MULTIPLE CHOICE QUESTIONS

S ource: The Roy al M arsden N inth Edition

CLINICAL NURSING PROCEDURES

Which one of the following types of wound is NOT suitable for How soon after surgery is the patient expected to pass
negative pressure wound therapy?
urine? A. 1-2 hours
A. Partial thickness burns
B. 2-4 hours
B. Contaminated wounds
C. 4-6 hours
C. Diabetic and neuropathic
D. 6-8 hours
ulcers D. Traumatic wounds
What functions should a dressing fulfil for effectiv e wound healing?
How long does the inflammatory phase of wound healing typically
last?
A. High humidity , insulation, gaseous exchange, absorbent.

A. 24 hours
B. Anaerobic, impermeable, conformable, low humidity . C.
B. Just minutes Insulation, low humidity , sterile, high adherence.

C . 1-5 day s D. Absorbent, low adherence, anaerobic, high

humidity When would it be beneficial to use a wound care
D. 3-24 day s

Which of the following methods of wound closure is most suitable plan? A. On all chronic wounds.
for a good cosmetic result following surgery?
B. On all infected wounds.
A. Skin clips
C. On all complex wounds.
B. Tissue adhesive
D. On ev ery wound
C. Adhesive skin closure
How would you care for a patient with a necrotic wound?
strips D. Interrupted sutures
A. Systemic antibiotic therapy and apply a dry
1
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. dressing. B. Debride and apply a hydrogel dressing.
Which of the following would be the most appropriate to apply?
C. Debride and apply an antimicrobial dressing.
A. Negative pressure dressing
D. Apply a negativ e pressure dressing.
B. Rapid capillary dressing
A new, postsurgical wound is assessed by the nurse and is found
C. Alginate dressing to be hot, tender and swollen. How could this wound be best
described?
D. Sk in barrier product
A. In the inflammation phase of healing.

What are the four stages of wound healing in the order they take B. In the haemostasis phase of healing.
place?
C. In the reconstructive phase of wound
A. Proliferative phase, inflammation phase, remodelling
phase, maturation phase. healing. D. As an infected wound

B. Haemostasis, inflammation phase, proliferation phase, When a patient is being monitored in the PACU, how frequently
maturation phase. should blood pressure, pulse and respiratory rate be recorded?

C. Inflammatory phase, dynamic stage, neutrophil phase, A. Every 5 minutes

maturation phase.
B. Every 15 minutes
D. Haemostasis, proliferation phase, inflammation phase,
remodelling phase C. Once an hour
support.
D. Continuously
Safe moving and handling of an anaesthetized patient is You have been asked to giv e Mrs Patel her mid day oral
imperative to reduce harm to both the patient and staff. What is metronidazole. You have never met her before. What do you need
the minimum number of staff required to provide safe manual to check on the drug chart before you administer it?
handling of a patient in theatre?
A. Her name and address, the date of the prescription and
A. 3 (1 either side, 1 at head). dose.

B. 5 (2 each side, 1 at head). B. Her name, date of birth, the ward, consultant, the dose
and route, and that it is due at 12.00.
C. 4 (1 each side, 1 at head, 1 at feet).
C. Her name, date of birth, hospital number, if she has any
D. 6 (2 each side, 1 at head, 1 at feet). known allergies, the prescription for metronidazole: dose, route,
time, date and that it is signed by the doctor, and when it was last
Why are anti-embolic stockings an effective means of reducing the given.
potential of developing a deep vein thrombosis?
D. Her name and address, date of birth, name of ward and
A. They promote arterial blood flow. consultant, if she has any known allergies specifically to penicillin,
that prescription is for metronidazole: dose, route, time, date and
B. They promote venous blood flow. that it is signed by the doctor, and when it was last given and who
gave it so you can check with them how she reacted.
C. They reduce the risk of postoperativ e swelling.
Accurate postoperative observations are key to assessing a patient's
D. They promote ly mphatic fluid flow, and drainage deterioration or recovery. The Modified Early Warning Score
(MEWS) is a scoring system that supports that aim. What is the
You are looking after a postoperative patient and when carrying primary purpose of MEWS?
out their observations, you discover that they are tachycardic and
anxious, with an increased respiratory rate. What could be A. Identifies patients at risk of deterioration.
happening? What would you do?
B. Identifies potential respiratory distress.
A. The patient is showing symptoms of hypovolaemic shock.
Investigate source of fluid loss, administer fluid replacement and C. Improve s communication between nursing staff and
get medical support. doctors.

B. The patient is demonstrating symptoms of atelectasis. D. Assesses the impact of pre existing conditions on
Administer a nebulizer, refer to physiotherapist for assessment. postoperative recovery.

