2024 NMC CBT QUESTIONS WITH ANSWERS PART – 3

201. You notice an area of redness on the buttock of an elderly patient and suspect they may be at risk of developing a pressure ulcer. Which of the following would be the most appropriate to apply?
a) Negative pressure dressing
b) Rapid capillary dressing
c) Alginate dressing
d) Skin barrier product
Answer: d) Skin barrier product

202. Which solution uses minimum tissue damage while providing wound care?
a) Hydrogen peroxide
b) Povidone iodine
c) Saline
d) Gention violet
Answer: c) Saline

203. Which are not the benefits of using negative pressure wound therapy?
a) Can reduce wound odour
b) Increases local blood flow in peri-wound area
c) Can be used on untreated osteomyelitis
d) Can reduce the use of dressings
Answer: c) Can be used on untreated osteomyelitis

204. Which one of the following types of wound is NOT suitable for negative pressure wound therapy?
a) Partial thickness burns
b) Contaminated wounds
c) Diabetic and neuropathic ulcers
d) Traumatic wounds
Answer: b) Contaminated wounds

205. How do you remove a negative pressure dressing?
a) Remove pressure then detach dressing gently
b) Get TVN nurse to remove dressing
c) Remove in a quick fashion
Answer: a) Remove pressure then detach dressing gently

206. How would you care for a patient with a necrotic wound?
a) Systemic antibiotic therapy and apply a dry dressing
b) Debride and apply a hydrogel dressing.
c) Debride and apply an antimicrobial dressing.
d) Apply a negative pressure dressing.
Answer: b) Debride and apply a hydrogel dressing.

207. The nurse cares for a patient with a wound in the late regeneration phase of tissue repair. The wound may be protected by applying a:
a) Transparent film
b) Hydrogel dressing
c) Collagenases dressing
d) Wet dry dressing
Answer: a) Transparent film

208. Black wounds are treated with debridement. Which type of debridement is most selective and least damaging?
a) Debridement with scissors
b) Debridement with wet to dry dressings
c) Mechanical debridement
d) Chemical debridement
Answer: d) Chemical debridement

209. If an elderly immobile patient had a “grade 3 pressure sore,” what would be your management?
a) Film dressing, mobilization, positioning, nutritional support
b) Foam dressing, pressure-relieving mattress, nutritional support
c) Dry dressing, pressure-relieving mattress, mobilization
d) Hydrocolloid dressing, pressure-relieving mattress, nutritional support
Answer: b) Foam dressing, pressure-relieving mattress, nutritional support

210. A client has a diabetic stasis ulcer on the lower leg. The nurse uses a hydrocolloid dressing to cover it. The procedure for application includes:
a) Cleaning the skin and wound with betadine
b) Removing all traces of residues from the old dressing
c) Choosing a dressing no more than a quarter-inch larger than the wound size
d) Holding it in place for a minute to allow it to adhere
Answer: a) Cleaning the skin and wound with betadine
b) Removing all traces of residues from the old dressing

211. The client at the greatest risk for postoperative wound infection is:
a) A 3-month-old infant postoperative from pyloric stenosis repair
b) A 78-year-old postoperative from inguinal hernia repair
c) A 18-year-old drug user postoperative from removal of a bullet in the leg
d) A 32-year-old diabetic postoperative from an appendectomy

Answer: d) A 32-year-old diabetic postoperative from an appendectomy

212. Mr Connor’s neck wound needed some cleaning to prevent complications. Which of the following concepts will you apply when doing a surgical wound cleaning?
a) Surgical asepsis
b) Aseptic non-touch technique
c) Medical asepsis
d) Dip-tip technique

Answer: a) Surgical asepsis

213. When doing your shift assessment, one of your patients has a Waterlow score of 20. Which of the following mattresses is appropriate for this score?
a) Water bed
b) Fluidized airbed
c) Low air loss
d) Alternating pressure

Answer: d) Alternating pressure

214. Waterlow score of 20 indicates what type of mattress to use? (Select x 2)
a) Standard-specification foam mattresses
b) High-specification foam mattresses
c) Dynamic support surface

Answer: b) High-specification foam mattresses and c) Dynamic support surface

215. For a client with Water Score >20, which mattress is the most suitable?
a) Water Mattress
b) Air Mattress
c) Dynamic Mattress
d) Foam Mattress

Answer: c) Dynamic Mattress

216. A patient has been confined to bed for months now and has developed pressure ulcers in the buttocks area. When you checked the Waterlow it is at level 20. Which type of bed is best suited for this patient?
a) Water mattress
b) Egg crater mattress
c) Air mattresses
d) Dynamic mattress

Answer: d) Dynamic mattress

217. You have just finished dressing a leg ulcer. You observe the patient is depressed and withdrawn. You ask the patient whether everything is okay. She says yes. What is your next action?
a) Say “I observe you don’t seem as usual. Are you sure you are okay?”
b) Say “Cheer up, Shall I make a cup of tea for you?”
c) Accept her answer & leave. attend to other patients
d) Inform the doctor about the change of behavior.

