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| Solved LUMHS Post RN BSN Semester I past papers (regular examination 2017, session 2016-18). Use as a revision guide and verify with your course notes |
Advance Nursing Concept – I
Q-1. Define cognitive perception pattern. Discuss the pain and types of pain.
Cognitive perception pattern: Gordon’s functional health pattern that describes a person’s ability to perceive, organise, and interpret sensory information, including pain, hearing, vision, and cognitive abilities.
Pain: An unpleasant sensory and emotional experience associated with actual or potential tissue damage.
Types of pain:
- Acute pain: Short duration, usually less than 3–6 months, with an identifiable cause.
- Chronic pain: Persists beyond 3–6 months, may be continuous or intermittent.
- Nociceptive pain: Arises from tissue damage (somatic or visceral).
- Neuropathic pain: Caused by nerve damage (e.g., diabetic neuropathy).
- Referred pain: Felt in a location remote from the site of injury.
- Phantom pain: Felt in an amputated limb.
Q-2. Describe elimination pattern. Example factors affecting bowel elimination.
Elimination pattern: Gordon’s functional health pattern that describes the regularity, quality, and quantity of bowel and bladder elimination.
Factors affecting bowel elimination:
- Diet (fibre, fluid intake)
- Physical activity
- Medications (opioids, laxatives)
- Stress and anxiety
- Age
- Disease conditions (IBS, Crohn’s, obstruction)
- Personal habits and privacy
- Surgery and anaesthesia
Q-3. Define term theory, enlist and explain the component of theory.
Theory: A systematic set of concepts, definitions, and propositions that explains or predicts phenomena.
Components of a theory:
- Concepts: Abstract ideas or mental images (e.g., health, caring).
- Definitions: Operational or conceptual meanings of concepts.
- Propositions: Statements that explain relationships between concepts.
- Assumptions: Accepted truths that form the foundation.
- Model: A visual or verbal representation of the theory.
Q-4. Define metabolism, explain its types and enlist tips of health diet.
Metabolism: The sum of all chemical reactions in the body that convert food into energy and building blocks for growth and repair.
Types:
- Catabolism: Breakdown of complex molecules into simpler ones, releasing energy.
- Anabolism: Synthesis of complex molecules from simpler ones, consuming energy.
Tips for a healthy diet:
- Eat a variety of foods
- Include plenty of fruits and vegetables
- Choose whole grains over refined grains
- Limit saturated fats, trans fats, and added sugars
- Maintain adequate hydration
- Control portion sizes
- Limit alcohol and avoid tobacco
Q-5. Define activity. Enlist types of joints movement and explain classification of joints.
Activity: Gordon’s functional health pattern describing a person’s level of exercise, activity, leisure, and recreation.
Types of joint movement: Flexion, extension, abduction, adduction, rotation, circumduction, pronation, supination, inversion, eversion, dorsiflexion, plantarflexion.
Classification of joints (structural):
- Fibrous (synarthrosis): Immovable, e.g., sutures of the skull.
- Cartilaginous (amphiarthrosis): Slightly movable, e.g., intervertebral discs.
- Synovial (diarthrosis): Freely movable, e.g., knee, shoulder. Subtypes: hinge, ball-and-socket, pivot, saddle, gliding, condyloid.
Q-6. Define any five of the following terms: a. Self esteem b. Anxiety c. Spirituality d. Body image e. Role conflict f. Attitude g. Stress
- Self-esteem: A person’s overall subjective emotional evaluation of their own worth.
- Anxiety: A feeling of worry, nervousness, or unease about an uncertain outcome.
- Spirituality: A sense of connection to something greater than oneself, often involving meaning, purpose, and values.
- Body image: A person’s perception, thoughts, and feelings about their physical appearance.
- Role conflict: Stress arising when incompatible demands are placed on a person by two or more roles.
- Attitude: A settled way of thinking or feeling about someone or something.
- Stress: A state of mental or emotional strain resulting from adverse or demanding circumstances.
Computer in Nursing
Q-1. Define software? Explain its types.
Software: A collection of instructions, data, or programs used to operate computers and execute specific tasks.
Types:
- System software: Manages hardware and provides a platform for applications. Examples: operating systems (Windows, Linux), device drivers, utilities.
