Q and A Examples FE 1 PDF

PREPARATION FOR THE SOUTH AFRICAN NURSING COUNCIL ADMISSION
EXAMINATION FOR FOREIGN APPLICANTS - REGISTRATION AS A GENERAL NURSE
ETHOS AND PROFESSIONAL PRACTICE

EXAMPLES OF EXAMINATION QUESTIONS AND ANSWERS 1
2012 / 2013
In preparation for the Admission Examination for Foreign Applicants that is conducted by the
South African Nursing Council, this guide is an example of possible questions and answers that
may appear in examination papers.
You are requested to study and understand both questions and answers and to create similar
scenarios for yourselves so that you will be able to apply answers if questions are asked in various
contexts.
The guide is based on the syllabus for Ethos and Professional Practice for general nurses.
Working through this document will assist in preparation for the workshops that will be held before
the South African Nursing Council Examination.
Good luck with your preparations!
Foreign Exam / Nov 2012
Page 1 of 128
ETHOS AND PROFESSIONAL PRACTICE & APPLIED SOCIAL SCIENCES
A patient who is going for surgery informs you that he did not understand what the doctor said to
him when he signed the consent form for the operation.
Explain your role as the registered nurse in dealing with this problem. [10]
Obtaining informed consent for medical or surgical intervention is the legal duty of the doctor.
Informed consent implies that the doctor has informed the patient atleast of the general nature
of the proposed procedure
As patients advocate she must ensure that the patient has givenInformed consent.
Where doctor has not clearly explained, the nurse must intervene.
She may ask the patient to explain the procedure as he understands it and clarify
If she feels doctor has withheld or neglected to provide information, she should discuss the
matter with the doctor
If he does not give ethically acceptable reason for withholding and pays no heed to
nurses Observation or objection she should consult her immediate supervisor
If still no response, she may diplomatically encourage patient/family to ask more questions.
However the nurse must at all times put patients welfare first and act professionally
i.e. doctor patient relationship, professional loyalty
Reference:
Pera and van Tonder Pg 160
You have a group of new students in your unit and are planning a talk on patient identification.
1. Describe the information you would give them to ensure they comply with requirements
for patient identification as per Life Healthcare policy.
[12]
Must be identified as soon as possible after admission to the unit

All patients must have white identification band with
o Initial and surname
o Hospital number
o Attending doctor
Pink identification band is used to identify type of procedure/operation indicating
o information as above
o procedure/operation
Ensure procedure on band corresponds with procedure on all other documentation,
especially confirmation of informed consent
Exercise extreme caution if specific limb or side of body identified
Yellow identification bands used when patients have allergies, with
o patients name and number
o allergies the patients suffer from
Identification bands must be checked
o daily
o every time procedure is done on a patient
Patients must be taught not to remove band or report if lost
Replace if writing no longer legible
Children identified by 2 bands on arm and leg
All patients specimens, laboratory results and x-rays must be identifiedwith same information
Page 2 of 128
as white band
Reference:
Life Healthcare policy NUR-POL- CP/001
2. Discuss the legal implications of patient identification for the nurse with reference to
Professional legislation.
[3]
In terms of R 387 the SANC may take disciplinary steps for negligent practice if the nurse
Willfully or negligently omits to maintain the health status of a patient under her care
Or fails to protect the name, persons or possessions of the patient through correct identification
Reference:
Reg 387 SANC
You are a unit manager in a surgical ward. One of your staff members has formally lodged a
grievance regarding what she perceives to be unfair labour hours.
Discuss the principles of grievance management that you would implement in this case.
[12]
The unit manager and personnel in the unit should be familiar with the institutions grievance policy.
If there is no formal procedure, the help of the professional association can be called upon.
Unit manager must be familiar with lines of communication andresponsibility in terms of grievance
policy and as she is first supervisor is responsible for managing or referring grievance.
Steps or phases of grievance procedure must be followed strictly.
Nursing practitioner has the right to be assisted by an external representative if she wishes.
Rights of the aggrieved person should be protected e.g. avoid any form of discrimination or intimidation.
A grievance is considered solved when the aggrieved person confirms in writing that he/she is satisfied.
A written record of the grievance and solutionwith relevant dates and signatures of both parties are
kept as per policy.
Inadequate management gives rise to job dissatisfaction which can spread to entire unit.
The unit manager should deal with or refer grievance within 2 days.
Entire grievance should be solved within 6 days
The longer it takes to resolve, the stronger the risk for labour unrest.
Reference:
rd
Muller 3 edition Pg 270 271.
You suspect a patient in your ward has contracted a nosocomial bloodstream infection, the
most likely source being the intravenous cannula that has been in situ for 3 days.
Define the concept nosocomial infection.
Infection acquired in hospital that was not present at the time of admission.
Identify three (3) possible routes whereby contamination could occur.
[3]
Contamination can occur from patients own flora transmitted along exterior of
the catheter.
or by contamination of internal cannula during insertion
or intravenous fluid can become contaminated and become a source of infection.
[1]
Page 3 of 128
Describe the reasons /conditions that may be present to support the above conclusion regarding the
source of infection.
[4]
There is no infection at another body site to indicate probable source of infection.

The site of vascular line insertion is red, swollen or draining purulent discharge.
The patient had vascular line in place at onset of infection.
The bloodstream infection is caused by Candida or common skin organisms e.g.
staphylococci.
The patient remains septic after appropriate therapywithout removal of the
vascular device (cannula)
Reference:
th
Brunner & Suddarth 10 ed Pg 2122 2123.
Outline the reasons for quality improvement.

Professional liability/accountability
- requires a formal programme in the unit
- to prove everything being done by staff to provide quality
nursing care
An internal quest for excellence

- motivates a person to do his best
- and encourages unity in the nursing team to develop
a quality improvement programme
Internal desire for positioning

- to be able to be compared favourably with other units
To be able to compete in a competitive market

- the level of patient satisfaction can be used for marketing
Financial considerations
- the unit will be able to function cost effectively and efficiently
[5]
Reference
Muller 2005 , Pg 201.
A patient in your unit has severe post operative pain.

Pethidine 50 mgs 6hrly Intravenously has been prescribed. After unlocking the schedule 6 cupboard
you discover that one ampoule of pethidine is missing.
Describe how you would manage this situation.
[8]
Patient can not be left without analgesia whilst investigatinge.g. make entry re incorrect balance and
that the investigation is underway,
and ask a witness to countersign next to your signature
OR obtain ampoule from neighbouring ward following usual procedure
Notify nurse manager who notifies hospital manager and pharmacy.
All records must be scrutinized for possible erroneous entry.
Obtain written statement from all persons involved according to SHEQ requirements.
A completed incident report must be given to pharmacy manager.
If missing items cannot be accounted for - nursing or hospital manager must institute disciplinary
Page 4 of 128
procedures.
As a last resort and at managers discretion, SAP and/or SANCmust be informed as this
constitutes criminal offence.
Pharmacy manager must be kept up to date with all developments in this regard.
Reference:
Life Healthcare Policy. Doc. No: NUR-WP-CP/004
Research has shown that people who are happy in their work are also more productive.
Apply the principles of teambuilding that can be utilized to increase productivity in your unit. [11]
Common goals and objectives

- ensure they are clear and all understand
- group members should be involved in determining objectives
Utilisation of resources and clarification of roles
- each member must be offered opportunity to make a
contribution and all opinions heard and considered.
- identification and utilization of talents/strengths promotes
productivity
- all should know what their own and other team members
roles and responsibilities are
A plan/strategy
- all team members should work together according to a
scheduled plan whereby responsibilities are allocated
to achieve objectives
Trust and conflict management
- important for teamwork to openly admit to differences and
and find ways to solve differences
- promote mutual trust, respect and acceptance e.g. regular
climate meetings
Participative leadership
- all members of team must accept responsibility and
ownership for task performance
Quality control and procedures
- development and commitment of group facilitated by
involvement of all members in establishment of procedures
Interpersonal communication
- teamwork depends on ability of members to communicate
therefore promote principles of good communication e.g.
listening skills, empathy, equal opportunity to participate in
discussions
Approach to problem solving and decision making
- implement problem solving and decision making strategies
that are acceptable to the group
Creativity and experimentation
- encourage generation of new ideas
Other
- get members to know each other on a personal level,
- activities to build team identity
Reference:
rd
Muller ,M 3 edition Pg 176-178
Page 5 of 128
nd
Booyens,SW 2 edition Pg 207
Differentiate between an incident report and a statement according to Life Healthcare policy. [6]
An incident report is a hospital document used to report anything that is out of routine
whilst a statement is a document issued by the hospital or nursing management that may
contain issues of an incident report.
INCIDENT REPORT
- a hospital document to report anything out of routine e.g. patient falling out of bed
- it is a permanent record (evidence) on a specific happening
- it should contain precise and accurate information
- incident report used by management to assess situation and take corrective action if necessary
STATEMENT
- may follow incident report if considered necessary
- legal statements are made by manager/nursing manager
- it may contain some information from incident report
- statement can be made available to police
- a sworn statement made under oath is an affidavit
Reference
Life Healthcare policy and procedure
To be a role model the registered nurse in the unit should be a professionally competent, mature
practitioner.
Identify the professional characteristics she should display.
[13]
The practitioner must possess the necessary abilities required for her practice
- theoretical knowledge and skills from her basic training
- but also specialized knowledge in her specific discipline
- familiar with professional-ethical basis of the profession
- does everything she can to update herself e.g. reading
research reports, following relevant short courses etc
- demonstrates sound professional socialization and personal
and professional philosophies are integrated
She practices quality scientific clinical nursing, maintaining a high standard of nursing practice.
- she displays high degree of responsibility and accountability.
Leadership
- she displays positive leadership
-
choice of leadership style based on followers ability and professional maturity

displays critical thinking in problem solving and decision making
She displays self-regulation and self-control and displays

- is patient friendly and kind
- and practices self-regulation to identify own shortcomings
- familiar with all professional regulations and legislation
Page 6 of 128
Professional commitment participates in professional affairs and familiar with latest professionalethical issues.
- e.g. votes in elections of professional organization,
- familiar with views on policy statements
Takes pride in profession and strives for maintenance of positive professional

image. - her professional appearance and conduct is an example
She reflects a service motive unconditional acceptance and prepared to make personal sacrifices
without being exploited.
Reference:
rd
MullerM 3 edition Pg 18-20.
The nurse has a duty to take care as to how she practices her
profession. Explain the following concepts:
Reasonable standard of care
[2]
Refers to the caution exercised by a reasonable/prudent person i.e. they on the look out for
positive dangers and take necessary steps to guard against them.
In nursing practice the practitioner is expected to take the level of care and exercise the level of skill
that the average practitioner is expected to exercise at all times.
Vicarious liability
[2]
The authority is responsible for the acts or omissions of its servants.
If a client suffers any loss or injury through negligence or incompetence of member of staff the
employing authority is liable to compensate the injured party if such injury is proved.
Gross negligence
Refers to failure to exercise even slight care to protect the rights of others.
[1]
Contributory negligence
[1]
Although the one who sues may have contributed to his own injury in some way, the injury
occurred because the nurse/other person was negligent in some respect.
Identify three (3) authorities which may take action against a nurse found guilty of negligence, and
give two examples of penalties that may be imposed by each.
[6]
Action can be taken in a civil or criminal

court - fine
- prison sentence
Action can also be taken by the registration authority i.e. the South African Nursing Council
- removed from register
- warning
Action may also be taken by employer
- dismissal
- withholding of promotion
Page 7 of 128
Reference:
th
Searle,S 4 edition. Pg 227
According to regulation 2598, the registered nurse is responsible forthe establishment and
maintenance of an environment which promotes both the physical and mental health of the patient.
Supply examples from your nursing practice to illustrate how theemotional safety of the patient
can be ensured.
[6]
Atmosphere in the ward is important

- attitude of staff must be polite, friendly, etc
- establish good nurse-patient relationship by treating patient with dignity and respect and building trust
relationship
Inform patient about confidentiality / professional secrecy
Show respect for physical as well as emotional privacy
Where possible avoid factors which may upset patients i.e. move very ill patient to side ward.
Provide recreational/diversional activities e.g. visitors lounge or getting up for meals.
Nursing staff that act confidently and knowledgeably go a long way to making the patient feel they
are in safe hands
Reference:
nd
Mellish,JM (Unit teaching & Administration)2 ed pg 199.
Performance evaluation is an important aspect of the quality improvement process. Outline,

indicating the situation in which each would be most appropriate, the strategies that can be used
to evaluate quality.
[12]
Self-evaluation
- practitioner uses self-judgment to evaluate her own competence
- results remain her concern
- can be used when the nurse evaluates her abilities against set standard e.g. against the procedure
for catheterization
Direct observation
- practitioner or evaluator assesses performance of another practitioner by direct observation
and assesses the quality against a set standard and criteria
- e.g. used in evaluation of student nurses
Document analysis and auditing

- content of a document such as patient records are studied to establish whether set standards
and criteria have been met
- can be done continually, e.g. incidental spot checks on a daily basis
- or can be done retrospectively, on discharge or when treatment completed
Peer group evaluation

- when colleague with same level of training/competence evaluates the work performance
of another colleague
- it is assumed the evaluation will be more accurate as evaluator knows what to look out for
- this type of evaluation used in personnel evaluation
- can also be informal when one colleague consults another
Patient satisfaction
Page 8 of 128
the patients view of the quality of nursing care is asked

can be done formally e.g. questionnaire/Q cards, or
informally on continuous basis e.g. care round, to identify problems
Monitoring of negative incidents

- negative incidents that can lead to direct or indirect harm to the patient are monitored and
evaluated monthly.
Reference
rd
Muller,M 3 edition pg 207-208
nd
Booyens,SW 2 edition pg 610-611
Describe the professional rights of nurses.
[7]
The nurse has the right to;

- copies of rules, laws and regulations that govern her practice
- basic and specialized nursing education appropriate to her level of service
- career development to improve her competence in patientcare
- in-service education to improve her nursing competence
- working conditions that protect her own health and that of the patient
- occupational health protection
- suitable areas of expertise to enhance her patient care potential
Reference:
th
Searle,S 4 edition Pg 360
Three basic ethical principles guide researchers: respect for persons, beneficence and justice.
Describe each of the above principles. [10]
Principle of respect for persons:
This principle involves 2 convictions
individuals are autonomous i.e. have the right to self-determination
- individuals with diminished autonomy require protection e.g. children, mentally impaired
Individuals have the right to decide voluntarily to participate in a study, without risk of discrimination.
They also have the right to withdraw from study at any time and refuse to give information or to ask
about purpose of the study.
Beneficence
This involves an effort to secure the well-being of persons
Principle states that one should do good and do no harm i.e. physically, emotionally etc
If an intervention is potentially harmful it may have to abandoned or restated and investigated
made to ascertain whether information can be obtained by means other than where there is
anticipated harm.
Justice
This principle involves subjects right to fair selection and treatment and their right to privacy.
They must be treated respectfully and courteously at all times
Subjects should be selected because they are directly related to the research problem, not
because they are available or can be manipulated
Researcher must respect any agreement made with the subjects.e.g. keep to time schedules for
interviews or provide agreed upon benefits.
Page 9 of 128
Privacy must not be invaded by sharing private information without knowledge or consent or
by gathering data from subjects without their knowledge e.g. hidden camera
Privacy can be assured by condition of anonymity.
Reference:
Brink, H.I. Pg 39 41.
List the reasons for conducting a literature review during the research process.
[5]
To determine what is already known about the topic to be studied.

- this will lesson the chance of duplication
- and increase possibility of new study making useful contribution
It provides researcher with information on what has and has not been tried with regard to
research methods and data collecting instruments.
It assists in refining certain parts of the study e.g. problem statement.
Findings from previous studies used for comparison when interpreting findings.
In qualitative research it informs or supports the study especially with the collection and analysis of data.
Reference:
Brink, H.I. Pg 76.
Health education forms part of the professional responsibilities that are set out in the scope of
practice of the registered nurse.
Apply the principles of learning to the planning of health education for a patient who has just
commenced treatment with digoxin.
[10]
Patients learning needs must be assessed

- e.g. does she know how to monitor pulse, knowledge of side effects etc
Education goals formulated from the above assessment are put into writing in patients progress record.
- E.g. the patient shall accurately demonstrate the recording of the radial pulse
Plan the education program in writing

- E.g. outline of content, when and by whom health education will be given, questions for evaluation
Implement education programme using most appropriate educational method e.g. lecture-demonstration
Assess patients knowledge and skills, especially before discharge
- E.g. ask patient to demonstrate recording of pulse.
Record health education given and patients response in patient records.
Reference:
rd
Muller M 3 edition. Pg 290.
The pledge of service confirms that you, as a registered nurse are prepared to carry out
your professional acts in accordance with the legal and ethical codes of your profession.
Interpret the following with regard to the above statement.
1. Advocacy role of the registered nurse.
It refers to the action a nurse takes to inform and support the patient
[4]
Page 10 of 128
To ensure that the patient can make the best decision for himself
It includes protection against possible abuse or neglect protection against their rights
as well as identifying situations where the patient is vulnerable e.g. the seriously ill, the
mentally ill
It is the duty of the nurse to ensure the patient receives health care according to his needs
anywhere in the health care system
2. Professional secrecy
[5]
This is a fundamental principle the RN should uphold to ensure a trust relationship between
the nurse and the patient.
This means the nurse may not divulge any information concerning a patient which becomes
known in a professional capacity
- unless it is to another member of the team directly involved in the patient`s care and in
the best interest of the patient
Information may only be given with consent of
- the patient
- or spouse ,
- or major children if patient unable to do so
If a nurse is required to give evidence in a court of law,
- the protest to do so should be recorded
3. Autonomy
[3]
The nurse must respect that a person has the right to determine their own actions
Based on their values and beliefs
The nurse must ensure that decisions made by the patient are based on adequate information
- are free of coercion
- and are reasoned and deliberate
The right of the patient to refuse treatment must be respected
The nurse remains responsible and accountable for patient well-being
4. Duty to take care
[3]
To take care is seen as an act of justice in every life situation
In health situation, patient is vulnerable, and the nurse has a special ethical duty to protect and
help him
The nurse is accountable for her actions and therefore has a duty to be careful as to how she
practices her profession.
She is guided by professional regulations e.g. 387
REFERENCE:
th
Searle, C. Professional practice.4 edition. Durban:Heinemann.2000
Indicate whether the following statements are true or false.

Write only the number and the correct answer.e.g. 1.1.8. True
[5]
1.
When a nurse assists the patient with deep breathing and chest exercises it is called
physiotherapy.
False
2.
The scope of practice implies a model of nursing which emphasises the basic needs
of man.
False
Page 11 of 128
3. The enrolled nurse may only practice under the direct supervision of a registered
nurse.
True
4. A nurse who gives an injection without the consent of the patient may be guilty of
assault
True
5. A doctor is responsible for supervising the care that nurses provide for the patients.
False
REFERENCE
R 2598
Searle,C. Professional practice 4th edition.Durban:Heinemann.2000
You are in charge of a ward where you admitted a patient who had to go for an emergency
operation. Post operatively the patient reports that his wrist watch is missing.
Describe your assessment and management of this problem.
[5]
Reassure the patient that the matter will be addressed

Conduct an investigation immediately
Establish if there were any relatives when the patient was admitted, who may have taken
the watch
The investigation must include all personnel who came into contact with the patient on his
admission
Matter must be reported to management
An SAPS investigation must only be initiated at the patient`s and management`s request
An incident must be recorded as per protocol and filed for insurance purposes
Claims instituted by patients for compensation of lost valuables will only be considered by
management once all statements have been evaluated
Where possible claims must be accompanied by a valuation certificate.
REFERENCE:
Life healthcare policy and procedure
Nursing staff are often confused about the differences between a trade union and a
professional association.
Differentiate between a trade union and a professional association.
Tabulate your answer.
Professional Association
[10]
Trade union
profession and
Represent the nursing
negotiate on their behalf at local,
provincial and national level
Not all nurses protected by a trade union

and only if a national union exists
Uplift the health of SA population through

a network of quality nurses
eg.salary,
working
Self-interest
conditions are the primary focus
Concerned with standards of nursing,

future development and the greater good
Promote a healthy
business life only
development
Page 12 of 128
of
above the immediate needs of members

Nurse does not leave patient to go out on
strike.
Labour is withdrawn
dispute
Work according to scope of practice
Trade union defines and demarcates

what nurses/midwifes may do
Protect all categories of nurses/midwives
Protect only certain categories, not

nursing staff in management positions
(cannot belong to trade union)
during industrial
REFERENCE:
th
Searle,C. Professional practice 4 edition.Durban:Heinemann.2000
Informed consent must be obtained from patients for all procedures to ensure that their
rights are upheld.
Discuss the legal and ethical aspects in this regard, with reference to information the patient
has to be given and the procedure of obtaining consent.
[7]
The patient should be given full and accurate information by the health care provider who is
responsible for the execution of the interaction for which informed consent is required
The appropriate and responsible health care provider, who is responsible for performing the
interaction should supply the relevant information with reference to:
- the nature and state of the patientus illness/disability
- the significance of any diagnostic procedures
- the proposed treatment
- the probable and reasonable side effects and risks related to the this
Interaction
- the alternative diagnostic procedures/treatments that are available
- the ways in which the treatment could impact on the patientus lifestyle
The doctor must ensure that the patient understands the nature of consent required from him
The patient must be informed effectively in order to ensure his/her rights
Consent must be obtained in writing and must be duly witnessed
All writing on the form of consent must be legible and dated
Patient must grant permission by:
- signing the form in the presence of witnesses who also sign the form immediately
The form must state clearly what treatment/investigation/operation is proposed. It is the
doctorus responsibility to explain to the patient what is to be done
The Registered Nurseus responsibility is to go through the consent before he/she signs it.
Consent must not be obtained under duress
(Consent must be given of the personus own free will, after due explanation)
Refusal of consent may be made on various grounds such as unwillingness to undergo further
suffering.
Patientus wishes must be respected
REFERENCE
Mellish, J.M.Unit teaching and Administration for Nurses. 2nd.edition.Durban:Butterworths.
1987. Muller, M. Nursing Dynamics,3rd edition. Sandown:Heinemann 2002.
Page 13 of 128
You are a professional nurse and must explain to your staff during an in-service training
session how to write an incident report.
Use this as an example: a patient that was found on the floor next to his bed.
[8]
Observe environment for safety and probable causes

Put patient to bed after proper observations are done to determine injury
Obtain history from fellow patients or nurses to determine what happened
Do emergency treatment after patient is re- assured e.g. giving oxygen; suture wound;
vital signs must be taken as baseline
Inform doctor and family members
Incident report must be:
- written in permanent ink
- dated and signed by each person/ witness independently;
- unbiased ;
- no personal views or hear say;
- relevant, accurate information
Inform SHEQ coordinator
Prevent future incidents
REFERENCE
th
Patient education forms an integral part of the nurse practioners professional responsibility.
Explain the general principles of health education you as the registered nurse will apply
when educating a patient.
[9]
Assess patients learning needs i.e. ability to administer injection

Place written educational goals into the patients progress report e.g....
Plan the education programme in writing ....
Information to be at the patients level of education and learning needs
Nature and possible implications of treatment or result if not compliant to treatment also to
be explained
Create conducive learning environment e.g. condition of patient, language ( 2 x examples )
Implement the programme by utilizing the most appropriate educational method
e.g. administration of an injection - demonstration
Maintain a non threatening learning atmosphere
Assess knowledge and skill especially before discharge and
Record on relevant record e.g progress record
REFERENCE
rd
Muller, M; Nursing Dynamics .3 edition.Sandown:Heinemann.2003
th
Kozier,B; Erb,G;Berman,AJ;Burke,K. Fundamentals of Nursing.6 edition.Ch 26
List the responsibilities the registered nurse has to her employer.

[6]
To render safe and effective care.
To assume duty on the day and hour agreed upon.
Give due notice of termination of services as stipulated in her contract.
Misunderstandings and apparent injustices must be dealt with through the correct channels.
She must inform herself of policies, standards and methods of functioning of her employer.
She must give a full days work for a full days pay.
Ensure the safety of the patients name, person and property.
Page 14 of 128
She must have the knowledge and the skills for the work she has to perform.
To co-operate with other members of the health team.
To safeguard property and supplies of the institution.
To remain professionally competent.
The duty to maintain registration.
The duty to be a law-abiding citizen
REFERENCE
th
Conflict is a situation where there is a conflict of interests between two persons or groups.
Outline the different sources of conflict that can be found in the nursing unit.
[5]
Personnel
the attitude of personnel towards work
as well as differences in personality can stimulate conflict
Responsibilites
if the individual responsibilities of personnel are not explicity clarified, conflict may arise
Conflict of values
a differences in the value of nurses can give rise to conflict
Communication
adequate information is essential to avoid conflict
Management style
autocratic leadership syles will stimulate conflict and
participative leadership style is better to avoid conflict
REFERENCE:
rd
Muller, M.Nursing dynamics.3 edition. Sandown:Heinemann.2003.
Describe the aims of the disciplinary procedure.

To change a personnel members negative behaviour.
To provide remedial guidance
To maintain fair and reasonable discipline.
To maintain equity by the standardisation of disciplinary steps and measures
[2]
REFERENCE:
rd
Identify the types of discipline that can be applied according to the disciplinary procedure.
[3]
A reprimand
A first warning, either verbal or in writing
A second, third or final warning, usually in writing.
Temporary suspension
Demotion or formal downgrading of the persons job level.
Dismissal/ termination of services of the personnel member.
Page 15 of 128
REFERENCE:
rd
You have been observing the staff performance in your unit and conclude that they are not
productive.
Outline the plan of action that you will implement to improve productivity.
[12]
Investigate the cause or reasons for low productivity

Evaluate personnel policies and ensure that staff are familiar with them
Assess their training needs and provide for training as needed
Delegation of tasks according to their scope of practice
Provide them with adequate equipment and stock to render quality care
Provide adequate personnel staffing as per the need of the unit
Provide the staff with clear job descriptions and set expected outputs/goals
Supervise staff and provide support and guidance
Create a non threatening environment that encourages team work
Conduct ward meetings frequently
Provide individual feedback sessions
Reward and recognition for good performance
Peer group pressure and peer group teaching/evaluation for staff not maintaining accepted
level of productivity
Disciplinary measures as a last resort
REFERENCE
rd
You have a group of second year students rotating through your paediatric ward.
Describe the information you would give them so that they may understand the value of
record keeping.
[7]
It forms the basis of the specific steps of the scientific nursing process or the nursing care
p
l
a
n
It serves as proof of implementation and evaluation of tasks executed by the health care
team involved in the care of the patient
Serves as a valuable administrative tool eg.auditing
Prevention of medico-legal issues eg. Failure to record may predispose the child to overdosage of medication
The progress of the child is monitored through maintaining of records
Serves a s a communication tool for all

team members i n v
Records are legal documents and must comply with the criteria
REFERENCE
nd
Booyens SW.Dimensions of nursing management.2 edition.Cape Town:Juta 1998.
Explain the following terms and give an example of each in the context of nursing research
Theory
A set of related statements that describes or explains phenomena in a
systematic way e.g.
[2]
Hypothesis
Is the formal statement of the expected relationship between two
[2]
Page 16 of 128
or more variables in a specific population e.g.

Pilot study
A small-scale trial run of an actual research study e.g.
[2]
REFERENCE
nd
Brink B. Fundamentals of Research methodology for health care professionals.2 edition. Cape Town:Juta.
2006.
Briefly outline the nursing theory of Florence Nightingale

[5]
Nightingales theory was known as the environmental model of nursing.
She viewed the manipulation of the physical environment as a major component of nursing
care.
She identified ventilation , warmth, noise, light, variety, bed and bedding cleanliness of
rooms ,
walls and nutrition as major areas of the environment that a nurse could control
When one or more aspects of the envornment are out of balance the patient must use
increased energy to counter the environmental stress.
The stresses drain the patient of energy needed for healing
The aspects of the physical environment are also influenced by the social and psychological
environment.
Reference:
th
George, Nursing Theories, 5 edition, 2002:36.
After the discharge of a patient from the unit, the registered nurse undertakes to audit the
patient`s nursing records.
Describe the importance of a nursing audit in a unit.
[10]
Shortcomings in recording can be identified

Standards can be evaluated against performance of the staff
Involvement of all staff members ensures that this is a learning situation
The best team.that performs well can be rewardedwhile the tteam
that performed poorly can be encouraged to improve
Shortcomings that are identified can be corrected and remediated
It assists the staff in evaluating whether policies are still relevant
Creates opportunities to staff to review nursing standards
Interviews conducted on patients can reveal whether they are satisfied with the nursing care
received
The outcomes of the nursing audit may be communicated to other units for peer review
Medico legal risks can be detected and prevented
REFERENCE
rd
Muller, M.Nursing dynamics.3 edition. Sandown:Heinemann.2003
nd
Booyens SW.Dimensions of nursing management.2 edition.Cape Town:Juta1998.
The Infection Control Sister has reported to you that needle stick injuries by staff in your unit
have increased.
Describe the measures you will implement to lower the incidence of needle stick injuries. [10]
Page 17 of 128
Assess the content o f their incident report t o identify the com

Analyse the factors contributing to the incidence e.g. New staff
Review the procedure o n a d m i n i s t r a t i o n o f injections a s well a s
Review the policy on needle prick injury
Conduct a ward meeting and communicate your findings to staff
Decide on the strategy to be adopted by the team, including the Infection control sister /
occupational health nurse
Implement in-service education for the staff
Supervise staff and monitor their compliance to the expected standard
Evaluate the rate of needle prick incidences
Reference:
Life Healthcare Policy and Procedure
You are working in a casualty unit as a newly qualified registered nurse.

