Procedure station 1

Administer oxygen on Mrs Alice that presented with asthmatic attack during your shift

PROCEDURE STATION 1
TITLE: OXYGEN ADMINISTRATION CANDIDATE NO__________
S/N ACTIVITIES 0mk ¼ ½
mk mk
1 Verify written order for oxygen therapy, including methods of delivery
and flow rate ( ½ mark)
2 Place a sign in the ward saying -oxygen in-situ ,no smoking ( ½ mark)
3 Wash hands and wear gloves ( ½ mark)
4 Explain the procedure to the patient and obtain consent ( ½ mark)
5 Assess the client for obstruction of the nasal passage by observing the
breathing patterns ( ½ mark)
6 Position the patient in a semi fowler’s position ( ½ mark)
7 Adjust the flow rate to the prescribed amount ( ½ mark)
8 Gently position nasal prongs into the patients nares, with curves of prongs
pointing toward the floor of the nostrils ( ½ mark)
9 Loop the cannula tubing over the clients ear; adjust the fit of the tubing by
sliding the adjuster upward to hold the cannula in place( ½ mark)
10 Assess the clients nares, face, and ears every 4 hours for signs of skin
irritation or breakdown and document findings ( ½ mark)
11 Mention that client’s vital signs and signs of toxicity will be monitored at
interval( ½ mark)
12 At the same time, inspect the nasal prongs for the presence of nasal
secretions or crust. If needed, wipe the prongs and clean with a gauze pad
( ½ mark)
13 Wash and dry hands ( ½ mark)
14 Document the procedure accurately, completing drug record if required,
ensure effect is noted and documented accurately ( ½ mark)

Total marks obtained -7marks

Marks obtained -------------
Examiner’s signature & Date --------------------------------
Question station 1
TITLE : OXYGEN ADMINISTRATION
INSTRUCTION : read the questions carefully and circle the correct option with a pen.
Each questions attracts ½ mark
1. The normal prescribed rate range of oxygen administration for adult and children
respectively is
(a) 2-4 litres and 1-2 litres
(b) 3-4 litres and 2-3 litres
(c) 4-6 litres and 0.5-4 litres
(d) 6-11 litres and 1-2 litres

2. Which of the following is the reason for placing a sign ”oxygen in use” is for people to
be a cautious because
(a) Oxygen is not good to be inhaled
(b) Oxygen is a noble gas
(c) Oxygen rekindle a glowing split
(d) Oxygen can lead to hyperventilation

3. The following are indication for oxygen administration except

(a) Severe anemia
(b) Hypoxia
(c) Chest injuries
(d) Erythropoiesis

4. What would the nurse monitor before applying oxygen to chronic obstructive pulmonary
disease COPD patient?
(a) Breath sound
(b) Heart rate
(c) Blood pressure
(d) Respiration rate

5. The normal arterial oxygen pressure is approximately between

(a) 40-100mmHg
(b) 50-100mmHg
(c) 60-100mmHg
(d) 70-100mmHg

6. Excessive administration of oxygen in premature babies can cause

(a) Retrolental fibroplasia
(b) Dystocia
 (c) Pneumonia
(d) Hyperplasia

7. Oxygen can be administered through the following methods except

(a) The non-rebreather mask
(b) The incubator
(c) Continuous positive airway pressure
(d) The N95 breather

8. The following are side effects of oxygen administration except

(a) Skin irritation
(b) Tiredness
(c) Headache
(d) Palor

9. The best position for patient during oxygen administration is

(a) Prone position
(b) Super position
(c) Left lateral position
(d) Semi-fowler’s position

10. Hourly checks should be made and recorded on the patient observation chart for the
following except
(a) Oxygen saturation
(b) Humidifier stings
(c) Heart rate
(d) Respiratory distress.
 PROCEDURE STATION 3
TITLE : VULVA SWABBING CANDIDATE NO

S/ Activities ¼ ½ ¾ 1 0

1 Assesses, informs & obtains consent (½)

2 Washes hands and dry and puts on face mask (1)

3 Places patient in appropriate position (supine with knees flexed and legs

abducted). (½)