- Application software: Performs specific user tasks. Examples: word processors, spreadsheets, hospital management systems.
- Programming software: Tools for writing code. Examples: compilers, debuggers, IDEs.
Q-2. What are the types of data?
- Qualitative data: Descriptive, non-numeric (e.g., patient name, gender).
- Quantitative data: Numeric (e.g., blood pressure, temperature).
- Discrete data: Countable whole numbers (e.g., number of patients).
- Continuous data: Measurable on a scale (e.g., weight, height).
- Structured data: Organised in a predefined format (e.g., database fields).
- Unstructured data: Free-form (e.g., clinical notes, images).
Q-3. Write down the advantages & disadvantages of internet.
| Advantages | Disadvantages |
|---|---|
| Instant access to information | Misinformation and fake news |
| Global communication | Privacy and security risks |
| Online education and telemedicine | Cyberbullying and harassment |
| E-commerce and banking | Addiction and social isolation |
| Remote work and collaboration | Malware and hacking |
Q-4. Describe the role of computers in medical sciences.
- Electronic health records (EHR) and patient data management
- Diagnostic imaging (MRI, CT, ultrasound)
- Laboratory information systems
- Telemedicine and remote monitoring
- Robotic surgery and computer-assisted procedures
- Drug interaction checking and e-prescribing
- Clinical decision support systems
- Health research and data analysis
- Nursing documentation and care planning
Q-5. List down the input devices. Explain any three.
Input devices: Keyboard, mouse, touchscreen, scanner, microphone, webcam, joystick, light pen, barcode reader, biometric scanner.
Three explained:
- Keyboard: Used to enter text and commands; most common input device.
- Mouse: A pointing device used to select, drag, and click on screen elements.
- Scanner: Converts physical documents or images into digital format for storage and editing.
Q-6. Differentiate in the following: a) Hardware Vs software b) RAM Vs ROM c) Soft copy Vs Hard copy d) Input devices Vs Output devices.
| Pair | Difference |
|---|---|
| Hardware vs Software | Hardware is physical equipment; software is intangible instructions/programs. |
| RAM vs ROM | RAM is volatile, temporary storage; ROM is non-volatile, permanent storage. |
| Soft copy vs Hard copy | Soft copy is digital (screen); hard copy is physical printout. |
| Input vs Output devices | Input devices send data to computer; output devices receive data from computer. |
Health Assessment
Q-1. What is the usual sequence of doing examination from head to toe?
- General survey and vital signs
- Head and face
- Eyes, ears, nose, mouth, and throat
- Neck (lymph nodes, thyroid, vessels)
- Chest and lungs (inspection, palpation, percussion, auscultation)
- Heart and peripheral vascular system
- Abdomen (inspection, auscultation, percussion, palpation)
- Genitourinary and rectal (if indicated)
- Musculoskeletal system
- Neurological system
- Skin and integumentary system (integrated throughout)
Q-2. List the name, region, types and one function of 12th cranial nerves.
12th cranial nerve: Hypoglossal nerve (CN XII)
- Region: Medulla oblongata, exits through hypoglossal canal.
- Type: Motor.
- Function: Controls tongue movements (speech, swallowing, food manipulation).
Q-3. Write down the five basic principles of physical examination.
- Inspection before palpation, percussion, and auscultation (except abdomen).
- Proceed from head to toe in a systematic order.
- Compare symmetrical body parts.
- Ensure privacy, comfort, and proper lighting.
- Explain procedures to the patient and obtain consent.
Q-4. Define health assessment and explain why it is important for nurses?
Health assessment: A systematic collection and analysis of data about a patient’s health status, including physical, psychological, social, and spiritual dimensions.
Importance for nurses:
- Establishes a baseline for care planning
- Identifies actual and potential health problems
- Guides nursing interventions and evaluation
- Promotes early detection of complications
- Enhances patient safety and advocacy
- Facilitates communication with the healthcare team
- Supports evidence-based practice
Q-5. Briefly described the parts of conduction system of heart.
- Sinoatrial (SA) node: Natural pacemaker, initiates electrical impulses.
- Atrioventricular (AV) node: Delays impulse to allow atrial filling.
- Bundle of His: Transmits impulse from AV node to ventricles.
- Right and left bundle branches: Carry impulse down the interventricular septum.
