🏥 Nurses Revision Uganda
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Foundations of Nursing I and Basic Computer Revision Guide
SECTION A: Objective Questions (20 marks)
💡 Exam Focus: Nursing fundamentals test your understanding of basic patient care, safety protocols, and infection control. Pay attention to specific techniques and rationales!
1
A patient who develops a body temperature of 39° is sponged with ..........................water.
(b) tepid
Tepid water (32-35°C) is used for sponging hyperthermic patients to reduce body temperature safely. Tepid water is lukewarm - neither hot nor cold. Cold water causes vasoconstriction, shivering, and paradoxical temperature rise. Tepid water promotes evaporative cooling without triggering the body's heat-conservation mechanisms.
SPONGING: "Tepid = Temperature reduction without Tremor" - Use 32-35°C water, sponge for 20-30 minutes, monitor temperature every 15 min
2
Which of the following parameters does the nurse NOT consider while taking vital signs?
(c) Body weight
Vital signs are the four core physiological measurements: temperature, pulse (heart rate), respiratory rate, and blood pressure. Body weight is an anthropometric measurement, not a vital sign. While important for health assessment, it's not part of the standard vital signs bundle that indicates immediate physiological status.
🌡️ The 5th Vital Sign: Some institutions add PAIN as the 5th vital sign. Others include SpO2. But weight is NEVER a vital sign!
3
Nurses perform disinfection of equipment in the ......................room.
(a) sluice
The sluice room (also called utility or dirty utility room) is specifically designed for cleaning, disinfecting, and storing used equipment. It contains sinks for cleaning, disinfectant solutions, waste disposal units, and storage for clean items. It's separate from clean areas to prevent cross-contamination.
SLUICE: "S" = Soiled items, "L" = Liquid waste, "U" = Utensils cleaned, "I" = Infection control, "C" = Contaminated equipment, "E" = Environmental services
4
The method of lifting a patient from chair to bed with nurses facing each other is
(d) orthodox
The Orthodox lift involves two nurses facing each other with the patient positioned between them. Each nurse places one arm under the patient's thighs and the other arm around the patient's back. The nurses coordinate to lift and transfer the patient. This method provides good weight distribution and stability when moving patients between surfaces.
⚠️ Manual Lifting Safety: Use mechanical lifts (hoists) when possible. Orthodox lift requires two staff, good communication, and patient cooperation. Risk of back injury to nurses if weight >20kg!
5
Nursing is recognised as an art because it is a profession
(b) with moral principles
Nursing is considered an art because it requires intuitive judgment, compassion, and ethical decision-making in unique human situations. The moral and ethical dimensions - caring, advocacy, compassion, integrity - transform technical skills into a healing art. While nursing uses science (evidence-based practice), the art lies in humanistic application guided by moral principles.
NURSING ART vs SCIENCE: "CARES" - Compassion (art), Advocacy (art), Research (science), Evidence (science), Science (knowledge) + Art (application)
6
Patients with neglected mouth care are at high risk of
(a) gingivitis
Gingivitis (inflammation of gums) is the MOST IMMEDIATE and direct consequence of neglected oral hygiene. Plaque accumulates within 24-48 hours, causing bacterial inflammation of gingival tissue. While halitosis, caries, and glossitis also occur, gingivitis develops first and fastest. In hospitalized patients, it can progress to periodontal disease and become a source of systemic infection.
🔴 24-Hour Rule: Plaque forms in 24 hours, gingivitis in 2-3 days! In ICU patients, oral care must be performed EVERY 2-4 hours to prevent ventilator-associated pneumonia.
7
Which of the following is NOT a pressure point for a patient in supine position?
(a) Acromion
The acromion (shoulder prominence) is not a pressure point in supine position. In supine (lying on back), pressure points are areas that contact the bed surface: occiput (back of head), scapulae, elbows, sacrum, coccyx, ischial tuberosities, and heels. The acromion becomes a pressure point in SIDE-LYING position, not supine.
SUPINE PRESSURE POINTS: "O-S-E-S-C-H" - Occiput, Scapulae, Elbows, Sacrum, Coccyx, Heels
8
Which of the following protects the patient against bedsores?
