REGIONAL EXAMINATION FOR NURSE REGISTRATION

CARICOM COUNTRIES

FUNCTIONAL NURSING-OBJECTIVE TYPE QUESTIONS

PAPER IV

OCTOBER 2000

NO OF ITEMS: 50
 SCENARIO 1 ITEM 1-6

Mr. and Mrs. Sony and their 3 children, aged 1-year, 5 years and 23 years, live in small rural community
where their water source is a nearby stream. They have a covered pit latrine some distance from the house.
Nurse Smith is planning a health promotion program with the family.

ITEM 1
Which of the following statements define health promotion?

i. The output of all the health services activities.

ii.Specific measures aimed at the prevention of disease or disability.
iii.Activities focusing on maintenance and enhancement of well-being.
iv.All the activities designed to improve or maintain your health status.

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

ITEM 2
Mrs. Sony does the housework at home in the day. She looks after the 1 year old while the older children
are at school. Nurse Smith determines that Mrs. Sony meets her need for rest and exercise by:
i. Maintaining good posture while sitting and standing.
ii.Walking 2 miles daily to the nearest shop- to purchase food.
iii.Relaxing completely for 1 hour when her 1 year old takes a nap.
iv.Sleeping most of the day to catch up on sleep lost the night before.

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

SCENARIO Cont’d
The Chemical factory, where Mr. Sony works, provides overalls for workers to wear Job. Mr.
Sony came home from work wearing his overalls and carrying two empty white containers that
previously held chemicals. He hugs and kisses his wife and lift 1 year old.
ITEM 3
The nurse plans to educate Mr. Sony, as a PRIORITY need to enable him to understand that

i. Chemical residue may be present on the garment.

ii. Wearing the overalls is a safety measure for use on the job only.
iii. The overalls were given to him so he could save his good clothes.
iv. There is no risk to him or his family while he is wearing the overalls.
A. i, ii
B. i, iii
C. ii, iv
D. iii, iv
ITEM 4
Mr. Sony planned to use the two empty chemical containers to store drinking water. Nurse Smith
explains to him the importance of

A. Ensuring that the container is properly cleaned before use.

B. Boiling all drinking water before storing it in the containers.
C. Securing several more containers to solve his water problem.
D. Avoiding the use of chemical containers for food and water storage.

ITEM 5
Nurse Smith encourages the development of healthy habits for the Sony family by demonstrating to

i. Mrs. Sony, how to examine her breast each month.

ii. Mrs. Sony's 5 year old, how to brush his teeth correctly.
iii. Mr. Sony how to do his prostate self-examination monthly.
iv. Mrs. Sony's 13 year old how to floss to keep her gums healthy.
A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv

ITEM 6
Nurse Smith concludes that Mrs. Sony understands the importance of a healthy environment when she
observes that
i Mrs. Sony does not throw garbage in the stream.
ii. the pit latrine remains uncovered most of the times.
iii. Mr. Sony is no longer permitted to smoke inside the house.
iv. Mrs. Sony no longer boils the water from the stream for drinking.
A. i, ii
B. i, iii
C. ii, iii
D. iii, iv
SCENARIO 2 ITEM 7-9

John Brown, a 16 year old student at the Community College was diagnosed with Human Immuno-
Deficiency Virus. His father well known businessman, was reluctant to have John at home even after
a period of counseling. He learned that his friends would no longer visit and socialize with him.

ITEM 7
Which of the following statements is the LEAST likely reason for the father's attitude?
A. That his son might be homosexual
B. Fear that he would lose his status in society
C. The disunity it will create among family members
D. That the virus would spread to other family members

ITEM 8
In helping Mr. Brown to cope with his son's condition, the nurse should

A. Insist that he takes his son home.

B. Hold counseling session with the family.
C. Educate Mr. Brown on the mode of transmission of the virus.
D. Encourage Mr. Brown to verbalize his fears about the illness.

