Examination number…………………………………..........

NACTE Registration number………………………

DECCA COLLEGE OF HEALTH AND ALLIED SCIENCES (DECOHAS)

BASIC TECHNICIAN CERTIFICATE IN CLINICAL MEDICINE

(NTA LEVEL 4)
SEMESTER I
CONTINUOUS ASSESSMENT TEST ONE
MODULE CODE: CMT 04214
MODULE NAME: CLINICAL SKILLS

TIME: 2:00 HOURS DATE: ………………

GENERAL INSTRUCTIONS:
1. Read the questions carefully
2. Write your examination number and NACTE registration number on each page of the
answer sheets.
3. Cellular phones and unauthorized materials are NOT allowed in the examination room.
4. This paper consists of five (5) sections with a total of sixteen (16) questions.
5. Attempt ALL questions.
6. The responses should be written in the spaces provided as instructed on each section.
7. Each essay question to be answered on NOT more than two (2) hand written pages.
8. No additional answer sheet will be provided.
9. Failure to follow instructions will lead to loss of marks.

FOR OFFICIAL USE ONLY

SECTION TYPE OF QUESTIONS ALLOCATED SCORED INITIAL INITIAL
MARKS MARKS SIGNATURE SIGNATURE
OF MARKER OF VERIFIER
A MULTIPLE CHOICE 10

B MULTIPLE TRUE/FALSE 10

C MATCHING 10

D SHORT ANSWER 40

E GUIDED ESSAY 30

TOTAL 100

SECTION A: MULTIPLE CHOICE QUESTIONS 10 MARKS

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 1
Examination number………………………………….......... NACTE Registration number………………………

Instructions:
 This section consists of Ten (10) items.
 One (1) mark will be awarded for each correct answer.
 Responses with SMALL letter will NOT be awarded any mark.

1. Answer item one (i) to ten (x) by choosing the letter of the most correct answer and write it in
the box provided using CAPITAL letter
i. Which of the following need to be avoided by the health care provider when interacting with
a client?
A. Empathy
B. Sympathy
C. Eye contact
D. Opening posture
E. Non verbal
ii. One of the following should be done when initiating a good rapport in order to attend a sick
female child who is one month old:
A. Greeting the child
B. Providing toys to the child
C. Shaking hands with a child
D. Self introduction to the informant
E. Involving the child into conversation
iii. Which of the following is specific component of obstetric history?
A. Painful coitus
B. Contraceptive use
C. Date of first menses
D. Regularity of menses
E. Date of booking at antenatal clinic
iv. Regarding “Empathy” as the characteristic of therapeutic relationship:
A. The clinician need to ask the patient to talk openly
B. The clinician need to be able to enter into the client private world
C. The client need to ask for help from the clinician and give appreciation
D. The clinician need to feel what the client is feeling and show emotional reaction
E. The clinician needs to make decisions on behalf of the patient during the whole process
of history taking
v. One of the following techniques is used when taking history to a patient with multiple
symptoms:
A. Assessment of the mental status
B. Spend much time for a detailed history
C. Interview the patient and the informant
D. Listen closely to the whole conversation
E. Validating the symptoms without agreeing to their reasons
vi. Informed consent basically follows which of the following principle?
A. Non discrimination
B. Beneficence
CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 2
Examination number………………………………….......... NACTE Registration number………………………

C. Maleficence
D. Autonomy
E. Fidelity
vii. Which of the following best describes dehydration status in pediatric?
A. Sunken fontanels
B. Dry skin
C. Cyanosis
D. Hematuria
E. Paleness
viii. During pediatric history taking, asking about when the child started speaking, holding
a cup of milk and sitting, belong to which part of history?
A. Social
B. Natal
C. Dietary
D. Post natal history
E. Development milestone
ix. Regarding taking past medical history to a 15 year old male patient:
A. childhood illness are not asked
B. Immunizations history is not part of it
C. History of blood transfusion and surgery is asked
D. Normally we ask the history of chronic illness in the family
E. It gives the detailed information of what the patient is suffering
x. When reviewing other systems during history taking:
A. The affected system is reviewed first
B. Review all systems including the affected system
C. Ask questions in series starting from the affected system
D. System mentioned in the main complaint is reviewed first
E. Review systems which are not included in history of the presenting illness

SECTION B: MULTIPLE TRUE/FALSE QUESTIONS 10 MARKS

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 3
Examination number………………………………….......... NACTE Registration number………………………

Instructions:
 This section consists of Four (4) questions with five (5) options each
 Write the word “TRUE’’ for a correct statement and the word “FALSE’’ for incorrect
statement in the space provided after each option.
 All responses should be in CAPITAL letters.
 Half (½) a mark will be awarded for each correct response.
 Responses with letters ‘T’ and ‘F’ will not be awarded any mark.
 There will be a penalty of half (½) of allocated marks for responses with small letters.

