Short Answer Test

Unit: 401010 Health Variations 1

Short Answer Test (SAT)

Assessment 2

Week 7 Commencing Monday April 3rd

In registered tutorials

Weighting – 40%

600 words

Unit: 401010 Health Variations 1 Short Answer Test Weighting: 40% Word count: 600 words Duration: 50 minutes Due Date: Week 7, in registered tutorial. Submission Details: This is a closed book assessment that will be completed in your registered tutorial class in week 7 under exam conditions. All students must attend their allocated tutorial to complete this assessment. You have an allocated time of 50 minutes. Important note If a student is unable to attend their registered tutorial in week 7 due to misadventure, they must apply for ‘Special consideration’. This application must be supported with appropriate evidence. If the application for ‘Special consideration’ is successful, the student may be eligible to complete a different, academically equivalent task in week 15. Marking Criteria and Standards: See page 13-16 of the Learning Guide

Aim of assessment The purpose of this short answer test in-class assessment is to enable the student to demonstrate: • An understanding of the principles of perioperative nursing care in relation to a person

who has ulcerative colitis (Learning outcome 1). • An understanding of alterations in body fluid homeostasis and the management of fluid

balance in the perioperative period (Learning outcome 1). • An understanding of the role of the nurse in the perioperative period in relation to a

person who has ulcerative colitis (Learning outcome 2). • An understanding of the pathophysiology of ulcerative colitis (Learning outcome 5). • An understanding of pharmacological agents that may be used in the perioperative care

of a person who has ulcerative colitis (Learning outcome 6). • An understanding of how safe and effective administration of pharmacological agents

support people in perioperative care (Learning outcome 1, 6 & 7). • An evaluation of relevant literature to support an understanding of the

pathophysiology, pharmacological and nursing management of a person experiencing Crohn’s disease and express this in a clear and succinct writing style (Learning outcome 9).

2

Unit: 401010 Health Variations 1 Details Eleanor Brown has been admitted to hospital with complications of ulcerative colitis. Eleanor, now 48 years old, was diagnosed with ulcerative colitis when she was 31 years old. Over the years, she has had numerous admissions to hospital for acute episodes of ulcerative colitis. Eleanor’s ulcerative colitis has been managed with a combination of diet, medication (infliximab) and medical monitoring. Eleanor has been experiencing an acute exacerbation of ulcerative colitis over the last two weeks. She has had up to fourteen episodes of diarrhoea with blood and pus per day and severe pain in her lower abdomen. She has been experiencing a sensation of abdominal bloating and cramping pain. Eleanor states she has been feeling too ill to eat and drink much and that she has lost nine kilograms in the last two weeks. She also states that she is feeling fatigued and has been unable to complete daily activities. A colonoscopy performed four years ago revealed that Eleanor had developed a large number of pseudopolyps in her descending and sigmoid colon. Due to her current exacerbation of ulcerative colitis, Eleanor’s gastroenterologist ordered an MRI scan of Eleanor’s abdomen as a colonoscopy posed a risk of perforation and haemorrhage. The MRI scan revealed that Eleanor had now developed pancolitis. The gastroenterological surgeon has recommended that Eleanor has a total colectomy and construction of an ileostomy. On examination, Eleanor has a tender distended abdomen. Her skin is dry, pale and cool to touch with poor turgor. Eleanor’s capillary refill is slow and she has flat neck veins. She states she has had reduced urine output over recent weeks. Observations on admission

• Blood pressure: 90/50 mm/Hg • Pulse rate: 112 beats/minute • Weak peripheral pulses • Respiratory rate: 23 breaths/minute • Temperature: 38.4C • Sa02: 97% in room air • Weight: 54 kilograms • Height: 165 cm • Urinalysis:

• specific gravity: 1039 • dark coloured urine • no other abnormalities noted

3

Unit: 401000 Professional Practice Experience 1 Initial pathology results

• Haemoglobin: 86 g/L (117 – 157 g/L) • Haematocrit: 52% (35 – 47%) • WBC 16780/mm3 (3500 – 11000/mm3) • Erythrocyte sedimentation rate (ESR): 31.3mm/hour (0 – 20 mm/hour) • C-reactive protein (CRP): 33.6mg/dl (20 mg/dl) • Albumin: 22.8g/L (35 – 50 g/L)

The MO orders the following

• Morphine 15mg IMI QID PRN • metoclopramide (Maxolon) 10mg IMI TDS • 1000mL Hartman’s solution over 6 hours • methylprednisolone 20mg IVI TDS • nil by mouth

Questions

Question 1. (30 marks, suggested 275 words)

Prioritise the nursing responsibilities and associated rationales related to the administration of morphine to Eleanor. (Learning outcome 7; NMBA Registered nurse standards for practice 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 2.3, 2.5, 4.1, 4.2, 4.3, 5.1, 5.2, 5.3, 5.4, 6.1, 6.2, 6.5, 7.1, 7.2, 7.3)

Question 2. (25 marks, suggested 225 words)

Describe the structural and functional changes that occur in the pathogenesis of ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus. (Learning outcome 5; NMBA Registered nurse standards for practice 1.1, 2.7, 3.3) Question 3. (15 marks, suggested 100 words)

