Exam Paper 1 Review (Pages 1-5)

Nurses Revision Uganda

https://www.nursesrevisionuganda.com

SECTION A: Objective Questions (20 marks)

1. Which of the following sectors provides most of the health care services in
Uganda?

(a) Ugandan Government.

(b) Private providers.

(c) Traditional healers.

(d) Complementary practitioners.

Answer: (b) Private providers.

Explanation:

(b) Private providers: This is generally considered correct. In Uganda, like

many developing countries, the private sector (including private-not-for-profit
(PNFP) organizations like faith-based hospitals, and private-for-profit (PFP)
clinics and hospitals) plays a very significant role in health service delivery, often
complementing public services and sometimes being more accessible or
perceived as higher quality in certain areas. They fill gaps where public services
may be overstretched or unavailable.

(a) Ugandan Government: While the Ugandan Government is a major provider

of health services through its network of public hospitals and health centers, and
 aims for universal access, the private sector collectively often serves a larger
proportion of the population, especially when considering initial consultations
and outpatient services.

(c) Traditional healers: Traditional healers are widely used in Uganda and play
a significant role in the healthcare-seeking behavior of many, but they are
typically not categorized as providing the "most" formal healthcare services in
the context of structured health systems and national health statistics that
usually focus on biomedical care.

(d) Complementary practitioners: Complementary practitioners (e.g.,

acupuncturists, homeopaths if distinct from traditional healers) generally form a
smaller segment of the overall healthcare provision landscape compared to
government and private biomedical providers.

2. Which of the following people do NOT belong to the traditional providers

of health care in Uganda?

(a) Herbalists.

(b) Spiritual healer.

(c) Traditional birth attendant.

(d) Village health teams.

Answer: (d) Village health teams.

Explanation:

(d) Village Health Teams (VHTs): VHTs are part of Uganda's formal primary
healthcare strategy. They are community volunteers trained by the Ministry of
Health to provide basic health information, mobilize communities for health
interventions (like immunization), and link communities with formal health
 facilities. They operate within the modern healthcare system, not as traditional
providers.

(a) Herbalists: Herbalists are a core component of traditional medicine, using

plants and herbs for healing. They are traditional providers.

(b) Spiritual healer: Spiritual healers, who address illnesses believed to have
spiritual causes, are also considered traditional providers in many African
contexts, including Uganda.

(c) Traditional birth attendant (TBA): TBAs have historically provided maternal
and newborn care within communities based on traditional knowledge and
practices. While efforts are made to integrate or train them, their roots are in
traditional healthcare provision.

3. The main duty of the district health officer is

(a) supervision of local level facilities.

(b) provision of funds to health facilities.

(c) disciplining health workers in wrong.

(d) carrying out immunisation outreaches.

Answer: (a) supervision of local level facilities.

Explanation:

(a) supervision of local level facilities: This is a primary role. The District
Health Officer (DHO) is responsible for overseeing the planning, management,
and coordination of all health services within the district, which includes
supervising public and often private health facilities to ensure quality and
adherence to standards.
 (b) provision of funds to health facilities: While the DHO's office manages the
district health budget and facilitates fund flow, the "provision of funds" itself is
more a function of the central ministry or district financial systems. The DHO's
role is more in planning, allocation, and accountability for these funds.

(c) disciplining health workers in wrong: The DHO plays a role in human
resource management, which can include disciplinary processes, but it's not
their *main* duty. Disciplinary actions are typically handled through established
HR procedures, potentially involving health service commissions or professional
councils.

(d) carrying out immunisation outreaches: The DHO's office coordinates and
supports immunization outreaches, but the DHO themself wouldn't typically be
"carrying out" the outreach directly as a main duty. This task would be delegated
to specific teams and health workers under their supervision.

4. Which of following strategies has the government implemented to ensure

equal distribution of health services in the country?

(a) Abolishing user fees.

(b) Constructing a health centre at parish level.

(c) Providing adequate number of health workers.

(d) Increasing the money given to the health sector.

Answer: (b) Constructing a health centre at parish level.

Explanation:

(b) Constructing a health centre at parish level: This strategy directly

addresses geographical equity by aiming to bring health services closer to
communities, particularly in rural and underserved areas. Establishing lower-
 level facilities like Health Centre IIs at parish level is a key part of Uganda's
decentralization and primary healthcare strategy to improve access.

(a) Abolishing user fees: Uganda did abolish user fees in public facilities in
2001 to improve access, especially for the poor. While this is a very important
strategy for equity, option (b) focuses more on the *distribution* of service points.
Both are crucial, but construction of facilities directly addresses physical
availability across regions.

(c) Providing adequate number of health workers: This is essential for

service delivery but is a means to an end rather than a direct strategy for
*distribution* of service points. Ensuring health workers are equitably distributed
to these facilities is a related but separate challenge.

(d) Increasing the money given to the health sector: While increased funding
is crucial for improving health services overall, it doesn't, by itself, ensure equal
distribution. How those funds are allocated and utilized for infrastructure, HR,
and supplies determines the impact on equity.

5. Sustainable development goals were developed at the

(a) UN general assembly.

(b) Abuja declaration.

(c) Alma-ata conference.

(d) Berlin conference.

Answer: (a) UN general assembly.

Explanation:

(a) UN general assembly: The Sustainable Development Goals (SDGs) were

adopted by all United Nations Member States in 2015 as part of the 2030
 Agenda for Sustainable Development, which was officially adopted at a UN
Summit (a high-level plenary meeting of the General Assembly).

(b) Abuja declaration: The Abuja Declaration (2001) was a commitment by

African Union countries to allocate at least 15% of their annual budgets to
improve the health sector. It is health-specific and Africa-specific, not the origin
of the global SDGs.

(c) Alma-ata conference: The Alma-Ata Declaration (1978) was a landmark

international conference that identified primary health care as the key to attaining
the goal of "Health For All." It predates the SDGs significantly.

