UNIVERSITY EXAMINATIONS UNIVERSITEITSEKSAMENS. UNISA een PYC2605 (499240) October/November 2012 HIV/AIDS CARE AND COUNSELLING Duraton 2 Hours 70 Marks EXAMINERS : FIRST MRS H HENDERSON MRS K SHIRINDA-MTHOMBENI MRS PB SIPUKA PROF AC VAN DYK PROF PJ VAN DYK ‘SECOND PROF | FERNS. Closed book examination. This examination question paper remains the property of the University of South Africa and may not be removed from the examination venue. This paper consists of 26 pages plus instructions for completion of a mark reading sheet This examination paper remains the property of the University of South Africa and may not be removed from the examination room. [ Please complote the attendance register on the back page, tear off and hand to the invigilator. ] This paper consists of 70 multiple-choice questions which must be answered on the mark reading sheet Your mark for this examination will be converted to a mark out of 90 Note that your mark for Assignment 01 and 02 will be converted to your year mark and a mark out of 10 which will be added to the mark you obtain for this examination paper Afier completing your answers, you must hand in the following (i) The mark reading sheet (i) This examination paper (All the pages must be handed in ) ENSURE THAT YOU HAVE WRITTEN YOUR STUDENT NUMBER, MODULE CODE AND UNIQUE NUMBER ON THE MARK READING SHEET [TURN OVER]2 PYC2605 OCTINOV 2012 * ANSWER THE FOLLOWING SEVENTY MULTIPLE CHOICE QUESTIONS ON THE MARK READING SHEET. * FOLLOW THE ATTACHED INSTRUCTIONS CAREFULLY. * SUBMIT YOUR COMPLETED MARK READING SHEET TOGETHER WITH THIS EXAMINATION PAPER. NO STAPLES PLEASE! Note: Section A (Question 1 to 56) is compulsory for all students. Students may then choose between Section B (Guidance track) and Section C (Care track) SECTIONA QUESTION 1 How would you explain to a client what is meant by ‘mmune deficiency”? (1) The HI virus in your body 1s immune to any deficiencies caused by the syndrome. (2) Your mmune system can no longer protect your body against infections from outside (3) The HI virus 1s deficient because itis a retrovirus. (4) Your mmune system 1s s0 deficient that it can only produce new viruses QUESTION 2 The defences of the immune system can be divided into two main groups the non-specific defences, for example (a) __, and the specific defences, for example (b) _ (1) (@) the skin and mucous membranes (©) plasma protens (2) (a) phagocytes (e.g. macrophages) (b) lymphocytes (e.g T cells and B calls) (8) _(@)plasma proteins () phagocytes (e.9. macrophages) (4) (@) T lymphocytes (e.g. CD4+ T cells) eect (e.g B memory is) QUESTION 3 When a person is newly infected by HIV, the immune system responds in the following way: The plasma Beells (1) manufacture antibodies which attach themselves to the viral proteins in an attempt to slow them down (2) are the ‘spies’ of the immune system, but they are ineffective because they can only destroy chemical poisons and environmental pollutants such as dust. (8) are the central regulatory cells of the mmmune system, and they stimulate the rest of the mmune response to take action against the virus (4) _ as antigen-presenting cells, present the foreign HIV antigens in the body to the immune system so that it takes action against the virus [TURN OVER]3 PYC2605 OCTINOV 2012 QUESTION 4 The World Health Organization (WHO) recommends which of the following guidelines to blood transfusion services to ensure that blood does not contain the Hi virus (or hepatitis B or syphilis): (a) _Noblood should be accepted from homosexual donors (0) Alldonated blood should be screened for HIV, hepatitis B and syphilis, {c) Donors should, preferably, not be paid for donating blood (d) Low nsk donors should be encouraged to return on a regular basis for blood donations (e) Blood should be stored for at least three months before it is used — to eliminate the dangers of the window period. The correct answer 1s (1) (@), (©), (©), (B) & (e) (2) (a), () &(e) (3) (b) ® b.@a@ QUESTION 5 Martin 1s a young medical student who accidentally sustained a needie-stick injury while admimustenng an injection to an HIV-positive patient Martin was HIV negative before the needle-stick injury What advice would you give him in terms of the nsk of contracting HIV through sharp instruments? (1) His risk 1s very high and he should immediately start with antiretroviral medication, which should be taken for three months (2) His risk of actually contracting the virus 1s so small (approximately 0,37%) that he can yust ignore the accident. {8) He should go for HIV testing immediately and again after three months and, ¢ he tests HIV osttve, after three months he should start with antiretroviral medication. (4) Although his chance of contracting HIV 1s relatively small (approximately 0,37%), its stil advisable that he immediately start taking antiretroviral medication as prophylaxis (QUESTION 6 Thandie tested HIV posttve when she gave birth to a baby boy She lives in a shack in an informal settlement and has no running water or electncity There is no clinic nearby and she does not have money for transport to the clic im town. Taking Thandiwe's circumstances info account, what advice would you give her regarding breastfeeding? (1) Breastmik is always the best nutrition for a baby and Thandiwe should therefore breastfeed her baby for at least two years to make sure that the baby 1s healthy. (2) The chances of the baby getting infected through breastfeeding are too high to risk breastfeeding and Thandiwe should, instead, give the baby formula milk However, she must make sure that she stenlises the botties to prevent gastroenteritis (8) Thandwe should exclusively breastfeed for six months and then wean the baby immediately after that She must, however, keep her breasts and ripples healthy and make sure that thrush and gastroententis in the baby are treated immediately (4) Thandwe should give her baby formula milk, but she and the baby should take high dosages of vitamin B, because a vitamin B deficiency increases the risk of mother-to-child transmission during breastfeeding. [TURN OVER]4 PYC2605 OCTINOV 2012 QUESTION7 Why is John more infectious to his sex partners shortly after sero-conversion has taken place? (1) The CD4+ T cells are depleted during this phase and cannot protect John properly (2) John does not yet know that he is infected so he cannot protect his sex partners (8) The wiral load in John’s blood and semen ts very high dung this phase (4) The process of sero-conversion is not yet completed, leaving insufficient time for CD4+ T cells and antibodies to form in John’s blood. QUESTIONS Which one or more of the following statements descnbe the process of sero-conversion? Sero-conversion 1s the pomnt at which a person's HIV status changes from being negative to positive (b) Sero-conversion usually occurs 4 to 8 weeks after infection with the HI virus. ()_Sero-conversion usually comcides with the time an HIV test is positive The correct answer 1s a @ 2) (b)&(C) (3) (a), (0) & (©) @ ©) QUESTION 9 The viral load m the blood of an HIV infected person usually reaches a certain ‘set pomnt’ Which of the following statements regarding the ‘set pomnt is/are true? (a) The set pomt is the pont at which wrral levels reach a steady state (b) The set pont usually occurs 16-24 weeks after HIV infection (©) Abigher set point is usually an indication of a lowered viral burden in the body (@) _Alower set point 1s usually an indication of a better outlook or prognosis for the patient. The correct answer 1s (1) (a) &(d) 2) (c)& (a) 3) (d) &(C) (4) (@), (©) & (d) QUESTION 10 Voluntary HIV counselling and testing (VCT) clinics should use TB checklists and refer patients with symptoms to their nearest TB treatment clinic Which of the following symptoms would you mclude m your TB checkiist? (a) swollen glands (h) malaise or a general feeling of ilness (b) diarrhoea () oral thrush (©) persistent coughing ()__ loss of appetite (d) enlarged liver (kK) _ recurrent herpes infections (e) weight loss ()__ night sweats and fever (shingles (m) coughing blood (g) shortness of breath [TURN OVER]5 PYC2605 OCTINOV 2012 The correct answer is (1) (a), (c), (€), (9), (i), (I) & (m) (2) (b); (e), (A), (0), (9), (M), (@, (D & (rm) (3) (), (e), (9), (h), G), () & (m) 4) ©.