Exam paper for second semester: Community Health Nursing Scienc

University of Johannesburg

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University of Johannesburg Institutional Repository

      PROGRAMME : COMMUNITY HEALTH NURSING SCIENCE   SUBJECT : FAMILY HEALTH   CODE    : VPK2C50    DATE    : NOVEMBER EXAMINATION 2016   DURATION   : 3 HOURS  WEIGHT   : 50:50  TOTAL MARKS  : 100   EXAMINERS  : MRS L BADENHORST   MODERATOR  : DR KF MEINTJES   NUMBER OF PAGES : THIS PAPER CONSISTS OF SIX (6) PAGES   INSTRUCTIONS  : PLEASE ANSWER ALL THE QUESTIONS ALL MARKS ARE EQUIVALENT TO HALF (½) MARK PER FACT OR MOTIVATION, UNLESS OTHERWISE STATED    FACULTY OF HEALTH SCIENCES DEPARTMENT OF NURSING SCIENCE - 2 - NOVEMBER EXAMINATION 2016 FAMILY HEALTH (VPK2C50)  _____________________________________________________________________________________    QUESTION 1  1.1 Write the mathematical formula down that you will use to establish the amount of formula a healthy six (6) week old baby will need in 24 hours.  (1)  1.2 Rotavirus can cause excessive diarrhoea.   1.2.1 Name the mode of transmission.          (½)   1.2.2 A healthy baby attends the clinic for the first time at the age of five (5) months. Explain the catch up vaccine schedule for rotavirus  (4x½)=(2)  1.2.3 Give health education to a group of mothers in the primary health care (PHC) clinic on what to do to prevent dehydration when their children have diarrhoea. (6x½)=(3)  1.3 A 25-year old female attends your clinic. She is already on TB treatment. Explain the non-permanent contraceptive method of choice for this patient.    (6x½)=(3)  1.4 List the absolute contra-indications for oral contraceptive methods. (6x½)=(3)  1.5 Differentiate between the genetic terminologies: ‘deletion’ and ‘translocation’ .   (2x½)=(1)  1.6 A 20-year female visits your clinic. She is sexually active and complains of a vaginal discharge. She does not have lower abdominal pain. She is also not aware of any allergies. Describe the drug management that you will prescribe for this patient. Prescribe according to SANC regulation 2418. (15x½)=(7½)   *[21]   QUESTION 2  A 5-year old boy is brought to the clinic by the mother. She states that that he is complaining about a painful left ear for two (2) days.  3/.. - 3 - NOVEMBER EXAMINATION 2016 FAMILY HEALTH (VPK2C50)  _____________________________________________________________________________________    2.1 Differentiate between the signs for a viral otitis media and a bacterial otitis media.   2.1.1 Tabulate your answer by using the following headings:   Tympanic membrane appearance  Tympanic membrane colour  Cone of light (6x½)=(3)  The same mother also brought her 3-year old daughter to the clinic and says she is sneezing a lot the past few days.   2.2    Tabulate the clinical features of viral rhinitis, bacterial rhinitis and allergic rhinitis under the following headings:   Discharge  Fever  Turbinates  Conjunctiva (15x½)=(7½)  2.3 Name the disease characterised by the following clinical features: a strawberry tongue; pastia lines; and a sandpaper rash. (½)   *[11]  QUESTION 3  Measles is one the diseases targeted by the World Health organisation to be eliminated. However, measles and rubella are still seen in the PHC clinics. Please differentiate between the signs that you will find on physical examination of measles and rubella. You may tabulate your answer.  (16x½)=*[8]  QUESTION 4  Malaria poses health risks to many people worldwide. Describe the different aspects of malaria under the headings:   4/... - 4 - NOVEMBER EXAMINATION 2016 FAMILY HEALTH (VPK2C50)  _____________________________________________________________________________________    4.1 Causative organisms (4x½)=(2)  4.2 Vector of the disease (1)  4.3 Natural habitat of the disease vector (4x½)=(2)  4.4 Health education that you can give to the community that can help to prevent the disease.    (6x½)=(3)  4.5 Describe the clinical features of an acute malaria episode. (6x½)=(3)   *[11]   QUESTION 5  A mother with a 10 week old baby who is exclusively breastfed visits your clinic. She has to go back to work when the baby is 14 weeks old and will not be able to breastfeed once she is back at work. Currently the baby is struggling with colic, excessive winds and vomiting. The mother has excluded milk from her diet whilst breastfeeding.  