The team shift leader asks you to sign as witness for an intramuscular injection of Pethidine,
which she prevoiusly administered to a very restless patient.
Describe and motivate your actions with regard to the above situation. [10]
Refuse to sign because you did not personally witness the drawing up and the
administration of the injection.
Suggest that the shift leader approach her own supervisor t o h e

Check if the patient was given an injection at the time stated and.
whether the effects o n the patient are congruent with the type o f
Assess who the shift leader usually asks to witness the administration of scheduled
substances with her
if she constantly uses junior staff , check on her modus operandi
If the injection appears not to have been given
i n f o r m the shift leader o f your intention t o report the m a t t e r t

Report the situation to the supervisor as immediately as possible
REFERENCE:
Life Healthcare policy and procedure.
You are part of a panel of judges, who have been asked to select a unit manager who will
be the recipient of the Best Promoter of Team-work prize.
Outline the criteria that the unit manager must possess to receive this award
[7]
Maintains good interpersonal relationships with subordinates

Motivates guides and directs personnel towards a high standard of work.
Deals with problems honestly and fairly
Strict but, easily accessible and available to all personnel
Listens to others point of view
Renders encouragement and help to all personnel
Recognizes the value of each member of the team
Communicates to the team that each member has a vital role to play in achieving
optimal patient care
Encourages the spirit of learning from each other
Builds an atmosphere of high morale by encouraging trust and loyalty to each other
Implements positive leadership style in all situations that arises in her unit
REFERENCE:
Page 18 of 128
rd
Interpret the following concepts, as related to the Scope of Practice, Regulation No. R2598 of
30 November 1984, for registered persons, and give one example of each.
Health needs
[2]
relates to those signs and symptoms and processes which indicates the individuals interaction
with any actual or potential health problem which will require nursing intervention
Nursing Regimen
[2]
The regulation o f the matters which through nursing i n t e r v e n

Preventive,promotive,curative or rehabilitative aspect of health care and
Includes provision of nursing care plans and implementation thereof
Quality improvement can only attain success if all group members involved commit to the
process.
Summarize the basic principles of quality improvement.
[4]
Informed commitment and group/team co-operation

Empowerment of individual i.e. training re abilities neded for quality improveme
Managerial support for training and establishment of infrastructure needed for
implementation of programme
Promotion of quality improvement culture to promote ownership by personnel
REFERENCE:
rd
A good theory is stated in the simplest terms possible.

Illustrate how Florence Nightingales Environmental theory complies with the above
statement.
Her main focus was on the environment of the pt
She highlighted four (4) Major concepts
Human or individual:
has vital reparative powers to deal with disease
Nursing:
the goal is to place the individual in the best condition for nature to act
by basically affecting the environment
Health/disease:
the focus is on the reparative process of getting well
Society / environment:
Involves those external conditions that affect life and
the development of the individual.
The focus is on the ventilation
Environmental factors involved

Page 19 of 128
[10]
clean air and

- water
proper drainage
reduction of chills
- adequate light
and a variety of activities
REFERENCE:
th
George JB. Nursing Theories: The Base for Professional Nursing Practice. 5 Edition. New Jersey: Prentice Hall: 2002; p
31 - 42
Differentiate between the following concepts:

Profession
Refers to a specific career where work of an intellectual nature is performed.
This career makes a public statement in respect of its uniqueness
the career specific training
education required
As well as the career specific values and norms that is pursued.
[2]
Professionalism [1]
Refers to the practitioner who practices the profession
and it implies that he / she fulfils all the norms and expectations thereof.
REFERENCE:
rd
Muller M. Nursing Dynamics. 3 Edition. Sandown: Heinemann: 2005; p 11
It is important for nurses to recognize and ensure the protection of vulnerable patients.
(Searle)
Identify ten (10) special groups for whom statements of rights are available.
The embryo and fetus
The pregnant mother
The neonate
The infant
The child
The seriously ill patient
The unconscious or anaesthetized patient
The weak or immobile patient
The mentally ill patient
The aged patient
The terminally ill patient
The dying patient
REFERENCE:
[5]
th
Searle C, Human S, Mogotlane SM. Professional Practice: A Southern African Nursing Perspective. 5 Edition. Sandton:
Heinemann Publishers; 2009; p123
You have been assigned to do a research project.

Summarize the ethical principles/considerations you have to keep in mind while conducting
your research.
[6]
Page 20 of 128
Respect for persons/right to self-determination

i.e. right to voluntarily decide whether to participate in the study or not
Beneficence/Freedom from harm

participants should be protected from experiences that could harm them (physical and/or
psychological harm)
Justice/ Freedom from exploitation

e.g. professional relationship and privacy to be ensured with participants
Right to informed consent

i.e. full disclosure on the nature of the study, rights to refuse participation, risks and
benefits to the participants
Confidentiality
information given by participants should not identify individuals and be used against
them, but should only be used for the purpose of the study
Risks and benefits

incurred during research should be made explicit to participants, e.g., the risks to be
incurred should not exceed humanitarian benefits
REFERENCE:
Brink H, Van der Walt C, Van Rensburg G. Fundamentals of Research Methodology for Health Care Professionals. 2 nd
Edition. Cape Town: Juta; 2006; 30 - 43
Government Notice R387, prohibits a nurse from advertising.

Explain the meaning of the concept Advertisement
[5]
Any written, illustrated,
visual or other descriptive material or
verbal statement or reference
Which appears in a newspaper, magazine, pamphlet or other publication
Which is distributed amongst members of the public
Which has been fixed to, or appear on walls, windows or boards
Which is brought to the attention of members of the public in any other manner
whatsoever, and which is meant to:
Promote a specific practitioners technique or treatment
Make known a practitioners professional proficiency or knowledge
Make known a product or business or institution or organization of any nature whatsoever
REFERENCE:
GN R387, dated 15 February 1985, as amended.
All patients must wear an identification band displaying specific information and special care
must be taken when identifying newborn babies.
Illustrate the information that should appear on the identification band of both the mother and
her newborn baby.
[4]
MOTHER
Initials and surname
NEWBORN BABY
Mothers initials and surname
Page 21 of 128
Hospital number
Number of nursing unit
Patients doctor
Mothers hospital number

Date and time of birth
Gender of baby
Demonstrate the correct way of identifying babies and children under the age of six (6) years.
[1]
Should wear two (2) identification bands
One on each arm or one on an arm and one on an ankle
REFERENCE:
rd
Meyer S, Naude M, Van Niekerd S. The Nursing Unit Manager: A Comprehensive Guide. 3 Edition.
Sandown: Heineman; 2009; p324 + 325
Distinguish between the purpose of the following types of nursing research:

1. Descriptive
To obtain complete and
accurate information about a phenomenon
Through observation
Description and
Classification
It provides new information on a phenomenon
[3]
2. Exploratory
Explore the dimensions of a phenomenon,
The matter in which it is manifested and
The other factors with which it is related
It provides more insight about the nature of a phenomenon
[2]
3. Methodological
To develop or refine a
New research technique
[1]
REFERENCE:
Brink H, Van der Walt C, Van Rensburg G. Fundamentals of Research Methodology for Health Care
nd
Professionals. 2 Edition. Cape Town: Juta; 2006; p 120
Negligence means to act differently from the way in which a reasonable man would have
done.
Summarize the degrees of negligence
[6]
Gross negligence:
Failure to exercise even slight care to
protect the rights of others
Criminal negligence:
That is a crime or an offence against the State and
for which the State punishes the individual
Any act of negligence resulting in the death of a patient
always has serious consequences
Page 22 of 128
Contributing negligence
That is where the one who sues (plaintiff) either deliberately or accidentally,
may have contributed to his own injury,
but where the injury occurred because the nurse/midwife or another person
was negligent in some respect
Explain the term liability
Means that a person is liable, regardless of whether the matter is taken to court
if the damage or loss is his fault
regardless of whether the matter is taken to court
[1]
REFERENCE:
Searle C, Human S, Mogotlane SM. Professional Practice: A Southern African Nursing Perspective. 5 th
Edition. Sandton: Heinemann Publishers; 2009; p299-300
Explain the following concepts:

Grievance
Any feeling of injustice or dissatisfaction which arises out of the employer Employee relationship and which requires the attention of management
[1]
Labour relations
[1]
All aspects and matters connected with the relationship between employer and employee
Including negotiations with regards to remunerations, the prevention and settlement of
disputes, the application, interpretation and effect of laws administered by departments
Mediation
Is the active intervention of a third party
for the purpose of inducing settlement
[1]
Arbitration
Is the procedure when an independent, impartial third party
Hears both sides of a matter and gives a binding decision
[1]
Disciplinary procedure
[1]
The formal process adopted whenever an employee breaks the rules of the undertaking
Commits any other act which might be in breach of the contract of employment
Unfair labour practice
Consists of discrimination, unfair conduct
Relating to training, promotion and demotion of benefits.
[1]
Centralised bargaining
[1]
Is when an industry negotiates collectively to determine an industrial norm
Similar to the collective bargaining process employers association represents the employee
Conciliation
Continuation of negotiation between the two parties
With or without a third party
[1]
Page 23 of 128
REFERENCE:
nd
Booyens S.W. Dimensions of Nursing Management. 2 Edition. Cape Town: Juta; 2004; p 664-685
Labour Relations act No 66 of 1995
Patient records are an important communication tool, not only for nurses, but for all other
healthcare professionals.
With regard to the above statement, examine the reasons for accurate recording and record
keeping.
[10]
To act as a basis for patient care and treatment
To provide current, comprehensive, accurate and concise information on the condition
and the care of the patient
To make suggestions for prevention of disease and health promotion,
For example, treatment required, the rendering of care by a multidisciplinary team,
Thus becoming a communication tool between team members
To provide for coordination of the patient treatment
through the notes written by different members of the healthcare team
To record and report on problems experienced in providing care and nursing
interventions taken to solve them
To give feedback on the patients progress on the health-illness continuum and
his/her response to treatment
To keep all records of all events pertaining to patient care in an orderly manner
To provide information for resource management, patient care,
self-evaluation, audits of performance,
quality assurance and research
To demonstrate that nurses comply with the statutory requirements and
to protect them from medico-legal risks
To manage risks by reporting on incidents and the steps taken to prevent recurrence
To use as a teaching tool for the staff in the nursing unit
To monitor the cost-effectiveness of patient care
To make future plans using the available statistics
To act as an important administrative and management tool for the nursing unit manager
REFERENCE:
Meyer SM, Naude M, Shangase NC, Van Niekerk S. The Nursing Unit Manager: A Comprehensive Guide. 3 rd
Edition. Sandown: Heineman; 2009; p330
Teamwork is important in nursing.

Evaluate the attributes of an effective team and justify why these attributes are essential.
[7]
Utilisation of resources and clarification of roles

- All opinions are heard and all contribute in decision making
- Strengths and talents are identified to promote effective personnel utilization
- All know their duties and responsibilities and work according to a plan
Trust and conflict management

- mutual trust and respect and conflict management maintain group cohesion
Participative leadership
- so all accept responsibility and ownership for tasks and goals, purposeful efforts by all
Quality control
Page 24 of 128
needs teamwork to develop the group and achieve commitment to achieve objectives
Interpersonal communication
open and honest important for group cohesion and acceptance of problem solving and
decision making to prevent frustration, conflict, time waste and misunderstandings
Creativity, experimentation and continuous assessment

brain storming, change and generation of new ideas and task, group and self
assessment to encourage the feeling of belonging
REFERENCE:
rd
Muller M. Nursing Dynamics. 3 Edition. Sandown: Heinemann: 2005; p 176 - 178
Ongoing stress can lead to burnout.

Demonstrate how you as a unit manager can lessen the stress levels of your personnel. [10]
Develop systems for effective two-way communication e.g.
make time to hear what employees think
Clarify role and performance expectations
Ensure prompt, constructive resolution of conflicts
Managers should become familiar with staff and their work e.g.
by learning names, being more visible, doing more rounds and visits
Psychological counseling and therapy should be easily accessible and available for
troubled staff members
Continuous education and staff development should be promoted
Assertiveness should be encouraged in all staff and
sessions could be conducted to teach staff assertiveness
Clear procedures should be followed regarding discipline and the handling of grievances
Greater participation in decision-making should be encouraged
Respect must be shown to staff members e.g.
consulting staff before taking action
Showing openness in discussions with others e.g.
being straight forward and avoid defensive response
The manager should increase her observational skills in order to detect increased
stress levels or signs of burnout
Policies which will reduce stress should be developed e.g.
re night and weekend shifts
Establish a support for nursing personnel e.g.
Stress support, health care support, Nutritional support and Health fitness programme.
REFERENCE:
nd
Booyens S.W. Dimensions of Nursing Management. 2 Edition. Cape Town: Juta; 2004; p 149 - 151
Identify the penalties that could be imposed on a nurse if found guilty of professional
misconduct.
[3]
A caution or a reprimand or a reprimand and a caution; or
Suspension for a specified period from practicing or performing acts specially pertaining to
his profession; or
Removal of his name from the register or roll; or
In the case of a student nurse, student midwife, pupil nurse or pupil nursing auxiliary,
extension of the prescribed period of education and training; or
A fine not exceeding R2000
Page 25 of 128
REFERENCE:
Nursing Act, 2005 (Act No. 33 of 2005)
You have been instructed to give health education to a group of hypertensive clients in the
clinic.
Summarise the factors that you should consider when educating patients on compliance with
medication.
[6]
The ability of the patient to follow the prescribed regimen e.g.
the complexity of the regimen including dosing frequency
The ability of the patient to adhere to the regimen e.g.
The degree of behavioral change required and duration of therapy
The convenience and efficiency of the health care setting
The adequacy of the health care provider with regard to supervision and communication
Level of patient satisfaction
Patients health beliefs, including the degree of belief that regimen will help or
Is worth the cost.
The patients history with regard to adherence
The mental illness history of the patient and
The stability of the family and the social support
REFERENCE:
Edition. Sandown: Heineman; 2009; p 179
Compare accountability and responsibility in the nursing Profession
Accountability
[6]
Responsibility
Giving an account of ones acts,

omissions and commissions
A duty to perform some functions in a

satisfactory manner
Relates to how one exercises

responsibility i.e. managing
the nursing unit
As a basis for acceptance of actions that go

with the post which requires accountability
Must be willing to be judged

according to the rules of professional
norms i.e. to self, employer, courts
and profession
Having an obligation to perform a delegated

task by an authority i.e. employer and is
subject to penalty in case of default
Requires acquisition of
knowledge, skills and values to be
held personally liable
To answer for, give reasons and/or

justify ones acts and omissions
Requires allocation of tasks to be carried out

by the nurse in terms of the contract between
the employee and employer according to the
Scope of practice for the nurse to accept
liability
Is task orientate
Page 26 of 128
Flow up the chain of command
Flows down the chain of command
REFERENCE:
Edition. Sandown: Heineman; 2009; p 229 + 313
rd
Muller M. Nursing Dynamics. 3 Edition. Sandown: Heinemann: 2005; p 55 - 58
Explain the concept accountability

[5]
Accepts and demonstrates accountability and responsibility for own professional judgment
and actions
Understands parameters of own role and competence
Consults with other nurse practitioners who have the required expertise, when nursing care
requires expertise beyond own current competence or scope of practice
Accepts responsibility and accountability for own competence in accordance with scope of
nursing practice
Limits practice to scope of competence
REFERENCE:
South African Nursing Council. Charter of Nursing Practice. Draft 1. 28 Sept 2004. Pg 32
Identify and briefly discuss ten steps of the quality assurance process
[10]
Assigning responsibility
The nursing unit must appoint a person or group of people to be responsible for the quality
assurance programme
Determining scope of care
Identify important aspects of care
on which the quality assurance process will focus
It will influence the categories and the numbers of staff allocated to the care of patients
Identifying indicators
which indicate the complexity and comprehensiveness of care
Establishing thresholds for evaluation
If results indicates a higher than acceptable level, an investigation will be necessary
Collecting and organizing data
Several methods can be used to collect data e.g. patient records, questionnaires, etc.
Evaluating care
Care must be evaluated if specific problems exist and there is an opportunity to improve the
situation
Taking action to solve the identified problems
A plan of action should be developed which indicates how, when and by whom the actions
will be implemented
Page 27 of 128
Assessing actions and documenting improvement

The findings of assessments and any suggestions regarding improvements should
be recorded
Communicating relevant information
to the central quality assurance programme
All findings should be communicated on a regular basis
REFERENCE:
rd
Meyer SM, Naude M, Shangase NC, Van Niekerk S. The Nursing Unit Manager: A Comprehensive Guide. 3 Edition.
Sandown: Heineman; 2009; p313 317
You are a senior nurse working at a community clinic, where there has been an increase in
the incidence of teenage pregnancies. You are approached by management to conduct a mini
research project, to help curb the incidence of these pregnancies.
Apply the steps you would take in order to complete this research project
[7]
Formulating the problem

- The increased incidence of teenage pregnancies
Reviewing the related literature

- Defining the theoretical framework by using previous theory to generate predictions for
present research
Formulating the hypothesis

- Making predictions e.g. teenagers receiving prenatal care would be more likely to use a
contraceptive postpartum than pregnant teenagers not receiving prenatal care
Selecting a research design Quantitative/ qualitative
Sampling the population

- Choosing a number of pregnant teenagers that is representative of the community
Data collection
- Using questionnaires or interviews relating to pregnancies
Analysing the data using numbers or categories

Interpretation of the results
- Making sense of the results - 90% of the teenagers were engaged in sexual because of
peer pressure
Communicating the results
REFERENCE:
nd
Professionals. 2 Edition. Cape Town: Juta; 2006
Six pts in your medical ward developed bed sores during the past month.
Investigate the situation by making use of the scientific method of nursing.
Page 28 of 128
[8]
Assess the problem

Collect information through observation, records and meetings
E.g. what is the knowledge of nurses regarding pressure sores
What pressure relief aids are used
How is pts risk for skin breakdown assessed
Analyze the information to determine the cause of the problem
Plan to solve the problem
Formulate an appropriate goal for the solution of the problem
E.g. the incidence of pressure sores shall be less than 1%
Develop alternative interventions by involving staff members
E.g. in-service training, use of special mattresses, delegation of pressure care to
specific people on every shift
Make a decision on the alternatives to be implemented
Implement the solution
Decide on a date of implementation
Decide when and by whom results will be evaluated
Evaluate the effect of nursing care
Re-plan if necessary
Record all steps taken
REFERENCE:
Edition. Sandown: Heineman; 2009; p 40 - 76
Explain the following terms:

Theory
A set of related statements that
describes or explains phenomena in a systematic way
[1]
Hypothesis
Is the formal statement of the expected relationship between two
or more variables in a specific population
[1]
Random Sampling
The selection on an element or unit from a population
having the same chance of being selected
[1]
Pilot Study
A small-scale trial run
of an actual research study
[1]
Survey
Research data collected from a sample
to determine characteristics of a phenomena
[1]
REFERENCE:
nd
Professionals. 2 Edition. Cape Town: Juta; 2006 p 203 208
As a registered nurse you should be acquainted with the Batho Pele principles to improve
service delivery.
Page 29 of 128
Demonstrate how you will ensure compliance with these principles in your nursing unit [10]
Consultation
Patients should be consulted about the level and quality of the services they receive
and where possible should be given a choice about the services that they are offered
Should be open minded towards the patients needs in this regard and initiate a
patient satisfactory survey
Service standards
Patient should be told what level and quality of service they receive so they are aware
of what to expect
The nursing unit should have a quality improvement project
Access
All citizens should have equal access to the service to which they are entitled
Nurses should facilitate the principle of equity
This could be a problem in the private sector especially in the trauma/ emergency / casualty
units. In this case there should be a hospital policy to make provisions for the treatment of a
trauma patient within the golden hour period
Courtesy
Citizens should be treated with courtesy and consideration
Information
Citizens should be given full, accurate information about the services they are entitled to
Openness and transparency
Citizens should be told how departments are run, how much they cost and who is in charge
Redress
If promised standard of service is not delivered, citizens should be offered an apology
A full explanation and a speedy effective remedy ad when complaints are made- positive
response required
Value for money
Service should be provided economically and efficiently in order to given citizens the
best possible value for money
REFERENCE:
rd
Muller M. Nursing Dynamics. 3 Edition. Sandown: Heinemann: 2005; p 9
An incident report and a statement may contain identical data, but are used for different
purposes.
Debate the above mentioned statement.
[6]
Incident Report
A hospital document to report anything out of routine
e.g. patient falling out of bed
It is a permanent record (evidence)
On a specific happening
It should contain precise and accurate information
Incident report used by management to assess situation and
Page 30 of 128
Take corrective action if necessary
Statement
May follow incident report if considered necessary
Legal statements are made by manager/nursing manager
It may contain some information from incident report
Statement can be made available to police
A sworn statement made under oath is an affidavit
REFERENCE:
nd
Booyens S.W. Dimensions of Nursing Management. 2 Edition. Cape Town: Juta; 2004; 587
Summarise the importance of patient identification

[4]
Prevent confusion of one patient with another
To avoid administering wrong medication to a patient
Elderly patients, very young and very ill that cannot confirm correct identification to different
personnel
Mentally disturbed or retarded patients cannot reliably identify themselves
Unknown patients who must be identified as unknown with a number to prevent
confusion with other unknown patients
A patient with an allergy must be identified clearly with specific allergy stated to ensure
that everybody treating him is aware thereof
Operation site must be clearly identified to prevent operating on the wrong area
Prevents surgery on a wrong patient because patient is unconscious and cannot identify
himself
After shift/rotation of personnel it facilitates the identification of patients
REFERENCE:
rd
Meyer S, Naude M, Van Niekerd S. The Nursing Unit Manager: A Comprehensive Guide. 3 Edition.
Sandown: Heineman; 2009; p324 + 325
Outline the registered nurses responsibility to ensure the patients emotional and
physical safety in a unit, according to Regulation 2598 :
(p) the establishment and maintenance, in the execution of the nursing regimen, of an environment
in which the physical and mental health of a patient is promoted;
[7]
Control access to the patient by:

no person is allowed in without proper identification
no unauthorized persons should have access to patients records
Identify patients according to policy
Treat patients with courtesy
Implement nursing care that is relevant to the needs and culture of the patient
The ward should be clean, well ventilated with minimal noise
Staff should perform within their scope of practice
Provide enough human and
material resources
for service provision
Display patients rights charter in the unit
Allow patients to provide feedback to the staff regarding the care they receive
Discuss information about the patient in confidence
Maintain safety of patients property
Page 31 of 128
Adequate supervision e.g. giving of forbidden food to patients (e.g. cakes to diabetic
patients)
REFERENCE:
rd
Mellish JM Unit Teaching and administration for nurses 3 edition page 190
Three elderly patients, with the medical diagnosis of diabetes mellitus, have been admitted to
your ward. You have identified a need for health education, which you will delegate to your
Bridging Course student.
Draw up guidelines of the principles and factors the student should take into consideration in
the planning of health education sessions for these specific patients.
(N.B. Actual content of the teaching is not required )
[10]
Assess patients for changes related to aging that may influence learning
May have slower mental functioning, decreased concentration and short term memory
therefore may have to plan teaching sessions for short periods
and at slower pace with frequent repetition
Create comfortable, friendly and understanding environment
Decrease distractions in environment
Minimize noise may be hard of hearing
Educator must speak clearly, facing the patients and making eye contact
Utilise teaching aids, which are clearly visible and audible
Varied aids may help to keep them focused
Assess learning needs and existing knowledge they are adults with years of experience
Assess understanding / knowledge and skills gained, especially before discharge and record
REFERENCE:
Brunner & Suddarth; 2004. Textbook of Medical- Surgical Nursing, pg 49 52
Muller,M. 2002. Nursing Dynamics. Pg 290 - 293
Explain the criteria for accurate, legal record keeping.

Records must be clearly identifiable with all relevant data such as name, age
Legibility is essential
Unclear signatures must have names printed next to them for better identification
Persons signing documents must put their designations such as R\N
Abbreviations are not acceptable because confusion may arise
Records must be quickly and effectively retrievable
Records must be clear, concise and relevant
Records must be dated with relevant times to facilitate care
Good reports are unambiguous
Filing of records must be meticulous
[4]
REFERENCE:
nd
Booyens Introduction to Health Service Management 2 Edition p368
Remedial action is the third step in the quality improvement process and depends on
information received when evaluating performance against a standard.
Explain measures the unit manager may have to implement to improve the quality of practice.
[4]
Page 32 of 128
Staff development may be necessary to improve knowledge, skills and attitudes e.g. in
service education on infection control.
The application of group pressure and discipline in the unit to increase compliance with the
standard.
The revision of the standard if it is unrealistic or if the objectives need to be adjusted
Action must be taken with a view to empowerment and capacity building.
REFERENCE:
Muller, M. 2002. Nursing Dynamics. Pg 212.
The hospital manager has donated a trophy to be awarded to a final year student who has shown
the most growth towards professional development.
Present the criteria you would use to decide on the winner of this award.
[13]
The candidates performance and behaviour show internalization of professional values.

He/She is able to recognize shortcomings in knowledge and makes an effort to rectify
He/she demonstrates familiarity with ethical philosophical basis of nursing and sound
professional socialization
The candidate has demonstrated a high standard of nursing practice and responsibility and
accountability
The candidate has displayed positive leadership i.e. SRC, class representative
The candidate is able to use critical thinking in problem solving / decision making
The candidate has displayed self-regulation (self-evaluation) and self-control and is familiar with all
the professional regulations and legislation
The candidate has participated actively in student/college affairs and is familiar with professional
ethical issues
The candidate attends meetings of interest groups/professional societies that are open to students
e.g. Clinician`s HIV AIDS group, Infection control
The candidate demonstrates pride in the profession and at all times strives to maintain a
professional image
e.g. by means of his or her conduct and appearance
The candidate has reflected a service motive i.e. unconditional acceptance of the patient
and is prepared to make sacrifices but without being exploited
REFERENCE:
rd
Muller, M. 3 edition. Nursing Dynamics. Pg 19 -20.
You are a unit manager in a surgical ward. One of your staff members has formally lodged a grievance
alleging unfair treatment in the allocation of off-duties.
Discuss how you would manage this grievance.
[12]
The unit manager and personnel in the unit should be familiar with the institutions grievance policy.
If there is no formal procedure, the help of the professional association can be called upon.
Unit manager must be familiar with lines of communication and responsibility in terms of grievance
policy and
as she is first supervisor is responsible for managing or referring grievance.
Steps or phases of grievance procedure must be followed strictly.
Nursing practitioner has the right to be assisted by an external representative if she wishes
Rights of the aggrieved person should be protected
e.g. avoid any form of discrimination or intimidation.
A grievance is considered solved when the aggrieved person confirms in writing that he/she is satisfied.
Page 33 of 128
A written record of the grievance and solution with relevant dates and signatures of both parties
are kept as per policy.
Inadequate management gives rise to job dissatisfaction which can spread to entire unit.
The unit manager should deal with or refer grievance within 2 days.
Entire grievance should be solved within 6 days as
The longer it takes to resolve, the stronger the risk for labour unrest.
REFERENCE:
rd
Muller 3 edition, p. 270 - 271
The Nursing process is a scientific approach to problem solving that makes quality nursing
care possible.
Summarise the five steps of the Nursing process
[10]
Assessment
Systematic process of gathering information
Of a patients physical, social, emotional and psychological status
as well as Biological data and family history
- subjective information from the patient and relatives
- objective information from diagnostic results, medical notes and physical assessment
Diagnosing
Nursing Diagnosis is a description made of the patients health
problem/need
Which will need nursing interventions
Requires critical judgement of all subjective and objective data
Planning
Holistic and comprehensive care is planned
on the basis of the identified problems
Implementation
Action phase where the nurse uses different methods to
deliver nursing care
And to monitor the expected effects of the plan
Evaluation
It is a planned ongoing activity
In which the nurse in co-operation with patient, family and health care
workers
Determine the effectiveness of the plan
And recommends changes
REFERENCE:
nd
Naude and Meyer.2 edition. The Nursing Unit manager A Comprehensive guide p 30 -65
A nurse may not divulge any information concerning a patient which has become known
to him in his personal capacity.
Government Notice R387 of 15 February 1985, as amended, stipulates where this rule
does not apply.
Explain the situations where this rule does not apply.
[5]
Page 34 of 128
With the explicit consent :
of a patient who is of age

of the parent/guardian of a patient who is a minor
of the surviving spouse
or the child who is of age
of the patient who is deceased
where instructed thereto by a court of law
or where a nurse is otherwise lawfully bound thereto
in the exclusive interests of a patient who is not able to or is not capable of
granting permission
or in a professional consultation with anybody involved in the treatment of the patient or
in the exclusive interest of the patient, with somebody else
REFERENCE:
Government Notice R387, page 6
On successful completion of your Bridging Course, you will be required to practice

according to the scope of practice of a registered nurse.
Identify the major differences between the scope of practice of the enrolled and the
registered nurse.
[5]
Emphasis on scientific basis

RN is responsible for the diagnosis of health needs
the prescribing
and provision and execution of the nursing regimen
to meet the needs of patients
When necessary she is responsible for referral to a registered person
The RN is responsible for the co-ordination of health care regimens provided by
other members of the team.
The RN is responsible for effective patient advocacy to enable the patients to obtain the
health care they need.
REFERENCE:
Government regulation 2598
Describe the value of policy and procedure manuals in the unit.