4 Rolls top sheet up to the umbilicus (¼ )

5 Places bed pan appropriately underneath patient’s buttocks. (¼)

6 Washes hands surgically and put on sterile gloves (1)

7 Puts dry swab into lotion in gallipot ( ½ )

8 Picks wet swabs, one at a time with the right hand (dominant hand) and

passes it to the left (non-dominant hand). ( ½ )

9 Swabs vulva carefully using each swab in a downward direction once only

and discards in destructor bowl (Cleans around the urethral catheter if in

situ). (1)

10 Parts labias with the thumb and index finger of the left hand. ( ½ )
11 Pours a little bit of the warm lotion in the jug on the patient’s thigh before

pouring on the vulva, so as to reassure and relax patient. ( ½ )

12 Pours the measured lotion in the jug over vulva and perineum (using the

right hand). ( ½ )

13 Takes dry swabs, one at a time and carefully swabs the vulva dry still in

downward direction (Applies perineal pad half way if necessary). (1)

14 Turns patient on left side and removes bed pan. Swabs buttocks in between

dry. (Applies pad completely). (1)

15 Removes gloves and discard. Tidies bed linen and leaves patient

comfortable. Washes hands and dry, document. (1)

Total mark obtainable 10marks

Total obtained ______________
QUESTION STATION 4
TITLE: VULVA SWABBING CANDIDATE NO ____________
INSTRUCTION : read the questions carefully and circle the correct option with a pen.
Each questions attracts ½ mark

1. Vulva swabbing is a __________ procedure ( 1mark )

2. In vulva swabbing, the parts of the female genitalia to be swabbed are basically
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________ (½ mark each = 2½
marks)

3. List any two indications for vulva swabbing ( 1mark )

_____________________________________________________

_____________________________________________________

4. Organs that makes up the external female genitalia are:

_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________ (½ mark each = 3
marks)
5. Movement of swabbing must be in which direction?
a. Downward, upward
b. Upward downwards
c. Sideways
d. Cris-cross (½ mark)
6. How often should vulva swabbing be for patient with purulent vaginal discharge on the
ward?
a. Daily
b. Twice daily
c. 4 hourly
d. Nocte (1mark)
7. Common complications that may arise from an improperly done vulva swabbing are;
a. Ascending infection / burns
b. Tear / bruises
c. Malformation / infection
d. Keloids formation / laceration (1mark)