(2) 0,0, &0 QUESTION 11 Health workers in Afnca often find the syndromic management approach for STI (sexually transmitted infection) treatment in Africa more practical than the diagnostic management approach. The following fare some of the disadvantages of the diagnostic management approach in resource-poor settngs in Afnicar (@) Laboratones with sophisticated techniques and faciities need to be acqured to diagnose the speotfic ST! (b) _Over-treating patients, who may receive more drugs than they actually need (c) Patents with asymptomatic ST! infections do not get treated at alll. (@) _STis often go untreated because itis often not possible for patients who reside far from clinics to return for test results and treatment at a later stage. ‘The correct answer 1s’ (1) (a) &() @ @ 3) (0) &(c) (4) (@), (0) & (0) QUESTION 12 The two factors that determine the accuracy of a blood test are sensitivity and specificity The sensitivity of an HIV antibody test refers to its ability (a) to pick up very low levels of antibodies; and (b) to__ (1) shorten the window penod (2) detect HIV positivity and not give false negative results (3) distinguish specific antibodies from other cross-reacting, non-specttic antibodies (4) demonstrate HIV negativity and not give false posttive results QUESTION 13 What is meant by the ‘window period’ within the HIV testing environment? (1) The person stil tests HIV negative and cannot, therefore, transmit the virus to another person. (2) The person already tests HIV postive, but is not yet infectious to others. (8) The person recewed a false positive result (4) The person may be fected with the HI virus, although he or she stil tests HIV negative If the persons indeed HIV positive, he or she may already be able to transmit the HI virus to others. QUESTION 14 ‘The HIV PCR technique can be used for diagnostic as well as for post-diagnostic or treatment purposes. ‘There are two types of PCR techniques, namely the qualitative and quantilatve PCR test A quantitative PCR test is used __ (1) To diagnose an individual as HIV positive or negative (2) To measure an individual's response to antiretrowral therapy by determining the viral load in the blood (3) To establish i the nucleic acid of the HI virus is present m the individual's blood (4) Toestablish the health of the immune system by measuring the CD4+ T cell count [TURN OVER]6 PYC2605 OCTINOV 2012 QUESTION 15 Anti-retroviral therapy has four primary goals, namely a virological goal, an immunological goal, a therapeutic goal and an epidemiological goal. The therapeutic goal is to __ (1) improve the quality of the HIV-positive person's Ife (2) reduce the HIV viral load as much as possible (3) reduce HIV-related sickness and death and to reduce the impact of HIV transmission in the ‘community (4) improve immune functioning, reduce opportunistic infections and delay the onset of Aids QUESTION 16 Under ideal conditions, how does antr-retroviral medication (ART) work to prevent HIV infection after ‘needle-stick mjunes or rape? (1) ART interferes with the integrase enzyme and prevents the viral RNA from integrating with the cal's DNA (2) ART ‘seals’ the entry pomnt of injury and prevents viruses getting past the first line of defence, namely the skin or mucose membranes. (8) ART interferes with the replication mechanisms of HIV and prevents the virus from attacking the CD4+ T celts and thus from reproducing. (4) ART kills all the CD4+ T cells in the vicinity of the HI viruses before the viruses have a chance to attack the CD4+ T cells QUESTION 17 Mabel read an article about HIV and Aids in the December edition of Love Life and realised that she may be at risk from contracting HIV, but that she has the ability to change the situation She made a New Year's resolution to ask her boyfriend to always use condoms from then on Which one or more of the principles of behaviour change do you recognise in Mabe''s decision to change her behaviour? (a) Recognition of the need to change. (0) _ Intention to perform a spectic behaviour. (©) Self-efficacy. ‘The correct answer is. a) (a) @) (a)&) @) (a), () & () @ QUESTION 18 One of the principles of behaviour change ts that the Aids educator should be absolutely specific about the behaviour that needs to be changed. It is therefore important to identify the action, target, context and time of the behaviour that you want to change. The important conceptual difference between buying a (1) latex condom versus buying a (2) non-fatex condom, refers to the of the behaviour. (1) action (2) target (3) context (@ time [TURN OVER]7 PYC2605 OCTINOV 2012 QUESTION 19 There are many teaching methods or strategies that can be used by Aids educators to promote learning (One of the advantages of group discussions is (1) Group discussions expose members of the group to the beliefs, values and practices of others (2) Leamers find it beneficial to practise new behaviour through simulated exercises (8) _Itis empowering for leamers ifthe facilitator builds on their expertise (4) Group discussions force silent members to take the lead in the discussions. QUESTION 20 You decide to advertise a workshop for sex workers as follows 'Sex workers! Aids kills! Stop spreading death through Africa’ Keeping the pnnciples of behaviour change m mind, do you think that this message will be effective? (1) No, because sex workers don’t have the intention or the self-efficacy to change their sexual behaviour (2) Yes, because the message is vety scary, and people will only change their behaviour if they are scared enough about the consequences of Aids (8) No, because the message discriminates against sex workers and blames them for spreading the disease through Africa (4) Yes, because sex workers will, for the first time, realise their role in spreading the disease through Africa QUESTION 21 ‘According to your prescribed book, which one or more of the following HIV and Aids group facilitators has/have the qualities of a good and successful facilitator? {a) Jan helps her group to discover how much they already know, and build upon their experiences by involving them in their own learning (b) May found that participants often remember the wrong answers that group members gave, and therefore prefers to give the group all the necessary information and only then allow them to ask ‘questions. (©) April remains as objective as possible, but when it comes to negative attitudes towards