(d) Frequently turning patients
Repositioning every 2 hours is the GOLD STANDARD for pressure ulcer prevention. It relieves pressure, restores circulation, and prevents tissue ischemia. Regular turning schedule (every 2 hours for high-risk patients) is the single most effective preventive intervention. Combined with pressure-reducing surfaces, it can prevent up to 85% of pressure ulcers.
⏰ 2-Hour Rule: Turn clock starts when patient stops moving. Document every turn! Use 30° lateral position to avoid pressure on trochanter. Don't forget heels - elevate off bed!
9
Which of the following is the founder of modern nursing?
(d) Florence Nightingale
Florence Nightingale (1820-1910) established the foundations of modern nursing during the Crimean War. She introduced evidence-based practice, sanitation, statistical analysis, and formal nursing education. Her book "Notes on Nursing" (1859) became the first nursing textbook. She established the first nursing school at St. Thomas' Hospital in London (1860), creating the profession as we know it today.
NIGHTINGALE'S LEGACY: "NURSING" - Night rounds, Uniform standards, Research, Sanitation, Infection control, Nursing education, Geriatric care, Administration, Lady with the Lamp, Evidence-based practice
10
A nurse who fails to use aseptic technique when required may be held responsible for
(c) negligence
Negligence is the failure to exercise the standard of care that a reasonably prudent nurse would exercise in similar circumstances. Not using aseptic technique when required breaches the standard of care, potentially causing patient harm. Malpractice is a type of negligence specific to professional misconduct, but negligence is the broader legal term that applies to this scenario.
⚖️ Legal Standard: Nurses must follow hospital protocols, NMC guidelines, and evidence-based practice. Deviations must be documented with rationale. "I didn't know" is not a defense!
11
A soiled dressing removed from a wound is disposed off into a .....................bin.
(c) red
Remember we now have only 3 bins, Red, Black and Brown, as of 2025
Remember we now have only 3 bins, Red, Black and Brown, as of 2025
Red bins are for infectious/clinical waste including soiled dressings, swabs, and any materials contaminated with blood or body fluids. Red is the internationally recognized color for hazardous infectious waste. The waste is then autoclaved or incinerated to destroy pathogens before final disposal.
WASTE COLOR CODING: "Red = Blood/Infection, Yellow = Sharps/Drugs, Black = Normal, Brown = Chemicals, Blue = Glass"
12
The knee-chest position in nursing care is indicated for
(a) rectal examination
The knee-chest (kneeling) position provides optimal visualization and access to the anorectal area. The patient kneels with chest on bed and buttocks elevated. This position allows gravity to separate buttocks and facilitate inspection of perianal area, digital rectal examination, proctoscopy, and sigmoidoscopy. Also used for certain surgical procedures (hemorrhoidectomy) and for administering rectal medications.
🔍 Multiple Uses: Knee-chest also treats rectal prolapse (reduces prolapse via gravity) and helps pass flatus in colicky infants!
13
Which type of hospital bed is suitable for the patient who has fracture femur with POP?
(a) Fracture bed
A fracture bed (also called orthopaedic bed or Balkan frame bed) is specifically designed for patients with fractures. Features include: Balkan frame with pulleys and weights for traction, firm mattress to support plaster cast, ability to attach traction devices, and raised side rails for safety. Allows proper positioning of the fractured limb while maintaining correct alignment during healing.
ORTHOPAEDIC BED FEATURES: "FRAME" - Fixed mattress, Raised sides, Adjustments for traction, Mechanical pulleys, Extra firmness
14
Which of the following is NOT a characteristic of second stage of rigor?
(b) Profuse sweating
The second stage of fever (fervescence) is characterized by cessation of chills, hot dry skin, and possible restlessness. Profuse sweating occurs in the THIRD stage (defervescence) when temperature begins to fall. During stage 2, the hypothalamic set point has been reached, vasodilation occurs, and skin feels hot but not sweaty. Sweating indicates crisis and temperature decline.