C. The patient is demonstrating symptoms of uncontrolled Why is it important that patients are effectively fasted prior to
pain. Administer prescribed analgesia, seek assistance from surgery?
medical team.
A. To reduce the risk of vomiting.
D. The patient is demonstrating sy mptoms of
hy perv entilation. Offer reassurance, administer oxy gen. B. To reduce the risk of reflux and inhalation of gastric
contents.
Who should mark the skin with an indelible pen ahead of surgery?
C. To prevent vomiting and chest infections.
A. The nurse should mark the skin in consultation with the
patient D. To prevent the patient gagging

B. A senior nurse should be asked to mark the patient's skin What are the principles of gaining informed consent prior to planned
surgery?
C. The surgeon should mark the skin
A. Gaining permission for an imminent procedure by providing
D. It is best not to mark the patient's skin for fear of information in medical terms, ensuring a patient knows the potential
distressing the patient. risks and intended benefits.

What serious condition is a possibility for patients positioned in the B. Gaining permission from a patient who is competent to
Lloyd Davies position during surgery? give it, by providing information, both verbally and with written
material, relating to the planned procedure, for them to read on
A. Stroke the day of planned surgery.

B. Cardiac arrest C. Gaining permission from a patient who is competent to

give it, by informing them about the procedure and highlighting
C. Compartment syndrome risks if the procedure is not carried out.

D. There are no drawbacks to the Lloyd Davies position D. Gaining permission from a patient who is competent to
give it, by providing information in understandable terms prior to
surgery, allowing time for answering questions, and inviting
voluntary participation.

2
On checking the stock balance in the controlled drug record book What are the key reasons for administering medications to patients?
as a newly qualified nurse, you and a colleague notice a
discrepancy. What would you do? A. To provide relief from specific symptoms, for example pain,
and managing side effects as well as therapeutic purposes.
A. Check the cupboard, record book and order book. If the
missing drugs aren't found, contact pharmacy to resolv e the issue. B. As part of the process of diagnosing their illness, to prevent
You will also complete an incident form. an illness, disease or side effect, to offer relief from symptoms or to
treat a disease.
B. Document the discrepancy on an incident form and
contact the senior pharmacist on duty. C. As part of the treatment of long term diseases, for example
heart failure, and the prevention of diseases such as asthma.
C. Check the cupboard, record book and order book. If the
missing drugs aren't found the police need to be informed. D. To treat acute illness, for example antibiotic therapy for a
chest infection, and side effects such as nausea.
D. Check the cupboard, record book and order book and
inform the registered nurse or person in charge of the clinical What are the most common types of medication error?
area. If the missing drugs are not found then inform the most
senior nurse on duty. You will also complete an incident form A. Nurses being interrupted when completing their drug
rounds, different drugs being packaged similarly and stored in the
A patient in your care is on regular oral morphine sulphate. As a same place and calculation errors.
qualified nurse, what legal checks do you need to carry out every
time you administer it, which are in addition to those you would B. Unsafe handling and poor aseptic technique.
check for every other drug you administer?
C. Doctors not prescribing correctly and poor communication
A. Check to see if the patient has become tolerant to the with the multidisciplinary team.
medication so it is no longer effective as analgesia.
D. Administration of the wrong drug, in the wrong amount to
B. Check to see whether the patient has become addicted. the wrong patient, via the wrong route

C. Check the stock of oral morphine sulphate in the CD A patient has collapsed with an anaphylactic reaction. What
cupboard with another registered nurse and record this in the symptoms would you expect to see?
control drug book; together, check the correct prescription and the
identity of the patient. A. The patient will have a low blood pressure (hypotensive)
and will have a fast heart rate (tachycardia) usually associated with
D. Check the stock of oral morphine sulphate in the CD skin and mucosal changes.
cupboard with another registered nurse and record this in the
control drug book; then ask the patient to prove their identity to B. The patient will have a high blood pressure (hypertensive)
you and will have a fast heart rate (tachycardia).

As a newly qualified nurse, what would you do if a patient vomits C. The patient will quickly find breathing very difficult because
when taking or immediately after taking tablets? of compromise to their airway or circulation. This is accompanied by
skin and mucosal changes.
A. Comfort the patient, check to see if they have vomited the
tablets, and ask the doctor to prescribe something different as D. The patient will experience a sense of impending doom,
these obviously don't agree with the patient. hyperventilate and be itchy all over

B. Check to see if the patient has vomited the tablets and, if What are the potential benefits of self-administration of medicines
so, document this on the prescription chart. If possible, the drugs by patients?
may be given again after the administration of antiemetics or
when the patient no longer feels nauseous. It may be necessary to A. Nurses have more time for other aspects of patient care
discuss an alternative route of administration with the doctor. and it therefore reduces length of stay.