Total mark obtainable 8marks

Mark obtained _____________
 PROCEDURE STATION 5

TITLE : CARE OF TRACHEOSTOMY CANDIDATE NO_____________

ACTIVITIES 0mk ¼ mk ½ mk
S/N
PREPARATION
1 Introduce self and verify clients identity ( ¼ mark)
2 Explain to the client everything that you need to do, why it is necessary ,
and how he can cooperate ( ¼ mark)
3 Observe appropriate infection control procedures such as hand hygiene (
¼ mark
4 Provide for clients privacy ( ¼ mark
Prepare the client and equipment
5 Assist the client to semi –fowler’s position so as to promote lung
expansion ( ½ mark)
6 Open the tracheotomy kit or sterile basins. Pour the soaking solution and
sterile normal saline into separate containers ( ¼ mark)
7 Establish the sterile field. Open other sterile supplies as needed
including sterile applicators, suction kits and tracheotomy dressing ( ½
mark)
Suction the tracheotomy tube
8 Put a clean glove on the non-dominant hand and a sterile glove on the
dominant hand (or put on a pair of sterile gloves ) ( ¼ mark)
9 Suction the full length of the tracheotomy tube to remove secretions and
ensure a patent airway ( ½ mark)
10 Rinse the suction catheter and wrap the catheter around the hand, and
peel the gloves off so that it turns inside out over the catheter ( ¼ mark)
11 Unlock the inner cannula with the gloved hand( ¼ mark)
12 Remove the inner cannula by gently pulling it out toward you in line
with its curvature. Place it in the soaking solution ( ½ mark )
13 Remove the soiled tracheotomy dressing .discard the glove and the
dressing materials ( ¼ mark )
14 Put on sterile gloves. Keep the dominant hand sterile during the
procedure ( ¼ mark)
Clean the inner cannula
15 Remove the inner cannula from the soaking solution ( ¼ mark)
16 Clean the lumen and entire cannula thoroughly using the brush or pipe
cleaner moistened with sterile normal saline ( ½ mark)
17 Inspect the cannula for cleanliness by holding it at eye level and looking
through it into the light ( ½ mark )
18 Rinse the inner cannula thoroughly in the sterile normal saline ( ½ mk)
19 Replace the inner cannula , securing it in place ( ¼ mark)
20 Insert the inner cannula by grasping the outer flange and inserting the
cannula in the direction of its curvature ( ½ mark)
21 Using sterile applicator or gauze dressings moistened with normal
saline, clean the incision site ( ¼ mark)
22 Handle the sterile supplies with the dorminant hand. Use each applicator
or gauze dressing only once and then discard( ½ mark)
23 Hydrogen peroxide many be used ( usually in a half strength solution
mixed with sterile normal saline; use a separate sterile container if this is
necessary ) to remove crusty secretions ( ¼ mark)
24 Thoroughly rinse the cleaned area using gauze square moistened with
sterile normal saline ( ¼ mark )
25 Clean the flange of the tube using gauze square moistened with sterile
normal saline ( ¼ mark )
26 Apply a sterile dressing. Avoid using cotton filled gauze square or
cutting the 4-in x4-in gauze ( ¼ mark)
27 Place the dressing under the flange of the tracheotomy tube ( ¼ mark)
28 Ensure that the tracheotomy tube is securely supported while applying
the dressing ( ½ mark )
29 Change the tracheotomy ties as needed to keep the skin clean and dry (
½ mark)
30 Check the tightness of the ties ( ½ mark )
31 Document all relevant information. Record suctioning, tracheostomy
care and he dressing change, noting your assessment ( ¼ mark)
32 Make patient comfortable in bed ( ¼ mark)

Total marks obtainable 11marks

Mark obtained __________________
Examiner’s signature & date : ________________
OUESTION STATION 6
CARE OF TRACHEOTOMY
Instruction: read the questions carefully and circle the correct option with a pen. Each
questions attracts ¼ mark
1. How often should tracheotomy with a silicon tube be changed?
a. Every 2 weeks
b. Every 4 weeks
c. Every 6 weeks
d. Every 8 weeks

2. The following are general indications for placement of tracheotomy except

a. Acute respiratory failure
b. Upper airway obstruction
c. Copious secretions
d. Positive mechanical ventilation

3. The following are indications for suctioning post tracheostomy except

a. Emphysema
b. Signs of respiratory distress
c. Vomiting
d. Desaturation on pulse oximetry

4. Tracheostomy is usually not considered in

a. Obstruction of the mouth or throat
b. Long term need for ventilator support
c. Chronic bronchitis
d. Airway protection from secretions

5. Immediately after a tracheostomy, the patient will communicate with significant others
by
a. Waving and sign language
b. Writing
c. Using braille
d. Touching
 6. The outer cannula of the tube inserted through the neck during tracheostomy can be
removed at the instance of
a. Health care provider
b. Patient himself
c. Patient relation
d. Chief medical director

7. The following are side effects of tracheostomy except

a. Irregular heart beat
b. Increased pain
c. Atelectasis
d. Difficulty in breathing

8. The following material are necessary for the care of the tube that was inserted during
tracheostomy except
a. Two non- sterile gloves
b. Clean gauze pads
c. Normal saline or tap water
d. Two sterile gloves

9. The following are complications of tracheotomy except

a. Pneumothorax
b. Pneumo-mediastinum
c. Subcutaneous emphysema
d. Hypostatic pneumonia

10. The following are noted of secretion during suctioning of a tracheostomy tube except
a. Amount
b. Odour
c. Colour
d. Consistency

MARKS OBTAINED 2 ½ MARKS

MARK OBTAINED _______________
 PROCEDURE STATION 7
PERFORM STEAM INHALATION ON MISS THOMPSON THAT PRESENTED WITH
CONGESTED NOSE AND IRRITATED THROAT

