6KNIM011 Exam Paper – May 2022
A management plan for a clinical scenario and a 750-word commentary
will be required.
Students are required to orally present their management plan and
commentary to a panel of examiners (80%). The plan, commentary, and a
reference list (1 side A4 single line spaced, font 12) MUST be submitted
before the exam no later than the 3rd of May at 12:00 hrs, as it will be
used to inform your grade.
You will need to describe your team management plan for the shift –
remember to include task prioritisation, patient and team safety and risk
management (up to 250 words).
You will also need to justify your plan with reference to relevant module
content, for example: risk assessment and management, mental health
treatment planning, evidence-based practice, clinical decision making,
shared decision making, ethical and legal responsibilities, conflict
management, leadership theory, reflection, and facilitation (up to 750
Throughout the module you and your team have been working with a caseload
of 9 service users. For the exam you are required to focus on the nursing care
of the service users in one specific setting either inpatient or community.
Use EITHER scenario 1 or 2 to complete your exam task
(See next page for Scenario 1)
You are the nurse in charge of the late shift for Cherry ward with nine patients.
It is 1:15pm and you have received the handover below. Your afternoon staff
are: Lisa and Ahmed (permanent staff, healthcare support workers), Flore, an
Registered Nurse – Mental Health, Clara Registered Nurse – Mental Health (a
bank nurse, not known to the team) and Simi, year three nursing student.
David absconded when on section 17 of the Mental Health Act 1983
accompanied leave in the hospital grounds and is still missing.
The weekly ward round has overrun by one hour, meaning that Flore, the ward
round nurse who was allocated to do the lunchtime medication round has not
done this task. Two patients are waiting to have their 30-minutes section 17 of
the Mental Health Act 1983 escorted leave each. Today you are scheduled to
have clinical supervision with Lisa and Ahmed.
Carlos’ wife attended ward round today and wants to see Carlos’ care plans.
Amina is currently on 1:1 close observations due to a risk from other patients
because she is intrusive and tactile. Since the start of the shift, she has been
knocking on the office door requesting for help to apply to a Mental Health Act
tribunal “to get me out of here.” Amina is currently being detained under section
2 of the Mental Health Act 1983.
Erica is informal and just returned from the Emergency Department after
having stitches in her arm because she broke a mirror this morning and cut
both her forearms. She was due to be discharged home this afternoon, but
there is disagreement in the staff team regarding whether she should be
discharged. The junior ward doctor is advocating for a Mental Health Act
Fela is still in bed. He was restarted on clozapine yesterday. The handover
was that he told the morning nurse to ‘go away I feel like I have the flu.’
Jo is detained under section 2 of the Mental Health Act 1983, waiting for a
mother and baby unit bed. She is not leaving her room at the moment, saying
she is ‘frightened’ of the other patients.
Henrietta has told the doctor that she ‘does not want to be treated by a nursing
student or support worker.’ She is waiting for a specialist eating disorder bed.
Gabriel has seen an Independent Mental Health Advocate this morning, with
an interpreter. He wants to appeal against his detention on Section 3 of the
Mental Health Act 1983.
Billie is on day leave and will return at 7:00pm.
(See next page for Scenario 2)
You are a Duty CPN [Community Mental Health Nurse] for a twelve  hour
shift and a practice assessor for year one nursing student, Betty who is in her
final placement of part one. Today you have a staff team made up of three
nurses [Registered Nurse – Mental Health] and one nursing associate. Michael
[Social Worker] has cancelled his shift and is isolating due to testing positive
on his routine covid 19 testing schedule.
Your team employs a collaborative and flexible approach to meet the daily care
needs of your caseload, currently nine  service users and the handover
summary as below:
Amina was recently discharged back to her local Mental health Team after
being supported by the crisis team and CPA needs to be arranged.
David has been home for four weeks following discharge from hospital. He
missed last week’s appointment with the team. His partner Julian called the
community team yesterday to say he found some bottles of alcohol in David’s
wardrobe, and they have been arguing, with David expressing feelings of
hopelessness. Julian asked you not to tell David about the call, but expressed
worry that David is relapsing.
Carlos is in Blueberry care home. A visit is planned for today and his wife
reported yesterday that she thinks he is ‘overmedicated and like a zombie’.
Fela is due a fortnightly visit. Last time you attended, you raised a complaint
with his sheltered housing support manager about his untidy/unhygienic flat.
Fela is subject to a community treatment order, but wants to leave the
Erica left a voice message yesterday to say she had been cutting her arms.
You also had a voice message from the mental health crisis helpline saying
that she called and spoke to two operators last night, and they ‘safety planned’
with her rather than referring her to a crisis service.
Jo has been doing well and working towards discharge. There is a joint visit
with her Health Visitor scheduled in the diary for today’s shift.
Billie is in temporary accommodation for women. The accommodation
manager has left you a message regarding Billie having a lot of visitors and
receiving noise complaints from other residents.
Henrietta was visited last week, and staff reported discussing with her a
possible readmission due to her presentation at the time. She has not been
following the agreed treatment plan and appeared to be relapsing. She
reported being under a lot of pressure as her GCSEs are due next week. A
review is scheduled for this afternoon.
Gabriel is in temporary accommodation with his sister. The flat is in an area
known for gangs and
street crime and he has left an incoherent tearful voice message on the team
duty nurse’s phone.
(End of Exam paper)
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