C. In the future administer antiemetics prior to B. It gives patients more control and allows them to take the
administration of all tablets. medications on time, as well as giving them the opportunity to
address any concerns with their medication before they are
D. Discuss with pharmacy the availability of medication in a discharged home.
liquid form or hide the tablets in food to take the taste away
C. Reduces the risk of medication errors, because patients are
Why would the intravenous route be used for the administration of in charge of their own medication.
medications?
D. Creates more space in the treatment room, so there are
A. It is a useful form of medication for patients who refuse fewer medication errors.
to take tablets because they don't want to comply with treatment.
with pharmacy so that their knowledge is kept up to date
B. It is cost effective because there is less waste as patients
forget to take oral medication.

C. The intravenous route reduces the risk of infection

because the drugs are made in a sterile environment and kept in
aseptic conditions.

D. The intravenous route provides an immediate therapeutic

effect and gives better control of the rate of administration as a
more precise dose can be calculated so treatment can be more
reliable
3
What is the most accurate method of calculating a respiratory rate? When would an orthostatic blood pressure measurement be
indicated?
A. Counting the number of respiratory cycles in 15 seconds
and multiplying by 4. A. If the patient has a recent history of falls.

B. Counting the number of respiratory cy cles in 1 minute. One B. If the patient has a history of dizziness or syncope on
cy cle is equal to the complete rise and fall of the patient's chest. changing position.

C. Not telling the patient as this may make them conscious C. If the patient has a history of hy pertension.
of their breathing pattern and influence the accuracy of the rate.
D. If the patient has a history of hy potension.
D. Placing your hand on the patient's chest and counting the
number of respiratory cycles in 30 seconds and multiplying by 2 What do the adverse effects of hypotension include?

You are caring for a 17 year old woman who has been admitted A. Decreased conscious level, reduced blood flow to vital
with acute exacerbation of asthma. Her peak flow readings are organs and renal failure.
deteriorating and she is becoming wheezy. What would you do?
B. The patient could become confused and not know who
A. Sit her upright, listen to her chest and refer to the chest they are.
physiotherapist.
C. Decreased conscious level, oliguria and reduced coronary
B. Suggest that the patient takes her Ventolin inhaler and blood flow.
continue to monitor the patient.
D. The patient feeling very cold
C. Undertake a full set of observations to include oxygen
saturations and respiratory rate. Administer humidified oxygen, What are the contraindications for the use of the blood glucose
bronchodilators, corticosteroids and antimicrobial therapy as meter for blood glucose monitoring?
prescribed.
A. The patient has a needle phobia and prefers to have a
D. Reassure the patient: you know from reading her notes urinalysis.
that stress and anxiety often trigger her asthma.
B. If the patient is in a critical care setting, staff will send
Why is it important to manually assess pulse rate? venous samples to the laboratory for verif ication of blood glucose
level.
A. Amplitude, volume and irregularities cannot be detected
using automated electronic methods C. If the machine hasn't been calibrated.

B. Tachycardia cannot be detected using automated D. If peripheral circulation is impaired, collection of capillary
electronic methods blood is not advised as the results might not be a true reflection of
the physiological blood glucose level.
C. Bradycardia cannot be detected using automated
electronic methods You are caring for a patient who has had a recent head injury and
you have been asked to carry out neurological observations every
D. It is more reassuring to the patient 15 minutes. You assess and find that his pupils are unequal and
one is not reactiv e to light. You are no longer able to rouse him.
What are the professional responsibilities of the qualified nurse in What are your actions?
medicines management?
A. Continue with your neurological assessment, calculate
A. Making sure that the group of patients that they are your Glasgow Coma Scale (GCS) and document clearly.
caring for receiv e their medications on time. If they are not
competent to administer intravenous medications, they should ask B. This is a medical emergency. Basic airway, breathing and
a competent nursing colleague to do so on their behalf. circulation should be attended to urgently and senior help should
be sought.
B. The safe handling and administration of all medicines to
patients in their care. This includes making sure that patients C. Refer to the neurology team.
understand the medicines they are taking, the reason they are
taking them and the likely side effects. D. Break down the patient's Glasgow Coma Scale as follows:
best verbal response V = XX, best motor response M = XX and
C. Mak ing sure they know the names, actions, doses and side eye opening E = XX. Use this when you hand over.
effects of all the medications used in their area of clinical practice.

D. To liaise closely with pharmacy so that their knowledge is

kept up to date

4
A patient in your care is about to go for a liver biopsy. What are How do you ensure the correct blood to culture ratio when
the most likely potential complications related to this procedure? obtaining a blood culture specimen from an adult patient?

A. Inadvertent puncture of the pleura, a blood vessel or bile A. Collect at least 10 mL of blood.
duct.
B. Collect at least 5 mL of blood.
B. Inadvertent puncture of the heart, oesophagus or spleen.
C. Collect blood until the specimen bottle stops filling.
C. Cardiac arrest requiring resuscitation.
D. Collect as much blood as the v ein will giv e y ou
D. Inadvertent puncture of the kidney and cardiac arrest.
If blood is being taken for other tests, and a patient requires
When should adult patients in acute hospital settings have collection of blood cultures, which should come first to reduce the
observations taken? risk of contamination?

