Page 727 

Answers to self tests

Chapter 1

1. The WHO (1946) definition of health states ‘health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’
Multidimensional refers to the inter-related and holistic nature of health comprising six dimen-sions – physical, mental, emotional, spiritual, social and societal.
2. Key determinants of health include core factors, e.g. age, sex and ethnicity; others include lifestyle, living and working conditions, community and environmental issues as well as the sociopolitical climate. The greatest determinants of health are poverty and inequality.
3. Absolute poverty is the inability to meet basic biological needs such as food, warmth and shelter. Relative poverty is usually defined in comparison with a country’s average living standards.
4. Ancient health beliefs still expressed today centre on moral behaviour causing ill-health, miasma issues related to damp atmosphere and cleanliness and the increasing popularity of non-Western beliefs such as those underpinning complementary therapies.
5. Health promotion and health education approaches are similar, both using top-down and bottom-up approaches:
a. Health promotion approaches are medical, educational, behavioural change, client-centred and societal
b. Health education approaches are medical, educational, media/propaganda, community development and political action.

Chapter 2

1. See page 38.
2. See page 44.
3. See page 41.
4. 1919.
5. See page 48.
6. See Box 2.7.
7. See page 67.

Chapter 3

1. 1948.
2. Disease, idleness, ignorance, squalor and want.
3. See page 72.
4. See page 79.
5. See pages 87–88.
6. For example, clinical governance, ICPs, benchmarking, clinical guidelines, Healthcare Commission, National Patient Surveys, etc.

Chapter 4

1. a.
2. d.
3. d.
4. b.
5. b.
6. a.

Chapter 5

1. Possibly based on those offered in Box 5.1 (p. 124), which should make reference to: making decisions and/or solving clinical problems; searching the literature for examples of current, best available, systematic research evidence; evaluating/critically appraising the evidence; make conscientious, explicit and judicious use of the evidence as it pertains to a particular situation; and integrating the evidence with individual clinical experience.
2. Questioning practice, refining question, finding the evidence, appraising the evidence, using the evidence, and evaluating practice/audit changes.
3. RCTs, systematic reviews, qualitative research, expert opinion and guidelines.
4. AMED (Allied and Alternative Medicine), BNI (British Nursing Index), CINAHL (Cumulative Index of Nursing and Allied Health Literature), Cochrane Library and MEDLINE.
5. PICO is an acronym to help structure a search question. P = Patient or population, I = Intervention, C = Comparison, O = Outcome.
6. To facilitate an understanding of research evidence, to improve the quality of practice through use of good quality evidence, to identify the credibility and value of evidence.
7. Qualitative research seeks to explore subjective narratives to gain an insight into experiences and perceptions of phenomena; quantitative research seeks to measure phenomena and applies control to a study.
8. RCTs, qualitative, survey and systematic review.
  Page 728 

Chapter 6

1. See pages 148–149.
2. See pages 150–151.
3. See pages 155–156.
4. Employer, professional, civil courts, criminal courts.
5. d.
6. See pages 160–161.

Chapter 7

1. The Nursing and Midwifery Council:
• Regulates preparation for practice of nursing students
• Stipulates criteria for registration as qualified practitioners
• Maintains a register of practitioners
• Supervises post-registration practice of practitioners via periodic re-registration
• Investigates allegations against practitioners of misconduct or unfitness to practice
• Takes appropriate action if allegations of misconduct or unfitness to practice are upheld
• Provides advice for nurses in relation to standards of professional practice.
2. The code of professional conduct: standards for conduct, performance and ethics (NMC 2004).
3. An NMC guide for students of nursing and midwifery (NMC 2002b).
4. The purpose is to:
• Inform the professions (nursing and midwifery) of the standard of professional conduct required of them in the exercise of their professional accountability and practice.
• Inform the public, other professions and employers of the standard of professional conduct that they can expect of a registered practitioner.
5.
a. Ethics: a formal identification of values, attitudes, beliefs and behaviours that a society or culture considers necessary for its moral functioning.
b. Morals: behaviours considered commensurate with the ethics of a society or culture.
6.
a. Non-maleficence: the ethical principle that individuals should not harm others.
b. Beneficence: the ethical principle that individuals should do good to others.
c. Autonomy: the ethical principle that individuals should make their own decisions about their lives.
d. Respect for persons: the ethical principle that all individuals should be accorded respect, i.e. due regard and consideration.
e. Justice: the ethical principle that individuals have rights, e.g. dignity, privacy, and that others have a duty to comply with these rights.

Chapter 8

1. i – c; ii – a; iii – b.
2. a.
3. Reconstituted family.
4. See Figure 8.3.
5. c.
6. All except e.
7. b.
8. Formal operational (Piaget).
9. From 6 months to about 3 years.
10. Stage 5: Identity versus role confusion.

Chapter 9

1. See page 224.
2. Environmental noise, pain, distress, etc.
3. See Table 9.1 (p. 227).
4. See page 237.
5. See page 231.
6. Preorientation, orientation, working, termination.
7. Intonation, emphasis, loudness, etc.