2. Regarding history taking in obstetrics and gynecology:

i. Natal history follows after antenatal history TRUE

ii. History of gravidity and parity is of no use FALSE
iii. Menarche history is asked in gynecological history TRUE
iv. Use of contraceptives is asked in the past obstetrics history FALSE
v. The details of LNMP, EDD and GA comes immediately after TRUE
demographic data

3. The following techniques are used when attending a confused patient:

i. Encouraging the patient to continue talking FALSE

ii. Speaking loud FALSE
iii. Do not spend so much time to get detailed history, you will make TRUE
the patient and yourself tired and frustrated
iv. Shift to the mental status examination focusing on the level of TRUE
consciousness, orientation, memory, and capacity to understand
v. Consider delirium in acutely ill or intoxicated patients and TRUE
dementia in elderly patients

4. Important practices to observe when recording the main complaints of the patient includes:

i. Arranging complaints in order of severity FALSE

ii. Most recent complaint should be recorded first FALSE
iii. Duration of each complaints should be indicated TRUE
iv. Life threatening complaints should be recorded first FALSE
v. Complaints of the nervous system should always come first FALSE

5. The following techniques are used when obtaining a history to patient with impaired hearing:

i. Being patient TRUE

ii. Speaking loud FALSE
iii. Maintaining eye contact TRUE
iv. Exaggerating facial movements FALSE
v. Writing things whenever necessary TRUE

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 4
Examination number………………………………….......... NACTE Registration number………………………

SECTION C: MATCHING ITEM QUESTIONS 10 MARKS

Instructions:
 This section consists of One (1) question with Two (2) parts of matching each having five (5)
options each.
 Match the items from column B with those in column A by writing the letter of correct response
in the table provided after each question. USE CAPITAL LETTERS.
 Each correct response is awarded one (1) mark.
 Each item from column B is used only once.

6. (A) Match the terminology in history taking from column A with their appropriate descriptions
in Column B.
COLUMN A (Terms) COLUMN B (descriptions)
i. Parity A. Number of weeks from last normal menstruation
ii. Gravidity B. Five or more deliveries
iii. Gestational age C. Last day of the last normal menstruation
iv. Grand multiparity D. Number of deliveries regardless of the gestational age
v. Last normal menstrual period E. Number of live births or stillbirths after 28 weeks
F. Number of pregnancy regardless of outcome
G. Number of weeks from conception
H. First day of the last normal menstruation

COLUMN A i. ii. iii. iv. v.

COLUMN B E F A B H
6. (B) Match the skills used to handle patient from column B with their corresponding type of
patient in Column A.
COLUMN A (type of COLUMN B (skills to handle patient)
patient)
i. Patient becoming silent A. Use a loud voice
ii. Confusing patient B. Have a translator
iii. Talkative patient C. Appear attentive and give brief encouragement
iv. Crying patient D. Assessment of mental status
v. Patient with altered capacity E. Validate their feelings without agreeing their reason
F. Make supportive remarks like “I am glad you were able
to express your feelings
G. Give the patient free reign for the first five to ten
minutes and listen closely to the conversation
H. Consider two interviews one with patient and other with
the patient and relative.

COLUMN A i. ii. iii. iv. v.

COLUMN B C D G F H
SECTION D: SHORT ANSWER QUESTIONS 40 MARKS

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 5
Examination number………………………………….......... NACTE Registration number………………………

