Practice question's

Question 1

Tikanga

Answer 1

AARRH - ACKNOWLEDGE, APOLOGISE, REMOVE, REFER, HANDOVER

1. Acknowledge the breach of tikanga and recognise that it was culturally inappropriate
2. Apologise to people present, showing respect
3. Remove the item that is causing the breach and place it in the correct location
4. Refer to Māori health worker/seek guidance to ensure correct cultural practices are followed
5. Handover the incident to next nurse/NIC so they are aware and cultural safety is maintained

Question 2

What is an impairment?

Answer 2

• A loss or abnormality in body structure or function impairments are conditions people may have (like physical, sensory, or intellectual). Disability happens when barriers in society limit their participation

Question 3

Give three examples of types of impairment.

Answer 3

• Physical (e.g., paralysis)
• Sensory (e.g., vision or hearing loss)
• Cognitive (e.g., memory difficulties)

Question 4

What is a disability?

Answer 4

• A restriction or limitation in performing everyday activities due to an impairment and barriers in the environment.

Question 5

Lily aged 15 years, attends a Special Needs support unit at her local high school. She has a profound intellectual disability and very little verbal communication; she uses a picture board. Lily is able to manage toileting independently, but needs prompting to wash her hands. She uses cutlery with thick handles and a plate with high sides when eating. Lily is able to walk. She does not usually show any signs of agitation.
Lily fell while at the school pool and was admitted to hospital with a fractured ankle. Family members arrive to visit Lily later that day and find her distressed and wearing an adult incontinence product. She has an untouched meal in front of her. They are angry and confront the RN.
What considerations would you need to have if Lily were your patient in clinical?

Answer 5

• Ensure accessibility and safety in care environment
• Communicate in ways that suit her needs (verbal, non-verbal, written, assistive devices)
• Provide extra time, patience, and support for her independence
• Involve family members for communication and care insights.
• Assess reasons for refusal to eat—consider pain, unfamiliar environment, or distress.
• Provide a calm, reassuring environment to minimize distress and agitation.

Question 6

Pete is 50, he has just had his gall bladder removed. How might an impairment such as being vision impaired, hearing impaired or if he has a condition such as Cerebral Palsy impact on his recovery?

Answer 6

• Muscle stiffness or weakness may slow mobilisation
• Communication difficulties may make it harder to express pain or needs
• Higher risk of respiratory issues, aspiration, or pressure injuries
• Difficulty understanding or remembering post-op care instructions.
• Over- or under-sensitivity to hospital environment (lights, sounds, touch). Can increase distress, agitation, or withdrawal, impacting recovery.

Question 7

Do health inequities exist for the disabled population?

Answer 7

• Yes, they often face reduced access to healthcare, delayed treatment, poorer health outcomes, and social disadvantage.

Question 8

List three things that are important for the safe discharge home of a person with visual impairment.

Answer 8

• Clear pathways and removal of hazards at home
• Accessible support (e.g., large-print or audio instructions, orientation training)
• Follow-up support or caregiver assistance for daily tasks and medications

Question 9

Patient 7 who has an intellectual disability has been admitted with a fractured femur following a fall.

Outline actions the nurse when educating this patient to ensure they understands their condition and plan. (3 marks)

Answer 9

• Use simple, clear language and visual aids, to explain the fracture and treatment plan.
  Rationale: Supports comprehension for patients with limited cognitive processing or literacy.
• Check understanding using teach-back method
  Ask the patient to explain the information back in their own words.
  Rationale: Ensures they truly understand and gives the nurse a chance to clarify if needed.
• Involve a caregiver, family member, or support person (if appropriate and with consent), include someone familiar with the patient’s communication style
  Rationale: Reinforces understanding and helps with decision-making or follow-up care.

Question 10

You are allocated Patient 6 who was admitted with an exacerbation of heart failure.
10. Management of this patient’s heart failure includes, administering Frusemide and oxygen therapy

What assessments would the nurse perform and what would they expect to find that indicates that these interventions have been effective?

Answer 10

Respiratory Assessment - Decreased RR, reduced WOB, SpO₂ maintained above 95%, Diminished or cleared crackles in lungs, which would indicate improved oxygenation and reduced pulmonary congestion

Fluid Status Assessment - increased UO, reduced oedema in lower extremities, decreased, which would indicate removal of excess fluid and improved volume status

Question 11

You are allocated Patient 5 who was admitted with a spinal fracture at the level of the first thoracic vertebrae (T1). The nurse notices a kink in the patient’s indwelling catheter.
9. Briefly explain the life-threatening complication that could occur from this and list the clinical manifestations (signs and symptoms) of this complication that is unique to spinal patients. (4 marks)

Answer 11

Autonomic Dysreflexia (AD)
A medical emergency that occurs in patients with spinal cord injuries at T6 or above, triggered by a noxious stimulus below the level of injury — such as a full bladder from a kinked catheter. Signs & Symptoms; bradycardia, flushed skin, piloerection, blurred vision. This condition requires immediate intervention to prevent stroke, seizures, or death.

Question 12

Patient 4 develops pain & swelling in their left leg. An ultrasound scan confirms a deep vein thrombosis (DVT).

8. Outline the aetiology and pathophysiological process that has most likely occurred in the formation of their DVT. (3 marks)

Answer 12

Venous stasis - occur’s with decreased blood flow - immobility, medication’s and in heart failure
Hyper-coagulability - occurs with deficient fluid volume, pregnancy, oral contraceptive use, smoking
Venous wall damage - may occur due to venipuncture, medication, trauma and surgery

Question 13

You are allocated Patient 3 has just returned to the ward following abdominal surgery.

7. The nurse undertakes the essential assessments of cultural and spiritual needs, family support, falls risk, smoking history, Braden scale and then records vital signs.

Identify three other priority nursing assessments that are specific to your patient during this acute stage and give your rationale (3 marks)

Answer 13

Abdominal Assessment - After abdominal surgery, patients are at risk of paralytic ileus. Monitoring bowel function helps detect early signs of GI complications.

Neurological assessment – To monitor level of consciousness and detect any signs of anaesthetic complication’s

COLDSPA to assess pain – to ensure pain is managed effectively and promote breathing and mobilisation

Question 14

Patient 2 who identifies as Maori is admitted with a myocardial infarction.
5. State four important points that the cardiac rehabilitation nurse would provide education on prior to discharge (4 marks)

Answer 14

Four important education points before discharge after a myocardial infarction:
- Medication education
Importance of taking prescribed medications (e.g. antiplatelets, beta-blockers, statins) regularly and understanding side effects, to prevent further cardiac events and supports heart recovery.

• Lifestyle changes
  Promote healthy eating (low fat/salt), smoking cessation, reduced alcohol, and regular physical activity to reduce modifiable risk factors for future heart attacks.
• Symptom recognition and when to seek help.
  Educate on signs of chest pain, shortness of breath, or dizziness, and when to call 111. Enables early intervention if symptoms recur.
• Support and cardiac rehabilitation services
  Encourage attending cardiac rehab programmes and involving whānau in education. To improves recovery, reduces anxiety, and respects the importance of collective decision-making in Māori culture.