ITEM 9
The nurse could assist in changing Mr. Brown's attitude towards his son by

A. suggesting that his son could be kept in the hospital.

B. providing information on Human lnununo-Deficiency Virus.
C. Offering to hold counseling sessions with his friends.
D. telling him that many other children have the same condition.

SCENARIO 3 ITEM 10-12

Sixteen (16) year old Jamal King was rushed to the Accident and Emergency unit complaining
of severe abdominal pain.

He was accompanied by his form teacher. Jamal was seen by the doctor, and was diagnosed as
Acute Appendicitis and scheduled for urgent surgery. Before the procedure can be carried o u t
a consent form must be signed.

A group of first year nursing students present at the time of Jamal's admission were unsure o f
the process of informed consent and sought clarification about it.
ITEM 10
W h i c h of the following is the BEST person to accept responsibility for signing Jamal's
consent in his parent's absence?

A.Doctor
B.Patient himself
C.School teacher
D.Nurse in Charge

ITEM 11
Jamal is concerned as to why he needs to have a consent form signed. The nurse should explain that
it is to
i. Protect him from unnecessary surgery.
ii. Limit the extent of the surgical procedure.
iii. Protect the health team from legal reprisal.
iv. Ensure that he was informed about the procedure.

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

ITEM 12
The Nurse's responsibility in relation to obtaining consent from a patient prior to a surgical procedure is
to witness that the
A. client was informed.
B. client signs the form.
C. client understands the procedure.
D. doctor explained the procedure fully.

SCENARIO 4 ITEM 13-15

Nathaniel Boyce sixty-five (65) years old has a cardiac condition and was admitted' to a medical
ward.' The doctor prescribed Digoxin (Lanoxin) 0.25 m g daily. Staff N u r s e G r a y
inadvertently administered 2.5 mg of the drug as the initial d o s e :

ITEM 13
Nurse Gray should ensure that Mr. Boyce's medication is administered safely by applying all of the
following principles EXCEPT
A. checking the drug and its dosage.
B. giving i n to him at the correct time.
C. observing his response to the drug.
D. identifying that he is the correct patient.
 ITEM 14
Which of the following actions should Nurse Gray take PROMPTLY on realizing that she had m a d e an
error in administering Mr. Boyce's medication?
A. Monitor the patient for adverse reaction
B. Report the incident to the patient's doctor
C. Document the error in the patient's record
D. Give prescribed antidote as soon as possible

ITEM 15
I n legal terms Nurse Gray's medication error would be classified
A. a felony,
B. malpractice.
C. incompetence.
D. a misdemeanor.

SCENARIO 5 ITEM 16-24

Nurses who are able to communicate effectively, initiate change that promotes health,
establishes a trusting, relationship with clients, supports persons and prevent legal problems
associated with nursing practice.

ITEM 16
The sequential elements of the communication process are
A. Message, sender, receiver and response
B. Receiver, message, response and sender
C. Response, receiver, message and sender
D. Sender, message, receiver and response

ITEM 17
The MAIN, intent of communication is to
A. elicit a response.
B. decipher the message.
C. convey a clear message.
D. ascertain one's responsiveness.

ITEM 18
Verbal communication is said to be highly conscious because it
A. allows a choice of the word used.
B. conveys ones emotions expressively.
C. involves the use of commonly used gesture.
D. includes the use of commonly understood words.
ITEM 19
Which of the following factors would POSITIVELY affect the communication process?
i. Use of intimate distance
ii. Ability to comprehend stimuli
iii. Fostering territorial attitude
iv. Exuding a high level of confidence

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

ITEM 20
Which of the following are characteristics of non-verbal communication? It
i. allows for the dynamic exchange of ideas.
ii. tells others more about what a person is feeling.
iii. reinforces and or contradicts what is said verbally.
iv. utilizes an abundance of words to form messages.