TITLE : STEAM INHALATION CANDIDATE N0__________________

ACTIVITIES 0mk ¼ mk ½ mk

Preparation
1 Indication for steam inhalation : headache, congested (stuffy) nose,
throat irritation, breathing problems caused by airway congestion, dry or
irritated nasal passage , cough ( ¼ mk each for any 2 = ½ mk)
2 Candidate state that it is a clean procedure ( ¼ mk)
3 Screen for privacy( ¼ mk)
4 Warm the inhaler by pouring a little hot water into the inhaler and
emptying it after one minute. This reduces loss of heat from inhaler
during procedure ( ½ mk)
5 Wrap a small towel around the inhaler and place it in the large bowl
( ¼ mk)
6 Measure the required amount of tincture of benzoic compound to use
( ½ mk)
7 Pour the required amount of benzoic compound into the inhaler and fill
to a level below the spout with boing water ( ½ mk)
8 Explain that the water should remain just below the spout. If the inhaler
is filled up to the level of spout there is possibility of drawing water into
the mouth when inhaling and can cause scald ( ½ mk)
9 Place sterile mouthpieces and close the inhaler tightly( ½ mk)
10 Ensure that the mouthpiece is in the opposite direction to the spout ( ½
mk)
11 Cover the mouth piece with a gauze piece and plug the spout with the
cotton ball( ½ mk)
12 Place a towel around the inhaler and position it in the bowl( ½ mk)
13 Take it to the patient without losing time( ½ mk)
14 Position the patient in high fowlers or sitting positin( ½ mk)
15 Place the apparatus conveniently in front of the patient on cardiac table
with spout opposite to the patient ( ½ mk)
16 Remove the cotton plug and discard it into the kidney dish ( ¼ mk)
Patient instruction
17 Instruct the patient to place lips on the mouthpiece and take deep breath.
After removing the lips from the mouthpiece, breathe out air through the
nose. directing the steam out through the nostrils relieves the congestion
of the mucous membrane of the nostrils( ½ mk)
18 Mention that the treatment/ procedures will continue for 15-20minutes as
long as patient gets the steam( ¼ mk)
19 Removes inhaler from the patient after the stated time , wife off
perspiration from the patients face( ¼ mk)
20 Give chest physiotherapy and encourage patient to bring out sputum by
coughing ( ¼ mk)
21 Instruct patient to remain in the bed for 1-2hours ( ¼ mk)
22 Give patient gauze or handkerchief to blow the nose and clean the mouth
and make the patient comfortable after procedure( ¼ mk)
23
Candidate states that he/she will document the procedure and findings (
¼ mk)

Total marks obtainable 9marks

Mark obtained __________________
Examiner’s signature & date : _________________
Question station 8
Title : Steam Inhalation Candidate no ____________
Instructions : read the questions carefully and circle the correct option with a pen. Each questions
attracts ¼ mark
1. Inhalation can be classified as
a. Direct or indirect
b. Primary or secondary
c. Dry or moist
d. Warm or cold

2. The following are purpose for steam inhalation except

a. To relieve respiratory tract congestion
b. To soften thick, tenacious mucus
c. To aid the absorption of oxygen
d. To ensure comfort to the patient

3. Which of the following is used when a high concentration of stem is required?

a. Tent
b. Kettle
c. Hot water bottle
d. Cubicle

4. Steam inhalation may be given for _________________at a time and maybe repeated
every four hours
a. 5 to 10 minutes
b. 10 to 20 minutes
c. 20 to 30 minutes
d. 30 to 60 minutes

5. The following are nurses responsibilities in the administration of steam inhalation except
a. Check the patients name and bed number
b. Check the patient’s next of kin’s name and number
c. Check the diagnosis and general condition of the patient
d. Assess the level of patients consciousness and the ability to follow instructions
 6. Patient with respiratory dysfunction are treated with ________inhalation to relieve
hypoxemia
a. Carbon monoxide
b. Hydrogen peroxide
c. Nitrogen
d. Oxygen

7. Steams adds warmth and moisture to the air to improve

a. Breathing
b. Heart beat
c. Cardiac output
d. Asthmatic

8. The use of steam to open the passages in the nose helps to relieve
a. Cardiac pressure
b. Intracranial pressure
c. Sinus pressure
d. Pulmonary pressure

9. The following are procedures for steam inhalation except

a. Heat the water to boiling point
b. Close nearby windows
c. Turn on timer
d. Carefully pour the hot water into the bowl

