lose the ability to eliminate excess salts, fluids, and waste materials from the blood. This elimination is the core of your kidneys’main function. Body fluids can rise to dangerous levels when kidneys lose their filtering ability.
Monitor 24-hour urine volume to follow clinical course of the disease.
Monitor BUN, creatinine, and electrolyte.
Monitor ABG levels as necessary to evaluate acid-base balance.
Weigh the patient to provide an index of fluid balance.
Measure blood pressure at various times during the day with patients in supine, sitting, and standing positions.
Adjust fluid intake to avoid volume overload and dehydration.
Watch for cardiac dysrhythmias and heart failure from hyperkalaemia, electrolyte imbalance, or fluid overload. Have resuscitation equipment available in case of cardiac arrest.
Watch for urinary tract infection and remove bladder catheter as soon as possible.
Employ intensive pulmonary hygiene because incidence of pulmonary oedema and infection is high.
10.Provide meticulous wound care.
11.Offer high-carbohydrate feedings because carbohydrates have a greater protein-sparing power and provide additional calories.
12.Institute seizure precautions. Provide padded side rails and have airway and suction equipment at the bedside.
13.Encourage and assist the patient to turn and move because drowsiness and lethargy may reduce activity.
14.Explain that the patient may experience residual defects in kidney function for a long time after acute illness.
15.Encourage the patient to report routine urinalysis and follow-up examinations.
16.Recommend resuming activity gradually because muscle weakness will be present from excessive catabolism.
Q4) a) what is abortion and describe its causes and types
Abortion is the termination of pregnancy before viability of the featus before 22 weeks or if the fetal weight is less than 500gm.
Interruption of pregnancy or expulsion of the product of conception before the fetus is viable is called abortion. The fetus is generally considered to be viable any time after the fifth to sixth month of gestation.
There are three main types
It is caused by
abnormality in the fetus
It is caused by
It is caused by
A voluntary induced termination of pregnancy is performed by skilled health care providers
right management of habitual abortion
After a spontaneous abortion, all tissue passed vaginally is saved for examination, if possible. The patient and all personnel who care for her are alerted to save any discharged material. In the rare case of heavy bleeding,the patient may require blood component transfusions and fluid replacement. An estimate of the bleeding volume can be determined by recording the number of perineal pads and the degree of saturation over 24 hours. When an incomplete abortion occurs, oxytocin may be prescribed to cause uterine contractions before D&E or uterine suctioning.
Because patients experience loss and anxiety, emotional support and understanding are important aspects of nursing care. Women may be grieving or relieved, depending on their feelings about the pregnancy. Providing opportunities for the patient to talk and express her emotions is helpful and also provides clues for the nurse in planning more specific care.
Q5) a) what is your understanding about infertility
Infertility is defined as a couple’s inability to achieve pregnancy after 1 year of unprotected intercourse
b) describe its pathophysiology and its management
Genetic causes ; turner syndrome
Hypothalamic pituitary disorder
Assist in reducing stress in relationship
Foster understanding and refer the couple to appropriate resources when necessary . Because infertility workups are expensive, time consuming , invasive , stressful, and not always successful .
Couples need support in working together to deal with endeavor
Smoking is strongly discouraged because it has an adverse effect on the success of assisted reproduction
Diet, exercise , stress reduction techniques, health maintenance ,and disease prevention are being emphasized in many infertility programs .
Q6) a) define anaemia
Anaemiais a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Having anaemiacan make you feel tired and weak. There are many forms of anaemia, each with its own cause.
b) enlist its types
The seven types of anaemia
Iron deficiency anaemia.
Sickle cell anaemia.
describe iron deficiency anemia in detail
As the name implies, iron deficiency anemiais due to insufficient iron. Without enough iron, your body can’t produce enough of a substance in red blood cells that enables them to carry oxygen (hemoglobin). As a result, iron deficiency anemiamay leave you tired and short of breath.
Iron-Deficiency Anemia: Signs, Symptoms, and Treatment
Shortness of breath.
Swollen, sore tongue.
Abnormal heart rate.
To treat iron deficiency anemia, your doctor may recommend that you take iron supplements.
Take irontablets on an empty stomach.
Don’t take ironwith antacids.
Take irontablets with vitamin C.
Q7) differentiate between palliative care and hospice care
It is mainly based on comfortable care without any intention of curing a patient
It targets on patient comfort and care with or without the presence of curative
Requires physician certification
Does not require physician certification
Patient is not seeking curative measures or return to the hospital
Patient may be seeking curative measures or return to the hospital
Patient has a terminal or untreatable illness with fewer than 6 months to live in the normal course of the disease
Patient has a serious chronic or life limiting illness
Focus on symptoms management and quality of life
Address goals of care focus on symptoms management and quality of life
Usually takes place in a home or home like environment
Usually takes place in a hospital or medical facility
Patient has agreed to stop active/curative treatment
1) It is clinical condition in which the arterial PH is greater then 7.45 PaCO3 is less then 38 mmHg.
A. Respiratory distress
B. Alkalosis & Acidosis
C. Respiratory acidosis
D. Respiratory alkalosis
2) Which nursing diagnosis is most applicable to client with fecal incontinences?
A. Risk for deficient fluid volume
B. Disturbed body image
C. Bowel incontinence
D. Altered nutrition: more than body requirement
3) Cystitis is a type of urinary tract infection of:
A. Uncomplicated lower or upper UTI
B. Upper UTI
C. Complicated lower or upper UTI
D. Lower UTI
4) When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most important?
