NMC CBT CRITICAL QUESTIONS WITH ANSWERS
1. During a busy shift, a nurse loads medication and asks you to administer it. What is your action?
A) Ask a student nurse to help you administer medication
B) Ask another staff nurse to help you with administering medication
C) Accept to administer the medication
D) Refuse to administer the medication
Ans) D) Refuse to administer the medication
2. What to teach a young patient when he is taking antibiotics
A) Take it during morning and complete the dose
B) Don’t take it with alcohol
C) Take it with food or after a meal and complete the dose
D) Medication may cause hypotension
Ans) B) Don’t take it with alcohol
3. A patient with burns is given anesthesia using 50% oxygen and 50% nitrous oxide to reduce pain during dressing. How long should this gas be inhaled to be more effective?
A) 30 sec
B) 60 sec
C) 1-2 min
D) 3-5 min
Ans) C) 1-2 min
4. All but one are Nursing teachings for patients taking Allopurinol:
A) Instruct patient to drink plenty of water
B) Educate the patient that he may experience these side effects: nausea, vomiting, loss of appetite; drowsiness
C) Encourage the patient to report unusual bleeding or bruising; fever, chills; gout attack; numbness or tingling; flank pain, skin rash
D) Instruct patient to chew medication
D) Instruct patient to chew medication
5. A 37-year-old woman presented in an accident and emergency accompanied by her husband due to a swollen wrist. On your assessment, you noticed some bruises over the arm upon rolling her sleeves. She looks reserved and only replies to your questions in short answers. When her husband left to see their children, she became extremely nervous and showed signs of restlessness. You suspected some safeguarding issues but she would not give much information when probed. What will be your next appropriate action?
A) Make a safeguarding referral on behalf of the woman and her children as you suspect domestic violence
B) Inform the nurse-in-charge about your suspicion and refer when appropriate
C) Alert the police on the safety of the woman’s children
D) Refer the husband to the Council for social work assessment and investigation on suspicion of violence against women and children.
B) Inform the nurse-in-charge about your suspicion and refer when appropriate
6. What angle to inject via the subcutaneous route?
A) 90
B) 45
C) 60
D) 15
B) 45
7. You are caring for a patient in isolation with suspected Clostridium difficile. What are the essential key actions to prevent the spread of infection?
A) Regular hand hygiene and the promotion of the infection prevention link nurse’s role
B) Encourage the doctors to wear gloves and aprons, to be bare below the elbow, and to wash hands with alcohol hand rub. Ask for cleaning to be increased with soap-based products
C) Ask the infection prevention team to review the patient’s medication chart and provide regular teaching sessions on the ‘5 moments of hand hygiene’.
D) Provide the patient and family with adequate information
E) Review antimicrobials daily, wash hands with soap and water before and after each contact with the patient, ask for enhanced cleaning with chlorine-based products, and use gloves and aprons when disposing of body fluids
E) Review antimicrobials daily, wash hands with soap and water before and after each contact with the patient, ask for enhanced cleaning with chlorine-based products, and use gloves and aprons when disposing of body fluids
8. All of the staff nurses on duty noticed that a newly hired staff nurse has been selective of her tasks. All of them thought that she had a limited knowledge of the procedures. What should the manager do in this situation?
A) Reprimand the new staff nurse in front of everyone that what she is doing is unacceptable
B) Call the new nurse and talk to her privately; ask how the manager can be of help to improve her situation
C) Ignore the incident and just continue with what she was doing
D) Assign someone to guide the new staff nurse until she is competent in doing her tasks
B) Call the new nurse and talk to her privately; ask how the manager can be of help to improve her situation
9. Why is it essential to humidify oxygen used during respiratory therapy?
A) Oxygen is a very hot gas so if humidification isn’t used, the oxygen will burn the respiratory tract and cause considerable pain for the patient when they breathe
B) Oxygen is a dry gas that can cause the evaporation of water from the respiratory tract and lead to thickened mucus in the airways, reduction of the movement of cilia, and increased susceptibility to respiratory infection
C) Humidification cleans the oxygen as it is administered to ensure it is free from any aerobic pathogens before it is inhaled by the patient
D) Humidifying oxygen adds hydrogen to it, which makes it easier for oxygen to be absorbed into the blood in the lungs. This means the cells that need it for intracellular function have their needs met in a more timely manner
B) Oxygen is a dry gas that can cause the evaporation of water from the respiratory tract and lead to thickened mucus in the airways, reduction of the movement of cilia, and increased susceptibility to respiratory infection
10. You can delegate medication administration to a student if:
A) The student was assessed as competent
B) Only under close, direct supervision
C) The patient has only oral medication
B) Only under close, direct supervision
11. A patient recently admitted to the hospital, requesting to self-administer the medication, has been assessed for suitability at Level 2. This means that:
A) The registrant is responsible for the safe storage of the medicinal products and the supervision of the administration process ensuring the patient understands the medicinal product being administered.