people with ‘Aids, she imposes her very strong opinions on the participants and tries to force them into agreeing with her that negative attitudes are harmful The better factitator is (1) Jan (2) May. (8) Apni (4) Jan, May and April- each one has something to contnbute to the learning process QUESTION 22 What is one of the disadvantages of the female condom? (1) _ tis made from polyurethane plastic and not from latex (2) _Itneeds special storage requirements. (3) _Itcan only be used with water-based lubncants. (4) _ tis more expensive than male condoms and not always readily available. [TURN OVER]8 PYC2605 OCTINOV 2012 QUESTION 23 It 1s very important for Aids counsellors to know the terminology of sex practices practised by their clients, If your chent has oral-pentie contact or oral sex performed on a male partner, itis called (1) anilingus (2) cunnilingus (8) fellatio (4) femiingus QUESTION 24 Charles went to a traditional healer, and complained about feeling dizzy and sick On questioning Charles, the traditional healer established that Charles only suffers from these symptoms when he has sex with his girfmend while she 1s menstruating He diagnosed the sickness as caused by (a)__ because (b)__. (1) @) God (b) Charles is not supposed to have pre-mantal sex with his girfiend (2) (a) pollution (b) Charles commutted a ritual mpunty by sleeping with a menstruating woman (3) (a) awitch or sorcerer (b) the gittriond’s jealous lover probably hired the witch to ‘punish’ Charles (@) (@) HIV (b) the girtfnend’s menstrual blood contains the HI virus QUESTION 25 Cultural beliefs and customs should be respected by Aids educators who work in Africa The following cultural practices practised by some traditional Afncans are, however, dangerous and should be changed. (@) dry sex (0) prostitution (©) widow cleansing (@) herbal remedies prepared by traditional healers (e) _mtuals where offerings are made to the ancestors ‘thigh’ sex ‘The correct answer is Q) O)& 2) (a) &(C) (3) (@), ()& 4) @), ©). ©). @). (2) & [TURN OVER]9 PYC2605 OCTINOV 2012 QUESTION 26 ‘Which one of the following four counsellors complies with the aims and tasks of counselling as proposed by Egan? (1) Juan helps his chents, by attentive listening and probing, to discover their own problems He then gives them various options based on his previous expenences and allows them to choose the option that will suit their circumstances the best. (2) Manan helps her clients to explore their problems. She then encourages them to manage their problems more effectively by developing their unused and underused opportunites so that they ‘can cope better in future. (3) Vusi empowers his clients by allowing them to tell their stones without any interruptions. He then shares the experiences of other clients with them so that they have a good example of how to become more effective setf-helpers in future. (4) Julie divides the counselling process into four phases and, in the first session, concentrates only ‘on relationship building and trust She then sends the client home to think about the second phase (telling the story) so that they can both start working in the second session. QUESTION 27 The counselling process can be divided into four phases to provide a framework or map for the counselling process. The goal of the phase to facilitate an increased understanding of the problem is to (a)___, while the goal of the intervention or action phase is to (b)__. (1) (@) allow the cent to tell his or her story {b) set goals and to decide on methods of achieving them (2) (a) _ establish an open and trusting relationship {b) get nsight into the chent’s context and explore the actions to be taken (8) (@) _ facilitate selt-exploration and to clanty feelings (b) _ set goals, decide on methods of achieving them and monitor and evaluate results (4) (@) _getiinsight into the client's context (b) facilitate self-exploration and clarify feelings QUESTION 28 In order to ‘isten attentively’ to your client in a counseling session, itis necessary to (1) sit with your eyes closed to listen and concentrate better (2) force the client to make eye contact, because this enhances attentive listening and communication (3) focus on the content of your client's story and ignore any contradictory statements (4) focus on your client's body language and the explicit and implicit meanings of his or her spoken words: QUESTION 29 A counsellor who was sexually abused by his father when he was a young boy got very upset and stopped listening to his HIV postive chent who disclosed his preference for sex with young boys. In this case, the counsellor experienced the following ‘roadblock or hindrance to effective listening: (1) red-tlag listening (2) evaluative listening (8) sympathetic listening (4) filtered listening [TURN OVER]10 PYC2605 OCTINOV 2012 QUESTION 30 ‘Thandiwe visited Mary and told her that she, Thandiwe, is very bitter about how unfair life is She was forced to have sex with her brother-in-law after her husband died and is sure that that is how she got infected with HIV. Mary sympathised with Thandiwe by (1) ‘stepping into Thandiwe's shoes’ by recognising and acknowledging Thandiwe's feelings. (2) sharing her own expenences in the HIV and Aids field with Thandiwe to try and convince her that it does not matter where she got the infection. Instead, what matters now is what Thandiwe 1s prepared to do about the situation (3) showing pity and compassion for Thandiwe, as well as anger towards Thandiwe's brother-in-law and a cultural system that allows widow cleansing. (4) showing an understanding of Thandwe's feelings towards her brother-inlaw, and by ‘communicating this understanding to Thandwe in such a way that Thandwe better understands her own feelings QUESTION 31 From the counsellor’s responses provided below, select the most empathic response to the following reaction from Khumo, one of your HIV positive clients: "My life is a mess. | am discouraged! Everything 1s going wrong in my Ife It seems that everything | do is doomed to failure — and now this! | might as well ot even try" (1) "You feel discouraged and ready to give up because things aren't working out for you.” (2) "Your whole life ts a mess and you feel suicidal" (3) ‘Dol understand you correctly i | say that you are feeling very discouraged”* (4) "Am | correct in saying that you are feeling very unhappy right now?" QUESTION 32 Which communication skill did the counsellor use if she responded as follows to Khumo’s statement in the previous question: “Everything you do seems to be going wrong and you feel trapped in this mess * (1) Clantication (2) Reflective commenting (@) Probing (4) Summarising QUESTION 33 According to Egan, tt 1s impossible for a counsellor to really understand the world of clients who ditfer from him or her m significant ways One of the counsellor’s most important tools for getting as close as possible to understanding the client's world is empathy based on effective (a)___ and (b)_. (1) (@) probing (0) self-disclosure Q @)attending {(b) listening (8) (@)clarification ——_(b) immediacy (4) @) listerung (b) advanced empathy [TURN OVER]" PYC2605 OCTINOV 2012 QUESTION 34 ‘A male university lecturer, aged 31, consults a counsellor for pre-test counseling, The lecturer has been In a monogamous relationship for two years. Prior to this he had two