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Opinion

30 Nursing Final Examination Questions from the 1960's

Published on

by Sarah J.
30 Nursing Final Examination Questions from the 1960's
Image: Nottingham Hospitals History.

The General Nursing Council for England and Wales required all nurses to complete the final state examination prior to completion of their training.

Below are 30 questions which have been taken from real final state examination papers from between 1960 and 1970.

They highlight the depth and variety knowledge that was required to become a registered nurse and why it was such an admired profession.

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How many of these can you answer?

The exam questions...

1) Describe how the structure of blood vessels is related to their function.

2) List the conditions of blood vessels which had lead to their impaired function.

3) What methods may be used to treat varicose veins of the leg?

4) A middle-aged man is in the hospital for investigation and treatment of hypertension.

  • What might have led him to seek medical advice?
  • Why may his wife be fearful about his condition?
  • Describe the nursing care and management of this patient.

5) Following a head injury, a man is admitted unconscious to a surgical ward. Indicate;

  • The observations the nurse should make and report in the first 24 hours.
  • How respiratory infection could be avoided.
  • How nutrition may be maintained.
  • How restlessness could be treated.
  • How bedsores may be prevented.

6) What common accidents occur in the home and how could they be prevented?

7) Laparotomy on a man of 50 has revealed an inoperable carcinoma of the stomach. How can the ward team help in regards to;

  • The patient in regards to anorexia, vomiting, pain and anxiety.
  • The Relatives.

8) An obese middle-aged woman is admitted for the repair of a large umbilical hernia.

  • What particular pre-operative preparation could they be given?
  • What chest and wound complications may occur?
  • How may they be prevented?

9) A man has been admitted to hospital with a severely septic hand and inflamed axillary gland.

  • What are the principles underlying the treatment of acute inflammation?
  • Describe how these principles can be applied in this care?

10) What investigations and nursing treatment may be carried out when preparing a patient for one of the following operations;

  • Hysterectomy for carcinoma of the cervix.
  • Nephrectomy for carcinoma of the kidney.

11) Give a detailed description of the pre-operate preparation and post-operative care required for. Making special reference to diet and feeding methods. 

  • A one-year-old child with a cleft palate.
  • A man of 70 with a cataract.

12) Attempted suicide is not uncommon. What mental illnesses may give rise to this?

13) Scurvy is a deficiency disease. Explain what this means. Describe briefly a typical case of scurvy.

14) What do you understand by the term anxiety neurosis? Discuss the management and treatment of such a case.

15) Give an account of congestive heart failure, paying attention to the signs of symptoms. How can a nurse assist patients suffering from this condition?

16) Describe paranoid schizophrenia. What role can a nurse plan in rehabilitating such a patient?

17) What are the causes of a common headache? What investigations do you think should be made to assist in establishing a diagnosis in a patient complaining of a constant severe headache?

18) Write notes on the following;

  • Mannerisms.
  • Echolalia.
  • Neologisms.
  • Delusions.
  • Illusions.

19) Describe the nursing care of a patient who is suffering from pre-senile dementia.

20) People often ask nurses for advice about the treatment for mental illness. What provisions for care and treatment can you explain to them?

21) What records are usually kept in a ward? How does record keeping help in the care of the patients and in the administration of the ward?

22) What factors should be considered when arranging a programme of occupational and recreational therapy for a patient whose illness is for a short duration?

23) While helping in the kitchen a patients clothing catches fire. What first aid should be given? Outline the subsequent nursing care for this patient.

24) Explaining to a junior nurse why, in hospital, the following procedure are sometimes necessary;

  • Weighing patients.
  • Taking the patients' blood pressure.
  • Testing urine.

25) How would you ensure that the meals for patients in a ward are adequate and enjoyable?

26) What are the advantages and disadvantages of breastfeeding?

27) A nine-year-old boy in your ward, on traction for a fractured femur, develops measles.

  • Describe the general management of his care whilst he is infectious.
  • Explain why some children in the ward will develop measles and not others.

28) A married woman aged 45 years is admitted to hospital with a severe uterine prolapse.

  • With reference to the structures involved, what difficulties may arise from this condition?
  • Give an account of pre and post-operative care this patient may receive.

29) A man aged 65 years is admitted to hospital with an enlarged prostate gland.

  • With reference to the structures involved, what difficulties may arise from this condition?
  • Give an account of pre and post-operative care this patient may receive.

30) Describe the observations which should be made on a primigravida aged 35 years during the three stages of labour.

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Opinion

How to prepare for your university nursing interview

Most of all, be confident, be passionate, be yourself and smile.

Published on

by Matt Bodell.
How to prepare for your university nursing interview

The majority of undergraduate nursing programmes will require you to undergo an interview prior to receiving an unconditional offer.