B) The patient accepts full responsibility for the storage and administration of the medicinal products.
C) None of the above
C) None of the above
12. John, 25 years old, was admitted to the Medical Assessment Unit because of a urine infection. During your assessment, he admitted using cannabis under prescription for his migraine and still has some in his bag. What is your best reply to him about the cannabis?
A) Cannabis is a class C drug under the UK Misuse of Drugs Act 1971.
B) A custodial sentence of 28 days is now given to anyone in possession 3 times or more.
C) Cannabis is a class B drug under the UK Misuse of Drugs Act 1971.
D) Possession of cannabis will incur a penalty of 3 months imprisonment with a £2000 fine.
C) Cannabis is a class B drug under the UK Misuse of Drugs Act 1971.
13. You are the named nurse of Colin, admitted to the Respiratory ward because of a chest infection. He also suffers from Parkinson’s syndrome. What medications will you ensure Colin has taken on regular time to control his ‘shaking’?
A) Co-careldopa (Sinemet)
B) Co-amoxiclav (augmentin)
C) Co-codamol
D) Co-Q10
A) Co-careldopa (Sinemet)
14. One busy day on your shift, a manager told you that all washes should be done by 10 AM. What would you do?
A) Follow the manager and ensure that everything is done on time
B) Talk to the manager and tell her that the quality of care will be compromised if washes are rushed
C) Ignore the manager and just continue with what you are doing
D) Provide a written statement of the incident
B) Talk to the manager and tell her that the quality of care will be compromised if washes are rushed
15. What do you have to consider if you are obtaining consent from the patient?
A) Understanding
B) Capacity
C) Intellect
D) Patient’s condition
16. Recommended preoperative fasting times are:
A) 2-4 hours
B) 6-12 hours
C) 12-14 hours
B) 6-12 hours
17. A nurse is not allowing the client to go to bed without finishing her meal. What is your action as an RN?
A) Do nothing as the client has to finish her meal which is important for her health
B) Challenge the situation immediately as this is related to the dignity of the patient and raise your concern
C) Do nothing as the patient is not under your care
D) Wait until the situation is over and speak to the client about what she wants to do
B) Challenge the situation immediately as this is related to the dignity of the patient and raise your concern
18. A client expressed concern regarding the confidentiality of her medical information. The nurse assures the client that the nurse maintains client confidentiality by:
A) Sharing the information with all members of the health care team.
B) Limiting discussion about clients to the group room and hallways.
C) Summarizing the information the client provides during assessments and documenting this summary in the chart.
D) Explain the exact limits of confidentiality in the exchanges between the client and the nurse.
D) Explain the exact limits of confidentiality in the exchanges between the client and the nurse.
19. Mrs. Smith developed an MRSA bacteremia from her abdominal wound, and her son is blaming the staff. It has been highlighted during your ward clinical governance meeting because it has been reported as a serious incident (SI). SI is best defined as:
A) Any incident or occurrence that has the potential to cause harm and/or has caused harm to a person or persons.
B) A consequence of an intervention, relating to a piece of equipment and/or as a consequence of the working environment.
C) An incident requiring investigation that occurred in relation to NHS-funded services and care resulting in; unexpected or avoidable death, or permanent harm.
D) All
D) All
20. A client had a fractured hand and is being cared for at home requiring analgesia. The medication was prescribed under PGD. Which of the following statements are correct relating to this?
A) A PGD can be delegated to a student nurse who can administer medication with supervision
B) PGD’s cannot be delegated to anyone
C) This type of prescription is not made under PGD
D) This can be delegated to another RN who can administer in view of a competent person
B) PGD’s cannot be delegated to anyone
21. A patient on your ward complains that her heart is ‘racing’ and you find that the pulse is too fast to manually palpate. What would your actions be?
A) Shout for help and run to collect the crash trolley
B) Ask the patient to calm down and check her most recent set of blood and fluid balance
C) A full set of observations: blood pressure, respiratory rate, oxygen saturation, and temperature. It is essential to perform a 12-lead ECG. The patient should then be reviewed by the doctor
D) Check baseline observations and refer to the cardiology team
C) A full set of observations: blood pressure, respiratory rate, oxygen saturation, and temperature. It is essential to perform a 12-lead ECG. The patient should then be reviewed by the doctor
22. As a nurse, the people in your care must be able to trust you with their health and well-being. In order to justify that trust, you must not:
A) Work with others to protect and promote the health and wellbeing of those in your care
B) Provide a high standard of practice and care when required
C) Always act lawfully, whether those laws relate to your professional practice or personal life
D) Be personally accountable for actions and omissions in your practice
B) Provide a high standard of practice and care when required
23. Consent is best defined as:
A) Obtaining consent is a process and is a one-off event
B) Valid consent must be given by a competent person (who may be a person lawfully appointed on behalf of the person) and must be given voluntarily
C) Another person can give consent to an adult who has the capacity to consent
D) The assessment as to whether an adult lacks the capacity to consent or not is primarily down to the clinician providing the treatment or care but nurses and midwives have no responsibility to participate in discussions about this assessment
B) Valid consent must be given by a competent person (who may be a person lawfully appointed on behalf of the person) and must be given voluntarily
24. One of your patients in bay 1 has been having episodes of vomiting in the last 2 days now. The norovirus alert has been enforced. The other patients looked concerned that he may spread the infection. What is your next action in this situation?