male partners (while he was studying in America) He has been feeling very tired lately and is worned that he may be HIV positive ‘The counsellor’s reaction 1s as follows “This was a very stupid thing to do, but # 1s not too late if you start practising safer sex now. Tiredness is, anyway, not necessarily a symptom of HIV infection.” Is this a good or a bad response, and why? (1) tis a good response, because the counsellor puts the lecturer at ease about his symptoms and she gives him good advice about practising safer sex. (2) _Itts a bad response, because the counsellor passes judgement on his behaviour and she does not take his symptoms seriously. (8) It'ts a good response, because the counsellor shows empathy by acknowledging the lecturer's feeling that he knows he did a stupid thing (4) Its a bad response, because the counsellor should concentrate on his positive behaviour by acknowledging the fact that he 1s currently in a monogamous relationship QUESTION 35 ‘Ann comes to the clinic and asks for an HIV test Here is Ann's story: “I am 15 years old and | went out with a group of fends to watch a movie at the drive-in. One of the boys and | fooled around a bit in the back seat and | am now worned that | have Aids" (On which of the following aspects would you concentrate in your discussion with Ann in the pre-test counselling session? (a) What the mowe was about (b) Assessment of Ann’s risk — what exactly did she mean by ‘fooling around’? (©) Assessment of Ann’s knowledge about HIV infection and safer sex. (@) Information about the HIV test that you are going to perform (e) The implications of a positive or negative HIV test result for Ann (f) Anticipation of a positive HIV test resutt — what will Ann do if the HIV test results posttive? (Q) What support networks do Ann have? The correct answer 1s: (1) (@), (b) & (e) (2) (b), (©), ), (€), () & Q) @) @.@)ah ) @), (0). (©). @). (0) & QUESTION 36 ‘When responding to a client's needs during post-test counselling, (1) Advice giving 1s more important than reflection because this 1s often the only te the counsellor has to spend with the client. (2) Talking 1s more important than listening because the client is often too shocked to say much and he or she really needs the input of the counsellor. (3) An atttude of empathic attentiveness is more important than doing or saying specific things (4) Taking action is more important than silence and merely being with the client. [TURN OVER}12 PYC2605 OCTINOV 2012 QUESTION 37 For a parent to disclose his or her HIV positive status to a child 1s a very difficutt thing to do How would you, as a counsellor, faciltate the process of disclosure? (@) Help the parent to deal with his or her feelings of guitt and shame first (b) Explain to the parent that disclosure is not a once-off experience Tell the child only what he or she needs to know and build on that as the need comes up (©) Allow children to participate in gneving and discuss the situation with the child ~ this leaves the cchuid with less unfinished business to manage after the parent's death (d) Plan for the child's future, but do not share the plans of who is going to take care of the child after the parent's death with the child, since this will lead to the child expenencing untimely grief and depression ‘The correct answer is (1) (b)&(@) (2) (a) &(@) (3) (a), (b) &@) (4) (a), (b), ©) &@) QUESTION 38 ‘Sue was diagnosed as HIV positive and she experienced severe feelings of anxiety and helplessness for the first two weeks after the diagnosis. She got nightmares and could think of nothing else except her posite diagnosis Sue came to terms with her diagnosis and felt better 4 weeks after her diagnosis. Which of the following did Sue experience? (1) Anear-death expenence. (2) Acute stress disorder. (8) Post-traumatic stress disorder. (4) Complicated gnef QUESTION 39 ‘The symptoms of depression can be categonsed as affective, physiological, cognitive and behavioural. Physiological symptoms of depression mclude (a)__, while behavioural symptoms of depression include (b)__. (1) @) pessimistic beliefs about the future, suicidal thoughts, negative thinking and concentration problems (b) sadness, unhappiness, worthlessness, anxiety and apathy (2) (a) neglect of personal appearance, crying, social withdrawal and slow or reduced speech (©) pessimistic beliefs about the future, suicidal thoughts, negative thinking and concentration problems (3) (@) loss of appetite and weight, sleep disturbance, loss of libido, disrupted menstrual cycle in women and constipation {b) neglect of personal appearance, crying, social withdrawal and slow or reduced speech (4) (a) sadness, unhappiness, worthlessness, anxiety and apathy (b) pessimistic beliefs about the future, suicidal thoughts, negative thinking and concentration problems [TURN OVER]13 PYC2605 OCTINOV 2012 QUESTION 40 The focus of the ecological or systems approach to HIV and Aids counselling is on (1) How systems can enhance our knowledge of virology. (2) How nature can be used to the beneftt of the client (8) The effect that epidemics (such as HIV and Aids) have on human populations. (4) The effect of a chent’s seropositive status on significant others and how it influences relationships QUESTION 41 According to Egan, the same counseling principles that apply to individuals also apply to the family or systems approach — with the family as client. In order to establish the family's preferred scenano, the ‘counsellor should help the family to_ (1) verbalise what they as a family want or need within the limits imposed by the virus. (2) identity what they as a family need to do. (8) _identty problems, concems and issues about the virus in their system. (4) implement strategies that will enable the family to live more effectively with the problems created by the virus. QUESTION 42 With the definition of crisis intervention in mind, which one of the following counsellors provides crisis counseling? (1) Counsellor A views cnsis intervention as a form of emotional ‘frst aid’ to support and help the client. He therefore takes a passive, non-directive and empathic stance to find a quick solution for the client's problem (2) Counsellor B knows that the only way to help a client through a crisis Is to establish a long-term helping process. He is attentive, non-directve and respectful and makes sure that his cent has access to ongoing therapy. (8) Counsellor C realises that this 1s an emergency situation and that his role 1s to provide mmediate relief for the client. He therefore takes an active role and decides what should be done to help the chent through this crisis (4) Counsellor D defines crisis interventon as a form of preventing suicide She therefore refers the chent fo an emergency service, and she also realises that this is the time to be passive and supportive. QUESTION 43 Juan recently found out that he 1s HIV positive He also realised that he has done a lot of wrong things in his life He promised God that he will never have sex again and go to church and chanty events if God will cure him from HIV Juan 1s n which of the Kubler-Ross stages of bereavement? (1) Denial (2) Bargaining and guilt (@) Sadness and depression (4) Resolution and acceptance QUESTION 44 One of the techniques used to faciltate the bereavement process is cognitive restructunng. The assumption behind