Answer: a) Say “I observe you don’t seem as usual. Are you sure you are okay?”

218. External factors that increase the risk of pressure damage are:
e) Equipment, age, and pressure
f) Moisture, pressure, and diabetes
g) Pressure, shear, and friction
h) Pressure, moisture, and age

Answer: g) Pressure, shear, and friction

219. Mr. Smith has been diagnosed with Multiple Sclerosis 20 years ago. Due to impaired mobility, he has developed a Grade 4 pressure sore on his sacrum. Which health professional can provide you prescriptions for his dressing?
a. Dietician
b. Tissue Viability Nurse
c. Social Worker
d. Physiotherapist

Answer: b. Tissue Viability Nurse

220. Sharp debridement may cause trauma to underlying structures, the procedure should only be carried out by:
a) A healthcare assistant working full time
b) A qualified nurse with at least 3 years of experience
c) A doctor of any type of specialty
d) A qualified healthcare professional with appropriate training

Answer: d) A qualified healthcare professional with appropriate training

221. 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 described 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) Incident requiring investigation that occurred in relation to NHS funded services and care resulting in; unexpected or avoidable death, permanent harm
d) All

Answer: d) All

222. How much urine should someone void an hour?
a) 0.5 – 1ml/Kg/hr of the patient’s body weight
b) 2mls/KG/hr of the patient’s body weight
c) 30mls
d) 50mls

Answer: a) 0.5 – 1ml/Kg/hr of the patient’s body weight

223. Patient usually urinates at night. Nurse identifies this as:
A) Polyuria
B) Oliguria
C) Nocturia

Answer: C) Nocturia

224. Wendy, 18 years old, was admitted to the Medical Ward because of recurrent urinary tract infection (UTI). She disclosed to you that she had unprotected sex with her boyfriend on some occasions. You are worried this may be a possible cause of the infection. How will best handle the situation?
A) Tell her that any information related to her well-being will need to be shared with the health care team
B) Inform her parents about this so she can be advised appropriately
C) Keep the information a secret in view of confidentiality
D) Report her boyfriend to social services

Answer: A) Tell her that any information related to her well-being will need to be shared with the health care team

225. What are the steps for proper urine collection?
a) Clean meatus with soap and water
b) Catch midstream
c) Dispatch sample to laboratory immediately (within 6 hours)
d) Ask the patient to void her remaining urine into the toilet or bedpan.
a) A, B, & C
b) B, C, & D
c) A, B, & D
d) A, C, & D

Answer: a) A, B, & C

226. On removing your patient’s catheter, what should you encourage your patient to do?
a) Rest & drink 2-3 liters of fluid per day
b) Rest & drink in excess of 5 liters of fluid per day
c) Exercise & drink 2-3 liters of fluid per day
d) Exercise & drink their normal amount of fluid intake

Answer: a) Rest & drink 2-3 liters of fluid per day

227. When should a penile sheath be considered as a means of managing incontinence?
a) When other methods of continence management have failed
b) Following the removal of a catheter
c) When the patient has a small or retracted penis
d) When a patient requests it

Answer: a) When other methods of continence management have failed

228. What is the most important guiding principle when choosing the correct size of catheter?
a) The biggest size tolerable
b) The smallest size necessary
c) The potential length of use of the catheter
d) The build of the patient

Answer: b) The smallest size necessary

229. When carrying out a catheterization, on which patients would you use an anaesthetic lubricating gel prior to catheter insertion?
a) Male patients to aid passage, as the catheter is longer
b) Female patients as there is an absence of lubricating glands in the female urethra, unlike the male urethra
c) Male & female patients require anaesthetic lubricating gel
d) The use of anaesthetic lubricating gel is not advised due to potential adverse reactions