A) Seek the infection control nurse’s advice regarding isolation
B) Give the patient an antiemetic to control the vomiting
C) Offer the patient a lot of drinks to rehydrate
D) Tell the other patients that vomiting will not cause infection to others
A) Seek the infection control nurse’s advice regarding isolation
25. Mr. Jones’ carers approach you to express their dissatisfaction with the care he is receiving while under your care. How will you best approach this situation?
A) Explain to them that evidence should be made explicit to move the case forward
B) Tell them to put their complaint forward to the nurse-in-charge or sister of the ward
C) Advise them to speak to the police if a case needs to be filed
D) Apologize to them and reassure them that their concerns will be dealt with in accordance with the policy.
D) Apologize to them and reassure them that their concerns will be dealt with in accordance with the policy.
26. Case scenario: Mr. Smith had been experiencing episodes of abdominal pain and was admitted for further investigation into these episodes. He had previously been treated for gastric ulcers. You have been caring for him for 2 days now. He is prescribed oral paracetamol 1 gram every 6 hours and was left on his table for him to take when able. You have noticed no improvement in his pain and decided to phone the doctor for advice. Dr. Quinn gave a verbal order of oral Diclofenac 50 mg, which you promptly administered. After an hour, Mr. Smith’s pain worsened, and vomited frank blood. His vital signs were not good, and you have asked a nursing assistant to phone the doctor again. Based on the scenario, which of the following actions contravenes safe medicine administration?
A) Leaving drugs unattended by the patient’s bedside
B) Taking a ‘verbal prescription’ over the phone
C) Administering an NSAID to a patient with a history of gastric ulcers
D) All
D) All
27. The NMC Code expects nurses to safeguard the health and well-being of the public through the use of the best available evidence in practice. Which of the following nursing actions will ensure this?
A) Using isopropyl alcohol 70% to wipe skin prior to cannulation
B) Suggesting healthcare products or services that are still trialed
C) Ensure that the use of complementary or alternative therapies is safe and in the best interests of those in your care
D) All
C) Ensure that the use of complementary or alternative therapies is safe and in the best interests of those in your care
28. Registrants must only supply and administer medicinal products in accordance with one or more of the following processes, except:
A) Carer specific direction (CSD)
B) Patient medicines administration chart (may be called medicines administration record MAR)
C) Patient group direction (PGD)
D) Medicines Act exemption
D) Medicines Act exemption
29. Mental Capacity Act 2005 explores which of the following concepts?
A) Mental capacity, advanced treatment decisions, and the act’s code of practice
B) Mental capacity, independent mental capacity advocates, and the act’s code of practice
C) Mental capacity, advance treatment decisions, independent mental capacity advocates, and the act’s code of practice
D) Mental capacity and the possible ethical and legal dilemmas in its interpretation
C) Mental capacity, advance treatment decisions, independent mental capacity advocates, and the act’s code of practice
30. You are transcribing medications from a prescription chart to a discharge letter. Before sending this letter what action must be taken?
A) A registrant should sign this letter
B) Transcribing is not allowed in any circumstances
C) The letter has to be checked by a nurse in charge
D) Letter can be sent directly to the patient after transcribing
A) A registrant should sign this letter
31. As a nurse, you are responsible for looking after patients’ nutritional needs and maintaining good weight during hospitalization. How would you achieve this?
A) Providing all clients with liquid nutritional supplements
B) Assessing all patients using MUST screening tool and by taking patient’s preferences into consideration
C) Checking daily weight and documenting
D) Assessing nutritional status, client preferences, and needs, making individual food choices available, and checking daily weight and documentation.
D) Assessing nutritional status, client preferences and needs, making individual food choices available, checking daily weight and documentation
32. One of your patients has challenged your recent practice of administering subcutaneous low-molecular-weight heparin (LMWH) without disinfecting the injection site. The guidelines for nursing procedures do not recommend this method. Which of the following responses will support your action?
A) “We were taught during our training not to do so as it is not based on evidence.”
