UNSBAC PAMPHLET

1. UGANDA NURSING SCHOOL BWINDI ACADEMIC UGANDA NURSING SCHOOL BWINDI ACADEMIC COUNCIL (UNSBAC) PREPARED PAMPHLET COUNCIL (UNSBAC) PREPARED PAMPHLET (QUESTIONS AND ANSWERS) FOR BOTH NURSES AND (QUESTIONS AND ANSWERS) FOR BOTH NURSES AND MID WIVES (YEAR 3 SEMISTER 1) MID WIVES (YEAR 3 SEMISTER 1) UNSB OUR SCHOOL UNSB OUR SCHOOL CONTENTS CONTENTS. . 1.LEADERSHIP AND MANAGIMENT. 1.LEADERSHIP AND MANAGIMENT. QNs(1 2.ENTREPRENEURSHIP. 2.ENTREPRENEURSHIP. 3.MENTAL HEALTH 3.MENTAL HEALTH 4.SURGERY 3 4.SURGERY 3 5.GUIDANCE AND COUNSELLING. 5.GUIDANCE AND COUNSELLING. 6.REPRODUCTIVE HEALTH. 6.REPRODUCTIVE HEALTH. 7.TROPICAL MEDICINE. 7.TROPICAL MEDICINE. 8.GYNACOLOGY . 8.GYNACOLOGY . QNs(1…… QNs.(8. QNs.(8.… ….13) QNs.(14 QNs.(14… …..23) QNs.(24 QNs.(24… …..31) QNs.(32 QNs.(32… …..34) QNs.(35 QNs.(35… ….46) QNs.(47 QNs.(47… ….53) QNs.(54 QNs.(54… ….63 ……..7) ..7) .13) ..23) ..31) ..34) .46) .53) .63 1

2. LEADERSHIP AND MANAGEMENT LEADERSHIP AND MANAGEMENT 1. 1. a) Define the term support supervision b) Outline 8 skills which a mentor should possess in order to carryout successful c) Support supervision d) With examples, explain 5 constraints mentors are likely to face during support supervision Solutions Solutions a) Definition; Definition; Supervision is the process of guiding, helping and encouraging staff to improve Their performance so that they meet the defined standard of performance of their Employer Purpose; A supervisory system is to ensure quality of programs and clinic operation and to enable the staff to perform their required maximum potential. Using a team approach to supervision requires supervisor to disregard their Convectional attitude and take up the role of a facilitator Traditional approaches emphasis inspecting facilities and controlling individual performance 2

3. b) Mentorship skills Mentorship skills Clear commitment to supervision He should be firm not to accuse so that there is active participation by the staff Ability to use supervisory tools which ensure that the essential areas are covered Ability to follow up action plan to ensure that identified problems are dealt with. It also helps to provide a record so that everyone knows what they are meant to do Ability to assess self so as to promote good performance Ability to support staff Ability to pay attention to staff needs and in the environment in which they work Ability to teach and devote self to educate staff as well as learning from them Discuss problems with staffs and work with them to find solutions Ability to understand the needs and demands of ones clients. c) These can also be understood as challenges faced 3

4. by mentors or supervisors Lack of common understanding about supervision Confusing supervision with monitoring and policing Inadequate supervision skills in supervision No clear job description and task analysis Supervision visits not planned Lack of in depth knowledge on technical programs supervised No documentary analysis done No check list Bumping on staff No feedback given 2. 2. i) Define; a) Management b) Efficiency c) Effectiveness. ii). what is the importance of Efficiency and Effectiveness when managing a health facility? Solutions Solutions. (a) Management is the organization and coordination of the activities of business in order to achieve defined objectives/ goals. (b) Efficiency is the comparison of what is actually 4

5. produced or performed with what can be archived with the same consumption of resources. (c) Effectiveness is the degree to which objectives are archived and the extent to which targeted problems are solved. ii) ii) Importance Importance’’s of Efficiency and Effectiveness s of Efficiency and Effectiveness Maximum production. Successful businesses are the ones that are very efficient. When management uses resources efficiently, there is quality and quantity production of goods. There is appropriate dealing with issues that rise with work force. Unhappy workers may be less productive egg if tensions exist in the work place, productivity may also suffer. Therefore effectiveness and efficiency provide a positive work environment. Ensures good customer service; which is important for the success of a business. Management should create the environment where the company has good relationship with its customers. Responding to changes in the economy and changes in business trends. The most successful business is the ones that deal most effectively with issues that rise in the economy with their work force. Social position. With effectiveness and efficiency, a manager can successfully defend his actions with evidence of cost cutting or revenue increasing that opens up doors for promotion, head hunting or increased 5