10. The steps of procedure for steam inhalation encompasses the following except
a. Explain the procedure
b. Invite patients relative
c. Wash hands
d. Measure the capacity of the inhaler with cold water

Mark obtainable 2 ½ marks

Marks obtained _____________
 PROCEDURE STATION 9
Admit Mr Thompson diagnosed with malaria into your ward

HOSPITAL ADMISSION CANDIDATES NO _______________

S/N ACTIVITIES 0mk ¼ ½
mk mk
Candidate explain as follows to the junior nurse
1 Greet client and introduce self or meet and receive the patient ( ¼ mk)
2 Perform hand hygiene ( ¼ mk)
3 Verify patient data by checking the record sheet , chart etc ( ½ mk)
4 Registers client in the ward admission chart( ½ mk)
5 Introduce immediate personnel( ½ mk)
6 Assist patient to the treatment area( ½ mk)
7 Give orientation to the patient and relatives about the hospital and ward (
½ mk)
8 Stress the importance of privacy( ½ mk)
Procedure
9 Help patient put on hospital gown( ¼ mk)
10 Mention that there is need to conduct comprehensive nursing assessment,
covering socio-demographic data, nursing history, history of present
illness, past medical and surgical instance , family history , diseases ,
occupational history etc( ½ mk)
11 Carry out complete physical examination, inspection, palpation,
percussion and auscultation( ½ mk)
12 Observe client vital signs and record to establish base line values( ½ mk)
13 Mention that client needs to take bath( ¼ mk)
14 Cross check admission order ( ½ mk)
14 Inform patient and relatives on treatment modalities, regimen and hospital
ward regulation( ½ mk)
15 Coordinate with the physician and carry out initial order( ½ mk)
16 Give the treatment and instructions as needed and serve prescribed
medication( ½ mk)
17 Assist client to fill admission form( ¼ mk)
Finishing
18 Mention the importance of taking care of patients valuables ( ½ mk)
19 Remove equipment and tidy the bed environment ( ¼ mk)
20 Document procedure i.e record and reports ( ½ mk)

Total marks obtainable 9marks

Mark obtained __________________
Examiner’s signature & date : _________________

QUESTION STATION 10
TITLE : HOSPITAL ADMISSION CANDIDATE NUMBER :
Instructions : Read the questions carefully and circle the correct option with a pen. Each
question attracts ¼ mark
1. The following are roles of a nurse in the admission process except
a. Meeting the immediate needs of the patient- physical and emotional
b. Thorough assessment of the patient using nursing process
c. Ensure the administration fees are paid in full
d. Ensure patient is assigned to the appropriate room

2. The following are types of discharge except

a. Transfer to other section of the hospital
b. Cured and discharged
c. Absconded
d. Death

3. The following are content of admission note except

a. Health insurance coverage
b. Chief complaint
c. History of present illness
d. Nursing evaluation

4. The following are forms of hospital admission except

a. Transfer in and discharge
b. Routine admission
c. Strict follow-up admission
d. Emergency admission

5. The two (2) major types of hospital admission are

a. Voluntary and urgent
b. Temporary and permanent
c. Specific and unspecific
d. Emergency
 6. During admission procedure , among the forms to be filled is a _____________ stating
who the patient wishes to make medical decision for them, if they themselves are unable
to do so
a. Durable power of attorney form
b. Living will form
c. Consent form
d. Excuse duty form

7. The form filled during admission procedure , which states clearly specific resuscitative
efforts the person does not want to be performed on him/her
a. Consent form
b. Power of attorney form
c. Resuscitative form
d. Living will form

8. The following are categories of trans-admission precautions except

a. Feaco-oral precautions
b. Airborne precautions
c. Contact precautions
d. Droplet precautions

9. Mr Anglo, 26-year old needs nursing support and cardiac monitoring buy not intensive
care. As the clinician, where will you admit him?
a. Intensive care unit (ICU)
b. Cardiac care unit (CCU)
c. Telemetry / step down unit
d. Male medical ward

10. The type of admission appropriate for a client with a known chronic condition that
requires further treatment is
a. Planned admission
b. Emergency admission
c. Elective admission
d. Observation admission