cognitive restructuring 1s that (@) our emotions and feelings are influenced by what we think about (b) _ we should get nd of negative or destructive thoughts (©) we should adopt healthier and life-affirming thoughts. [TURN OVER]14 PYC2605 OCTINOV 2012 The correct answer 1s (1) @) (2) (b) (3) &) &() 4) @),b)& ©) QUESTION 45 In the table below, column A lists the cognitive stages of development for children, and column B the ways in which children understand death. Select the correct combination of these two columns to explain how a child in each of these developmental stages (Column A) understands death (Column B) COLUMN A: COGNITIVE STAGES OF COLUMN B: WAYS OF DEVELOPMENT IN CHILDREN UNDERSTandING DEATH (a) Pre-school children (3 - 5 years) (@) Realise that death 1s final, personal and universal (b) Young children (6 - 9 years) (@) Regard death as temporary in nature Children of 1 (f) Do not regard death as personal (applying to Oe eee them) or as universal (affecting all people) ‘The correct answer is (1) (@)& (2); (b) & (4), (C) & (2) (a) & (A), (b) & (@), (©) & @) 8) @)&@), O&M, ©) &@ 4) (a) &@); (b) &, ©) &(e) QUESTION 46 Disclosure to a child of his or her HIV positive status should be very carefully considered and possibly be withheld or delayed in the following circumstances (2) Achild with severe emotional disturbance (b) A child with developmental delay or with an IQ lower than 70 (©) Avery young child (under the age of five years) ‘The correct answer is (1) (@), (6) &(@) (2) (a) &(b) (3) (©) 4) (b) [TURN OVER]15 PYC2605 OCTINOV 2012 QUESTION 47 ‘A mother went to see a counsellor about her six year old son who is behaving strangely after his father’s death. She 1s certain that there 1s ‘something very wrong’ with her son and that he is ‘going crazy’ The counsellor should assure the mother that the following behaviour or expentences are ‘normaf for a young bereaved child to experience: (a) Regression to a previous stage (e.g. thumb sucking or bed wetting) (b) Nightmares and bad dreams. (c) Withdrawal from social activities and clinging behaviour (@) Behaviour lke trying to hang himsetf with his father's tle n his cupboard. (e) Claims that he sometimes see his dead father sitting in his rocking chair The correct answer 1s. (1) (b)&() 2) (a), (©), (c) & (e) @ @& (4) (a), (b). (©), (d) & (0) QUESTION 48 ‘What does it mean when we say that to disclose a parent's HIV positive status to her child ts not a once- offexpenence? (a) Disclosure takes time and the parent needs at least a month to tell the child that she is HIV postive. (©) The age of the child should be kept in mind and the parent should only tell the child what she needs to know at that time. The parent should then build onto this at a later stage when the child is ready (©) Disclosure should be delayed as long as possible because the parent never knows fit really is in the best interest of the child Disclosure can cause tremendous arniety about the imminent death of a parent The correct answer is. Q) (a) &(b) 2) (b)&(C) 3) (b) 4) @ QUESTION 49 It is important for HIV-positive individuals to learn how to cope with stress What are the negative effects of excessive or too much stress? (2) Excessive stress can cause the immune system to develop new strains of HIV, which can make the person very sick. (©) Excessive stress has a negative effect on the immune system and it can render the person more vulnerable to infections such as colds. (©) Excessive stress can cause a decrease m the CD4+ T cell count. (@)__ Excessive stress can cause an increase in both the viral count, as well as in the CD4+ T cell count ‘The correct answer 1s: () (a) &(c) (2) () &(c) (3) (0) & (a) (4) (@), (0) & (d) [TURN OVER]16 PYC2605 OCTINOV 2012 QUESTION 50 Too much stress can have a negative impact on our lives, our work and our relationships Occupational stress (which can lead to bumout if not addressed appropriately) can broadly be defined as (1) a syndrome of physical and emotional exhaustion, mvoiving the development of a negative selt- concept, negative job attitudes and loss of concem or feelings for clients. (2) the perception of being unable to cope with an internal or extemal expectation or demand in the workplace. (8) feelings of sadness, unhappiness, worthlessness, anxiety and apathy due to an unbearable demanding workload (4) a syndrome of behavioural and physiological symptoms such as lack of energy, neglect of personal appearance and a loss of appetite QUESTION 51 Which one of the following nurses finds it difficult to set professional boundanes between themselves and their patients? (1) Nurse A cannot ‘got the patients out of her head.’ She thinks of them all night at home and she cenies about thelr problems (2) Nurse B looks after her patients’ children after work when they feel too sick to look after their own children. (3) Nurse C is profoundly touched by the negative effects of stigmatisation on her patients’ lives but also by the secondary stigmatisation on her own fe. (4) Nurse D is overwhelmed by the Ards statistics and she wonders how the country will cope with the ‘Aids crisis in the future. QUESTION 52 Which one of the following statements about the use of coping mechanisms by health care workers 1s true? (1) The aim of problem-focussed (or active) coping 1s to reduce the emotional discomfort that the caregiver 1s experiencing when his or her workload becomes overwhelming. (2) When caregivers are faced with situations that they cannot control or change, problem-focussed (or active) coping may be more appropriate to use than emotion-focused (or passive) coping. (3) The best form of coping 1s passive attempts to deal with a situation that is perceived as stressful (4) Caregivers who use problem-focused (or active) coping strategies have a greater sense of control over work-related stressors and will suffer less bumout than caregivers who use emotion-focused (or passive) coping mechanisms (QUESTION 53 Stefan ts a securty guard at a shopping mall in Cape Town. He was recently diagnosed as HIV positive. ‘What are Stefan’s legal obligations to his employer, customers and/or co-workers, 1) Stefan has no legal obligation towards his customers or co-workers, but he must disclose hss status to his employers immediately so that they can assist him. (2) Stefan has a legal obligation to protect his co-workers from infection by using separate cups at teatime, as well as a separate tollet. (8) Stetan has no legal obligation to disclose his status to his employer, his co-workers or his customers. (4) Stefan has a legal obligation to protect his co-workers from infection and must therefore disclose his status to them ITURN OVER]7 PYC2605 OCTINOV 2012 QUESTION 54 After a few years Stefan decides to inform his employer about his HIV posttive status because he 1s experiencing health problems. For example, it is often not possible for him to stand on guard for tong periods of time. In terms of the South African law, what are his employers’ legal obligations? (1) They can discontinue his service as long as they pay him proper compensation, for example, three month's salary. (2) They are not allowed to fire him as long as he can do his work, or as long as he can do other work in the secunty company (e.g administrative) i he is no longer able to do his current job as secunty guard (8) They should