Literacy and Numeracy Entrance Test for Certificate IV in Nursing (Enrolled Nurse) APPLICANT S NAME: DATE INSTRUCTIONS TO APPLICANTS You have ten (10) minutes reading time. Do not pick up your pens during this time. STEPS INSTRUCTIONS SUGGESTED TIME 1 (Refers to Part A) 2 (Refers to Part B) 3 (Refers to Part C) Answer questions 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 from the article Diabetes. In your own words, write a summary of the article on Diabetes using full sentences, NOT dot points. Complete the numeracy section without using a calculator. All working must be shown. 20 MINUTES 20 MINUTES 20 MINUTES TIME LIMIT: 60 MINUTES Marks: PART A PART B PART C TOTAL TAFE NSW Community Services, Health, Tourism & Recreation Curriculum Centre 1
Diabetes Diabetes, or diabetes mellitus to use its correct name, has been known since ancient times. The words actually mean passing through and honey sweet. Today diabetes - the prevalence of which is increasing at an alarming rate - is one of the major health challenges facing Australia and the world. Diabetes is a disease that now affects approximately one million Australians, its incidence having doubled in the last ten years. This number is predicted to increase to 1.7 million by 2010. There are two main types of diabetes: Type 1, or Insulin Dependent Diabetes Mellitus, (IDDM), and Type 2 or Non Insulin Dependent Diabetes Mellitus (NIDDM). Type 1, which is referred to as an auto-immune disorder due to the fact that the body makes antigens and antibodies which react with the cells preventing the production of insulin. This type is also often called juvenile diabetes as its onset usually occurs prior to the age of 25. 80-90% of those with diabetes, however, have Type 2. Typically, Type 2 occurs later in life, usually after the age of 40. Today, however, doctors are starting to see children as young as ten years of age with Type 2 diabetes. Scientists believe this form of diabetes is preventable. Many people believe that diabetes is caused by eating too much sugar. This is a fallacy. Diabetes mellitus is a disorder resulting from the inefficient metabolising of sugar. The body needs glucose, a natural sugar, in order to function normally. Glucose is released in the body when carbohydrates are broken down in the intestine. The glucose enters the blood stream triggering the release of the hormone insulin from the pancreas. Insulin allows the glucose to enter the cells where it is used for energy. When there is no insulin present, or an insufficient amount, the glucose remains in the blood and cannot be used. The result is high blood glucose levels, tiredness and the passing of a lot of glucose in the urine. The glucose extracts water from the cells resulting in the need to pass urine and an increased thirst. When glucose does not enter the cells the body compensates by breaking down fat stores in the body, and later on protein tissue such as muscle, in order to produce glucose. This contributes to weight loss. The new glucose cannot be used because there is no insulin and so it remains in the blood causing a greater problem. People who have been diagnosed with Type 1 diabetes need daily injections of insulin as the pancreas gland no longer provides the insulin needed. In Type 2 diabetes, either the body does not produce sufficient insulin to allow glucose into the cells or the cells become resistant to insulin. It is not known why this happens. However, research has shown that excess weight and fatty tissue are important factors and most people diagnosed with Type 2 diabetes are overweight. People with Type 2 diabetes need oral tablets to help control the glucose level and may also later on need insulin. Type 2 diabetes is on the increase worldwide. Researchers believe this is primarily due to an increase in excess body weight and an increasingly inactive lifestyle. Increasing a person s activity level is an important step in controlling and preventing Type 2 diabetes as it has been shown that physical activity is effective in lowering blood glucose levels. Activity increases the body s need for glucose which in turn increases the cells sensitivity to insulin leading to a more efficient use of this hormone. Increased activity can TAFE NSW Community Services, Health, Tourism & Recreation Curriculum Centre 2