A. When they are admitted or initially assessed. A plan A. Inoculate the aerobic culture first.
should be clearly documented which identifies which observations
should be taken and how frequently subsequent observations B. Take the other blood tests first.
should be done.
C. Inoculate the anaerobic culture first.
B. When they are admitted and then once daily unless they
deteriorate. D. The order does not matter as long as the bottles are clean

C. As indicated by the doctor. Which of the following would indicate an infection?

D. Temperature should be taken daily, respirations at night, A. Hot, sweaty, a temperature of 36.5C, and bradycardic.
pulse and blood pressure 4 hourly.
B. Temperature of 38.5C, shivering, tachycardia and
Why are physiological scoring systems or early warning scoring hypertensive.
systems used in clinical practice?
C. Raised WBC, elevated blood glucose and temperature of
A. They help the nursing staff to accurately predict patient 36.0C.
dependency on a shift by shift basis.
D. Hypotensive, cold and clammy, and bradycardic
B. The system provides an early accurate predictor of
deterioration by identifying physiological criteria that alert the Which of the following techniques is advisable when obtaining a
nursing staff to a patient at risk. urine specimen in order to minimize the contamination of a
specimen?
C. These scoring sy stems are carried out as part of a national
audit so we k now how sick patients are in the United Kingdom. A. Clean around the urethral meatus prior to sample
collection and get a midstream/clean catch urine specimen.
D. They enable nurses to call for assistance from the outreach
team or the doctors v ia an electronic communication sy stem. B. Clean around the urethral meatus prior to sample
collection and collect the first portion of urine as this is where the 5
A patient on your ward complains that her heart is racing and you most bacteria will be.
find that the pulse is too fast to manually palpate. What would
your actions be? C. Do not clean the urethral meatus as we want these
bacteria to analyse as well.
A. Shout for help and run to collect the crash trolley.
D. Dip the urinalysis strip into the urine in a bedpan mixed
B. Ask the patient to calm down and check her most recent with stool
set of bloods and fluid balance.
If a patient is experiencing dysphagia, which of the following
C. A full set of observations: blood pressure, respiratory rate, investigations are they likely to have?
oxygen saturation and temperature. It is essential to perform a 12
lead ECG. The patient should then be reviewed by the doctor. A. Colonoscopy.

D. Check baseline observations and refer to the cardiology B. Gastroscopy.

team.
C. Cy stoscopy.

If a patient feels a cramping sensation in their abdomen after a D. Arthroscopy

colonoscopy, it is advisable that they should do/have which of the
following? Which of the following can a patient not have if they have a
pacemaker in situ?
A. Eat and drink as soon as sedation has worn off.
A. MRI.
B. Drink 500 mL of fluid immediately to flush out any gas
retained in the abdomen. B. X ray.

C. Have half hourly blood pressure performed for 12 C. Barium

hours. D. Be nursed flat and kept in bed for 12 hours. swallow. D. CT.
In a fully saturated haemoglobin molecule, responsible for carrying You are caring for a patient with a hi story of COAD who is requiring
oxygen to the body's tissues, how many of its haem sites are 70% humidified oxy gen v ia a facemask . You are monitoring his
bound with oxygen? response to therapy by observ ing his colour, degree of respiratory
distress and respiratory rate. The patient's oxy gen saturations hav e
A. 2 been between 95% and 98%. In addition, the doctor has been tak ing
arterial blood gases. What is the reason for this?
B. 4
A. Oximeters may be unreliable under certain circumstances,
C. 6 e.g. if tissue perfusion is poor, if the environment is cold and if the
patient's nails are covered with nail polish.
D.
B. Arterial blood gases should be sampled if the patient is
Which of the following is NOT a cause of Type 1 (hypoxaemic) receiving >60% oxygen.
respiratory failure?
C. Pulse oximeters provide excellent evidence of
A. Asthma oxygenation, but they do not measure the adequacy of ventilation.

B. Pulmonary oedema D. Arterial blood gases measure both oxygen and carbon
dioxide levels and therefore give an indication of both ventilation
C. Drug overdose and oxygenation

D. Granulomatous lung disease When using nasal cannulae, the maximum oxygen flow rate that
should be used is 6 litres/min. Why?
Prior to sending a patient home on oxygen, healthcare providers
must ensure the patient and family understand the dangers of A. Nasal cannulae are only capable of delivering an inspired
smoking in an oxygen-rich environment. Why is this necessary? oxygen concentration between 24% and 40%.

