APRIL 1999 PAPER 1

CLINICAL NURSING ESSAY TYPE TEST ITEMS

SCENARIO 1 ITEM 1
Jimmy, a 17 yr old secondary school student, was brought to the A&E by his parents.
They were concerned about the following changes in his behavior.
ood swings
!igid posture
"taring into space without spea#ing
$oss of weight
They suspected that he is a substance abuser. %e was subse&uently admitted to the
psychiatric unit for observation and treatment.
ITEM 1
"pecify nursing intervention measures for the following nursing diagnosis developed
for 'immy.
1. Alteration in nutrition ()pts*
+. ,mpaired verbal communication ()pts*
-. ,neffective individual coping ()pts*
Total 24 points
*Approi!at"l# 2$% &or's
SCENARIO 2 ITEM 2
rs. ary ar# --yrs is the mother of . children ages /01+. "he was admitted to the
surgical unit with a history of 1reast 2ancer and was scheduled for Right Total
Mastectomy. %er husband accompanied her and they were both fearful and an3ious.
"urgery was performed + days later. "he returned to the unit with blood transfusion in
progress and vacuum drainage institu. "he was restless and complained of severe pain.
ITEM (2
4etermine the nursing intervention measures, which will assist rs. ar# in meeting
the following needs during the first .) hrs after surgery.
A. 2omfort ()pts*
1. 5luid and Electrolyte (6 pts*
2. "afety and "ecurity ()pts*
4. $ove and 1elonging (6 pts*
Total 2) points
*Approi!at"l# 4%%*4$% &or's
SCENARIO + ITEM
+
r. John 1rown, a //0year0old Accountant has been treated for
2ardiomyopathy for five years. 7ver the past three wee#s he has
noticed mar#ed weight gain and became breathless on e3ertion. %e
was admitted to hospital and was diagnosed as having mild
congestive 2ardiac failure.
8ursing assessment findings revealed the following90
oderately obese man with mild pitting edema of the an#les
and pre0tibial area.
T -7 2 (:).6 5*, ; :6 1<; 1.=<1==mm%g
%istory of smo#ing 10+ pac#s of cigarettes per day.
4octor>s orders are9
!estricted sodium inta#e
4igo3in =./mg daily
5urosemide (lasi3* += mg bid and ?2$ (slow ?* 6==mg daily
ITEM +
4escribe in appro3imately -==0-/= words, the nursing intervention
measures for r. 1rown over the ne3t .) hours to meet the following
needs9
A. 73ygen (1=pts*
1. !est, Activity and 2omfort (-pts*
2. Elimination (.pts*
4. "afety and "ecurity (-pts*
E. ;sychosocial (6pts*
Total 2, points
SCENARIO 4 ITEM
4
r. "ervice a seventy0five (7/* year old businessman is admitted to
the surgical ward with a diagnosis of 2ancer of the prostate. %e had a
radical prostatectomy performed and is returning to the ward from
!ecovery !oom %e is receiving blood transfusion and he is on
continuous bladder irrigation.
ITEM +
4iscuss the post operative nursing care for r. "ervice during the
first +. hours, focusing on the following needs9
A. "afety and "ecurity (1+pts*
1. 5luid and Electrolytes (6pts*
2. ;sychosocial (6pts*
Total 24 points
*Approi!at"l# 4%%*$%% &or's