(d) Berlin conference: The Berlin Conference (1884-1885) was related to the
European colonization and trade in Africa (the "Scramble for Africa") and is
completely unrelated to the SDGs or modern global health/development
agendas.

6. By which day of the week should the weekly report be received at the
district health office?

(a) Monday.

(b) Tuesday.

(c) Wednesday.

(d) Thursday.

Answer: (a) Monday.

Explanation:

(a) Monday: In many health information management systems (HMIS), weekly

reports cover the preceding week (e.g., Monday to Sunday). To allow for timely
data aggregation and action at the district level, these reports are often due early
 in the following week, typically Monday. This allows district staff to review the
data and plan for the current week.

(b) Tuesday, (c) Wednesday, (d) Thursday: While submission deadlines can
vary, submitting later in the week (Tuesday, Wednesday, or Thursday) would
delay the aggregation and use of weekly data for timely decision-making and
response at the district level.

7. Timeliness of HMIS data are said to have been achieved when weekly
reports

(a) reach the district by Monday.

(b) reach the district by Friday.

(c) are fully completed.

(d) are sent by SMS system.

Answer: (a) reach the district by Monday.

Explanation:

(a) reach the district by Monday: Timeliness in HMIS refers to data being
available when it is needed for decision-making. For weekly reports, this
generally means submission early in the following week so the data is current
and actionable. Monday is a common target for this, reflecting the need for
recent data.

(b) reach the district by Friday: Submitting a weekly report by Friday of the
*following* week would mean the data is almost two weeks old by the time it's
fully processed, significantly reducing its timeliness and utility for immediate
action.
 (c) are fully completed: This refers to the *completeness* of data, which is
another crucial aspect of data quality, but it is distinct from timeliness. Data can
be complete but late, or timely but incomplete.

(d) are sent by SMS system: The method of transmission (e.g., SMS, paper,
online portal) can affect timeliness, but it is not the definition of timeliness itself.
An SMS system might facilitate timely reporting, but the report could still be sent
late via SMS.

8. Which of the following HMIS tools is used at the outpatient clinic?

(a) Operating theatre register.

(b) Inpatient register.

(c) Laboratory forms.

(d) Inpatient discharge form.

Answer: (c) Laboratory forms.

Explanation:

(c) Laboratory forms: Outpatient clinics frequently require laboratory

investigations for diagnosis and management. Laboratory request and result
forms are standard HMIS tools used to document these tests for outpatients as
well as inpatients.

(a) Operating theatre register: This is used to record details of surgical

procedures performed, which are typically for inpatients or specialized day-
surgery units, not general outpatient clinics.

(b) Inpatient register: As the name suggests, this is used to record admissions
to the inpatient wards, not for patients seen at the outpatient clinic who are not
admitted.
 (d) Inpatient discharge form: This form is completed when an admitted patient
is discharged from the hospital. It's specific to inpatient care.

Note: While OPDs have their own registers (e.g., Outpatient Register - HMIS
Form 031 in Uganda), among the given options, laboratory forms are most
universally applicable to outpatient clinic activities involving investigations.

9. A tool that indicates all the details of a given item in a health facility is
referred to as

(a) stock card.

(b) inventory book.

(c) stock book.

(d) record book.

Answer: (a) stock card.

Explanation:

(a) stock card: A stock card (or bin card) is a detailed record kept for each
individual item in storage. It tracks the quantity received, issued, and the balance
on hand, often including details like batch number, expiry date, supplier, etc. This
provides all the details for a *specific given item*.

(b) inventory book: An inventory book or register lists all items held in
inventory, often with their quantities and values, but it's a summary list rather
than a detailed transaction record for *each* item like a stock card. It's used for
overall inventory control and valuation.

(c) stock book: This term can be used synonymously with an inventory ledger
or a summary of stock movements, but "stock card" is more specific for the per-
item detailed record.
 (d) record book: This is a very general term and could refer to any book used
for keeping records, not specifically for inventory details.

10. Managers who use organizational funds for personal purposes are
practicing

(a) bribery.

(b) corruption.

(c) fraud.

(d) theft.

Answer: (b) corruption.

Explanation:

This question is tricky as multiple options can seem correct. The best fit depends
on the nuance. Misuse of organizational funds for personal purposes is a form of
corruption. It can also be classified as fraud or theft (embezzlement).

(b) Corruption: This is a broad term defined as the abuse of entrusted power for
private gain. Using organizational funds for personal benefit fits this definition
well, as it's an abuse of the manager's position and trust.

(c) Fraud: Fraud involves intentional deception to secure unfair or unlawful gain.
If the manager falsifies records to cover up the personal use of funds, it's clearly
fraud. The act of using the funds itself might be considered fraudulent if it
involves misrepresentation.

(d) Theft: Theft is the unlawful taking of another person's property with the
intention to permanently deprive the owner of it. Misappropriating organizational
funds (embezzlement) is a form of theft.
 (a) Bribery: Bribery involves offering, giving, receiving, or soliciting something of
value to influence the actions of an official or other person in charge of a public
or legal duty. This is different from directly misusing funds for personal use,
though they are both forms of corruption.

Considering the options, "corruption" is a good encompassing term. If forced to

choose the most specific legalistic term for the act of taking the money, "theft"
(specifically embezzlement) or "fraud" (if deception is involved in the process)
would be strong contenders. In a general management context, it's widely seen
as corrupt behavior.

11. At which stage of team development do members trust each other?

(a) Forming.

(b) Norming.

(c) Performing.

(d) Storming.

Answer: (b) Norming.

Explanation:

Based on Tuckman's stages of group development:

(b) Norming: In the Norming stage, conflicts are resolved, and team members
begin to understand each other's strengths and weaknesses. Cohesion, mutual
support, and trust develop as rules and norms are established, and members
feel more comfortable expressing their opinions and ideas.