A. It is especially dangerous to the patient's health to smoke B. For any giv en flow rate, the inspired oxy gen concentration w ill
while using oxygen v ary between breaths, as it depends upon the rate and depth of the
patient's breath and the inspiratory flow rate.
B. Oxygen is highly flammable and there is a risk of fire
C. Higher rates can cause nasal mucosal drying and may
C. Oxygen and cigarette smoke can combine to produce a lead to epistaxis.
poisonous mixture
D. If oxygen is administered at greater than 40% it should
D. Oxy gen can lead to an increased consumption of cigarettes be humidified. You cannot humidify oxygen via nasal cannulae

What action would you take if a specimen had a biohazard sticker You are currently on placement in the emergency department
on it? (ED). A 55 year old city worker is bluelighted into the ED having
had a cardiorespiratory arrest at work. The paramedics have been
A. Double bag it, in a self-sealing bag, and wear gloves if resuscitating him for 3 minutes. On arrival, he is in ventricular
handling the specimen. fibrillation. Your mentor asks you the following question prior to
your shift starting: What will be the most important part of the
B. Wear gloves if handling the specimen, ring ahead and tell patient's immediate advanced life support?
the laboratory the sample is on its way.
6
A. Early defibrillation to restart the heart.
C. Wear goggles and underfill the sample bottle.
B. Early cardiopulmonary resuscitation.
D. Wear appropriate PPE and ov erfill the bottle.
C. Administration of adrenaline ev ery 3 minutes.
What is the best way to avoid a haematoma forming when
undertaking venepuncture? D. Correction of rev ersible causes of hy poxia

A. Tap the vein hard which will get the vein up, especially if Why is it essential to humidify oxygen used during respiratory
the patient has fragile veins. This will avoid bruising afterwards. therapy?

B. It is unavoidable and an acceptable consequence of the A. Oxygen is a very hot gas so if humidification isn't used,
procedure. This should be explained and documented in the the oxygen will burn the respiratory tract and cause considerable
patient's notes. pain for the patient when they breathe.

C. Choosing a soft, bouncy vein that refills when depressed B. Oxygen is a dry gas which can cause evaporation of water
and is easily detected, and advising the patient to keep their arm from the respiratory tract and lead to thickened mucus in the
straight whilst firm pressure is applied. airways, reduction of the movement of cilia and increased
susceptibility to respiratory infection.
D. Apply pressure to the vein early before the needle is
removed, then get the patient to bend the arm at a right angle C. Humidification cleans the oxygen as it is administered to
whilst applying firm pressure 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 to the blood in the lungs. This
means the cells that need it for intracellular function have their
needs met in a more timely manner
Which of the following is NOT a symptom of impacted earwax? What does the term breakthrough pain mean, and what type of
prescription would you expect for it?
A. Dizziness
A. A patient who has adequately controlled pain relief with
B. Dull hearing short lived exacerbation of pain, with a prescription that has no
regular time of administration of analgesia.
C. Reflux cough
B. Pain on movement which is short lived, with a q.d.s.
D. Sneezing prescription, when necessary.

After death, who can legally give permission for a patient's body to C. Pain that is intense, unexpected, in a location that differs
be donated to medical science? from that previously assessed, needing a review before a
prescription is written.
A. Only the patient, if they left instructions for this
D. A patient who has adequately controlled pain relief with
B. The patient's spouse or next-of-kin short lived exacerbation of pain, with a prescription that has 4
hourly frequency of analgesia if necessary
C. The patient's GP
A patient has just returned from theatre following surgery on their
D. The doctor in charge at the time of death left arm. They have a PCA infusion connected and from the
admission, you remember that they have poor dexterity with their
What should be included in your initial assessment of your right hand. They are currently pain free. What actions would you
patient's respiratory status? take?

A. Review the patient's notes and charts, to obtain the A. Educate the patient's family to push the button when the
patient's history. patient asks for it. Encourage them to tell the nursing staff when
they leave the ward so that staff can take over.
B. Review the results of routine investigations.
B. Routinely offer the patient a bolus and document this
C. Observe the patient's breathing for ease and comfort, rate clearly.
and pattern.
C. Contact the pain team/anaesthetist to discuss the
D. Perform a systematic examination and ask the relatives situation and suggest that the means of delivery are changed.
for the patient's history.
D. The patient has paracetamol q.d.s. written up, so this
What should be included in a prescription for oxygen therapy? should be adequate pain relief

A. You don't need a prescription for oxygen unless in an In which of the following situations might nitrous oxide (Entonox)
emergency. be considered?

B. The date it should commence, the doctor's signature and A. A wound dressing change for short term pain relief or the
bleep number. removal of a chest drain for reduction of anxiety.

C. The type of oxygen delivery system, inspired oxygen B. Turning a patient who has bowel obstruction because
percentage and duration of the therapy. there is an expectation that they may have pain from pathological
fractures.
D. You only need a prescription if the patient is going to
have home oxygen C. For pain relief during the insertion of a chest drain for the
treatment of a pneumothorax.
You are caring for a patient with a tracheostomy in situ who
requires frequent suctioning. How long should you suction for? D. For pain relief during a wound dressing for a patient who
has had radical head and neck cancer that involved the jaw.
A. If you preoxygenate the patient, you can insert the
catheter for 45 seconds. What are the key nursing observations needed for a patient
receiving opioids frequently?
B. Never insert the catheter for longer than 10-15 seconds.
A. Respiratory rate, bowel movement record and pain
C. Monitor the patient's oxygen saturations and suction for assessment and score.
30 seconds.
B. Checking the patent is not addicted by looking at their
D. Suction for 50 seconds and send a specimen to the blood pressure.
laboratory if the secretions are purulent.
C. Lung function tests, oxygen saturations and addiction
levels.