FEVER STAGES: "C-H-S" - 1. Chills (Cold), 2. Hot (No sweats), 3. Sweating (Crisis)
15
Which of the following techniques involves the sense of sight?
(c) Inspection
Inspection is the visual examination of the patient using the sense of sight. It's the first and most important technique in physical assessment, providing immediate clues about the patient's condition. Nurses observe skin color, breathing pattern, posture, wounds, edema, and overall appearance. Should be performed systematically from head to toe.
16
Which of the following parameters do nurses check for while assessing respiration?
(d) Rate
Respiratory rate (breaths per minute) is the PRIMARY parameter assessed in routine vital signs. Normal adult rate is 12-20 breaths/minute. Rate abnormalities (tachypnea >20, bradypnea <12) are critical indicators of respiratory distress, metabolic acidosis, neurological problems, or pain. While rhythm, symmetry, and volume are important, rate is the first and most essential measurement.
RESPIRATORY ASSESSMENT: "R-R-D-E-S" - Rate, Rhythm, Depth, Effort, Symmetry
17
The most effective method of processing instruments is
(c) sterilisation
Sterilisation is the MOST effective method as it destroys ALL microbial life including bacteria, viruses, fungi, and spores. This is absolute sterility (Sterility Assurance Level of 10⁻⁶). Required for all invasive procedures and surgical instruments. Autoclaving is ONE METHOD of sterilisation, but sterilisation is the overarching process that includes other methods (dry heat, ethylene oxide, radiation).
🔥 Sterilisation Hierarchy: Sterilisation > Disinfection > Decontamination > Cleaning. For invasive instruments, only sterilisation is acceptable!
18
The most appropriate nursing action for an infected patient with chills and shivering is to
(a) cover with additional bed linen
Chills and shivering indicate the FIRST STAGE of fever (chill phase) where the hypothalamic set point is rising. The patient feels cold despite rising temperature. Covering with blankets provides comfort and reduces shivering, which generates excess metabolic heat and increases oxygen consumption. Once the set point is reached and skin feels hot, covers should be removed.
CHILL PHASE CARE: "C-WARM" - Cover patient, Warm drinks, Assess temperature, Record, Monitor
19
Which of the following is NOT a storage device for data?
(b) Read only memory
Read Only Memory (ROM) is a type of computer memory (RAM) that temporarily holds data while computer is running. It is NOT a storage device - it's volatile memory that loses data when power is off. Storage devices permanently retain data. ROM is for active processing, not long-term storage.
💾 Memory vs Storage: Memory (RAM/ROM) = temporary workspace; Storage (HDD/SSD/USB) = permanent filing cabinet. ROM is firmware, not storage!
20
Which of the following is an output device?
(b) Printer
A printer is an output device that produces a physical copy of digital information (hard copy). It takes data from the computer and outputs it to paper. Other output devices include monitors, speakers, and projectors. Input devices bring data INTO the computer (keyboard, mouse, scanner).
OUTPUT DEVICES: "MSP" - Monitor, Speakers, Printer
SECTION B: Fill in the Blank Spaces (10 marks)
21
The art and science of providing compassionate patient-centred care is called ..........................................
Nursing
The WHO defines nursing as "the autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people." It combines scientific knowledge with the art of caring.
22
The bed appliance used by nurses to prevent jerking of an amputated stump is called ..........................................
Bed cradle
A bed cradle is a metal frame placed over the lower limbs to support bedclothes, preventing them from touching and causing pain to the amputated stump or sensitive surgical site. Allows air circulation, prevents pressure, and enables easy wound inspection without disturbing dressings.
23
An ulcerated, sloughed area of tissue resulting from pressure is called ..........................................
Pressure ulcer (or bedsore, decubitus ulcer)
Pressure injury localized damage to skin and underlying tissue due to sustained pressure, friction, or shear. Stages range from non-blanchable erythema (Stage 1) to full-thickness tissue loss with exposed bone (Stage 4). Prevention is easier than treatment - requires regular repositioning, pressure-relieving surfaces, and skin care.
24
Nurses are able to remove dry blood stains from hospital linen by applying a chemical called ..........................................
