MSN-II-Sample Paper Solution

Points to remember before appearing for Gujarat Nursing Council examination:

1. First Reading of Paper: Read through the entire paper once initially to gain familiarity with all the questions.
2. Writing Instrument: Use only a black ballpoint pen unless otherwise specified. Blue pens are not allowed.
3. Avoid Patterns: Do not use any patterns like lines, boxes, circles, etc., unless explicitly asked in the paper.
4. Correct Representation: Ensure accurate representation of shapes as per the paper’s requirements.
5. Restrictions on Writing: Apart from seat number, do not write any other type of annotations.
6. Double Reading for Questions: Before answering, read each question carefully twice as per the asked weightage for correct answers.

(Sample Answer only-Full paper inside)

Que.Define tonsillitis and write its types.

The tonsils are masses of lymphatic tissue located at the back of the throat. Their function is to protect the body from microorganisms and toxins by trapping and neutralizing them. When an infection occurs in the tonsils and inflammation spreads, it is termed tonsillitis. This condition is painful because the foreign substances or toxins accumulated in the tonsils lead to increased pain perception. Tonsillitis typically presents with symptoms such as sore throat, swollen tonsils, difficulty swallowing, and sometimes fever. Treatment usually involves rest, fluids, pain relievers, and sometimes antibiotics if the cause is bacterial. Severe or recurrent cases may require surgical removal of the tonsils (tonsillectomy).

When inflammation occurs in the tonsils, they appear swollen (enlarged), red, and tender. The affected area may also exhibit a combination of grey and white patches. Additionally, around the tonsils, lymph nodes may swell due to the nearby infection.

Tonsillitis commonly manifests in two forms:

Acute Tonsillitis:

• This form of tonsillitis typically presents with sudden onset symptoms and is often caused by bacterial or viral infections.
• Symptoms include sore throat, difficulty swallowing, fever, swollen and tender lymph nodes, and sometimes white or yellow patches on the tonsils.

Chronic Tonsillitis:

• Chronic tonsillitis refers to recurring or persistent inflammation of the tonsils.
• It may occur when acute tonsillitis episodes are frequent or when infections persist despite treatment.
• Symptoms can be less severe than acute tonsillitis but may still include persistent sore throat, bad breath, and persistent swollen tonsils.

Management of tonsillitis depends on its severity and cause. Treatment may include rest, fluids, over-the-counter pain relievers, antibiotics (if bacterial), and in some cases, surgical removal of the tonsils (tonsillectomy) if infections are frequent or severe.

Chronic Tonsillitis:

Chronic tonsillitis is a condition where episodes of acute tonsillitis recur frequently over a long period of time, leading to persistent inflammation of the tonsils.

Causes:
Chronic tonsillitis is primarily caused by bacterial infections, with Streptococcus pyogenes (group A streptococcus) being a common culprit. Viral infections can also contribute to chronic inflammation of the tonsils.

Symptoms:
The symptoms of chronic tonsillitis are similar to acute tonsillitis but may be less severe and more persistent:
– Sore throat or discomfort in the throat
– Persistent mild fever
– Persistent bad breath (halitosis)
– Persistent swollen tonsils
– Recurrent episodes of tonsil stones (calcified deposits in the tonsils)
– Enlarged and tender lymph nodes in the neck

Diagnosis:
Diagnosis of chronic tonsillitis involves a thorough examination of symptoms and medical history. Chronicity of symptoms and frequent recurrence of tonsillitis episodes are key diagnostic criteria.

Treatment:
Treatment for chronic tonsillitis may involve:
– Antibiotics: Courses of antibiotics may be prescribed during acute exacerbations or if bacterial infection is suspected.
– Tonsillectomy: In cases where chronic tonsillitis significantly impairs quality of life or causes complications, surgical removal of the tonsils (tonsillectomy) may be recommended.

Complications:
Complications of chronic tonsillitis may include:
– Recurrent throat infections
– Formation of abscesses around the tonsils (peritonsillar abscess)
– Obstructive sleep apnea (due to enlarged tonsils obstructing the airway)
– Rheumatic fever (a rare inflammatory condition affecting the heart, joints, skin, and nervous system), although less common than in acute tonsillitis

Prevention:
Preventive measures for chronic tonsillitis include good hygiene practices, avoiding close contact with individuals who have respiratory infections, and timely treatment of acute tonsillitis episodes to prevent recurrence.

In summary, chronic tonsillitis is characterized by recurrent episodes of tonsillar inflammation and is often associated with bacterial infections, particularly group A streptococcus. Treatment options range from antibiotic therapy during acute episodes to surgical removal of the tonsils in severe or recurrent cases.

Que. List the clinical manifestations of tonsillitis.

In this condition, the main symptom is experiencing pain when swallowing anything. Local neck structures show redness and swelling in the mucous membrane of the tonsils. Such pain can radiate to the ear.

Other symptoms include:

• Fever and chills.
• Headache.
• Muscle pain.

Swelling of lymph nodes in the neck area. Halitosis or bad breath. Snoring.

Disturbed sleep patterns are observed.

The individual experiences general weakness, anorexia, malaise, nausea, abdominal pain, constipation, and other signs and symptoms can also be seen in tonsillitis.

que. Write nursing management of tonsillitis.

For the management of this condition, analgesics such as ibuprofen are specifically recommended to relieve pain, inflammation, and swelling. Antibiotic therapy is also recommended for treating this condition.

Here are some specific recommendations for managing the patient:

• Advise the patient to increase fluid intake to facilitate swallowing and recommend consuming green leafy vegetables and fruits.
• Drugs such as aspirin and acetaminophen can be given to the patient for relief from throat pain and inflammation.

Here are some specific recommendations for relieving the patient:

• Advise the patient to avoid any irritants.
• It is advisable to gargle with warm saltwater.
• Some herbal and home remedies can also be recommended to the patient to obtain relief, such as slippery elm.

In cases of chronic tonsillitis, surgery may be required to remove the tonsils. The patient should be advised to take special care after surgery, and physical activity should be avoided until then, and going out should be restricted. It is especially important to monitor children’s precautions for infection after surgery.

After surgery, it is recommended to provide the patient with a liquid diet for a short time, which will reduce pain and gradually start a semi-solid diet. Spicy foods should be avoided, and hard, crisp foods should also be avoided.

After the operation, the patient may complain of pain. It is advisable to prescribe pain relief medicine to relieve them of the pain, and it is advisable to apply an ice collar to relieve the patient of pain by placing an ice bag on the affected side.