6. autonomy to the clients. Increased profits. When jobs are done effectively and efficiently, there is excellent resource management, utilization and information flow which heads to high profits. With efficiency and effectiveness, there is maximum utilization of resources which reduces the costs of production hence a deduction in prices of finished goods. Improved living standards. Identification and avoidance of uncertainties/risks in the facility of service/ products. Quality improvement through good efficient and effective skills. Creation of good relationship with clients, health workers and managers of the health facility and therefore increased level of trust between the manager and the subordinates. There is increased discipline maintenance with an organization. It provides a health worker with the opportunity to improve to the competitiveness of their businesses by providing them with skills that will put them at an advantage. It helps them to manipulate with changes to benefit the business. Managers improve their management skills to ensure that they are leading their staff to the best of their 6

7. abilities. It helps to be able to predict a future crisis that could potentially affect a business. This means that the business can react proactively before suffering damage. It ensures managers capability of making the right decision of the business in times of crisis and uncertainty. It helps to know how the functions of the business are affected by external changes thus preventing damage to the business financially. It helps health workers in translation of their ideas and put them in practice in the real world .It helps health workers to connect to the world with better communication skills which ensures proper understanding of one another in management of their health facility. It helps health workers to utilize available resources efficiently and effectively in such a way that there is less wastage and in non-harmful 3. 3. A). Explain how you would plan, organize and conduct a successful staff meeting. b) What is importance of regular staff meeting onward? Solutions ; a Solutions ; a Agenda Agenda is the most crucial part in preparing and planning a meeting .It help stout line the meeting in 7

8. timely and logical manner and presents the documented and presents the focus area and them as area and the main object. This agenda aids in prioritizing and works as good checklist during the meeting. Make your objective clear Make your objective clear. A meeting must have a specific and well defined purpose. Before you send that calendar invite you send that calendar invite, ask yourself: What do I seek to accomplish? Are you alerting people a change in management or a shift in management or a shift in strategy Are you seeking input from others on a problem facing the company? Are you looking to arrive at a decision on apart? Standing meetings with vague purposes, such as ―status up dates, ―is rarely a good use of time. Consider who is invited Consider who is invited. When you‘re calling a meeting, take time to think about who really needs to be there .If you‘re announcing a change, invite the people who are affected by the announcement if you‘re trying to solve a problem, invite the people who will be good sources of information for we will be good sources of information for a solution. When people feel that what‘s being discussed isn't relevant to them, or that they lack the skills or expertise to assistance they‘ll view their attendance at the meeting as wastage of time. Stick to your schedule Stick to your schedule. Create an agenda that lays 8

9. out everything you plan to cover in, along with a timeline that allots a certain number of minutes to each item, and email it to people in advance email it to people in advance. Once you‘re in the meeting, put that agenda upon a screen or whiteboard for it. This keeps people focused. Take no hostages Take no hostages. Nothing derails a meeting faster than one person talking more than a fair share. If you notice one person monopolizing the conversation, call him out .Say, ― we appreciate your contributions, but now we need input from other before making a decision.‖ be public about it .Establishing ground rules early on will create a framework for how your group functions of or how your group functions. Start on time, end on time Start on time, end on time. If you have responsibility for running regular meetings and you have a reputation for being someone who starts and ends prompt, you will be amazed how many of your colleagues will make every will make every effort to attend your meet in effort to attend your meetings. People appreciate it when you understand that their time is valuable. Another note on time: Do not schedule any meeting to last longer to. Sixty minutes is generally the longest time workers can remain truly engaged. Ban technology Ban technology. The reality is that if people are 9

10. allowed to bring iPods or Blackberries into the room, they won‘t be focusing on the meeting or on contributing .Instead; they‘ll be emailing surfing the web, or just playing around with their technology. Eyes up here, please. Followup Followup.It‘s quite common for people to come away from the same meeting with very different interpretations of what‘s. To reduce this risk, email a memo highlighting what was accomplished to all who attended within 24 hours after the meeting. Document the responsibilities given, tasks delegated, and any assigned deadlines. That way, everyone will be on the same page. Meetings truly can be valuable and product of. You just have to take the steps to make them. b). Importance Importance’’s of regular staff meeting. s of regular staff meeting. Building supportive relationship .Staff meetings give team members a place to help each other and offer their support. Learning. They are vital for learning about our colleague‘s motivation, fears, hopes, troubles. Even when it‘s not actually said 55% any communication is counted 10

11. through nonverbal means and face time is the only way you can read it. Safe environment. Staff meeting provides us with an opportunity to share information we would not be so comfortable sharing by email or in report Staff meeting is a level playing field and an open forum. Everybody present shares the same opportunity to communicate and listen everybody gets the chance to speak. Nothing can replace intimacy. The closeness, security and intimacy of a team meeting especially in time of crisis can be vital It's difficult to replace a physical meeting with conference calls and video conferencing. Sure given no other opportunity to get together. Conference calls will have to do but if you can get together in person, then it‘s much more rewarding to do. Improvement of opportunity. Helps people to know how to work in team and how to manage a team towards its objectives and what improvement a team can achieve. They create a space forgiving each other a feedback to each other. 11