Hydrogen peroxide
Hydrogen peroxide (3% solution) breaks down blood proteins through oxidation, removing stains effectively. For hospital laundry, sodium hypochlorite (bleach) is also used for disinfection and stain removal on white cotton fabrics. Blood stains must be treated with cold water first (hot water coagulates proteins and sets stain).
25
An isolation technique where a patient suspected of a contagious disease is screened under heavy physical infection prevention measures is called ..........................................
Strict isolation
we have types, please read more about barrier, respiratory, enteric, etc
we have types, please read more about barrier, respiratory, enteric, etc
Strict isolation this is designed to prevent transmission of highly contagious or virulentinfections that may be spread by air or contact. This is recommended for chickenpox aswell as for viral hemorrhagic fevers. A private room is required and gowns, masks, andgloves must be worn before entry. Hands must be washed after leaving the room andcontaminated articles should be discarded or bagged and labeled before being sent for decontamination and reprocessing
26
After feeding, nurses turn the head of an unconscious patient to the side to prevent ..........................................
Aspiration (or airway obstruction)
Unconscious patients lose protective airway reflexes (gag, cough, swallow). Turning head to side (lateral position) uses gravity to drain oral secretions and prevents aspiration of food/fluid into lungs. Maintains patent airway and reduces risk of aspiration pneumonia - a leading cause of death in unconscious patients.
27
The part of a stethoscope placed over the felt artery is called ..........................................
Bell (or diaphragm - depending on stethoscope type and frequency of sounds)
For blood pressure measurement, the diaphragm (flat side) is used to hear Korotkoff sounds over the brachial or radial artery. The bell (cup-shaped side) is used for low-frequency heart sounds. In clinical practice, most nurses use the diaphragm for all vital sign assessments as modern stethoscopes have tunable diaphragms.
28
The commonest site for taking pulse in adults is known as ..........................................
Radial artery (at the wrist)
The radial artery at the wrist (thumb side) is the most accessible and convenient site for routine pulse assessment in adults. It's superficial, easy to locate, and doesn't require disrobing. Other sites: carotid (emergency), brachial (children, BP), femoral (infants), popliteal, dorsalis pedis.
29
The button on the keyboard used to go to the next line is known as ..........................................
Enter key (or Return key)
The Enter key creates a line break in word processing, moves cursor to next line, and executes commands in dialog boxes. On most keyboards, it's the largest key on the right side. In spreadsheets, it moves to the next cell down.
30
The pointing arrow which is moved by the mouse on the computer screen is called ..........................................
Cursor (or pointer)
The cursor indicates the position on the screen where the next action (click, type, select) will occur. Different shapes indicate different functions: arrow (selection), I-beam (text insertion), hand (link clickable), hourglass (processing).
SECTION B: Short Essay Questions (20 marks)
31
Outline ten (10) general principles of performing all nursing procedures. (10 marks)
Universal principles ensure patient safety, quality care, and professional accountability:
1. Patient identification: Use at least two identifiers (name, DOB, hospital number) before any procedure to prevent errors and ensure right patient, right treatment.
2. Informed consent: Explain procedure to patient/family including purpose, risks, benefits, alternatives. Obtain verbal or written consent except in emergencies.
3. Hand hygiene: Perform handwashing before and after every patient contact using 7-step technique for at least 20 seconds or alcohol-based sanitizer.
4. Privacy and dignity: Provide screens, close doors, expose only necessary body parts, use appropriate draping to maintain patient dignity.
5. Aseptic technique: Use sterile gloves, sterile equipment, and maintain sterile field for invasive procedures to prevent healthcare-associated infections.
6. Documentation: Record procedure, patient response, any complications, and education provided immediately after completion.
7. Patient assessment: Assess patient's condition before, during, and after procedure including vital signs, pain level, and comfort.
8. Safety precautions: Check for allergies, verify prescriptions, use bed rails, ensure proper lighting, and have emergency equipment available.
9. Proper equipment use: Check equipment functionality before use, assemble correctly, and handle according to manufacturer instructions.