A. Eat a low-fat low cholesterol diet
B. Limit exercise to 10 minutes/day
C. Keep weight proportionate to height
D. Eat a low-protein diet
5) % of abortion in the first 12 weeks of pregnancy result from chromosomal abnormalities:
A. 50 to 80
B. 20 to 30
C. 30 to 40
D. 40 to 45
6) The patient should be setting when deep breating and coughing because this position:
A. Loosens respiratory secretions
B. Helps the patient to support their incision wiht a pillow
C. Allows the patient to observe their area and relex
D. Is physically more comfortable for the patient
7) Five minutes after the client’s first post operative exercise, the client’s vital sign have not yet return to baseline. Which is an appropriate nursing diagnosis:
A. Alteration in comfort
B. Risk for activity intolerance
C. Impaired physical mobility
D. Risk for discuss syndrome
8) The doctor has ordered 500 mg of a medication po once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient?
A. 03 Tablets
B. 1 Tablets
C. 02 Tablets
D. 04 Tablets
9) Foods high in purine are restricted to patients in:
A. Calcium stones
B. Oxalate stones
C. Uric acid stones
D. Struvite stones
10) What is/are the most common cause(s) of chronic liver disease?
C. Gall bladder stones
D. Alcohol abuse
11) Inflammation of the lower end of the esophagus leading to a back flow of gastric juices is called:
A. Structural abnormalities
B. Lactose intolerance
C. Acid reflux
D. Reflux esophagitis
12) Which statement about appendicitis is accurate and true?
A. Mc Burney’s point tenderness is suggestive of appendicitis
B. Lefty lower quadrant pain is suggestive of a appendicitis
C. Appendicitis is more common among females than males
D. A high fiber diet is a risk factor associated with appendicitis
13) Renal cell carcinoma which is greater than 7 cm tumor limited to the kidney, no evidence of lymph node involvement & metastatic disease is called:
A. Stage II RCC
B. Stage I RCC
C. Stage IV RCC
D. Stage III RCC
14) Excessive bleeding occurs at frequent intervals in reproductive disorders is:
15) A hernia is the of an organ or tissue out of the body cavity in which it is normally found:
16) Swelling of the salivary glands in mumps is called:
17) Painless enlargement of one or more lymph nodes on one side of the neck is:
B. Non Hodgkin disease
D. Hodgkin’s Disease
18) When establishing realistic goal, the nurse:
A. Bases of the goals on the narse’s personal knowledge
B. Must have the client cooperation
C. Knows the resourses of the health care facility, family and the client
D. Must have a client who is phyiscally and emotionally stable
19) Puberty age in female is:
A. 18 to 19 years
B. 19 to 20 years
C. 16 to 17 years
D. 10 to 14 years
20) A client being treated for chronic cholecystitis should be given which of the following instructions?
A. Use anti cholinergic as prescribed
B. Increase protein in diet
C. Avoid antacids
D. Increase rest
21) Which nursing diagnosis is most applicable to client with fecal incontinence?
A. Altered Nutrition:more than body requirement
B. Risk for Deficient fluid volume
C. Bowel Incontinence
D. Disturbed body image
22) What can reduce a patient’s anxiety and postsurgical pain?
A. Preoperative checklist
B. Psychological counseling
C. Preoperative teaching
D. Preoperative medication
23) A hiatus hernia occurs when the upper part of the stomach is dislocated through the hole, called a Hiatus, in the , into the chest:
B. Abdominal cavity
24) Mechanical obstruction of intestine in which bowel twists and turns on itself:
25) Which electrolyte is essential for enyzme and neurological activities?
26) Which of the following stage the carcinogen is irreversible?
A. Progression stage
B. Promotion stage
27) From the following nursing diagnosis which is suitable for hemorrhoids:
A. Urinary retention related to postoperative reflux spasm and fear of pain
B. Imbalance nutrition less than body requirement
C. Anxity related to surgical intervention
D. Constipation related to ignoring the urge to defecate because of pain during elimination
28) Which one is the best investigation to find out the stone in urinary tract:
D. CT scan
29) Which is the most common complication of peptic ulcer disease?
C. Gastric outlet obstruction
30) In what order should one perform an abdominal assessment:
A. Inspection, percussion, palpitation, auscultation
B. Inspection, auscultation, percussion, palpitation
C. Percussion, Palpitation, Inspection, Auscultation
D. Palpitation, Inspection, Percussion,. auscultation
31) From the following in which operation patient needs sitz bath:
32) Food poisoning “should be suspected with persons who shared food within the previous 1-6 hours, and symptoms of nausea, vomiting,and idarrhea, typically, this is due to:
33) Is a malignant disorder of hemopoietic tissues, associated increased number of
leukocytosis in the blood:
B. H. Influenza
D. Poly cythemia
34) is primarily a disease of children older than 2 years of age:
A. Acute glomerulonephritis
B. Nephrotic syndrome
C. Renal abscess
D. Acute pyelonephritis
35) Spread of cancer cells from the primary tumor to distant sites:
36) What intervention is the best relieve constipation during pregnancy?
A. Lying flat on back when sleeping
B. Taking a mild over-the counter laxative
C. Reduction of iron intake by half or more
D. Increasing the consumption of fruits and vegetable
37) Anemia which can be classified based on the body temperature and antibodies react with the RBC antigen is:
B. Aplastic anemia
C. Immune hemolytic anemia
D. Hemolytic anemia
38) is disorder in which bone lose density and become porous and fragile:
39) The most appropriate tool in confirmation of malignancy in the patient is:
B. Physical examination
C. Blood CP
D. Biopsy of tissue
40) Normal Glomerular filtration rate (GFR) per minute is:
A. 115 ml
B. 100 ml
C. 105 ml
D. 120 ml