(a) Forming: In the Forming stage, team members are usually polite and
tentative as they get to know each other. Trust is not yet established; individuals
are more focused on understanding the team's purpose and their own roles.
 (c) Performing: In the Performing stage, the team is fully functional, and
members are highly interdependent. Trust is very high, and the team works
effectively towards achieving its goals. While trust is highest here, it significantly
begins to establish and solidify in the Norming stage.

(d) Storming: The Storming stage is characterized by conflict and competition

as personalities clash and disagreements arise over roles, responsibilities, and
procedures. Trust is often low during this stage.

Trust starts developing in Norming and is well-established by Performing.

"Norming" is when it becomes a characteristic feature.

12. Which of the following strategies ably solves the problem of lack of space
in the hospital?

(a) Constructing more buildings.

(b) Integrating health services.

(c) Renting from the neighbourhood.

(d) Providing only preventive services.

Answer: (a) Constructing more buildings.

Explanation:

(a) Constructing more buildings: This directly addresses the physical lack of
space by creating additional infrastructure. It is the most direct and long-term
solution if the problem is genuinely insufficient physical space for existing or
planned services.

(b) Integrating health services: Integrating services might improve efficiency

and patient flow, potentially optimizing the use of existing space, but it doesn't
 inherently create more space. It could even exacerbate space issues if more
services are brought into a confined area without reorganization.

(c) Renting from the neighbourhood: This can be a temporary solution to

alleviate space constraints, but it may not be sustainable, cost-effective in the
long run, or ideal for clinical services due to regulatory and logistical issues. It
doesn't "solve" the problem in a permanent way for the hospital itself.

(d) Providing only preventive services: This would drastically change the
nature of a hospital and is not a solution to lack of space for existing hospital
functions. While preventive services are crucial, hospitals are generally expected
to provide curative and rehabilitative services which require space.

13. Which of the following leadership styles ensures that rules and
regulations are strictly followed?

(a) Laissez-faire.

(b) Democratic.

(c) Autocratic.

(d) Charismatic.

Answer: (c) Autocratic.

Explanation:

(c) Autocratic: Autocratic leaders make decisions unilaterally and expect strict
obedience to rules and procedures. This style often emphasizes control and
adherence to directives, thus ensuring rules and regulations are followed closely.
(A bureaucratic leadership style, not listed, is also very focused on rules and
regulations).
 (a) Laissez-faire: This is a hands-off leadership style where leaders delegate
most authority to team members and provide little direction. It is least likely to
ensure strict adherence to rules, as oversight is minimal.

(b) Democratic: Democratic leaders involve team members in decision-making

and encourage participation. While rules are important, the emphasis is more on
collaboration and consensus than strict, unquestioning adherence enforced from
the top down.

(d) Charismatic: Charismatic leaders inspire and motivate followers through

their personality and vision. While they can enforce rules, their primary
mechanism of influence is inspiration, not necessarily strict adherence to
regulations as a defining feature of the style.

14. Which of the following actions taken during a drug stock out shows that
the nurse manager is a good decision maker?

(a) Talking to the clients.

(b) Reporting to the district.

(c) Borrowing from other departments.

(d) Asking clients to buy from clinics.

Answer: (c) Borrowing from other departments..

Explanation:

A good decision-maker in a drug stock-out situation would take immediate steps

to mitigate patient harm and also address the systemic issue. The options
provided are limited.

(c) Borrowing from other departments: If feasible and permissible within the
facility (e.g., from a ward with a surplus to one with a deficit of a common drug,
 or from a central store if the issue is at unit level), this is a quick, internal solution
to ensure immediate patient needs are met. This shows resourcefulness and a
focus on patient care continuity.

(a) Talking to the clients: Informing clients about the stock-out is important for
transparency and managing expectations, but it's not a solution to the stock-out
itself. It's part of managing the consequences.

(b) Reporting to the district: Reporting the stock-out to higher authorities (like
the District Health Office or National Medical Stores) is a critical step to address
the supply chain issue and prevent future occurrences. This is a good decision,
but option (c) addresses the immediate patient need more directly if possible.

(d) Asking clients to buy from clinics: While this may become a necessary
last resort if the drug is unavailable within the public system, it shifts the burden
to patients and indicates a failure of the supply system. A good nurse manager
would first exhaust internal options and official channels. This action alone
doesn't show good decision-making regarding the facility's responsibility.

A comprehensive approach would involve (c) or other immediate mitigation, (a)

for communication, and (b) for systemic resolution. Given the choices, (c)
represents an immediate problem-solving action to obtain the drug.

15. Which type of communication is displayed when nurses are discussing

with each other during break time?

(a) Horizontal.

(b) Vertical.

(c) Upward.

(d) Downward.
Answer: (a) Horizontal.

Explanation:

(a) Horizontal: Horizontal (or lateral) communication occurs between individuals

at the same hierarchical level within an organization. Nurses discussing matters
with fellow nurses during break time are engaging in peer-to-peer
communication, which is horizontal.

(b) Vertical: Vertical communication flows up and down the organizational

hierarchy. It includes both upward and downward communication.

(c) Upward: Upward communication flows from subordinates to superiors (e.g.,

a staff nurse reporting to a nurse manager).

(d) Downward: Downward communication flows from superiors to subordinates

(e.g., a nurse manager giving instructions to staff nurses).

16. The most effective measure of minimizing physical noise in the operating
theatre is through

(a) sound proofing.

(b) insulating walls.

(c) sealing the roofs.

(d) closing doors.

Answer: (a) sound proofing.

Explanation:

(a) sound proofing: Soundproofing involves using specific materials and

construction techniques designed to block or absorb sound, thereby reducing
 noise transmission into and out of a space. This is the most comprehensive and
effective structural measure for minimizing noise in a sensitive environment like
an operating theatre.

(b) insulating walls: Insulation (e.g., thermal insulation) can have some sound-
dampening properties, but its primary purpose is to reduce heat transfer. Proper
soundproofing materials are more effective for noise reduction.