This pre-admission nursing interview might seem like a thoroughly nerve-wracking experience, but with the adequate preparation, it will enable you to shine.

Here we talk through how you can prepare on the days leading up to your interview, what you can expect on the day and during your interview and what to do afterward.

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The days leading up to the interview.

The days leading up to your interview can be just as important as the day itself. Preparation is key.

  • Understand why you want to be a nurse - nursing is a career, it will take handwork and dedication. But, why is this the career for you? What makes you want to do this over anything else?
  • Understand the roles and responsibilities of a nurse  - many students apply and attend their interview without really understanding the role of a nurse. Ideally, arrange to work with a nurse but you could also use the NHS jobs website to look at job descriptions.
  • Plan your journey  -  try a 'dry-run' if your journey is likely to be complex.
  • Read the pre-interview information pack  - if the university has supplied an information pack it will contain important information. Read it carefully.
  • Consider an open day - if you have your heart set on a certain institution ensure you attend an open day.
  • Research the NMC Code - the NMC Code presents the standards that nurses must uphold, both personally and professionally, in order to be registered to practise in the UK. You don't need to learn it word-for-word but you should understand the principles.
  • Know the 'hot topics' - these change on a yearly basis, be aware of concepts such as the 6C's, sepsis six or antimicrobial resistance.

Good websites to browse prior to your interview are the Nursing and Midwifery Council, Royal College of Nursing, NursingNotes and the Nursing Times.

On the day of the interview.

Don't let your nerves get the better of you.

  • Eat breakfast  - you are going to need the energy.
  • Be on time - know the time and location of your interview.
  • Being all the documentation that is requested - the university may ask for proof of ID, grades and a portfolio of work.
  • Dress appropriately - dress smarty, shower, shave. This interview could change the direction of your life.
  • Know your application  - you may be asked questions on the content of your application.

Today marks the start of your career as a Nurse.

Group interviews.

During group interviews, interviewers are looking specifically at how you interact within the group, how easily you build relationships and how well make your point while simultaneously listening to, and considering, the points of others.

The group interview will usually consist of a handful of applicants completing tasks or discussing questions.

  • Talk but not too much.
  • Listen to what everybody is saying.
  • Work as a team. 
  • Be confident and be yourself.

To do well in the group interview phase you need to ensure you listen and consider the opinions of others and voice your views in a constructive manner - try to be factual and concise when answering any questions.

There will always be a natural leader in the group, if this is you, lead the group but don't control it.

One on one interviews.

This is your chance to shine - you will have one on one time with the interview panel and can really sell yourself as a potential nurse. The interview panel will vary depending on your chosen institution but they are usually made up of university lecturers, clinicians, and potentially existing students.

  • Show you understand the role of a nurse - Ask yourself, do you know the roles and responsibilities of a nurse?
  • Sell yourself -  emphasise the qualities you have that would make you a good nurse; good communication skills, good interpersonal skills, ambition, drive, empathy etc.
  • Show emotion - show the interviewer how passionate you are about becoming a nurse.
  • Tell them how you have prepared for today  - did you attend an open day? Spend time with a nurse? Complete an access to nursing course? The universities are always looking for students who go just that little further.
  • Ask questions  - have a few questions prepared for the end of the interview and if you don't understand something during the interview ask the interviewer to clarify.
  • Talk, smile and make eye-contact  - it can be hard when you are nervous but showing you can develop a relationship quickly is one of the key skills of a nurse.

Ultimately, universities are looking for the next generation of nurses. You need to sell yourself and explain why you would make an amazing nurse.

After the interview.

Now you can breathe and head out for a celebratory lunch.

You may be forced to wait, anything from several days to several months, to find out the results of your interview. Stay optimistic but keep your options open.

If you are interviewing for more than one university, learn from each interview and if you are unsuccessful, don't be disheartened and ask for feedback from the panel.

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Opinion

Nurses don’t need bursaries – here are four reasons why

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by Roger Watson - Professor of Nursing, University of Hull.
Nurses don’t need bursaries – here are four reasons why

Until 2017, students studying nursing in England received a bursary and paid no fees. The bursary was paid by the NHS and was a remnant of the days when nursing students were employed by the hospitals where they trained. By the end of the 1990s, all nursing education moved to universities, but the bursaries remained.

The UK government’s decision to stop bursaries in England was met with protests, especially by the Royal College of Nursing. Proponents of the bursaries argued that it would exacerbate current nursing shortages. We need to attract more candidates, not drive them away, they argued, especially older women from lower socio-economic groups.

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Only the bursary system did not solve nursing shortages and it was not flexible enough to respond to changing demands. When we needed more nursing students, the NHS did not necessarily have the funding to provide bursaries. Contracts between universities and the NHS had a cap on the numbers of nursing students funded.

I propose four reasons why bursaries for nursing students aren’t needed.

