DN150: One Hundred & Fifty Years of District Nursing

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district nursing 150

Questions from Queen’s Nurse examination papers 1914-1918


NB answers given reflect medical and nursing knowledge at the time and should not be relied upon to give first aid or other assistance to patients today.

March 19th, 1914

Q: If when visiting school children in their own homes you found a bad case of pediculi capitis, how would you proceed to deal with it?

A: “Try and get the consent of the mother to have the child’s head shaved, rub in paraffin all over the head, warn the mother to keep the child away from the fire or any light,…cover the child’s head up in a towel or capulin, tell the mother to take it off in the morning and immediately burn it.  Wash the child’s head well with soft soap and water, continue the treatment until the head is clean….”

June 18th 1914

Q: You are walking down the street on your morning round and you are suddenly called into a house where a child has been burnt: how would you act?

A: As quickly as possible cover up the burnt surface to exclude the air, with either olive oil or carron as available, or a solution of carbonate of soda applied and the parts well protected. Get medical advice as quickly as possible. Meanwhile put the child to bed and take all precautions to guard against shock and collapse. Give some warm milk if able to swallow, keep warm and quiet, and fresh air. If badly burnt it would be unwise to try and remove all the burnt clothing. Whilst waiting for the arrival of the medical man get a further supply of suitable dressings. Carefully note condition of pulse, and respiration etc.

September 17th 1914

Q: If sent to attend an urgent operation for strangulated hernia, how would you prepare the patient and the room?

A “…I should instruct the people to light the copper, for plenty of boiling water, and to boil the basins, and also see that a fire is put in the patient’s room…I should do any necessary dusting, with a cloth wrung out of Lysol… The abdomen, and as much of the patient as possible, should be washed, and warm stockings put on.”

March 18th, 1915

Q: What are the principal causes of infantile mortality?
A: The principal causes of infantile mortality are: (Pre-natal) unhealthy parents, suffering from phthisis, syphilis etc., overwork of the mother in factories and ill-lighted workshops.
(Natal) Inattention at birth, congenital disease, feebleness and low resistive powers, inability of the mother to breast feed the child. (Anti-natal) Contraction of disease or fever, summer diarrhoea, whooping cough, measles, etc.

September 16th, 1915

Q: Give an account of the ways in which typhoid may be carried.

A: Typhoid may be carried by milk from a milkman who gets his milk from an unsanitary farm. By water, where water pipes run side by side with drainage pipes and both are faulty. Shallow wells may be a source of infection, also stored rain water. Also cistern water in houses where the w.c. has no separate cistern… Typhoid may be spread by nurse or attendant through urine, excreta, perspiration, clothing from the bed, feeding cups and any utensils used by the patient if not carefully disinfected. Also by food taken out of the sick room.

Q: What are the dangers of the common fly and how do they carry disease?

A: Flies are dangerous because they are carriers of disease. A fly carries disease by alighting on the foulest smelling thing possible and then going straight to the food…All kinds of sweet stuffs are attraction for flies, such as jams, puddings, sugar. Meat again the flies are very fond of. The public is very apt to treat flies lightly and think them very harmless, but they are a great source of danger.  All eatables should be covered over to prevent them from contamination.


September 21st, 1916

Q: A rash occurs at the onset of measles and scarlet fever: how do the rashes, and also the modes of onset of these fevers, enable you to suspect which fever is present?

December 14th, 1916

Q: give the cause and symptoms of Phlegmasia Alba Dolens (white leg) and the nursing treatment of such a case in an artisan’s dwelling.

March 15th, 1917

Q: If it were considered necessary to sterilise milk supplied from a diary how would you do it? What diseases may be conveyed by milk?

A: A double saucepan should be used, or, if that is not available, place the milk in a jar or jug and stand it in a saucepan of water. Put the saucepan on the fire and let it remain until the milk is raised to a temperature of 160 degrees. Keep it at that temperature for twenty minutes. The diseases that may be conveyed by milk are tuberculosis, typhoid fever, scarlet fever, enteritis.


Q: How would you make a patient understand why bread, meat and sugar must be saved, and how to help her divide and plan the amount allowed so that the children and husband shall be adequately nourished?

A: Tell the patient in simple language that our common supply of food is largely obtained from abroad, and that, on account of the submarine menace and the amount needed to keep the troops in fit condition, the quantities available for civilians are very much lessened. She can be told to use ground and whole rice, oatmeal, tapioca, lentils, maize flour, dates, and any available dried cereals, and also cheese and fish. Root vegetables, such as carrots, parsnips, swedes, and turnips, can also be used. The housewife should be encouraged to use the above-mentioned foodstuffs in place of bread, meat, and sugar, so as to keep within the amount allowed by the Food Controller.

April 1918

Q: What are the chief nursing points to be observed in a case of rheumatic fever that has to be nursed in a small labourer’s cottage?

A: Wool and bandages must be applied to all painful joints as they become affected; the patient should have a flannel gown and lie between blankets except for a drawsheet; and strict measures should be taken in order that the patient should not get out of bed, or even sit up, on account of the strain that is already being put upon the heart by the rheumatic germ and the fever. Temperature, pulse and respiration must be taken twice daily. On account of the profuse perspiration the patient will need to be sponged down frequently. Milk and water or barley water should be given in large quantities, and no beef tea….the friends should be warned that the patient will need close and careful attention for four or six weeks…

Q: Given an outline of suitable and economical meals for a meatless day for a working-class family.

A: Breakfast. Porridge and milk, bread and margarine or ,marmalade, cocoa. Dinner. Fresh herrings (if salted ones are used they must be bought a day put into soak in water), baked potatoes, parsnips or carrots, boiled rice and syrup. Tea. Oat cake or potato cake, a little bread and jam or margarine, tea. Supper. Chick lentil soup, milk pudding.

June 20th, 1918

Q: In a country district you are called to see a ‘gathered finger’; you find serious swelling and pain, involving hand and arm. What steps should you take pending doctor’s orders?

A: the finger should first be soaked in some antiseptic lotion, the pus squeezed out, and the wound made as clean as possible. A formentation should then be put on, and the arm placed in a sling, care being taken that the hand is raised no higher than the elbow. The patient must then be sent without delay to see his doctor, or to the nearest hospital.

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