12. 4. 4. a) State seven advantages of team building b) List twelve characteristics of team building c) Outline pillars of team building Solutions. Solutions. a) Team building is a group of people with full set of complementary skills required to complete a task or job The advantages of team building The advantages of team building. . Learning new skills and experience. Democracy and participation. Recognition and respect. Encourages development of other team members. Give each other help and support. Show appreciation for help received Make decisions based on facts not on emotions and personalities. Recognize and deal with differences and disagreements. know about other personal lives Listen to and show respect for others 11. Share ideas. Talk more about "we" and less about "I" and" me". 12

13. b) The characteristics of team building. The characteristics of team building. Good communication regarding the goals of the organization. Having a plan ahead. Clear satisfaction between members. All signs of creativity and development; Every time members think about new skills Promotions of a win win culture. Sharing resources. Clear respect for each other Should be able to solve problems together 9. Room for people to learn from each other. 10. Cooperation between the team Effort to achieve the best. Achievement of goals. c) c) Pillars of team building include the following Pillars of team building include the following: : Support for each other. Trust and openness. Clear work .process Workplace democracy and participation. Motivation. Respect for each other sound leadership 13

14. 5. 5. a) Outline five important types of information you would give during orientation of a new staff? b) b) Explain at least ten specific management roles of ward manager? Solutions Solutions (a) Important types of information given to a new staff during orientation Health and secur Expected code of conduct Like Smartness. Responsibilities. Background e.g. religious basis. Collaborators of the organization. Utilization of facilities (b) Specific management roles of ward manager (b) Specific management roles of ward manager Planning; is considered to be the central function of management .determines the organization‘s direction. It is setting goal and deciding how best to achieve them. Organizing; is a process of mobilizing and allocating human and non-human resources so that plans can 14

15. be carried out. Leading is the process of influencing others to engage in the work behaviors necessary to achieve goals. Controlling; is the process of regulating/steering organizational activities so that actual performance /outcome conforms to standard. Staffing; function of management control all recruitment and personnel needs in the Organization. Its main purpose is to hire the right people for the right jobs to achieve the objectives of the organization. Motivation like giving incentives to workers. Resource allocator. Delegation of duties/roles Mentoring Recruitment Records management 6. 6. a) a) Define decision making b) b) Explain the steps of decision making process c) c) What is the role of a manager in decision making? Solutions Solutions 15

16. (A) Decision making is systematic process in which manager chooses among the alternatives, comes to a conclusion and selects an action. OR, it is the process of choosing between alternatives to achieve a goal. b) Steps of decision making process. Steps of decision making process.  Step1. Step1. Identify and define the area of concern Identify and define the area of concern .It is critical before taking any step of taking a decision.To be clear about the problem or concern you are addressing.  Step2: Step2: Gather and analyze information: Gather and analyze information: Try together all the necessary information about the problems or concern in order to accurately understanding the situation. Decision made without adequate information would not produce on appropriate results. In gathering information, the manager depends on good communication and assessment skills. Once you gather enough information, you will than analyze and interpret the data. This is an essential step where information is critically analyzed.  Step3: Step3: Establish Goals Establish Goals This is an essential step prior to proper planning and talking a decisive action. At this stage a manager should consider what he needs to accomplish and when .In addition one should one draw specific criteria to measure the anticipate outcome 16

17. Step4: Step4: Seek alternatives Seek alternatives. These are frequently several approaches to any given problem or concern. The more strategies you generate, the more likely you are to identify an effective action. Then form the alternatives you will determine the appropriate action to be taken. In this phase of the decision making process, you will use your knowledge, experience Choice should also be taken into consideration to its consequences. Then choose the alternative which will most likely achieve the desired outcome.  Step5: Step5: implement the selected strategy implement the selected strategy Once the strategy has been selected, it follows logically that it will be implement .In this phase the managers should decide who will implement the decision. It is necessary to know that the manager remains responsible and accountable for the outcome. Because the manager is still responsible and accountable for the outcome, he will have to maintain amount of control over the implementation. A sound communication skill and a clear guideline are necessary to achieve the expected outcome.  Step6: Step6: evaluate the outcomes evaluate the outcomes Compare the actual outcomes from the desired 17

18. outcomes. If the decision was effective, then the actual matches the desired outcomes. If not effective, then the situation remains the same or perhaps worse than the original status. If your decision was effective you will read to review the steps again. Take into consideration of the following; Problems/concerns were not correctly identified Assessment was not complete or PR Decision taken without considering other possible alternative and consequences The strategy chosen was incorrectly implemented due to lack of specific guidelines Evaluation of responses was incomplete or situation changed rapidly c) Decisional roles of a manager Decisional roles of a manager Entrepreneur: is that person who looks at the environment generates ideas turns these ideas into business opportunities Disturbance handler Resource allocator Negotiator 7a) 7a) Define the term team building? b) b) Outline the steps if team building c) c) As a nurse manager, explain how you would build an effective team on Ward. 18