Chapter 10

1. True.
2. True.
3. False.
4. b.
5. See pages 264–265.
6. d.
7. b.

Chapter 11

1. See pages 277–278.
2. Affect, cognition, behaviour and physiology.
3. See Figure 11.1 (p. 279).
4. Alarm, resistance and exhaustion.
5. b.
6. Search for meaning, sense of mastery, enhanced self-esteem.
7. Hope, personal responsibility, education, self-advocacy, support.

Chapter 12

1. See pages 300–301.
2. See pages 309, 311.
3. General nurses, medical staff, district nurses, GPs, specialist palliative care nurses and doctors, physiotherapists, occupational therapists, psychologists, religious figures, etc.
4. See Box 12.2 and pages 301–303.
5. See pages 307–308.
6. See Box 12.15 (p. 316).

Chapter 13

1. b.
2. c.
3. c.
4. c.
5. b.
6. c.
7. d.
8. b.
  Page 729 

Chapter 14

1. b.
2. c.
3. c.
4. a.
5. d.
6. b.
7. c.
8. d.

Chapter 15

1. Must wash hands: b, c, d, f, g; Not necessary: a, e.
2. b and d.
3. a.
4. All.
5. a.
6. Is at risk: a, c; Is not at risk: b, d.

Chapter 16

1. These can be found in the glossary.
2. A, B, C – meaning assess airway, breathing and circulation.
3. See pages 429–430.
4. See Box 16.11 (p. 432).
5. They were devised by the Department of Health to enhance aspects of patient care in which there was widespread room for improvement.
6. See pages 446–447.
7. See Box 16.28 (p. 452).

Chapter 17

1. Coronary arteries.
2. b.
3. See page 480.
4. See page 486.
5. See page 471.
6. c.
7. Makes the secretions less viscous and easier to expectorate.
8. True (see p. 493).

Chapter 18

1. Assess the Task, the Individual characteristics of the handlers, the Load and the Environment (TILE).
2. Active exercises are initiated by the patient. Passive exercises involve the application of an external force, e.g. a piece of equipment or a physiotherapist, to initiate the movement.
3. Nurses, physiotherapists, occupational therapists, doctors and liaison nurses all work together to promote independence. Each profession brings its own skills to assist with such aspects of care as pain control, assistance with mobility, prevention of boredom and assistance in carrying out the activities of living.
4. Rest, ice, compression, elevation.

Chapter 19

1. See page 532.
2. See pages 538–539.
3. a. 42; b. 125 mL.
4. Carbohydrates, fats and proteins.
5. See page 557.
6. BMI 18.2; underweight.
7. See page 561.

Chapter 20

1. Filtration, reabsorption and secretion.
2. See Table 20.3 (pp. 578–579).
3. See Box 20.2 (p. 574).
4. Clean catch, midstream and specimen bags, or suprapubic aspiration.
5. See pages 582–583, 585, 587.
6. See pages 584–585 and Box 20.16 (p. 584).
7. See Table 20.4 (p. 586).
8. 23–26 cm, Ch 10–12.
9. Ensure that the catheter bag is securely attached to a catheter bag stand or the person’s leg, making sure that the bag does not get dragged along or the tubing to become caught up or twisted.

Chapter 21

1. d.
2. c.
3. See Box 21.2 (p. 602).
4. See Table 21.1 (p. 605).
5. See Box 21.19 (p. 614).
6. See page 617.

Chapter 22

1. Two tablets.
2. Half a tablet
3. 10 mL.
4. 450 mg.
5. a. 0.9 mg; b. 0.9 mL.
6. a. True; b. True; c. True; d. False; e. False.
7. a. Intramuscular; b. Intramuscular; c. Subcutaneous.
8. 30 seconds.
  Page 730 

Chapter 23

1. See pages 654–656, Figure 23.1 (p. 654).
2. See pages 656–657, Figure 23.3 (p. 656).
3. True.
4. See page 666, Figure 23.5D (p. 665).
5. Peripheral side-effects, e.g. constipation and dry mouth.
6. True, see Figure 23.9 (p. 671).
7.
c. Disturbed sleep pattern reduces the ability to cope with pain and fatigue can open the ‘pain gate’. Sleeplessness is frequently a problem in the hospital environment and for patients with chronic pain.

Chapter 24

1. See pages 683–684.
2. See page 685.
3. See page 690.
4. See page 692.
5. See page 692.
6. See page 698.
7. See pages 700–701.

Chapter 25

1.
a. Surgical wound, burn.
b. Pressure ulcer, leg ulcer.
2. Vascular response–inflammation–proliferation–maturation.
3. See page 705.
4. True.
5. Cause, size, location, exudate, condition of surrounding skin, tissue type, odour, pain.
6. See page 714.
7. See Table 25.3 (p. 718).
8. See pages 723–724.