[5]
Serves as a means by which authority can be delegated
Help achieve regularity by setting out the steps of a of a procedure which must be followed in
a chronological sequence
Serve as a basis of orientation and staff development
Are a ready reference source for all personnel
Provide a basis for evaluation
Serve as a basis for future decisions and actions
Helps co-ordinate plans
Helps control work performances
Ensures similar decisions when faced with similar situations
They save time and effort
REFERENCE:
Page 35 of 128
Booyens, S. Dimensions of Nursing Management p 200
The unique characteristics and traditions determined by its practitioners alone do not secure
professional status for nursing. A profession must meet international criteria in respect of a
profession.
Analyse the following criteria and explain how nursing as a profession in South Africa meets these
criteria :
A profession is characterized by an extensive, specialized theory content with well developed
technical skills based on such a theory.
[2]
The nursing profession complies with this criterion as it has a unique, specialized body
of knowledge which is applicable only to nursing.
The practical nature of nursing has given rise to clinical techniques and procedures which
are specific to the practice of the various nursing disciplines.
A profession is characterized by self-organisation, which leads to the establishment of a professional

association and a self-governing body to exercise control over professional standards.
[3]
Members of a profession decide for themselves about the nature of self-regulation
and determine the ethical codes and professional standards
by means of practice regulations
In SA we have the SANC which exercises control over professional nursing Standards by
e.g. approving training schools and programmes
developing practice regulations e.g. R.387
A profession is characterized by some form of registration and licensure to practice.

In SA the law which determines this regulation is the Nursing Act
In SA the nursing profession has met this criterion for many years (since 1891)
When first Nursing Act was promulgated in SA registration became compulsory
And the SANC was made responsible for maintaining registration of all categories
In SA it is illegal to practice unless registered
And registration must be renewed annually
[2]
A profession is characterized by ethical control of professional conduct by members of the

profession.
[2]
With the promulgation of the first Nursing Act in SA, the SANC was established and professional
Ethical and legal practice of nursing is controlled by SANC
In terms of the Act the SANC also has disciplinary powers
May conduct hearings and discipline members found guilty of unprofessional conduct
REFERENCE:
Muller, M. 2002. Nursing Dynamics. Pg 11 14
NURSING IN THE RSA IS REGARDED AS A PROFESSION. MOTIVATE THIS

STATEMENT OR
Describe 10 criteria for the recognition of nursing as a profession
CRITERION 1
Page 36 of 128
[10]
A profession is characterized by an extensive, specialized theory-content with well -developed

technical skills, which are based on such a theory
- According to this criterion, there should be unique specialized subjects in the nursing course,
which are studied only in nursing
- The basic 4yr nursing course currently has 4 main subjects viz. GNS, Midwifery, Community
Nursing Science, Psychiatric Nursing Science
- Each of these subjects contains specialized nursing knowledge, based on the scientific
method of nursing
- Specific nursing skills are therefore, taught to the student in each of the main subjects
- All these nursing subjects are unique and exclusive by nature and are studied only in the
nursing profession
- The nursing profession in RSA thus meets the criterion that requires specialized theoretical
content and related skills
CRITERION 2
A profession is characterized by the utilization of the theory of physical science, as well as other
disciplines related to the practice thereof
- Nursing cannot be practiced meaningfully without the utilization of other sciences
- The physical sciences such as chemistry, physics, human anatomy, physiology,
pharmacology and microbiology are included in the nursing programs
- Social sciences are also utilized, e.g. psychology, sociology, education, preventive and
promotive health science
- Meaningful nursing is possible only if the above-mentioned sciences are integrated
- Thus the requirements of criterion 2 are met
CRITERION 3
A profession is characterized by specialized preparation over a long period at a recognized
educational institution
- Preparation for professional in SA at present requires 4yrs of integrated training/education for
registration as a general nurse, midwife, psychiatric and community nurse
- This 4yr training course can be followed at a nursing college in the case of a diploma, or at
an university or technikon in the case of a degree
- The SA nursing profession thus meets this criterion, which requires specialized preparation
at recognized educational institutions
CRITERION 4
A profession is characterized by the testing of professional competence prior to admission to the
ranks of the profession
- Formal theoretical and clinical evaluation takes place in respect of each subject before a
nurse can be registered professionally
- Formal examinations take place at nursing colleges in collaboration with the university with
which the college has a collaboration agreement
- The university staff acts as moderators
- The universities have a system of external examination by personnel from other universities
- External quality control is thus ensured
- The SA nursing professions meets the requirements of criterion 4
Page 37 of 128
CRITERION 5
A profession is characterized by some form of registration and licensure to practice
-
The SA nursing profession has met this requirement since 1891, with the voluntary
registration of trained nurses with the different colonial medical councils
With the promulgation of the first Nursing Act in 1944, the SANC was established to deal with
these registrations and the nursing profession itself thus regulates licensing in terms of the
Nursing Act, any person who practices nursing must be registered or enrolled with SANC and
this must be renewed annually
CRITERION 6
A profession is characterized by self-organization, which leads to the establishment of a professional
association and a self-governing body to exercise control over professional standards
-
Members of a profession decide for themselves about the nature of self regulation
The members of the profession thus determine the ethical codes and professional standards
by means of practice regulations
This implies that the profession itself regulates the nature of training, educational programs,
admission requirements, etc.
The first Nursing Act was promulgated in 1944 and it made provision for a Nursing Council,
as well as for the SANA, as a statutory mouthpiece for the nursing profession
Self regulation for the SA profession thus became a reality in 1944
The SANA (DENOSA) acts in the interests of the nursing profession (including nurses), while
the SANC acts in the interests of the public
Thus SA meets the requirements of criterion 6
CRITERION 7
A profession is characterized by ethical control of professional conduct by members of such a
profession
-
Since the establishment of the SANC in 1944, professional ethical control has been
exercised by the SANC over the conduct of the nurses
The SANC regulates the professional - ethical practice of the nurse
CRITERION 8
A profession is characterized by a service motive based on the needs of the client who requires
professional assistance, regardless of her/his ability to pay for services, because the well-being of
the client is the primary consideration
-
Nursing came into existence as a result of the communitys specific need for care, initially
during the illness phase
Nursing was originally inspired by religious convictions, and a purely service motive
Today, nursing is an independent science which is practiced in SA
Although nurses receive remuneration for their services, nursing still remains a service
Page 38 of 128
When a pt requires nursing, it is not the nurse who assess the pts financial abilities before
nursing is provided
Nursing is thus still primarily a service to humankind
CRITERION 9
A profession is characterized by a high degree of accountability for professional acts towards the
public, the client, the employer and other members of the profession
-
In terms of the Nursing Act, the nurse/midwife in SA is an independent practitioner who is

accountable for his/her own acts and omissions
In the event of negligence or unprofessional conduct, the nurse/midwife must be able to
account for his/her acts to the public court, the disciplinary committee of the SANC, the
employer, etc.
The sub-categories (E/N, E/NA, student/ pupil nurses) practice under the direct or indirect
supervision of a professional nurse/midwife
She/he is, however, also accountable for her/his acts and omissions, either with or without
supervision
A certain level of knowledge and skills is also expected from the sub-categories and they are
thus also accountable for their own acts
The nursing profession in SA therefore meets this criterion
CRITERION 10
A profession is characterized by a feeling of exclusiveness
-
A profession demarcates its own exclusiveness by prescribing training requirements,

exclusive registration and practice standards
The method of practice thus determines the exclusiveness of the profession
Nursing in SA belongs to a specific group, which excludes persons who do not meet the
prescribed requirements of the profession
CRITERION 11
A profession is characterized by an acknowledgement status in terms of legislation
-
Since 1944, with the promulgation of the Nursing Act, nursing has been acknowledged as a
legal profession by the SA Parliament
This independent acknowledgement of the nursing profession was an exceptional milestone,
of which the nursing profession is proud
CRITERION 12
A profession is characterized by a high social status and considerable power in society
-
The social status and power of a profession depend on the members of that profession
There is a special relationship of trust between the nursing profession and the community
This relationship of trust is determined mainly by the conduct of members of the specific
profession and the way in which they provide for the communitys needs in their practice of
the profession
This criterion is challenged when nurses in SA participate in strikes, or when they are given a
lot of publicity on account of unprofessional conduct and other transgressions
Page 39 of 128
The SANC exercises pressure when the image of the profession is threatened
Both the SANC and DENOSA advise the Minister of Health when the nursing profession
may have a significant influence on the delivery of health services
CRITERION 13
A profession is characterized by the performance of activities that are based on an understanding of
what these activities involve, so that the consequences of acts or omissions can be predicted
-
The nursing profession has not remained static

Necessary changes have been brought about especially with regard to the training of nurses
At present, training is extensive in order to be in line with the health policy of the country
The SANC is presently transforming nursing education to meet the primary health care
needs of the community in line with the health care policy and legislation
CRITERION 14
A profession is characterized by sustained critical analysis of activities, which leads to change in
practice on the basis of such analysis, with the result that a profession is always subjected to
change and development and is never static
-
This means that obsolete practices are rejected in favour of what is more useful in the
execution of activities related to the nature of the profession
This criterion is an extension of criterion 13
With the changes in the health plan and health legislation, as well as the implementation of
the RDP, the nurse is being regarded as an essential member of the front line health team
Considerable progress has been made, with authorization to nurses to prescribe medicine
under certain conditions and in accordance with regulations (38A of the Nursing Act)
CRITERION 15
A profession is characterized by the ability of its members to select, in a responsible manner, the
activities which are of material importance to the practice thereof, and where the mastering thereof
falls within the realistic reach of members of the profession
-
This implies that the members of the nursing profession make their own decision about the
activities that should be included in the nurses responsibilities
Nursing, including specialized nursing practitioners, know which functions fall outside their
scope of practice
When there is a need in a specialized nursing group e.g. the midwife, to be authorized to
perform a specific function (such as the administration and maintenance of epidural
analgesia during labour), which has not traditionally fallen within the scope of practice of that
group, and the profession, in consultation with the profession which traditionally performed
the function, decides whether such authorization is justified
After such an act has been authorized, the profession must make provision for the necessary
training and regulations in this regard
Thus the requirements of criterion 15 is met in SA
CRITERION 16
Page 40 of 128
A profession is characterized by the individual member being allowed the maximum discretion and
initiative in the practice, while independent functions and accountability for the performance thereof
are inherent
-
In terms of the Nursing Act, the nurse/midwife is an independent practitioner who is

professionally and ethically accountable for her acts and omissions
It is therefore, the nurse/midwife who decides whether she has the necessary knowledge,
skills or experience to perform a specialized task
No other person can accept responsibility on her behalf for the performance of the act
The nurse decides for herself according to her training standards, knowledge and skills,
whether she is competent to perform the act
If she performs the act, she is accountable for the consequences thereof
As an independent practitioner she is expected to display the necessary discretion and
initiative in the performance of her responsibilities, including the updating of her knowledge
and skills as circumstances demand
Thus the requirements of criterion 16 is met in SA
CRITERION 17
A profession is characterized by the obligation of its members to use their best endeavours in
meeting the needs of the pt
-
The nurse/midwife today undergoes extensive training, which enables her to provide for the
health needs of pts in the promotion of health and the prevention of, and recovery from,
illness
The nurse/midwife thus has a responsibility, regardless of where she practices , to provide
comprehensively for the health needs of the pt
In SA the requirements of criterion 17 are met
CRITERION 18
A profession is characterized by a sustained striving towards excellence because competence alone
is not enough
-
This criterion implies that the nurse/midwife must be prepared at all times to render quality
service and also be prepared to provide evidence of international best practice principles
being executed
This means that various indicators must be utilized to prove or demonstrate that quality
nursing/midwifery care is provided in a specific service
The formalization of quality assurance in SA has made the profession more credible in this
regard
External accreditation standards have been set country wide and are implemented in various
hospitals
The SANC has also developed clinical professional standards for nursing and midwifery
(Muller p11 18)
REFERENCE:
Muller, M. 2002. Nursing Dynamics. Pg 11 14
In terms of GR387 of 1985 the nurse has an obligation and duty to prevent the spread of
infection.
Page 41 of 128
Describe your responsibility as a registered nurse regarding this duty.
[10]
Hand washing practices according to hospital protocol

Adhere to safety and standard precautions according to policy
Careful observation of patient's condition and reporting possible signs of infection
Supervision of all categories of nursing and other staff re preventative measures and
implement correcting measures where appropriate
Encourage patients and visitors to wash hands or use hand spray
To notify line manager if nurse has an infection - not to come on duty
The RN is responsible for the safe practice of all the staff directly under her control
The RN is also responsible for the safe infection control practice of all the staff who come
into the ward, including doctors, physiotherapists etc
Strict adherence to protocols
- sharps
- management of bodily fluids
- wearing of protective clothing
It is within her rights to insist on safe infection control practices e.g. hand washing and
wearing of gloves
She has the responsibility of the safety of the patient and therefore must ensure that the
staff practices do not put them at a risk of contracting a nosocomial infection
As well as the safety of the staff to ensure that they do not put themselves at risk of
contracting an infection from the patient
The RN must therefore make sure that the staff know the correct protective procedures for
each specific patient
Universal precautions must become standard practice in the ward
The RN must ensure that the necessary protective clothing, disinfectants, plastic bags etc
are readily available in the ward
The RN must update her/his knowledge in infection control practice and keep the staff in the unit
informed
The RN must communicate with the infection control sister who will assist her/him with
her infection control function
Unsafe practices and incidents must be reported as per hospital policy
REFERENCE:
Life Healthcare Policies and Procedures. SHEQ Policy
The Registered Nurse provides patient advocacy to enable the patient to obtain the
health care they need.
Describe the advocacy role of the Registered Nurse.
Duty to speak on behalf of the patient

Is the voice of the patient
Advocacy must be factual and directed to attainable ends
Acquire knowledge of professional practice issues
- Including patient rights to be able to advocate for patients more effectively
Empower the patient so that the patient can advocate for themselves
- By ensuring the patient is well informed with regard to rights and health education /
information required
Ensure safety of patients at all times and implement safety standards
- E.g. protect name, belongings and health of the patient
Provide specific care to infants and children, aged, terminal and mentally ill
Page 42 of 128
[6]
To safeguard their health needs problems

Implement prescribed treatment intelligently and professionally
Monitor and manage effects of the treatment/nursing care
Acquire/implement emergency measures in the absence of a professional person whose
service is required in the situation to save the life of a patient
Refer patients timely for adequate care and support
REFERENCE:
Searle, C. Professional Practice. Second Edition p137
Searle, C. Ethics in Nursing. p128, 204
Match the terms in column A with the most appropriate description in column B.
Write only the number of the question and the letter of your choice e.g. 11. = N
COLUMN A
[10]
COLUMN B
1. Labour relations
The exclusion by an employer of employees from the

workplace to compel them to accept a demand.
2. Trade unions
It is a process whose purpose is to apply pressure on the

employer to redress perceived inadequacies in the conditions
of employment.
3. Grievance
It is the active intervention of a third party for the purpose

of inducing settlement.
4. Collective bargaining
Aims to help settle disputes and assist in the conduct of

labour relations.
5. Mediation
Involves the authority of management to direct and influence

the actions in place in an organization.
6. Arbitration
It is a procedure in terms of which an independent and

impartial third party hears both sides of a matter and gives a
binding decision.
7. Commission for Conciliation, G

Mediation and Arbitration
(CCMA)
8. Disciplinary procedure
H
Aim to improve the working conditions of members
9. Workplace forums
Outlines the formal process adopted whenever an employee

commits any act which is in breach of the contract of employment.
10. Lockout
A complaint relating to an employees treatment or position

within his/her daily working routine
Aim to promote the interests of all employees at the

workplace, to increase efficiency and engage in consultation
and joint decision making
Refers to all aspects and matters connected with the

relationship between the employer and employees.
Page 43 of 128
1. H
2. G
3. J
4. B
5. C
6. F
7. D
8. I
9. K
10. A
REFERENCE:
Booyens, SW. 1998. Dimensions of Nursing Management. Ch 29
You are the unit manager of a busy medical ward and have become aware of a drop in
productivity and increasing interpersonal conflict in the ward.
After investigation you arrive at the conclusion that many of your staff are experiencing high
stress levels due to the heavy workload and the many terminally ill patients admitted to the ward
With reference to individual indicators of stress, motivate why you have drawn the above conclusion.
[5]
Staff may have complained of any the following physiological indicators :
Headaches
Alteration in blood pressure
Constant fatigue
Pain in neck, shoulder muscles, lower back.
There may be evidence of any of the following behavioural symptoms :
tension
Anger or irritability
Anxiety
Depression or suicidal ideas
Indecision
Impaired judgement
Alcohol and or drug abuse
Altered eating or sleeping patterns
Plan an intervention programme that would be relevant in the above situation, addressing
stress management and increased productivity.
[10]
Assist with / teach effective time management

- planning of nursing tasks and duties
- educe unnecessary work and redoing of work
- eg. standardized, simplified, streamlined procedures grouping of tasks
- nursing staff to perform nursing tasks only
Develop interpersonal skills e.g. conflict management

- communication skills e.g. non-verbal, listening
- assertiveness skills
Page 44 of 128
Maintain clinical skills and update re changes, improvements

- could improve productivity and uncertainty causes stress
Promote a positive, can do attitude
Encourage short discussions of work tension, with colleague or friend

- sharing concerns / frustrations may provide necessary support
- and help staff to separate work and personal life
Review job and workload allocation

- fairness, competency levels etc
Ensure resources adequate to provide quality care

- equipment, supplies, staff
Identification and utilization of appropriate debriefing strategy after traumatic situation
Educating re other stress management techniques

- healthy lifestyle, relaxation techniques
REFERENCE:
Meyer,S, Naude,M , van Niekerk,S. 2004. The Nursing Unit Manager: A comprehensive guide. Pg 164 -165,
189 192.
Knowledge of and participation in research is an important function of the

registered nurse.
Match the research concepts in column A with the explanation in column B.
Write only the number of the question and the letter e.g. 11 = N
COLUMN A
[10]
COLUMN B
1. Hypothesis
The characteristic of the person or object that varies.
2. Research
Is concerned with how data is collected
3. Variable
It provides a statement of the researcher`s expectations

about a specific relationship between variables.
4. Research Design
Units or subsets of cases drawn from the accessible

population.
5. Sample
Is a purposeful, accurate and systematic search for new

knowledge
6. Pilot study
Any research activity in which the investigator

gathers data.
7. Instrument
A technique in which questions are asked to

the respondent, usually face to face
8. Research proposal
A trial run, done in preparation for a major study
9. Interview
A document which communicates the research problem,
Page 45 of 128
its significance and planned procedures for solving the

problem
10. Literature review
Examples are questionnaires, tests or observation

schedules
A critical summary, generally prepared to put a research

problem in context or to identify gaps and weaknesses
Process of developing specific predictions from

general principles
ANSWER:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
C
E
A
B
D
H
J
I
G
L
Reference :
Brink,H 2006. Fundamentals of research Methodology for Health Care Professionals.
A quality improvement programme has recently been implemented in your unit,

but not as successfully as you had hoped.
Explain the term Quality improvement
[2]
Quality improvement is a formal process where standards are set, work performance is
monitored, and evaluated against set standards and remedial steps are taken to solve or
counteract problems
Explore the reasons that may be responsible for the poor results and non-acceptance of
the programme.
[7]
Success of a quality programme depends on group effort
- Were all members informed about all aspects?
- Did each member know what was expected of him, her?
- Did the group commit themselves to the programme?
- How well does the group function as a team?
The development and implementation of a quality programme requires specific skills on the
part of the staff ( empowerment )
- Where all trained in the principles of quality improvement?
- Is there sufficient infrastructure support in the unit to enable implementation?
Page 46 of 128
Sufficient management support is necessary for successful implementation.

Was there sufficient guidance?
Was staff involved in development of the programme so that they could take ownership?
The way in which the programme is sold to the group is important to promote ownership and
so that they don`t see this as more work
Is there a culture of pride in their work and the proven results of quality nursing care?
Does the staff see this as part of daily work or as unnecessary extra work?
REFERENCE:
Muller, M. 2002. Nursing Dynamics. Pg 202 203.
Nurses have a responsibility not only to protect patientsrights, but also to make them aware
of the obligations attached to the patient role.
With reference to the Patients`Rights Charter, describe the information you would give a
group of patients in this regard.
[6]
They must take care of their own lives and live a healthy life style
They should care for and protect the environment.
They should respect the rights of other patients and also of health care providers
They should utilize the health system optimally and without abuse.
They should get to know the local health service and what they offer.
They should provide health care workers with relevant and accurate information
They should advise health care workers re their wishes with regard to death
They should comply with the prescribed treatment procedures
They should ask what the related costs of treatment going to be and arrange for payment thereof
They should take care of their own health care records when appropriate.
A good nurse-patient relationship impacts positively on the image of the nursing profession.
Justify this statement.
[10]
The nurse patient relationship is of great importance in all phases of nursing.
It is an intellectual and emotional bond between the nurse and the patient.
It is directed at meeting the patients goals.
It takes place within a structured and designated setting.
Respect in the relationship should bring uniqueness, integrity
and an appreciation of the patients right to participate in or receive care
The patient as participant brings certain values as well as his own background of:
- culture
- educat ion exper ience
which the nurse respects
Mutual acceptance
is fundamental to the effectiveness of the nurse-patient relationship
The nurse should develop empathy with the patient, so he should develop trust and
Recognition of identity by addressing the patient by name
Respect for personal preferences
Express and share information with family
Nurse advocate for patient
Nurse demonstrates: sincere interest and willingness to help
Nurse shows concern and anticipates needs
Page 47 of 128
Nurse is ready to listen and answer questions

Frequently an appropriate light touch of the nurses hand
conveys - acknowledgement,
understanding of problems and anxieties
as well as caring
Nurse upholds principles of confidentiality
REFERENCE:
rd
Searle C, Pera: SA. professional practice A South African nursing perspective. 3 edition. Sandton: Heinemann; p. 317.
Identify and explain the five (5) stages of grieving.
[9]
Denial:
Refuses to believe that the loss is happening
Is not ready to deal with practical problems
such as prosthetic after loss of limb
May assume artificial cheerfulness to prolong denial
Anger:
Client or family
May direct anger at nurse or staff, about matters that would not normally bother them
Bargaining:
Seeks to bargain with God to avoid loss
May express feelings of guilt or fear of punishment for past sins, real or imagined
Depression:
Grieves over what has happened and what cannot be
May talk freely or may withdraw
Acceptance:
Comes to terms with loss
May have decreased interest in surroundings and support people
May wish to begin making plans to accommodate changes in lifestyle
REFERENCE:
th
Kozier B, Erb G, Berman AJ, Burke K: Fundamentals of nursing. 8 edition. New Jersey: Prentice-Hall; 2008,
p.1089.
Describe the emotional support that you would give to a dying patient.
[6]
Use silence and personal presence as well as techniques of therapeutic communication,
that encourage exploration of feelings and show acknowledgement of patient`s feelings
Treat patient with dignity, honour and respect at all times
Allow patient to make choices that will promote autonomy gives sense of some control
Respond with honesty to client`s questions
Acknowledge grief of family family support persons NB part of dying patient`s world
Provide information regarding community resources e.g. clergy, support groups
REFERENCE:
th
Kozier B, Erb G, Berman AJ, Burke K. Fundamentals of nursing. 8 edition. New Jersey:Prentice-Hall, 2008;
p.1089.
Page 48 of 128
Explain the role of the family with regard to the socialisation process.
[10]
An infant becomes a human being with a set of

attitudes and values
Likes and dislikes
Goals and purposes
Patterns of response
Self concept
These are obtained through socialisation
The first group with whom the child comes into contact is the family
This is the primary agent of socialisation
Through association with the family and especially the mother
(grandmother, primary caregiver in some cases) the child learns what is expected of him
He learns responsibility and self control
He learns that he cannot always get what he wants
and has to subjugate his wants for the greater good of the family
In the family he learns language
He learns his place and role in the family eg oldest child
He learns acceptable behaviour eg please and thank you
He learns to control bodily functions
He learns the norms of his culture from the family
He learns right and wrong in a nurturing group
He learns what his role will be as an adult in his culture from his family
He learns how to have social relationships
Reference:
du Toit DA, van Staden SJ. Nursing sociology. 4th edition.
Pretoria: Van Schaik, 2009; p. 144.
Study Guide LU 1.5 additional notes.
The nursing programme at your college is being reviewed and a suggestion has been made to
exclude Sociology as a subject.
Present the information you would give to motivate for the retention of Sociology.
[6]
Answer:
Sociology can help with social relationships
- as members of society nurses have many social relationships with a variety of individuals, in
their own lives and with people with whom they work in various settings
To give holistic care

the nurse must know the variety of individuals she cares for, in his/her totality
i.e. as a member of some family or social structure
Nurses often work in a formal organisation
and sociology can help the nurse understand the structure and norms of behaviour
as well as maintaining good relationships with other health care professions
As sociology provides scientific knowledge about different cultures
sociology promotes understanding of the clients of health services in our culturally
diverse society
and allows the nurse to individualise
nursing care
e.g.health education to patient living in informal settlement
Page 49 of 128
Sociological knowledge can help with understanding of the complex functioning of health
care settings
and of the many groups, factors that play a role
e.g. family, socio-economic status
Reference:
du Toit DA, van Staden SJ. Nursing sociology. 4th edition. Pretoria: Van Schaik, 2009; p. 1-4.
With reference to social mobility, describe the potential impact of the economic recession on
workers in the motor industry.
[4]
Social mobility is the movement of an individual from one social status or class to another
Determinants of social class include occupational
and income status
If people lose their jobs or have to do the same jobs for lower pay , downward mobility on the
status ladder occurs
Downward mobility may have many negative consequences
e.g. stress, depression, suicide ,family problems
Reference:
du Toit DA, van Staden SJ. Nursing sociology. 4th edition. Pretoria: Van Schaik, 2009; p.96.
Nursing is a unique and organized profession.