Answer: c) Male & female patients require anaesthetic lubricating gel

230. What are the principles of positioning a urine drainage bag?
a) Above the level of the bladder to improve visibility & access for the health professional
b) Above the level of the bladder to avoid contact with the floor
c) Below the level of the patient’s bladder to reduce backflow of urine
d) Where the patient finds it most comfortable

Answer: c) Below the level of the patient’s bladder to reduce backflow of urine

231. What would make you suspect that a patient in your care had a urinary tract infection?
a) The patient has spiked a temperature, has a raised white cell count (WCC), has new-onset confusion & the urine in the catheter bag is cloudy
b) The doctor has requested a midstream urine specimen
c) The patient has a urinary catheter in situ & the patient’s wife states that he seems more forgetful than usual
d) The patient has complained of frequency of faecal elimination & hasn’t been drinking enough

Answer: a) The patient has spiked a temperature, has a raised white cell count (WCC), has new-onset confusion & the urine in the catheter bag is cloudy

232. A client with frequent urinary tract infections asks the nurse how she can prevent the reoccurrence. The nurse should teach the client to:
a) Void every three hours
b) Douche after intercourse
c) Obtain a urinalysis monthly
d) Wipe from back to front after voiding

Answer: a) Void every three hours

233. A patient is prescribed metformin 1,000mg twice a day for his diabetes. While talking with the patient he states, “I never eat breakfast, so I take ½ tablet at lunch and a whole tablet at supper because I don’t want my blood sugar to drop.” As his primary care nurse you:
a) Tell him he has made a good decision and to continue
b) Tell him to take a whole tablet with lunch and with supper
c) Tell him to skip the morning dose and just take the dose at supper
d) Tell him to take one tablet in the morning and one tablet in the evening as ordered

Answer: d) Tell him to take one tablet in the morning and one tablet in the evening as ordered

234. The nurse is caring for a diabetic patient and when making rounds, notices that the patient is trembling and stating they are dizzy. The next action by the nurse would be:
a) Administer the patient’s scheduled metformin
b) Give the patient a glass of orange juice
c) Check the patient’s blood glucose
d) Call the doctor

Answer: c) Check the patient’s blood glucose

235. Common signs and symptoms of hypoglycaemia exclude:
a) Feeling hungry
b) Sweating
c) Anxiety or irritability
d) Blurred vision
e) Ketoacidosis

Answer: e) Ketoacidosis

236. Hypoglycaemia in patients with diabetes is more likely to occur when the patients take: (Select x 3 correct answers)
a) Insulin
b) Sulphonylureas
c) Prandial glucose regulators
d) Metformin

Answer: a) Insulin, b) Sulphonylureas, c) Prandial glucose regulators

237. What are the contraindications for the use of the blood glucose meter for blood glucose monitoring?
a) The patient has a needle phobia and prefers to have a urinalysis.
b) If the patient is in a critical care setting, staff will send venous samples to the laboratory for verification of blood glucose level.
c) If the machine hasn’t been calibrated
d) If peripheral circulation is impaired, collection of capillary blood is not advised as the results might not be a true reflection of the physiological blood glucose level.

Answer: d) If peripheral circulation is impaired, collection of capillary blood is not advised as the results might not be a true reflection of the physiological blood glucose level.

238. What would you do if a patient with diabetes and peripheral neuropathy requires assistance cutting his toenails?
a) Document clearly the reason for not cutting his toenails and refer him to a chiropodist.
b) Document clearly the reason for not cutting his nails and ask the ward sister to do it.
c) Have a go and if you run into trouble, stop and refer to the chiropodist.
d) Speak to the patient’s GP to ask for referral to the chiropodist, but make a start while the patient is in the hospital.

Answer: a) Document clearly the reason for not cutting his toenails and refer him to a chiropodist.

239. For an average person from the UK who has non-insulin-dependent diabetes, how many servings of fruits and vegetables per day should they take?
a) 1 serving
b) 3 servings
c) 5 servings
d) 7 servings

Answer: c) 5 servings

240. Common causes of hyperglycaemia include: (select 4)
a) Not eating enough protein
b) Eating too much carbohydrate
c) Over-treating a hypoglycaemia
d) Stress
e) Infection (for example, colds, bronchitis, flu, vomiting, diarrhoea, urinary infections, and skin infections)

Answer: b) Eating too much carbohydrate, c) Over-treating a hypoglycaemia, d) Stress, e) Infection (for example, colds, bronchitis, flu, vomiting, diarrhoea, urinary infections, and skin infections)