(c) sealing the roofs: Sealing roofs is important for weatherproofing and
preventing leaks. While gaps can transmit sound, "sealing" alone isn't as
comprehensive as soundproofing for noise minimization.

(d) closing doors: Closing doors is a basic and necessary step to reduce noise
from outside the operating theatre, but it doesn't address noise generated within
or noise transmitted through walls, ceilings, and floors. Soundproofing would
make closed doors even more effective and address other transmission paths.

17. The process by which an entrepreneur develops a new idea and

transforms it into new market products is

(a) initiation.

(b) persuasion.

(c) modernisation.

(d) innovation.

Answer: (d) innovation.

Explanation:

(d) innovation: Innovation is the process of translating an idea or invention into

a good or service that creates value or for which customers will pay. It involves
 the practical implementation of new ideas to create new products, services, or
processes that are successfully introduced to the market.

(a) initiation: Initiation is the act of starting something. While developing a new
idea involves initiation, "innovation" specifically covers the transformation into a
market product.

(b) persuasion: Persuasion is the act of convincing someone to do or believe

something. It might be part of marketing the new product but isn't the process of
developing and transforming the idea itself.

(c) modernisation: Modernisation refers to updating something to make it more

current or contemporary. It might involve adopting existing innovations but isn't
the process of developing a *new* idea into a *new* market product from
scratch.

18. Provision of accommodation to nurses within the hospital complex is an

example of

(a) fringe benefits.

(b) motivation.

(c) appreciation.

(d) obligation.

Answer: (a) fringe benefits.

Explanation:

(a) fringe benefits: Fringe benefits are extra benefits supplementing an

employee's salary, such as company car, private healthcare, pension schemes,
or subsidized housing/accommodation. Hospital-provided accommodation
clearly falls into this category.
 (b) motivation: While providing accommodation can be a motivator for nurses
(enhancing job satisfaction and retention), "motivation" itself is the psychological
drive to act. The accommodation is a *type of benefit* that can contribute to
motivation.

(c) appreciation: Providing accommodation can be a sign of appreciation, but

it's a tangible benefit, not just a gesture of thanks. "Appreciation" is an
expression of gratitude.

(d) obligation: Unless specified in a contract or by law, providing

accommodation is generally not a mandatory "obligation" for the hospital, but
rather an additional benefit offered.

19. Which of the following is usually delegated?

(a) Authority.

(b) Power.

(c) Responsibility.

(d) Accountability.

Answer: (a) Authority. (and Responsibility for tasks)

Explanation:

In delegation:

(a) Authority: Authority is the right to give commands, make decisions, and take
action. When a task is delegated, the necessary authority to complete that task
is also (or should be) delegated.

(b) Power: Power is the ability to influence others. While authority is a form of
power, "power" itself is a broader concept and not typically what is formally
 "delegated" in the same way as authority for a specific task.

(c) Responsibility: Responsibility is the obligation to perform assigned tasks.

When a task is delegated, the person to whom it is delegated accepts the
responsibility for performing it. So, responsibility for the *task* is delegated.

(d) Accountability: Accountability is the answerability for the outcome of a task

or assignment. Crucially, while you can delegate authority and responsibility for a
task, the ultimate accountability often remains with the manager who delegated
the task. You can hold someone responsible for doing the task, but the manager
is accountable for ensuring it's done correctly by their team.

The question asks what is "usually delegated." Both Authority to act and
Responsibility for completing the task are delegated. However, if only one can be
chosen, Authority is essential for the delegatee to perform the task. Many
models state that authority and responsibility are delegated, while accountability
is retained. Given the options, "Authority" is a very direct answer.

20. Which of the following motivators increases the morale of a staff nurse
for a long time?

(a) Promotion.

(b) Money.

(c) Leave.

(d) Prizes.

Answer: (a) Promotion.

Explanation:

This relates to Herzberg's Two-Factor Theory, which distinguishes between

hygiene factors (which prevent dissatisfaction) and motivators (which create
 satisfaction).

(a) Promotion: Promotion typically involves increased responsibility, recognition,

achievement, and opportunity for growth. These are considered intrinsic
motivators and tend to have a longer-lasting impact on morale and job
satisfaction compared to purely extrinsic rewards.

(b) Money: Salary increases and bonuses (money) are primarily extrinsic
motivators. While important and can boost morale in the short term, their
motivational effect often diminishes over time as employees adapt to the new
level of pay (it becomes a hygiene factor).

(c) Leave: Adequate leave is important for well-being and can prevent burnout
(a hygiene factor). Extra leave might be a temporary morale booster, but it's less
likely to provide sustained long-term motivation like a promotion does.

(d) Prizes: Prizes are typically one-off extrinsic rewards. They can provide short-
term recognition and a temporary morale boost but are unlikely to lead to long-
term sustained motivation or significant morale increase in the way that career
advancement and growth opportunities do.

Fill in the blank spaces (10 marks)

21. The type of motivation aimed at internal rewards is known as ...................

Answer: Intrinsic motivation

Intrinsic motivation refers to behavior that is driven by internal rewards. In other

words, the motivation to engage in a behavior arises from within the individual
because it is naturally satisfying, enjoyable, or aligns with their values and sense
of purpose (e.g., learning a new skill for personal growth, helping patients
because it feels meaningful).
22. The term used to refer to the act of self examining good and bad
practices in a business is ...................

Answer: Audit

Several terms could fit here depending on the specific context. Self-assessment
or Self-evaluation is a broad term for systematically reviewing one's own
performance, practices, or processes. Internal audit is a more formal process of
examining and evaluating an organization's activities, including its governance,
risk management, and internal control processes. Reflective practice is
common in professions like nursing, involving critically reviewing one's actions
and experiences to improve future practice. Given "business" context, "self-
assessment" or "internal review" are good fits.

23. Voluntary termination of an employment contract between a worker and

employer is referred to as ...................