A. i, ii
B. i, iv
C. ii, iii
D. iii, iv
ITEM 21
Which of the following manifestations is likely to indicate the client’s inability to communicate
effectively?
i. Loose association of ideas
ii. Constant verbalization of some phrases
iii. Significant change from normal vocabulary
iv. Slowed, deliberate and spontaneous speech

A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv
ITEM 22
Which of the following nursing diagnoses would be MOST appropriate for a client experiencing
communication problems?
i. Powerlessness related to impaired verbal communication
ii. Inappropriate verbalizations as evidenced by stuttering
iii. Social isolation related to ineffective verbal communication
iv. Deficit in Self Care associated with impaired communication
A. i, iii
B. i, iv
C. ii, iii
D. ii, iv
ITEM 23
Which of the following techniques should the nurse utilize for the promotion of therapeutic
communication?
i. Using silence
ii. Passing judgment
iii. Seeking clarification
iv. Giving common advice

A. i, ii
B. i, iii
C. ii, iii
D. iii, iv
ITEM 24
Which of the following outcome criteria would be appropriate to evaluate effective communication?
The client
i. expresses minimum fear, anxiety, frustration and depression.
ii. performs self care adequately without being asked.
iii. begins to establish a method of communication using learnt signals.
iv. perceives the message correctly as evidenced by appropriate verbal and non-verbal
communication.

SCENARIO 6 ITEM 25-30

To increase employee motivation, a Nurse Manager must know and predict which needs the
employee expects to satisfy through the job of each nursing position.

As a Nurse Manager, being able to motivate workers/staff, impact greatly on the operation of the
ward/unit.

ITEM 25
Which of the following may be used to motivate workers?
i. Set good examples
ii. Build a team spirit
iii. Reward good workers
iv. Discipline workers often

A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv
ITEM 26
ALL of the following statements are indicative of motivation EXCEPT
A. a motivated individual works better.
B. motivation is dependent on the worker himself.
C. all workers are motivated by the same desires.
D. management and colleagues can help to motivate others.

ITEM 27
Which of the following is a PRIORITY need for most workers?
A. Salaries
B. Promotion
C. Study leave
D. Staff meeting

ITEM 28
Which of the following conditions is likely to have positive effects on workers?
A. Not having to work hard
B. Working under close supervision
C. Allowing some amount of freedom on the job
D. Knowing they will be disciplined if they do a bad job

ITEM 29
Which of the following methods of rewarding workers should produce the BEST result?
A. Give each worker the same reward
B. Give each worker what he/she wants
C. Reward workers only on request
D. Reward each worker according to his efforts

SCENARIO cont’d

As a Charge Nurse responsible for a unit you have asked the supervisor to allow you to leave
half' an hour earlier to attend Public Administration classes.

ITEM 30
The supervisor will cover or seeks coverage for you if she understands the importance of the need
for
A. self esteem.
B. self preservation.
C. self actualization.
D. safety and secure

SCENARIO 7 ITEM 31-34

Nurse Managers at every organizational level need to select leadership styles and methods that
suit the work force requirement.
ITEM 31
Which of the following leadership styles would be MOST appropriate to deal with a Nursing
Assistant who divulges information?
A.Democratic
B.Autocratic
C.Consultative
D.Participative

ITEM 32
If decision makers carefully consider the approach to their decision making, which leadership
style would they choose?
A.Autocratic
B.Democratic
C.Situational
D.Laissez-faire
ITEM 33
According to Weber's Bureaucracy, when the nurse prepares a plan of care for her patients, which
leadership style is she using?
A. Legitimate
B. Traditional
C. Situational
D. Charismatic

ITEM 34
Which of the following leadership styles is BEST, if there is time to make decision?
A. Autocratic
B. Democratic
C. Situational
D. Laissez-faire

SCENARIO 8 ITEM 35-39

Miss Mary Thomas has been a nurse educator for twenty-five years. Throughout her career she
maintained good interpersonal relationships with her students and was able to identify with their
needs. The students were also successful at their examination.

ITEM 35
Learning can be defined as a
A. dynamic interaction between a teacher and one or more learners.
B. dynamic process in which there is a change in human behavior.
C. process which communicates information and attitude from one person to another.
D. process which involves a type of communication for which there are specific goals.