Describe ten (10) criteria needed for the recognition of nursing as a profession.
[10]
It is characterized by:
A large body of specialized theory with well developed technical skills based on the theory
The use of theory from the sciences and other fields of learning relevant to its practice
A long period of specialized preparation at a recognized educational institution
The testing of professional competence before admission to the ranks of the profession
Some recognized form of registration and license to practice
Self organization leading to the formation of the professional association and a self governing
body controlling professional standards
Ethical control of professional conduct by its own members
A motive of service based on the needs of the client for professional assistance irrespective of his
ability to pay for services rendered
The welfare of the client is the overriding consideration
High degree of professional accountability to the public, the client and the employing body
and other members of the profession
A feeling of exclusiveness
Recognized status in law
High social status and considerable social power
Performance of activities based on an understanding of what is involved in these activities so that
the results of acts and omission can be predicted
Constant critical analysis of its activities leading to the modification of practice the light of this analysis
This leads to discarding of what is no longer relevant in favor of what is of more use in the carrying
out of the activities related to the nature of the occupation
The ability of its members to select in a responsible manner, the activities of intrinsic importance to
its practice
Individual member being allowed the maximum use of discretion and initiative in practice.
Independent functions and accountability for their performance are inherent
Page 50 of 128
Reference:
nd
Mellish JM, Paton F. Introduction to the ethos of nursing:a text for basic student nurses.2 edition.
Sandton: Heinemann,2004;p:98-106.
According to Regulation R387, a nurse may not divulge information concerning a patient
which has become known to him/her.
List the situations when this rule does not apply.
[5]
With the explicit consent:
of a patient who is of age
of the parent/guardian of a patient who is a minor
of the surviving spouse
or the child who is of age
or the patient who is deceased
where instructed thereto by a court of law
or where a nurse is otherwise lawfully bound thereto
in the exclusive interests of a patient who is not able to or is not capable of
granting permission
or in a professional consultation with anybody involved in the treatment of the patient
or in the exclusive interest of the patient, with somebody else
Reference:
Regulation R387 p 6-7.
Discuss the risks that may be involved when acting as an advocate on behalf of a patient.
[3]
The nurse may experience conflict and opposition
And she must be capable in dealing with it
Opposition may be from the doctor, nursing colleagues, and hospital authorities
The nurses first concern may be for her job and career, because she might be dismissed
Another source for concern is her collegial relationship with the doctor which must be
maintained
The working relationship with the doctor may suffer if she acts as an advocate for a
patient where she believes that the doctor has failed
Reference:
nd
Pera SA and Van Tonder S. Ethics in health care.2 edition.Cape Town:Juta, 2005; p.51-52.
Explain the term autonomyas it applies to nursing.

The principle of autonomy holds that people have the right to determine their own
actions based on their values and beliefs
Autonomous decisions needs adequate information , are free from coercion and
are reasoned and deliberate
[2]
Reference:
nd
Pera SA and Van Tonder S. Ethics in health care.2 edition.Cape Town:Juta, 2005;p.32-33.

Labour relations
[2]
The regulation of relationships between collectives such as worker,s organizations, unions,
Employer associations and individual company managements
Primarily concerned with negotiations and consultations about conditions of employment
Page 51 of 128
And all decisions directly affecting employees
Mediation
[2]
Procedure in terms of which an independent and impartial third party attempts to assist the
parties in a dispute to reach a settlement
The mediator does not make the final decision
Arbitration
[1]
The procedure in terms of which an independent and impartial third party hears both sides
in a dispute and gives a binding decision.
Reference:
nd
Booyens SW. Editor. Dimensions of nursing management. 2 edition.Pretoria:Juta,1999;p.685.
Culture plays an important role in our society.

Summarise the characteristics of culture and give an example of each
Culture is an exclusively human product eg. Language
Culture is acquired behaviour eg. Values
Culture is the common property of members of a community or group. Eg. patterns of
behaviour.
Culture is dynamic and cumulative eg. advances in technology
Different cultures display a high degree of similarity eg. marriage as a form of a family
system
Culture differs from society to society. Eg. Symbols
[3]
Reference:
th
Du Toit DA, van Staden SJ. Nursing Sociology. 4 edition.Pretoria: van Schaik,2009; p20.
Distinguish between the following concepts:
Culture and sub-culture

Culture:
The total of the man made environment and products
Material and non material that is carried from generation to generation
[2]
Sub-culture:
Culture of a smaller social group within a society
That is not in conflict with the general culture.
Cultural shock and cultural lag

Cultural shock
A feeling of disorientation, surprise or shock which is experienced
When an individual is confronted with cultural practices of a different culture.
[2]
Cultural lag
The period during which a groups norms and values
Has not yet adapted to new material conditions.
Sanctions and norms
Page 52 of 128
[2]
Sanctions:
A reward for conforming to norms
Or a punishment for non conformance
Norms:
Social rules of conduct or precepts
Specifying how people should behave in a specific situation.
Reference:
th
Du Toit DA, van Staden SJ. Nursing Sociology. 4 Edition.Pretoria: van Schaik, 2009; p46-47.
Outline the functions of the socialization process and give an example of each.
Establishes certain basic principles
e.g. toilet habits
Gives an individual an identity
e.g. gender
Teaches a person social rules
e.g. fulfilling social roles
Teaches the individual certain skills
e.g. language
[4]
Reference:
th
Du Toit DA, van Staden SJ. Nursing Sociology. 4 Edition.Pretoria: van Schaik, 2009; p49 - 50.
Socialization agents play an important part in the development of the individual. Analyze the
influence of the following two (2) socialization agents:
The school
Secondary socialization starts when
the individual goes to school
And continues with tertiary education or the work environment.
Involves the individual moving into and internalizing knowledge of new areas of life.
Children learn new values ,
attitudes and
views on life and
the world
from teachers.
They learn to be part of a peer group and
to interact in a group context.
Learn the concept of universality ie.
The same rules apply and sanctions apply to all pupils
irrespective of who their parents are.
The school is a preview of what the adult social world is all about.
Students are developed intellectually,
Physically
Physically
morally
The school aims to develop a well intergrated socialized person
who will grow up to be a socially responsible adult.
Page 53 of 128
[10]
The peer group

[3]
Often the peer group offers better guidance concerning aspects that are important for
the individual at that stage of his life.
Such as whether to take drugs or not, music, dress ,etc
Peer group has similar interests to those which are important to the individual at that stage
of his life.
Individual has to conform to belong to a group.
Conformance is either positive or negative.
Gives the individual a sense of belonging ,
especially if he is a victim of family disorganization.
Reference:
th
Du Toit DA, van Staden SJ. 2009. Nursing Sociology. 4 edition.Pretoria: van Schaik,2009;P 58-62.
In an effort to improve the quality of nursing care rendered, each unit in your hospital has
been given a topic to research. As the nursing unit manager, you will be required to lead the
research project undertaken in your unit.
Describe any eight (8) ethical considerations to be kept in mind as you guide your team through
this project.
[8]
Quality of the researcher and the research project
Identity, qualifications and the experience should be known to the participants
Researcher has to adhere to highest possible standards
Must not attempt projects beyond ability and knowledge
Confidentiality and anonymity
Information a participant wants to keep secret is not revealed
Anonymity of people and institutions should be protected by making it impossibleto
link information to them
Informed consent
Researcher has obligation to respect privacy of participant
And to ensure that he/ she knows the purpose of the research
Written consent must be obtained from participants
If minors are used, their parents must consent for them
Privacy
Protection of privacy of participant during data collection
Therefore researcher cannot use concealed media
Termination
Any project that does not adhere to standards formulated in planning phase is to be
terminated
Any participant can terminate at any stage
Convenient groups
It is unethical to use convenient groups like prisoners because they are easy to recruit
Page 54 of 128
Deceiving participants
Researcher is not allowed to deliberately mislead participants
By withholding information or giving incorrect facts
Publication of research findings
Researcher has a responsibility to ensure that the data is accurate, clear, objective
and honest
Debriefing of participants
This can minimize/ correct harm suffered by participants
Benefits and risks
The possible benefits to be obtained should be weighed against risk to participants
Reference:
nd
Meyer S, Naude M, van Niekerk S. The nursing unit manager. 3 edition. Johannesburg: Heinemann, 2009;
p.392-397.
Brink H. Fundamentals of research methodology for health care professionals.
2nd edition.Cape Town: Juta,2006; p31-35
Match the research terms in column A with the explanation in column B.

Write only the number of the question and the letter you have chosen e.g. 7 H
[6]
COLUMN A
1. Literature review
COLUMN B
Respondants or subjects drawn from the accessible population
2. Sample
Is conducted to find out precisely what is known about the topic.
3. Pilot Study
It provides a statement of a researchers expectations about a specific

relationship between two variables
4. Hypothesis
The characteristics of a person or object that varies.
5. Variable
Is the overall plan for gathering data in a research study
6. Research design
An instrument containing a set of questions
A trial run, done in preparation for a major study
ANSWER
1.
2.
3.
4.
5.
6.
B
A
G
C
D
E
Reference:
nd
343-359.
Page 55 of 128
One of the characteristics of a role model is someone who acts or behaves in the manner
expected of a person who holds such a position.
To meet the above criterion, describe the behaviour you would expect from a nurse with
regard to ETHICAL aspects of practice.
[8]
The nurse must conserve life
promote health
alleviate suffering
and provide highest standard of care at all times
Shows respect for the dignity of human beings
e.g. irrespective of religion
and provides care according to need
Appropriate use of knowledge
Avoids harm to her patients
and does not participate in illegal acts
pertaining to the welfare of her patients
Keeps in confidence what she learns about her patient
she has a duty to protect the safety of her patient`s name
She observes all legislation relating to the provision of health care
She is accountable for her acts and omissions
and accepts responsibility for the care of her patients
The nurse does not advertise
As this could mislead the public
Reference:
Searle C, Human S, Mogotlane SM. Professional practice:a South African nursing perspective.5
Sandton: Heineman, 2009; p.53-54.
th
edition.
Most nurse theorists identify four (4) major components common to nursing practice
1. Describe Florence Nightingales views on the environment.
Florence environmental aspects
Warmth
Diet
Cleanliness
Ventilation
Light
absence of noise
[3]
2. Explain Virginia Hendersons views on nursing.

Virginia Henderson nursing
a unique function
to assist individuals sick or well
to perform activities that contribute to health
[2]
3. Name the unifying focus for nursing practice according to Jean Watson.
Caring
Page 56 of 128
[1]
Reference:
Young A, editor. Jutas manual of nursing: health care priorities. Volume 1. Lansdowne: Juta, 2005;p. 13.
Berman A, Snyder SJ, Kozier B, Erb GL. Kozier and Erb`s fundamentals of nursing:concepts,process and
th
practice. 8 edition. Pearson:New Jersey, 2008; p 47
A patient who was admitted to your ward is suing the hospital because of an error that
occurred due to poor record keeping.
Summarise the basic principles of record keeping that you need to include in the in-service
education plan for your staff .
[7]
Include the date and time in all entries in patients records

Ensure that all pages are numbered
Unclear signatures must have names written next to them
All signatures must be followed with clear designation
Patients records may not be erased or overwritten, as they are legal documents
Any correction or addition to the existing entry must be dated and signed
Records should be clear and unambiguous
Do not use abbreviations, except international acceptable abbreviation
Nursing records must be in a scientific order using correct terminology
Records should be clear, concise and relevant. No silly remarks
Entries should be made after completion of each procedure e.g. medication
To prevent danger of not doing the procedure at all
Records of patient care should be complete and include all aspects of patient care
Records should be filed carefully in a chronological order
Reference:
rd
Meyer S, Naude M, Shangase N, van Niekerk S. The nursing unit manager: a comprehensive guide.3
edition.Sandown : Heineman, 2009; P.331 - 332
You are a Unit Manager. Discuss the actions you would implement in your unit to safeguard the
physical safety of patients, staff and visitors.
[8]
Display signs to indicate wet slippery /floors or
Areas with X Ray or other radiation risks
Fit cot sides to the bed of children, elderly and confused patients
Children and all patients who move with difficulty must be accompanied to the bathrooms
Bathrooms pose a threat as children may drown and
All bathroom floors must be kept dry to avoid slip and falls
In paediatric nursing units door handles should be out of reach of children
In paediatric nursing units doors should be kept locked
In paediatric nursing units and Maternity units special precautions must be taken against abduction of
babies and infants
Visitors must be limited in these units
Staff working in high risk areas should wear protective clothes and monitoring devices
All equipment should be maintained and in good condition
Broken equipment must be repaired or replaced
All staff must be taught how to use equipment safely
A safety committee must be established in a unit to work together with institution safety committee
Safety committee must focus on the management of risks in a unit
Reference:
Page 57 of 128
Meyers, Naude M, Shangase N, van Niekerk S. The nursing unit manager: a comprehensive guide.3
edition.Sandown : Heineman 2009 P.321 -322
rd
According to the Patient`s Rights Charter, patients have the right to informed consent.
Describe the information that needs to be supplied to the patient to ensure that this right is
upheld.
[3]
The significance of any diagnostic procedures
The proposed treatment
The probable and reasonable side-effects and risks related to this interaction
The alternative diagnostic procedures or treatments that are available
The possible costs involved
How treatment could impact on lifestyle
Reference:
th
Muller M. Nursing dynamics. 4 edition. Johannesburg: Heinemann, 2009; p.16.
Discuss the assessment phase of the scientific method of nursing using the following
headings:
1. Definition
It is a systematic process of gathering,
verifying and
recording data about a patient
It is interactive, involving nurse,
Patient
and any other person
who can help define the patient`s health needs
2. Sources of data
The patient during interview and physical assessment
Relatives e.g information re lifestyle, identification of specific needs
Healthcare team member e.g docter, other nurses involved in care
Medical records e.g. can identify patterns, response to treatment
[3]
[4]
Reference:
nd
Meyer S, Naude M, Shangase NC, van Niekerk S. The nursing unit manager. 3 edition. Johannesburg: Heinemann, 2009;
p.49-50.
List four (4) reasons for writing an incident report.

To inform management of a problem
so that they can handle any complaints/queries that may arise from it
It reflects the facts that may be required at a later stage
when detail can no longer be remembered
The integrity of staff
and responsibility of actions can be proved
To serve as evidence
in a formal investigation or court case
Reference:
th
Match the term in column A with the description in column B. Write only the number of the
Page 58 of 128
[4]
question and the letter you have chosen e.g. 7 = h

Column A
[5]
Column B
1. Mediation
Consists of discrimination, unfair conduct relating to

training, promotion and demotion of benefits.
2. Labour relations
The formal process adopted whenever an employee breaks the

rules of the undertaking/commits any other act which might be
in breach of the contract of employment.
3. Unfair labour practice
To protect against loss or injury
4. Arbitration
Refers to all aspects and matters between employer and employee.
5. Disciplinary procedure
It is a procedure in terms of which an independent and impartial third

party hears both sides of a matter and gives a binding decision
Involves the ability of management to direct and influence the

action taking place in an organization and directs employees
It is an active intervention of a third party for the purpose of

inducing settlement.
Answer
1.
2.
3.
4.
5.
g
d
a
e
b
Reference:
nd
Booyens SW. Dimensions of nursing management. 2 edition. Cape town: Juta & Company Ltd, 1999; ch 29
Illustrate how you, as a Registered Nurse, will promote team building in your unit.
Maintain good interpersonal relationships with subordinates
Motivate, guide and direct personnel towards a high standard of work
Deal with problems honestly and fairly
Be strict, but easily accessible and available to all personnel
Listen to others point of view
Give encouragement to all personnel
Recognize the value of each member of the team
Communicate to the team that each member has a vital part to play to achieve
optimal patient care
Encourage a spirit of learning from each other
Build up an atmosphere of high morale by encouraging trust
and loyalty to each other
Provide for physical needs of the personnel such as
tea/coffee and meals
Page 59 of 128
[7]
Stimulate the intellectual abilities of the personnel by means

of training and the promotion of critical thinking
Reference:
th
Muller M. Nursing dynamics. 4 edition. Johannesburg: Heinemann, 2009; p174-177.
Justify the reasons for the implementation of a quality assurance program in a nursing unit.
[ 10]
Professional accountability
One of the characteristics of professionalism is the pursuit of excellence and the desire to
regulate ones own performance
The professional health practitioner is professionally-ethically accountable for his/her acts
and omissions
Financial Considerations
Prevention of legal action taken against health care institutions
Quality care should reduce length of stay and therefore cost of care
Quest for excellence
Health care professionals realize they need to define and prove that they provide quality care
Staff should be given the opportunity to initiate and implement Quality innovations to show
that they are striving to be the best
Marketing of health services
The proven evidence of quality care could serve as a marketing tool for the health institution
Internal desire to position oneself
The last reason for formalized quality, is that man has an internal desire to compare
his/her performance against that of another
The health care professional and the organization can become competitive
Reference:
th
nd
Booyens, J.W. 2004. Dimensions of Nursing Management. 2 edition. Landsdown. Juta Pg. 599
Explain the value of policy and procedure manuals in a nursing unit.

Policies prevent temporary problems from becoming permanent
They protect the employer, employee and the patient
Promote interdepartmental co-ordination
Are of great value in orientating and training of personnel
Ensure consistent treatment of all personnel,
Favouritism and discrimination is minimized
It prevents conflict and promotes fairness
Continuity of action is ensured even though top management personnel may change
Policies promote stability
Policies serve as a standard of performance:- actual results can be compared against
the policy
They help to build employee enthusiasm and loyalty
[5]
Reference:
rd
Booyens SW. Introduction to health service management. 2 edition. Cape town: Juta & Company Ltd, 1999;
p 200-202.
Page 60 of 128
rd
Meyer SM, Naude M, Shangase N, van Niekerk S. The nursing unit manager: a comprehensive guide.3 edition.
Sandown : Heineman, 2009 ;p.199-204.
Describe the principles you would implement to improve productivity in your ward
Monitor absenteeism and
identify reasons so as to try and reduce absenteeism
If staff turnover is too high, have a strategy to reduce this
Apply effective time management in the ward
Group duties/responsibilities to avoid unnecessary duplication
Non nursing duties can be delegated to other categories of staff
Determine the workload of the unit to
calculate the number of staff required
Have a policy regarding working overtime
As well as a policy regarding time off when there is reduced patient workload
Personnel organization to be done
Promote harmony amongst staff
and quality work amongst staff
as well as the welfare of the staff
Ensure competencies of all staff and
monitor and supervise staff
[8]
Reference:
Muller M. Nursing dynamics. 4th edition. Johannesburg: Heinemann, 2009; p.311
Define the process of quality improvement

A formal process
where standards are set
work performance is monitored and evaluated
Remedial steps taken to counteract problems
[2]
Reference:
Muller M. Nursing dynamics. 4th edition. Johannesburg: Heinemann, 2009; p.257.
Illustrate the value of patient records as a monitoring strategy in the unit.

The content of patient records
is studied to establish if it meets set standards
Can be done continually
eg can do spot checks during care rounds
Or retrospectively after discharge
[2]
Reference:
Muller M. Nursing dynamics. 4th edition. Johannesburg: Heinemann, 2009; p. 262.
Name the four (4) concepts that are used to define nursing theories.
The human or individual
Society or environment
Health
Nursing
[2]
Page 61 of 128
Reference:
George JB. Nursing Theories The Base for Professional Nursing Practice. New Jersey: Appleton and Lange,
1995; p. 1.
Summarize the responsibilities of the registered nurse towards the profession

Maintenance of high standards of professional practice
Maintenance of a professional dress code and behaviour
Maintenance of interest in and support for activities which advance the profession.
Adherence to the accepted code of nursing ethics in all her professional activities.
A duty towards herself.
[2]
Reference:
nd
Mellish JM, Oosthuizen A, Paton F. An Introduction to the Ethos of Nursing. Sandton: 2 ed.
Heinemann, 2010;p185
Differentiate between the independent and dependent functions of the nurse
[7]
Independent function:
Her usual prescriptive, organizational and implementation functions in the nursing process
involve all the factors inherent in nursing assessment, diagnosis, treatment and care.
She must carry out her duties as a registered nurse in the appropriate manner
regardless of whether these are interdependent or independent functions
She is totally responsible and accountable for her actions
and the doctor cannot be held accountable for them.
She, and only she, can decide whether she has the knowledge and competence, and.
whether the act would be legally and/or ethically permissible for her to participate in or carry
out on her own
She has a duty to act responsibly within the parameters of her scope of practice,
The legal and ethical constraints, and her own level of competence ( except in
an emergency).
Dependent function:
To obey the law that authorizes her practice,
as well as common and relevant statutory laws.
She is dependent on the Nursing Act and its regulations for every aspect of her professional
role and function.
The law includes decisions given by the courts on the interpretation of the law.
She can function as a nurse only if she is either registered or enrolled.
She is dependent on the law to perform certain functions.
Reference:
th
Searle C, Human S, Mogotlane SM. Professional Practice A South African perspective.5 ed. Sandton:
Heinemann,2009; p110
Define the following terms according to R2598:

Health needs
Those signs, symptoms and processes which denote the individuals interaction with
any actual or potential health problem and which require nursing interventions.
Page 62 of 128
[1]
Co-ordination
[1]
The bringing together of the acts of members of the health team to meet the spectrum of
identified health needs of an individual or a group.
Diagnosing
[1]
The identification of and discriminating between physical, psychological and social signs
and symptoms in man.
Nursing regimen
[1]
The regulation of those matters which, through nursing interventions have an influence
on the preventative, promotive , curative or rehabilitative aspects of health care
And includes the provision of nursing care plans, their implementation and evaluation
thereof and recording of the course of the health problem
The health care received by a patient and its outcome whilst a patient is in the charge of the
nurse.
Prescribing
Giving the written directions regarding those treating, nursing care, co-ordinating,
collaborating and patient advocacy functions essential to the effective execution and
management of the nursing regimen.
[1]
Reference:
R2598
Discuss the principle relating to restriction of advertising by a registered nurse.

[4]
The registered nurse should be known to patients, other nurses and doctors by the quality of
her service.
The restriction of advertising by a nurse is aimed at the protection of the public.
The public is not in a position to judge whether the advertising is inaccurate or misleading.
This principle is also essential in order to maintain sound inter-professional relations.
Advertising may denigrate the abilities of her colleagues whilst attracting personal gain
to herself and misleading the public.
She cannot advertise or recommend commercial products to the public although she may be
a representative for a commercial organisation.
She may not attach her name to any health care product, instrument or appliance or
advertise these items.
to protect the public against possible exaggerated or false claims.
She may introduce these products to other registered health care professionals as they are
in a position to assess the quality , content and possible use of the product.
Reference:
R387
Tabulate the difference between autonomy and advocacy.

Advocacy
It is the action the nurse takes to
inform and support the patient
[2]
Autonomy
The patient has the right to determine

his own actions based on his values and
beliefs.
Page 63 of 128
so that he can make the best decision

for himself.
Adequate information is provided and

there is no evidence of coercion
Reference:
nd
Pera Sa, van Tonder S. Ethics in health care. 2 ed. Cape Town : Juta, 2005;p 46, 51
Choose the most appropriate answer from the options provided, for each question:
[4]
1. Applied (practical) research:

a) Aimed at generating new knowledge and validating existing knowledge only.
b) Focuses on the solution of specific problems in nursing.
c) Refers to the systematic action to improve the situation
2. Basic (pure) nursing research:
c) Refers to the systematic action to improve the situation
3. Action research:
c) refers to the systematic action to improve the situation
4. Quantitative research:
a) Analysis through numbers
b) Holistic
c) Predetermined sample size.
Answers
1.
2.
3.
4.
b
a
c
a
Reference:
Meyer SM, Naude M, Shangase NC, van Niekerk SE. The Nursing Unit Manager A comprehensive Guide. 3 rd
ed. Sandton: Heinemann, 2009; p345-347, 346
Describe Virginia Hendersons nursing theory.
Known as the Definition of Nursing theory.
Indicates that the nurse is concerned with the sick or well individual
Even when recovery is not possible and death inevitable.
The individual forms the focal point.
The nurses focus is to help individuals and families to gain independence
In meeting 14 fundamental needs related to breathing, eating and drinking

adequately, and elimination.
Other needs include the need to move, sleep and rest, maintain body temperature
And to keep the body clean and well groomed.
Henderson also lists emotional and spiritual needs
As well as needs related to learning and recreation

Reference:
Page 64 of 128
[5]
George JB. Nursing Theories The Base for Professional Nursing Practice. New Jersey: Appleton and Lange, 1995; p. 3.
According to R2598, the registered nurse must ensure that every nursing action is
implemented legally and ethically.
Discuss how the registered nurse would uphold the regulations and avoid illegal actions.
[5]
The Registered nurse must:
Demonstrate an in-depth understanding of all the laws and regulations relevant to nursing
and health care.
Practice nursing in accordance with the laws and regulations relevant to nursing and health
care.
Create and maintain an enabling environment for ethical nursing practice
Practice nursing in an ethically justifiable manner, in accordance with the standards set
by the profession
Accept and assume accountability and responsibility for nursing acts and omissions
within the legal and ethical parameters of a changing health care environment.
Reference:
R2598
Searle C, Human S, Mogotlane SM.Professional Practice- A South African Perspective. Pretoria:
Heinemann, 2009; p. 179-180.
Briefly discuss quantitative research using the following headings:

1. Characteristics
Content is broken down
Focus is concise and narrow
A lot of generalisation
Analysis through numbers
Data is collected through instruments such as questionnaires
Linear process(uses the research process)
Literature study done before data collection and analysis
Validity and reliability used as validation
[4]
2. Aims of the different types of research
[5]
Descriptive research:
To obtain complete and accurate information about a specific occurrence , aspect or
phenomenon in real life situations
Correlation research:
To systematically investigate the relationships between or among variables.
Quasi-experimental research:
To examine the cause and effect relationship between variables
Experimental research:
To predict and control selected phenomena in nursing practice
Evidence-based research:
To achieve the appropriate balance of sound theory and relevant empirical evidence to
make the best decisions
Page 65 of 128
Reference:
Meyer SM, Naude M, Shangase NC, van Niekerk SE. The Nursing Unit Manager A comprehensive Guide. 3 rd
ed. Sandton: Heinemann, 2009; p345-347
Differentiate between the following: Tabulate your answer.

1. Mediation and arbitration
2
MEDIATION
active intervention of a third party
to induce a settlement
ARBITRATION
when an independent, impartial third party
hears both sides and gives a binding decision
2. Collective bargaining and Centralised bargaining

COLLECTIVE BARGAINING
formal negotiation process between
representatives of the employer
falling within the parameter of the
service contract
and recognition agreement and the law
a legally binding agreement is reached
includes things like hours of work

- remuneration
- performance
- appraisal
- staff development
- the agreement forms the basis for
- resolution of any disputes of the same
nature
[7]
CENTRALISED BARGAINING
an industry negotiates collectively
to determine the industrial norm
similar to collective bargaining
employers association represents
the employee
Reference:
Labour Relations Act,1995 (Act 66 of 1995)
Explain the term informed consent.

consent for provision of a specified health service
given by a person with legal capacity to do so
user has the right to participate in any decision affecting their health/treatment
consent required prior to any treatment, examination or assessment
the right of a competent adult patient to give/withhold consent
[2]
Reference:
Brooker C Waugh A, van Rooney D, Jordan P.J. Foundations of nursing practice:
Fundamentals of holistic care. African ed. Edinburgh: Elseriver,2009: p 122 - 123
Name the factors to be taken into consideration in order to provide successful health education. [3]
target group
age
Page 66 of 128
language preference
culture and beliefs
environment
sex
length of time
pre-requisite knowledge
Reference:
rd
Meyer SM, Naude M, Shanghais. The Nursing Unit Manger. 3 ed. 2009. p 178 -180
The scientific method of nursing includes assessment of patients.

Interpret the purpose of assessment.
to collect a data base for
identification of all problems
identification of high risk factors
egg allergies, communication barriers
habits which constitute a health hazard
impressions of patients physical, emotional and social status
identification of any special assistance required for personal needs
future progress assessments on individual problems
forming a bond of trust with the client
inform the patient
commence health education
prepare the patient psychologically for hospitalization
[6]
Reference:
rd
Meyer SM, Naude M, Shanghais. The Nursing Unit Manger. 3 ed. 2009. p 49-76 Berman
A.J, Snyder S.J, Cozier B, Erg G. Cozier and Ergs fundamentals of nursing Concepts,
th
process and practice. 8 Edition. New Jersey: Prentice Hall, 2008; p 196,198
Explain the term nursing diagnosis.

a statement of a judgement made by
a professional nurse
regarding an actual or
potential health problem
that occurs in association
with a patients current health status
that require nursing intervention
that professional nurses
are required to make
and for which they are held accountable
[5]
Reference:
rd
Meyer SM, Naude M, Shangase. The Nursing Unit Manger. 3 ed. 2009. p 49-76
Berman A, Snyder SJ, Kozier B, Erb GL. Kozier and Erb`s fundamentals of nursing:concepts,process and practice.
8th edition. Pearson:New Jersey, 2008; p196,198
Define the following terms:

Ethnocentrism
[1]
Page 67 of 128
Ethnocentrism is a belief that elements of their own culture are superior to those of other
cultures
Xenocentrism
[1]
Xenocentrism is a belief that the elements of another culture are inferior to those of their
own. It is the opposite of ethnocentrism
Stereotyping
[1]
Stereotyping is a standardised belief or idea of a type of thing or person e.g. all white people
are rich
Reference:
rd
Du Toit D A and van Staden S J. 2005. Nursing sociology. 3 Edition. Pretroria: van Schaik p 35
Child X, 5 years old is admitted to a hospital far from his home.