immediately transfer hum to another type of work (@.g an office job) and offer him a lower salary. (4) They can only fire him if his co-workers refuse to work with him because he is HIV positive QUESTION 55 Prison A isolates and quarantines HIV positive patients, while Prison B refuses to provide information about HIV and Aids to rts inmates. Which basic human rights applying to all citizens are infringed upon by Prison A and Prison B? (1) Prison A: the nght not to be unfairly discrminated against Prison B* the night to body, psychological and educational integrity (2) Prson A: the right not to have one’s privacy infringed Pnson B. the right to information and a basic education (3) Prison A’ the nght to bodily and psychological integnty Pnson B: the right not to be unfairly discriminated against (4) Pnson A: the right to hberty, autonomy and freedom of movement Pnson B: the right to information and education If you have chosen the GUIDANCE TRACK, do Section B, Questions 56 to 70. if you have josen the CARE TRACK, go to Section C on page 21 and answer Questions 56 to 70 ‘SECTION B: GUIDANCE TRACK QUESTION 56 Which aspects should be emphasised, when a religious counsellor is dealing with a seculansed (Westernised) HIV positive client? (a) _ People are not machines. Nobody is perfect and therefore people sometimes do take risks (©) The acceptance that a high-risk lifestyle will sometimes have negative consequences, for example, HIV infection (c) Repentance and believing in the true God that controls our lives, including ilinesses and disasters The correct answer ts () ) 2) @a&) @ © @ Hae [TURN OVER]18 PYC2605 OCTINOV 2012 QUESTION 57 Within a Judeo-Chnstian framework, how would you deal with the relationship between sin and sickness? (a) Sickness and sin have absolutely nothing to do with each other (©) Although sickness and death came into the world because of sin (Gen 6:3), there 1s no direct relationship between them in the sense that a specific sin can always be linked to a specific illness, such as HIV and Ards. (©) Due to our limited human insight into the mind of God, its not always possible to give reasons why something bad happens to us. () Suffering (e.g illness) is always ultmately good, because tt tests the believer's faith and strengthens him or her sparitually. The correct answer is (1) (a) & ©) (2) (a)& (9) (3) (bl) & (0) (4) (b)&@) QUESTION 58 In traditional African societies the death of young people is seen as. (1) ‘unnaturar (2) asad part of ito (8) caused by certain sexual sins such as prostitution and idolatry (4) a natural consequence of living in a dangerous environment. QUESTION 59 Fill in the missing word in the following sentence. “Within a religious context it is a more realistic and ‘compassionate option to emphasise the ___of Ife, rather than punishment when dealing with HIV and Aids” (1) sinfulness: (2) shortness: (2) sanctity (4) unimportance Read the following story and answer Questions 60 and 61. Thandeka, a retired teacher, is concemed about the large number of children orphaned by HIV and Aids in her community. She starts visiting child headed households in her community. During these visits she provides basic medical care and a balanced meal to the household and teaches the children basic household skuls like cooking, cleaning and gardening, Question 60 ‘Thandeka's nitiative ts an example of a __ based approach for caring for orphans and other vulnerable children. (1) community (2) family (8) foster-care (4) institution [TURN OVER]19 PYC2605 OCTINOV 2012 QUESTION 61 Which of the following human needs ts Thandeka fulfiling in the children she 1s visiting? (1) _ subsistence and understanding (2) subsistence and transcendence (8) protection and understanding (4) _ protection and transcendence QUESTION 62 ‘The young child in the foundation school phase (grade 1 to grade 3) defines iliness in terms of (1) intemal, unobservable features that are associated with the disease, such as ‘infection m the lungs" (2) _ feelings that are associated with the disease, such as ‘feeling hurt and lonely" (3) causes that are associated wit the disease, such as ‘sleeping with bad women’ (4) external and observable features that are associated with the disease, such as ‘red spots on the body” QUESTION Young children (grades 1 to 3) have an overwhelming fear of Aids, because (1) they can already grasp the consequences of HIV infection and what the virus can do to their bodies (2) although they can already comprehend that Aids 1s not a punishment for sin, they find it dificult to understand how one can prevent infection (8) they have a good understanding of how sex and drug usage can cause Aids, but find it dificult to deal with it emotionally (4) they see disease in rather vague, supernatural and imaginative terms due to the level of ther emotional development. QUESTION 64 In which school phase are children especially prone to the acquisition of myths (@g about HIV and ‘Axds)? (1) Foundation schoo! phase (grades 1 10 3). (2) Senior school phase (grades 7 to 9) (8) Intermediate school phase (grades 4 to 6) (4) Further education and training phase (grades 10 to 12) QUESTION 65 ‘Which one of the following statements 1s true in terms of the child in the intermediate school phase's (grades 4-6) perception of the causes, effect and prevention of iliness? (1) They are too young to have formed any perceptions of iliness and can therefore not distinguish between cause, effect and prevention (2) They understand the difference between internal and extemal symptoms, but they find it difficult to distinguish between cause of illness and prevention (3) They can distinguish between the causes and symptoms of disease, but they find it difficult to conceptualise prevention. (4) They are old enough to distinguish between the cause and effect of iliness, and they have a good understanding of prevention [TURN OVER]20 PYC2605 OCTINOV 2012 QUESTION 66 If you were an intermediate (grades 4 to 6) teacher, how would you handle HIV and Ards education with your classes? (1) By occasionally devoting a special period to HIV and Aids education. (2) Byadding elements of HIV and Aids education on a regular basis to existing school curriculum (@) _ By starting HIV and Ards education as part of a lifeskills programme, but at this stage it is still too early to make sex education part of the curriculum (4) Byscanng the children as much as possible, by relating the disastrous effects of the disease. QUESTION 67 ‘At what developmental stage are children egocentric, in the sense that they believe they are the focus of everyone's attention (imaginary audience) and that their experiences bear no resemblance to those of others (personal fable)? (1) Adolescent years. (2) Pre-school years (8) Foundation school phase (4) Intermediate school phase. QUESTION 68 How does the young adolescent (grades 7 to 9) percewe illness, HIV and Aids? (@) Young adolescents understand the causes of illness in more complex ways and they can explain the interaction between multiple causes (b) Young adotescents do not understand the concept of a ‘cause and effect’ of illness and they see illness merely as a collection of symptoms (©) Young adolescents understand the concept of ‘relative susceptibilty’ and they realise that anybody ‘can become infected with HIV under certain circumstances (4) Young