241. Most of the symptoms are common in both type 1 and type 2 diabetes. Which of the following symptoms is more common in type 1 than type 2?
a) Thirst
b) Weight loss
c) Polyuria
d) Ketones

Answer: d) Ketones

242. Alone, metformin does not cause hypoglycaemia (low blood sugar). However, in rare cases, you may develop hypoglycaemia if you combine metformin with:
a) a poor diet
b) strenuous exercise
c) excessive alcohol intake
d) other diabetes medications
e) all of the above

Answer: e) all of the above

243. The nurse is caring for a diabetic patient and when making rounds, notices that the patient is trembling and stating they are dizzy. The next action by the nurse would be:
a) Administer the patient’s scheduled Metformin
b) Give the patient a glass of orange juice
c) Check the patient’s blood glucose
d) Call the doctor

Answer: c) Check the patient’s blood glucose

244. When developing a program offering for patients who are newly diagnosed with diabetes, a nurse case manager demonstrates an understanding of learning styles by:
a) Administering a pre- and post-test assessment.
b) Allowing patients time to voice their opinions.
c) Providing a snack with a low glycaemic index.
d) Utilizing a variety of educational materials.

Answer: d) Utilizing a variety of educational materials.

245. Mr Cross informed you of how upset he was when you commented on his diabetic foot during your regular home visit. He is considering seeing another tissue viability nurse. How will you best respond to him?
A. Apologize for the comments made
B. Tell him of his overreaction
C. Explain that his condition will make him oversensitive to a lot of things
D. Apologize and tell him to deal with the event lightly

Answer: A. Apologize for the comments made

246. Which of the following indicates the patient needs more education when doing capillary sampling to check for blood sugar?
a) Prick tip of the index finger
b) Prick sides of a finger
c) Rotates sites of fingers

Answer: a) Prick tip of the index finger

247. The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:
A. Measure the urinary output.
B. Check the vital signs.
C. Encourage increased fluid intake.
D. Weigh the client.

Answer: B. Check the vital signs.

248. You are preparing to consider a Tuberculin (Mantoux) skin test to a client suspected of having TB. The nurse knows that the test will reveal which of the following?
A) How long the client has been infected with TB
B) Active TB infection
C) Latent TB infection
D) Whether the client has been infected with TB bacteria

Answer: D) Whether the client has been infected with TB bacteria

249. How do we handle a specimen container labelled with a yellow hazard sticker?
a) Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens
b) Wear gloves and apron, inform the infection control team and complete a datix form
c) Wear gloves and apron, place the specimen in a blue bag & complete a datix form

Answer: a) Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens

250. When collecting an MSU from a male patient, what should they do prior to the specimen being collected?
a) Clean the meatus and catch a specimen from the last of the urine voided
b) Clean the meatus and catch a specimen from the first stream of urine (approx. 30mls)
c) Clean the meatus and catch a specimen of the urine midstream

Answer: c) Clean the meatus and catch a specimen of the urine midstream

251. How do you ensure the correct blood to culture ratio when obtaining a blood culture specimen from an adult patient?
a) Collect at least 10 mL of blood
b) Collect at least 5 mL of blood.
c) Collect blood until the specimen bottle stops filling.
d) Collect as much blood as the vein will give you

Answer: b) Collect at least 5 mL of blood.

252. If blood is being taken for other tests, and a patient requires collection of blood cultures, which should come first to reduce the risk of contamination?
a) Inoculate the aerobic culture first
b) Take the other blood tests first.
c) Inoculate the anaerobic culture first.
d) The order does not matter as long as the bottles are clean

Answer: b) Take the other blood tests first.

253. Which of the following techniques is advisable when obtaining a urine specimen to minimize the contamination of a specimen?
a) Clean around the urethral meatus prior to sample collection and get a midstream/clean catch urine specimen.
b) Clean around the urethral meatus prior to sample collection and collect the first portion of urine as this is where the most bacteria will be.
c) Do not clean the urethral meatus as we want these bacteria to analyze as well.
d) Dip the urinalysis strip into the urine in a bedpan mixed with stool

Answer: a) Clean around the urethral meatus prior to sample collection and get a midstream/clean catch urine specimen.

