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The correct answer is C. III and IV. Explanation: Workplace impairment, particularly substance misuse or drug diversion in a healthcare setting, may be indicated by changes in work practices, poor documentation, and unusual interest in controlled medications. III (Does not sign the nurses’ notes and medication chart): Incomplete or neglected documentation can be a warning sign of impairment and poor professional practice. IV (Offers to administer opioids for the nurses’ clients): Unusual eagerness to administer controlled drugs such as opioids may raise concerns about possible substance misuse or drug diversion. Why the other options are incorrect: I (Interacts well with patients and staff): Positive interaction with patients and colleagues does not indicate impairment. II (Absent from work on most days): Although absenteeism can sometimes be associated with impairment, it is nonspecific and does not by itself indicate workplace impairment.

GENERAL PAPER You noticed that a colleague’s behaviour has changed during the past month. Which behaviour could indicate signs of impairment? I. Interacts well with patients and staff II. Absent from work on most days III. Does not sign the nurses’ notes and medication chart IV. Offers to administer opioids for the nurses’ clients A. I and II B. I, III and IV C. III and IV

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🚨 MoH MOP-UP RECRUITMENT FOR NURSES The Ministry of Health is reportedly set to conduct a nationwide mop-up recruitment exercise to replace applicants who failed to report to their assigned districts and facilities. 📅 Date: Monday, 5th October 2026 ⏰ Time: 11:00 AM GMT Nursing vacancies reportedly include: Teaching Hospitals – 266 CHAG – 133 GHS – 30 Total Nursing Slots – 429

𝗘𝗩𝗘𝗡 𝗪𝗛𝗘𝗡 𝗬𝗢𝗨 𝗖𝗔𝗡𝗡𝗢𝗧 𝗦𝗘𝗘 𝗪𝗛𝗔𝗧 𝗟𝗜𝗘𝗦 𝗔𝗛𝗘𝗔𝗗, 𝗧𝗥𝗨𝗦𝗧 𝗚𝗢𝗗’𝗦 𝗣𝗟𝗔𝗡. 𝗛𝗘 𝗞𝗡𝗢𝗪𝗦 𝗧𝗛𝗘 𝗣𝗔𝗧𝗛 𝗕𝗘𝗙𝗢𝗥𝗘 𝗬𝗢𝗨 𝗔𝗡𝗗 𝗛𝗔𝗦 𝗣𝗟𝗔𝗡𝗦 𝗙𝗜𝗟𝗟𝗘𝗗 𝗪𝗜𝗧𝗛 𝗛𝗢𝗣𝗘 𝗔𝗡𝗗 𝗣𝗨𝗥𝗣𝗢𝗦𝗘. 𝗚𝗢𝗢𝗗 𝗠𝗢𝗥𝗡𝗜𝗡𝗚 ☕❤️

The correct answer is A. Hysterectomy. Clinical Reasoning: A woman with a mechanical valve may be on long-term anticoagulation, which can worsen heavy menstrual bleeding. Since she has completed her family and has no fertility desire, hysterectomy provides a definitive treatment for the bleeding. • B. Endometrial ablation: Can reduce bleeding but is generally not preferred when a definitive treatment is appropriate. • C. Depo-Provera: May reduce menstrual bleeding but is a hormonal, non-definitive option.

OBSTETRICS AND PAEDIATRICS ANATOMY AND PHYSIOLOGY A woman with a mechanical heart valve presents with heavy menstrual bleeding and has no desire for future fertility. Which of the following is the BEST treatment option? A. Hysterectomy B. Endometrial ablation C. Depo-Provera

The correct answer is A. Chest radiograph. Clinical Reasoning The patient’s clinical presentation is highly suspicious for a spontaneous pneumothorax. • Clinical Clues: He is a young man presenting with acute chest pain, difficulty breathing, tachycardia (pulse rate of 110 bpm), and hypoxia (SpO₂ 90%). • Physical Examination Findings: The key finding is unilaterally diminished breath sounds on the right side without wheezes, crackles, or rhonchi. His history of asthma also increases the risk of pneumothorax. • Diagnostic Choice: A chest radiograph (chest X-ray) is the best initial investigation to confirm pneumothorax. It can demonstrate a visible pleural line with absence of lung markings beyond it. Why the Other Options are Incorrect • B. Echocardiogram: This is mainly used to assess cardiac structures, valve function, and conditions such as pericardial effusion. The patient’s unilateral respiratory findings point more strongly to a pulmonary cause. • C. Helical computed tomography: CT is more sensitive for detecting pneumothorax but is not the initial investigation of choice in this situation. It may be used when the chest X-ray is inconclusive or when another diagnosis requiring CT is suspected.