19. Solutions Solutions a) Definition of Team building Team building is the action or process of using a group of people to work together effectively as a team, especially by means of activities and events designed to increase motivation and promote cooperation. OR Is the process of turning a group of individual contributing employees into a cohesive team. b) Steps of team building b) Steps of team building Forming Forming. In this stage, most members are positive and polite, some are anxious as they haven't fully understood what work the team will do. Whereas others are simply excited about the task. In this step the leader is dormant because the roles and responsibilities of team members are not clear Storming Storming. Storming often starts where there is; Conflict between team members natural working styles,. People start to push against the boundaries established in forming stage, This is the step where many teams fail, Team members who have a task at hand may experience stress. Norming Norming. Gradually, the team moves into the morning stage. Leadership is shared, methodical Ways of working, receptive to changes, mutual problem solving, open exchange ideas, and Team 19

20. spirit develops and the team starts to perform better. Performing Performing. Openness and trust, shared leadership, strong relationships, high flexibility of contribution, acceptance of differing views, The team performs as a unit and members work to their strengths. This is the most reproductive stage of team development..... As a leader you can delegate much of your work and you can concentrate on developing team members. Adjourning Adjourning. Many teams will reach this stage eventually, for example, project teams exist for only a fixed period and even permanent teams may be disbanded through organizational restructuring. Team members who like routine or who have developed close working relationships with colleagues may find this stage difficult, particularly if their future now looks UN certain c) c) How a nurse can build an effective team on Ward How a nurse can build an effective team on Ward Focus on the team. Team work improves morale and organizational productivity. So a nurse manager should encourage team work. Team oriented goal setting. Medicine is a collaborating effort among patients, health service providers, Care providers, and team members require definitive goals to produce this outcome. Leaders provide this through verbalization and written policy. Set bar. 20

21. Measurable goals help organizations reduce errors, service delivery time and wasted resources, while concurrently increasing patient's satisfaction. Learned communication skills. To prevent misunderstandings and errors, leaders or managers practice and teach effective communication. Encouraging respect and trust. Health care leaders build mutual respect and trust with each interaction they experience with clients and staff members. Determining, identifying and assigning specific roles. A manager determined , identifies and assigns specific roles to individuals in the team hence making work easy on Ward. ENTREPRENEURSHIP ENTREPRENEURSHIP 8. 8. a) Define the term business opportunity. b) State any three characteristics of a good business opportunity. c) List the strategies of ensuring that your business is attractive and successful. d) Analyze the steps taken in starting up a business Solutions Solutions a) A business opportunity is an attractive investment idea that provides the possibility of a monetary return for the investor taking the risk. A proven concept that generates 21

22. on going income. Is business idea that has been researched upon refined and packaged into a promising venture that is ready to launch. b) b) Four major Characteristics of a good business Characteristics of a good business opportunity opportunity o Good income potential o Reasonable ease of entry into the market o Low or Modest start- up costs o Good growth potential C) Strategies of ensuring that the business is attractive Strategies of ensuring that the business is attractive and and successful successful o Provide legendary customer service.treat your customers like royals. o Admit mistakes and fix problems to build stronger relationships. Accept your o mistakes whether they are your fault or not because customers prefer business that own their mistakes and take steps to correct them o is honest about your products and services. 22

23. Honesty is not just the best policy; it should be your main policy. Can‘t deliver by due date, o calls and let your customers / buyers know. Lying to customers is like shooting yourself in the foot. Because when you’re caught by your customers laying them, then they will lose faith in you and even spread negative feedback about your business. o Come up with something new. Continue to reinvent ,your company by adopting emerging technologies and introducing new processes, products and solutions.e.g make use of social media and mobile apps as growing number of buyers prefer to find and work with you through their phones. o Embrace corporate social responsibility. while some may argue that a company main responsibility is to take care of its stake holders such as customers, employees and owners, experts believe that business should give back to the society as well. o Start a blog.A blog is a website that allows users to reflect, share opinions and discuss various topics in form of an online journal where readers may comment on posts. o Offer a guarantee and warrantee 23

24. d) ) 10 steps of starting up a business 10 steps of starting up a business • Prepare a business plan and materials to define your business, products and services, and outline your goals, operating procedures and competition. • Create a business logo, cards and stationery. These items establish your company‘s identity and help potential customers find and remember you. • Incorporate your business to protect your personal assets from business debts and Liabilities. • Select an accountant and attorney. Many small business owners seek advice from accountants and attorneys • Get necessary tax identification numbers, licenses and permits • Insure your business and investigate other requirements. Some industries have specific insurance requirements, workers' compensation. • Open a business bank account. It is crucial to separate business finances from personal ones. Most banks require company details, such as formation date, business type, and owner names and addresses • Arrange your business accounting and apply for loans. You may want to use an accountant, or handle finances yourself with a small business accounting solution 24