Answer: Resignation

Resignation is the formal act of an employee voluntarily leaving their job. This is
initiated by the worker, as opposed to termination initiated by the employer (like
dismissal or redundancy).

24. Any misconduct or lack of skill displayed while carrying out professional
responsibilities is referred to as ...................

Answer: Negligence

Professional misconduct is a broad term referring to behavior by a

professional that falls below the standards expected by their profession or
breaches ethical codes. Malpractice specifically refers to negligence or
incompetence on the part of a professional (like a doctor or nurse) that results in
harm to a patient. Negligence is a failure to exercise the appropriate and or
 ethical ruled care expected to be exercised amongst specified circumstances.
"Professional misconduct" is a good general term. "Malpractice" is more specific
if harm results from lack of skill.

25. Girl child education globally is advocated for in the sustainable

development goal number ...................

Answer: 4

Sustainable Development Goal 4 (SDG 4) is "Ensure inclusive and equitable

quality education and promote lifelong learning opportunities for all." This directly
includes ensuring equal access to education for girls. SDG 5, "Achieve gender
equality and empower all women and girls," also strongly supports girl child
education as a means to empowerment and equality.

26. The art of providing services in a professional manner that displays a

positive image of the organization is called ...................

Answer: Customer service/Care

Professionalism encompasses the conduct, aims, or qualities that characterize

or mark a profession or a professional person, including competence, skill,
ethics, and a positive demeanor. Customer service focuses on ensuring
customer satisfaction with a product or service, often involving professional
conduct. Public relations (PR) is about managing the spread of information
between an individual or an organization and the public to shape a positive
image. "Professionalism" is a very fitting term here.

27. A form of communication which does not involve any written document is
said to be ...................

Answer: Verbal communication

 Oral communication is the exchange of information through spoken words.
This is the most direct answer. Verbal communication technically refers to
communication using words (spoken or written), but in common parlance, it's
often used synonymously with oral communication. Non-written
communication is a broader term that would also include non-verbal cues.
Given the contrast to "written document", "oral communication" is very
appropriate.

28. A statement of goals and objectives expressed in monetary terms in a

specific period is called ...................

Answer: Budget

A budget is a financial plan that outlines an organization's expected income and

expenditure, or allocation of resources, expressed in monetary terms for a
specific future period (e.g., a year). It translates strategic goals and objectives
into quantifiable financial targets.

29. The nurse's obligation to observe privacy of another person and withhold
certain information is known as ...................

Answer: Confidentiality

Confidentiality is a fundamental ethical principle in healthcare. It refers to the

duty of healthcare providers to protect a patient's private information, shared in
trust, from unauthorized disclosure.

30. The government strategy aimed at improving men's sexual health is

called ...................

Answer: Male involvement strategy (in SRH)

 Male involvement strategy in Sexual and Reproductive Health (SRH):
Programs aimed at increasing men's participation and access to SRH services
and information."

SECTION B: Short Essay Questions (20 marks)

31. List ten (10) qualities of a good nurse leader. (10 marks)

A good nurse leader possesses a combination of personal attributes, interpersonal

skills, and professional competencies. Here are ten essential qualities:

Effective Communicator: Clearly conveys information, listens actively to team

members and patients, and provides constructive feedback.
Example: A nurse leader who holds regular team meetings to discuss patient
care plans and addresses staff concerns openly.

Visionary: Has a clear sense of direction for the team or unit, inspiring others to
work towards common goals that align with the organization's mission.
Example: A unit manager who introduces a new patient-centered care model
and motivates the team to adopt it.

Empathetic: Understands and shares the feelings of others (staff and patients),
fostering a supportive and compassionate environment.
Example: A nurse leader who takes time to listen to a staff member
struggling with a personal issue affecting their work and offers support.

Decisive: Able to make timely and effective decisions, especially under

pressure or in critical situations, based on sound judgment and evidence.
Example: During an emergency, a charge nurse quickly assigns roles and
resources to manage the situation effectively.

Integrity and Honesty: Acts ethically, is trustworthy, and maintains high

professional standards, serving as a role model for the team.
Example: A nurse leader who admits a mistake in scheduling and takes
responsibility to correct it transparently.
Motivational: Inspires and encourages team members to perform at their best,
recognizing their contributions and fostering a positive work attitude.
Example: A leader who publicly acknowledges a nurse's excellent patient
care, boosting team morale.

Knowledgeable and Competent: Possesses strong clinical skills and

knowledge, as well as an understanding of healthcare systems and
management principles.
Example: A nurse leader who can guide junior nurses through complex
clinical procedures or explain new treatment protocols.

Advocate: Champions the needs of patients and staff, speaking up for their
rights and ensuring they receive necessary resources and support.
Example: A nurse manager who advocates for better staffing ratios to
ensure patient safety and reduce nurse burnout.

Team Builder: Fosters collaboration, resolves conflicts constructively, and

promotes a sense of unity and shared purpose among team members.
Example: A leader who organizes team-building activities or implements
strategies to improve inter-shift communication.

Resilient and Adaptable: Able to cope with stress, setbacks, and a changing
healthcare environment, maintaining composure and guiding the team through
challenges.
Example: A nurse leader who manages staff schedules and patient care
effectively during an unexpected surge in admissions due to an outbreak.

Fair and Just: Treats all team members equitably, applies policies consistently,
and avoids favoritism.
Example: A nurse leader who uses a clear and objective process for
assigning duties or approving leave requests.

Good Problem-Solver: Can identify issues, analyze them, and develop

effective solutions in a systematic way.
Example: A unit manager who investigates recurrent medication errors and
implements a new checking system to prevent them.
32. (a) State five (5) sources of capital in a business. (5 marks)

Capital is essential for starting and growing a business. Here are five common
sources:

Personal Savings (Owner's Equity): Funds invested by the business owner(s)

from their personal financial resources.
Example: A nurse uses her personal savings accumulated over several
years to buy initial equipment for her new private clinic.

