Short Answer Test (SAT)
Week 7, in registered tutorial groups
Weighting: 40%
Word limit: 1000 words
Submission Details: This is a closed book assessment that will be completed in your tutorial
class in week 7.
All students must attend their allocated tutorial to complete this assessment.
You have an allocated time of 90 minutes.
Marking Criteria and Standards: See page 12-17 of the Learning Guide
Aim of assessment
The purpose of this short answer test in-class assessment is to enable the student to
demonstrate:
• An understanding of the principles of perioperative nursing care in relation to a
person who has Crohn’s disease (Learning outcome 1).
• An understanding of alterations in body fluid homeostasis and the management of
fluid balance in the perioperative period (Learning outcome 1).
• An understanding of the role of the nurse in the perioperative period in relation to a
person who has Crohn’s disease (Learning outcome 2).
• An understanding of the pathophysiology of Crohn’s disease (Learning outcome 5).
• An understanding of pharmacological agents that may be used in the perioperative
care of a person who has Crohn’s disease (Learning outcome 6).
• An understanding of how safe and effective administration of pharmacological
agents support people in perioperative care (Learning outcome 1, 6 & 7).
• An evaluation of relevant literature to support an understanding of the
pathophysiology, pharmacological and nursing management of a person
experiencing Crohn’s disease and is able to express this in a clear and succinct
writing style (Learning outcome 9).
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Unit: 401010 Health Variations 1
Details
Lucy is a 19 year old university student. She has been admitted to hospital with a six (6) day
history of lower right quadrant abdominal cramping pain increasing with intensity, diarrhoea
with blood, anorexia, fatigue, nausea and episodes of vomiting. Lucy states that she was
diagnosed with Crohn’s disease at age 15. She has had two previous hospital admissions for
acute exacerbations of Crohn’s disease with clinical manifestations of diarrhoea, abdominal
pain and vomiting. Her Crohn’s disease has been managed with a combination of diet,
medication and medical monitoring. Remission of her Crohn’s disease was maintained by oral
mesalazine (Mesasal). Lucy currently rates her pain as 9/10.
On examination, Lucy was pale, her extremities were cool, and her skin was dry with poor
turgor. Her abdomen was distended and tender. A mass was palpable in the lower right
abdominal quadrant.
Observations on admission
• Blood pressure: 95/60
• Pulse rate: 110 beats/minute
• Respiratory rate: 22 breaths/minute
• Temperature: 37.7C
• Sa02: 98% in room air
• Weight: 62 kilograms
• Height: 165 cm
• Urinalysis:
• specific gravity: 1040
• dark coloured urine
• no other abnormalities noted
Initial pathology results
• Haemoglobin: 105 g/L (117 – 157 g/L)
• Haematocrit: 49% (35 – 47%)
• WBC 15000/mm3 ( 3500 – 11000 mm3)
• Erythrocyte sedimentation rate (ESR): 28mm/hour (0 – 20 mm/hour)
• C-reactive protein (CRP): 30mg/dl (20 mg/dl)
• Albumin: 28g/L (35 – 50 g/L)
The MO orders the following
• fentanyl 75mcg IMI QID PRN
• metoclopramide (Maxolon) 10mg IMI TDS
• 1000mL 0.9% normal saline over 8 hours
• nil by mouth
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Unit: 401010 Health Variations 1
Lucy was prepared and sent for an urgent colonoscopy, upper barium x-ray and abdominal
CT scan. A bowel obstruction at the proximal end of the ascending colon at the ileocecal
junction was diagnosed. A balloon dilation of the obstructed colon was attempted, but was
unsuccessful. Lucy was scheduled for a surgical resection of the affected proximal ascending
colon and end-to-end anastomosis of her colon.
Questions
Question 1. 10 marks (250 words)
Explain the pathogenesis of Crohn’s disease that has led to the development of Lucy’s
obstruction of the proximal ascending colon.
(Learning outcome 5; NMBA competency standards 2.6, 3.1, 4.2)
Question 2. 10 marks (250 words)
Explain the pathophysiological processes that lead to Lucy’s conscious perception of
pain in her lower right abdominal quadrant.
(Learning outcomes 1, 5; NMBA competency standards 2.6, 4.2, 3.1)
Question 3. 5 marks (165 words)
Describe the characteristics of the intravenous fluid that was ordered for Lucy, and the
specific rationale, related to the details of the case study, for the administration of this
intravenous fluid to Lucy.
(Learning outcome 1, 2; NMBA competency standards 2.6, 3.1, 4.2, 5.2, 5.3)
Question 4. 5 marks (165 words)
Describe the mechanism of action of fentanyl in relation to its administration to Lucy.
(Learning outcome 6; NMBA competency standards 1.1, 2.6, 3.1, 4.2)
Question 5. 5 marks (165 words)
Prioritise the nursing responsibilities and associated rationales related to the
administration of fentanyl to Lucy.
(Learning outcome 7; NMBA competency standards 1.1, 1.2, 1.3, 2.2, 2.5, 2.6, 5.2, 5.3, 6.1,
7.4)
END OF QUESTIONS
NOTE - WORD LIMIT
There is a total word limit of 1000 words for the SAT. If you exceed the word limit by
more than 10% the marker will stop marking at 1100 words (word limit of 1000 words +
10%). This assessment does not require in text citations or a reference list.
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Marking criteria and standards: Assessment 2 – Short Answer Test (SAT) In Cl