REGIONAL EXAMINATION FOR NURSE REGISTRATION

CARICOM COUNTRIES

CLINICAL NURSING-OBJECTIVE TYPE QUESTIONS

PAPER II

APRIL 2001

NO OF ITEMS: 100

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 SCENARIO 1 ITEM 1-4
Mark, aged nine (9) months was brought to the Accident and Emergency Department by his mother, who
stated that he was crying throughout the night and his abdomen appears to be swollen. He was examined by
the doctor and a diagnosis of Intussusception was made. He was admitted and prepared for surgery.

ITEM 1

Essential pre-operative interventions for Mark would include:

i. Maintenance of hydration
ii. Institution of gastric suction
iii. Administration of antibiotics
iv. Administration of enema saponis
A. I, ii, iii
B. I, ii, iv
C. I, iii, iv
D. ii, iii, iv

ITEM 2
The three (3) most important post-operative nursing interventions to be used for Mark are:
i. monitoring of vital signs
ii. assessment of bowel sounds and pattern
iii. provision of psychological support
iv. aspiration of naso-gastric tube as prescribed

A. i, ii, iii
B. i, ii, iv
C. I, iii, iv
D. ii, iii, iv

ITEM 3

The nursing observations which would indicate successful surgical intervention of intusseseption are:

i. decreases passage of barium

ii. abdominal distention
iii. return of peristalsis
iv. passage of a normal stool

A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv

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Start
ITEM 4

Sister Spanker assigned two (2) committee members to be responsible for recruitment of staff. the committee is likely
to succeed if they carry out all of the following EXCEPT:

A. advertise the risk to patient care because of shortage of staff.

B. organize career days focused on the profession of nursing.
C. emphasize a recent hike in the nurses' take home salary and benefits.
D. circulate literature with attractive photographic display of the hospital.

ITEM 5

Sister Spanker and her committee will verify applicants' references and educational certificates during the stage of

A. selection
B. recruiting
C. placement
D. interviewing.

ITEM 6
Sister Spanker and her committee recognized a bias in the selection process when they noticed that an employee was
omitted because:

A. she was not qualified for the job.

B. she was planning to migrate within the month.
C. her mother was disliked by one of the interviewers.
D. her character reference revealed unsatisfactory attributes.

ITEM 7
The sub committee responsible for placement of staff, rated their efforts as successful because each ward:

A. received a higher rating for care by patients.

B. was staffed with persons of equal qualification.
C. has an addition of the same number of nurses per shift.
D. staff was able to participate in client teaching activities.

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ITEM 8

Sister Spanker and her team determined that the factors MOST advantageous to the staffing process were:

i. conducting a review of current staffing levels.

ii. using staffing history as a basis for recruitment.
iii. determining the system of patient care utilized.
iv. placing employees where they preferred to work.

A. i, ii, iii

B. i, ii,iv

C. i, iii, iv

D. ii, iii, iv

ITEM 9

Sister Spanker utilized long term planning to recruit and retain staff because it promotes:

i. good support among staff.

ii. quality of nursing personnel.
iii. a more stable staff complement.
iv. job satisfaction and morale.

A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv

SCENARIO 2 ITEM 10-14

The nurse in charge of a twenty-five (25) bed Male Medical Ward in a Rural District Hospital in
Abberine, while on duty, heard that Hurricane Janet will strike the country within the next six (6)
hours.

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ITEM 10

The order of PRIORITY which the nurse will follow,to prepare the ward and patients for the hurricane is

i. inform the supervisor on duty of the news.

ii. review ward preparations with staff members.
iii. make a list of supplies needed for the ward.
iv. inform the patients about plans to re-arrange the ward.
A. i, ii, iii. iv
B. i, iii, iv. ii
C. iii, i, ii. iv
D. i, ii, iv, iii

ITEM 11
The nurse can help the patients to be more relaxed during the re-arrangement of the ward by allowing them to:

i. remain in bed or the T.V. area.

ii. assist with the re-arrangement.
iii. use their specific skills where applicable.
iv. apply name tags on patients who cannot help themselves.

A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv

ITEM 12

Torrential rains preceded the hurricane creating widespread flooding in Abberine' which of the following are typical
adverse effects of flooding?

i. Anxiety and panic

ii. Physical damage and casualties
iii. Contamination of water supplies
iv. Loss of crops and food supplies
A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv

ITEM 13
The steps that are used for managing a disaster situation in order of PRIORITY are
i. collating data.
ii. analyzing and interpreting data.
iii. identification of information needs and sources of reliable data.
iv. reporting conclusions, forecasts and alternatives to appropriate planner and decision makers.

