SECOND YEAR GNM – MEDICAL SURGICAL NURSING –I
GIVE REASONS – PREVIOUS QUESTIONS AND ANSWERS
1 Anemia is common in Chronic Kidney Disease.
2 Anemia is common in renal disorders
In Chronic Kidney Disease/renal disorders, the kidneys are damaged, leading to
reduced Erythropoietin (EPO) production, which is a hormone produced by the kidneys
that stimulates the bone marrow to produce red blood cells. This in turn causes a
decrease in red blood cell production and finally leads to anemia.
3 Atropine Sulphate is administered during endoscopy.
Atropine Sulphate is an anticholinergic medication that reduces salivation,
bronchial secretions, and other bodily secretions. This helps to clear the visual field for
better visualization during endoscopy and also reduce the risk of aspiration during
endoscopy.
4 Bland diet is prescribed for patients with Peptic Ulcer Disease.
A bland diet is diet that are low in fat, spice, or acidity which helps to reduce
irritation to the stomach lining and the ulcer site, allowing the ulcer to heal. Also a bland
diet is easy to digest and minimizes acid production thus reduces the workload on the
stomach and allowing it to heal.
5 Chest tubes are never clamped for longer periods.
Clamping a chest tube for longer periods can cause air to become trapped in the
pleural space, leading to tension pneumothorax which is a life-threatening condition.
Hence to avoid this complication chest tubes are never clamped for longer periods.
6 Coagulation disorders are common in cirrhosis of liver.
The liver plays a crucial role in producing different clotting factors like
prothrombin. Cirrhosis impairs the liver's ability to produce these clotting factors,
leading to coagulation disorders. Also cirrhosis can lead to impaired absorption of
vitamin K, which is essential for the synthesis of clotting factors.
7 Constipation is common in older adults.
Aging is associated with a decrease in muscle mass and strength, including the
muscles in the digestive tract. Usually older adults experience a decrease in physical
activity also. This can lead to constipation.
8 Epinephrine is used to treat anaphylaxis.
Epinephrine rapidly reverses the symptoms of anaphylaxis like constriction of
airways and decreased blood pressure by relaxation of smooth muscles in the airways
and vasoconstriction which helps to relief of respiratory distress and increase blood
pressure.
9 Hand rails should be provided in Geriatric wards.
Geriatric wards are areas in which old age people are admitted. They usually have
neurological deficits and mobility issues which place them at high risk of falls and
related injuries. Handrails provide support and balance, reducing the risk of falls and
related injuries. Also handrails assist older adults with mobility issues to walk safely and
confidently.
10 High flow oxygen is contraindicated in patient with COPD.
COPD patients often rely on hypoxia (low oxygen levels) to stimulate their
respiratory muscles. High-flow oxygen can reduce the stimulus for breathing which can
lead to respiratory depression by reducing the respiratory drive and increasing carbon
dioxide levels.
11 Insulin is not given orally
12 Insulin should not be given by mouth
Insulin is a protein hormone that will be digested and degraded by stomach acid
and enzymes if taken orally. Also insulin inactivated by various enzymes in the
gastrointestinal tract and its absorption through the gastrointestinal tract is very poor
due to its large molecular size.
13 Lactulose is given orally in Hepatic encephalopathy.
Lactulose reduces the production of ammonia in the gut, which is the main reason
for development of Hepatic encephalopathy. Also lactulose promotes the excretion of
ammonia which is produced by gut bacteria. Hence lactulose is given orally in Hepatic
encephalopathy.
14 Low flow O2 is recommended for COPD patients.
COPD patients often rely on hypoxia (low oxygen levels) to stimulate their
respiratory muscles. High-flow oxygen can reduce the stimulus for breathing which can
lead to respiratory depression by reducing the respiratory drive and increasing carbon
dioxide levels. So low flow O2 is recommended for COPD patients.
15 Morphine sulphate is contra indicated in Pancreatitis.
Morphine can cause constriction of the sphincter of Oddi, which can lead to
accumulation of pancreatic enzymes and worsen pancreatic inflammation by auto
digestion. Also morphine can cause increased pancreatic secretions, which can
exacerbate pancreatitis.