Explain the characteristics of the intravenous fluid that was ordered for Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor. (Learning outcome 1, 2; NMBA Registered nurse standards for practice 1.1, 2.7, 3.3, 4.1, 4.2, 4.3) END OF QUESTIONS

4

Unit: 401000 Professional Practice Experience 1 NOTE - WORD LIMIT

There is a total word limit of 600 words for the SAT. If you exceed the word limit by more than 10% the marker will stop marking at 660 words (word limit of 600 words + 10%). This assessment does not require in text citations or a reference list

5

Marking criteria and standards: Assessment 2 – Short Answer Test (SAT) In Class closed book assessment based on Case History

Criteria Mark High Distinction Distinction Credit Pass Fail

Q 1. Accurately, clearly and comprehensively prioritises the nursing responsibilities and associated rationales in relation to the administration of morphine to Eleanor.

/30

Comprehensively, clearly and accurately prioritises all relevant nursing responsibilities related to the administration of morphine to Eleanor.

Provides detailed and accurate rationales for each of these actions.

Accurately prioritises all relevant nursing responsibilities related to the administration of morphine to Eleanor.

Provides accurate rationales for each of these actions.

Accurately prioritises most relevant nursing responsibilities related to the administration of morphine to Eleanor.

Provides accurate rationales for each of these actions.

Identifies most relevant nursing responsibilities related to the administration of morphine to Eleanor.

Nursing interventions may not be presented in a prioritised order.

Provides superficial rationales for these actions.

Some nursing actions may lack specific rationales.

Identifies minimal relevant nursing responsibilities related to the administration of morphine to Eleanor.

Rationales may be incomplete or not related to specific nursing actions.

(7.5-14.5)

Identifies minimal relevant nursing responsibilities related to the administration of morphine Eleanor.

Does not provide associated rationales for these actions or rationales are inaccurate.

(0-7)

25.5-30 22.5-25 19.5-22 15-19. ≤14.5

6

Criteria Mark High Distinction Distinction Credit Pass Fail

Q 2. Accurately, clearly and comprehensively explains the structural and functional changes that occur in the pathogenesis of ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

/25

Provides an accurate, clear and comprehensive explanation of the structural and functional changes that occur in the pathogenesis of

ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

Provides an accurate and clear explanation of the structural and functional changes that occur in the pathogenesis of

ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

Provides an accurate explanation of the structural and functional changes that occur in the pathogenesis of

ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

The information may be incomplete or lack clarity in explaining the structural and functional changes that occur in the pathogenesis of

ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

Provides a basic explanation of the structural and functional changes that occur in the pathogenesis of

ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow in explaining the structural and functional changes that occur in the pathogenesis of

ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

Provides a superficial explanation of the structural and functional changes that occur in the pathogenesis of

ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

(6-12)

Response does not demonstrate an accurate understanding of the structural and functional changes that occur in the pathogenesis of

ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.

(0-5.5)

21.5-25 19-21 16.5-18.5 12.5-16 ≤12

7

Criteria Mark High Distinction Distinction Credit Pass Fail

Q 3. Accurately, clearly and comprehensively describes the characteristics of the intravenous fluid that was ordered for Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor.

/15

Provides an accurate, clear and comprehensive description of the characteristics of the intravenous fluid that was ordered for Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor.

Provides an accurate and clear description of the characteristics of the intravenous fluid that was ordered for Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor.

Provides an accurate description of the characteristics of the intravenous fluid that was ordered for Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor.

The information may be incomplete or lack clarity.

Provides a basic description of the characteristics of the intravenous fluid that was ordered for Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor.

There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow.

Provides a superficial description of the characteristics of the intravenous fluid that was ordered for Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor.

(4-7)

Response does not demonstrate an understanding of the characteristics of the intravenous fluid administered to Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor.

(0-3.5)

13-15 11.5-12.5 10-11 7.5-9.5 ≤7

8

Criteria Mark High Distinction Distinction Credit Pass Fail

Academic Writing Style

/10

Writes in an advanced style exhibiting highly coherent and logical flow of ideas.

No errors in spelling, grammar, punctuation or sentence structure.

Writes clearly and succinctly with a coherent, logical flow of ideas exhibiting advanced clarity.

No errors in spelling, grammar, punctuation or sentence structure.

Ideas are clearly expressed.

Use of language enables effective flow of ideas.

Minor errors in spelling, grammar, punctuation or sentence structure that do not impede the logical flow of ideas and meaning.

Writes in a reasonably clear style, but limited use of language sometimes hinders the effective flow of ideas and meaning.

Minor, frequent errors in spelling, grammar, punctuation or sentence structure sometimes impede meaning and the flow of ideas.

Writes in an elementary style with basic use of language and poor articulation of ideas.

Organisation of material and main points are unclear, confused or disorganised

Multiple errors in spelling, grammar, punctuation and sentence structure.

8.5-10 7.5-8 6.5-7 5-6 ≤4.5

Please Note: Although these marking criteria give a total mark out of 80, the student’s mark for this assessment task will be calculated to an equivalent mark out of 40.

Comments:

Total Mark /80

Mark: /40% Marker: Date: / /2017

9