254. When dealing with a patient who has a biohazard specimen, how will you ensure proper disposal? Select which does not apply:
a) The specimen must be labeled with a biohazard
b) The specimen must be labeled with the danger of infection
c) It must be in a double self-sealing bag
d) It must be transported to the laboratory in a secure box with a fastenable lid

Answer: b) The specimen must be labeled with the danger of infection

255. What action would you take if a specimen had a biohazard sticker on it?
a) Double bag it, in a self-sealing bag, and wear gloves if handling the specimen.
b) Wear gloves if handling the specimen, ring ahead and tell the laboratory the sample is on its way.
c) Wear goggles and underfill the sample bottle.
d) Wear appropriate PPE and overfill the bottle.

Answer: a) Double bag it, in a self-sealing bag, and wear gloves if handling the specimen.

256. How do we handle a specimen container labeled with a yellow hazard sticker?
a) Wear gloves and apron and inform the laboratory that you are sending the specimen.
b) Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens
c) Wear gloves and apron, Inform the infection control team and complete a datix form.
d) Wear gloves and apron, place specimen in a blue bag & complete a datix form.

Answer: b) Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens

257. You are caring for a patient who is known to have dementia. What particular issues should you consider prior to discharge?
a) Involve in his care: Independent Mental Capacity Advocacy Service (Mental Capacity Act 2005)
b) Involve other support services in his discharge: The hospital discharge team, social services, the mental health team

Answer: a) Involve in his care: Independent Mental Capacity Advocacy Service (Mental Capacity Act 2005)

258. Which of the following is a guiding principle for the nurse in distinguishing mental disorders from the expected changes associated with aging
a) A competent clinician can readily distinguish mental disorders from the expected changes associated with aging b) Older people are believed to be more prone to mental illness than young people
c) The clinical presentation of mental illness in older adults differs from that in other age groups
d) When physical deterioration becomes a significant feature of an elder’s life, the risk of comorbid psychiatric illness arises.

Answer: c) The clinical presentation of mental illness in older adults differs from that in other age groups

259. A normal sign of aging in the renal system is
a) Intermittent incontinence
b) Concentrated urine
c) Microscopic hematuria
d) A decreased glomerular filtration rate

Answer: d) A decreased glomerular filtration rate

260. A 76-year-old man who is a resident in an extended care facility is in the late stages of Alzheimer’s disease. He tells his nurse that he has sore back muscles from all the construction work he has been doing all day. Which response by the nurse is most appropriate?
a) “ you know you don’t work in construction anymore”
b) “What type of motion did you do to precipitate this soreness?”
c) “You’re 76 years old & you’ve been here all day. You don’t work in construction anymore.”
d) “Would you like me to rub your back for you?”

Answer: d) “Would you like me to rub your back for you?”

261. How should be the surrounding area of a patient with dementia?
A) Increased stimuli
B) Creative environment
C) Restrict activities

Answer: B) Creative environment

262. An 86-year-old male with senile dementia has been physically abused & neglected for the past two years by his live-in caregiver. He has since moved & is living with his son & daughter-in-law. Which response by the client’s son would cause the nurse great concern?
a) “How can we obtain reliable help to assist us in taking care of Dad? We can’t do it alone.”
b) “Dad used to beat us kids all the time. I wonder if he remembered that when it happened to him?”
c) “I’m not sure how to deal with Dad’s constant repetition of words.”
d) “I plan to ask my sister & brother to help my wife & me with Dad on the weekends.”

Answer: B) “Dad used to beat us kids all the time. I wonder if he remembered that when it happened to him?”

263. Knowing the difference between normal age-related changes & pathologic findings, which finding should the nurse identify as pathologic in a 74-year-old patient?
a) Increase in residual lung volume
b) Decrease in sphincter control of the bladder
c) Increase in diastolic BP
d) Decreased response to touch, heat & pain.

Answer: D) Decreased response to touch, heat & pain.

264. Which of the following is a behavioral risk factor when assessing the potential risks of falling in an older person?
a) Poor nutrition/fluid intake
b) Poor heating
c) Foot problems
d) Fear of falling

Answer: D) Fear of falling

265. What medications would most likely increase the risk for a fall?
a) Loop diuretic
b) Hypnotics
c) Betablockers
d) NSAID

Answer: B) Hypnotics

266. Among the following drugs, which does not cause falls in an elderly?
A. Diuretics
B. NSAIDS
C. Beta blockers
D. Hypnotics

Answer: C. Beta blockers

267. Mr. Bond, 72 years old, complains of difficulty of chewing his food. He normally wears upper dentures daily. On assessment, you noticed some signs of gingivitis. Which of the following signs will you expect?
a) redness of the soft palate and tissues surrounding the teeth
b) haemo-serous discharges around the gums
c) loosening of teeth
d) presence of pockets deep in the gums