16 Patient with peritonitis is placed in Semi Fowler’s position.
Semi-Fowler's position reduces pressure on the abdomen, which can help to
decrease pain and discomfort and reduce tension on the peritoneal cavity. Also
elevation of the head and body can improve respiratory function by increasing lung
expansion.
17 Podiatric care is important for a patient with Diabetes Mellitus.
Diabetes can cause peripheral neuropathy, leading to loss of sensation in the feet,
reduced ability to feel pain and pressure which increases the risk of undetected foot
injuries, infections, and ulcers. Also diabetes can cause peripheral artery disease (PAD),
leading to reduced blood flow to the feet with increased risk of ischemia and non-
healing diabetic foot ulcers.
18 Post-menopausal women are more prone to Urinary tract infections.
In post- menopausal women estrogen level will be decreased. Normally estrogen
helps to maintain the health of the urinary tract by thickening the urethral mucosa and
maintaining the normal pH balance of the vagina and urinary tract. Decreased estrogen
levels after menopause can lead to thinning of the urethral mucosa and increased pH
levels, making it more conducive for bacterial growth.
19 Pre-operative preparation is essential before surgery.
Pre-operative preparation ensures patient safety by verifying patient identity and
surgical site, ensuring necessary laboratory tests and imaging studies are completed.
Also it helps identify potential complications and takes steps to prevent them.
20 Protein diet is restricted in hepatic coma.
Protein metabolism produces ammonia, which is normally detoxified by the liver.
However, in hepatic coma, the liver is unable to detoxify ammonia effectively. Ammonia
levels build up in the blood, leading to the worsening of Hepatic Encephalopathy.
21 Remove nail polish before surgery
Nail polish can interfere with the accuracy of oxygen saturation readings taken by
pulse oximeters. Also, nail polish can hide signs of cyanosis. Hence removing nail polish
ensures accurate oxygen saturation readings detection of cyanosis.
22 Strict bed rest is advised for patients with glomerulonephritis.
Physical activity can increase renal blood flow, which can exacerbate kidney
damage. Also, physical activities worsen proteinuria (excess protein in the urine). Bed
rest helps reduce renal blood flow, decreasing the strain on the kidneys.
23 The site for Insulin injection should be rotated.
Insulin injection at the same site repeatedly can cause lipodystrophy, which can
lead to altered insulin absorption which in turn increases the risk of hypoglycemia.
Rotating injection sites helps prevent lipodystrophy and reduces the risk of
hypoglycemia.
24 Thyroid storm may occur after Thyroidectomy.
During thyroidectomy, manipulation of the thyroid gland can causes release of
stored thyroid hormones into the bloodstream. Also, thyroidectomy can disrupt the
normal regulation of thyroid hormone production, leading to uncontrolled release of
thyroid hormones. These changes causes thyroid storm.
25 Urgency and incontinence of urine are common in old age.
Aging causes weakening of the pelvic floor muscles and decreased bladder
capacity. Also, aging can cause neurological changes, such as decreased nerve function
and impaired bladder control leading to urgency and incontinence.
26 Written consent is essential before surgery.
Written consent ensures that patients are fully informed about the surgical
procedure and enables them to make informed decisions about their care. Also, written
consent is a legal document ensuring protection of healthcare providers and
institutions.
27 Routine suctioning is never done to remove secretions in patients with head injuries
Suctioning can stimulate coughing and can increase ICP, which worsen cerebral
edema and exacerbate brain damage. Also, increased ICP caused by suctioning can lead
to brain herniation which is a life-threatening complication.
28 Aspirin is not given to patients with asthma
Aspirin can trigger bronchospasm (constriction of the airways), which can worsen
asthma symptoms. Also, Aspirin can exacerbate asthma symptoms by increasing airway
inflammation.
29 Stripping/Milking of chest tube should be done only if ordered by the physician
Improper stripping or milking can introduce air into the chest cavity, leading to
pneumothorax or tension pneumothorax. Also, stripping or milking can cause the chest
tube to become dislodged, causing decreased drainage.
30 Metallic objects should be removed from body before undergoing MRI
MRI is Magnetic Resonance Imaging which uses strong magnetic field which
attracts metallic objects causing them to be moved or displaced. This can lead to injury
or damage to surrounding tissues. Moreover MRI machine's magnetic field can interfere
with the functioning of certain medical devices, such as pacemakers or implantable
cardioverter-defibrillators (ICD).
