University College Cork – BSc Nursing Studies
Advanced Level Assessment Examination –
Version 2.0 (Enhanced Complexity) updated
2026
Exam Cycle: September 2026 | Programme: BSc (Hons) Nursing Studies (NFQ Level 8)
| Module Weighting: 60 Credits | Accrediting Body: Nursing and Midwifery Board
of Ireland (NMBI)
Section Module / Topic Area Questions
A Nursing Theory and Science Informing Professional Practice (NU4001) 1–25
B Evidence-Based Nursing Practice (NU4016) 26–50
Patient Safety and Quality Improvement in Nursing and Healthcare
C 51–75
(NU4108)
Leadership, Management, Ethical and Legal Accountability in Nursing
D 76–100
(NU4111)
Nursing Individuals with Cancer, Chronic, and Infectious Diseases
E 101–125
(NU4112)
F Primary Healthcare for Population Health (NU4113) 126–150
,SECTION A: NURSING THEORY AND SCIENCE INFORMING
Module descriptor: Theoretical foundations of concepts central to the discipline of
nursing and professional nursing practice. Disciplinary knowledge developments in nursing;
contribution of Carper, Benner, Watson and other nurse theorists.
Question 1
A registered nurse working in an acute medical unit reflects on a complex clinical situation
involving a patient with conflicting treatment wishes from family members. The nurse considers
what ought to be done in this morally challenging situation, weighing duties to the patient
against duties to the family. This reflective process primarily engages which of Carper's
fundamental patterns of knowing?
A. Esthetic knowing – the art of nursing and perceptual awareness
and obligations
C. Personal knowing – therapeutic use of self and self-awareness
D. Empirical knowing – the scientific basis of nursing practice
Rationale: Ethical knowing addresses questions of obligation, moral reasoning, and what
ought to be done in nursing practice. It involves the nurse's moral perception and the ethical
dimensions of care. Esthetic knowing is the expressive, creative aspect; personal knowing
involves self-awareness and authentic relationships; empirical knowing is the science of nursing.
The nurse's reflection on conflicting duties and moral obligations explicitly engages ethical
knowing.
Question 2
According to Benner's novice-to-expert model, a registered nurse with four years of
experience in a busy emergency department now consistently recognises subtle patterns in
patient presentations, anticipates clinical deterioration before objective signs manifest, and
often cannot articulate the full reasoning behind clinical intuitions but is consistently accurate.
This nurse is functioning at which level of clinical proficiency?
,A. Competent – able to see patterns but still relies on analytical thinking
B. Proficient – sees situations holistically and recognises patterns
understanding
D. Advanced beginner – demonstrates marginally acceptable performance
Rationale: The expert level, as described by Benner, is characterised by intuitive grasp of
clinical situations, pattern recognition without conscious analytical deliberation, and the ability
to anticipate events based on deep situated understanding. The competent level (typically 2–3
years) still relies on analytical thinking; the proficient level (3–5 years) sees situations holistically
but may not yet operate from pure intuition; the advanced beginner demonstrates marginally
acceptable performance based on rules.
Question 3
A nurse manager is redesigning the care delivery model on a surgical ward to emphasise
authentic presence, caring relationships, and the cultivation of nurses' own spiritual and
personal growth as foundations for therapeutic practice. This approach draws most heavily from
which nursing theorist's framework?
A. Dorothea Orem's Self-Care Deficit Theory – focusing on patients' self-care abilities
B. Patricia Benner's skill acquisition model – focusing on clinical proficiency development
factors and transpersonal caring
D. Madeleine Leininger's Culture Care Theory – focusing on cultural congruence in care
Rationale: Watson's Theory of Human Caring emphasises carative factors including the
formation of a humanistic-altruistic value system, cultivation of one's own spiritual practices,
and transpersonal caring relationships. Authentic presence and the nurse's personal growth are
central to Watson's framework. Orem's theory focuses on self-care deficits; Benner's on skill
acquisition; Leininger's on cultural care.
