1. A pregnant woman, HIV positive is normally counseled on the following issue: (5 Marks)

Answers:

i. Healthy life style practices

ii. Infant feeding options

iii. Shared confidentiality

iv. Prevention of further spread of HIV

v. Importance of bringing her partner for counseling and testing

 

2. List down six (6)  roles of family in supporting  HIV positive patient    (6 Marks)

Answers:

i. Family could provide simple care fort patient at home

ii. The family  should learn about  existing services in the community which can be utilized by the patient

iii. The family should try and involve the patient in all maters relating to family and those relating to their health.

iv. Family should accept to live with the HIV patient which help the patient to socialize.

v. Support the patient to prepare for death and encourage the patient to write a will.

vi. Assist the patient to meet their  spiritual needs

vii. The family has to take preventive measures to prevent HIV infection transmission and or re-infection.  

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3. For a Will to be valid there are basic requirements. Explain them        (6 Marks)

 

Answers:

i. It must be in writing and signed by the testator.

ii. It must be in a permanent ink or preferably typed

iii. The date of writing the will must be clear

iv. The signature must be witnessed by two or more persons present at the same time

v. Each witness should attest and sign the will

vi. The number will increase to four if the testator does not know how to read and write. And the testator should affix their right hand thumb print on the will.

 

 

 

4. List down FIVE  myths/misconceptions  of our community towards HIV:        (5 Marks)

Answers:

i. HIV is a punishment from   God

ii. HIV is a curse from the parents

iii. HIV is made by Europeans

iv. It is a be witched and not acquired  diseases

v. It is a wishful disease

 

5. Explain five factors that should be considered when choosing infant feeding options for  HIV positive mother :       (5 Marks)

Answers:

i. Nutritional requirements

ii. Psychological motivation

iii. Risk of bacterial infection

iv. Cost

v. Method of contraception

vi. Social-cultural  factors  

 

6. During conduction of HIV testing; mixing of blood sample can be avoided by: (3 Marks)

Answers  

i. Labeling the blood sample

ii. Give client code number

iii. Before providing the results, ask the client to produce his or her code number  

 

7. The following are the five reasons for sexual partners to attend VCT (5 Marks)

Answers:

i. They intend to get married

ii. One or both members are sick

iii. They intend to have  children

iv. They are having conflicts in the home around being honest about sexual practices and safe sex.

v. The couple has a sick child; or the child dies of AIDS related complex.

vi. They have been referred (1 mark each point, any five (5) points)

 

 

 

 

 

 

 

8. Mention five (5) skills that may be used to communicate  with children :      (5 Marks)

Answers:

i. Show interest to the child: - first talking  to the child then to the care taker

ii. Asking questions appropriate (especially open ended questions)

iii. Answering all of the child’s  questions, as well as the care taker’s

iv. Observing  and interpreting non-verbal communication

v. Giving age

- Appropriate information

- Clearly

- Accurately

- Simply

vi. Helping children express themselves

-Relieves psychosocial stress

- Help hem vent feelings, emotions and anxieties

vii. Listening skills

- Pay attention and keep eye contact

- Show interest in what the child is telling you

- Use encouraging gestures and words

viii. Try to avoid physical barriers like table between you and the child

ix. Be empathetic, patient, and accepting

x. Set timing clearly

xi. Introduce yourself before starting first session  

 

 

SECTION E: GUIDED ESSAY          30 MARKS

INSTRUCTIONS

· This section consists of two (2) questions which are supposed to be answered in a narrative way

· Write your answer on a separate sheet of paper provided; each question should start on a new page DIRTY WORK IS NOT ALLOWED.

· Write your examination number on each answer sheet you are using.

 

1. 30 year old long-distance truck driver is admitted to the hospital due high grade fever and chest pain for 2 weeks. Prior to admission; he has been treated several times for productive cough and evening fevers but gets relief for a short time. As counselor, you have been informed by a ward attendant that the patient is not ready for HIV test. Write an essay on this case explaining: The possible reasons for refusing HIV test, principles of counseling and testing you are going to use to convince him to accept a test, and then how you are going to conduct pre-test counseling. (15 Marks)

ANSWERS:

Possible reasons for refusing HIV test, (at least 4 points): (2 Marks)

· Fear of the disease

· Fear of the outcome of the disease

· Social stigma

· Marital disharmony

· Fear of losing a job

· Fear of taking lifelong ART and their side effects

Principles guiding PITC, (1 mark for each elaborated point): (3 Marks)

· Counseling

· Informed consent

· Confidentiality

Pre-test counseling a counselor or health care provider should discuss the following  (10 Marks).

· A counselor have to build relationship, building a  rapport to a client

· Through greetings, introducing his or her name and professional

· Assessing client’s knowledge about HIV, TB, STIs, ARVs    

· Assessing Risk/Risk reduction plan    

o Clients risk behavior, like multiple partners

o Condom uses

· Assessing knowledge of HIV test, possible outcomes of the test and possible interventions.

· Example, what results client is expecting.  If he will be HIV position, what his further plan   

· Discuss about two types of HIV results HIV positive, HIV negative and its meaning.

o HIV positive means your  blood has HIV & virus

o HIV Negative, your blood doesn’t have HIV virus

· Discuss about window period           

· Getting  informed consent for conducting HIV test    

 

2. Kabwekere is a 35 year old married man who has been taking ART for four years now.  He feels great and has had no illness in a long time and wants to give up the medication.  He is tired of taking pills every day and is convinced he no longer needs them.  Lately his lack of Motivation has caused him to miss a few doses. Describe how you are going to counsel Anorld for ART adherence. (15 Marks)

Answers:

Assess (3 Marks)

A review the medications with the patient and their treatment supports if patient has already stopped the medication a is just thinking of stopping.

Advice:  (2 Marks)

· Determine whether there is an adherence problem  

· Ask about stigma related to taking the Pills  

Agree:  (3 Marks)

· Agree an any changes an treatment plan

· Discuss agreements you have reached and check for  commitment

Assist:  (3 Marks)

· Recruitment the information given before

· Give additional information that may help adherence problem.

· Reinforce intervation which match the patient needs and adherence problem

Arrange: (4 Marks)

· Record adherence estimate on patients card

· Arrange for refill

· Arrange for next follow up visit

· Make sure that patient & supporter understood follow-up