also assist in weight control and cardiovascular strength. Diet is the other important factor in controlling and preventing NIDDM. A diet which is low in saturated fat and sugar but high in fibre, with plenty of fresh fruit and vegetables is the best diet for not only diabetics but all Australians. A diet such as this will prevent the build up of fat around the cells which can inhibit the absorption of glucose. It has also been found that carbohydrate foods that have a low glycaemic index are best for people suffering from diabetes. These carbohydrate foods break down slowly, thus releasing glucose slowly into the bloodstream. Carbohydrates which fall into this category include low fat milk, yoghurt, oats, barley, vegetables such as sweet corn and sweet potato and fruits such as apples and oranges. The risk factors for Type 2 diabetes include having a family history of diabetes, increasing age, being overweight or obese, living a sedentary lifestyle and having high blood pressure. The first symptoms of diabetes for many people include passing excessive amounts of urine, tiredness, increased thirst and weight loss. However, for others, the first sign is cardiovascular disease. The primary indicator in the diagnosis of diabetes is hyperglycaemia elevated circulating blood sugar. Both types of diabetes are serious as high blood glucose levels can damage every organ in the body. Diabetes leads to many health complications such as eye disease, heart disease, kidney disease, nerve damage and leg ulcers. These complications occur when the blood glucose level is kept above the normal level for too long. People with diabetes may also suffer from low blood glucose levels resulting in dizziness and loss of consciousness. References A fresh and healthy approach to diabetes. Heartwise Journal Vol.22 (1); http://www.woolworths.com.au/dietinfo /diabetes/content/diabetes_info.asp Beim, M. (1994). Nutritional support for diabetes. In Inside Good Health. Ed. J. O Brien; Inside good Health; Wahroonga, NSW MayoClinic.com - Diabetes http://www.mayoclinic.com/invoke.cfm?id=ds00329 TAFE NSW Community Services, Health, Tourism & Recreation Curriculum Centre 3
Diabetes Part A Comprehension questions. Possible marks: 30 1. Circle the best answer. The author s main purpose in writing this article is to: (2 marks) a) explain how diet can control diabetes b) provide an overview of diabetes c) explain how we can avoid diabetes by exercising d) discuss different treatments for diabetes. 2. Are these statements true or false? Circle (T) if true or (F) if false (1 mark each) a. Insulin is produced in the intestines... (T) (F) b. Type 1 diabetes is called juvenile diabetes.. (T) (F) c. Glucose is a natural sugar... (T) (F) d. Diabetes is caused by eating too much sugar.. (T) (F) e. Insulin allows glucose to enter the bloodstream... (T) (F) f. If there is not enough insulin production glucose cannot be used by the body.. (T) (F) g. If there is not enough insulin production body glucose levels decrease. (T) (F) h. If the body cannot get enough glucose from carbohydrates it will attempt to get it from the body s fat and muscle. (T) (F) i. Diabetes can lead to weight loss..(t) (F) j. Low glycaemic index foods are best for diabetics because they release glucose slowly into the bloodstream... (T) (F) 3. How does Type 1 diabetes differ from Type 2? (State 2 differences) (3 marks) TAFE NSW Community Services, Health, Tourism & Recreation Curriculum Centre 4
4. Name 4 low glycaemic index carbohydrates stated in the article. (1 mark) 5. How many Australians were diagnosed with diabetes ten years ago? (2 marks) 6. When diagnosing a patient s medical problem, what is the main indicator of diabetes? (2 marks) 7. What are the risk factors for diabetes? (2 marks) 8. State four early symptoms of diabetes. (2 marks) 9. Why is it important for diabetics to lose their excess body weight? (2 marks) 10. Based on what you have learned about diabetes, what do you think are some of the everyday health and lifestyle practices that could be contributing to an increase in diabetes? (2 marks) TAFE NSW Community Services, Health, Tourism & Recreation Curriculum Centre 5
Diabetes Part B Writing task: Summary Possible marks: 30 Summarise the article Diabetes on the following pages. Do NOT write beyond the lines provided. Keep to general points and to main ideas. Use one or two examples if you think it will help get across your meaning. This summary must be written in your own words, using full sentences, NOT dot points. Marks will be deducted for copying whole sentences from the article. The following areas should be included in your summary (not necessarily in this order): 1. what diabetes is 2. incidence of the disease 3. symptoms 4. effects 5. risk factors 6. ways to control / prevent the disease. In general, you should write 2 or 3 sentences only on each area. (a possible total of 2 marks for each point will be awarded) Marks will also be awarded for: 1. correct spelling 2. punctuation 3. grammar and sentence formation 4. vocabulary 5. the logical organisation of ideas 6. legibility of handwriting... Content For Examiners Use only Summary Point 1 2 3 4 5 6 Sub-Total /12 Mark Language Features Feature 1 2 3 4 Mark Sub-Total /18 TOTAL / 30 TAFE NSW Community Services, Health, Tourism & Recreation Curriculum Centre 6
Summary Possible marks: 30 TAFE NSW Community Services, Health, Tourism & Recreation Curriculum Centre 7