B) “Our guidelines, which are based on current evidence, recommend a non-disinfection method of subcutaneous injection.”
C) “I am glad you called my attention. I will disinfect your injection site next time to ensure your safety and peace of mind.”
D) “Disinfecting the site for subcutaneous injection is a thing of the past. We are in an evidence-based practice now.”
B) “Our guidelines, which are based on current evidence, recommend a non-disinfection method of subcutaneous injection.”
33. Barbra’s friend Colin is inquiring about her condition over the phone. As her named nurse, you will keep confidentiality by:
A) Providing him with the information he needs
B) Asking him to speak to Barbara’s relative for information
C) Gaining Barbara’s consent to provide him with information
D) Asking Barbara to speak to him
C) Gaining Barbara’s consent to provide him with information
34. You are the sign-off mentor of Ben, a third-year nursing student. Your ward is his last clinical area placement. When caring for a patient with diarrhea who uses the commode, you will expect him to:
A) Use alcohol gel to clean his hands before and after
B) Wash his hands with soap and water before and after
C) Clean the commode with soap and water
D) Clean the commode with triclosan solution
B) Wash his hands with soap and water before and after
35. When delegating any task to anyone what must you consider?
A) Delegating according to job description
B) Delegating tasks to student nurses they can be able to do
C) Delegating tasks only to healthcare assistants
D) Before delegating tasks to anyone, you have to make sure that person is competent and able to carry out the task
D) Before delegating tasks to anyone, you have to make sure that person is competent and able to carry out the task
36. Gurgling sound from the airway in a postoperative client indicates what?
A) Complete obstruction of the lower airway
B) Partial obstruction of the upper airway
C) Common signs of a post-operative patient
D) Indicates immediate insertion of laryngeal airway
B) Partial obstruction of the upper airway
37. Your patient has been prescribed Tramadol 50 mg tablet for pain relief. Upon receipt of the tablets from the pharmacist, you will:
A) Record this in the controlled drug register book with the pharmacist witnessing
B) Put it in the patient’s medicine pod
C) Store it in the ward medicine cupboard
D) Ask the pharmacist to give it to the patient
Correct answer: A) Record this in the controlled drug register book with the pharmacist witnessing
38. Steve was admitted to your ward after sustaining a head injury following a fight with another fan during a football match. One of the police officers has asked you if he can access his medical records. You will:
A) Allow the police officer to read through his medical notes
B) Ask the police officer to obtain a warrant
C) Refer the police officer to the nurse-in-charge
D) Ask the police officer to seek the patient’s consent
C) Refer the police officer to the nurse-in-charge
39. What infection control steps should not be taken in a patient with diarrhea caused by Clostridium difficile?
A) Isolation of the patient
B) All staff must wear aprons and gloves while attending to the patient
C) All staff will be required to wash their hands before and after contact with the patient, their bed linen, and soiled items
D) Oral administration of metronidazole, vancomycin, and fidaxomicin may be required
A) Isolation of the patient
40. An elderly client tells you that the carer is using his money when going shopping and not buying him any food. The client appears malnourished and weighs only 35 kg. As a newly qualified nurse, what is your action?
A) Listen to the client and raise concerns with the line manager
B) Do nothing as he is confused
C) Listen to the client and call the safeguarding lead
D) Listen to the client and confirm with the carer
C) Listen to the client and call the safeguarding lead
41. When will you disclose the information about a patient under your care?
A) Justified by public interest law and order/when there is a threat to public safety
B) When the media demands it
C) When patient relatives wish to
D) You can disclose it anytime you want
A) Justified by public interest law and order/when there is a threat to public safety
42. Dennis was admitted because of an acute asthma attack. Later on in your shift, he complained of abdominal pain and vomited. He asked for pain relief. Which of the following prescribed analgesia will you give him?
A) Fentanyl buccal patch
B) Ibuprofen enteric-coated capsule
C) Paracetamol suppositories
D) Oral morphine
C) Paracetamol suppositories
43. You were asked by the nursing assistant to see Claudia whom you have recently given trimethoprim 200 mg PO because of a urine infection. When you arrived at her bedside, she was short of breath, wheezy, and some red patches evident over her face. Which of the following actions will you take if you suspect anaphylaxis?
A) Call for help and give oxygen
B) Give oxygen and salbutamol nebs if prescribed and call for help
C) Give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed and call for help
D) Call for help, give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed
D) Call for help, give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed
44. You went back to see Mr Derby who is 1 day post-herniorrhaphy. As you approached him he complained of difficulty of breathing with a respiration rate of 23 breaths per minute and oxygen saturation of 92% in room air. What is your next action to help him?