Question 4
A nursing student is formulating a care plan for a patient with chronic obstructive
pulmonary disease who experiences dyspnoea on minimal exertion. The student identifies
, "Activity Intolerance" as the nursing diagnosis. According to the NANDA-I taxonomy, this
diagnosis is correctly classified under which domain, and what is the defining characteristic that
distinguishes it from a related diagnosis?
A. Domain: Activity/Rest; defining characteristic: verbal report of fatigue
B. Domain: Activity/Rest; defining characteristic: exertional
dyspnoea with physiological evidence of inadequate oxygenation
C. Domain: Coping/Stress Tolerance; defining characteristic: anxiety-related dyspnoea
D. Domain: Nutrition; defining characteristic: metabolic demand exceeding supply
Rationale: Activity Intolerance falls under the Activity/Rest domain in NANDA-I taxonomy.
The defining characteristics include exertional dyspnoea, physiological evidence of inadequate
oxygenation, and the patient's inability to perform activities of daily living. While fatigue may be
present, exertional dyspnoea with physiological evidence is the key distinguishing characteristic
that separates Activity Intolerance from Fatigue as a diagnosis.
Question 5
A nurse is preparing a teaching session for nursing students on the epistemological
foundations of nursing knowledge. The nurse correctly explains that Carper's four patterns of
knowing are:
A. Mutually exclusive categories that operate independently in nursing practice
B. Interrelated and overlapping patterns that together constitute
the full breadth of nursing knowledge
C. Hierarchically arranged with empirical knowing as the most important pattern
D. Descriptive of nursing knowledge but not applicable to clinical decision-making
Rationale: Carper's patterns of knowing—empirical, esthetic, personal, and ethical—are
interrelated and overlapping. They together constitute the full breadth of nursing knowledge
and are all essential for comprehensive nursing practice. They are not mutually exclusive, not
hierarchically arranged, and are highly applicable to clinical decision-making.
Question 6
A patient with end-stage renal disease who has been on haemodialysis for five years tells
the nurse, "I just can't do this anymore. I'm tired of being tethered to a machine. I want to stop
Advanced Level Assessment Examination –
Version 2.0 (Enhanced Complexity) updated
2026
Exam Cycle: September 2026 | Programme: BSc (Hons) Nursing Studies (NFQ Level 8)
| Module Weighting: 60 Credits | Accrediting Body: Nursing and Midwifery Board
of Ireland (NMBI)
Section Module / Topic Area Questions
A Nursing Theory and Science Informing Professional Practice (NU4001) 1–25
B Evidence-Based Nursing Practice (NU4016) 26–50
Patient Safety and Quality Improvement in Nursing and Healthcare
C 51–75
(NU4108)
Leadership, Management, Ethical and Legal Accountability in Nursing
D 76–100
(NU4111)
Nursing Individuals with Cancer, Chronic, and Infectious Diseases
E 101–125
(NU4112)
F Primary Healthcare for Population Health (NU4113) 126–150
,SECTION A: NURSING THEORY AND SCIENCE INFORMING
Module descriptor: Theoretical foundations of concepts central to the discipline of
nursing and professional nursing practice. Disciplinary knowledge developments in nursing;
contribution of Carper, Benner, Watson and other nurse theorists.
Question 1
A registered nurse working in an acute medical unit reflects on a complex clinical situation
involving a patient with conflicting treatment wishes from family members. The nurse considers
what ought to be done in this morally challenging situation, weighing duties to the patient
against duties to the family. This reflective process primarily engages which of Carper's
fundamental patterns of knowing?
A. Esthetic knowing – the art of nursing and perceptual awareness
and obligations
C. Personal knowing – therapeutic use of self and self-awareness
D. Empirical knowing – the scientific basis of nursing practice
Rationale: Ethical knowing addresses questions of obligation, moral reasoning, and what
ought to be done in nursing practice. It involves the nurse's moral perception and the ethical
dimensions of care. Esthetic knowing is the expressive, creative aspect; personal knowing
involves self-awareness and authentic relationships; empirical knowing is the science of nursing.