D. Daily completion of a Bristol stool chart, urinalysis, and a

record of the frequency with which the patient reports
breakthrough pain.

7
 Your patient has a bulky oesophageal tumour and is waiting for
Why should healthcare professionals take extra care when surgery. When he tries to eat, food gets stuck and giv es him
washing and drying an elderly patient's skin? heartburn. What is the most likely route that will be chosen to
provide him with the nutritional support he needs?
A. As the older generation deserve more respect and tender
A. Nasogastric tube feeding.
loving care (TLC).
B. Feeding via a percutaneous endoscopic gastrostomy (PEG).
B. As the sk in of an elder person has reduced blood supply , is
thinner, less elastic and has less natural oil. This means the sk in is less
resistant to shearing forces and wound healing can be delay ed. C. Feeding via a radiologically inserted gastrostomy (RIG).

D. Continue oral food

C. All elderly people lose dexterity and struggle to wash
effectively so they need support with personal hygiene.
What is the best way to prevent a patient who is receiving an enteral
feed from aspirating?
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
A. Lie them flat.
colonization of Gram positive and negative micro organisms on the
skin is avoided
B. Sit them at least at a 45 angle.
What would you do if a patient with diabetes and peripheral
neuropathy requires assistance cutting his toe nails? C. Tell them to lie on their side.

A. Document clearly the reason for not cutting his toe nails D. Check their oxygen saturations.
and refer him to a chiropodist.
Which of the following medications are safe to be administered via
B. Document clearly the reason for not cutting his nails and a nasogastric tube?
ask the ward sister to do it.
A. Enteric coated drugs to minimize the impact of gastric
C. Have a go and if you run into trouble, stop and refer to irritation.
the chiropodist.
B. A cocktail of all medications mixed together, to save time
D. Speak to the patient's GP to ask for referral to the and prevent fluid overloading the patient.
chiropodist, but make a start while the patient is in hospital
C. Any drugs that can be crushed.
A patient is agitated and is unable to settle. She is also finding it
difficult to sleep, reporting that she is in pain. What would you do D. Drugs that can be absorbed via this route, can be crushed
at this point? and given diluted or dissolved in 10-15 mL of water.

A. Ask her to score her pain, describe its intensity, duration, Which check do you need to carry out before setting up an enteral
the site, any relieving measures and what makes it worse, looking feed via a nasogastric tube?
for non verbal clues, so you can determine the appropriate
method of pain management. A. That when flushed with red juice, the red juice can be seen
when the tube is aspirated.
B. Give her some sedatives so she goes to sleep.
B. That air cannot be heard rushing into the lungs by doing
C. Calculate a pain score, suggest that she takes deep the whoosh test.
breaths, reposition her pillows, return in 5 minutes to gain a
comparative pain score. C. That the pH of gastric aspirate is <5.5, and the
measurement on the NG tube is the same length as the time
D. Give her any analgesia she is due. If she hasn't any, insertion.
contact the doctor to get some prescribed. Also give her a warm
milky drink and reposition her pillows. Document your action. D. That pH of gastric aspirate is >6.0, and the measurement
on the NG tube is the same length as the time insertion
On which step of the WHO analgesic ladder would you place
tramadol and codeine? Fred is going to receive a blood transfusion. How frequently should
we do his observations?
A. Step 1: Non Opioid Drugs.
A. Temperature and pulse before the blood transfusion
B. Step 2: Opioids for Mild to Moderate Pain. begins, then every hour, and at the end of bag/unit.

C. Step 3: Opioids for Moderate to Severe B. Temperature, pulse, blood pressure and respiration before
the blood transfusion begins, then after 15 minutes, then as
Pain. D. Herbal medicine indicated in local guidelines, and finally at the end of the bag/unit.

C. Temperature, pulse, blood pressure and respiration and

urinalysis before the blood transfusion, then at end of bag.

D. Pulse, blood pressure and respiration every hour, and at

the end of the bag.

8
Approximately how long is the spinal cord in an adult? Mrs Jones has had a cerebral vascular accident, so her left leg is
increased in tone, very stiff and difficult to position comfortably
A. 30cm when she is in bed. What would you do?