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 A. i, ii, iii, iv
B. ii, iii, iv, i
C. ii, iv, i, iii
D. ii, i, ii, iv

ITEM 14

Assessment in disaster management is the process of determining the impact of a disaster on a society. The FIRST
priority of assessment is to:

A. determine what has happened and what might be needed.

B. collate, evaluate, and interpret information from various sources.
C. identify possibilities for facilitating and expediting recovery and development.
D. establish the need for immediate emergency measures to save and Sustain lives of survivors

SCENARIO 3 ITEMS 15-18

ITEMS 15 - 18

Nursing is a profession with national, regional and international affiliations.

ITEM 15
The Regional Nursing Body is a:

A. body set up by Commonwealth Governments.

B. statutory body that has its headquarters in Guyana.
C. non statutory, autonomous, collaborative, advisory organization.
D. statutory body that makes recommendation to Carribean Governments.

ITEM 16
Nursing Care Standards are introduced to provide all of the following EXCEPT:

A. safe levels of care.

B. specialized medical care.
C. acceptable levels of care.
D. effective and excellent care.

ITEM 17
Which of the following responsibilities of professional nursing is receiving increasing emphasis in nursing practice
today?

A. Intensive Care
B. Emergency care
C. Health Promotion

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 D. Private duty nursing

ITEM 18
All of the following have contributed positively to the advancement of nursing as a profession EXCEPT:

A. changing values in society.

B. traditional sexist attitudes.
C. advancement in Nursing Research.
D. development of nursing philosophies.

SCENARIO 4 ITEMS 19 - 22

Nursing is responsible and accountable for the provision of quality care to its clients.

Registered nurses must assume accountability for whatever judgement is made on the client's

ITEM 19
Which of the following are pre-requisites for accountability?

i. skills
ii. knowledge
iii. consistency
iv. responsibility

A. i, ii, iii

B. i, ii, iv

C. i, iii, iv

D. ii, iii, iv

ITEM 20

The nurse, by adhering to an Agency's policies and procedures, demonstrates her accountability to which of the
following?

A. Manager
B. Institution

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 C. Regulatory Body
D. Nurses' Association

ITEM 21

Which of the following is legally responsible for nursing practice?

A. General Nursing Council

B. Regional Nursing Body
C. National Nurses Association
D. Caribbean Nurses Organization

ITEM 22

Which of the following seeks to enhance accountability by nurses?

A. Nursing Protocols
B. Nursing Procedure Manuals
C. Nursing Association's Constitution
D. The Caribbean Standards of Nursing Practice

SCENARIO 5 ITEMS 23-26

Nurse Eden is assigned to the Gynecological Ward where sixteen (16) year old Mary was admitted
with retained products of conception following a criminal abortion. Nurse Eden refused to prepare
her for the operating theatre as abortion conflicts with her values.

ITEM 23
Nurse Eden's behavior conflicts with the ICN Code of Ethics as it relates to Nurses and:

A. practice.
B. society.
C. people.
D. profession.

ITEM 24
Ethics may be defined as:

i. personal conviction.
ii. standards for profession behaviour.
iii. established rules in prescribed situations.
iv. principles that influence individual behaviour.

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 A. i, ii
B. i, iii
C. ii, iv
D. iii. IV

ITEM 25
Nursing Ethics:

i. state duties of nurses to clients.

ii. dictate obligations of nurses to nurses.
iii. provide standards for professional behaviour.
iv. establish clear distinction between right and wrong.

A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii. iii, iv

ITEM 26
If Nurse Eden is assigned to care for Mary following her operation. her behaviour would be considered ethical if
she:

i. made no effort to assess the patient.

ii. asked to be reassigned to another ward.
iii. delegated her duties to the student nurse.
iv. discussed her dilemma with the charge nurse.

A. i, ii
B. i, iii
C. ii, iv
D. iii, iv

SCENARIO CONT'D

Next day Nurse Eden summoned the Family planning team without Mary's knowledge as she thinks
Mary should be started on a contraceptive method. When the team arrives, Mary refused.

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ITEM 27
In not discussing her intention to refer Mary to the Family Planning Service Nurse Eden has breached the ICN
Code as it relates to nurses and:

A. people.
B. society.
C. practice.
D. profession.

ITEM 28
Nurse Eden's action is MOST likely to be interpreted as a/an:

A. disregard for Mary's right to autonomy.

B. attempt to with-hold information from Mary.
C. disregard for Mary's right to confidentiality.
D. responsible attempt to provide Mary with the best care possible.

SCENARIO CONT'D

Mary has consented to be part of as research study on abortion in teenagers.

ITEM 29
Informed consent implies that all subjects:

A. protected and respected.

B. involved in data collection.
C. expected to complete the study.
D. educated in detail about the study.

SCENARIO 6 ITEMS 30 - 33

Developmental tasks require practice and energy, the focus which vary with each developmental stage
and task accomplished. The family as the primary social unit of society plays an important role in this
process. Other social institutions support the family in this role.