25. • Establish a business line of credit. This will help reduce the number of times your company prepays for purchased products and services. It also helps establish a strong credit history, which is helpful for vendor and supplier relationship. • Ready your workspace. For home-based businesses, ensure you are meeting city zoning requirements for your area 8 official steps for 8 official steps for Legally Legally Starting a Business in Uganda Starting a Business in Uganda • Search for a business Name • Reserve the business Name • Obtain Certificate of Incorporation • Obtain Investment License • Obtain Tax Identification Number (TIN) • Obtain Trading license • Register with National Social Security Fund (NSSF) • Make a company seal 9. 9. a) Explain ways through which self employment has been encouraged in Uganda. b) With examples, explain 5 advantages of starting up one own's business 25

26. Solutions Solutions a) Through carrying out education reforms such as encouraging teaching of practical or technical/vocational subjects which impart vocational skills for self employment and science subjects to promote innovation and inventions Through sensitising the public on the benefits of self employment such as increased income and provision of employment to others By providing low interest loan capital for starting up personal income generating activities for instance the youth entrepreneurship fund By improving infrastructures such as roads and stable power of as this helps to reduce production costs and allows cheap and easy access to the market. Through creating favourable investment environment by giving tax holidays and exemptions and subsides that reduce production costs for starting entrepreneurs. Encouraging consumption of locally produced goods through protecting the domestic market for locally produced goods by charging high taxes on imported goods Through encouraging talent development.This allows setting up of personal income generating activities from talents possessed such Art and crafts,sports and music among others. Through further privatization by selling of 26

27. government owned enterprises to private individuals which allows setting up of more enterprises to compete with them. Through further liberalisation of the economy by the removal of unnecessary restrictions on economic activities which allows increased participation by the public hence creation of more enterprises. By improving on the political stability. This provides peace and security of life and property . b) Advantages of sole proprietorship Advantages of sole proprietorship Increased income, it offers a greater possibility of achieving significant financial rewards than working for someone else. Independence, they are their own bosses, able to make decisions on their own, choose whom to do business with and what work they will do. Creates an opportunity for a person to make a contribution through their innovations. Control, enables one to be involved in total operation of the bussiness as they are driven by passion, creativity and possess a vision of what they aim to achieve and this helps them to truly create something of their own. Prestige, offers the status of being in charge, they are attracted to the idea of being the boss, there is prestige and pride of ownership. 27

28. 10. 10. a) Explain the factors affecting competition in a business? b) Explain how entrepreneurs cope with competition in a business. c) Identify and describe five characteristics of a good indicator? Solutions Solutions a) Level of product overlap. High level of product overlap where many already existing business leads to high business competition since number of competitors increase and vise-vasa. Level of mobility and accessibility overlap. High level of mobility and accessibility overlap leads to high business competition and vise-vas Level of substitution for the entreprenuer's products. High level of substitution leads to business competition and vise-vasa. Level of public awareness about the entreprenuer's products. High level of public entrepreneur's products through advertising compared to those competitors leads to low business competition Level of product priority. High level of priority given to the entrepreneur products in the customer's budget leads to low competition since the entreprenuer product is on top of the customer's scale od preference and vise-vasa. 28

29. (b) .How entrepreneurs cope with competition in a business. How entrepreneurs cope with competition in a business. By advertising products persuasively Keeping good image. Providing customer convinience and service in terms of access to business products. Reducing prices. Through sales promotion. Offering discounts eg trade discounts and cash discounts. Motivating business employees. Providing variety of products Listening to customer complaints Through appropriate after sales service. Improving customer care services. By selling on credit or providing hire purchase facilities. Training workers to ensure they have right skill. Trough personal selling. Offer warantees and guarantees to customers. Having appropriate inventory levels. Ensuring proper distribution channels. Through use of attractive packaging materials. Through ensuring honesty. Through ensuring effective communication. Through bargaining and negotiation. 29

30. (c) Characteristics of a good indicator Characteristics of a good indicator Flexible- indicator. Acceptable- by the people in the community. Simple Specific Sensitive Timely Cheap Accurate Reliable or Reproducible 11. 11. a) Define Monitoring and Evaluation? b) List five questions that a monitoring and evaluation system can answer. c) Define the term entrepreneurship? d) With examples, discuss the types of entrepreneurs. e) List at least 6 functions of an entrepreneur. Solutions. Solutions. a) Monitoring is a continuous assessment that aims at 30

31. providing all business stake holders with early detailed information on the progress or delay of the ongoing assessed activities. Evaluation is a systematic and objective examination concerning the relevance, effectiveness, efficiency and impact of activities in the light of specified objective b) 5 Questions that an M&E systems can answer. What are the measures of the project‘s impacts? What are the measures of the project‘s outcomes? What are the measures of the project‘s outputs? What are the measures of the project inputs? What is the measure of the project‘s success? c) Entrepreneurship is the process of designing, launching and running a new business which is initially a small business. d) Types of Entrepreneurs. Types of Entrepreneurs. Setup failure entrepreneur. An entrepreneur who is to fail before taking off. Always complaining and talk of projects that are too ambitious to have a strong desire and determination to succeed but never gives up. 31