A) Give him oxygen
B) Give him pain relief
C) Give him antibiotics
D) Give him nebulizers
A) Give him oxygen
45. Mrs. Clay reported to you that she is feeling unwell. She is admitted because of an exacerbation of her COPD. Her vital signs showed the following: Respiration rate- 16 breaths per minute; SpO2- 94% on 2 liters oxygen via nasal cannula; BP- 100/50 mmHg; Pulse- 106 beats per minute, weak and thread; Blood sugar- 5.1 mmol/L. Which of the following actions will you take next?
A) Keep her comfortable by sitting upright
B) Call the doctor
C) Reassess for any deterioration
D) Encourage her to do deep breathing exercises
B) Call the doctor
46. An overall risk of malnutrition of 2 or higher signifies:
A) Low risk of malnutrition
B) Medium risk of malnutrition
C) High risk of malnutrition
C) High risk of malnutrition
47. A nurse documented on the wrong chart. What should the nurse do?
A) Immediately inform the nurse in charge and tell her to cross it all off
B) Throw away the page
C) Write a line above the writing; put your name, job title, date, and time
D) Ignore the incident
C) Write a line above the writing; put your name, job title, date, and time
48. A patient is in the immediate recovery post-surgery. What should you monitor?
A) Breathing
B) Temperature
C) Blood loss
D) Pain
A) Breathing
49. Barrier Nursing for Clostridium difficile patient. What should you not do?
A) Use of hand gel/alcohol rub
B) Use gloves
C) The patient has his own set of washers
D) Strict disinfection of the patient’s room after isolation
A) Use of hand gel/alcohol rub
50. A patient’s daughter wants to visit her mom in the hospital; she has been experiencing diarrhea, what will you advise her?
A) Advise to visit when she feels better
B) Advise her that she can visit when she is 48 hours symptom-free
C) She can visit when she is fully recovered
D) None of the above
B) Advise her that she can visit when she is 48 hours symptom-free
51. The infection control nurse phoned and reported to you the following results of the samples taken from four patients in Bay A- one of the patients tested positive for MRSA; another tested positive for clostridium difficile; and the remaining two were negative for both. Your ward has 1 isolation room only. What action will you take?
A) Put the patient with c-diff in an isolation room
B) Put the patient with MRSA in an isolation room
C) Transfer the two patients who are negative for both infections to another bay
D) Keep them all in the same bay but reinforce strict hand washing
A) Put the patient with c-diff in an isolation room
52. Which is the most dangerous site for intramuscular injection?
A) Ventrogluteal
B) Deltoid
C) Rectus femoris
D) Dorsogluteal
D) Dorsogluteal
53. A solution contains 12.5 g of glucose in 0.25 l; what is the percentage concentration (%) of this solution?
A) 5%
B) 10%
C) 25%
A) 5%
54. A liter bag of 5% Glucose is prescribed over 4 hours. If a standard giving set is used, at what rate should the drip be set?
A) 83
B) 60
C) 24
A) 83
55. You believe that an adult you know and support has been a victim of physical abuse that might be considered a criminal offense. What should you do to support the police in an investigation?
A) Question the adult thoroughly to get as much information as possible
B) Take photographs of any signs of abuse or other potential evidence before cleaning up the victim or the crime scene
C) Explain to the victim that you cannot speak to them unless a police officer is present
D) Make an accurate record of what the person has said to you
D) Make an accurate record of what the person has said to you
56. If you suspect abuse is happening to someone, and it is not serious enough to involve the police straight away, who should you inform?
A) A manager with safeguarding responsibility (if within an organization) or Adult Social Care directly (if you are a member of the public)
B) No one – it is up to the adult at risk to raise the alert
C) The adult’s next of kin
D) Everyone with a caring responsibility for the adult
A) A manager with safeguarding responsibility (if within an organization) or Adult Social Care directly (if you are a member of the public)
57. Before administering Digoxin, you must check specifically for what?
A) Breathing
B) Temperature
C) Heart Rate
D) LOC
C) Heart Rate
58. A patient is rapidly deteriorating due to a drug overdose. What to do?
A) Assess ABCDE, call help, and keep an anaphylactic kit
B) Call for help, keep an anaphylactic kit, assess ABCDE
C) Assess ABCDE, keep an anaphylactic kit, inform doctor, call for help
A) Assess ABCDE, call help, and keep an anaphylactic kit
59. Your hospital supports the government’s drive on breastfeeding. One of your patients being treated for a urinary tract infection was visited by her husband and their 4-month-old baby. She would like to breastfeed her baby. What advice will you give her?
A) It is ok to breastfeed as long as it is done privately
B) It is ok to breastfeed because the hospital supports this practice
C) Refrain from breastfeeding as of now because of her UTI treatment
D) Breast milk is the best and she can feed her baby anytime they visit
B) It is ok to breastfeed because the hospital supports this practice
60. Mr. Connor’s neck wound needed some cleaning to prevent complications. Which of the following concepts will you apply when doing surgical wound cleaning?