The nurse's reflection on conflicting duties and moral obligations explicitly engages ethical
knowing.
Question 2
According to Benner's novice-to-expert model, a registered nurse with four years of
experience in a busy emergency department now consistently recognises subtle patterns in
patient presentations, anticipates clinical deterioration before objective signs manifest, and
often cannot articulate the full reasoning behind clinical intuitions but is consistently accurate.
This nurse is functioning at which level of clinical proficiency?
,A. Competent – able to see patterns but still relies on analytical thinking
B. Proficient – sees situations holistically and recognises patterns
understanding
D. Advanced beginner – demonstrates marginally acceptable performance
Rationale: The expert level, as described by Benner, is characterised by intuitive grasp of
clinical situations, pattern recognition without conscious analytical deliberation, and the ability
to anticipate events based on deep situated understanding. The competent level (typically 2–3
years) still relies on analytical thinking; the proficient level (3–5 years) sees situations holistically
but may not yet operate from pure intuition; the advanced beginner demonstrates marginally
acceptable performance based on rules.
Question 3
A nurse manager is redesigning the care delivery model on a surgical ward to emphasise
authentic presence, caring relationships, and the cultivation of nurses' own spiritual and
personal growth as foundations for therapeutic practice. This approach draws most heavily from
which nursing theorist's framework?
A. Dorothea Orem's Self-Care Deficit Theory – focusing on patients' self-care abilities
B. Patricia Benner's skill acquisition model – focusing on clinical proficiency development
factors and transpersonal caring
D. Madeleine Leininger's Culture Care Theory – focusing on cultural congruence in care
Rationale: Watson's Theory of Human Caring emphasises carative factors including the
formation of a humanistic-altruistic value system, cultivation of one's own spiritual practices,
and transpersonal caring relationships. Authentic presence and the nurse's personal growth are
central to Watson's framework. Orem's theory focuses on self-care deficits; Benner's on skill
acquisition; Leininger's on cultural care.
Question 4
A nursing student is formulating a care plan for a patient with chronic obstructive
pulmonary disease who experiences dyspnoea on minimal exertion. The student identifies
, "Activity Intolerance" as the nursing diagnosis. According to the NANDA-I taxonomy, this
diagnosis is correctly classified under which domain, and what is the defining characteristic that
distinguishes it from a related diagnosis?
A. Domain: Activity/Rest; defining characteristic: verbal report of fatigue
B. Domain: Activity/Rest; defining characteristic: exertional
dyspnoea with physiological evidence of inadequate oxygenation
C. Domain: Coping/Stress Tolerance; defining characteristic: anxiety-related dyspnoea
D. Domain: Nutrition; defining characteristic: metabolic demand exceeding supply
Rationale: Activity Intolerance falls under the Activity/Rest domain in NANDA-I taxonomy.
The defining characteristics include exertional dyspnoea, physiological evidence of inadequate
oxygenation, and the patient's inability to perform activities of daily living. While fatigue may be
present, exertional dyspnoea with physiological evidence is the key distinguishing characteristic
that separates Activity Intolerance from Fatigue as a diagnosis.
Question 5
A nurse is preparing a teaching session for nursing students on the epistemological
foundations of nursing knowledge. The nurse correctly explains that Carper's four patterns of
knowing are:
A. Mutually exclusive categories that operate independently in nursing practice
B. Interrelated and overlapping patterns that together constitute
the full breadth of nursing knowledge
C. Hierarchically arranged with empirical knowing as the most important pattern
D. Descriptive of nursing knowledge but not applicable to clinical decision-making
Rationale: Carper's patterns of knowing—empirical, esthetic, personal, and ethical—are
interrelated and overlapping. They together constitute the full breadth of nursing knowledge
and are all essential for comprehensive nursing practice. They are not mutually exclusive, not
hierarchically arranged, and are highly applicable to clinical decision-making.
Question 6
A patient with end-stage renal disease who has been on haemodialysis for five years tells
the nurse, "I just can't do this anymore. I'm tired of being tethered to a machine. I want to stop