32. Life style entrepreneur. This is an entrepreneur who wants to live life he wants and acts the way he likes. Have lots of ideas about entrepreneurship but does not actually do anything. Cash flow entrepreneur. This entrepreneur is only interested about money but also innovation, team inspiring and thinking ahead. Headline entrepreneur. This is an entrepreneur who is interested in making it to the front page of the newspapers than actually doing business. Better world entrepreneur. This is a type of entrepreneur who is not for money but to make the world a better place. Thus the first focus should be making an idea or company more successful and then using success to make the world a better place Manager entrepreneur. An entrepreneur who invests every little funding once an opportunity is available and has been involved and start up before. 32

33. e) Functions of entrepreneur Functions of entrepreneur An entrepreneur increases standards of living of people through production of wide/ variety of goods and services on a large scale at lower cost. An entrepreneur promotes regional development through setting up enterprises or industries in less developed regions. An entrepreneur also creates employment opportunities for the people. An entrepreneur promotes capital formation by mobilizing idle saving of the public. An entrepreneur also helps in production of goods and services in large scale for the purpose of earning huge amount of foreign exchange thus promoting country‘s export trade. An entrepreneur facilitates overall development through acting as a catalyst agent for change which results in chain reaction. 12. 12. a) Define social entrepreneurship and state three types of social enterprises. b) Distinguish between microenterprises and small enterprises c) Discuss the factors to evaluate a business idea in a health service. 33

34. Solutions Solutions a) Social entrepreneurship is the use of start up companies and other entrepreneurs to develop, fund and implement solutions to social, cultural and environmental issues. It‘s generally using socially innovative means to address the problems by mobilizing communities in different ways. Types of social enterprises Types of social enterprises Awareness Awareness; A variety of social entrepreneurs and enterprises seek to bring awareness to a particular problem, cause or second brand solving a social issue. It attracts attention to draw out help from the community that may exceed the local community. In one sense, awareness brands crowd source solutions to social challenges. Nonprofit Nonprofit; A type of enterprise that can be sustainable while not turning pro fit and does not have to exist solely on gifts from donors. The work of a business and earned income can go towards sustaining business practices, paying salaries and giving towards the cause it‘s seeking to address. In 34

35. most countries, nonprofit benefit from taxes and less restricting business laws making it an agile form of social business For profit For profit; These are businesses that have a stated goal to increase their profit margins, yet still maintaining a social goal e.g. clothing companies which create an increased transparency in the textile industry. They maintain focus of transparency in practices and pricing to ensure fair pricing and fair waging. Community projects ; Community projects ; A small scale effort to address an issue within a specific community. Social, environmental and economic issues are the primary focus but the interpretation of what it means can be quite abroad. Anything from an effort to build a community e.g. a volunteer fire department in a poverty stricken poor area. Co-operatives Co-operatives; People come together to address a specific need and form groups thus the focus on basic needs like housing and grocery. b) Differences between micro and small businesses or b) Differences between micro and small businesses or enterprises. enterprises. All micro businesses are small business, the only difference is that a micro business is a subset of a small 35

36. business community based on the number of employees within the company i.e. While one business can be technically considered a small business even when it has dozens of employees the other is a micro business if it has less than ten people employed in the company. A small enterprise is a privately owned business in the legal form of a corporative, partnership or sole proprietorship whereas sole proprietorship is usually the legal form of ownership for all micro businesses. Your business is a micro business if you required less than $35, 000 in start up capital whereas a small business can require even more. (C) Evaluating a business idea in a health care service Evaluating a business idea in a health care service Ask your friends and associates to help you evaluate your concept; If you know of successful people in the kind of business, ask them what they think of your idea, however it‘s important to ask the failures too. They may think of problems you‘re going to encounter thus you may be willing to face those obstacles or you may decide that some of them are unbearable. Ask your potential customers how much they would pay for your service or product; Their answers will help you focus on your potential marked and will give you a sense of how strong that market is.Once you have some answers to this question, you can begin to estimate your 36

37. prospective firm‘s potential revenues. Consider whether you are excited about the idea; Will you actually enjoy the work that will be required to make your venture a success? If ―YES‖move on. Feasibility study (Getting down to details; If your initial research and thinking turns up positive results, begin work on a feasibility study. It can take formal documents that will help you recruit potential partners, investors and lenders. Alternatively, it can be a simple memo to yourself. A series of questions designed to help you decide whether you should proceed to next level of commitment.It should also address the following issues each of which will require in depth consideration Product or service: What are its unique features? How will it be designed, manufactured and delivered to your customers? Management team: Does your team have experienced in the health service? What skills or qualifications are missing in the current team? Market; How big is the potential market? What are the target costs required to reach the target market? Competition; Who are your competitors? o Is the product or service superior to the competition? Would it be easy for competitors to duplicate your product or service? o What are your competitors‘ strengths and weaknesses? How will your competitors respond when your firm enters 37

