1. Read the passage below and answer the questions that follow:

Malnutrition is caused by on interplay of a wide variety of medical and social factors which are interrelated and form a vicious cycle. Etiology may be broadly divided into two groups: Dietary deficiency and diseases leading to poor appetite, weight loss and malabsorption.

Poverty/food scarcity: Poor socioeconomic status of the family contributes a lot to development of malnutrition in resource poor countries. Low income is not sufficient to meet the dietary requirements and purchase of nutritious food for the children. .....Natural calamities like drought, floods etc often bring food scarcity for poor families.

Large families/Closely-spaced families/Unequal distribution of food in the family: Nutritional status is adversely affected by the large size of the family. Malnutrition is much higher among children of birth order fourth and higher. There is evidence that when pregnancies occur rapidly, incidence of malnutrition is higher

Low birth weight/Maternal malnutrition Although several factors are responsible for the development of intrauterine growth retardation and subsequent low birth weight deliveries, maternal malnutrition plays an important role in its causation. These babies are prone to infections which further compromises their nutritional status.

Infections: Infections and disorders such as diarrhea, malaria or measles are important contributory factors in development of malnutrition, indirectly or directly..... Intestinal parasitic infestations may either deprive the host of nutrients or lead to malnutrition by reducing appetite, causing diarrhea or by producing absorptive defect.

Inappropriate Feeding practices Inappropriate feeding practices are most important risk factor for developing malnutrition. The typical diet in population with a high prevalence of malnutrition consists predominantly of a starch rich staple, such as a cereal like maize, rice and wheat or tuber like cassava, with limited amount of fruits and vegetables and legumes or no animal source food.

Give a title to the above paragraph. Give reasons for it.

List the five main causes of malnutrition in children.

Which of the following statements is correct

Starch-rich food is good for nutrition.

Limited amounts of fruits is a cause of malnutrition.

Parasitic infections do not lead to malnutrition.

Etiology for malnutrition may be divided into groups. What are those groups?

Fill in the blanks with the right form of the verbs given in brackets.

When I woke up, the sun already (rise).

Fortune the brave (favour).

Necessity the mother of invention

He right through all the 1 noise (sleep).

He going to join work tomorrow

Make sentences for the following answers.

Yes, I am the new doctor.

No, I do not mind answering your questions.

I have already prepared the case-file.

I am asking you because I think nobody else knows the answer.

There are several causes for malnutrition in children.

I am willing to donate my eyes after death.

Fill in the blanks with articles and determiners (much/some)

Check his temperature on hourly basis.

Feed him orange or apple daily.

He was offered appreciation for his help of the poor and needy.

people never learn from experience.

Fill in the blanks with the correct prepositions.

Come to my office ten clock in the morning.

There is no information my book about this topic.

Do not lean the table as it is unstable.

Even as I ran, the murderer ran me to shoot me.

3. You are the head of your institution and need to issue a letter to all department heads stressing the need for punctuality and discipline. Write a formal but polite letter, giving reasons.

4. Write a summary of the given passage in about one-third of the words of the original passage. Give a title to the passage. Physical examination for features of malnutrition helps in identifying malnourished children. Examination should focus to identify wasting, bilateral edema and changes in skin (dermatosis), eye (Vitamin A deficiency signs), hair (sparse, lusterless, depigmented) and mouth (glossitis, angular stomatitis).

Look for wasting -To look for wasting, remove the child's clothes.

Look at the front view of the child and find out

• Is the outline of the child's ribs easily seen?

• Does the skin of the upper arms look loose?

• Does the skin of the thighs look loose?

Look at the back view of the child and decide

• Are the ribs and shoulder bones easily seen?

• Is flesh missing from the buttocks?

When wasting in extreme, there are folds of skin on the buttocks and thighs. It looks as if the child is wearing "baggy pants". Because a wasted child has lost fat and muscle, this child will weigh less than other children of the same height and will have a low weight-far-height.

Look for oedema: Oedema is swelling from excess fluid in the tissues. Oedema is usually seen in the feet and lower legs and arms. In severe cases it may also be seen in the upper limbs and face. To check for oedema, the foot should be grasped so that it rests in hand with thumb on top of the foot. Thumb should be pressed gently for a few seconds (approx 10 seconds). The child has oedema if a pit (dent) remains in the foot when thumb is lifted.

5. Write a conversation between you as a nurse and a patient who does not understand, the importance of taking her medicine regularly despite repeatedly being told why.

6. Make notes after reading the following passage. You can make notes in any of the ways that you have learnt in the unit.

Skills Required for Nursing

Nurses are an important part of the health care system. Hospitals all over the world depend on nurses. Working in the health care system requires many skills and requirements that nurses need in their career. Such skills are responsibility, time management, organization, communication, commitment and determination. Requirements include a caring nature, patience, quick decision making, maths skills and compassion. Current trends in today's society allow Nurses to care for patients in a community setting. Here we will discuss the skill required to succeed in Nursing and also the trends and requirements needed to work in the Health Care system.

Firstly responsibility plays an important role in the field of Nursing. It is a tremendous amount of responsibility to care for an ill patient. Close observations of the patient are crucial. Also ensuring that there are no mistakes or problems occurring, which could be caused from lack of responsibility. Time management is important as well. You will have a number of patients to look after on your shift. You need to make sure you prioritize your work load so you use your time efficiently. Obviously depending on your shifts, whether they were days or nights you would alter your time management accordingly. The Day shift would have more staff, doctors and even the public coming in to visit your patient. The Night shift would see fewer doctors and public visitors. Communication is a very important skill that is required from a nurse. There are so many people who you need to communicate with, such as the patient, the patient's doctor, the patient's family and friends, other staff in the hospital and many more. Nurses must have the ability to communicate soundly and confidently.