5.1 Explain your health education to the mother on how to stop breastfeeding completely. (3x½)=(1½)  5.2 Name all the baby milk formulas the mother can choose and provide a motivation why these formulas could be the correct choice for her baby. (6x½)=(3)  5.3 Explain to the mother how to introduce solid foods from the age of four (4) months, up until and including nine (9) months of age. (13x½)=(6½)  5.4 Indicate the amount of formula a baby should be offered at the ages of six (6) months and nine (9) months respectively. (2x½)=(1)     5/... - 5 - NOVEMBER EXAMINATION 2016 FAMILY HEALTH (VPK2C50)  _____________________________________________________________________________________    5.5 Pellagra and Beri-Beri are both nutritional related conditions. Differentiate between Pellagra and Ber-Beri according to the following:  Definition (2x½)=(1)  Non-drug management (6x½)=(3)  *[16]  QUESTION 6  A 6-year old girl visited the clinic with her mother. The girl is having an itchy skin rash for a few days now. They stay in an informal settlement and do not have runny water and no electricity. They visited her cousin two (2) weeks ago who had the same type of rash. It is a popular-vesicular rash.  GOBIFFF: No abnormalities detected There are no other complaints.  6.1 Take a complete history for this child in order to derive at a differential diagnosis. The history taking should be written in the form of a dialogue, e.g. How many days have you had this rash? Two days.  The history should start at the date and time and end with the differential diagnosis DO NOT INCLUDE ANY PHYSICAL EXAMINATION (24x½)=*[12]   QUESTION 7  Tetanus is a worldwide notifiable communicable disease. Answer the following questions regarding tetanus:  7.1 State the causative organism. (1)  7.2 Explain the pathophysiology of this tetanus. (14x½)=(7)  7.3 How often do adults need to be immunised against tetanus? (1)  7.4 Explain the clinical features of Tetanus Neonatorum. (4x½)=(2)      6/... - 6 - NOVEMBER EXAMINATION 2016 FAMILY HEALTH (VPK2C50)  _____________________________________________________________________________________    7.5 Briefly discuss the health education that you could give to mothers to prevent Tetanus neonatorum.  (2x½)=(1)  A healthy 2-year child is brought in by the parents and presents with a superficial scratch on her leg that she got from a meerkat.  7.4.1 Name the disease she might have been exposed to, as well as the category of exposure. (2x½)=(1)  7.4.2 Describe the vaccine management for this child in full (also following R2418).     (10x½)=(5)  7.4.3 Explain the wound management of this child. (6x½)=(3)   *[21]   ---oOo---                                                                                                   PROGRAMME : COMMUNITY HEALTH NURSING SCIENCE    SUBJECT : FAMILY HEALTH    CODE    : VPK2C50     DATE    : SUPPLEMENTARY EXAMINATION JANUARY 2017   DURATION   : 3 HOURS   WEIGHT   : 50:50   TOTAL MARKS  : 100   EXAMINERS  : MRS L BADENHORST   MODERATOR  : DR KF MEINTJES   NUMBER OF PAGES : THIS PAPER CONSISTS OF FIVE (5) PAGES          INSTRUCTIONS  : PLEASE ANSWER ALL THE QUESTIONS ALL MARKS ARE EQUIVALENT TO HALF (½) MARK PER FACT OR MOTIVATION, UNLESS OTHERWISE STATED        2/...   FACULTY OF HEALTH SCIENCES DEPARTMENT OF NURSING SCIENCE - 2 - SUPPLEMENTARY EXAMINATION JANUARY 2017 FAMILY HEALTH (VPK2C50)  ______________________________________________________________________________________    QUESTION 1  1.1 Discuss the differences between marasmus and kwashiorkor under the following headings: a) Wasting b) Oedema c) Hair changes d) Skin appearance                                                                                    (8x½)=(4)  1.2 South Africa recently had a few cases of diphtheria in KwaZulu Natal.  1.2.1 State the direct mode of transmission (½)  1.2.2 A healthy baby attends the clinic for the first time at the age of five (5) months and only received immunisation at birth. Explain the catch up vaccine schedule for diphtheria according to the EPI schedule.  (10x½)=(5)  1.3 A 22-year old female who is HIV positive and on anti-retroviral treatment (the fixed dose schedule), visits your clinic. She is in a new relationship and her partner is also HIV positive. She wants to start a contraceptive method that she wants to use for a few months. She wants to plan a pregnancy six (6) months from now. She is a para 0 and gravida 0.  1.3.1 Explain the non-permanent contraceptive methods that could be suitable for this patient. (10x½)=(5) 1.3.2 From the methods provided in 1.3.1, choose the best option for this patient and motivate your choice.        (6x½)=(3)  1.4  Breastfeeding is the first choice to feed babies. However, there are certain absolute contraindications for breastfeeding. List these absolute contraindications. (5x½)=(2½)  1.5  Briefly explain the difference between Downs syndrome and Mosiac Downs syndrome. (2x½)=(1)  1.6 A 20-year female who is sexually active presents with a foul smelling and very itchy vaginal discharge. She also complains of a lower abdominal pain. She does not have any allergies.   4/... - 3 - SUPPLEMENTARY EXAMINATION JANUARY 2017 FAMILY HEALTH (VPK2C50)  ______________________________________________________________________________________    On examination you find: No pyrexia No guarding on palpation of the lower abdomen No vaginal bleeding  Cervical excitation tenderness is present on per vagina examination.  1.6.1  Describe the drug management for this patient according to R2418 (16x½)=(8)   *[29]  QUESTION 2  A 5-year old boy is brought to the clinic by his mother and he complains of a sore throat since yesterday. His 10-year old brother is currently on treatment for a streptococcal throat infection.  2.1 Tabulate the symptoms and signs for rheumatic heart fever. Do not mix the symptoms and signs.  (10x½)=(5)  2.2  Tabulate the symptoms and signs for streptococcal meningitis. Do not mix the symptoms and signs.  (12x½)=(6)   *[11]  QUESTION 3  3.1 Compare the signs of measles and scarlet fever. You may tabulate your answer.   (16x½)=(8)   *[8]  QUESTION 4  Scabies is a common condition that people who stay in hostels suffer from.  4.1 Discuss the condition under the following headings:  4.1.1 Mode of transmission  (2x½)=(1)  5/... - 4 - SUPPLEMENTARY EXAMINATION JANUARY 2017 FAMILY HEALTH (VPK2C50)  ______________________________________________________________________________________    4.2 Clinical manifestation (do not include secondary infection).  (3x½)=(1½)  4.3 Non-drug management. (4x½)=(2)  4.4 Prevention measures for scabies. (7x½)=(3½)   *[8]  QUESTION 5  A mother with a five (5) month old baby who is exclusively breastfeeding visits your clinic. She has to go back to work and will not be able to breastfeed once she is back at work. She says the baby is an extremely hungry baby who wants to feed all the time.  5.1 Name four (4) baby milk formulas that could be suitable for this baby when the mother goes back to work.     5.1.1 Motivate your answer. (6x½)=(3)  5.2 Stipulate the amount of formula milk this baby should be offered in a 24-hour period                                                                                                                (½)  5.3 Explain to the mother how to introduce solids into the baby’s diet from six (6) months up to and including nine (9) months. (13x½)=(6½)   *[10]  QUESTION 6  A 6-year old girl visited the clinic with her mother. The girl complains of a dry cough after playing netball with her friends. They stay in an informal settlement and do not have runny water and no electricity.   GOBIFFF: She did not receive her six (6) year immunisation. Review of systems: No abnormalities were detected    5/... - 5 - SUPPLEMENTARY EXAMINATION JANUARY 2017 FAMILY HEALTH (VPK2C50)  ______________________________________________________________________________________    6.1 Take a complete history for this child in order to derive at a differential diagnosis. The history taking should be written in the form of a dialogue, e.g. How many days have you had this rash? Two days.  The history should start at the date and time and end with the differential diagnosis DO NOT INCLUDE ANY PHYSICAL EXAMINATION (24x½)=(12)   *[12]  QUESTION 7  Pertussis is a worldwide notifiable communicable disease.  Answer the following questions regarding pertussis:  7.1 State the causative organism. (1)  7.2 Explain the pathophysiology of pertussis. (12x½)=(6)  7.3 How long is the incubation period of pertussis. (½)  7.4 If you have contracted pertussis once, what is your immunity status for the disease?    (½)  7.5 Describe the clinical manifestation of pertussis under the following headings: 7.5.1 Catarrhal stage (10x½)=(5) 7.5.2 Paroxysmal stage (8x½)=(4) 7.5.3 Recovery stage (2x½)=(1)  7.6 The private sector has a different immunisation schedule for pertussis than the public sector (EPI) schedule.  7.6.1 List the ages at which children are routinely immunised against pertussis according to the private immunisation schedule. (6x½)=(3)  7.6.2 List the adult immunisation schedule. (1)   *[22]  ---oOo--- 

Community Health Nursing Science

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Community Health Nursing Science

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