B. 45cm A. Give Mrs Jones analgesia and suggest she sleeps in the
chair.
C . 60cm
B. Try to diminish increased tone by avoiding extra stimulation
D. 120cm by ensuring her foot doesn't come into contact with the end of the
bed; supporting, with a pillow, her left leg in side lying and keeping
Dehydration is of particular concern in ill heath. If a patient is the knee flexed.
receiving intravenous (IV) fluid replacement and is having their
fluid balance recorded, which of the following statements is true of C. Give Mrs Jones diazepam and tilt the bed.
someone said to be in a positive fluid balance?
D. Suggest a warm bath before she lies on the bed. Then use
A. The fluid output has exceeded the input. pillows to support the stiff limb

B. The doctor may consider increasing the IV drip rate. Which of the following is a behavioural risk factor when assessing
the potential risks of falling in an older person?
C. The fluid balance chart can be stopped as positive in this
instance means good. A. Poor nutrition/fluid intake

D. The fluid input has exceeded the output. B. Poor heating

What specifically do y ou need to monitor to avoid comp lications and C. Foot problems
ensure optimal nutritional status in patients being enterally fed?
D. Fear of falling
A. Blood glucose levels, full blood count, stoma site and
bodyweight. When positioning the supine patient in bed, why should you ensure
the patient is lying centrally in the bed?
B. Eye sight, hearing, full blood count, lung function and
stoma site. A. To ensure spinal and limb alignment

C. Assess swallowing, patient choice, fluid balance, capillary B. To ensure patient comfort
refill time.
C. To ensure the airway is patent
D. Daily urinalysis, ECG, protein levels and arterial pressure
D. To minimize the risk of injury to the practitioner
A patient needs weighing, as he is due a drug that is calculated on
bodyweight. He experiences a lot of pain on movement so is In what instances shouldn't you position a patient in a side-lying
reluctant to move, particularly stand up. What would you do? position?

A. Document clearly in the patient's notes that a weight A. If they are pregnant
cannot be obtained.
B. If they have a spinal fracture
B. Offer the patient pain relief and either use bed scales or a
hoist with scales built in. C. If they have pressure sores

C. Discuss the case with your colleagues and agree to guess D. If they have lower limb pain
his bodyweight until he agrees to stand and use the chair scales.
What does muscle atrophy mean?
D. Omit the drug as it is not safe to give it without this
information; inform the doctor and document your actions A. Increase in muscle mass

If the prescribed volume is taken, which of the following types of B. Loss of muscle mass
feed will provide all protein, vitamins, minerals and trace elements
to meet a patient's nutritional requirements? C. A change in the shape of muscles

A. Protein shakes/supplements. D. Disease of the muscle

B. Sip feeds.

C. Energy drinks.

D. Mixed fat and glucose polymer solutions/powders

A patient has been admitted for nutritional support and started

receiving a hyperosmolar feed yesterday. He presents with
diarrhoea but has no pyrexia. What is likely to be the cause?

A. The feed.

B. An infection.

C. Food poisoning.

D. Being in hospital
9
How do the structures of the human body work together to Perdue categorizes constipation as primary , secondary or iatrogenic.
provide support and assist in movement? What could be some of the causes of iatrogenic constipation?

A. The skeleton provides a structural framework. This is A. Inadequate diet and poor fluid intake.
moved by the muscles that contract or extend and in order to
function, cross at least one joint and are attached to the B. Anal fissures, colonic tumours or hypercalcaemia.
articulating bones.
C. Lifestyle changes and ignoring the urge to
B. The muscles provide a structural framework and are
moved by bones to which they are attached by ligaments. defaecate. D. Antiemetic or opioid medication.

C. The skeleton provides a structural framework; this is A patient is admitted to the ward with symptoms of acute
moved by ligaments that stretch and contract. diarrhoea. What should your initial management be?

D. The muscles provide a structural framework, moving by A. Assessment, protective isolation, universal precautions.
contracting or extending, crossing at least one joint and attached
to the articulating bones. B. Assessment, source isolation, antibiotic therapy.

What are the most common effects of inactivity? C. Assessment, protectiv e isolation, antimotility medication.

A. Pulmonary embolism, urinary tract infection and fear of D. Assessment, source isolation, univ ersal precautions
people.
Your patient has undergone a formation of a loop colostomy. What
B. Deep arterial thrombosis, respiratory infection, fear of important considerations should be borne in mind when selecting
movement, loss of consciousness, deconditioning of cardiovascular an appropriate stoma appliance for your patient?
system leading to an increased risk of angina.
A. Dexterity of the patient, consistency of effluent, type of
C. Loss of weight, frustration and deep vein thrombosis. stoma.