38. market? o The cost; What will it cost to start and run your business? o Where will you raise the money? 13. 13. a) explain the five roles of small enterprises in promoting development. b) outline five challenges faced by small and medium enterprises in Uganda. c) state five types of competition in business. Solution Solution a) Roles of small enterprises in promoting development Roles of small enterprises in promoting development Small enterprises is an enterprise which employs few people and its turnover is small. An enterprise is undertaking carried out for the purpose of making profits. The roles include the following; Generation of income. The small enterprises generates income through making profits to the enterprise thus promoting development to the enterprise. 38

39. Opens new opportunities. They offer several advantages and opportunities for investigation. Firstly; they are less capital intensive. They even receive financial support and funding easily. Secondary; procuring manpower and raw materials is also relatively easier for them. Even government‘s export policies favor then heavily. Provision of services. Services are brought near to the customers hence easy accessibility and thus promoting development. Pay taxes. It pays taxes to the government hence the government getting income and promoting the development of the country. Advances welfare. These enterprises not only reduce poverty and income inequality but they also raise standards of living of poor people. Furthermore, they enable people to make a living with dignity hence promoting development. c) challenges faced by small and medium enterprises in challenges faced by small and medium enterprises in Uganda. Uganda. They lack skilled manpower to manage the business. They have limited storage facilities especially for perishable goods. They normally collapse as soon as the owner dies. It is not easy for them to obtain loan from financial institutions. 39

40. They often produce low quality products. They normally have poor infrastructure. Price fluctuation. In security.  d) Types of competition in business. Types of competition in business. •Pure competition. •Imperfect competition. •Oligopoly competition. •Monopoly competition. Pure competition. Pure competition. In an environment of pure competition, there are barriers of entering the market. The are multiple sellers and no single companies dominates the market. Consumers can buy the products or services easily and choose from a number of different suppliers. The products or services themselves are easily replaced by those of another competitor and prices are set by what the market is willing to pay. Small business such as convenience stores are an example. 40

41. Imperfect competition. Imperfect competition. This is similar to perfect competition in the multiple sellers and no barriers to entering the marketplace. The difference is that the sellers are offering essentially the same product with variations in quality and prices. Oligopoly competition. Oligopoly competition. In oligopoly competition, a limited number of companies compete for the clientele. The product in question may be differentiated between companies or exactly the same. There are significant barriers to entering the marketplace which keep most other companies out. It also means most companies will be large and similar in size. The banking industry is an example. Monopoly competition. Monopoly competition. in this case, there is only one business operating in sectors without ant competition. This may be based on ownership of resources or a patent. Monopolistic competition involves a market dominated by one large where there may be other smaller companies as well. MENTANTAL HEALTH MENTANTAL HEALTH 14 14 Suicide is common complication among psychiatric patients a) Outline 10 causes of suicidal behaviors b) Describe the management of suicidal behavior c) Outline 10 predisposing causes of mental illness 41

42. Solutions Solutions Suicide is the act of taking one‘s own life • Suicidal behavior refers to talking about or taking actions related to ending one‘s own life. a) causes of suicidal behavior causes of suicidal behavior –Mental disorders e.g. depression, BAD, schizophrenia, anxiety disorders and personality disorders –Incarceration –Poor job security or low levels of job satisfaction – History of being abused or witnessing continuous abuse – Being diagnosed with a serious medical condition such as cancer or HTN – Being socially isolated or a victim of bullying or harassment – Substance abuse – Child hood abuse or trauma – Family history of suicide – Major losses. – Extreme thinking and teaching e.g. terrorists -Lack of access to mental health for treatment - Following belief systems that accept suicide as a solution to personal problems 42

43. b) Management of suicidal behaviour: Management of suicidal behaviour: aims aims: To stop person from committing suicide Find the cause Find the cause. Actual management o Admit on an open ward , safe ground and free from hangings and electric wires. o Establish a rapport to explore patient‘s findings and confidence o Further physical and proper assessment for suicidal ideas and the cause. o Carry out vital and specific observations Chemotherapy Psychotherapy Occupational therapy Family therapy Advice on discharge Advice on discharge. o Take treatment as prescribed. Encourage and involve family support at home. o Patient should find something to do at home. Avoid factors that may cause relapse. o Come back for review to mental clinics in time. o Join social support groups at home. 43

44. c) c) Predisposing causes of mental illness Predisposing causes of mental illness These are factors that put an individual at risk of developing mental illness  Genetics/ hereditary  Physiological change  Age  Biochemical factors  Chronic illnesses  Personality. 15. 15. a) a) Define panic attacks b) Outline the clinical features of panic attacks c) Describe the management of a patient with panic attacks 44