A) Surgical asepsis
B) Aseptic non-touch technique
C) Medical asepsis
D) Dip-tip technique
B) Aseptic non-touch technique
61. Lumbar post-op patient moving and handling
A) Move the patient as a unit
B) Move the patient close to the side rails so he/she can assist herself
C) Move with leg raised/flexed
A) Move the patient as a unit
62. IV injection needs to be reconsidered when?
A) Medicine is available in tab form
B) Poor alimentary absorption
C) Drug interaction due to GI secretions
A) Medicine is available in tab form
63. The doctor prescribes 25 mg of a drug to be given by injection. It is a drug dispensed in a solution of strength 50 mg/ml. How many ml should you administer?
A) 2 ml
B) 1.5 ml
C) 0.5 ml
C) 0.5 ml
64. A doctor prescribes an injection of 200 micrograms of a drug. The stock bottle contains 1 mg/ml. How many ml will you administer?
A) 20 ml
B) 2 ml
C) 0.2 ml
C) 0.2 ml
65. In interpreting ECG results there is clear evidence of atrial disruption this is interpreted as
A) Cardiac arrest
B) Ventricular tachycardia
C) Atrial fibrillation
D) Complete blockage of the heart
C) Atrial fibrillation
66. Enteral feeding patient checks patency of tube placement by:
A) Pulling on the tube and then pushing it back in place
B) Aspirating gastric juice and then checking for pH <4
C) Infusing water or air and listening for gurgles
D) X-ray
B) Aspirating gastric juice and then checking for pH <4
67. It is mandatory that the GCS of a patient who has arrived in the emergency department should be checked within 15 minutes of the patient’s arrival; if the score you got is 15/15, how much time after should the GCS be checked again?
A) 15 min
B) 30 min
C) No need to check again unless the patient shows some serious symptom
D) After 1 hour
B) 30 min
68. You are monitoring a patient in the ICU when suddenly his consciousness drops and the size of one of his pupils becomes smaller what should you do?
A) Call the doctor
B) Refer to the neurology team
C) Continue to monitor the patient using GCS and record
D) Consider this as an emergency and prioritize ABC
D) Consider this as an emergency and prioritize ABC
69. The patient asking for LAMA, and the medical team is concerned about the mental capacity of the patient, what decision should be made?
A) Call the police
B) Call the security
C) Let the patient go
D) Encourage the patient to wait, by telling the need for treatment
D) Encourage the patient to wait, by telling the need for treatment
70. Mr. Connor is prescribed oromorphine 10 mg every 6 hours. The drug is supplied in a concentration of 5 mgs per 2 mls. How much will you give him for a single dose?
A) 4 mls
B) 8 mls
C) 6 mls
D) 10 mls
A) 4 mls
71. Which of the following drugs will require 2 nurses to check during preparation and administration?
A) Oral antibiotics
B) Glycerine suppositories
C) Morphine tablet
D) Oxygen
C) Morphine tablet
72. The doctor prescribes a dose of 9 mg of an anticoagulant for a patient being treated for thrombosis. The drug is being supplied in 3mg tablets. How many tablets should you administer?
A) 3 tablets
B) 1.5 tablets
C) 6 tablets
A) 3 tablets
73. Which bag do you place infected linen in?
A) Water-soluble alginate polythene bag before being placed in the appropriate linen bag, no more than ¾ full
B) Orange waste bag, before being placed in the appropriate linen bag, no more than ¾ full
C) White linen bag, after sorting, no more than ¾ full
A) Water-soluble alginate polythene bag before being placed in the appropriate linen bag, no more than ¾ full
74. A nurse is having trouble with doing care plans. Her team members are already noticing this problem and are worried about the consequences this may bring to the quality of nursing care delivered. The problem has already been brought to the attention of the nurse. The nurse should:
A) Accept her weakness and take this challenge as an opportunity to improve her skills by requesting lectures from her manager
B) Ignore the criticism as this is a case of a team issue
C) Continue delivering care as this will not affect the quality of care you are rendering to your patient
A) Accept her weakness and take this challenge as an opportunity to improve her skills by requesting lectures from her manager
75. Which of the following nursing actions demonstrate safe medicine management principles?
A) Asking a nursing assistant to give oral laxatives to an elderly patient
B) Allowing a final placement nursing student to give a paracetamol tablet unsupervised
C) Checking an IV antibiotic with a pharmacist
D) Checking a controlled drug with a medical student
C) Checking an IV antibiotic with a pharmacist
76. If someone collapses while queuing or falling in line, what must be assessed first?
A) Call a code
B) Check for responsiveness
C) Check if the scene is safe
B) Check for responsiveness
77. What is the purpose of clamping a chest tube?
A) To prevent further lung collapse and entry of air
B) To minimize the feeling of pain on drain insertion
C) To aid the drain into the correct position
D) To minimize the risk of infection
A) To prevent further lung collapse and entry of air
78. A patient suffered from CVA and is now affected with dysphagia. What should not be an intervention for this type of patient?
