Posted: February 14th, 2023

HLT54115 – Diploma of Nursing Assessment Type Assessment 1 Underpinning Knowledge/Questions

Assessment Details
Qualification Code: Title HLT54115 – Diploma of Nursing
Assessment Type Assessment 1 Underpinning Knowledge/Questions
Due Date
Location
Term-Year

Unit of Competency
Unit Code/Title HLTENN005 Contribute to nursing care of a person with complex needs

Student Details
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Feedback to Student

RESULTS (Please Circle) SATISFACTORY NOT SATISFACTORY

Assessor Details
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Assessment 1 -Underpinning knowledge questions

Assessment 1 Underpinning knowledge questions

Instruction to Students:
• Answer the questions below in the spaces text box provided.
• Ensure all references are documented under each individual question.
• Answers are to be typed or for written submissions, use black or blue ink and ensure your name is attached to the responses.

1. Complete the table below about common disorder and/or condition associated with body systems and the diagnostic procedures/tests used for diagnosis.
Body system List the names of 2 common disorders and/or conditions List 1or more diagnostic test used for diagnosis of the disorder or condition
Musculoskeletal
Integumentary
Cardiovascular
Respiratory
Gastrointestinal
Special senses: Ear
Special senses: Eye
Nervous
Endocrine
Urinary
Reproductive
male
Reproductive female

2. Briefly discuss the characteristics and difference between of each of the following and from the scenarios listed below select which scenario matches the types of thinking in the table. (more than 1 scenario may match the type of thinking)

Types of thinking Characteristics and differences Scenario match
critical thinking

creative thinking

problem-solving

Scenario 1
A 16-year-old girl presents to the local Medical service at 11pm in a distressed state with a small laceration to her head and blood running down her face. The Doctor orders for the girl to have some stitches to her laceration and some pain relief for her headache. The girl has presented before and has a history of injuries from family violence, she is fearful, uncooperative and refuses to have stitches and wants to leave.
• The nurse asks the doctor to change the order from stitches to steri-strips;
• applies the steri-strips
• confirms with the girl she has someone to transport her home
• administers the ordered medication.

Scenario 2
A 16-year-old girl presents to the Medical service at 11pm in a distressed state with a small laceration to her head and blood running down her face. The Doctor orders for the girl to have some stitches to her laceration and some pain relief for her headache. The girl has presented before and has a history of injuries from family violence, she is fearful, uncooperative and refuses to have stitches and wants to leave.
The Nurse asks herself the following questions:
• What other ways can the girl be persuaded to be more cooperative?
• What would be the consequence of not stitching the laceration?
• What would be the consequence of not administering the pain relief for her headache?
• What is the big picture here? (what other factors have contributed to the girl coming to the medical service, is the girl really a victim of family violence or just wanting attention, but now feels foolish for coming to the Medical centre)

Scenario 3
A 16-year-old girl presents to the Medical service at 11pm in a distressed state with a small laceration to her head and blood running down her face. The Doctor orders for the girl to have some stitches to her laceration and some pain relief for her headache. The girl has presented before and has a history of injuries from family violence, she is fearful, uncooperative and refuses to have stitches and wants to leave.
The nurse considers the following options:
• Offer the girl a warm washer to clean her face and to visualise the actual laceration and determine its severity in consultation with the girl.
• ask the girl if she would like someone to be with her that would make her feel more comfortable in the medical service setting.
• speak to the girl in non-technical terms to form the basis of a relationship for the girl to trust the nurse’s opinion of what treatment she should consider
• Suggest some options other than stitches that would help close the wound but would not prevent a noticeable scar so she can make an informed decision on her treatment.

Case Story 1
Dora is a 52-year-old woman who lives in a small remote town in south western NSW. Dora has a history of emphysema due to smoking since she was 12 years old and has recently been experiencing a persistent cough and respiratory difficulty.
Dora was referred by her Primary Health Care service to have a series of chest x-rays and a lung biopsy. Dora has refused to undergo these diagnostic procedures as she will have to go to the closest city hospital 50 kilometres away and leave her adolescent family at home without parental guidance as her husband is a ‘miner’ and is presently working away from home.
Dora’s health deteriorated and she was rushed to the emergency department of the hospital and was given the diagnostic tests and medication to help her breathing. The doctor has ordered for Dora some ongoing chest therapy, respiratory exercise treatment and further diagnostic testing such as blood and sputum specimen collections and recommends she stay in hospital as he suspects she may also have Pertussis. Dora refuses to stay in the hospital and wants to go home to her family.
The doctors are concerned for Dora health as the remote town she lives in does not have a local GP only a visiting GP every fortnight. Dora asks the RN about expenses and necessary trips to the city for ongoing treatment as she does not drive or own a car, the RN states that Dora is free to go home and does not have to comply with treatment.
Dora is concerned about her addition to smoking and deteriorating health as she is no longer able to care for her family. A social worker is asked to speak to Dora about her concerns and family situation.

Provide responses to the following questions based on the case story.
3. Which medical service staff could have written a referral for Dora to go to the hospital for diagnostic tests?