adolescents realise that an illness can resutt in external as well as internal symptoms. The correct answer is (1) (@)and (ce) (2) (@), (c) and (d) (3) (b) and (d) (4) Allof the above QUESTION 69 Although the nsk of HIV transmission as a result of contact play and contact sport 1s generally insignificantly tow, teachers must make sure that the following rules are followed. (a) _ No leamer with an open wound or an open sore may participate in contact sport (b) Aplayer who 1s bleeding must be removed from the sports field immediately and treated (©) Ableeding wound should be cleaned immediately and covered with a waterproot plaster. (@) Although 1 is important to treat wounds immediately, it 1s not necessary for the injured player to change clothes soiled with blood. The correct answer 1s" (1) (b) & (ce) (2) (@)&(d) (3) (@). (©) & (©) (4) Allof the above TURN OVER}at PYC2605 OCTINOV 2012 QUESTION 70 John, a matne leamer in the St Peter's Private Secondary School, refuses to study with another learner in us class who is HIV positive. May John refuse to study with this boy, according to the National Policy ‘on HIV and Aids for Leamers and Educators? (ty (2) 3) co) No, John may not refuse to study with an HIV positive learner, but f John's classmates, or their parents insist that the HIV positive boy leaves the school, the headmaster has the right to ask the boy in question to leave. It depends on how the school handled the situation If the school pre-empted the situation by providing accurate information on HIV and Aids to everybody in the school, John may not refuse to study with the HIV positive boy On the other hand, if the school did not inform the leamers about HIV and Aids beforehand, John has a point and the school may ask the boy to leave Yes, John may refuse to study with an HIV posttve leamer The South African Constitution as well as the Bill of Rights protect the nghts of all people, not only of HIV positive people and if a situation ike this makes it difficult for John to study, his right of free association should be taken serous No, John may not refuse to study with another leamer who is HIV posttive If this happens, John should be counselled and if he stil refuses, disciplinary steps may be taken against John. NOTE: If you have chosen the CARE TRACK, do Section C, Questions 56 to 70 SECTION C: CARE TRACK QUESTION 56 Communtty- and home-based care 1s often the best way to look after someone with Aids There are, however, certain potential problems associated with community: and home-based care, such as the following. (a) Families often don't want home-based caregivers in their homes due to stigma, ignorance and superstition (b) Patients often fee! very isolated when they have to stay at home or in the bed all day {c) Patients often show symptoms of bumout by being cared for by the same home-based caregivers day-in and day-out (4) Home-based caregivers who are not properly trained, are offen afraid of looking after Aids patients due to a lack of knowledge and fear that they might become infected themselves The correct answer is a (2) (3) (4) (a) & (d) {a), (b) & (d) (b) & (c) (a), (b). (€) & (d) [TURN OVER]22 PYC2605 OCTINOV 2012 QUESTION 57 Local community volunteers play a very important role in community- and home-based care programmes According to Frohlich (1999), many of the perceived disadvantages of using volunteers can be overcome if the volunteers are (a) _ selected from outside the community to assure objectivity (©) recognised as key workers in the programme (©) chosen by members of the community {d) properly trained in basic home care ‘The correct answer is (1) (@)&@) 2) (a)&(d) (3) (©), (c) & @) (4) (@), (©), ©) & d) QUESTION 58 ‘When canng for a person with Aids in the home-based care situation, the care giver is advised to always wash her/his hands thoroughly (a) before and after a bref physical contact with the person (e.g helping her to sit more comfortable against the cushions) (6) _ before prepanng food and feeding the person (©) _ before and after prolonged physical contact with the person (e.g canng for the patents skin and pressure parts to prevent bedsores) (d) immediately after contact with blood or urine The correct answer 1s (1) (b), (c) & (d) (2) (a) &(d) (3) @), (0), & ©) (4) (@), (©) & (0) ‘QUESTION 59 ‘What precautions should be taken to keep the risk of HIV transmission from a mother to her baby as low ‘as possible during delivery, the mother is diagnosed as HIV positive? (a) Don't rupture the membranes unnecessary, (b) Avoid an episiotomy whenever possible (©) __ Use foetal scalp electrodes to monttor the baby's progress (@) Ifyou have to use instruments to deliver the baby, rather use forceps instead of vacuum () Suction the baby’s nose and throat immediately after birth to clean the baby from the mother’s blood The correct answer is 1) 0), (©) & (6) (2) (@),()& (e) (3) (a), (0) & (@) (4) (@), (©), (©), (2) & (e) [TURN OVER]23 PYC2605 OCTINOV 2012 QUESTION 60 In which of the following situations 1s tt necessary to wear latex gloves? (a) When administering medication orally. (b) When inserting a rectal suppository (©) When bathing and giving an HIV and Aids patient a back rub. (d) When drawing blood The correct answer 1s: 1) (b)&@) 2) (ad) (3) (db) &(c) @) (©) &(d) QUESTION 61 A group of voluntary caregwers visit your clinic n the rural area for advice on the cheapest but most effective method to disinfect equipment they used while nursing Ards patients at home What would you tell them? (@) Needles should be stenlised with disinfectant, such as household bleach, for at least 30 minutes (b) Dryheat at 121°C for 16 hours is effective tor disinfecting disposable plastc instruments. (6) Household bleach (chionne) 1s effective for disinfecting equipment if it 1s soaked for at least 30 minutes (@) Domestic pressure cookers can be used for 30 minutes at their highest pressure to stenlise ‘equipment ‘The correct answer is (1) (c)& (d) @) @ @) © 4) (0), (©) & (@) QUESTION 62 What are the signs and symptoms of electrolyte disturbances (for example in patients who have diarthoea or who vomit)? (a) awet, clammy skin (b) muscle cramps (©) an irregular pulse (@) weakness ‘The correct answer is (1) (b) & (d) 2) @.0)&@ (3) (@) &(c) (4) ©), (©) & (@) ITURN OVER]24 PYC2605 OCTINOV 2012 QUESTION 63 ‘The basic rules for treating diarrhoea in adults are (1) Drink more fluids than usual, stop the intake of solid foods for at least 24 hours, and be on the lookout for danger signs such as weight loss (2) Drink something nutritious like milo or mikshake after every loose stool, eat small amounts of nutritious foods high in fibre, and be on the lookout for any signs of dehydration such as a rapid pulse (8) Restrict the intake of fluids as well as sold foods for at least 12 hours, and be on the lookout for danger signs such as fever and itability (4) Dink more fluids than usual, eat small amounts of nutritious, low-fat foods and be on the lookout for any signs of dehydration such as a dry skin. QUESTION 64 How would you treat a patient with rectal abrasions due to rectal herpes? (@) Wash the area of the anus with a weak lemon juice solution to slow down the rate of the fungus growth (b) Let the patient sit in a luke-warm bath with Savion or salt to relieve the discomfort. (©) Administer pan medication if necessary. {d) Encourage