Section 5: SHORT ANSWERS (10 × 2 = 20 marks)

1. Define Health & List Down the Determinants of Health

1. Biological/Genetic factors (age, sex, heredity)
2. Physical environment (water, sanitation, housing)
3. Social and economic environment (education, income, employment)
4. Health services (availability and accessibility)
5. Individual behaviour and lifestyle (diet, exercise, smoking)
6. Psychosocial factors (stress, mental health)

2. List the Key Elements of National Health Policy

1. Universal health coverage
2. Health assurance - assured healthcare to every citizen
3. Strengthening primary healthcare
4. Maternal and child health
5. Disease prevention and control (communicable and non-communicable)
6. Regulation of private sector
7. Human resource development (training of health workers)
8. Health technology and research
9. Financial protection - reducing out-of-pocket expenditure
10. Intersectoral coordination

3. Explain the Types and Methods of Sterilization

1. Dry heat - Hot air oven (160°C for 1 hour)
2. Moist heat / Steam - Autoclave (121°C, 15 psi, 15-20 minutes)
3. Boiling - 100°C for 20 minutes (disinfection, not full sterilization)
4. Flaming / Incineration - for inoculation loops
5. Radiation - UV rays, gamma rays (for disposable equipment)
6. Filtration - Millipore / Seitz filters

1. Ethylene oxide (ETO) gas - for heat-sensitive instruments
2. Formaldehyde - for fumigation
3. Glutaraldehyde (2%) - for endoscopes

4. Types of Surgical Dressing

1. Dry dressing - Gauze/non-woven dressings; for clean, dry wounds
2. Wet dressing - Saline-soaked gauze; for infected or sloughing wounds
3. Occlusive/semi-occlusive dressing - Transparent film (e.g., Tegaderm); maintains moist environment
4. Absorbent dressing - Foam dressings; for highly exudative wounds
5. Pressure dressing - Applied with pressure to control bleeding
6. Medicated dressing - Impregnated with antiseptic (e.g., povidone-iodine, paraffin gauze - Jelonet)
7. Biological dressing - Skin grafts, collagen; for large wounds/burns

5. Factors Affecting Sleep

1. Age (newborns sleep 16-20 hrs; elderly sleep less)
2. Physical activity - exercise promotes sleep
3. Illness and pain - disturb sleep

6. Enlist the Sites of Pulse

1. Radial pulse - wrist (most common site)
2. Carotid pulse - neck (used in CPR/emergency)
3. Brachial pulse - antecubital fossa (used for BP measurement)
4. Femoral pulse - groin
5. Popliteal pulse - behind the knee
6. Posterior tibial pulse - behind the medial malleolus
7. Dorsalis pedis pulse - dorsum of the foot
8. Temporal pulse - temporal region of the scalp
9. Apical pulse - apex of the heart (auscultated)

7. Factors That Affect Blood Pressure

1. Age - BP increases with age due to arterial stiffness
2. Sex - males have higher BP before menopause; equalizes after
3. Body weight/Obesity - increases BP
4. Exercise - temporarily raises BP; regular exercise lowers resting BP
5. Emotions/Stress - anxiety, fear raise BP
6. Medications - antihypertensives lower BP; vasoconstrictors raise it
7. Smoking and alcohol - raise BP
8. Circadian rhythm - BP lowest at night, peaks in morning
9. Posture - BP slightly lower when lying down vs. standing
10. Cardiac output and peripheral resistance - directly determine BP

8. Principles of Nursing

1. Respect for dignity - treat every patient with respect and individuality
2. Non-maleficence - do no harm to the patient
3. Beneficence - act in the best interest of the patient
4. Autonomy - respect the patient's right to make decisions
5. Justice - provide fair and equal care to all patients
6. Confidentiality - maintain privacy of patient information
7. Holistic care - address physical, mental, social, and spiritual needs
8. Safety - maintain a safe environment for patients and staff
9. Communication - maintain therapeutic nurse-patient relationship
10. Continuity of care - ensure uninterrupted care

9. Explain the Dynamics of Interpersonal Relationship

1. Orientation phase - patient identifies a need; nurse and patient meet and begin to establish trust
2. Identification phase - patient identifies those who can help; begins to feel a sense of belonging
3. Exploitation phase - patient makes full use of available services; nurse helps the patient use resources
4. Resolution phase - patient becomes independent; the professional relationship ends

• Trust - foundation of any therapeutic relationship
• Empathy - understanding the patient's feelings
• Communication - verbal and non-verbal exchange
• Boundaries - maintaining professional limits
• Respect and acceptance - non-judgmental attitude

10. Define Enema. List 2 Purposes of Giving Enema

1. Cleansing/Evacuant purpose - to relieve constipation or to empty the bowel before surgery, delivery, or diagnostic procedures (e.g., colonoscopy)
2. Therapeutic purpose - to administer medications (e.g., corticosteroids in ulcerative colitis) or to relieve flatulence and abdominal distension

Note: All answers are written in the short-answer RUGH's pattern - definition followed by numbered point-wise listing, suitable for 2 marks each in nursing examinations.