Loans from Financial Institutions: Borrowed money from banks, credit unions,
or microfinance institutions that must be repaid with interest over a specified
period.
Example: A small pharmacy owner takes a loan from a local bank to expand
her inventory and renovate the shop.

Friends and Family: Capital obtained from close relations, often with more
flexible repayment terms or as an investment in exchange for equity.
Example: A midwife starting a maternity home borrows money from her
supportive relatives to cover rent and initial operational costs.

Venture Capital or Angel Investors: Investment from firms or wealthy

individuals who provide capital to startups and small businesses with high
growth potential, usually in exchange for an ownership stake (equity).
Example: A health-tech startup developing a new medical app receives
funding from an angel investor who believes in the product's potential.

Retained Earnings (Profits): Profits generated by the business that are

reinvested back into the company for growth, expansion, or operational needs,
rather than being distributed to owners.
Example: A successful dental clinic uses its profits from the previous year to
purchase advanced dental imaging equipment.

Grants and Subsidies: Funds provided by government agencies, NGOs, or

foundations to support specific types of businesses or projects (e.g., in health,
agriculture, or technology), which often do not require repayment.
Example: A community health project run by nurses receives a grant from an
international NGO to fund its maternal health outreach programs.
 Trade Credit: An arrangement where a business can purchase goods or
services from suppliers on credit and pay for them at a later date. This is a short-
term source of financing.
Example: A pharmacy gets a 30-day credit from a drug wholesaler, allowing
them to stock medicines and pay after making some sales.

32. (b) Outline five (5) reasons why health workers need to have other income
generating activities. (5 marks)

Health workers, like any other professionals, may find it beneficial to have
additional income-generating activities (IGAs) for several reasons:

Supplementing Income: Salaries in the health sector, particularly in public

service or in certain regions, may not always be sufficient to meet all financial
needs and aspirations of health workers and their families.
Example: A nurse starts a small poultry farm on weekends to earn extra
money for her children's school fees, as her nursing salary mainly covers
basic household expenses.

Financial Security and Diversification: Relying on a single source of income

can be risky. IGAs provide a financial cushion in case of job instability, delayed
salaries, or unexpected personal financial emergencies.
Example: A lab technician invests in a small retail shop run by a family
member, providing an alternative income stream if there are issues with his
primary job.

Utilizing Skills and Hobbies: Health workers often possess diverse skills or
hobbies that can be monetized, providing personal satisfaction alongside
financial gain.
Example: A midwife with excellent baking skills starts a small cake-making
business from home during her off-duty days.

Planning for Retirement or Future Investments: Additional income can be

saved or invested for long-term goals, such as retirement, purchasing property,
or funding further education.
 Example: A doctor uses income from part-time consultancy work to build up
a retirement fund or invest in real estate.

Entrepreneurial Development and Personal Growth: Engaging in IGAs can

help health workers develop entrepreneurial skills, business acumen, and a
sense of independence, which can be valuable for personal and professional
growth.
Example: A clinical officer starts a small private clinic in the evenings,
learning about business management, customer service, and financial
planning.

Meeting High Cost of Living: In areas with a high cost of living, a single salary
may be stretched thin. IGAs can help bridge the gap and improve the overall
quality of life.
Example: A nurse living in an expensive urban area offers home-based care
services for a few hours a week to afford better housing.

Addressing Unmet Community Needs: Sometimes, an IGA started by a

health worker can also address an unmet need in the community, combining
income generation with service.
Example: A pharmacist in a rural area opens a small drug shop (if
regulations allow and it's ethically managed) to improve access to essential
medicines, while also earning extra income.

It's important for health workers to ensure that any IGAs do not conflict with their
primary professional responsibilities, ethical obligations, or employment contracts.

SECTION C: Long Essay Questions (50 marks)

33. (a) Outline five (5) factors a nurse considers before selecting the location
of his/her business. (5 marks)

Selecting the right location is crucial for the success of any business, including one
started by a nurse (e.g., a private clinic, pharmacy, or home care agency). Here are
five key factors:
Accessibility and Visibility to Target Clients: The location should be easily
reachable for the intended clients. This includes proximity to public transport,
good road access, and ample parking if applicable. Visibility means the business
can be easily seen and found.
Example: A nurse planning to open a well-woman clinic would consider a
location near a busy residential area or a shopping center frequented by
women, with clear signage.

Proximity to Target Market / Demographics: Understanding the population

characteristics (demographics) of an area is vital. The location should be where
the target clients live, work, or frequently visit. The needs of the local population
should match the services offered.
Example: A nurse specializing in geriatric care might choose a location in a
neighborhood with a high population of elderly residents or near retirement
communities.

Competition: The level and type of existing competition in the area should be
assessed. While some competition can be healthy, an oversaturated market
might make it difficult to attract clients. Conversely, an area with no similar
services might indicate an untapped market or lack of demand.
Example: Before opening a small pharmacy, a nurse would research how
many other pharmacies are in the immediate vicinity and what services they
offer.

Cost of Rent or Purchase, and Utilities: The financial implications of the

location are critical. This includes rent or purchase price of the premises, utility
costs (water, electricity), and any local taxes or rates. The cost should be
affordable and sustainable for the business.
Example: A nurse starting a new health consultancy with a limited budget
might opt for a smaller, more affordable office space initially, rather than a
prime, expensive location.

Safety and Security: The location should be safe for both clients and staff, day
and night. Factors include crime rates, lighting, and general security of the area
and the building itself.
Example: When choosing a location for a 24-hour walk-in clinic, a nurse
would prioritize an area with good street lighting and a low crime rate.
 Zoning Regulations and Licensing Requirements: The chosen location must
comply with local zoning laws (i.e., whether a business of that type is permitted
in that area) and allow for necessary licenses and permits to operate legally.
Example: A nurse must ensure that the chosen building for her clinic is
zoned for commercial or medical use and meets all Ministry of Health
licensing standards.