10. Evaluation and patient education: Assess procedure effectiveness, teach patient/family about self-care, observe for adverse reactions, and provide emotional support.
NURSING PRINCIPLES: "P-I-H-P-A-D-A-S-P-E" - Patient ID, Informed consent, Hand hygiene, Privacy, Asepsis, Documentation, Assessment, Safety, Proper equipment, Evaluation
32
(a) List five (5) indications of a divided bed. (5 marks)
(b) List five (5) precautions taken during hand washing. (5 marks)
(b) List five (5) precautions taken during hand washing. (5 marks)
(a) Indications of a Divided Bed:
1. Postoperative patients: Allows raising head and knees to semi-Fowler's position for comfort, breathing, and reduced wound tension without patient sliding down.
2. Cardiac/respiratory patients: Elevates head to 45-60° to improve lung expansion, reduce dyspnea, and decrease cardiac workload.
3. Patients with reflux/GI conditions: Head elevation prevents aspiration and reduces gastroesophageal reflux.
4. Patients receiving tube feeding: Maintains head of bed at 30-45° to prevent aspiration pneumonia during enteral feeding.
5. Patients with lower limb edema: Elevates legs to promote venous return and reduce swelling.
(b) Hand Washing Precautions:
1. Remove all jewelry: Rings, bracelets, and watches harbor microorganisms and prevent proper cleaning of skin surfaces.
2. Use running water: Avoid standing water which can become contaminated; ensure water flows from clean to dirty areas.
3. Wash for minimum 20 seconds: Duration is critical - must be long enough to mechanically remove and kill microbes effectively.
4. Clean under fingernails: Use nail brush or orange stick to remove dirt and microbes from nail beds where organisms concentrate.
5. Dry hands with single-use towel: Use disposable paper towels or individual cloth towels; never share towels which transmit organisms.
🦠 Hand Hygiene Saves Lives! WHO 5 Moments: Before touching patient, Before clean/aseptic procedure, After body fluid exposure risk, After touching patient, After touching patient surroundings.
SECTION C: Long Essay Questions (50 marks)
33
(a) State five (5) protective gears used in nursing and the body parts they protect. (10 marks)
(b) Describe the process of waste segregation and management in a health facility. (10 marks)
(c) State five (5) reasons why medical waste may be poorly managed. (5 marks)
(b) Describe the process of waste segregation and management in a health facility. (10 marks)
(c) State five (5) reasons why medical waste may be poorly managed. (5 marks)
(a) Protective Gears in Nursing:
1. Gloves (latex/nitrile): Protect hands from blood, body fluids, chemicals, and microorganisms. Prevent cross-contamination and reduce risk of infection transmission.
2. Face mask (surgical/N95): Protect nose and mouth from airborne droplets, splashes, and aerosols. N95 respirators filter 95% of airborne particles.
3. Goggles/face shield: Protect eyes from splashes, sprays, and droplets. Essential during procedures with risk of body fluid projection (suctioning, surgery).
4. Apron/gown: Protect skin and clothing from contamination with blood/body fluids. Impermeable gowns provide full body protection during high-risk procedures.
5. Closed shoes/boot covers: Protect feet from sharps injury, chemical spills, and heavy equipment. Steel-toed shoes protect against dropped objects.
(b) Waste Segregation and Management Process:
1. Point-of-generation segregation: Waste is sorted at the source using color-coded bins: Red for infectious waste, Yellow for sharps/pharmaceuticals, Black for general waste, Blue for glass, Brown for chemicals.
2. Containerization: Waste placed in leak-proof, puncture-resistant containers with lids. Sharps go in puncture-proof boxes. Bags should be 2/3 full maximum.
3. Labeling and identification: Containers marked with biohazard symbols, date, ward of origin, and type of waste. Enables traceability and proper handling.
4. On-site storage: Waste stored in secure, ventilated, lockable storage area away from patient care areas. Maximum storage time is 24-48 hours in warm climates.
5. Treatment and disposal: Infectious waste autoclaved or incinerated. Sharps incinerated at high temperature. General waste landfilled. Liquid waste chemically treated before sewer disposal.