1. We can’t afford it and they don’t need them

The NHS can no longer afford the scheme, especially with the proposed expansions in the numbers of nursing students. Nursing students, along with other university students, have access to student loans that cover their tuition fees and provide them with a living allowance.

Nurses, almost uniquely, are virtually guaranteed a job on graduation and if they earn £24,000 annually – the middle of the lowest pay band for a staff nurse – they only need to repay £11 a week.

2. Nursing students are not employees

It is often thought that nursing students are working as employees of the NHS while they are in hospital. They are not. They are “supernumerary”, which means they are not included in the workforce. This recognises that they are students and that they are there to learn. They may have less opportunity than other students to work and earn money to support themselves, but this is surely offset by almost guaranteed employment on graduation?

3. Nursing is not a vehicle for social engineering

Some worry that older women from lower socio-economic groups, those who have had families or are seeking a late or second career, will find it hard to study nursing. But are these concerns justified? The initial introduction of student loans did not reduce the numbers of applicants from lower socio-economic groups to university. Why should it affect nursing?

We need a nursing workforce that is diverse in gender, ethnicity and age. But someone entering nursing late may only work for a short time in the NHS. This is not good value for money if that money is being spent by the NHS.

Nursing and the NHS do not exist as vehicles for social engineering where everyone who ever wanted to be a nurse can become a nurse. Both nursing and the NHS exist to provide a service: patient care.

4. We’ll get the most motivated students

While bursaries were available, both nursing students and nursing lecturers reported that some students were only studying nursing for the bursary. They had no intention of entering nursing on graduation and, in fact, many nursing students never enter nursing.

With an end to bursaries and an end to the cap on numbers, we have a much more flexible system that can respond to the need for nurses. The issue remains the availability of places for nursing students in the NHS. But universities can now negotiate with any part of the NHS they wish – not just their local hospitals – and can pay the NHS for training places. This should provide the flexibility needed and an incentive to the NHS to provide, and even compete to provide, the best training places.


This article was originally published on The Conversation. Read the original article. The Conversation

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Opinion

Are Unions still valued in the modern workplace?

What price do you put on even remaining in the country to do the job you’ve worked so hard to get?

Published on

by Simon Huxtable.
Are Unions still valued in the modern workplace?

It's fair to say trade unions are something many people know about and use, but very rarely understand.

As a young NHS worker, I vividly remember the words of considered importance my mother gave me on the first day I started work (a long, long time ago) “Join a union,” She said, “Doesn’t matter which one, they will protect you.” Essentially, this is the general expectation of what a union does - stick up for the workers during tough times - but is that a role they are fulfilling? Do the nuances of UK employment law; the difficulties of the negotiation negate they apparent lack of observable progress?

“In any industrial negotiation the work starts months, even years, before reaching the negotiating table.” Josie Irwin, Associate Director of Employment Relations at the RCN, believes a lot of the good work that happens behind the scenes goes largely unnoticed by the general public. “In 2015, we took a strategic decision to work together with all fourteen trade unions represented in the NHS to get our members out of austerity. To achieve this, trade unions employ a wide range of techniques to influence government policy, from direct lobbying to securing media coverage. But what unites all these elements is they rely on members getting involved – it is members’ voices that carry the most impact, whether meeting MPs or [being] quoted in the national media.”

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It wasn’t until the mid-1800s that trade unions had any real power.

In 1820, a sixty thousand-strong mob went on general strike for a week - later referred to as the Radical War or Scottish Insurrection. They downed tools in defiance of the high unemployment, unfair working conditions and unresponsive Government, at a time of national civil and economic unrest in the aftermath of the Napoleonic Wars.

Much of the Nineteenth Century is littered with instances of fractious industrial tensions; of trade unions becoming more organised, well funded and powerful. For men. Women, on the other hand, were largely excluded from the unions, both in membership, formation and in fact its hierarchies until late in the Twentieth century. There is evidence of challenges to the male-dominated world, largely due to the tenacity groups of reformers like the Women's Protective and Provident League (WPPL), but it wasn’t until the 1875 West Yorkshire weavers’ strike that women played a central role in unionism. Symbiotic to the development of unionism is the way in which the Labour Party and in part, Socialisms’ ontogenesis, unfolded in the UK.

Very much a grassroots party, Labour came into being through the political ambitions of trade unionists understanding their ability to affect real change came from within the walls of power. Political manoeuvring became a prominent tool of protest during the first half of the Twentieth century, with trade unions offering strong support to the war effort by cutting back on restrictive practices during the Great War, for the good of the nation. Even so, the introduction of the Munitions of War Act 1915 saw strike action and lock-outs forbidden with swift interventions to quell any trouble. In spite of this increasing Government macro management, union membership increased from 4.1 million to 8.3 million by 1920 and the TUC (Trades Union Congress) saw numbers swell with 77% associated to the Congress.

