NMC Part 1 – Previously Asked CBT Questions and Answers – Page 3
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100. At what stage of the nursing process does the revision of the care plan occur?
101. Hypoglycaemia in patients with diabetes is more likely to occur when the patients take:
- Prandial glucose regulators
102. What advice do you need to give to a patient taking Allopurinol?
- Drink 8 to 10 full glasses of fluid every day, unless your doctor tells you otherwise.
- Store allopurinol at room temperature away from moisture and heat.
- Avoid being near people who are sick or have infections
- Skin rash is a common side effect, it will pass after a few days
103. On assessment of the abdomen of a patient with peritonitis you would expect to find:
- Rebound tenderness and guarding
- Hyperactive, high-pitched bowel sounds and a firm abdomen
- A soft abdomen with bowel sounds every 2 to 3 seconds
- Ascites and increased vascular pattern on the skin
104. Who will you inform first if there is a shortage in supplies in your shift?
- Nursing assistant
- Purchasing personnel
- Immediate nurse manager
105. You believe that an adult you know and support has been a victim of physical abuse that might be considered a criminal offence. What should you do to support the police in an investigation?
- Question the adult thoroughly to get as much information as possible
- Take photographs of any signs of abuse or other potential evidence before cleaning up the victim or the crime scene
- Explain to the victim that you cannot speak to them unless a police officer is present
- Make an accurate record of what the person has said to you
106. 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 manager with safeguarding responsibility (if within an organisation) or Adult Social Care directly (if you are a member of the public)
- No one – it is up to the adult at risk to raise the alert
- The adult’s next of kin
- Everyone with a caring responsibility for the adult
107. If you were told by a nurse at handover to take ‘standard precautions’ what would you expect to be doing?
- Taking precautions when handling blood and ‘high-risk’ body fluids so that you don’t pass on any infection to the patient.
- Wearing gloves, aprons and mask when caring for someone in protective isolation to protect yourself from infection.
- Asking relatives to wash their hands when visiting patients in the clinical setting.
- Using appropriate hand hygiene, wearing gloves and aprons when necessary, disposing of used sharp instruments safely and providing care in a suitably clean environment to protect yourself and the patients.
108. You are caring for a patient in isolation with suspected Clostridium difficile. What are the essential key actions to prevent the spread of infection?
- Regular hand hygiene and the promotion of the infection prevention link nurse role.
- Encourage the doctors to wear gloves and aprons, to be bare below the elbow and to wash hands with alcohol handrub. Ask for cleaning to be increased with soap-based products.
- Ask the infection prevention team to review the patient’s medication chart and provide regular teaching sessions on the ‘5 moments of hand hygiene’. Provide the patient and family with adequate information.
- 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.
109. What steps would you take if you had sustained a needlestick injury?
- Ask for advice from the emergency department, report to occupational health and fill in an incident form.
- Gently make the wound bleed, place under running water and wash thoroughly with soap and water. Complete an incident form and inform your manager. Co-operate with any action to test yourself or the patient for infection with a bloodborne virus but do not obtain blood or consent for testing from the patient yourself; this should be done by someone not involved in the incident.
- Take blood from patient and self for Hep B screening and take samples and form to Bacteriology. Call your union representative for support. Make an appointment with your GP for a sickness certificate to take time off until the wound site has healed so you don’t contaminate any other patients.
- Wash the wound with soap and water. Cover any wound with a waterproof dressing to prevent entry of any other foreign material.
110. What factors are essential in demonstrating supportive communication to patients?
- Listening, clarifying the concerns and feelings of the patient using open questions.
- Listening, clarifying the physical needs of the patient using closed questions.
- Listening, clarifying the physical needs of the patient using open questions.
- Listening, reflecting back the patient’s concerns and providing a solution.
111. Dehydration is of particular concern in ill health. If a patient is receiving intravenous (IV) fluid replacement and is having their fluid balance recorded, which of the following statements is true of someone said to be in a ‘positive fluid balance’?
- The fluid output has exceeded the input.
- The doctor may consider increasing the IV drip rate.
- The fluid balance chart can be stopped as ‘positive’ in this instance means ‘good’.
- The fluid input has exceeded the output.
112. What specifically do you need to monitor to avoid complications and ensure optimal nutritional status in patients being enterally fed?
- Blood glucose levels, full blood count, stoma site and bodyweight.
- Eye sight, hearing, full blood count, lung function and stoma site.
- Assess swallowing, patient choice, fluid balance, capillary refill time.
- Daily urinalysis, ECG, protein levels and arterial pressure.
113. What is the best way to prevent a patient who is receiving an enteral feed from aspirating?
- Lie them flat.
- Sit them at least at a 45° angle.
- Tell them to lie on their side.
- Check their oxygen saturations.
114. Which check do you need to carry out before setting up an enteral feed via a nasogastric tube?
- That when flushed with red juice, the red juice can be seen when the tube is aspirated.
- That air cannot be heard rushing into the lungs by doing the ‘whoosh test’.
- That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is the same length as the time insertion.”
- That pH of gastric aspirate is >6.0, and the measurement on the NG tube is the same length as the time insertion.
115. Why should healthcare professionals take extra care when washing and drying an elderly patient’s skin?
- As the older generation deserve more respect and tender loving care (TLC).
- 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.
- All elderly people lose dexterity and struggle to wash effectively so they need support with personal hygiene.
- 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.
116. What should be included in your initial assessment of your patient’s respiratory status?
- Review the patient’s notes and charts, to obtain the patient’s history.
- Review the results of routine investigations.
- Observe the patient’s breathing for ease and comfort, rate and pattern.
- Perform a systematic examination and ask the relatives for the patient’s history.
117. When using nasal cannulae, the maximum oxygen flow rate that should be used is 6 litres/min. Why?
- Nasal cannulae are only capable of delivering an inspired oxygen concentration between 24% and 40%.
- For any given flow rate, the inspired oxygen concentration will vary between breaths, as it depends upon the rate and depth of the patient’s breath and the inspiratory flow rate.
- Higher rates can cause nasal mucosal drying and may lead to epistaxis.
- If oxygen is administered at greater than 40% it should be humidified. You cannot humidify oxygen via nasal cannulae.
118. Why is it essential to humidify oxygen used during respiratory therapy?
- 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.
- Oxygen is a dry gas which can cause 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.
- Humidification cleans the oxygen as it is administered to ensure it is free from any aerobic pathogens before it is inhaled by the patient.
119. Which of the following would indicate an infection?
- Hot, sweaty, a temperature of 36.5°C, and bradycardic.
- Temperature of 38.5°C, shivering, tachycardia and hypertensive.
- Raised WBC, elevated blood glucose and temperature of 36.0°C.
- Hypotensive, cold and clammy, and bradycardic.
120. A nurse is having trouble with doing care plans. Her team members are already noticing this problem and are worried of the consequences this may bring to the quality of nursing care delivered. The problem is already brought to the attention of the nurse. The nurse should:
- Accept her weakness and take this challenge as an opportunity to improve her skills by requesting lectures from her manager
- Ignore the criticism as this is a case of a team issue
- Continue delivering care as this will not affect the quality of care you are rendering your patient