Answer: d) presence of pockets deep in the gums

268. Mr. Bond also shared with you that his gums also bleed during brushing. Which of the following statements will best explain this?
a) lack of vitamin C in his diet
b) he is brushing too hard
c) he is not using the proper toothbrush to remove the plaque
d) he is flossing wrongly

Answer: B) he is brushing too hard

269. What are the principles of communicating with a patient with delirium?
a) Use short statements and closed questions in a well-lit, quiet, familiar environment.
b) Use short statements and open questions in a well-lit, quiet, familiar environment
c) Write down all questions for the patient to refer back to.
d) Communicate only through the family using short statements and closed questions.

Answer: A) Use short statements and closed questions in a well-lit, quiet, familiar environment.

270. Why is pyrexia not evident in the elderly?
a) Due to lesser body fat
b) Due to immature T cells
c) Due to aged hypothalamus
d) Due to biologic changes

Answer: C) Due to aged hypothalamus

271. Which of the following is a sign of dehydration in the elderly?
a) diminished skin turgor
b) hypertension
c) anxiety attacks
d) pyrexia

Answer: A) diminished skin turgor

272. In a community hospital, an elderly man approaches you and tells you that his neighbour 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

Answer: A) Raise a safeguarding alert

273. Which is not an appropriate way to care for patients with Dementia/Alzheimer’s?
a) Ensure people with dementia are excluded from services because of their diagnosis, age, or any learning disability. b) Encourage the use of advocacy services and voluntary support
c) Allow people with dementia to convey information in confidence.
d) Identify and wherever possible accommodate preferences (such as diet, sexuality and religion).

Answer: A) Ensure people with dementia are excluded from services because of their diagnosis, age, or any learning disability.

274. Barbara, an elderly patient with dementia, wishes to go out of the hospital. What will be your appropriate action?
a) Call the police, make sure she does not leave
b) Encourage the patient to stay for his well being
c) Inform the police to arrest the patient
d) Allow her to leave, she is stable and not at risk of anything

Answer: b) Encourage the patient to stay for his well being

275. Conditions producing orthostatic hypotension in the elderly:
A) Aortic stenosis
B) Arrhythmias
C) Diabetes
D) Pernicious anaemia
E) Advanced heart failure
F) All of the above

Answer: F) All of the above

276. An 83-year old lady just lost her husband. Her brother visited the lady in her house. He observed that the lady is acting okay but it is obvious that she is depressed. 3weeks after the husband’s death, the lady called her brother crying and was saying that her husband just died. She even said, “I cant even remember him saying he was sick.” When the brother visited the lady, she was observed to be well physically but was irritable and claims to have frequent urination at night and she verbalizes that she can see lots of rats in their kitchen. Based on the manifestations, as a nurse, what will you consider as a diagnosis to this patient?
A) urinary tract infection leading to delirium
B) delayed grieving with dementia

Answer: A) urinary tract infection leading to delirium

277. Angel, 52 years old lose her husband due to some disease. 4 weeks later, she calls her mother and says that, yesterday my husband died…I didn’t know that he was sick…I cant sleep and I see rats and mites in the kitchen. What is angel’s condition?
a) She cant adjust without her husband
b) Late grievance with signs of dementia

Answer: B) Late grievance with signs of dementia

278. Why are elderly prone to postural hypotension? Select which does not apply:
a) The baroreflex mechanisms which control heart rate and vascular resistance decline with age.
B. Because of medications and conditions that cause hypovolaemia.
C. Because of less exercise or activities.
D. Because of a number of underlying problems with BP control.

Answer: C. Because of less exercise or activities.

279. Why should healthcare professionals take extra care when washing and drying an elderly patient’s skin?
a) As the older generation deserves more respect and tender loving care (TLC).
b) As the skin of an elder person has reduced blood supply, is thinner, less elastic and has less natural oil. This means the skin is less resistant to shearing forces and wound healing can be delayed.
c) All elderly people lose dexterity and struggle to wash effectively so they need support with personal hygiene. d) As elderly people cannot reach all areas of their body, it is essential to ensure all body areas are washed well so that the colonization of Gram-positive and negative micro-organisms on the skin is avoided.

Answer: B) As the skin of an elder person has reduced blood supply, is thinner, less elastic and has less natural oil. This means the skin is less resistant to shearing forces and wound healing can be delayed.