- Purkinje fibres: Distribute impulse throughout ventricular myocardium, causing contraction.
Q-6. Define the following terms any five of the following: a) Tactile fremitus b) Vesicular breathing sounds c) Bronchophony d) Romberg test e) Homan’s sign f) Diaphragmatic excursion g) Murphy sign
- Tactile fremitus: Vibration felt on the chest wall when the patient speaks; increased in consolidation, decreased in pleural effusion.
- Vesicular breathing sounds: Soft, low-pitched sounds heard over normal lung tissue.
- Bronchophony: Increased clarity and loudness of spoken words heard through the stethoscope over consolidated lung.
- Romberg test: Assesses balance; patient stands with feet together and eyes closed; positive if they sway or fall.
- Homan’s sign: Pain in the calf on dorsiflexion of the foot; suggestive of deep vein thrombosis.
- Diaphragmatic excursion: The distance the diaphragm moves during inspiration and expiration, assessed by percussion.
- Murphy sign: Pain on deep inspiration when the examiner presses below the right costal margin; indicative of gallbladder inflammation.
Integrated Sciences – I
Q-1. Compare Gram staining and Acid fast staining (Any five).
| Feature | Gram Staining | Acid Fast Staining |
|---|---|---|
| Primary stain | Crystal violet | Carbol fuchsin |
| Mordant | Gram’s iodine | Heat |
| Decolouriser | Alcohol/acetone | Acid-alcohol |
| Counterstain | Safranin | Methylene blue |
| Result | Gram-positive (purple) / Gram-negative (pink) | Acid-fast (red) / Non-acid-fast (blue) |
| Example organisms | Staphylococcus (positive), E. coli (negative) | Mycobacterium tuberculosis |
Q-2. Differentiate between Prokaryotic cell and Eukaryotic cell (any five).
| Feature | Prokaryotic Cell | Eukaryotic Cell |
|---|---|---|
| Nucleus | No true nucleus | True nucleus present |
| Size | Small (1–10 µm) | Large (10–100 µm) |
| Organelles | No membrane-bound organelles | Membrane-bound organelles present |
| DNA | Circular, naked | Linear, associated with histones |
| Ribosomes | 70S | 80S |
| Examples | Bacteria, archaea | Plants, animals, fungi |
Q-3. What are B-cells and T-cells.
B-cells (B lymphocytes): White blood cells that mature in the bone marrow. They are part of the humoral immune response, producing antibodies against pathogens.
T-cells (T lymphocytes): White blood cells that mature in the thymus. They are part of the cell-mediated immune response. Types include helper T-cells (CD4+), cytotoxic T-cells (CD8+), and regulatory T-cells.
Q-4. Enlist hormones produced by Pituitary gland
Anterior pituitary:
- Growth hormone (GH)
- Thyroid-stimulating hormone (TSH)
- Adrenocorticotropic hormone (ACTH)
- Follicle-stimulating hormone (FSH)
- Luteinising hormone (LH)
- Prolactin (PRL)
Posterior pituitary:
- Antidiuretic hormone (ADH / vasopressin)
- Oxytocin
Q-5. Define buffer system. Name different blood buffer system
Buffer system: A solution that resists changes in pH when acids or bases are added.
Blood buffer systems:
- Bicarbonate buffer system (most important in blood)
- Phosphate buffer system
- Protein buffer system (haemoglobin, plasma proteins)
Q-6. Define any two of the following: a. Atrophy b. Blood brain barrier c. Charle’s Law d. Osmosis
- Atrophy: Decrease in the size of a cell, tissue, organ, or body part due to reduced workload, nutrition, or hormonal stimulation.
- Blood-brain barrier: A selective semipermeable membrane that separates circulating blood from the brain extracellular fluid, protecting the brain from harmful substances.
- Charles’s Law: The volume of a gas is directly proportional to its absolute temperature at constant pressure (V ∝ T).
- Osmosis: Movement of solvent (usually water) across a semipermeable membrane from an area of lower solute concentration to higher solute concentration.
Professional Development
Q-1. Briefly explain the process of problem solving.
- Identify and define the problem.
- Gather relevant information.
- Generate possible solutions.
- Evaluate each solution.
- Select and implement the best solution.
- Evaluate the outcome and revise if needed.