He is in hospital for 3 weeks and because his parentshome is far away, they are only able to
visit him at the weekend.
Describe the behaviour that the child might exhibit as a result of mat ernal deprivation and
your interventions to manage this behaviour.
[9]
Behaviour:
Anxiety and insecurity,
becomes overdemanding
Socially irresponsible behaviour
and regression
e.g. bedwetting, temper tantrums
Becomes so unhappy, escapes into fantasy world
When mother does visit, distrusts her, might ignore her totally
feels abandoned so turns to own body for comfort
e.g. thumb sucking, rocking, head banging, nail biting etc
Interventions:
Do not label the child as naughty
This will lead to a lack of empathy amongst staff
Explain what is happening in non-threatening words
Give positive reinforcement when child cooperates
Reassure the child that hospitalisation is not a punishment
The child will go home again, he has not been abandoned
Remind him that his parents will be coming at the weekend
Explain why they are unable to be there all the time
Reference:
Study guide
Young A. (Editor) 2005. Jutas Manual of Nursing Volume 3 Lansdowne: Juta
Discuss the sociological concept sanctions giving examples where appropriate

[6]
Sanctions are the consequences of not conforming to norms,
they may be positive
or negative e.g punishment or reward
Positive sanctions can range from a smile, a well done or something material like a cash
bonus or a medal
Page 68 of 128
Negative sanctions show disapproval and can include a fine, a frown, termination of
employment etc or ignoring someone
Sanctions are corrective
They are not meant so much to punish as to rehabilitate
Sanctions are used to teach children acceptable behaviour as part of socialisation
After a while children obey the norms of a culture even when there is nobody to observe
them
e.g stealing, potty training
Reference:
rd
Du Toit D A and van Staden S J. 2005. Nursing sociology. 3 Edition. Pretroria: van Schaik p 28
List the reasons for the implementation of quality improvement programs in the private
healthcare setting.
[2]
Professional liability/accountability.
The quest for excellence.
Internal desire for positioning.
A competitive market.
Financial considerations.
Reference:
rd
Muller M. Nursing Dynamics. 3 Edition. Cape Town: Heinemann. 2002; p. 201.
Describe auditing as a monitoring strategy for quality nursing care.

[5]
Auditing is an evaluation method for assessing the quality of nursing
As reflected in the hospital documents.
Continuous auditing is carried out daily by the nursing professionals and the supervisor.
While the patient is still in their care.
Retrospective auditing is done formally on completion of the patients health treatment
E.g. after discharge.
The audit tools should be based on the specific kind of nursing practiced.
Nursing care is measured against the set standard.
The audit tool should be valid and reliable.
Assessment data should be assessed and action plans implemented to prevent
reoccurrence.
Reference:
nd
Booyens SW. Dimensions of Nursing Management. 2 Edition. Cape Town: Juta and Co. Ltd, 2002; p. 610.
You are a newly qualified Registered Nurse appointed in the medical ward. The unit manager
tells you that her personnel do not like the ward and that 4 had resigned in the last month.
Therefore, the personnel are stressed and there are not enough on duty to cover the shifts.
The blood pressure machine is not working today and the maintenance department has not
been able to fix it yet. The Enrolled Nursing Auxilary phoned in sick this morning and the
agency nurse that should replace her, is still on her way. You observe that the unit manager
looks anxious and she tells you that she is close to tears.
1. Analyse the scenario and identify the factors in this ward that has a negative influence on
productivity.
[3]
Page 69 of 128
Absenteeism of the ENA.

Knowledge, skill and experience of personnel (newly qualified and novice agency nurse).
Availability of equipment and supplies BP machine broke
Planning and organisation of the unit not enough personnel
Management and leadership style in the nursing unit UM not in control
Commitment of personnel resigned
Low quality of work life of personnel sick and stressed
Reference:
nd
Meyer S, Naude M, Van Niekerk S. The nursing unit manager. 2 Edition. Johannesburg: Heinemann, 2004;
p. 164.
2. Devise a plan for use in this unit to improve their productivity.

[5]
Improve methods of work performance by ensuring there is enough equipment by borrowing
a BP machine from another ward or getting maintenance to fix the broken one
The workload should correspond with the number and the categories of personnel
Encourage personnel to help each other or use the team method of nursing to care for
patients
People are more productive when they find their jobs meaningful.
Ensure that personnel know what theyre supposed to do and delegated tasks
are understood
Productive staff is well-organised staff
UM should prioritise and manage the unit and her staff effectively
The classification system of patients should be in place to determine the number of hours of
nursing care that each patient requires and the number of personnel which the unit should
have
The acuity should be completed and personnel requirements determined
Reference:
nd
Booyens SW. Dimensions of Nursing Management. 2 Edition. Cape Town: Juta and Co. Ltd, 2002; p. 576.
Summarise the reasons for performing research in nursing.

[5]
The RN in the nursing unit is in continuous contact with the patients and is in the ideal
position to do clinical research, using co-workers to act as field workers to collect data
Self care theories can be used because nursing actions are based on holistic care
while medical care tends to be fragmented and aimed at specialization
Research should be congruent with nursing theories
The researcher can apply the principals of the theory and apply them in a specific context in
order to assess and describe the outcomes thereof
Multiple and unique variables also impact on nursing practice and the nursing unit, and
therefore continuous research needs to be done to ensure updated and continuous quality
nursing care on a comprehensive basis
Nursing research is conducted to improve nursing care and to ensure that patients receive
the best possible nursing care
Nursing research includes research regarding topics such as nursing management and
nursing education
Nursing education research can impact on the training and practice of nurses and
nursing research may influence nursing management
For nursing to develop and grow as a profession and as a science, it is important that current
knowledge is validated and refined and new knowledge created
Nursing research enables the profession to grow
Through research, nurses can explore how and why things are done
Page 70 of 128
Nurses are professionally accountable for their actions. Nursing actions should be based on
research that was done to validate actions
There is an important relationship between the existing theory of nursing, nursing research
and the practice of nursing
Research in nursing usually originates in the clinical setting, whereas research reports
may influence the theory of nursing as well as the practice thereof
With research it can be established how nursing and nursing research differs from other
health disciplines
Reference:
nd
Meyer S, Naude M, Van Niekerk S. The nursing unit manager. 2 Edition. Johannesburg: Heinemann, 2004;
p. 251.
A sound nurse-patient relationship is dependant on good communication. Being available

or Attending is one of the most important skills that must be acquired in this regard.
1. Explain the reasons why the above statement is true.
[2]
It implies the nurse is aware of the purpose of the interaction and that her full attention is
focused on the patient
It implies interest , expectancy, readiness and attentiveness
2. Describe the non-verbal behaviour of the nurse that would convey the messages implied
by being available
[2]
Ignoring or eliminating distractions
Looking directly at the patient as opposed to gazing about the room
Remaining quietly composed as opposed to fidgeting in the chair
Sitting erect and slightly forward as opposed to leaning back and away from the patient
Reference:
th
Kozier B, Erb G, Berman AJ, Burke K.Fundamentals of nursing.6 edition. New jersey:Prentice-Hall,2000;
p 437 439.
Match the statement in column A with the applicable defence mechanism in column B.
Write only the number of the question and the letter of the correct answer e.g. 1.6 = g
[ 5]
Column A
Jan is paralysed but has mastered the art of painting with his mouth
2. A patient is angry with his wife and shouts at the nurses
3. A person with terminal carcinoma does not accept the fact that
he cannot continue working
4. A toddler resumes drinking from a bottle on being admitted
to hospital
5. A student regularly forgets her dentist appointment
Answer
1.
2.
3.
4.
5.
a
b
c
Column B
Projection
Compensation
Repression
Denial
e
f
Identification
Regression
b
a
d
f
c
Page 71 of 128
Reference:
th
Kozier B, Erb G, Berman AJ, Burke K.Fundamentals of nursing.6 edition. New jersey:Prentice-Hall,2000;
p 956-957.
Summarize the penalties that could be imposed on a nurse if found guilty of professional
misconduct.
[3]
A caution
or reprimand
Suspension for a specific period from practicing
In case of a learner nurse or midwife extension
or suspension for a specified period of a prescribed education and training
Removal of his or her name from the register
A prescribed fine or
Payment of the costs of the proceeding
Reference:
Nursing Act No.33 of 2005 P:33
You have been assigned to orientate a newly qualified registered nurse in your unit.
Plan an in-service training programme for her on how to prevent the spread of infection in a
unit
[8]
Hand washing practices according to hospital protocol
Adhere to safety
and standard precautions according to policy
Careful observation of patient's condition
and reporting possible signs of infection
Supervision of all categories of nursing and other staff re preventative measures
and implement correcting measures where appropriate
To notify line manager if nurse has an infection - not to come on duty
The RN is responsible for the safe practice of all the staff directly under her control
The RN is also responsible for the safe infection control practice of all the staff who
come into the ward, including doctors, physiotherapists etc.
Strict adherence to protocols:
sharps,
management of bodily fluids,
wearing of protective clothing
The RN must therefore make sure that the staff know the correct protective procedures
for each specific patient
Universal precautions must become standard practice in the ward
The RN must ensure that the necessary protective clothing, disinfectants, plastic bags
etc are readily available in the ward
The RN must update her/his knowledge in infection control practice and keep the staff in
the unit informed
The RN must communicate with the infection control sister who will assist her/him with
her infection control function
Unsafe practices and incidents must be reported as per hospital policy
Reference:
Life Healthcare Policies and Procedures. SHEQ Policy
Meyer et. al. (2004)The Nursing Unit Manager, A comprehensive guide P:242
Page 72 of 128
In terms of a Declaration of Human Rights published by the United Nations Organisation in

1984, every human being is free and has rights.
Justify this statement referring to the Patients Rights
[4]
Right to life, freedom and security
Not being subjected to torture or to cruel, inhuman and degrading treatment
Recognition everywhere as a person before law
Equal access for every one to the public service
A standard of living adequate for health and well being which include medical care and
social services
Special care during motherhood and childhood
Healthy and safe environment
Participation in decision-making
Access to health care
Knowledge of ones health
Insurance/medical aid scheme
Choice of health services
Treated by a named health care provider
Confidentiality and privacy
Informed consent
Refusal of treatment
A second opinion
Continuity of care
Complaints about health services
Reference:
nd
Mellish ,J .M &Paton ,F (2000)Introduction to ethos of nursing, a text for basic student nurses.2 edition,
Sandton P:141
National Department of health: patients rights
Prevention of medication errors is an important function of the registered nurse.

Explain the criteria that you would assess to ensure legality of the prescription.
[5]
Date on which the prescription was written should appear
The name,
Quantity
Strength
Dosage
And route of medication must be written
In cases of Schedule 5 and 6 medication, the amount must be written in both figures and words
The prescription must legible
The prescription must have the medical practitioners name, signature and qualification
A sticker with patients name and hospital number must appear on the prescription sheet
Reference:
Fletcher L A, Van Niekerk EC. Control and Administration of medicine.NUR-WP-CP/004 Revision 1.2007;p1
The nursing process is a scientific approach to problem solving that makes quality nursing
care possible.
Summarize the five (5) steps of Scientific Nursing process
[5]
Assessment
Page 73 of 128
Systemic process of gathering information of a patients physical emotional, social

and psychological status
Diagnosing
It is a description made of patients health problems \ needs which will need nursing
intervention
Planning
A holistic and comprehensive care plan on the basis of identified problems
Implementation
Action phase where the nurse uses different methods to deliver nursing care and to monitor
the expected effects of the plan
Evaluation
A planned ongoing activity in which the nurse in co-operation with the patient and other
health care workers determine the effectiveness of the plan and recommends changes
Reference:
nd
p.25.
Describe the general principles of writing an incident report

[11]
A statement form should be completed according to the terms of the policy of the health
institution
Reports must be in triplicate
Write only what has happened
Use clear and unprejudiced language
The statement should be unambiguous and un emotional
Use descriptive terminology
Write legibly and make sure that all copies are legible
It must be factual no conclusion to be stated
To be written chronologically
Not use adjectives
Summarise the facts objectively
Quantify the observable damage e.g. the wound is 10 mm long
Write the report as soon as an incident has happened
Avoid abbreviations that are not medical terms
State the names of witnesses and audiences
Describe the immediate actions taken
State the observations, medical treatment that followed if applicable
State the precautionary measures that have been taken to prevent secondary complications
Add the biographical and medical history of the patient and hospital reference number
The name, rank and signature of a person writing the report must added
Accurate time and date of the event must appear on the report
Adjective such as enormous, terrible, etc. should be avoided
Reference:
Muller M. Nursing dynamics. 4th edition. Johannesburg: Heinemann, 2009; p.16-17
Autonomy refers to the patient`s right to self-determination.

Page 74 of 128
Use examples from your nursing practice to illustrate your understanding of this concept. [3]
The patient is included in decision making in all aspects of his care
e.g. drawing up care plan
The patient`s right to make his own choices is always respected
e.g. accepting patient`s decision to refuse life support
A patient who is not capable of making a free choice must be protected
e.g. protect the rights of an unconscious patient
Reference:
rd
Identify possible reasons why nurses may fail to act as patient advocates.
When taking on role of patient advocate, may face opposition from doctors,
Colleagues
hospital management
May fear for her career prospects if she opposes employer
May be concerned her collegial relationship with docter may suffer
If she acts as advocate where she believes the docter has failed
[3]
Reference:
nd
Pera SA, van Tonder S. Ethics in nursing practice.2 edition. Landsdowne:Juta,2005;p.52.
Poor planning is one of the biggest time wasters.

Discuss the strategies that you will apply to limit this problem.
[4]
Set realistic and obtainable goals and objectives
Establish priorities
Set realistic deadlines and keep to deadlines
Provide alternatives by having an alternative plan ready
Plan for an uninterrupted period of time when a difficult task needs to be completed
Plan the work area and placement of furniture and equipment
Make use of a personal diary that has enough space for writing but that is small enough to
carry around
Always keep the diary up to date
Reference:
nd
Meyer S. Naude M. van Niekerk S. The Nursing Unit Manager: A Comprehensive Guide. 2 Edition. Sandown:Heineman:
2004; pg. 144
Discuss the reasons for quality improvement listed below:

Professional liability/accountability
[2]
All nursing practitioners should be accountable.
Be able to prove that they are doing everything in their power to provide the quality care
The public are also more aware of their rights
There is an increase in the incidence of court cases in which health services are involved
The quest for excellence
Every person has an internal motive/drive to do her best
The above is also reason enough to stand together as a team in the development of
quality improvement program for the nursing unit
Page 75 of 128
[2]
A competitive market
Everyone has a choice as to which health care service he/she wants to utilize
This results in a health service wanting to announce its results to the public for
marketing purposes
The demand for health care services is higher than the supply
The quality results of a nursing unit e.g. the level of patient satisfaction, can be
utilized advantageously and in a professional manner for marketing purposes
[2]
Financial considerations
[2]
When formal quality improvement programs are implemented, the initial financial outlay
may be slightly higher
However, it has been proven, that a nursing unit where a formal quality system is
in operation, functions more cost-effectively, efficiently and safely
Internal desire for positioning
Nurse practitioner compare his/her work performance with that of others
The nursing unit is aware of how it compares with other units in the nursing service
This is another reason for the implementation of a formal quality program in the unit.
[2]
Reference:
rd
Muller M. Nursing Dynamics. 3 Edition. Sandown: Heinemann: 2005: pg. 201 202.
Differentiate between policy and procedure manuals.
[4]
A policy:
Is a written guideline to direct decision-making during a specific action in the nursing unit
It is a rule or prescription that regulates behaviour
It is a plan of action
It is a statement of intention committing management to a general course of action
Procedure manual:
Provides guidelines to ensure adherence to consistent recognized standards of
nursing practice
Shows how a policy must be carried out and supplies a more specific guide to action
Help to achieve a high degree of regularity by
enumerating the chronological sequence of steps in a process
Reference:
rd
Muller M. Nursing Dynamics. 3 Edition. Sandown: Heinemann: 2005: pg 129
Telephone calls are one of the biggest time wasters in the unit.
Apply strategies that you will use to limit this problem.
Plan a block of time for returning calls
Do not phone people during tea and lunch times as they might not be available
Do not phone at the end of the day, as people are in a hurry
Plan each call write down what you want to say
Keep calls short, but friendly
When a person cannot take a call, ask that a message be taken
When put on hold, use time to do filing, sign papers or clear work area
Ask somebody to take calls when you do not want to be disturbed
Page 76 of 128
[4]
Reference:
nd
Meyer S, Naude M, Shangase NC, van Niekerk S. The nursing unit manager. 3 edition. Johannesburg: Heinemann, 2009; p
234.
Distinguish between the following components of an audit schedule

Baseline assessment data established on admission
Critical indicators for care identified
Re-assessment done
Progress Monitoring
Effect of medication/treatment monitored and recorded
Medical prescription updated where needed
Nursing care evaluated
Nursing care plan updated where needed
Appropriate referrals recorded
[2]
Reference:
Life Healthcare patient audit tool
The question Why should a student nursing professional learn about sociology has
constantly been asked.
Analyse this question by stating the reasons why it is necessary for nurses to study sociology.
[5]
Nurses are members of society
Own social relationships
Total, all inclusive care
Hospitals and clinics are structured around rules and regulation of behavior
Certain set of norms and values being set by society
Scientific knowledge about different cultures in our rainbow nation
Knowledge of society where your patient exist in order to give correct health
education and making a correct nursing diagnosis, rehabilitation
Nursing is part of a complex whole in a society
Insight into socio-economic status of patients and the impact that it has on their health care
Reference:
Brooker C, Waugh A, van Rooyen D, Jordan PJ. Foundations of Nursing Practice, Fundamentals of Holistic Care.
African Edition. Mosby Elsevier 2009. Pg 154 155.

Ethno centrism
The tendency to regard ones own cultural values and baggage as superior
And use this as a criteria for assessing convictions and customs of other cultures
[1]
Xenocentrism
[1]
It is the conviction that ones own cultural baggage, products, fashions, ideas, norms, values
is inferior to that of another society
Xenophobia
[1]
Page 77 of 128
Fear and hatred of foreigners
Sanctions
[2]
In order to function in a orderly manner a group or community has certain ways to enforce its
norms and values
This may be positive or negative
Positive in the form of a reward offered to those who behave in accordance with the norm
Negative - in the form of punishment if behavior is unacceptable according to the
social norm.
Reference:
van Staden SJ, du Toit DA. Nursing Sociology Fourth Edition. Pretoria: van Schaick Publishers. 2009. Pg 22
- 27
The family is seen as a primary group in our society and plays an important role in the
socialization of a child.
Explain the characteristics of a this primary group and how it assists in the socialization of a
child
[8]
A few selected members to form a small
intimate group strong bond especially with the mother
A lot of face to face contact which is needed
to raise a child in emotional stability
Basis of self concept
In this close contact the child will learn what
is expected of him in terms of values and norms
This group will have its own goal they share
the same needs of physical contact, emotional
security, social bonds all this is needed in raising a child
Interaction in informal way
In this process socialization is taking place
first process where the child learns his role
what is accepted behavior and what not
norms and values of his culture
how to establish social relationships
Likes and dislikes
Reference:
van Staden SJ, du Toit DA. Nursing Sociology Fourth Edition. Pretoria: van Schaick Publishers. 2009. Pg
107 & 144
Select the correct answer in Column B to match the statement in Column A.

Write only the question number and the correct answer. Eg: 1.4.6 = G
Column A
[5]
Column B
1. Status
How people think about themselves and consider their own

actions and nature
2. Self identity
The learning of beliefs, norms and values that are socially expected
of us as members of a particular society
3. Socialisation process
Fulfilment of actual activities and expectations in respect of a role.
Page 78 of 128
4. Role ambiguity
Defined and recognised social position occupied by a person in

a social group
5. Instrumental roles
The activities through which harmonious environment is maintained for

the patient.
Lack of clarity in the expectations associated with a specific role.
Answer
1. D
2. A
3. B
4. F
5. C
Reference:
van Staden SJ, du Toit DA. Nursing Sociology Fourth Edition. Pretoria: van Schaick Publishers. 2009. Pg
48, 75, 86
Explain how you would promote team work in the unit.

[8]
Maintain good interpersonal relationships with subordinates
Motivate, guide and direct personnel towards a high standard of work
Deal with problems honestly and fairly
Be strict, but easily accessible and available to all personnel
Listen to others point of view
Give encouragement to all personnel
Recognize the value of each member of the team
Communicate to the team that each member has a vital part to play to achieve optimal patient care
Encourage a spirit of learning from each other
Build up an atmosphere of high morale by encouraging trust
and loyalty to each other
Provide for physical needs of the personnel such as
tea/coffee and meals
Stimulate the intellectual abilities of the personnel by means
of training and the promotion of critical thinking
Reference:
th
rd
Meyer SM, Naud, Shangase NC, van Niekerk SE. The Nursing Unit Manager, A Comprehensive Guide. 3 edition. Cape
Town: Heinemann; 2009, Pg 261-263
Nursing audits are used to evaluate the quality of nursing care rendered in the units.
Justify the need for nursing audits
Improves quality nursing care
Improves safety and protection of patients
Reduces the risk of medico-legal hazards
Allows the nurse manager to assess learning needs of staff
Allows for realistic suitable allocation of staff.
Identifies learning\teaching needs of the institution
Highlights problems which can initiate research
Page 79 of 128
[3]
Reference:
Booyens S W, Dimension of Nursing Management 2nd edition. Kenwyn: Juta & Co , Ltd,2005:610
Summarise the use of progress monitoring as a component of an audit schedule [3]

Reference:
Interpret the term quality assurancein your own words

[3]
Is the process of establishing desirable standard of nursing care
Planning and providing the type of care
That will meet with those standard
The performance of care is evaluated for effectiveness against pre-established standards
To provide a basis for assessing potential risk
Reference:
Meyer SM, Naud, Shangase NC, van Niekerk SE. The Nursing Unit Manager, A Comprehensive Guide. 3 rd
edition. Cape Town: Heinemann; 2009. Pg 311.

Trans-cultural nursing
Nursing of patients in hospital, coming from a diverse cultural background
ethnic populations
socio economic groupings
and religious groups
[2]
Cultural diversity
[1]
Refers to different modes of understanding different systems of values and diverse
knowledge
Existence and acknowledgement of different cultural groups
Globalisation
[1]
Culture is never static, constantly changing
Modern electronic media, television, cell phones, internet brings different parts of the world
together which results in globalization
Stereotype
Way in which society categorize people
Generalize about a person or group in terms of beliefs, values
[1]
Reference:
van Staden SJ, du Toit DA. Nursing Sociology Fourth Edition. Pretoria: van Schaick Publishers. Pg 40.
Brooker C, Waugh A, van Rooyen D, Jordan PJ. Foundations of Nursing Practice, Fundamentals of Holistic
Care. African Edition. Mosby Elsevier 2009. Pg 12
Page 80 of 128
Communication is a very important component of group dynamics.

There are 3 (three) important effective communication skills within small groups:
1) Reciprocal communication 2) Active listening and 3) Self awareness.
Explain how these skills can be applied in the nurse patient relationship.
Give examples for each skill.
Reciprocal communication
two way communication more effective
but time consuming
ask questions
feedback to ensure that message was understood correctly
feedback ensure trust and friendliness
one way communication lead to hostility, irritation, frustration and doubt
[10]
Active listening
focus on the other person while speaking
being concerned and receptive to message
show empathy
that will lead to openness in relationships
Self awareness
know who you are
what do you expect from patient relationship
how do you feel about patient (possibility of stereotyping, aggression ext.)
what do you want to convey to your patient
Reference:
van Staden SJ, du Toit DA. Nursing Sociology Fourth Edition. Pretoria: van Schick Publishers. 2009. Pg
115 116.
Distinguish between the following components of an audit schedule

Patient assessment
Baseline assessment data established on admission
Critical indicators for care identified
Re-assessment done
[1]
Progress Monitoring
[2]
Reference:
Describe the objectives of quality assurance

[5]
Monitor and evaluate the quality, comprehensiveness and appropriateness of patient care
Monitor patients satisfaction and complaints
Monitoring of the satisfaction\complaints from patients families
Monitoring of the satisfaction\complaints\grievances of staff members
Page 81 of 128
Evaluate the utilization of effective of effective management and leadership strategies

and principles
Monitor medico legal risks and infection control
Ensure a safe environment for nursing care
Ensure continuity and comprehensiveness of nursing care
Evaluate risk management
Review and approve credentials of healthcare facility
Reference:
rd
Meyer SM, Naude M, Shangase N, van Niekerk S. The nursing unit manager: a comprehensive guide.3
edition. Sandown : Heinemann, 2009 ;p.312
Define the following concepts. For each concept, provide a nursing example:
Cultural relativity
[2]
It refers to an attitude of understanding
And respect for cultural differences
e.g. you as a nurse shows an attitude of acceptance to your patients culture e.g. by letting
the priest come and bless the new baby
Xenocentrism
the conviction that ones own cultural content
e.g. values, beliefs, practices ext is inferior to those of other cultures
e.g. western societies after feel a lack of culture compared with eastern societies.
[2]
Social relationships
[2]
A relationship that come into being when two or more persons interact with each other
It implies a mutual understanding about how to behave towards each other.
E.g. nurse- patient relationship
Role conflict
A person does not occupy only one role,
when roles are irreconcilable it is called role conflict
e.g. role as a nurse takes you away from your role as mother
[2]
Reference:
th
Du Toit DA, van Staden SJ. Nursing sosiologoy 4 Edition 2009 van Schaik p 78, 82, 32, 35
The mother-child bond is very important in the development of a child and very traumatic
when it is disturbed due to hospitalization.
Describe the nursing interventions that you would incorporate in your nursing care plan for a
3 year old patient during hospitalization, to alleviate the stress that it causes
[5]
Parents must be actively involved
To hold, cuddle, comfort during procedures
Let them stay 24 hours if possible
Or visit as often as possible
Demonstrate what needs to be done with dolls, pictures, books
Allow children and parents to explore and look at material or equipment being used
Explain procedures in age appropriate language
Support parents emotional with information and for them to be able to support the child
Page 82 of 128
Leave personal belonging e.g. picture of mother, dolls anything that will remind child and
reassure that mother will come back
Reference:
Berman A, Snyder SJ Kozier B et al. Kozier and Erbs Fundamentals of nursing: Concepts, process and
th
practice. 8 Edition 2008 Pearson; p. 826.
st
Young A, editor Jutas manual of nursing: Health care priorities. Volume 3 1 Edition 2005 Juta; p. 2-7
Develop a nursing care plan that focuses on the specific developmental needs of the
adolescent and the nursing interventions that would ensure that these needs are met.
[4]
NEED
Highly concern in appearance of physical

self / body changes
Peer group very important for coping

and accepting situations
Conflict between independence and
depending on nurse for care
Self absorbed in own situation. Tend to

be selfish, stay late up at night etc
INTERVENTION
Sensitive in caring and exposing body.
Privacy very important.
Help patient to better appearance by
doing hair, makeup etc.
Let friends visit, will give them hope
and strength
Give them choices
Ask permission
Integrate them in care as far as possible
Positive attitude
Need to give guidelines for organization
in ward
Rules must be clear
Reference:
th
practice. 8 Edition 2008 Pearson; p. 384-386
Wealth is the only criteria according to which social stratification occurs. Analyse this
statement and determine whether you agree with it or not.
Justify your answer.
This statement is not true
Stratification takes place mainly on the basis of wealth & income
But also on the basis of power
And prestige
Power is the ability of an individual or a group
To influence the actions of others
Prestige is subjective and personal
Ones prestige depends on how others regard you
[4]
Reference:
th
Du Toit DA, van Staden SJ. Nursing Sociology 4 Edition 2009. Van Schaik p. 92 93
Analyze the characteristics of a helping relationship and describe how you can apply this to
establish a nurse-patient relationship.
[6]
Listen actively gives a sense of true concern
Identify problems let them talk
Put yourself in patients shoes
Page 83 of 128
Be honest and open

Be genuine and credible they will sense your concern
Be open and accept patients way of thinking, values, morals
Be aware of cultural differences, language barriers
Maintain confidentiality they need to trust you
Know your role and limitations
Tell them if it is not your role or you dont know something
Respect their decisions give opportunity to take part in care and discussions
Mutual trust, respect and acceptance must be clearly visible in your attitude
Reference:
Berman A, Snyder SJ, Kozier B et al. Kozier and Erbs Fundamentals of nursing: Concepts, process and
th
practice 8 Edition 2008 Pearson p 472
Analyse the rights of the dying patient listed below.