280. Why is pyrexia not always evident in the elderly?
a) Due to immature T cells
b) Due to mature T cells
c) Due to immature D cells
d) Due to mature D cells
Answer: d) Due to mature D cells

281. Why constipation occurs in old age?
a) Anorexia and weight loss
b) Decreased muscle tone and peristalsis
c) Increased mobility
d) Increased absorption in colon
Answer: b) Decreased muscle tone and peristalsis

282. You are looking after an emaciated 80-year old man who has been admitted to your ward with acute exacerbation of chronic obstructive airways disease (COPD). He is currently so short of breath that it is difficult for him to mobilize. What are some of the actions you take to prevent him developing a pressure ulcer?
a) He will be at high risk of developing a pressure ulcer, so place him on a pressure-relieving mattress
b) Assess his risk of developing a pressure ulcer with a risk assessment tool. If indicated, procure an appropriate pressure-relieving mattress for his bed & cushion for his chair. Reassess the patient’s pressure areas at least twice a day & keep them clean & dry. Review his fluid & nutritional intake & support him to make changes as indicated.
c) Assess his risk of developing a pressure ulcer with a risk assessment tool & reassess every week. Reduce his fluid intake to avoid him becoming incontinent & the pressure areas becoming damp with urine
d) He is at high risk of developing a pressure ulcer because of his recent acute illness, poor nutritional intake & reduced mobility. By giving him his prescribed antibiotic therapy, referring him to the dietician & physiotherapist, the risk will be reduced.
Answer: b) Assess his risk of developing a pressure ulcer with a risk assessment tool. If indicated, procure an appropriate pressure-relieving mattress for his bed & cushion for his chair. Reassess the patient’s pressure areas at least twice a day & keep them clean & dry. Review his fluid & nutritional intake & support him to make changes as indicated.

283. You are looking after a 76-year old woman who has had a number of recent falls at home. What would you do to try & ensure her safety whilst she is in hospital?
a) Refer her to the physiotherapist & provide her with lots of reassurance as she has lost a lot of confidence recently
b) Make sure that the bed area is free of clutter. Place the patient in a bed near the nurse’s station so that you can keep an eye on her. Put her on an hourly toileting chart. obtain lying & standing blood pressures as postural hypotension may be contributing to her falls
c) Make sure that the bed area is free of clutter & that the patient can reach everything she needs, including the call bell. Check regularly to see if the patient needs assistance mobilizing to the toilet. ensure that she has properly fitting slippers & appropriate walking aids
d) Refer her to the community falls team who will assess her when she gets home
Answer: c) Make sure that the bed area is free of clutter & that the patient can reach everything she needs, including the call bell. Check regularly to see if the patient needs assistance mobilizing to the toilet. Ensure that she has properly fitting slippers & appropriate walking aids.

284. You are looking after a 75-year old woman who had an abdominal hysterectomy 2 days ago. What would you do to reduce the risk of her developing a deep vein thrombosis (DVT)?
a) Give regular analgesia to ensure she has adequate pain relief so she can mobilize as soon as possible. Advise her not to cross her legs
b) Make sure that she is fitted with properly fitting antiembolic stockings & that are removed daily
c) Ensure that she is wearing antiembolic stockings & that she is prescribed prophylactic anticoagulation & is doing hourly limb exercises
d) Give adequate analgesia so she can mobilize to the chair with assistance, give subcutaneous low molecular weight heparin as prescribed. Make sure that she is wearing antiembolic stockings
Answer: d) Give adequate analgesia so she can mobilize to the chair with assistance, give subcutaneous low molecular weight heparin as prescribed. Make sure that she is wearing antiembolic stockings.

285. Fiona, a 70-year old, has recently been diagnosed with type 2 diabetes. You have EC devised a care plan to meet her nutritional needs. However, you have noted that she has poor-fitting dentures. Which of the following is the least likely risk to the service user?
a) Malnutrition
b) Hyperglycemia
c) Dehydration
d) Hypoglycemia
Answer: c) Dehydration.

286. What is the most common cause of hypotension in the elderly?
a) Decreased response in adrenaline & noradrenaline
b) Atheroma changes in vessel walls
c) Hyperglycemia
d) Age
Answer: a) Decreased response in adrenaline & noradrenaline.