6. Transportation: Waste transported in covered trolleys by trained staff wearing PPE. Separate routes prevent contamination of clean areas. Licensed contractors handle off-site disposal.
(c) Reasons for Poor Medical Waste Management:
1. Lack of knowledge and training: Staff unaware of segregation protocols, health risks, and proper disposal methods leading to indiscriminate mixing of waste.
2. Inadequate resources: Shortage of color-coded bins, puncture-proof containers, PPE, and waste collection trolleys forces staff to improvise improperly.
3. No enforcement of policies: Absence of monitoring, supervision, and disciplinary measures allows non-compliance to continue unchecked.
4. Financial constraints: Limited budget for waste management services, treatment equipment, and licensed disposal contractors leads to shortcuts and unsafe dumping.
5. Low staff-to-patient ratio: Overworked nurses prioritize direct patient care over waste segregation, especially during emergencies and high workload periods.
☠️ Infectious Waste Kills! Improper management causes hepatitis B, HIV, cholera outbreaks. Segregation at source reduces treatment costs by 70%!
34
(a) List five (5) input devices of computers. (5 marks)
(b) Explain five (5) characteristics of computers. (10 marks)
(c) Describe five (5) measures taken to protect computers against viruses. (10 marks)
(b) Explain five (5) characteristics of computers. (10 marks)
(c) Describe five (5) measures taken to protect computers against viruses. (10 marks)
(a) Input Devices:
1. Keyboard: Primary input device for entering text, numbers, and commands. Contains alphanumeric keys, function keys, and special keys for navigation and shortcuts.
2. Mouse: Pointing device that controls cursor movement on screen. Enables selecting, clicking, dragging, and dropping icons and files.
3. Scanner: Converts physical documents and images into digital format for storage and editing. Used for digitizing patient records and diagnostic images.
4. Microphone: Captures audio input for voice commands, dictation, and teleconferencing. Increasingly used in healthcare for voice-to-text documentation.
5. Webcam: Captures video and still images for telemedicine, remote consultations, and video conferencing between healthcare teams.
(b) Characteristics of Computers:
1. Speed: Processes millions of instructions per second (MIPS). Performs calculations in nanoseconds, enabling rapid data processing for lab results, imaging analysis, and patient monitoring systems.
2. Accuracy: Performs calculations with 100% accuracy if programmed correctly. Eliminates human calculation errors critical in medication dosing and radiation therapy planning.
3. Storage capacity: Stores vast amounts of data in small space. Hospital information systems store millions of patient records, images, and research data for instant retrieval.
4. Versatility: Can perform multiple tasks simultaneously - word processing, database management, communication, image processing. Same computer used for patient registration, lab reports, and telemedicine.
5. Automation: Performs repetitive tasks without fatigue. Automated medication dispensers, reminder systems for appointments, and scheduled backups improve efficiency and reduce errors.
(c) Measures to Protect Against Viruses:
1. Install and update antivirus software: Reputable antivirus programs (Kaspersky, Norton) detect and remove malware. Must update virus definitions daily to recognize new threats. Schedule daily scans of entire system.
2. Use strong passwords and firewalls: Complex passwords with letters, numbers, symbols. Enable firewall to block unauthorized access. Change passwords every 3 months and never share credentials.
3. Avoid suspicious downloads and emails: Don't open attachments from unknown senders. Avoid downloading software from untrusted websites. Phishing emails are primary virus delivery method.
4. Regular system updates: Install operating system and software security patches promptly. Updates fix vulnerabilities that hackers exploit. Enable automatic updates where possible.
5. Backup important data regularly: Copy critical files to external hard drive or cloud storage. If infected, restore clean backup instead of paying ransom. Follow 3-2-1 rule: 3 copies, 2 media types, 1 offsite.
VIRUS PROTECTION: "AVAST" - Antivirus, Updates, Avoid suspicious files, Strong passwords, Training
🔒 Healthcare Data is GOLD! Ransomware attacks on hospitals can shut down entire systems. Always have offline backups of critical patient data and incident response plan!
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