In the nursing profession, Medical-Surgical Nursing I is often considered the “great divide.” it is the unit where theoretical knowledge of anatomy meets the high-pressure reality of the hospital ward. This subject covers the care of adult patients dealing with a vast array of physiological imbalances, from surgical recoveries to chronic respiratory struggles. It is the foundation upon which your clinical intuition is built.
Below is the exam paper download link
Pdf Past Paper On Medical Surgical Nursing I For Revision
Above is the exam paper download link
For students in Kenya’s national polytechnics and KMTC campuses, this unit requires more than just memorization; it requires a deep understanding of the “why” behind every nursing intervention. To assist in your preparation, we have compiled a high-yield Q&A session focused on the core pillars of Med-Surg I. Once you have tested your clinical judgment here, use the link at the bottom of the page to download the complete past paper for your revision.
Section 1: Fluid, Electrolyte, and Acid-Base Balance
Question 1: How do you clinically distinguish between “Hypovolemia” and “Dehydration”?
While they both involve fluid loss, they aren’t the same. Hypovolemia (Fluid Volume Deficit) is the loss of water and electrolytes from the extracellular fluid. You’ll see a drop in blood pressure and a weak, rapid pulse. Dehydration is specifically the loss of water alone, which causes the sodium levels to rise (hypernatremia). In an exam, always check the electrolytes before deciding on the type of IV fluid to administer.
Question 2: What is the “Nursing Priority” for a patient with severe Hypokalemia?
Potassium is the king of cardiac rhythm. If a patient’s levels drop below $3.5 \text{ mmol/L}$, the priority is cardiac monitoring. Look for flattened T-waves or U-waves on the ECG. When administering potassium supplements, remember the golden rule: Never give Potassium IV push, as it can cause immediate cardiac arrest. It must always be diluted and infused slowly.
Section 2: Perioperative Nursing Care
Question 3: What are the essential components of “Informed Consent” before surgery?
The surgeon is responsible for explaining the procedure, but the nurse is the witness to the signature. For consent to be valid, the patient must be mentally competent, acting voluntarily, and have a clear understanding of the risks, benefits, and alternatives. If the patient expresses confusion about the surgery after the surgeon leaves, it is your duty to call the surgeon back before the patient goes to the theater.
Question 4: Why is “Early Ambulation” emphasized in the postoperative phase?
As soon as a patient is stable after surgery, we want them moving. Why? Because immobility is the best friend of a Deep Vein Thrombosis (DVT). Walking stimulates circulation, prevents pneumonia by encouraging deep breathing, and wakes up the digestive system to prevent paralytic ileus.
Section 3: Respiratory and Cardiovascular Disorders
Question 5: How does the “Pursed-Lip Breathing” technique help a patient with COPD?
Patients with Chronic Obstructive Pulmonary Disease (COPD) often struggle with air trapping. Pursed-lip breathing creates a small amount of back-pressure in the airways, which keeps the bronchioles open longer during exhalation. This allows the patient to remove more trapped $CO_2$ and reduces the work of breathing.
Question 6: What is the “Classic Triad” of symptoms in a patient with a Pulmonary Embolism?
While symptoms vary, look for the sudden onset of Dyspnea (shortness of breath), Chest pain (pleuritic), and Hemoptysis (coughing up blood). In a Med-Surg exam, if a postoperative patient suddenly gasps for air and clutches their chest, a PE should be your first suspicion.
Sharpen Your Clinical Edge
Medical-Surgical Nursing I is a unit that rewards the “thinking nurse.” It isn’t just about what you do, but knowing the physiological sequence that happens when you do it. While these Q&As cover the high-priority topics, the best way to master the integration of these systems is to practice with actual exam-style questions.
Whether you are preparing for your final college assessments or the NCK licensing exams, these resources are designed to help you transition from the classroom to the bedside with confidence.
Stay dedicated to your patients, keep your physiological knowledge sharp, and remember that every detail matters in the ward. Good luck with your revision!
Last updated on: March 17, 2026