A) Place the patient in a sitting position / upright during and after eating
B) Water or clear liquids should be given
C) Instruct the patient to use a straw to drink liquids
D) Review the patient’s ability to swallow, and note the extent of facial paralysis
B) Water or clear liquids should be given
79. In a community hospital, an elderly man approaches you and tells you that his neighbor has been stealing his money, saying “sometimes I give him money to buy groceries but he didn’t buy groceries and he kept the money.” What is your best course of action for this?
A) Raise a safeguarding alert
B) Just listen but don’t do anything
C) Ignore the old man, he is just having delusions
D) Refer the old man to the community clergy who is giving him spiritual support
Correct answer: A) Raise a safeguarding alert
80. When will you consider giving out information about the patient to a police officer?
A) If he has the rank of an inspector
B) If the safety of the public is at risk
B) If the safety of the public is at risk
81. What could be the reason why you instruct your patient to retain its original container and discard nitroglycerine meds after 8 weeks?
A) Removing from its darkened container exposes the medicine to the light and its potency will decrease after 8 weeks
B) It will have a greater concentration after 8 weeks
A) Removing from its darkened container exposes the medicine to the light and its potency will decrease after 8 weeks
82. You have assigned a new student to an experienced healthcare assistant to gain some knowledge in delivering patient care. The student nurse tells you that the HCA has pushed the client back to the chair when she was trying to stand up. What is your action?
A) Suspend HCA immediately
B) Intervene on the spot and raise concern immediately to the manager on duty
C) Ask the client later on what has happened
D) Ignore the student as she is new and does not have any experience
B) Intervene on the spot and raise concern immediately to the manager on duty
83. A newly admitted client refusing to hand over his own medications and this includes controlled drugs. What is your action?
A) You have to take it anyway and document it
B) Call the doctor and inform about the situation
C) Document this refusal as these medications are his property and should not do anything without his consent
D) Refuse the admission as this is against the policy
C) Document this refusal as these medications are his property and should not do anything without his consent
84. What is the best way to prevent a patient who is receiving an enteral feed from aspirating?
A) Lie them flat
B) Sit them at least at a 45° angle
C) Tell them to lie on their side
D) Check their oxygen saturation
B) Sit them at least at a 45° angle
85. Which check do you need to carry out before setting up an enteral feed via a nasogastric tube?
A) That when flushed with red juice, the red juice can be seen when the tube is aspirated
B) That air cannot be heard rushing into the lungs by doing the ‘whoosh test’
C) That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is the same length as the time insertion.
D) That pH of gastric aspirate is >6.0, and the measurement on the NG tube is the same length as the time insertion
C) That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is the same length as the time insertion.
86. What is the best site for buttock injections?
A) Ventrogluteal site
B) Dorsogluteal site
C) Rectus femoris
D) Greater trochanter area
A) Ventrogluteal site
87. You are mentoring a 3rd-year student nurse, the student requests that she wants to assist a procedure with a tissue viability nurse, how can you deal with this situation?
A) Tell her it is not possible
B) Tell her it is possible if you provide direct supervision
C) Call the college and ask whether it is possible for a 3rd student to assist with the procedure
D) Allow her as this is part of her learning
B) Tell her it is possible if you provide direct supervision
88. After 2 hours in A and E, Barbara is now ready to be moved to another ward. You went back to tell her about this plan and noticed she was not responding. What is your next action as a priority?
A) Assess for signs of life
B) Shout for help
C) Perform CPR
D) Keep her airway open
B) Shout for help
89. When doing your drug round at midday, you have noticed one of your patients coughing more frequently whilst being assisted by a nursing student at mealtime. What is your initial action in this situation?
A) Tell the student to feed the patient slowly to help stop coughing
B) Ask the student to completely stop feeding
C) Ask the student to allow the patient some sips of water to stop coughing
D) Ask the student to stop feeding and assess the patient’s swallowing
D) Ask the student to stop feeding and assess the patient’s swallowing
90. The doctor was about to insert an IV cannula when he was called to assist in an emergency. The nurse is not experienced in peripheral cannulation. What should the nurse do?