Availability of Infrastructure and Amenities: Reliable infrastructure like

electricity, water supply, internet connectivity, and waste disposal services are
essential for most health-related businesses.
Example: A nurse planning to open a diagnostic lab would need a location
with stable power supply or make provisions for a backup generator.

33. (b) Explain ten (10) reasons why some nurses may hesitate to start their
own businesses. (10 marks)

Despite the potential rewards, many nurses may hesitate to venture into
entrepreneurship. Here are ten common reasons:

Lack of Capital/Financial Resources: Starting a business requires significant

upfront investment for rent, equipment, supplies, licenses, and initial operating
costs. Many nurses may not have access to sufficient personal savings or find it
difficult to secure loans.
Example: A nurse dreams of opening a specialized wound care clinic but
cannot raise the 50 million shillings needed for equipment and setup.

Fear of Failure and Financial Risk: Entrepreneurship is inherently risky.

There's no guarantee of success, and the possibility of losing invested capital
and incurring debt can be a strong deterrent.
Example: A nurse is worried that if her home-based care agency doesn't
attract enough clients, she will lose all her savings.

Lack of Business Management Skills and Knowledge: Nurses are trained in

clinical care, not necessarily in business planning, marketing, financial
management, or human resources. This skills gap can feel overwhelming.
 Example: An excellent clinical nurse feels unsure about how to create a
business plan, manage accounts, or market her proposed health screening
service.

Job Security and Stable Income: Employment in a hospital or established

institution often offers a regular salary, benefits, and a sense of security, which
can be difficult to give up for the uncertainties of a new business.
Example: A senior nurse with a stable government job and pension benefits
hesitates to leave it to start a private practice, fearing income instability.

Heavy Workload and Time Commitment: Running a business, especially in

the initial stages, is extremely demanding and time-consuming, often requiring
longer hours than a regular nursing job. This can impact work-life balance.
Example: A nurse who is also a parent is concerned that starting a new clinic
will leave her with no time for her family.

Regulatory and Bureaucratic Hurdles: Navigating the complex process of

obtaining licenses, permits, and complying with various health and business
regulations can be daunting and time-consuming.
Example: A nurse gets discouraged by the numerous forms and inspections
required by the Ministry of Health and local council to register a small clinic.

Lack of Confidence or Entrepreneurial Mindset: Some nurses may doubt

their ability to succeed as entrepreneurs or may not possess the risk-taking
appetite and proactive mindset often associated with entrepreneurship.
Example: Despite having a good business idea, a nurse constantly tells
herself, "I'm just a nurse, I can't run a business."

Limited Support Systems or Mentorship: Lack of access to experienced

mentors, supportive networks, or business development services can make the
entrepreneurial journey feel isolating and more challenging.
Example: A young nurse wishes to start a health education consultancy but
doesn't know any other nurses who have done it and feels alone in her
endeavor.

Personal Responsibilities and Commitments: Family obligations, childcare,

or caring for elderly relatives can limit the time, energy, and financial resources
available to dedicate to a new business venture.
 Example: A nurse who is the primary caregiver for her elderly mother feels
she cannot take on the additional stress and demands of starting a
business.

Perceived Conflict with Professional Identity: Some nurses may feel that
engaging in business is primarily about profit-making and could conflict with their
core identity as caregivers focused on altruism and service.
Example: A nurse feels uncomfortable about charging fees for services she
believes should be accessible to all, making her hesitant about a for-profit
venture.

33. (c) Explain five (5) interventions that should be implemented to empower
nurses to start their own businesses. (10 marks)

Empowering nurses to become entrepreneurs can enhance healthcare delivery

and provide them with alternative career pathways. Here are five interventions:

Provide Business and Entrepreneurship Training: Offer specialized training

programs, workshops, or modules within nursing education and continuing
professional development that cover essential business skills like financial
management, marketing, business planning, legal aspects, and human resource
management.
Example: Nursing schools could incorporate a "Healthcare
Entrepreneurship" course into their curriculum, or nursing associations could
offer affordable workshops on "Starting a Private Nursing Practice."

Facilitate Access to Affordable Finance and Startup Capital: Create specific

loan schemes, grants, or microfinance opportunities tailored for nurse-led health
businesses. Partner with financial institutions to offer favorable terms or
establish revolving funds.
Example: The government or a health-focused NGO could set up a "Nurse
Entrepreneurship Fund" that provides low-interest loans or seed grants to
nurses with viable business plans for clinics or community health services.

Establish Mentorship Programs and Support Networks: Connect aspiring

nurse entrepreneurs with experienced business owners (both nurses and non-
 nurses) who can provide guidance, advice, and support. Foster peer support
networks where nurses can share experiences and learn from each other.
Example: A national nursing council could launch a mentorship program
where senior nurses who have successfully started private practices mentor
younger nurses interested in doing the same.

Simplify Regulatory Processes and Provide Guidance: Streamline the

procedures for registering and licensing nurse-led health businesses. Provide
clear, easily accessible information and support services to help nurses navigate
regulatory requirements.
Example: The Ministry of Health could create a dedicated helpdesk or online
portal with step-by-step guides and checklists for nurses wanting to open
clinics or other health enterprises.

Promote a Culture of Entrepreneurship and Recognize Nurse Innovators:

Actively encourage and celebrate nurse entrepreneurship through media
campaigns, awards, and showcasing success stories. This can help change
mindsets and inspire more nurses to consider business ventures.
Example: Annual "Nurse Innovator Awards" could be established to
recognize nurses who have developed successful health businesses or
innovative healthcare solutions, highlighting their contributions.

Develop Incubation Hubs for Health Startups: Create business incubators or

accelerators specifically for health-related startups, including those led by
nurses. These hubs can provide office space, shared resources, business
development support, and networking opportunities.
Example: A university's nursing faculty could partner with its business school
to establish an incubator that supports student and alumni nurses in
developing their health business ideas.