Focus only on these five (5) rights of the dying patient and describe the nursing interventions
that will ensure that these rights are taken care of.
[5]
The right to be treated as a human being
Keep on talking to patient, touch, make eye contact
Do fully needed nursing care till death comes
The right to a sense of hopefulness
Focus on what is achievable in patients situation e.g. family that comes to visit
Restoring broken relationships
Day to day achievements
The right to express feelings and emotions
Be available to listen
Give time to express, cry, anger without judgement
Confront own feeling of fear, death and dying
The right to participate in decisions concerning ones own care
Keep on explain, ask for permission for
Procedures, respecting decision made by patient and family
The right not to die alone
Family can stay with patient as long as possible
Be willing to stay at the bedside when obvious that the end is near
Reference:
Smeltzer SC, Bare BG, Hinkle JL, Cheever KH. Brunner & Suddarths: Textbook of medical-surgical nursing
th
11 Edition 2008. Lippincott Williams & Wilkins p. 451 - 475
th
practice. 8 Edition 2008 Pearson; p. 1094
Identify the aims of nursing research.

Create new nursing knowledge.
or to validate existing knowledge.
that can be implemented to improve health care.
To understand
or assess nursing issues
[3]
Page 84 of 128
To plan for the future
Reference:
nd
p.250.
Analyze the literature review phase of the research process.

[6]
Is conducted to obtain more information from the literature on the research topic.
Information is gathered from books, articles and other research done on the same topic.
It provides a picture of what is known on the topic and gaps in knowledge on the topic area
can be identified.
The researcher should consider the aim and objectives of the project when conducting the
review.
And not read everything even remotely related to the topic.
E.g. causes of wound infection and how to control these. Not types of wounds and
sutures used.
The literature review helps the researcher to build on previous knowledge and research.
It provides information on the content for the intended project and methods and instruments
that could be use.
Staying focused helps to delineate the topic, make progress and reach the desired outcome.
Without focus, unnecessary time is spent on interesting information and not on reaching the
aim of the project.
Provides the researcher with an awareness of the facts and the knowledge available on the
intended project.
Reference:
nd
p.258.
It is said that culture is acquired behavior.

Apply this statement in order to explain the changes seen in a first and final year nursing student.
[10]
Culture is not genetically inherited, but is acquired through a learning process.
People learn it from other people.
The person entering nursing for the first year, learns or adopts the nursing culture from other nurses.
Patterns of behavior are conveyed to this person by other nurses.
This is known as socialization and takes place in the hospital.
The nurse adopts the values, behavior patterns and norms of other nurses because she
belongs to the nursing society.
As the individual is inducted into nursing, she/he internalizes the values of nursing and this
becomes road signs for her/his behavior and the rest of his/her life
Culturally speaking, a baby is born with a clean slate.
What is written on this slate depends on the culture of the community this baby is born in as
well as the time at which he is socialized.
Nurses are taught over a period of time and are thus exposed to the nursing profession for
an extended period.
This allows the nurse to acquire more and more cultural traits and values seen in nursing.
Mans ability to acquire culture and to pass it on is a result of his enormous learning potential.
A person enters the nursing profession with a specific culture and learns to act like a nurse.
Depending on the level of development of a specific community (nursing), cultural patterns
are therefore transmitted to new members and from generation to generation.
Page 85 of 128
Acquisition of cultural goods and ideas does not take place consciously.
A large part of the learning process is unconscious, unintentional and incidental activity for
the teacher and the pupil.
Reference:
th
Du Toit DA, van Staden SJ. Nursing sociology. 4 edition. Pretoria: Van Schaik, 2009; p. 21.
By means of examples, demonstrate how a patients right to autonomy will be maintained during
hospitalization.
[5]
Even though the patient chooses to come to the hospital, his right to autonomy is not forfeited.
Ensure informed consent principals is maintained with any decision that is made with regards to
patient care.
Provide the patient with information and what is done and the reasons for actions.
Allow him/her to make own choices with regards to health related issues.
The nurse needs to allow the patient to continue with a decision made based on religious beliefs,
and respect the patients choice, e.g. Jehovah witnesses refusing blood transfusions.
Provide the patient with health education in a language that he/she understands and on his/her level.
If a patient refuses treatment, the nurse needs to respect this choice 1/2 and act as advocate
for the patient.
In emergency situations, the nurse has an obligation to act on behalf of their patients and this
place some limitations on autonomy.
When a parent or a guardian of a child makes a decision which will affect the child negatively, the
nurse has an obligation to act on behalf of the child.
Reference:
nd
Pera, S. A.& Van Tonder, S. Ethics in Nursing Practice. 2 Edition. Lansdowne: Juta. 2005.
Analyse how the socialisation process shapes the personality of a child in the family.
[7]
An infant acquires a set of attitudes and values
Goals and purposes
Patterns of response
Self concept through socialisation
The first group with whom the child comes into contact is the family
This is the primary agent of socialisation
Through association with the family and especially the mother
(or primary caregiver ) the child learns what is expected of him
He learns that he cannot always get what he wants
He learns his place and role in the family
He learns acceptable behaviour
He learns the norms of his culture from the family
He learns how to have social relationships
and likes and dislikes
Reference:
th
du Toit DA, van Staden SJ. Nursing sociology.4 edition. Pretoria:Van Schaik,2009; p.144.
Study Guide LU 1.5 additional notes.
Explain the purpose of policy and procedure manuals.

The purpose of policy manuals is to further the objectives of the health service
Policies prevent temporary problems from becoming permanent
Page 86 of 128
[5]
It protects the employer, employee and the patient

Is of great value in orientating and training of personnel
Ensures consistent treatment of all personnel
Continuity of action is ensured even if top management personnel may change
Policies therefore promote stability
Policies serve as a standard of performance
Policies ensure that similar problems do not have to to be addressed repeatedly
Policies conserve time by setting standards
It ensures uniformity in response to a particular situation by different employees
Reference:
Booyens SW. Introduction to health service management. Cape Town:Juta,1999;p30
Empathic listening and responding is an important skill in therapeutic communication.

Explain what is meant by empathic listening and why it is considered to be such an important skill.
[5]
The nurse listens attentively
and responds in a way that indicates to the patient
she has understood how the patient feels
She responds to content as well as feelings
The nurse`s non-verbal behaviour should indicate empathy
i.e. head nodding, steady gaze, little body movement
Empathic listening helps to develop an understanding of the patient and their world,
Which is communicated to the patient
Resulting in comfort and care for the patient
and a helping relationship ( or good nurse- patient relationship )
Reference:
Berman A, Snyder SJ, Kozier B, Erb G. Kozier and Erb`s fundamentals of nursing: concepts,process and practice.
8th edition. New Jersey: pearson Prentice-Hall;2008, p 473.
It is said that culture is acquired behavior.

Apply this statement in order to explain the changes seen in a first and final year nursing student.
[10]
Culture is not genetically inherited, but is acquired through a learning process.
People learn it from other people.
Patterns of behavior are conveyed to this person by other nurses.
This is known as socialization and takes place in the hospital.
The nurse adopts the values, behavior patterns and norms of other nurses because she
belongs to the nursing society.
As the individual is inducted into nursing, she/he internalizes the values of nursing and this
becomes road signs for her/his behavior and the rest of his/her life
Culturally speaking, a baby is born with a clean slate.
What is written on this slate depends on the culture of the community this baby is born in as
well as the time at which he is socialized.
Nurses are taught over a period of time and are thus exposed to the nursing profession for
an extended period.
This allows the nurse to acquire more and more cultural traits and values seen in nursing.
Mans ability to acquire culture and to pass it on is a result of his enormous learning potential.
A person enters the nursing profession with a specific culture and learns to act like a nurse.
Page 87 of 128
Depending on the level of development of a specific community (nursing), cultural patterns

are therefore transmitted to new members and from generation to generation.
Acquisition of cultural goods and ideas does not take place consciously.
A large part of the learning process is unconscious, unintentional and incidental activity for
the teacher and the pupil.
Reference:
th
State the risks that may be involved when acting as an advocate on behalf of a patient.
[3]
The nurse must be capable of dealing with conflict and opposition
Opposition may be from the doctor, nursing colleagues and hospital authorities
The nurses first concern may be for her job and career, because she might be dismissed, instead
of correctly putting the patients best interests first
Another source for concern is her collegial relationship with the doctor which must be maintained
The working relationship with the doctor may suffer if she acts as an advocate for a patient
Where she believes that the doctor or other colleague hasor is about to perform an act or omission
that is not in the patients best interests and must be objected to
Reference:
nd
Pera SA and Van Tonder S.Ethics in health care 2 edition. Cape Town : Juta, 2005:pg51-52
Discuss the ethical and legal rights of a patient diagnosed with Acquired Immune Deficiency
Syndrome (AIDS)
[7]
The patients diagnoses with AIDS has the right to:
Information regarding the disease to make informed decisions
Treatment and compassionate care
Privacy and confidentiality concerning health and treatment to maintain dignity
Healthy and safe environment that will promote mental and physical health
Access to health care
Adequate counseling without discrimination
Refusal of treatment
The health care provider must provide adequate information to enable the patient to make an
informed decision
Referral for a second opinion on request
Continuity of care by healthcare workers
Complain about healthcare services
Have such complaints investigated and to receive a full response
Participate in decision making when it concerns his health
Right to be treated by the named healthcare provider of her choice
Reference:
rd
Meyer SM, Naud, Shangase NC, van Niekerk SE. The Nursing Unit Manager, A Comprehensive Guide. 3 edition.
Cape Town: Heinemann; 2009. Pg 141-142.
Discuss the characteristics of a role model in nursing

Holds a certain position in a particular social system
Acts or behaves in a manner expected of a person in her position
Enacts her role in a way that can be observed
[4]
Page 88 of 128
Has certain role expectations

Learns her role by locating herself accurately in the social structure
Has undergone role socialisation
Experiences role stress when meeting obligations
Has a definite view of the components of the role
Demonstrates the validity of role theory
Reference:
th
Searle c, Human S, Mogotlane SM. Professional Practice, A South African Nursing Perspective. 5 edition.
Sandton: Heinemann; 2009; p 52
Differentiate between the following terms:

Profession
Refers to a specific career where
work of an intellectual nature is performed
[1]
Professional
Refers to the practitioner who practices the profession and
it implies that he / she fulfils all the norms and expectations thereof.
[1]
Reference:
rd
Mellish M, Oosthuizen A, Paton F. An Introduction to the Ethos of Nursing. 3 edition. Cape Town: Heinemann; 2010; p 111 112
Choose the incorrect statement pertaining to The Nursing Act, 2005 (Act 33 of 2005).
Write the question number and the alphabet only e.g. 2.5.1 = e
[3]
1. A person is prohibited to use the title registered nurse when:

a) The name has been removed from the register due to non-payment of the annual fees
b) The name has been removed from the register of another country
c) She has failed to notify council of her change of address within six months
d) She has not practiced for two years
2. The following penalties could be imposed on a nurse if found guilty of unprofessional
conduct:
a) Payment of the costs of the proceedings
b) A jail sentence of maximum 6 months
c) A prescribed fine
d) Suspension for a specified period from practising
3. The Registrar must restore the name of a person whose name has been removed from the
register if the person concerned:
a) Lodge and wins an appeal against the council
b) pays the prescribed fee, if any
c) is otherwise eligible for registration
d) Complies with such other requirements as the Council may determine
Reference:
The Nursing Act, 2005 (Act 33 of 2005)
Page 89 of 128
Differentiate between the following scopes of practice:

Professional nurse
[1]
A person who is qualified and competent to
independently practise comprehensive nursing in the manner and to the level prescribed and
who is capable of assuming responsibility and accountability for such practice
Staff nurse
A person educated to practise basic nursing in the manner and level prescribed
[1]
Reference:
The Nursing Act, 2005 (Act 33 of 2005) Section 30
Distinguish between the following terms as indicated in R2598 of the South African Nursing
Council:
Prescribing
[1]
Giving the written directions regarding
those treating, nursing care, co-ordinating, collaborating and patient advocacy functions
essential to the effective execution and management of the nursing regimen
Treatment
Selection and
performance of those therapeutic measures
essential to the effective execution and management of the nursing regimen
[1]
Reference:
R 2598. Chapter 1
For a problem to be researchable, certain criteria are needed. Identify the criteria needed
[6]
Problem is significant to nursing
The problem is related to observable incidents
The researcher has the necessary knowledge, skill and experience to conduct the project
The needed equipment is available
Research will make a definite contribution to patient care
Support systems are available
Problem is new or unique
Money needed for the project can be obtained
Participants will be available
Problem can be researched in an ethical manner
Researcher has time to complete project
Researcher is enthusiastic about the topic
Administrative support is available
Reference:
Meyer SM, Naud, Shangase NC, van Niekerk SE. The Nursing Unit Manager, A Comprehensive Guide. 3 rd
edition. Cape Town: Heinemann; 2009; p 373 374
Choose the correct statement pertaining to research designs

Write the question number and the letter only e.g. 2.10.1 = e
[4]
Page 90 of 128
1. The main aim of quantitative research is to:

a) explore issues and reflect the collected data through frequencies and
percentages in tables and figures
b) explore peoples experiences and reflect these through words and concepts
c) It is a systematic and subjective approach to describing, understanding and
providing meaning to life experiences
d) It aims to give meaning to the whole
2. The following are characteristics of a qualitative research design:
a) Focus is concise and narrow
b) Generalisation
c) Holistic
d) Data collected through instruments such as questionnaires
3. The following is a type of quantitative research:
a) Phenomenological research
b) Ethnological research
c) Quasi-experimental research
d) Historical research
4. The following method can be applied in both the qualitative and quantitative designs:
a) Questionnaires
b) Focus groups
c) Interviews
d) Literature study
Reference:
Meyer SM, Naud, Shangase NC, van Niekerk SE. The Nursing Unit Manager, A Comprehensive Guide.
3rd edition. Cape Town: Heinemann; 2009; p 346, 347,350
Match the research concept in Column A with the statement in Column B. Write only the number
and the letter in your answer book e.g. 7 = I
[6]
Column A
Column B
1. Research design
2. Variable
3. Survey
4. Hypothesis
b
c
d
5. Research proposal
6. Sample
e
f
g
h
A letter written by the researcher detailing the hypothesis, the

sample and the methods of collection
Units or subset of cases drawn from the accessible population
The characteristic of the person or object that varies
Broad statements which indicate what is to be done, where and
with whom
Is concerned with how data are to be collected
A technique in which questions to the respondent are face to face
It provides a statement of the researchers expectations about a
specific relationship between variables
Any research activity in which the investigator gathers data
Page 91 of 128
Answer
1.
2.
3.
4.
5.
6.
e
c
h
g
a
b
Reference:
rd
Meyer SM, Naud, Shangase NC, van Niekerk SE. The Nursing Unit Manager, A Comprehensive Guide. 3 edition. Cape
Town: Heinemann; 2009
Describe the value of policy and procedure manuals in the ward.

Policies explain the steps to be followed for achieving goals
Policies serve as a basis for future decisions and actions
Policies help coordinate plans
Policies help control work performance
Policies serve as a means by which authority can be delegated
Procedure manuals provide a specific guide for actions
They help to achieve regularity by setting out the steps
Which must be followed in chronological sequence
Procedure manuals can serve as a basis for orientation
And staff development
Procedure manuals are ready reference sources for personnel
They standardise equipment and procedures
They provide a basis for evaluation
Productivity is increased by improving work procedures
[7]
Reference:
nd
Booyens JW. Dimensions of nursing management. 2 Edition. Landsdowne: Juta,1998; p.200-201.
Describe Auditing as a monitoring strategy of quality nursing care

Auditing can take place continuously,
Incidentally (spot checking)
Formally
Retrospectively
Documents are studied to establish
whether the set standard and criteria is met
Feedback and reporting of results must take place
to ensure improvement
Auditing is the evaluation method for assessing the quality of nursing
according to professional and ethical requirements
[5]
Reference:
rd
Muller M. Nursing Dynamics. 3 Edition. Sandown: Heinemann; 2005: p. 203,207-208.
nd
Booyens JW. Dimensions of nursing management. 2 Edition. Landsdowne: Juta,1998; p.610-611.
Name and briefly describe the four (4 ) phases of the research process.
Page 92 of 128
[5]
Phase 1: Conceptual phase

Thinking/planning phase with the standard element the research problem
Phase 2: Empirical phase
Doing phase with the standard element the research design
Phase 3: Interpretive phase
The researcher engages with the meaning of the study
empirical evidence is the standard element
Phase 4 : Communication phase

The phase of writing the research report
the set of conclusions is the standard element
Reference:
Brink H, van der Walt C, van Rensburg G. Fundamentals of Research Methodology for Health Care
nd
Professionals. 2 Edition. Cape town: Juta, 2006; p. 50
Explain the term Productivity

refers to the inputs divided by the outputs
[1]
Reference:
rd
Muller, M. Nursing dynamics. 3 Edition. Sandown: Heinemann; 2005: p. 263.
Describe how productivity can be improved in a nursing unit.

[7]
Absenteeism and turnover can be monitored and determined monthly
The reason for absenteeism/turnover among personnel are identified and a strategy can be
implemented to reduce the figure
The principles of effective time management to be implemented.
Avoid nursing staff performing non-nursing duties
Determine staff-patient ratios
Limit overtime
Implement policy of flexi-time when patient numbers down
The unit manager can become involved in the monthly evaluation of the personnel costs of
the unit, including the cost of overtime
The principles of personnel organization, promotion of harmony and quality work life in
the unit
as well as occupational health of personnel can be
applied. Reference:
rd
Muller M. Nursing dynamics. 3 Edition. Sandown: Heinemann; 2005: p. 263
Choose the correct description in Column B that matches the concept in Column A. Write
only the number of the question and your chosen letter in your answer book
[4]
Column A
1. Norms
2. Relative deprivation
3. Values
A
B
C
Column B
A combination of related cultural complexes.
Entails friendly interaction and adjustments
Negative discrepancy between ones own expectations and
Page 93 of 128
4. Status
D
E
F
existing realities.
The expression of what is desirable
Social rules of conduct
Hierarchical position of the individual.
Answer
1. E
2. C
3. D
4. F
Reference:
rd
Du Toit DA, van Staden SJ. Nursing sociology. 3 edition. Pretoria: Van Schaik, 2007; p. 73, 26, 29.
Demonstrate by means of examples, the functions of play in the development of a child.

OR
Explain the importance of play when nursing a child
[6]
It encourages the development of creative imaginations through make believe play.
It allows for the development of perceptual skills and preparation for school.
E.g. drawing, block building.
It has therapeutic value child learns to master its feelings though finding an outlet for its
destructive impulses by
Playing with sand, water, clay.
Promotes intellectual development tests reality by constructive play and to learn
casual relationships, although primitive through processes are still evident.
It enhances social interaction and the playroom is the laboratory for practicing future adult
roles.
The child can play co-operatively with other children.
In its style of playing, the child displays imitator, leadership, gender appropriate behavior
and abnormal behavior can be identified.
Sensory development occurs by playing with objects of different texture and a sense of
feeling develops, e.g. smooth/coarse.
Sense of smell and taste improves by exposure to different odors and tastes through play.
Hearing and sight develops by exposure to different sounds, e.g. rattles and bright
colored toys.
Development of eye-hand coordination by
Throwing and catching a ball, by dressing dolls, playing with cars and trains and coloring
in books.
Reference:
Louw, D. A. Human development.
A five (5) year old child has been in hospital for 4 weeks with a chronic condition.
He displays the following behaviour:
Crying uncontrollably in the morning on waking up
Throwing all toys offered to him on the floor and refusing to eat
Identify the psychological problem this child has
Maternal deprivation.
[1]
Page 94 of 128
Prioritise the nursing actions in order to manage this behaviour

Hold the child and try to calm him.
Promote physical, non threatening contact with the child.
Be patient and realize that the child is not acting spitefully
Take the child to the playroom and spend some time with him.
[2]
Reference:
Young A, editor. Jutas manual of nursing: health care priorities.Volume 3. Lansdowne: Juta ,2005;
Describe the effects of maternal deprivation in a hospitalized child
[8]
Neonate (Birth to 1 month)

Impairment of the infants ability to respond to parents and family members
Impairment of the parents ability to love and care for the baby
Risk of compromise in the infants emotional and physical well being
Risk of stress within the family
Infant (1 to 12 months)
Separation anxiety crying, terror, blank facial expression, fear of strangers, clinging
and overdependence on the parents
Emotional withdrawal and depression
Interference with development of basic trust
Interference with growth and achievement of developmental milestones
Child (1- 5 years)
Protest has urgent desire to find mothe.
Despair may cry continuously or intermittently
Uses comfort measures thumbsucking, tightly clutching a toy or blanket
Regression temporarily ceases use of newly acquired skills e.g. bedwetting
Child (6- 12 years)
Regession
Separation anxiety
Negativism
Depression
Tendency to be phobic - Fears of Drs, hospitals, blood, needles
Adolescent
Anxiety or embarrassment related to loss of control
Insecurity in strange environment
Rejection of treatment measures
Anger towards parents and staff
Depression
Increased dependency on parents and staff
Denial or withdrawal
Demanding or uncooperative behaviour usually an attempt to assert control
Capitalization on gains from illness or pain
Reference:
th
Nettina Sandra M. Lippincott. Manual of nursing practice. 8 Edition. 2006. p1384
Page 95 of 128
Differentiate between Ethnocentrism and Xenocentrism.
Ethnocentrism
The tendency of people to believe that the
elements of their own societys culture, norms
and values are superior to the cultural baggage
of other societies.
This is seen all over the world, but the
Americans think that everything in the USA is
better, bigger and prettier and will not
understand the actions of the people in Africa.
It is normal for people to believe that their
way of thinking or doing is better; giving rise
to a feeling of ownership and solidarity, which
is necessary for survival and progress within
an organisation or group.
An exaggerated degree of ethnocentrism on
the part of either the patient or the nurse may
hamper the nursing process and may be
problematic in the multicultural society found in
SA.
[6]
Xenocentrism
The conviction that ones own
cultural baggage, such as
products, fashions, ideas, norms
and values is inferior to those of
other societies.
People in SA accept that
imported electronic equipment
from Japan, glassware from
Denmark and perfume from
France, is superior to those
products produced in SA.
If this feeling of xenocentrism
becomes a common
occurrence, it may have fatal
consequences for SA industries
and employment.
Reference:
rd
Explain the following terms according to the Scope of Practice of Registered Nurses,
Government Notice No 2598 of 30 November 1984(as amended):
Nursing regimen
regulation of matters which through nursing intervention influence health
and includes the provision of nursing care plans
their implementation
and evaluation
and recording the course of the health problem
the health care received by the patient
and its outcome
while a patient is in the charge of the nurse
Co-ordination
bringing together of the acts
of members of the health team
[4]
[2]
Page 96 of 128
to meet the spectrum of identified health needs of individuals
Diagnosis
identification and discrimination between
physical
psychological
and social signs and symptoms in man
[2]
Treatment
selection and performance
of those therapeutic measures
essential to the effective execution
and management of the nursing regimen
Reference:
R 2598 30 November 1984
Explain the concept accountability

the duty to account for
conditional liability
give an account of an act or omission
be willing to be judged according to rules
bear the consequences of judgement
required on four levels
to oneself
to the patient
to the employer
to courts and professional council
[5]
Reference:
rd
Muller M. Nursing dynamics. 3 edition. Johannesburg: Heinemann, 2005; p53.
Describe the measures you will implement in your ward to prevent personnel burnout
increase self awareness of staff
to evaluate themselves, job and career for advancement possibilities
develop outside interests
e.g. hobbies, recreational activities
maintain regular physical exercise
as tension is reduced by exercise
change of scene is essential for the mind
learning how to relax
e.g. listen to music, yoga or meditate
promote good interpersonal skills
time management
[5]
Reference:
nd
Meyer S, Naude M, van Niekerk S. The nursing unit manager. 2 edition. Johannesburg: Heinemann, 2004; p
189.
rd
Booyens SW. Introduction to health service management. 3 edition. Cape town: Juta & Company Ltd, 2006; p 149.
Describe the measures that a registered nurse can take to create an environment conducive to
good supervision
[10]
Page 97 of 128
An atmosphere of mutual respect and trust in the unit so that supervision is accepted by all in
a positive light
Competence in her own practice so that she is truly known to be one who can watch with
authority, who has the right to supervise
Readiness to help and guide during supervision not merely to offer carping criticism so that the
learner has an opportunity to learn
Ability to adapt to the needs of the situation, so that the type of supervision, though not the
quality, is changed when necessary
Ability to motivate learning by showing interest in the progress and ability of learners as well as
in the progress of those receiving care at their hands while carrying out supervision of care
Proper employment of the management function required to enable nursing to be done, that is the
provision of stores, equipment and personnel as and when required and ensuring that these are
correctly used
Noticing areas during the process of supervision where improvement is necessary, planning such
improvement, teaching persons so that the plan can be implemented, and evaluating results
Acknowledgement of the value of other members of the staff as part of the supervision of pt care
and providing learning teaching situations so that they in turn also become good supervisors
Insistence on the absolute safety of the pt, his dignity, comfort and the confidentiality of hios affairs
as part of the supervisory function
direct the work of the employee, which includes planning, co-ordinating and instructing
Regulating and guiding activities
Watching with authority
By acting as a resource person with professional knowledge and keeping up with new
developments
Ensuring co-operation and two way communication between supervisor and person being
supervised
Being an expert and willing to assist in the unit
Evaluating the progress of employees
Setting realistic goals based on professional knowledge and skills
Observing and assessing work of the nursing staff
Reference:
rd
Meyer S, Naude M, van Niekerk S. The nursing unit manager. 3 edition. Johannesburg: Heinemann, 2009; p 225.
rd
Mellish & Brink. Teaching the practice of nursing.3 edition .1986.p199
Describe the purpose of keeping accurate patient records

basis for patient care
make future plans using statistics
monitor cost effectiveness
use as a teaching tool
manage risks to report on incidents
protect from medico legal hazards
feedback on the patients progress
prevention of disease
health promotion
problem solving
[5]
Reference:
Meyer S, Naude M, van Niekerk S. The nursing unit manager. 3rd edition. Johannesburg: Heinemann, 2009; p
330.
Describe the emotional support you would give to a dying patient

[10]
Page 98 of 128
focus on the clients needs

as they feel they have lost control over their own lives
treat them with dignity and respect
maintaining the patients humanity
by respecting their culture, beliefs and values
allow them to have control too,
by introducing options available to them
eg going to hospice or visits from friends
support the clients hope and will
by helping them to find meaning in living while suffering
establish a communication relationship with them
so that they know you are always available
talk about death
determine what the patient knows about the illness
avoid imposing personal beliefs on the client
respond with honesty and directness
make time available for the client to provide support, listen and respond
be caring and make use of touch
be aware of different coping strategies such as withdrawal
Reference:
th
practice. 8 edition. Pearson:New Jersey, 2008; p1094.
Explain the nurse- patient relationship.