A) Inform the supervisor that the doctor left you to do it
B) Apply the cannula since you have seen it done before
C) Do not give because you’re not trained and assessed as competent
D) Have a friend help you apply it
A) Inform the supervisor that the doctor left you to do it
91. What is the purpose of NPO after surgery?
A) To prevent a blood clot
B) To prevent aspiration
C) To facilitate respiration
D) To prevent embolism
B) To prevent aspiration
92. A patient underwent abdominal surgery and will be unable to meet nutritional needs through oral intake. The patient was placed on enteral feeding. How would you position the patient when feeding is being administered?
A) Sitting upright at 30 to 45 degrees
B) Sitting upright at 60 to 75 degrees
C) Sitting upright at 45 to 60 degrees
D) Sitting upright at 75 to 90 degrees
A) Sitting upright at 30 to 45 degrees
93. An unmarried young female admitted with ectopic pregnancy with her friend to the hospital with complaints of abdominal pain. Her friend assists in a procedure and becomes aware of her pregnancy, and when the family arrives at the hospital, she reveals the truth. The family reacts negatively. What could the nurse have done to protect the confidentiality of the patient’s information?
A) Should tell the family that they don’t have any right to know the patient’s information
B) That the friend was mistaken and the doctor will confirm the patient’s condition
C) Should insist friend on confidentiality
D) Should have asked another staff nurse to be a chaperone while assisting a procedure
C) Should insist friend on confidentiality
94. Johnny still refused to have a catheter inserted despite numerous strategies attempted to gain his consent. He promised to let you know what he drinks and eats and when he goes to the toilet. What will be your next action at this stage?
A) Still do the catheterization as this is required for his care
B) Consider his promise
C) Ask a doctor to fill out a consent form for him
D) Inform his relatives and ask them to convince him to have it done
B) Consider his promise
95. Barbara, a frail lady admitted to your ward because of a urine infection, wanders off with anti-embolic socks on causing her to slip and eventually fall. How will you keep her safe when mobilizing?
A) Remove her anti-embolic socks and replace them with non-slip ones
B) Refer to a physiotherapist for other mobilizing support
C) Inform Barbara of restricting her mobilization
D) Assign someone to supervise her closely when mobilizing
D) Assign someone to supervise her closely when mobilizing
96. When do we need to document?
A) As soon as possible after an event has happened (to provide current (to date) information about the care and condition of the patient or client)
B) Every hour
C) When there are significant changes to the patient’s condition
D) At the end of the shift
A) As soon as possible after an event has happened (to provide current (up to date) information about the care and condition of the patient or client)
97. The nurse monitors the serum electrolyte levels of a client who is taking digoxin (Lanoxin). Which of the following electrolyte imbalances is a common cause of digoxin toxicity?
A) Hypocalcemia
B) Hyponatremia
C) Hypomagnesemia
D) Hypokalemia
D) Hypokalemia
98. You were the nurse on duty and it’s time to take your patient’s vital signs. Upon checking, you noted that the patient was given Digoxin and now has a heart rate of 50 BPM. What will you do with the next dose of Digoxin?
A) Omit then document
B) Omit then double the next dose; document
C) Administer then document
D) Administer then recheck VS
A) Omit then document
99. An elderly client with dementia is cared for by his daughter. The daughter locks him in a room to keep him safe when she goes out to work and not considering any other options. As a nurse what is your action?
A) Explain this is a restraint. Urgently call for safeguarding and arrange a multi-disciplinary team conference
B) Do nothing as this is the best way of keeping him safe
C) Call the police, and social services to remove the client immediately and refer to safeguarding
D) Explain this is a restraint and discuss other possible options
A) Explain this is a restraint. Urgently call for safeguarding and arrange a multi-disciplinary team conference
100. A Chinese woman has been admitted with a fracture of the wrist. When you are helping her undress, you notice some bruises on her back and abdomen of different ages. You want to talk to her and what is your action?
A) Ask her husband about the bruises
B) Ask her son/daughter to translate
C) Arrange for an interpreter to ask questions in private
D) Do not carry out any assessment and document this is not possible as the client cannot speak English
C) Arrange for an interpreter to ask questions in private
101. In a GP clinic when you are assessing a pregnant lady, you observe some bruises on her hand. When you ask her about this, she remains silent. What is your action?
A) Call her husband to find out what is happening
B) Tell her that you are concerned about her welfare and that you may need to share this information appropriately with the people who offer help
C) Do nothing as she does not want to say anything
D) Call the police
B) Tell her that you are concerned about her welfare and that you may need to share this information appropriately with the people who offer help
102. As an RN when you are administering medication, you make an error. Taking the health and safety of the patient into consideration, what is your action?
A) Call the prescriber. Report through the yellow card scheme and document it in patient notes
B) Let the next of kin know about this and document it
C) Document this in patient notes and inform the line manager
D) Assess for potential harm to the client, inform the line manager and prescriber, and document in patient notes
D) Assess for potential harm to the client, inform the line manager and prescriber, and document in patient notes