34. (a) Define the term delegation. (1 mark)

Delegation is the process by which a manager or leader assigns a specific task,

responsibility, and the necessary authority to a subordinate or team member to
carry out that task, while the manager retains overall accountability for the
outcome.
 Example: A charge nurse (manager) assigns a staff nurse (subordinate) the
task of conducting a patient education session on diabetes management,
giving her the authority to use specific educational materials and answer patient
questions. The charge nurse remains accountable for ensuring the education is
effectively delivered.

34. (b) Outline twelve (12) benefits of delegation to the delegated staff. (12
marks)

Delegation offers numerous benefits to the staff members who receive delegated
tasks. Here are twelve:

Skill Development: Provides opportunities to learn new skills and enhance

existing ones by tackling new and challenging tasks. E.g., A junior nurse
delegated to assist in a minor procedure gains practical skills.

Increased Competence: Successfully completing delegated tasks builds

confidence in their abilities. E.g., After leading a ward round successfully, a
nurse feels more competent.

Career Growth and Advancement: Exposure to higher-level tasks can prepare

staff for future promotions and expanded roles. E.g., A nurse delegated to
manage inventory might be considered for a future supplies coordinator role.

Increased Job Satisfaction: Being trusted with important tasks can make work
more interesting, engaging, and fulfilling. E.g., A nurse feels more satisfied
when delegated the responsibility of mentoring a new student.

Enhanced Motivation: Delegation can be a sign of trust and recognition from

management, boosting morale and motivation. E.g., A staff member feels
motivated when chosen to represent the unit at a hospital committee meeting.

Empowerment: Gives staff more control and autonomy over their work, leading
to a greater sense of ownership. E.g., A nurse delegated to develop a new
patient information leaflet feels empowered.

Better Understanding of Organizational Goals: Involvement in a wider range

of tasks helps staff see the bigger picture and how their work contributes to
 overall objectives. E.g., By participating in a quality improvement project, a
nurse better understands the hospital's focus on patient safety.

Improved Time Management Skills: Handling additional responsibilities

requires staff to manage their time more effectively. E.g., A nurse delegated
multiple tasks learns to prioritize and organize her workday better.

Development of Decision-Making Skills: Some delegated tasks require staff

to make decisions, thereby honing their judgment. E.g., A nurse delegated to
manage patient complaints learns to make on-the-spot decisions to resolve
issues.

Increased Sense of Value and Recognition: Being selected for delegated

tasks shows that their skills and contributions are valued. E.g., A healthcare
assistant feels valued when delegated the task of orienting new assistants to
ward routines.

Reduced Boredom and Monotony: New tasks and responsibilities can break
the routine and make the job more varied and stimulating. E.g., A nurse
enjoys the variety when delegated to conduct health talks in the outpatient
department.

Improved Teamwork and Collaboration: Delegation can involve working with

others, fostering better teamwork and interpersonal skills. E.g., A nurse
delegated to lead a small project team learns to collaborate effectively with
colleagues from different cadres.

34. (c) Outline twelve (12) reasons why managers may fear to delegate. (12
marks)

Managers may hesitate or fear to delegate tasks for a variety of reasons, even
when delegation could be beneficial. Here are twelve common reasons:

Fear of Losing Control: Managers may worry that if they delegate tasks, they
will lose control over the process and the outcome. E.g., A ward manager
insists on personally checking all discharge summaries because she fears
errors if others do it.
Lack of Trust in Subordinates: Some managers may doubt the skills,
competence, or reliability of their staff to perform tasks correctly. E.g., A
senior nurse avoids delegating complex patient assessments to junior nurses,
believing they are not yet capable.

Belief That They Can Do It Better or Faster: Managers might think it's quicker
and more efficient to do the task themselves rather than explaining it and
supervising someone else. E.g., A pharmacy manager prefers to do the
monthly stock-take herself because she feels she is more accurate than her
staff.

Fear of Being Blamed for Subordinates' Mistakes: Since managers retain

ultimate accountability, they may fear being held responsible if the delegated
task is done poorly. E.g., A unit head is reluctant to delegate report writing,
fearing criticism from top management if the report contains errors.

Lack of Time to Train or Explain: Proper delegation requires time to explain

the task, provide necessary information, and train the staff member, which busy
managers may feel they don't have. E.g., A charge nurse during a busy shift
feels she doesn't have time to teach a junior nurse how to use a new piece of
equipment.

Fear of Subordinates Outshining Them: Insecure managers might worry that

if a subordinate performs exceptionally well on a delegated task, it could make
the manager look less competent or indispensable. E.g., A manager avoids
delegating a presentation to a talented team member for fear the team member
will impress superiors more.

Perfectionism: Some managers are perfectionists and believe no one else can
meet their high standards. E.g., A meticulous head of department re-does
work delegated to others because it's "not quite right."

Lack of Delegation Skills: Some managers may not know how to delegate
effectively – what to delegate, to whom, and how to monitor progress. E.g.,
A newly promoted nurse manager struggles with identifying tasks suitable for
delegation.

Enjoyment of Certain Tasks: Managers might hold onto tasks they personally
enjoy doing, even if those tasks could be delegated. E.g., A nurse manager
continues to do direct patient care for certain "interesting" cases, even though
her primary role is management.

Fear of Subordinates Becoming Overburdened: Some managers may be

overly concerned about adding to their staff's workload, even if the staff are
capable and willing. E.g., A compassionate team leader hesitates to
delegate additional tasks to a nurse she perceives as already busy.

Concern that Delegation Implies Incompetence (of the manager): Some

managers might feel that delegating tasks makes them appear unable to handle
their own workload. E.g., A manager tries to do everything himself to prove
he is hardworking and capable.

Poor Past Experiences with Delegation: If previous attempts at delegation

resulted in poor outcomes, a manager might be reluctant to try again. E.g.,
After a delegated task was mishandled once, a manager decides it's "safer" not
to delegate important work anymore.

END OF PAPER 1 REVIEW

NURSES REVISION UGANDA