Instructions:
 This section consists of Eight (8) questions.
 Write your answers in the space provided on each question.
 Write a readable handwrite: DIRTY WORK IS NOT ALLOWED.
7. Outline six (6) situations that man appear challenging or even troublesome to the clinician during
history taking. (6 Marks)
 Patient becoming silent
 Confusing patient
 Talkative patient
 Patient with altered capacity
 Crying patient
 Angry or disruptive patient
 Interview across language barrier
 Patient with low literacy
 Patient with impaired hearing
 Patient with impaired vision
 Patient with limited intelligence
 Patient with personal problems
8. A 34 year old patient presents at the hospital with complaints of pain. Mention five (5) important
attributes when amplifying the complaints of this patient. (5 Marks)
i. Duration
ii. Mode of onset
iii. Site
iv. Character
v. Site
vi. Severity
vii. Associating factors
viii. Radiation
ix. Aggravating/exarbating factors
x. Relieving/alleviating/remitting factors
9. Mention five (5) components of patient’s history. (5 Marks)
i. Demographic data/Identification of the patient
ii. Chief Complaint
iii. History of presenting illness Amplification
CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 6
Examination number………………………………….......... NACTE Registration number………………………

iv. Review of other systems

v. Past medical history
vi. Personal History
vii. Family history
10. Outline six (6) skills which may be used to handle patients with altered capacity. (6 Marks)
i.Determine if the patient has the decision making capacity or the ability to understand
information related to health to make preferences about treatment
ii. Determine if the patient has the decision making capacity or the ability to understand
information related to health to make preferences about treatment
iii. Determine if the patient has the decision making capacity or the ability to understand
information related to health to make preferences about treatment
iv. Determine if the patient has the decision making capacity or the ability to understand
information related to health to make preferences about treatment
v. Determine if the patient has the decision making capacity or the ability to understand
information related to health to make preferences about treatment
vi. Determine if the patient has the decision making capacity or the ability to understand
information related to health to make preferences about treatment
11. Mention five (5) common complaints of pregnant women in first trimester; (5 Marks)
i. Lower abdominal pain
ii. Vaginal discharge
iii. Vomiting
iv. Breast pain
v. Nausea
12. Outline four (4) characteristics of arterial pulse which should be evaluated during physical
examination. (4 Marks)
i. Rate
ii. Rhythm
iii. Volume (character)
iv. Symmetry
13. What parts of history are specific to paediatric clients? Mention five (5). (5 Marks)
i. Prenatal history
ii. Natal history
iii. Postnatal history
iv. Immunization history
v. Developmental milestones
14. To reach a common understanding of the problem you need to explore the patient’s perspective
in atleast four (4) domains, list them down. (4 Marks)
CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 7
Examination number………………………………….......... NACTE Registration number………………………

xi. Patient’s feelings (fears and concerns)

xii. Ideas about the nature and cause of the problem
xiii. Effect of problem on patients function
xiv. Expectations of the disease and clinician

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 8
Examination number………………………………….......... NACTE Registration number………………………

SECTION E: GUIDED ESSAY QUESTIONS 30 MARKS

Instructions:
 This section consists of Two (2) questions which are supposed to be answered in a narrative way
 Bulleting and numbering is NOT ALLOWED.
 Write your answers on the Answer sheets provided.
 Each question should start on a new page.

15. Describe seven (7) characteristics of therapeutic relation. (15 Marks)

Answer
Definition
Therapeutic relation or making alliance refers to the relationship between a health pretension
and a patient. (1 Mark)

Main body (describe 7 points correctly @ 2 marks)

 Report
 Trust
 Genuiness
 Unconditional positive regard
 Empathy
 Collaboration
 humor

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 9
Examination number………………………………….......... NACTE Registration number………………………

16. Explain seven (7) situations that may appear challenging or even troublesome to the clinician
during history taking. (15 Marks)
Answers
Definition
Is the art/systematic process of obtaining patient’s information for medical use. (1 mark)
Challenging situations @ 2 marks (14 marks)
 Patient becoming silent
 Confusing patient
 Talkative patient
 Patient with altered capacity
 Crying patient
 Angry or disruptive patient
 Interview across language barrier
 Patient with low literacy
 Patient with impaired hearing
 Patient with impaired vision
 Patient with limited intelligence
 Patient with personal problems

BEST WISHES

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 10
 Examination number………………………………….......... NACTE Registration number………………………
Question SECTION E Do not write
to this
number margin

Do not write
Question SECTION E to this
number margin

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 11
 Examination number………………………………….......... NACTE Registration number………………………

SECTION E Do not write

Question to this
number margin

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 12
 Examination number………………………………….......... NACTE Registration number………………………

SECTION E Do not write

Question to this
number margin

CMT ………: Theory Question Paper for Continuous Assessment Test ………., DECOHAS, …….. 2020 Page 13