4. How might the following listed strategies be used to support and manage a person with deteriorating health such as Dora and her family?

Strategies that might be used in the health care management of Dora How could this strategy be used to Help health staff with the issues presented in the case story
conflict resolution

mediation

negotiation

referrals

5. How would you raise the issue of Dora wishing to be discharged with the RN; where the nursing intervention of discharge home, is at odds with an already prescribed course of action by multidisciplinary team?

6. In the context of the enrolled nurse role, describe how you would apply isolation nursing practices for Dora whilst she is in the hospital.

Case Story
Eric, a 60-year-old male, 167cm tall, with a history of smoking and severe chronic obstructive pulmonary disease (COPD) presented to the emergency department with acute onset shortness of breath and associated back pain. Oxygen was given with the aim of maintaining oxygen saturation between 88% and 92% due to his COPD. Arterial blood gas upon admission showed reduced oxygen saturation with respiratory acidosis. An urgent chest X-ray was ordered and a sputum specimen. Eric was placed on bedrest and a underwater sealed chest drain was inserted into the axilla. Clinical bubbling from the underwater seal drain and the respiratory swing of fluid confirmed chest tube patency. Eric’s breathing improved rapidly after the chest drain insertion, however, two days later Eric complained of pain radiating down his right arm and was sent for an ECG.

Provide responses to the following questions based on the case story.
7. Explain what the following diagnostic test results indicate for Eric.
Diagnostic test What does this information indicate
a) 12-lead ECG result is:
b) Peak flow monitoring

c) Spirometry test
Which diagram A, B, C or D represents the typical ventilatory function of a person with COPD.

d) Oxygen saturation levels = SpO2 of 86%

Figure 1. Source https://pixabay.com/en/photos/healthcare/

e) Chest X-ray shows

Figure 2. Source: https://pixabay.com/en/photos/healthcare/

f) Sputum culture was positive for Haemophilus influenzae

Figure 3. Source: https://pixabay.com/en/photos/healthcare/

8. You are requested to perform the nursing intervention of placing thigh length anti-embolic stocking on Eric. Describe why you need to place anti-embolic stocking on Eric and how you would perform this task.

9. Describe what you would check when managing the care and monitoring of Eric’s underwater sealed chest drain system (no suction ordered) and monitoring of his oxygen saturation levels.

10. Using the following resource Working with People with Chronic and Complex Health Care Needs Practice Package; which respiratory health threats should be reviewed with the General Practitioner or respiratory specialist when developing Eric’s chest management plan on his return back home and into the community.
Resource link: http://www.adhc.nsw.gov.au/__data/assets/file/0003/301782/Working-with-people-with-chronic-and-complex-health-care-needs-Practice-Package.pdf Pages 14 – 16

Questions Checklist
Questioning Checklist: HLTENN002 Apply communication skills in nursing practice
The assessor needs to indicate whether they have conducted the questioning as written questions or as verbal questions by ticking the box below.
 Written Questioning  Verbal Questioning
For written questions, the assessor must provide the student’s original written responses.
For verbal questioning, the assessor must provide dot points as a Maximum on the student’s responses.
For details on how to conduct and contextualise this form of assessment, please refer to the questioning checklist explanation in the assessor guide.
Student’s name:
Assessor’s name:
If questions are answered verbally, the assessor must write detailed answers in the sections provided below. The space below does not indicate the size of the answer anticipated. Keep typing and the space will expand. If answers are recorded separate to this document, they must be attached to the assessment documents. Satisfactory response
Yes No
Q 1 Complete the table below about common disorder and/or condition associated with body systems and the diagnostic procedures/tests used for diagnosis.

Q 2 Briefly discuss the characteristics and difference between of each of the following and from the scenarios listed below select which scenario matches the types of thinking in the table. (more than 1 scenario may match the type of thinking)

Q 3 Which medical service staff could have referred Dora to the hospital for diagnostic tests?

Q 4 How might the following listed strategies be used to support and manage a person with deteriorating health such as Dora and her family?

Q5 How would you raise the issue of Dora wishing to be discharged with the RN; where the nursing intervention of discharge home, is at odds with an already prescribed course of action by multidisciplinary team?

Q 6 In the context of the enrolled nurse role, describe how you would apply isolation nursing practices for Dora whilst she is in the hospital.

Q7 Explain what the following diagnostic test results indicate for Eric.

Q8 You are requested to perform the nursing intervention of placing thigh length anti-embolic stocking on Eric. Describe why you need to place anti-embolic stocking on Eric and how you would perform this task.

Q9 Describe what you would check when managing the care and monitoring of Eric’s underwater sealed chest drain system (no suction ordered) and monitoring of his oxygen saturation levels.

Q10 Using the following resource Working with People with Chronic and Complex Health Care Needs Practice Package; which respiratory health threats should be reviewed with the General Practitioner or respiratory specialist when developing Eric’s chest management plan on his return back home and into the community.

Feedback to Student:

Result  Satisfactory  Not Yet Satisfactory
Assessor’s Signature: Date:

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