Q-2. List down the professional accountability of nursing
- Maintaining competence through lifelong learning
- Adhering to the nursing code of ethics
- Practising within the scope of practice
- Advocating for patient rights and safety
- Documenting accurately and honestly
- Reporting errors and near misses
- Collaborating with the healthcare team
- Maintaining patient confidentiality
Q-3. List down the nursing profession’s code of conduct.
- Respect for patients’ dignity and rights
- Providing safe, competent, and ethical care
- Maintaining confidentiality and privacy
- Obtaining informed consent
- Acting with integrity and honesty
- Maintaining professional boundaries
- Advocating for social justice and equity
- Engaging in continuous professional development
Q-4. Define the six steps of critical thinking.
- Identify the problem or question.
- Gather relevant information and evidence.
- Analyse and evaluate the information.
- Consider alternative perspectives and solutions.
- Draw conclusions and make decisions.
- Evaluate the outcomes and reflect.
Q-5. What are the issues in nursing education in Pakistan?
- Shortage of qualified nursing faculty
- Limited clinical training facilities
- Outdated curriculum
- Inadequate infrastructure and resources
- Low salaries and poor working conditions
- Lack of research culture
- Gender stereotypes and social stigma
- Inconsistent regulatory standards
Q-6. As a ward incharge how would you deal with political issues in ward?
- Remain neutral and professional.
- Focus on patient care and unit goals.
- Listen to concerns and mediate conflicts.
- Follow institutional policies and chain of command.
- Document incidents objectively.
- Escalate to higher management when necessary.
- Promote teamwork and open communication.
Q-6 (second). Define any two of the following: a. Culture b. Acculturation c. Society d. Social norms e. Family
- Culture: The shared beliefs, values, customs, behaviours, and artefacts that characterise a group or society.
- Acculturation: The process of adopting the cultural traits or social patterns of another group.
- Society: An organised group of individuals associated together for religious, benevolent, cultural, scientific, political, patriotic, or other purposes.
- Social norms: Shared expectations and rules that guide behaviour within a social group.
- Family: A group of people related by blood, marriage, or adoption, forming a basic social unit.
Social Sciences
Q-1. Define emotions and components of emotion.
Emotions: Complex psychological states involving subjective experience, physiological arousal, and behavioural or expressive responses.
Components:
- Subjective experience (feelings)
- Physiological arousal (heart rate, sweating)
- Expressive behaviour (facial expressions, body language)
- Cognitive appraisal (interpretation of the situation)
Q-2. What is personality? Enlist the personality disorders.
Personality: The enduring pattern of thoughts, feelings, and behaviours that distinguishes one individual from another.
Personality disorders (DSM-5 clusters):
- Cluster A (odd/eccentric): Paranoid, Schizoid, Schizotypal
- Cluster B (dramatic/emotional): Antisocial, Borderline, Histrionic, Narcissistic
- Cluster C (anxious/fearful): Avoidant, Dependent, Obsessive-Compulsive
Q-3. Define the term sociology. Function of sociology.
Sociology: The scientific study of society, social institutions, and social relationships.
Functions:
- Understanding social structures and processes
- Analysing social problems and inequalities
- Informing social policy and reform
- Promoting cultural awareness and tolerance
- Providing tools for social research
Q-4. Define social institutions and discuss one institution.
Social institutions: Established systems of norms, values, and roles that organise society and meet basic human needs (e.g., family, education, religion, economy, government).
Discussion – Family: The family is the most basic social institution. It provides emotional support, socialisation of children, economic support, and care for dependents. Types include nuclear, extended, single-parent, and blended families. Functions include reproduction, protection, education, and transmission of culture.
Q-5. Define Leininser’s sunrise model.
Leininger’s Sunrise Model: A conceptual model in transcultural nursing that depicts the multiple factors influencing health and care, including technological, religious, philosophical, kinship, social, political, legal, economic, and educational factors. It helps nurses provide culturally congruent care by understanding the worldview and cultural values of patients.
Q-6. As a ward incharge how would you deal with political issues in ward?
Same as Paper 5, Q-6 above.
- Remain neutral and professional.
- Focus on patient care and unit goals.
- Listen to concerns and mediate conflicts.
- Follow institutional policies and chain of command.
- Document incidents objectively.
- Escalate to higher management when necessary.
- Promote teamwork and open communication.
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