the patient only to use toilet paper, as the use of cotton wool or Wet Ones may worsen the condition. ‘The correct answer is (1) (b) & @) 2) (a &(c) (3) (b) &(C) (a), (0), )& (A) QUESTION 65 ‘Some people in the final phase of Aids may expenence continuous pan. How should pain preferably be dealt with? (1) Patients with Aids can easily become addicted to pain medication, and it 1s therefore advisable to avoid pain medication and rather to encourage relaxation exercises. (2) Use the ‘adder’ approach, and start at the ‘top of the ladder’ with the strongest medicaton, rather than giving medication at the ‘bottom of the ladder’ that won't help at all (8) _ Encourage patients to take their pain medication on a regular basis as prescnbed, before the pain becomes too great. (4) _Aspinn and paracetamol should be avoided as pain medication if possible, because these drugs often cause constipation ‘QUESTION 66 ‘Anorexia, nausea and vomiting may cause weight loss and a fluid and electrolyte imbalance. What advice would you give a patient who experiences these probiems? (1) Drink lots of fluids (preferably water) before, during and immediately after meals. (2) Eat dry, salty foods that are low in fat and avoid gas-producing foods (3) Domild exercises directly after meals to help with digestion and to prevent nausea. (4) _ In the case of vomiting, stop the intake of food and fluids for 12 hours, and gradually introduce fluids such as flat coke. [TURN OVER]25 PYC2605 OCTINOV 2012 QUESTION 67 Severe herpes zoster (or shingles) often occurs in people with depressed immune systems. What is shingles? (1) Shingles is a viral mfection that 1s caused by the same virus that causes chicken pox. It affects nerve cells and it is charactensed by an extremely painful skin rash or tiny bisters on the face, limbs or body. (2) Shingles is a bactenal skin infection caused by the herpes zoster bactena, and it 1s often one of the first symptoms of HIV infection in young people. (8) Shingles is a rare form of skin cancer, charactensed by a painful swelling or rash on the skin, or on the mucous membranes. It was used to be seen only in older people, but we see it nowadays in people with depressed immune systems (4) Shingles is an infection that 1s caused by the HI virus attacking nerve cells. It causes extreme pain in the lower extremities, for example, in the hands and feet of the patient. QUESTION 68 ‘The purpose of palliative care is to (a) _ affirm life while regarding dying as a normal process {b) make treatment choices for the patient and family (©) _ provide relief from pain and other distressing symptoms (d) _ integrate the psychological and the spiritual aspects of care ‘The correct answer 1s (1) (b) & @) @ (@.()&@) @) (@)&(0) 4) @), (0), (©) & (@) QUESTION 69 ‘Aids can often make a person feel very tired and weak due to problems such as diarthoea, anaemia, poor nutrition and depression When should a home-based caregiver, who cares for a patient who experiences general fatigue and weakness, seek professional help? (a) If the patient suddenty becomes very weak and cannot walk anymore (b) _ If the patient is develops a hugh fever (c) Ifthe patient ts confused (d) If the patient complains of a headache ‘The correct answer 1s (1) @)&(c) (2) (b) &(a) 8) @), ©), (©) & (@) (4) @),()&(d) ITURN OVER}26 PYC2605 OCTINOV 2012 QUESTION 70 ‘A patient comes to you with the following treatment plan for antiretroviral and asks you to explain it to her Study the treatment plan first and then answer her questions Name of ART Number of pills _| Time to take pills TOF i Bam and8pm (i2hourly) 3TC 1 8am and 8pm (12 hourly) Efavirenz (EFV) 3 apm Her questions are as follows (2) How many plis should | take every day? (e) How many pills and which one’s should | take with breakfast? (©) How many pills and which one’s should | take at lunchtime in the afternoon? (©) How many pills and which one’s should | take just before bedtime at night?” ‘Your answers to her above questions are (1) (@) Spills, (b) 2 pills (one TOF and one 3TC pill), (©) 2pils (one TDF and one 3TC pill), (4) 3 pills (three EFV pills) (2) (a)7 pills (b) 5 pills (three EFV pills, one TDF and one 3TC pill), (©) 2 pills (one TDF and one 3TC), (d) none (3) (a) 5 pills, (b)2 pills (one 3TC pill and one TOF pill), {c) None, (d) 3 pills (three EFV pills) (4) (@)7 pills, {b) 2 pills (one TDF and one 3TC pill), {c) None, (@) 5 pills (three EFV pills, one 3TC pill and one d4T pill) [YOUR MARK FOR THIS PAPER WILL BE CONVERTED TO A MARK OUT OF 90 AND YOUR 10% YEAR MARK WILL BE ADDED IF YOU QUALIFIED FOR IT TO MAKE UP YOUR FINAL MARK.] 170] IS YOUR STUDENT NUMBER, UNIQUE NUMBER AND MODULE CODE FILLED IN ON THE MARK READING SHEET? © UNISA 2012UNIVERSITY OF SOUTH AFRICA U N l SA EXAMINATION MARK READING SHEET PART 1 (GENERAL/ALGEMEEN) DEEL 1 — UNIVERSITEIT VAN SUID-AFRIKA EKSAMEN-MERKLEESBLAD - aren numacn a ‘ammamon cenrnc(e3 encrorad 8 = otamgaaueh an o- - fsamarmamal fowmo ma ley eta es ens e03 e134 C4 joeesmr@ a nay Lh cas cs ume gu dc ei eG prion, / Beers faves ys cass} Eh ipigs en sores cy legs eas eg coo eg 243 3 Hy fen eas eas ean 8s 93 ipa aap a 5 cit gms cos ee Ges) iss ces ROR css tes ces cgn ces cb easy sys cgs ene ets eos cbs eb obs ds ees eS) eda ey £85 99 For use by examination invigilator Vir gebruik deur eksamenopsiener 4 PORTANT MARKLICE TAS ‘Gntk THAT YOUR STUDENT NUMBER naS BEEN FILED IW CORRECTLY ‘GnEEX THAT THE UNIQUE NUMBER HAS DEEN FILLED IN CORRECTLY (GAEEK THAT ONLY ONF ANSWER PER QUESTION HAS BEEN MARESO 159 NOT FOLD ONIROLEER DAT OIE UNIEKE ROMMEEA REG INGEVUL 1S MAAC SEXER DAT NET EEN ALTERNATE PER VRAaG GEMERK. IS Motu vou ME PART 2 (ANSWERS/ANTWOORDE) DEEL 2 Tp aay e away boned Taam Eb thadvases sy Bo dep em eh eb 431 ub oy Bo fides chs by 8 cheba coc] tebe eas | riven eds eas es are ce eas ess ‘ 1 tara ea a mami al 8 ese asa iy chap chen a 3 2s 132 eb 32s wo 13 ds eb Hh do edi eh Mh tsege go ear es 2 da aew sy ets ea eg caso toe baw oy dias ahem ey Haas Ho thes ase ey Hoes dies eas a tia eb el ero eas ei ca en aiep ea cal Sea 1b eo ih gg Eh eb ob eb 15) «Rade ie eb 3) cho ebs eae G es Whi sco 3} p oma Ge no maar fs does ee Bo sada His edie es eh 2 dyes lO) ado ch B tiararas sy 3 egy os et 5 wae oy fea es cerca D Gye area es @ diag sca Bo rae gece Bo dietsed eb eo Bo ioepen ens & Gidea ey 50 anc Gora be B ties cy B masmen & maces Ro ches aree a Bf cerenes! Bo chaebol ieee chr ess Bw oy @ aes a eo Bid eg em sy Sh ted ea ens 08 2 Neva ip edy es che ey Wappen a i R wean assy ‘or Bo share ai a 1% Tae Ss eds ea eee 693 «2s as case Mo ties 9 cade ai ces ey deeb as ND dae ares Bo mene mM aparece cs D Haeuey cee Me 3 a i ee eo 3 Gaenen ca es 3 Bodog: es ne BP chiegseg chi aa 18 rere rerines Ha egs gs eas eo Hob ee ey ® pace @ | ie aaa h iiicn cee Wess Bowden cig Suip ena maby th Sparen 6 3 “Oo ( BEGGS) | | om areas canes 8 MM peda ea es Ho eb eo ea ey heed ch ME Used Ores ey Be chr ease ody 1S spas dred cs aes e aise Me deep er ees Br dsede ao fa daca eds ca B divas as cay fe dae ay oi BM Ghicdves cas eb MB coed i a B Sudan cana @ charac easep oe m mma aas 7 thedaeh op $32 32s Bs cas cbs Rosas sess 13 d2egsas et St ds Gs 8 BA dae as et Wo thy ds eds a8 M8) eda eds ct jor ra aa ray 0 es 1 onsen cae es 1 cha cds 193 cas eo AM dade cay 13 Shs edo cas eo 1B dias decal 108 43 23 cas «6 dae ara We Ho as we Ga aca a