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ITEM 30
All of the following are functions of the family EXCEPT:

A. highly intimate relationships.

B. sexual differentiation and teaching.
C. physical growth of individual members.
D. emotional development and maintenance.

ITEM 31

Assessment of the client includes observation of his growth and development status. Growth is BEST defined as:

A. the process of becoming developed.

B. a person's experience in quantitative measurement.
C. increase in the functioning capacity of an individual.
D. measurable aspects of an individual's increase in physical attributes.

ITEM 32

When the nurse assesses the infant at six (6) months, her findings should include all of the following EXCEPT:

A. walks with help.

B. twice the birth weight.
C. appearance of first teeth.
D. tolerates semi solid foods.

ITEM 33

Erickson states that the development tasks for the young adult is based on:

A. initiative versus guilt.

B. integrity versus despair.
C. intimacy versus isolation.
D. industry versus inferiority.

SCENARIO 7 ITEMS 34 - 37

Mrs. Kate is a fifty-five (55) year old patient who has been recently diagnosed with Diabetes. She will be
discharged from hospital on insulin and a teaching programme is being initiated.

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Match the following activities in Column I to the appropriate domain in Column II by writing the appropriate
letter in the space provided.

ITEM 34
Column I Activitv Column II Domains
Mrs. Kate is showing willingness to listen to the nurse
explain how to use the insulin syringe ____________
A. Cognitive

B. Affective

C. Psychomotor

ITEM 35
Explaining the indications for continuous glucose
monitoring to Mrs. Kate _________________

ITEM 36
Showing Mrs. Kate how to use the insulin syringe. ___________

ITEM 37
Mrs. Kate learns about insulin and can describe its purpose and side effects. _____________

SCENARIO 8 ITEMS 38 - 43

You are the Staff Nurse working in the community, and you are assigned the tasks of developing a
prevention programme for diarrrhoeal diseases.

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ITEM 38
Two (2) activities which will motivate community participation in the control of diarrhoeal
diseases are:

i. setting up an educational programme for food handlers.

ii. providing proper toilet facilities for community members.
iii. distributing food supplements to all mothers in the community.
iv. carry out an immunization campaign against typhoid.

ITEM 39
Which of these advice should be given to mothers of infants to prevent diarrhoea?

i. Avoid the use of pacifiers

ii. Give water after each feed
iii. Ensure infant has all immunization
iv. Give only breast-feeds for six (6) months of life

A. i, ii, iii
B. i, ii, iv
C. i, iii, iv,
D. ii, iii, iv

ITEM 40

Which two (2) of the following are points of referral for patients with diarrhoeal diseases?

i. Epidemiologist

ii. Infection Control Nurse

iii. Caribbean Epidemiology Centre

iv. Caribbean Food & Nutrition Institute

A. i, ii
B. i, iv
C. ii. Iii
D. iii, iv

ITEM 41

Two (2) INITIAL actions to be taken by parents/guardians should a child develop gastroenteritis are:

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 i. keep child away from siblings.
ii. stop feeds for twenty-four hours.
iii. administer anti-diarrhoeal drugs on time.
iv. observe frequency and amount of stool and vomit.
A. i, ii
B. i, iv
C. ii, iii
D. iii, iv

SCENARIO CONT'D

One of the activities of your prevention programme is a two (2) hour teaching session for community
members.

ITEM 42
Which of the following methods would be MOST appropriate for presentations of information on typhoid?

i. role play
ii. film show
iii. poster display
iv. lecturer/discussion

ITEM 43
Which of the following actions taken by school age children will pre dispose them to diarrhoea?

i. eating unwashed fruits

ii. buying from food vendors
iii. walking outside bare footed
iv. drinking water from nearby streams
A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv

SCENARIO 9 ITEMS 44 - 50

Research has become a major force in Nursing and is being used to change Nursing practice and education.

Sampling is an important step in the research process.

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Match the sampling techniques described in COLUMN A by assigning the correct name given in COLUMN
B.
COLUMN A COLUMN B
COLUMN B
ITEM 44 A. Quota Sampling
Technical name for actual list of the population
elements from which sample will be
chosen_________________

ITEM 45 B. Stratified Random Sampling

A process in which each element of the population has
an equal chance of being selected.________

ITEM 46 C. Simple Random Sampling

Handpicking the cases to be included in the
Sample __________________

ITEM 47
Using the most readily available subjects in the sample. D. Previous Sampling
____________________________

ITEM 48 E. Systematic Sampling needed from

Choosing a determined proportion of elements various
strata of a population.________________

ITEM 49 F. Accidental Sampling

A process in which each element of the population
has an equal chance of being selected after the
population is placed in a stratum. ________

ITEM 50 G. Sampling Frame

H. Sample Cluster
Selection of every tenth case from some list or I. Sampling
group.________ J. Cluster sampling
K. Multi Phase Sampling

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