Also called a helping relationship
This is a growth facilitating process
Strives to achieve two basic goals:
Help clients manage their problems in living more effectively
And use opportunities to the fullest
Help clients to become better at helping themselves in their daily lives
The relationship may develop over a few weeks
Or within minutes of working with the patient
The keys to the helping relationship are: the development of trust
And acceptance between nurse and patient
And an underlying belief that the nurse cares about and wants to help the patient
[5]
Reference:
th
Berman A, Snyder SJ Kozier B et al. Kozier and Erbs Fundamentals of nursing: Concepts, process and practice. 8 Edition
2008 Pearson; p. 472
Describe the nursing interventions for grief and mourning following the death of a loved one.
[ 10]
support the expression of feelings
use open-ended questions
to encourage the telling of the story
assist the mourner to find an outlet for his/ her grief
Eg: talking, attending a support group, keeping a journal
Assist to find an outlet for his/ her anger
Eg: writing letters that will not be mailed
And reinforce the normalcy of the these feelings
Page 99 of 128
Assess for guilt or regret

Assess for the presence of social support
Assess coping skills
Use of skills like attentive listening
Silence
Paraphrasing
Clarifying & reflecting feelings
Summarizing
Use communication relevant to their stage of grief
Whether the client is angry or depressed will affect how he/ she hears messages
And how the nurse will interpret the clients statements
Implement a plan to provide client and family teaching
And to help the client work through the stages of grief
Reference:
th
Smeltzer SC, Bare BG. Brunner & Suddarths: Textbook of medical-surgical nursing. 10 edition. Philadelphia:
Lippincott Williams and Wilkins, 2004; p. 418
And Berman A, Snyder SJ Kozier B et al. Kozier and Erbs Fundamentals of nursing: Concepts, process and practice.
8th Edition 2008 Pearson; p. 1088-1089
Describe the techniques which will improve communication with a patient

[7]
Using silence
Accepting pauses or silences that may extend for several seconds or minutes without
interjecting any verbal response
E.g. sitting quietly and waiting attentively until the client is able to put thoughts and feelings into words
Being specific and tentative
Making statements that are specific rather than general, and tentative rather than absolute
E.g. Rate your pain on a scale of 0 10 (specific statement)
E.g. Are you in pain (general statement)
E.g. You seem unconcerned about your diabetes (tentative statement)
E.g. You dont care about your diabetes and you never will (absolute statement)
Using open ended questions
Asking broad questions that lead or invite the client to explore thoughts or feelings
E.g. Tell me about .....
Using touch
Providing appropriate forms of touch to reinforce caring feelings
E.g. putting an arm over the clients shoulder.
Placing your hand over the clients hand
Seeking clarification
A method of making the pts broad overall meaning of the message more understandable
E.g. Im not sure I understand that
E.g. Would you tell me more?
Giving information
Providing, in a simple and direct manner, specific factual information the pt may or may not request
E.g. Your surgery is scheduled for 11am tomorrow
Page 100 of 128
Acknowledging
Giving recognition, in a non judgmental way, of a change in behaviour, an effort the pt has made, or
a contribution to a communication
E.g. You walked twice as far today with your walker
E.g. I notice you keep squinting your eyes. Are you having difficulty seeing?
Reference:
th
practice. 8 edition. Pearson:New Jersey, 2008; p469.
Describe the precautionary measures that the R/N should take to prevent a lawsuit by
pts with regard to the following:
a) Confidentiality
[4]
Nurses should not divulge ptus diagnosis to others without the ptus consent
Pts records are to be kept confidential
Nurses are to maintain the trust relationship between their pts
Use professional judgment in relation to the nurse pt interactions
The R/N holds in confidence all personal information, which is entrusted to her by the pt
Ptus personal matters are not discussed, even with colleagues, except in so far as they
affect the progress of the pt
Everything told in confidence remains confidential
Ptus information to be given to relatives with ptus consent
A ptus diagnosis is a matter between the Dr, nurses caring for him and the pt
b) Privacy
[3]
The nurse should not expose the pt unnecessarily
Always obtain consent/permission from the pt before exposing them
Personal belongings such as diaries are private property and shall be respected
Anything that is experienced by the pt as private by the pt must be hidden from the
public eye
Privacy must be maintained when giving the pts information regarding their diagnosis
Visitors are not allowed to read through the ptus records
Privacy must be maintained when obtaining information from the pt e.g. counseling or
history taking
Pts to be awarded the privacy if he/she wants to talk to relatives alone
c) Accountability
[4]
Nurses must keep in mind that they are accountable for the care they provide to the pts
They have professional responsibility to provide quality pt care that is free from medico-legal
risks
Nurses need to make decisions that shall not violate ethical codes
Nurses are legally accountable for decisions they take on behalf of pts
The R/N is accountable for her actions, the way in which she exercises her responsibility
The R/N has the right to refuse to practice or act illegally even if the actions are prescribed
The R/N must be aware of an act of omission or commission involving neglect,
incompetence or willfulness on her part
Page 101 of 128
The R/N must answer and justify her actions when called to account for her acts of
omission or commission
The R/N must always be aware that she may be held accountable by the courts for any
physical injury or death on the part of the pts
Reference:
Searle C. 2001. Professional practice: a Southern Africa nursing perspective. 4th edition. Sandton:
Heinemann. Pg 71 - 74.
Describe the duties of a Registered Nurse as supervisor of a unit
[5]
The patient
To ensure that there is no infringement of pts rights
Safe environment
- physical furniture and equipment in good condition
- social no undesired visitors
- emotional calm, quiet ward
Nursing care
- according to doctors prescription
- procedures done according to policy of the institution
- safety no injuries
- adequate personnel
Safe-keeping of property
- Two witnesses to sign with pt
Provision of basic needs of the
pt - nutritional
- Rest and sleep
Identification of pt e.g. on admission
Nursing care plans
Accurate record keeping
Maintenance of competence and proficiency by nursing staff
The student
Rendering nursing care according to the level of training / Scope of practice
Ensure adequate learning opportunities
Direct supervision over delegated tasks
Offer support and guidance to all students
Reference:
nd
Mellish and Brink. Teaching the practice of nursing. 2 Edition 1986. p198
Describe the role of the Registered Nurse in creating an emotional environment in the ward
which is conducive to speedy recovery
[5]
Staff must maintain a positive attitude towards patients, clients and colleagues
Talk to patients in a friendly and respectful way
Page 102 of 128
Ensure good relationships between staff and patients, based on respect and trust
Allow patients to voice their fears and listen when patients communicate
Provide enough and the correct information
Promote a feeling of safety by providing competent care
And by effective management of the nursing unit
Eliminate disturbances which can upset patients, e.g. noises or bad smells
Provide enough rest periods and silence during rest periods
Use recreational facilities, e.g. a garden, playroom for children, magazines
Promote access of people who can provide emotional support to the patient, e.g. his family
and spiritual leader
Respect the right of patients to complain and handle complaints effectively
Describe the conduct of the R/N which may threaten the image and integrity of the profession
[5]
Criminal offences of an immoral / culpable nature e.g. rape, assault, murder

Conduct / omissions that compromises the professional integrity / reputation of another
professional person e.g. incriminating remarks of a personal nature regarding a R/N ,
medical practitioner
Conduct which damages the person or personality of another individual e.g. spreading
unfound rumours / gossiping
Disregard for the SANC rules of conduct e.g. pt neglect or abuse
Collective conduct by nurses which compromise the health / nursing of pts e.g.
absence without leave, participation in an illegal strike
Reference:
South Africa 2005. Nursing Act (Act 33 of 2005). Pretoria: Government Printer. Chapter 3
Describe the nursing actions to reduce anxiety in a patient

[4]
Listen attentively
Provide an atmosphere of wwarmth and trust
Convey a sense of caring and empathy
Stay with pt as needed to promote safety and feelings of security and to reduce fear
Control the environment to minimize additional stressors such as reducing noise, limiting the number
of persons in the room, and providing catre by the same nurse as much as possible
Help pts to:
- Determine situations that precipitate anxiety
- Identify signs of anxiety
- Verbalize feelings, perceptions, and fears as appropriate
- Some cultures discourage the expressions of feelings
- Identify personal strengths
- Recognize usual coping patterns and differentiate positive from negative coping mechanisms
- Identify new strategies for managing stress e.g. exercise, massage, progressive relaxation
- Identify available support systems
Give pts choices about some aspects of care but do not overwhelm them with choices
Berman A, Snyder SJ Kozier B et al. Kozier and Erbs Fundamentals of nursing: Concepts, process and practice.
8th Edition 2008 Pearson; p. 1072
Describe the developmental problems of a mentally retarded child during early childhood
Page 103 of 128
[10]
Feeding difficulties a weak or uncoordinated suck results in poor breast feeding or bottle feeding,
leading to poor weight gain
Delayed or decreased visual alertness and curiosity with poor visual tracking of face or objects
Decreased or lack of auditory response
Decreased spontaneous activity
Delayed head and trunk control
Floppy (hypotonia) or spastic muscle tone
No social smile by age 4 months
No babbling (ga ga, da da) by age 9 months
Unresponsive to name
Not rolling over by age 6 months
Not sitting by age 9 months
Not walking by age 15 months
Not stair climbing by age 2 years
Delayed independent sitting, crawling, pulling to stand and independent ambulation
Delayed communication
- failure to develop receptive and expressive language milestones
Failure of the child to make progress or show interest in the area of independence in self
feeding, dressing, and toilet training may reflect cognitive impairment
Short attention span and distractibility
Behavioural disturbances
Clumsiness
Reference
th
Nettina Sandra M .Lippincott Manual of Nursing Practice. 8 Edition. 2006. p1706; 1711
Describe the independent functions of the registered nurse
[5]
The independent function of the nurse has four aspects

The first aspect relates to all those factors that inherent in nursing assessment, diagnosis
, treatment and care
These are the normal prescriptive, organisational and implementation functions of the nurse
in the nursing process
The second aspect relates to the manner in which the nurse carries out her duties
She is totally responsible and accountable for her actions
It is expected that the registered nurse is competent
The third aspect relates to the fact that only the nurse can decide whether she has the
necessary knowledge and skill to carry out a task
She alone must decide whether the act is legally and ethically permissible
The fourth aspect is that she has a duty to act responsibly within the limitations of her
scope of practice
This duty forms the basis for her accountability
Reference
Searle. Professional practice. 2010: p170
Describe the underlying principles that stipulate the Scope of Practice of the Registered Nurse
[10] Basic principles of rules and conditions of practice may be published as a list of acts and omissions
and a list of conditions under which a practitioner may exercise her calling
Definitions
Page 104 of 128
Concepts which forbid the nurse to do certain activities must be defined, so that no
misunderstanding can arise
Restriction of advertising by a nurse / midwife

The RN/ Midwife should be known to pts, other nurses and Drs by the quality of her service
The restriction on advertising by a professional person is aimed at the protection of the
public, for the public is not in a position to judge whether the advertising is inaccurate or
misleading A bona fide patient
No nurse / midwife practitioner may treat a bona fide pt of any other practitioner without
that practitioners knowledge and consent
Bona fide patient means a pt who has at any time previously been treated by the
practitioner concerned
The concept of bona fide pt is important to prevent registered persons from sending out circulars
or letters to households, as is done in commercial practice
Wilfully or negligently omitting to carry out certain acts
This principle entrenches the concept that the nurse has a duty to practice her profession with
care and with intent to protect the patient at all times.
The principle places accountability for own actions on the nurse
Keeping clear and accurate records
This is a vital principle, for it protects the pt, the nurse and all the health professionals concerned
with the pts treatment and care
It strengthens the co-ordinating function and ensures the safety and the rights of the pt
Actions that are not in good taste
Certain items such as elaborate nameplates, visiting cards and letterheads that may appear as
advertising in a distasteful manner, or which intrude on the preserves of other practitioners, or glorify
the practitioner are not in the interests of the profession or of the public
Such details must preserve the dignity and standing of the profession, while being worded
and displayed so as to make the practitioner and her practice known to the public
Avoiding canvassing or touting
Pts must seek the services of a practitioner because they have trust in the service she will give
and must not be offered inducements to choose the particular practice
Itinerant practice
The fundamental principle of itinerant practice is that the nurse must be able to give a complete
and satisfactory service
It must be a regular service and it must ensure that the pts well being is protected in the
absence of the practitioner
Financial interest in rendering a service
This principle is aimed at preventing nurses from accepting bribes or other forms of compensation
to give preference to consumer commodities used in the practice of nursing, or paying or accepting
commission in any form for recommendation of pts
Professional secrecy
This principle is fundamental to the trust relationship between nurse and pt
In the event that a nurse is ordered to disclose a matter in a court of law, she must protest and ask
that her protest be recorded before carrying out the instructions of the presiding judicial officer
Avoiding secret remedies
Page 105 of 128
From time to time there are health professionals who claim that they have a secret remedy
or apparatus for certain illnesses or to diagnose certain conditions
This practice is condemned, because a professional person must work in a scientific manner that
is open to assessment or evaluation by her profession
Avoiding impeding a patientus treatment

This principle is important for it is grossly unethical for a nurse/midwife to prevent a pt from
obtaining advice or treatment from another registered person
Action falling outside the practitionerus scope of practice
Except in cases of emergency, a nurse/midwife may not perform acts which fall outside the scope
of her profession and for which she has had inadequate training or experience
A person must do whatever she can in an emergency, but must limit such action to that which
her knowledge and competence permits
She must not place the pt at risk by undertaking action so far beyond her knowledge and
competence that she jeopardizes the well being of the pt
Co-operation, partnerships and contracts
This principle acknowledges that health care is largely a matter of teamwork and that nurses
must co-operate with other members of the health care team in legitimate practice and may enter
partnerships and make contracts
Such a principle forbids the nurse to break contracts, commit illegal acts or support others in doing
so, and to use persons who are not nurses or midwives in performing nursing acts, otherwise
known as covering
A registered or enrolled nurse mau not refuse, or in a deliberate or negligent manner fail, to
execute any lawful duties for which she has been employed
Avoiding tendering for jobs
This does not refer to answering an advertisement for a post
It deals with the situation where a nurse offers her services to an employer and states that
she is prepared to do it for less than the remuneration expected by other applicants
In other words, she puts in a lower bid
This is not only professionally undignified, it is also against the interests of the profession as a
whole, as well as the interests of the public, which may consequently be exposed to the services of
persons of inferior ability and standards
Avoiding supersession
The registered practitioner does not take over a doctor or another nurseus pts unless they have
been referred to her by the persons concerned, or unless the pt has cut his connections with the
other practitioner before coming to her
A nurse who changes a doctorus treatment without warning him that she has to do so, or who
prescribes and administeres to the doctorus pt medications that the doctor has not authorized,
is superseding the doctor
This is unethical and constitutes blatant interference with another personus practice
Obtaining medical assistance
The principle entrenches the concept that in accordance with the circumstances and the
seriousness of the ptus condition, a nurse may not neglect:
- to refer the pt for medical care where such care is beyond the scope of her practice, and may
not delay such a referral
- to do what she can to save a life, to arrest deterioration in the health status of the pt, to prevent
deformity or to reduce pain and suffering
The registered person must obtain medical or dental assistance for her pt in accordance with the
Page 106 of 128
urgency of the situation and the reasonable availability of such services

Pts with serious health conditions must be referred to a Dr, or a dentist as the case may be, but in
the absence of these practitioners the nurse must try to obtain the assistance of a more experienced
or specially qualified nurse or midwife
She must record that she has recommended such a referral and record what action she has taken
In the case of a pt refusing medical care, she should impress on him the seriousness of such
action or inform a responsible member of his family
She cannot force him to seek such care and must do the best she can for him
She must, however, protect herself by maintaining a full written record of the :
- circumstances that convinced her that such aid was necessary
- guidance she provided to the pt and / or his relatives
- decision of the pt or his relatives
- date, time and place that this occurred
- problems that arose
- outcome of the decisions and actions by pt / relatives / nurse
the nurse must stay with the pt and do the best she can for him, and must record fully what she
has done
Protecting the professional reputation of other registered persons

A nurse may not injustly cast reflection, explicitly or by implication, upon the professional reputation,
skill, knowledge, service or qualifications of any person registered or enrolled under a nursing act, or
any other act related to the welfare of the pt
It is not in the interests of the public to sow distrust in the profession
Refraining from defaming a council / board or its members
The principle states that a nurse may not perform any willful act that is calculated to:
- prevent the council, a committee of the council or the registrar from performing a duty which
may be lawfully performed by the council, such committee or the registrar
- bring the council or any member or official into contempt or discredit
Avoiding exploitation
It is contrary to the interests of the public and the profession for a registered person to allow
herself to be exploited in a manner that may be detrimental to public interest, because by allowing
herself to be exploited she is not acting as a person who is accountable for her actions
Refraining from divulging views on health science topics
There are professional journals, books and addresses to professional audiences with which health
professionals can expand their views on health science matters
Where a nurse, through the requirements of her service, has to address a lay audience in
such matters, she should do so with extreme care to avoid causing confusion or public fears
Persons in private practice may not undertake such activities without the permission of their
nursing council, as iot may be interpreted as advertising
Reference
The registered nurse is responsible for administration of medications once he / she accepted the
prescription.
Describe the lawsuits that may occur as result of the administration of medication
[6]
Civil lawsuit
- Substantive law deals with the legal rights and obligations of persons
Page 107 of 128
The law of procedure sets out the nature of the proceedings to be followed in court to secure
redress when legal rights have been infringed or legal duties neglected. Health professionals
are often sued in court for the commission or omission of an act which has resulted in harm
being done to the pt
Common lawsuit
- Law or doctrine of precedent is used extensively in decisions relating to malpractice litigation
involving health professionals
- Judges use this principle, known as stare decisis, or to stand by that which is decided, as
the basis for applying rules formulated in the past to present and future decisions
- It is only the legal principle involved that the judge use the ratio decidendi, or reason for the
decision
Criminal lawsuit
- Relates to the infringements of the rights of the state
- It deals with violation of the law for which the state applies sanctions or exacts punishment
- Transgressions of the provisions of a nursing act fall within the criminal law context
Disciplinary action can also be taken by:

- The employer
- The SANC
Reference
Describe the measures you will implement in your ward to prevent personnel burnout
[5]
Develop systems for effective two way communication
Clarifying role and performance expectations
Promoting prompt, constructive resolution of conflicts
Managers should become familiar with staff and their work e.g. by learning names, being more
visible, doing more rounds and visits
Psychological counseling and therapy should be easily accessible and available for troubled
staff members
The nurse manager should demonstrate good listening skills and empathy by not interrupting people,
by allowing them time to lead up to an important point, by acknowledging the feelings behind the
words, and by not joking about important matters
Continuing education and staff development should be promoted
Assertion should be encouraged in all staff, and sessions could be conducted to teach staff
essential assertive skills
Clear procedures should be followed regarding discipline and the handling of grievances
Greater participation in decision making should be aimed at, especially in decisions affecting
work increases, job involvement, and commitment
Personal respect must be shown to staff members by passing information promptly to staff, giving
time for staff, encouraging discussion before giving ones own views, consulting staff before taking
action, being encouraging in difficult times, and by thanking people for their contributions
Showing openness, or an absence of defensiveness, in discussions with others by giving direct
answers to questions, by being straight-forward, by being open about ones doubts, uncertainties,
faults and mistakes, and by avoiding a defensive response when one feels that one is being criticized
The manager should increase her observational skills in order to detect increased stress levels or
signs of burnout among her personnel in the early stages and in order to identify the sources of
stress and to reduce or eliminate them
Policies which reduce stress from shift work should be developed
Page 108 of 128
A support group for nursing personnel is recommended

A health care support programme for individual employees suffering from problems with
substance abuse, weight, etc. could be helpful
Reference
nd
Booyens SW. Dimensions of Nursing Management. 2 Edition. 2005.p149
The adolescent experiences conflict between a childish wish for safety and an intense need for
adult self determination
Describe the factors that precipitate stress in the adolescent
Changing physique
Relationships involving sexual attraction
Exploring independence
Choosing a career
Death of a family member
Illness
Birth of a new sibling
Studying for final examinations
Transition from childhood into puberty
[8]
Berman A, Snyder SJ Kozier B et al. Kozier and Erbs Fundamentals of nursing: Concepts, process and practice.
8th Edition 2008 Pearson; p. 1061
Describe the main arguments against the professional status of nursing used by some sociologist
and nurses
[5]
Not all nurses are educated at university
The majority of nurses are not self employed or independent fee for service practitioners
Only a very small percentage of nurses have attained high intellectual status through writing,
research and other manifestations of leadership in comparison with other professions
There is no clearly defined theory of nursing
Nursing is largely dependent on the doctor for its practice
Reference
Explain the responsibility of the registered nurse with regard to the release of information concerning
patients to the press
[6]
By law, patient information is confidential and may not be disclosed to the media
Hospital Managers or their designated staff only divulge information regarding the admission
to hospital and condition of a patient in their facility to the media, or allow the media to visit,
interview and / or photograph a patient in their facility, after they have obtained written
approval from the patient or, in the case of a minor, with the written approval of the patients
parent or legal guardian authorizing the hospital release such information to the media who
initiated the enquiry
Any enquiry by the news media relating to the hospital or patients should be referred to
the Nursing Manager
No information whatsoever should be given about a patient to the news media (press,
radio, TV) without the prior written consent of the pt and the treating Dr
The ward sister must make sure that all personnel working in her ward are conversant
with this administrative aspect i.e. no information to be given to the press
Page 109 of 128
Reference
Life Healthcare Policy Document: Policy and Procedures for Media Communications.
Describe the following values, fundamentals in nursing practice

1. Commitment
[5]
Is a pledge or contract to fulfill some obligation or agreement
Commitment implies affirmation of the social contract, that unwritten contract the
nurse concludes with society when she becomes registered or enrolled
The act of registration or enrolment implies commitment to the ethics of the profession
and the provision of care that is compassionate, empathetic, supportive and
individualized according to the needs of those needind nursing intervention
Commitment to accountability characterizes responsible professional practice and
ensures the rights of the public and individual pt
Commitment to maintaining standards of quality nursing and this is reflected in the way the
pt receives care
Commitment to the employer and the pts the nurse has undertaken to serve
Commitment to other members of the health team and to effective interactivity and cooperation requires reciprocal commitment between all members of the health team
Commitment to effective management is a basic requirement to ensure quality pt care
The commitment of the individual demonstrates the commitment of the profession
Without this commitment the pts rights are endangered and can even be disregarded entirely
Being a member of the nursing profession requires commitment to its philosophy, ideals
and objectives
The commited nurse gives support to the development of the ethos of her profession
She shares in
- classification of its values,
- the development of a body of knowledge through research,
- the search for objective criteria of practice in a changing world
- the strengthening of its educational base and role
- the improvement of the professions advocacy role for the improvement of the health
services of society and
- to enable nurses to provide better care
As a role model the committed nurse evokes a desire in others to follow her example, and
as a preceptor and mentor she guides others to protection of the pts rights and to
committed practice
Commitment to the growth of professional knowledge
The committed nurse exposes herself to the networking system of her profession and
shares in the assertive efforts of her profession to ensure that the nation receives the health
care it needs
Reference
rd
Searle. Professional practice. 2010: 3 edition. P112
2. Compassion
[5]
A value relates to modes of conduct and the right or wrong of such conduct. Ones values
determine ones decision making and attitude towards person, object or idea.
Compassion is having empathy and sympathy for the sufferings of others. Caring is
feeling and exhibiting concern for others.
If a nurse has compassion it stems from her value to care about the wellbeing of others.
A nurse cannot exhibit compassion if she does not care about people
Page 110 of 128
In order to respond to the health care needs of society the nurse must be able to
provide high quality, compassionate and personalized care at all times.
The caring value of nursing is hence based on the empathy and sympathy that a nurse
shows to the patient and his family i.e. she is able to care for the patient with respect and
dignity and support the patients right to self determination and not abandon the patient if
she disagrees with the patient on some issue.
Compassion is tender loving care which is more than skills and knowledge
It is something which flows from a compassionate human being who has the ability to dispel
anxiety and to handle people with sensitivity, patience and insight
A compassionate nurse has to learn to cultivate patience, tolerance and kindness and
never to let go of her personal integrity
She has to build up reserves of spiritual and emotional strength and of the ability to love
Reference
nd
Pera S, van Tonder S. 2005. Ethics in health care. 2 edition. Lansdowne: Juta. Pgs 14 -17.
th
rd
Searle. Professional practice. 2010: 5 edition. p54; 3 edition. P321
Match the statement in Column A with the applicable defence mechanism in Column B.
Write only the number of the question and the letter of the correct answer in your answer book e.g. 7 = g
COLUMN A
COLUMN B
1. A male person is paralyzed but has mastered the

art of painting with his mouth
a) Projection
2. A patient is angry with his wife and shouts at

the nurses
b) Compensation
3. A person with glandular carcinoma does not

accept the fact that he cannot continue working
c) Identification
4. A toddler resumes drinking from a bottle on

being admitted to hospital
d) Denial
5. A student regularly forgets her dentist appointment
e) Repression
f) Regression
Answer
1. b
2. a
3. d
4. f
5. e
Reference
th
Kaplan. Synopsis of Psychiatry. 7 edition p250
Describe the emotional support of a terminally ill patient

[10]
Page 111 of 128
The phase of becoming aware

Sincere empathy is essential
Give the pt encouragement and assure him / her of your support, as well as that of
the family
Convince the pt and family through your attitude that you accept them and that they
are free to express their feelings
The phase of denial

You must accept that the pt or family might not be ready yet to admit the seriousness
of the illness
Give the pts loved ones the opportunity to stay with him / her so that the pt may
obtain reassurance from them
Strengthen your relationship with the pt by spending time with him / her
Allow the pt to go home to perform rituals, if this is the wish of the family and pt
The phase of aggression

Stimulate free expression of feeling through empathetic listening, so that the pt can
vent their feelings of rebelliousness and resentment
Be patient and never counter such reactions with aggression
Give the pt the opportunity to formulate thoughts and feelings in words
The phase of bargaining

Encourage the conversation further and inquire into bargaining
If the pt wishes to see somebody or do something, give hem / her the necessary
assistance
Try to divert his attention from himself
The phase of depression

Listen and give the pt the opportunity to unburden himself, to talk about guilt feelings,
anxieties, sorrows and frustrations, and to find solutions to problems and conflicts
Try to be with them as much as possible, although it may seem that they would prefer
to be alone
The phase of acceptance

Give the pt practical assistance in affairs that have to be settled, e.g. finalizing a will
or sending messages
Listen sympathetically if the pt wishes to confess to something and comfort him / her
in a sensible manner
LR Uys. Fundamental Nursing. 1999. P426
Describe the use of an ethical code in nursing

[3]
Ethical codes for professions set the parameters of the responsibilities the nurse owes her pt
It is a unifying mechanism which brings persons of diverse cultures, religious beliefs
and practices into a common system of behaviour
It is based on personal morality, which is the foundation of trust for the pt and the community
Ethical codes also serve to protect the reputation and credibility of the profession
It emphasizes personal responsibility
Professions adopt and promulgate ethical codes as a means of establishing standards of
behaviour to protect the recipient of service
th
rd
Searle. Professional practice. 2010: 5 edition. p54; 3 edition. P267

Page 112 of 128
According to Chapter2, Regulation (b) of Government Notice R2598 of 30 November 1984

(as amended) the registered nurse has to execute a programme of treatment or medication
prescribed by a Registered person for a patient
Describe the responsibilities of the registered nurse with regard to the above
mentioned [5]
Where the treatment of a patient falls outside of the nurses Scope of Practice, the nurse is
obliged to refer the patient for medical care as soon as possible
Any delay in obtaining such medical assistance, whether deliberate or not, is seen as a form
of negligence and may result in professional conduct action
This provision of the rules places a responsibility on the nurse to accurately monitor the
progress of the patient and to identify problems promptly so that appropriate treatment can
be given
Failure to provide the patients medical practitioner with accurate and up to date
information regarding the condition of the patient may be interpreted as being a delay in
obtaining medical assistance
The nurse is obliged to do everything in his / her power to save life, prevent complications and
relieve suffering whatever the circumstances, regardless of the availability of medical
assistance
If a medical practitioner is not immediately available, the nurse must send for one and then do
whatever he / she is able to do to assist the patient while awaiting the medical practitioner
It is an offence for the nurse to refuse to carry out the reasonable prescriptions and
instructions of any medical practitioner who is responsible for the treatment of the patient
Should the nurse be unable to carry out such instructions or prescriptions for whatever
reason, he / she is obliged to inform the medical practitioner so that alternative arrangements
can be made
If the nurse feels that the prescription or instruction is dubious and needs to be queried he /
she should discuss the matter with the medical practitioner and arrive at an appropriate
solution
The nurse may not simply refuse to carry out or alter the prescription / instruction just
because he / she feels that the prescription is incorrect or invalid
Reference
R2598 as amended by the South African Nursing Council. Ch 1.
R387 as amended by the South African Nursing Council. Ch 2, Section 22.
Describe the rights of the pt with regard to giving informed consent before an
operation/treatment
[5]
The patient should be given full and accurate information by the health care provider who
is responsible for the execution of the interaction for which informed consent is required
The appropriate and responsible health care provider, who is responsible for performing the
interaction should supply the relevant information with reference to:
- the nature and state of the patients illness/disability
- the significance of any diagnostic procedures
- the proposed treatment
- the probable and reasonable side effects and risks related to the this interaction
- the alternative diagnostic procedures/treatments that are available
- the ways in which the treatment could impact on the patients lifestyle
Page 113 of 128
The doctor must ensure that the patient understands the nature of consent required from him
The patient must be informed effectively in order to ensure his/her rights
Consent must be obtained in writing and must be duly witnessed
All writing on the form of consent must be legible and dated
Patient must grant permission by:
- signing the form in the presence of witnesses who also sign the form immediately
The form must state clearly what treatment/investigation/operation is proposed. It is the doctorus
responsibility to explain to the patient what is to be done
The Registered Nurseus responsibility is to go through the consent before he/she signs it.
Consent must not be obtained under duress
(Consent must be given of the personus own free will, after due explanation)
Refusal of consent may be made on various grounds such as unwillingness to undergo further
suffering. Patientus wishes must be respected.
Know the potential results of the operation
Know other possible options and who will undertake (perform) the operation/procedure
Be given time to think about the operation and consult family members if he/she so wishes
Withdraw consent after giving it if he/she so wishes
Know the type of anaesthesia that is going to be used
Verbalize his or her fears and concerns about the operation/treatment
Reference
SANC BC2
Mellish, J.M., 1982, 1st edition, Unit teaching and Administration for Nurses, p 165 Muller, M. 2003, 3rd
edition Nursing Dynamics p 7
Searle,C. 4th edition, Professional Practice p 206
Describe cultural aw areness and indicate how it w ill enhance patient

care [6]
A person is culturally aware if he has the ability to understand alternative points of view
and respect the views of other cultures
It involves knowledge and sensitivity about the values, beliefs and behaviours of cultures other
than oneus own and a recognition of oneus own cultural orientation
The nurse who is culturally aware (or sensitive) will be able to:
Recognize the similarities (e.g. basic needs and respect) and differences (e.g. language, rituals,
diet) between different people
Approach the patient in a sensitive way
Identify the issues which influence patient care e.g. diet, family, rituals
Identify norms and behaviour that support or conflict with good health practices
Recognize and reduce stressors, e.g. communication and isolation
Develop good verbal and non-verbal communication skills
Provide holistic care to the patient
Implement flexible hospital routines e.g. regarding visiting hours
Show respect, care and compassion to patients and families
Reference
Young A, van Niekerk CF, Mogotlane S. 2003. Jutas manual of nursing. Volume 1. Lansdowne: Juta. Pg
130.
Page 114 of 128
Explain the importance of the nursing of a child using the following headings:
1. Family involvement
The family must be included in the nursing care as far as possible
Must be informed of all procedures and treatment
Their reactions to be observed and handled therapeutically
The childs relationship with the family must be maintained and extended
Encourage family to visit the child
[5]
2. Play
[5]
Sensory development
By playing with objects of different texture, sense of feeling develops e.g. smooth /
coarse, thick / thin
Sense of smell and taste improves by exposure to different odours tastes through play
Hearing and sight develop by exposure to different sounds e.g. rattles and bright
coloured toys
Development of eye hand co-ordination
Throwing and catching a ball
By dressing dolls, playing with cars and trains etc
Colouring in books
Facilitation of child development
It encourages the development of creative imaginations
It allows the practice of motor and perceptual skills in preparation for formal
schooling, through drawing, block building, etc.
It has a therapeutic value
- the child learns to master his / her feelings through finding an outlet for their
destructive impulses using clay, water, etc.
- provides for emotional outlet for child to cope with own feelings e.g. acting out during
play
It promotes intellectual development