Mark obtainable 2 ½ marks

Marks obtained _____________
 Perform enema on Mrs Martins with constipation of 1 week duration
Procedure station 11
TITLE :ENEMA ADMINSTRATION
ACTIVITIES 0mk ¼ ½
mk mk
1 Obtain inform consent, identifying allergies and any contraindications
( ½ mk)
2 Reassure the patient( ¼ mk)
3 Assess patient privacy and dignity and take steps to maximize both
( ¼ mk)
4 Ascertain prescribe details ( ½ mk)
5 Wash hand and don plastic apron( ½ mk)
6 Check the enema for expiration and intactness. Warm the solution to
desired temperature( ½ mk)
7 Position the patient on left side , lying with the knee drawn to the
abdomen, this eases the passage and flow of fluids into the rectum, gravity
and anatomical structure of the sigmoid colon also suggest that this will
aid enema distribution and retention( ½ mk)
8 Position an incontinence sheet or mackintosh underneath the patient
( ½ mk)
9 Assess the area and perform a digital rectal examination ( ½ mk)
10 Break the enema seal( ¼ mk)
11 Lubricate the nozzle ( ½ mk)
12 Expel air from the enema tubing( ½ mk)
13 Gently separate the buttocks with the thumb and index fingers od the
dominant hand , identifying the anus ( ½ mk)
14 Insert the lubricated nozzle into the rectum slowly to a depth of
approximately 10cm (in adult) ( ½ mk)
15 Gently expel the content into the rectum,rolloing the container from the
bottom up to reduce backflow ( ½ mk)
16 Keeping the container rolled/compressed withdraw the container ( ½ mk)
17 Attend to peri-anal hygiene( ½ mk)
18 Ask the patient to retain the enema for as long as required
or press the patient buttocks together for 2-3 minutes to prevent evacuation
of the solution( ½ mk)
19 Offer the bed pan or assist the patient to the bedside commode or the
bathroom. ( ½ mk)
20 Dispose of any waste, remove apron, wash hands lean and replace the
equipment ( ¼ mk)
21 Instruct patient in diet , fibre, fluids and activity. Educate patient to avoid
excessive laxative use ( ½ mk)
22 Document procedure ,solution, amount, patients tolerance, result of enema
and patient instructions on patient visit report ( ½ mk)

Total amrk obtained 10marks

Mark obtained ____________
QUESTION STATION 12
Title : ENEMA ADMINISTRATION
INSTRUCTION : read the questions carefully and circle the correct option with a pen.
Each question attract ¼ mark
1. The best position for administration of an enema is
a. Supine
b. Prone
c. Left lateral
d. Right lateral

2. The length of the enema tube that can be inserted into the anus of an adult is
a. 7cm
b. 8cm
c. 9cm
d. 10cm

3. The following are the common cleansing enemas except

a. Glucose water
b. Water
c. Saline
d. Epsom salt

4. The administration of enemas is contraindicated in patients who have undergone the

following surgery except
a. Colonic surgery
b. Butt enlargement
c. Gynecological surgery
d. Radiotherapy

5. Patients are advised to eat post enema administration

a. Immediately
b. After 15 minutes
c. After 30 minutes
d. After 6hours

6. Before enema administration the patient is asked to observe nil per oral for
 a. 20 minutes
b. 30 minutes
c. 60 minutes
d. 90 minutes

7. Retention enemas are designed to be held in the bowel for a minimum of

a. 5 minutes
b. 7 minutes
c. 10 minutes
d. 15 minutes

8. As an enema for constipation , the recommended adult dose is

a. 120ml of 25-30% solution administered twice
b. 120ml of 50% solution administered once
c. 150 ml of 25-30% solution administered once
d. 120 ml of 25-30% solution administered once

9. The following are indications for enema administration except

a. Stimulation of stool evacuation
b. Relieve severe constipation
c. Used as a laxative
d. To force waste out of the rectum

10. The equipment required to perform an enema is as follows except

a. Wall thermometer
b. Incontinence pads
c. Lubricating solution
d. Jug with water, warmed to the desired temperature

Marks obtainable – 2 ½ marks

Marks obtained _____________