287. What is an intermediate care home?
a) It is the day-to-day health care given by a health care provider.
b) It includes a range of short-term treatment or rehabilitative services designed to promote independence.
c) It is a system of integrated care.
d) It is a means of organizing work, that is patient allocation.
Answer: b) It includes a range of short-term treatment or rehabilitative services designed to promote independence.

288. What is not included in the care package in a nursing home?
a) Laundry
b) Food
c) Nursing Care
d) Social Activities
Answer: d) Social Activities.

289. The nurse cares for an elderly patient with moderate hearing loss. The nurse should teach the patient’s family to use which of the following approaches when speaking to the patient?
a) Raise your voice until the patient is able to hear you.
b) Face the patient and speak quickly using a high voice.
c) Face the patient and speak slowly using a slightly lowered voice.
d) Use facial expressions and speak as you would formally
Answer: c) Face the patient and speak slowly using a slightly lowered voice.

290. Your nurse manager approaches you in a tertiary level old age home where complex cases are admitted, and she tells you that today everyone should adopt task-oriented nursing to finish the tasks by 10 am. What’s your best action?
a) Discuss with the manager that task-oriented nursing may ruin the holistic care that we provide here in this tertiary level.
b) Ask the manager to reconsider the time-bound, make sure that all staff are informed about task-oriented nursing care.
Answer: a) Discuss with the manager that task-oriented nursing may ruin the holistic care that we provide here in this tertiary level.

291. A patient with dementia is mourning and pulling the dress during night. What do you understand from this?
a) Patient is incontinent
b) Patient is having pain
c) Patient has medication toxicity.
Answer: b) Patient is having pain.

292. An elderly client with dementia is cared 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 a safeguarding and arrange a multi-disciplinary team conference
b) Do nothing as this is the best way of keeping him safe
c) Call police, social services to remove client immediately and refer to safeguarding
d) Explain this is a restraint and discuss other possible options
Answer: a) Explain this is a restraint. Urgently call for a safeguarding and arrange a multi-disciplinary team conference.

293. In a community setting, an elderly patient reported to you that he gives shopping money to his neighbors but failed to bring groceries on frequent occasions. What is your best response to this situation?
a) Confront the neighbor
b) Ignore, maybe he is very old and does not think clearly
c) Fill up a raising a concern/safeguarding form, and escalate
d) Ask the patient to report the neighbor to the police
Answer: c) Fill up a raising a concern/safeguarding form, and escalate.

294. Which of the following displays the proper use of Zimmer frame?
a) Using a 1 point gait
b) Using a 2 point gait
c) Using a 3 point gait
d) Using a 4 point gait
Answer: d) Using a 4 point gait.

295. The client advanced his left crutch first followed by the right foot, then the right crutch followed by the left foot. What type of gait is the client using?
A) Swing to gait
B) Three point gait
C) Four point gait
D) Swing through gait
Answer: C) Four point gait.

296. Nurse is teaching the patient about crutch walking, which is incorrect?
a) Take long strides
b) Take small strides
c) Instruct to put weight on hands
Answer: a) Take long strides.

297. After instructing the client on crutch walking technique, the nurse should evaluate the client’s understanding by using which of the following methods?
a) Have client explain produce to the family
b) Achievement of 90 on written test
c) Explanation
d) Return demonstration
Answer: d) Return demonstration

298. A nurse is caring for a patient with canes. After providing instruction on proper cane use, the patient is asked to repeat the instructions given. Which of the following patient statements needs further instruction?
a) ‘The hand opposite to the affected extremity holds the cane to widen the base of support & to reduce stress on the affected limb.’
b) ‘As the cane is advanced, the affected leg is also moved forward at the same time’
c) ‘When the unaffected extremity begins the swing phase, the client should bear down on the cane’
d) ‘To go up the stairs, place the cane & affected extremity down on the step. Then step down the unaffected extremity’
Answer: d) ‘To go up the stairs, place the cane & affected extremity down on the step. Then step down the unaffected extremity’

299. Nurses assume responsibility for a patient with a cane. Which of the following is the nurse’s topmost priority in caring for a patient with a cane?
a) Mobility
b) Safety
c) Nutrition
d) Rest periods
Answer: b) Safety.

300. To promote stability for a patient using walkers, the nurse should instruct the patient to place his hands at:
a) The sides of the walker
b) The hips
c) The hand grips
d) The tips
Answer: c) The hand grips.

 

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Free NMC CBT Study Materials for UK Nurses and Midwives Aspirants – MIHIRAA