ITEM 36
Which of the following strategies are utilized by Miss Thomas when teaching the students about the
administration of insulin?
A. Affective, which involves attitudinal change over a period of time
B. Cognitive, which involves the acquisition of theoretical knowledge
C. Both Cognitive and Psychomotor teaching methods and strategies
D. Psychomotor, which involves teaching in relation to demonstration and repeated
practice.

ITEM 37
Which of the following should, the nurse do when implementing a teaching plan?
A. Introduce material to be learned at a lower level of abstraction
B. Utilize posters or charts that can help focus a learner's attention.
C. Provide clients with all the information needed on a particular subject area
D. Provide an environment which is quiet, but should be flexible regarding
interruptions.

ITEM 38
Which of the following is the BEST strategy to be used by nurses when teaching?
A. Specifying only the learning objective but not the responsibilities of the client and
nurse.
B. Establishing a contract with a client that states certain objectives and when they are
to be met.
C. Instructing individually as it provides the individual with an opportunity to learn
from the teacher.
D. Designing a system in which behaviors are weakened or eliminated under person's
conscious control

ITEM 39
All of the following are tools used to determine if learning has taken place EXCEPT
A. having the client do a self-report.
B. observing the client carry out a particular procedure.
C. observing client behaviors that reflect knowledge gained.
D. asking questions of the client to determine what has been learned.
SCENARIO 9 ITEM 40-43

A group of third year nursing student; are undertaking a study to determine the lack of
involvement of Registered Nurses in the national Nurses Association.

ITEM 40
Which of the following methods would be MOST suitable for this type of study?
A. Survey
B. Case Study
C. Trend Study
D. Classical experiment
ITEM 41
Which of the following classifications would BEST describe this type of study?
A.Historical
B.Descriptive
C.Explanatory
D.Exploratory

ITEM 42
From which of the following groups would the student select a sample for this study?

A. All third year students

B. Members of the nurses association

C. Active members of the nurses association

D. All registered nurses on the Nursing Council Register

ITEM 43
Which of the following is the BEST method of sampling for this study?
A.Multiphase
B.Random
C.Cluster
D.Quota
SCENARIO 10 ITEM 44-50

Mrs. Holmes, Ward Sister/Head Nurses in charge of Accident/Emergency Department, has been
informed of a hurricane that is expected to hit her island within the next 24- 48 hours. She is
expected to take appropriate action in preparation for that disaster.

ITEM 44
When planning for an impending hurricane, which of the following activities should be PRIORITY for
the Ward Sister?
i. Organizing staff roster
ii. Identifying triage area
iii. Ensuring adequate supplies
iv. Securing hospital records
A. i, ii, iii
B. i, ii, iv
C. i, iii, iv
D. ii, iii, iv

ITEM 45
Which of the following activities would BEST assist in improving the disaster management
competencies of the Ward Sister?
A. First Aid Training
B. Simulation exercises.
C. Shelter management
D. Lectures for one (1) week

SCENARIO Cont’d

A hospitalized Patient learnt that during the recent hurricane his home was completely destroyed.

ITEM 46
Which of the following persons or groups should the Ward Sister refer the patient to initially?
A. Hospital social worker
B. Social Security services
C. Hospital management team
D. National Disaster Committee

ITEM 47
In responding to an emergency situation, the first activity of the nurse should be to
A. Plan.
B. Direct.
C. Delegate.
D. Organize.
ITEM 48
In developing a comprehensive health sector emergency plan relating to disaster management, the plan
should include the ability to respond to all of the following EXCEPT

A. Epidemic control.
B. Environmental threats.
C. Obstetrical Emergencies.
D. Mass casualty incidents.

ITEM 49
Which of the following situations is likely to have the MOST serious and long lasting effects, following
a natural disaster?
A. Access to adequate housing
B. Inadequate schools for the children
C. Access to and safety of drinking water
D. Inadequate vaccine to complete immunization

ITEM 50
When selecting a good shelter location, the country's national disaster committee should consider all of
the following EXCEPT
A. Size.
B. Sanitation.
C. The affected area.
D. Potential hazards for the community.