Looking back, it feels like nothing has ever really changed and if you look a little deeper, it really hasn’t.

Margaret Thatcher’s iron grip on unionism lead to mass unrest, strikes up and down the country - most famously the year-long Miners strike of 1984/5 - and mass unemployment. Thatchers’ capitalist ideology saw unions as a barrier to economic growth and so imposed laws to further restrict their powers; powers which she felt had blighted both the Wilson and Callaghan (Labour) government that had preceded her.

Are Unions still valued in the modern workplace?The Miners strike became very much a war of attrition, each side fighting for what they felt was right. For Miners’ Union leader Arthur Scargill and the miners that was financial stability - coal pit closures were rife in the 70s and 80s as the seams dried up and work was hard to come by. While the Tory-led Government wanted to bring the country out of a paralysing economic downturn.

The narrative of the unions continues to be that of protecting the proletariat from the tyranny of their capitalist overlords. A tad histrionic maybe, but when you consider the Government implemented the Trade Union Act in 2016 leading to a TUC-led investigation on it’s effects to members in terms of work/life balance, it's clear even today, that trade unions and Government are at loggerheads over pay and conditions. You only have to look at the recent junior doctors pay dispute and the response by Jeremy Hunt or even the nurses pay rise to see that the role of the unions is perilous and fraught with frustration. But due to this perceived lack of results or underachievement, is it any wonder then that the average person on the street views trade unions as somewhat feckless, lazy organisations doing only the bare minimum for its membership.

Writing in the Guardian, an anonymous trade union employee blows the whistle on the inner workings of their organisation telling a disturbing (and somewhat one-sided) story of alleged membership fee wastage, underwork - they point out the article was written at their desk  - and a lack of fresh ideas. With all the signs of an employee burnt out but reluctant to leave the obvious benefits of being paid ‘money for old rope’ their words are alarming: “When potential members ask me why they should join, I give them the usual spiel but what I’m really thinking is: “Join our rivals, they are cheaper and care more about you than we do.”” Interestingly, this was borne out in part when contacting four of the main healthcare unions for their right to reply. Only two, the RCN and Unison initially responded, asking what was needed. Only one, the RCN, managed to email a comment after a week of waiting for management sign-off.

One of the main obstacles preventing unions is the rise in individual-rights based employment law.

An article written in the Industrial Law Journal by O’Sullivan et al (2015) finds this somewhat hampers the union's ability to negotiate using tried and tested collective bargaining methods. However, they go on to highlight the unions concede that the new laws can be used positively to support and protect vulnerable groups of workers. Added to this, at some point down the years, unionism became a commodity. On forums all over the internet, union members discuss the value of their membership in terms of money - A is cheaper than B and you get XYZ as well - but does that miss the point of having representation? Many articles exist for student nurses and qualified staff alike comparing the value of each union against each other: Unionism boiled down to determine its price per pound of flesh - fairly ironic.

What price do you put on even remaining in the country to do the job you’ve worked so hard to get?

Are Unions still valued in the modern workplace?
Unions appear, by and large, to be the only ones doing more than voicing concern for the ever-dwindling NHS workforce. RCN general secretary, Janet Davies is quoted as saying European expat staff play an integral part in the skill mix of hospital wards all over the UK. “With 40,000 nursing vacancies in England alone after years of poor workforce planning,” She said, “We cannot afford to lose EU nurses too.” Over a fifth of EU nationals have left the country as a direct result of Brexit and the uncertainty they face over the longevity of their stay in the UK. Equally, as more and more young workers bounce between a cafe job here and a zero hour contract there, never has there been a time for trade unions to have the powers to level the playing field.

And yet they are continually viewed in a negative light, the victims of a well-orchestrated narrative. Or are they?

There is always more they could do to improve their standing. Millennials, for all their perceived faults, are in fact a different breed to the hairy-armed activists we remember from university, full of bluster about saving the planet, tofu and recycling. The kids of today can see the troubles ahead of them but rather than band together like the old days and ‘march in solidarity’ which they see just doesn’t work anymore, they instead choose different careers, travel more and look to overcome their issues in spite of authority. Trade unions need to be smart, rebrand their messages and allow new members to consider the benefits of working with a union behind them, supporting their ambition and providing opportunities for betterment.

So, do unions have a place in today’s workforce?

Absolutely, but with that comes new challenges which require new thinking and new energy. This new generation is at peace with the real world application of robots taking their jobs. They are already fostering new avenues of wealth creation and more cohesively working towards a better future. Two-way communication is key to unions surviving this latest workforce re-enablement, but if current experience serves as their narrative, unions will make themselves extinct long before Government legislate them out of existence.

A union is only as powerful as its members.

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