45. Solutions Solutions a) Panic attacks- this is an abrupt surge of intense fear or intense discomfort usually lasting for seconds or minutes but not going beyond to hours These conditions can be mistaken to be panic attacks Hyperthyroidism Cardio- pulmonary conditions Substance abuse Panic attacks furthermore can be triggered by psychiatric conditions e.g. depression Note : a person with worry of re occurrence of a certain situation is said to be having panic disorder b) Clinical features of panic attacks Clinical features of panic attacks Dyspnea/ shortness of breath-breathing becomes more shallow and restricted. A person takes a short breath Trembling and shaking- this is the most common symptom of panic and one of the clearest ways to tell that one is nervous Numbness throughout the body-this is caused by blood rushing to the most important parts of the body that can aid fight and flight. It can occur anywhere in the body but mostly common felt on the face, hands , arms , feet and legs Diarrhea, nausea and stomachache- Panic attacks 45

46. tend to trigger a more profound response in the gut so diarrhea can occur at any time Chest pain-it is a common concern because of the possible connection to the heart attacks and other heart conditions. It is more likely a form of chest pain caused by muscle contractions that may occur with anxiety hyperventilation- occurs when a person breathes from chest . Its excessive exhalation of carbon dioxide in relation to amount of oxygen in one‘s blood stream Heart palpitations-it is typically an expected sensation when the force and rate of the heart beat are considerably elevated Flashing vision- the patient finds difficult t see clearly, notices flashes or visual snow Heart attack-this is a result of dyspnea and chest pain . If not assessed, the patient may be treated for heart failure Depersonalization Derealisation Sweating chocking 46

47. c) Management of panic attack. Management of panic attack. Aims of management -to find out the cause and manage accordingly -to allay anxiety Real management o Patient is admitted in a quite environment , well ventilated and free from noise o Create a positive nurse- patient relationship o Take thorough history – Patients particulars – Past surgical, medical, obstetric history o Past mental state i.e. if the patient has ever suffer from any mental illness o Proper physical examination is done to rule out physical diseases o Inform the doctor or clinician o Investigations should be done to rule out the cause of the attacks Base line investigations e.g. blood slide for malaria – RCT for HIV – VDRL for syphilis o Specific investigations – Thyroid function test – Serum drug screening – 47

48. o psychological counseling, psychotherapy and social support. o Psycho education o Avoid alcohol and recreational drugs. The substance can cause or worsen anxiety. If. a patient can‘t quit on his own advise him to find a support group to help him o Quit smoking, drinking caffeinated beverages. Both nicotine can worsen anxiety o Make sleep apriority. Patient should make sure she is getting enough sleep to feel rested. If not sleeping well, he/she should visit a doctor o Eat well- healthy eating such as focusing on vegetables , fruits whole grains and fish may be linked to reduce anxiety o Social support- patient feels secure by isolating him from others and family members. Give patient company o Involve family members o CBT(cognitive behavior therapy) o Create a positive thinking on challenging situation Help to change un helpful cognitive distortions o Psychotherapy o Relaxation therapy o Breathing exercise o Exercises o Meditation 48

49. Chemotherapy o Benzodiazepines- should be prescribed for few weeks Beta adrenergic antagonists o Tricyclic antidepressants o Anti-anxiety medications e.g. buspirone may be prescribed Note these medications are for short term relief of panic attack symptoms and are not intended to be used for long term Advice on discharge The patient should be educated on how to be on Rx and to come for follow up Before d/c the nurse should organize to visit the pts community, it will help the nurse to know the factors that will trigger the pts condition and hence manage accordingly 16. 16. a) State 10 clinical signs of dementia b) b) State the signs and symptoms of post natal depression Solutions Solutions a) Clinical signs of dementia: a) Clinical signs of dementia: The disorders may be diagnosed by the presence of the 49

50. following; Impairment of memory that results in non- aggressive behaviour like pacing,restlessness and wondering. Disorientation.may get lost in the place of work, walk out of home and fail to trace his/her home until brought by a friend. There is lack of sleep and restlessness at night and may pre-dispose a patient to injury. Language impairment which shows up verbally, aggressive behaviour like demand, complaining and negative behaviour. Agrosia.Inability to recognize familiar objects including family members despite infact sensory functions. Aphasia. Difficult in speech i.e loss of ability to understand and express speech. Apraxia. Apraxia. Difficult in carrying out motor activities the intact motor function. Abstract thinking. Difficult in carrying out complex intellectual function like planning, sequencing, organizing, implementing, abstract thinking and evaluation. Personality change like irritability less concerned with daily activities and self-care, negative behavior. Depression and anxiety Physical aggression and violence that results in aggressive psychomotor behavior Lack of judgment and poor impulse control 50