- The child continues to test reality
- In play, the child experiments without interference and in so doing develop complex
skills
- By constructive play and to learn causal relationships, although primitive thought
processes are still evident
It enhances social interaction and the playroom is the laboratory for practicing future adult
roles
The child can play cooperatively with other children
In its style of playing the child displays imitation, leadership, gender appropriate
behaviour, etc.
Provides opportunity for the child to develop language, interpersonal skills
Develops norms, rules for behaviour in interaction with other children e.g. sharing,
caring, cooperation
Identity development i.e. role modeling significant others during play
Reference
SANC BC2
Page 115 of 128
Describe the causes of psycholoigical abuse of the elderly
[5]
The exact cause of psychological abuse is not known
Poor or crowded living conditions may be one of the reasons why it occurs
Risks / causes related to the abuser

Depends heavily on the elderly for the elder for things such as money or housing
Drinks alcohol or uses illegal drugs, such as cocaine, heroin, and marijuana
Has a personality disorder, depression, or another mental illness
Has a history of family violence, such as physical or sexual abuse
Has stress due to work, taking care of the elderly, or financial problems
Risks / causes related to the elderly
Age more than 75 years
Has a great amount of money, properties, or other assets
Has learning or memory problems
Has long term conditions such as dementia, diabetes, paralysis, or stroke
Has no relatives or friends who can take care of him
Shows aggressive or disruptive behaviour
Reference
http://www.drugs.com/cg/psychological-abuse-of-the-elderly-for-family-members-and- 10/05/2012
Describe the social development of the adolescent

They are very fond of their friends and prefer to be in their company
They are very sensitive of social pressure
They are very sensitive for social relationships
- It is a time for parties
[5]
They have a need for social acceptability

They must fit in with the fashion of the time with regard to clothes, way of speech, etc.
Reference
SANC - EN
Describe the nursing actions to reduce anxiety in a patient

[5]
Introduce yourself to the pt
Be sensitive to non verbal communication to identify unhappiness, depression, etc.
Promote verbal communication
Be friendly and helpful
Explain all procedures before carrying them out
Create privacy
Do not expose the pt unnecessary
Introduce the pt to staff members and fellow patients
Show pts where to find the toilet, bathroom, how the TV and radio functions, how to use
the bell, etc.
Explain the ward routine, visiting hours, meal times to the pt
Inform pt of shifts of staff members, doctors rounds
Page 116 of 128
Reference
SANC - EN
Explain how a registered nurse will ensure safekeeping of schedule drugs

[10]
The R/N is responsible for the safekeeping of the schedule medications and is
accountable for their use
A register must be kept in the unit which shows clearly what stock is on hand, what has been
administered to who, in what quantity and by whom
Recording on the relevant pts care records must be done of every schedule
medications administered with the date, time, dose and signature of the administrator
The cupboard used for safekeeping of schedule medications must be separated from other
medicine cupboards and must be fixed to the wall
The key to the cupboard must be carried on the person or the R/N on duty in charge of the
unit
The schedule medications must be checked and signed for when changing shifts
Prescription for schedule medications must contain the name of the substance, quantity
ordered and dose, signature and qualifications of persons prescribing the medication
Two nurses, one of whom is a R/N, must check the pts prescription
To ensure the correct dosage, route, time and type of medication
Prescription must be signed by a registered medical practitioner
The two nurses count the balance of the medication at hand that has to correlate with
the balance in the drug register
The medication must be checked by the two nurses before administration to the pt and
Excess injection must be dispensed of in a wash basin
Both nurses must witness the administration of the medication
The date, time, medication, route and pts name, registration number, Dr who ordered
the drug must be entered into the register
The names, qualifications and signatures of the two nurses are entered into the register
The administration is also documented in the medicine administration chart as well as
the pts progress record
Reference
R2598 as amended by the South African Nursing Council. Ch 2.
R387 as amended by the South African Nursing Council. Ch 2, section 4 & 22.
nd
Meyer S, Naude M, van Niekerk S. 2004. The nursing unit manager: a comprehensive guide. 2 edition.
Sandton: Heinemann. Pgs 138 139 & 243 244.
SANC BC2
Describe the psychosocial development of an adolescent
[10]
The psychosocial task of the adolescent is the establishment of identity

The danger of this stage is role confusion
The inability to settle on an occupational identity commonly disturbs the adolescent
Doubts about sexual identity arise
They are concerned about their body, their appearance, and their physical abilities
Hair styling, skin care, and clothes become very important
Adolescents look for ideal persons whom they can trust
Development of autonomy search for ways to express the right to choose freely
Free choice and autonomy present conflicts to the adolescent
Conflict can arise between behaving well in the eyes of the parents and behaving in a manner that
will lead to peer acceptance
Page 117 of 128
The adolescent needs to establish a self concept that accepts both personal strengths and weaknesses
Many experience temporary difficulty in developing a positive self image
This is due to dramatic changes in body structure and function as well as greater expectations to
assume responsibilities
Adolescents who are accepted, loved and valued by family and peers tend to gain confidence and
feel good about themselves
Teenagers with physical disabilities or illnesses are vulnerable to peer rejection
Establishing a sense of sexual identity and clarifying ones sexual orientation occurs during
late adolescence
Adolescents explore sexual images, fantasies, ideas and roles
Experimenting with dress, language, and social interactions (e.g. dances, dating, youth activities) help
them define who they are
Adult role models (e.g. parents, movie stars, music idols) can influence the way adolescents think and
behave, helping teens to decide which as[ects of masculinity or femininity to adopt or reject
Many adolescents are sexually active and may engage in masturbation as well as heterosexual
and homosexual activity
At about the age of 15 years, many adolescents gradually draw away from the family and
gain independence
This need for independence combined with the need for family support sometimes creates conflict within
the adolescent and between the adolescent and the family
The young person may appear hostile or depressed at times
At this stage, adolescents prefer to be with their peers rather than their parents and may seek
advice from adults other than their parents
Parents sometimes are bewildered by this stage of development instead of reducing controls,
they increase them, causing the adolescent to rebel
Adolescents also have to resolve their ambivalent feelings towards the parent of the opposite sex
As part of the resolution, adolescents may develop brief crushes on adults outside the family e.g.
teachers or neighbours
Adolescents sometimes adopt some of the attributes of the adults with whom they are infatuated
This modeling can be helpful in the maturing process
Some of the discord in the family at this time is due to the generation gap
The values of the adolescent may differ from those of the parents
This difference may be difficult for the parents to understand and accept
Adolescents still need guidance from their parents, although they appear to neither want it nor need it
Discipline and guidance need to be presented in a manner that makes adolescents feel loved
They should have the independence they can handle yet know that their parents will assist them
when they need help
Peer groups assume a great importance and has a number of functions
It provides a sense of belonging, pride, social learning, and sexual roles
Adolescent peer group relationships enhance self esteem and self identity
Reference
th
Kozier B, Erb G Beman A, Snyder S. Fundamentals of Nursing. 7 Edition. New Jersey: Pearson. 2012. p391
Describe the factors which would motivate students to remain members of a study group [8]
Cohesion refers to the degree to which members are motivated to remain in the group
The personalities of the group members
The psychological or material factors that act as incentives to continue group membership
The expectation that certain positive or even negative consequences will result from membership
The cost of membership as opposed to the rewards obtained, compared with other activities which may
involve a higher cost and a lesser reward
Page 118 of 128
Clarity of group aim

Members who were aware of the group goal are more attracted to the mutual task, demonstrate less
tension, conform more with group expectations and are more attracted to the group as a whole
Staus in the group
The higher status member is more inclined to support conformity within the group and also feels
more attracted to the groupas a whole than is the case with the lower status member
Group atmosphere
Members feel more attracted to a group which accepts and appreciates them
The more frequently members interact with one another, the greater will be the power of
attraction exerted by the group over its members
Group size
The smaller the group, the more attractive it is for its individual members
Group norms
Groups maintain their norms and solidarity by a means of a system of reward and punishment
The satisfaction of individual needs within the group context is a reward in itself
However, when people deviate from the group expectations or group norms, negative sanctioning is
applied, which will make the group less attractive to those who tend to deviate
Cooperation and competition

The members of cooperative groups, like each other better, make more attempts to influence one
another, more readily accept attempts by others to influence them, and are generally more friendly
towards each other
The above is not the case in competitive groups
Similarities among members
Similarities among group members in respect of values, interests, attitudes and beliefs about
subjects important to the group usually increase the attractiveness of the group
Reference:
rd

1. Identification
[2]
This involves gratification being achieved by attributing to oneself achievements and
positive qualities inherent in another person
Examples are a parent who identifies with the success of a child or a child who identifies with
the strength of the mother or father
2. Denial
[2]
This is the inadmission to consciousness of certain aspects of the external environment
Example a person who denies that his illness is serious, even though he has been told that it
is terminal
3. Projection
[2]
Page 119 of 128
This is the opposite of identification in that a person assigns his own undesirable or
unacceptable characteristics to others
Example a cheater who always suspects others of cheating
4. Introjections
[2]
It is an ego defense mechanism whereby an individual unconsciously incorporates into hos own
ego structure, the qualities of another person, usually a significant other
Reference:
Leanna Uys & Lyn Middleton. Mental Health Nursing. A South African Perspective. 5th Edition. Juta.2010.p27
Identify the aims of patient education
[5]
Make health a priority in the patients value system

Teach the principles of healthy living to patients
Assist patients to manage their own health problems
Inform patients about the health services available
Urge patients to make use of these health services
Supply patients with the necessary knowledge regarding common diseases in their
community
Reference:
rd
Naude M, Meyer S, Van Niekerk S. The Nursing Unit Manager. A comprehensive guide 3 ed. Sandton:
Heinemann 2009. P176
Describe the purpose of keeping accurate patient records
[5]
The information obtained from the pt, (if it is accurate and thoroughly documented), provides
the data needed to plan individualized pt care
Accurate record keeping ensures the continuity of care
It is a means of communication between members of the health team
It can assist in the prevention of errors due to inadequate knowledge
It can be used as a teaching tool for students
The record of the pt eventually becomes the nurses data base for further planning and
implementation of care
It forms a legal record of pt care and it is in the interest of the pt, the hospital and the nurses
that the records be meticulously kept
Facilitates coordination of care
It can be used when doing a nursing audit
They serve as a guide to progress, upon which action can be taken
They can be used for compiling statistical data for research, for motivation, etc.
Reference:
SANA Record keeping booklet
Describe the aspects to be taken into consideration to ensure that the patients dignity is
maintained
[10]
Respecting the privacy of the pt by screening during procedures and examinations
Ensure gown closes well at the back, to prevent overexposure
Allowing pts to wear his/her own clothes if he/she wishes to do so
Ensure that information is kept confidential
Page 120 of 128
Treat the patient with the respect due to him/ her

As the adult, rational decision making person that he/ she is outside of the hospital
Pts should be addressed according to their correct titles and surnames, e.g. Mr,
Mrs or Miss and not by diagnosis, bed numbers or nicknames
Include patient in decision making, especially about his/ her own care
This should make the patient feel more in control
Respect the patients culture and rituals, even if they are far removed from your own
This allows the patient to feel validated that his/ her culture is being considered
Explaining every procedure that is going to be done on the pt and obtaining his/her consent
Allowing the pt some degree of independence if his condition permits
Ensuring the safety of the pts person, name and personal belongings
Orientating the pt to the environment, ward routine and staff responsible for his care
Reference:
Brooker. C. et al (eds) 2009. Foundations of Nursing Practice. UK: Elsevier. p.159
Explain the following terms:

Paedophilia
[1]
An abnormal interest in children
A psychosexual disorder in which the fantasy or act of engaging in sexual activity with
prepubertal children is the preferred or exclusive means of achievingsexual excitement
and gratification
Transvetism
[1]
A tendency to achieve psychic and sexual relief by dressing in the clothing of the opposite
sex
Reference:
Mosby p1417;1885
Describe the aims of disaster management

Preventing or reducing the risks of disasters
Mitigating the severity or consequences of disasters
Emergency preparedness
A rapid and effective response to disasters
Post disaster recovery and rehabilitation
[5]
Reference:
th
Marie Muller. Nursing Dynamics. 4 Edition. 2009 P290
Describe the nursing intervention for grief and mourning following the death of a loved one
[ 10]
The phase of becoming aware
- Sincere empathy is essential
- Give the pt encouragement and assure him / her of your support, as well as that of
the family
- Convince the pt and family through your attitude that you accept them and that they
are free to express their feelings
Page 121 of 128
The phase of denial

- You must accept that the pt or family might not be ready yet to admit the seriousness
of the illness
- Give the pts loved ones the opportunity to stay with him / her so that the pt may
obtain reassurance from them
- Strengthen your relationship with the pt by spending time with him / her
- Allow the pt to go home to perform rituals, if this is the wish of the family and pt
The phase of aggression

- Stimulate free expression of feeling through empathetic listening, so that the pt can
vent their feelings of rebelliousness and resentment
- Be patient and never counter such reactions with aggression
- Give the pt the opportunity to formulate thoughts and feelings in words
The phase of bargaining

- Encourage the conversation further and inquire into bargaining
- If the pt wishes to see somebody or do something, give hem / her the necessary
assistance
- Try to divert his attention from himself
The phase of depression

- Listen and give the pt the opportunity to unburden himself, to talk about guilt feelings,
anxieties, sorrows and frustrations, and to find solutions to problems and conflicts
- Try to be with them as much as possible, although it may seem that they would prefer
to be alone
The phase of acceptance

- Give the pt practical assistance in affairs that have to be settled, e.g. finalizing a will
or sending messages
- Listen sympathetically if the pt wishes to confess to something and comfort him / her
in a sensible manner
Reference:
LR Uys. Fundamental Nursing. 1999. P426
Describe the advantages of a good orientation program for newly appointed trained
personnel
[5]
Personnel experience less anxiety as they know what is expected from them and receive
the support
They become productive sooner
They make fewer mistakes as they have been taught to do procedures correctly
They know and accept the culture and rules of the new employer
They are happier as they experience acceptance into and support by the new working team
They have the opportunity to learn and ask questions
Personnel do not leave the organization because they are supported to adapt to their
new environment
Reference:
SANC BC2
Page 122 of 128
Describe the importance of clinical accompaniment in the clinical setting

[5]
Check compliance of performance against set standards
Identify faults and to take remedial actions
Determine correlation of theory to practice
Determine level of competence in carrying out nursing procedures safely
Evaluate the students developmental level in cognitive, affective and psychomotor skills
Determine students readiness for an evaluation and promotion
Opportunity to provide objective feedback to the student
Provide motivation for the student
Self evaluation
Reference:
SANC BC2
Describe the following:

Agoraphobia
[1]
An anxiety disorder characterized by a fear of being in an open, crowded, or public place,, such as a
field, tunnel, bridge, congested street, or a busy department store, where escape is perceived as
difficult or help not available in case of sudden incapacitation
Claustrophobia
A morbid fear of being in or becoming trapped in enclosed or narrow places
[1]
Erythrophobia
[1]
An anxiety disorder characterized by an irrational fear of blushing or of displaying embarrassment
Necrophobia
A morbid fear of death and dead bodies
[1]
Zenophobia
The fear or dislike of people different from ones self
[1]
Reference:
Mosby p56;394;674;1266
According to Chapter 2, Regulation (b) of Government Notice R2598 of 30 November 1984,

the registered nurse has to execute a program of treatment or medication prescribed by a
registered person
Describe the responsibilities of the nurse with regard to the abovementioned statement
[9]
This refers to carrying out the prescriptions for the treatment and care of a patient provided
this has been prescribed by one or more of the following:
A Registered Nurse / A Registered Midwife with more specialized knowledge than
the practitioner
A registered medical practitioner / registered dentist
Does not include psychologist or supplementary health services personnel
Page 123 of 128
Responsibilities include carrying out prescriptions or directives for treatment and care
Prescriptions to conform to the legal requirements
Directives to be within the Scope of Practice of the nurse
Nurse to make independent decision to:
Accept and carry out such prescriptions and directives
To monitor the patient adequately and to keep proper and complete records
1) Legal
Responsible for the execution/ delegation of execution of the treatment/med without
causing harm/injury to the client
The nurse must encourage the registered health practitioner to write the prescription on
the relevant documents in the patientus clinical record
Responsible for ensuring that a standard of care is maintained when treatment/med
is executed
Understands that even if treatment/med prescribed by another registered person, the RN
is still responsible for her nursing activities
If the RN believes the treatment/med to be harmful/injurious to client, is the RNus
responsibility to refuse to carry out prescription and report to the registered person and
supervisor
It is the RNus responsibility to ensure all acts and omissions are clearly and
accurately documented as per legal requirements
The prescription must comply with all the legal requirements e.g. legible, unambiguous,
signed in full and accompanied by the registered personus qualifications
Review / confirm the prescription upon receipt thereof
2) Professional
Delegate the work to the appropriate staff member
The following aspects must be considered prior to delegating the task:
Patientus needs assessment
The Scope of practice of the staff member
The competency level of the staff member
Ensure that the RN/person delegated to has the necessary knowledge and skill to execute
the prescribed treatment/med
Ensure that in executing the treatment/med the RN/ subordinate works within his/her
scope of practice
Update the nursing care plan accordingly
Ensure the availability of requirements for carrying out the prescription
Commence and continue with the treatment as prescribed
Evaluate the patientus response to the treatment based on his needs assessment i.e. at
least twice in 24 hours and more frequently if necessary
Record the following information on the relevant document in the patientus clinical record:
Type of treatment provided and the specifications thereof
When the treatment was provided, reflecting the accurate dates and times
The name and rank of the person who administered the treatment
The patientus response to the treatment
Notification of unexpected responses to the medical practitioner / registered person and
the subsequent actions
3) Ethical
Page 124 of 128
The treatment/med is executed in such a manner that the patients autonomy, dignity
and rights are preserved at all times
It is the RNs responsibility to use judgment regarding individual competence
when executing/delegating treatment/med
It is the responsibility of the RN to ensure the in executing the treatment/med,
the RN/subordinate functions within the nurses code of ethics
4) Medication
Obtain a written legal prescription
Ensure that the prescription is clearly understood
Responsibility to give the correct medication and dosage at the right time, via the right
route and according to the right prescription and to the right patient
The patients permission must be obtained after the treatment/ medication is explained
to patient
Identify and verify the correct patient prior to execution
Ensure that the RN has the necessary knowledge and skill to execute the treatment/med
All actions documented accurately and according to legal requirements
Patient is monitored after treatment/med for effect
If error made, must be reported immediately to registered person who prescribed
the treatment / medication
RN is responsible for own actions and for direct supervision of subordinates if execution of
prescription
Reference:
SANC BC2
Describe competence as a caring value fundamental to effective nursing practice

[6]
Competence refers to comprehensive knowledge and skill

It entails commitment to a profession
It includes compassion to patients and other clients
Nursing competence impacts on other health care providers
It adds value to the socialization process of the neophyte (junior / learner)
Competence should be maintained at an optimum level by the professional nurse
The nurse should keep up to date with the latest developments
Continuing education is important
Competence is a personal and professional responsibility
Accountability is implied in all acts and omissions
Reference:
SANC BC2
Describe the principles for facilitation of student learning in the clinical situation
[10]
The learner should perceive that the clinical learning experience contains a problem that
needs to be solved
- The learner should be challenged to use his own initiative and creativity to analyze
the problem and arrive at a solution
- The solution might not be successful, but the learner must be allowed to assess the
effects thereof and make changes if necessary
Page 125 of 128
The UM should involve learners in the process of learning, and not only supply facts
and information
The objectives of the clinical learning experience should be relevant to the learners learning
needs
- Learners should have a clear understanding of why they are learning something
- This can be achieved by relating the learning experiences to practical applications
throughout
- E.g. learners need to know how to aseptically wash their hands from the very beginning
of a nursing programme
- After the initial learning experience, learners will have the opportunity to apply their new
knowledge immediately
The best time to learn anything is when the learning is of immediate use
- If learners learn how to measure vital signs and they can practice the skills in the clinical
setting, the learning is more likely to be effective
If the learner is allowed to accept a share of the responsibility for planning and / or directing
the learning experience, the learner will be more committed to the learning experience
- The learner should be allowed to make mistakes (without causing harm to the patient)
and learn from those mistakes
- In this way, learners take control of their own learning
Adult learners bring their knowledge and experiences to the learning situation, and they can
assist each other to learn
- Even though the learner is not an expert in the clinical setting, this does not mean
that the learner has no skills or knowledge that could be employed in the new
learning situation
- The learner can use existing skills and knowledge to gain more from new learning
experiences
- Learners might be on the same level in a learning programme, but they do not have
the same previous knowledge and experience
- Valuable lessons might be learnt from learners
The learning experience should be related to and make use of the learners experience
- Adults can tie in new learning with what they have previously learnt
- A learner who has previously performed a specific procedure such as the removal of
sutures will definitely make use of the knowledge of that experience to perform a
similar procedure on another patient
The learning environment should be characterized by mutual helpfulness, freedom of

expression and acceptance of differences
- The emphasis is on the uniqueness of the person
- By allowing learners freedom to be innovative and creative, they become actively
involved in their own learning
- The ability to think critically and analytically is enhanced
The learner should be an active participant in the learning process

- Adults learn by doing and develop skills through practices
- However, nursing is a dynamic profession
- As soon as we think we are doing something perfectly, situations and conditions
change, which requires more practice
Page 126 of 128
Learning experiences that are realistic, dramatic and exciting are more likely to be
remembered than routine or boring experiences
- Learners must therefore not only be allocated to perform the routine tasks in the nursing
unit such as measuring vital signs or doing bed baths
- They must also be allocated responsibilities that will challenge them and allow them
to experience new clinical learning experiences
The learner should receive feedback concerning his progress towards achieving the learning
goals
- Positive reinforcement (praise, encouragement, reward and knowledge of results) can
facilitate learning
- Accompaniment and facilitation of clinical learning should be done in a formative
manner
- This means that learners must be informed about what they are doing wrong, and
assisted and guided towards performing their allocated responsibilities in the correct
manner
- If learners are not informed of their mistakes, they will not know what they are doing
wrong
Reference:
rd
Naude M, Meyer S, Van Niekerk S. The Nursing Unit Manager. A comprehensive guide 3 ed. Sandton:
Heinemann 2009. P108
List two clinical features which are the result of psychosomatic disorder in the following systems:
System
Clinical features
Tachycardia
Palpitations
Pain in chest
Feeling faint
Alimentary [1]
Difficulty in swallowing
Nausea
Vomiting
Loss of appetite
Respiratory [1]
Choking feeling
Pressure or constriction in the chest
Sighing
Dyspnea
Muscular
Aches and pains

Wobbling legs
Clumsiness
Spasms
Dry mouth
Tendency to sweat
Tension headache
Flushing
Cardiovascular [1]
[1]
Nervous
[1]
Page 127 of 128
Pallor
Reference:
Leanna Uys & Lyn Middleton. Mental Health Nursing. A South African Perspective. 5th Edition.
Juta.2010.p321
Describe the steps to be taken by the nurse to help an elderly patient to manage his / her
medication at home
[7]
Reference:
th
Kozier B, Erb G Beman A, Snyder S. Fundamentals of Nursing. 5 Edition. New Jersey: Pearson. 2004. p. 856
Describe important environmental factors that promotes the positive development of the mentally
retarded child
[5]
Reference
th
Nettina Sandra M .Lippincott Manual of Nursing Practice. 8 Edition. 2006. p1706; 1710
Page 128 of 128

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PREPARATION FOR THE SOUTH AFRICAN NURSING COUNCIL ADMISSION

EXAMINATION FOR FOREIGN APPLICANTS - REGISTRATION AS A GENERAL NURSE

ETHOS AND PROFESSIONAL PRACTICE

Good luck with your preparations!

Foreign Exam / Nov 2012

ETHOS AND PROFESSIONAL PRACTICE & APPLIED SOCIAL SCIENCES

Must be identified as soon as possible after admission to the unit

Foreign Exam / Nov 2012

There is no infection at another body site to indicate probable source of infection.

Outline the reasons for quality improvement.

An internal quest for excellence

Internal desire for positioning

To be able to compete in a competitive market

A patient in your unit has severe post operative pain.

Common goals and objectives

Booyens,SW 2 edition Pg 207

choice of leadership style based on followers ability and professional maturity

She displays self-regulation and self-control and displays

Takes pride in profession and strives for maintenance of positive professional

Action can be taken in a civil or criminal

Atmosphere in the ward is important

Performance evaluation is an important aspect of the quality improvement process. Outline,

Document analysis and auditing

Peer group evaluation

the patients view of the quality of nursing care is asked

Monitoring of negative incidents

Describe the professional rights of nurses.

The nurse has the right to;

To determine what is already known about the topic to be studied.

Patients learning needs must be assessed

Plan the education program in writing

Record health education given and patients response in patient records.

Indicate whether the following statements are true or false.

Reassure the patient that the matter will be addressed

Not all nurses protected by a trade union

Uplift the health of SA population through

Concerned with standards of nursing,

Foreign Exam / Nov 2012

above the immediate needs of members

Work according to scope of practice

Trade union defines and demarcates

Protect all categories of nurses/midwives

Protect only certain categories, not

Foreign Exam / Nov 2012

Observe environment for safety and probable causes

Assess patients learning needs i.e. ability to administer injection

List the responsibilities the registered nurse has to her employer.

Describe the aims of the disciplinary procedure.

Investigate the cause or reasons for low productivity

Serves a s a communication tool for all

Foreign Exam / Nov 2012

or more variables in a specific population e.g.

Briefly outline the nursing theory of Florence Nightingale

Shortcomings in recording can be identified

Assess the content o f their incident report t o identify the com

You are working in a casualty unit as a newly qualified registered nurse.

Suggest that the shift leader approach her own supervisor t o h e

i n f o r m the shift leader o f your intention t o report the m a t t e r t

Maintains good interpersonal relationships with subordinates

Muller, M.Nursing dynamics.3 edition. Sandown:Heinemann.2003

The regulation o f the matters which through nursing i n t e r v e n

Informed commitment and group/team co-operation

A good theory is stated in the simplest terms possible.