D. Social isolation, loss of independence, exacerbation of B. Patient preference, type of stoma, consistence of effluent,
symptoms, rapid loss of strength in leg muscles, deconditioning of state of peristomal skin, dexterity of patient.
cardiovascular system leading to increased risk of chest infection,
and pulmonary embolism. C. Patient prefere nce, lifestyle, positio n of stoma, consistency
of effluent, state of peristomal skin, dexterity of patient, type of
What do you need to consider when helping a patient with stoma.
shortness of breath sit out in a chair?
D. Cognitive ability, lifestyle, patient dexterity, position of
A. They shouldn't sit out in a chair; lying flat is the only stoma, state of peristo ma l skin, type of stoma, consiste ncy of
position for someone with shortness of breath so that there are no effluent, patient preference.
negative effects of gravity putting pressure on the lungs.
What type of diet would you recomm e nd to your patient who has a
B. Sitting in a reclining position with the legs elevated to newly formed stoma?
reduce the use of postural muscle oxygen requirements,
increasing lung volumes and optimizing perfusion for the best V/Q A. Encourage high fibre foods to avoid constipation.
ratio. The patient should also be kept in an environment that is
quiet so they don't expend any unnecessary energy. B. Encoura g e lots of vegetable s and fruit to avoid constipatio n.

C. The patient needs to be able to sit in a forward leaning C. Encourage a varied diet as people can react differently.
position supported by pillows. They may also need access to a
nebulizer and humidified oxygen so they must be in a position D. Avoid spicy foods because they can cause erratic function
where this is accessible without being a risk to others.
What would be your main objectives in providing stoma education
D. There are two possible positions, either sitting upright or side when preparing a patient with a stoma for discharge home?
ly ing. Which is used is determined by the age of the patient. It is also
important to remember that they will alway s need a nebulizer and A. That the patient can independently manage their stoma,
oxy gen and the air temperature must be below 20 C and can get supplies.

Your patient has bronchitis and has difficulty in clearing his chest. B. That the patient has had their appliance changed
What position would help to maximize the drainage of secretions? regularly, and knows their community stoma nurse.

A. Lying flat on his back while using a nebulizer. C. That the patient knows the community stoma nurse, and
has a prescription.
B. Sitting up leaning on pillows and inhaling humidified
oxygen. D. That the patient has a referral to the District Nurses for
stoma care.
C. Lying on his side with the area to be drained uppermost
after the patient has had humidified air.

D. Standing up in fresh air taking deep breaths

10
When communicating with someone who isn't a native English What are the principles of communicating with a patient with
speaker, which of the following is NOT advisable? delirium?

A. Using a translator A. Use short statements and closed questions in a well lit,
quiet, familiar environment.
B. Use short, precise sentences
B. Use short statements and open questions in a well lit, quiet,
C. Relying on their family or friends to help explain what you familiar environment.
mean
C. Write down all questions for the patient to refer back to.
D. Write things down
D. Communicate only through the family using short
When should a penile sheath be considered as a means of statements and closed questions.
managing incontinence?
Which of the following is NOT an example of non-verbal
A. When other methods of continence management have communication?
failed.
A. Dress
B. Following the removal of a catheter.
B. Facial expression
C. When the patient has a small or retracted
C. Posture
penis. D. When a patient requests it.
D. Tone
What is the most important guiding principle when choosing the
correct size of catheter? Which of these is an example of an open question?

A. The biggest size tolerable. A. Are you feeling better today?

B. The smallest size necessary. B. When you said you are hurt, what do you mean?

C. The potential length of use of the C. Can you tell me what is concerning you?

catheter. D. The build of the patient D. Is that what you are looking for?

When carrying out a catheterization, on which patients would you According to Argyle (1988), when two people communicate what
use anaesthetic lubricating gel prior to catheter insertion? percentag e of what is communica te d is actually in the words
spoken?
A. Male patients to aid passage, as the catheter is longer.
A. 90%
B. Female patients as there is an absence of lubricating
glands in the female urethra, unlike the male urethra. B. 50%

C. Male and female patients require anaesthetic lubricating C. 23%

gel.
D. 7%
D. The use of anaesthetic lubricating gel is not advised due
to potential adverse reactions Which of the following are barriers to effective communication?

On removing your patient's catheter, what should you encourage A. Cultural differences
your patient to do?
B. Unfamiliar accents
A. Rest and drink 2-3 litres of fluid per day.
C. Overly technical language and terminology
B. Rest and drink in excess of 5 litres of fluid per day.
D. Hearing problems
C. Exercise and drink 2-3 litres of fluid per day.
E. All of the above
D. Exercise and drink their normal amount of fluid intak e.
What are the principles of positioning a urine drainage bag?

A. Above the level of the bladder to improve visibility and

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.

11
Which behaviours will encourage a patient to talk about their What infection is thought to be caused by prions?
concerns?
A. Leprosy
A. Giving reassurance and telling them not to worry.
B. Pneumocystis jirovecii
B. Asking the patient about their family and friends.
C. Norovirus
C. Tell the patient you are interested in what is concerning
them and that you are available to listen. D. Creutzfeldt Jakob disease

D. Tell the patient you are interested in what is concerning E. None of the above
them and if they tell you, they will feel better
If a patient requires protective isolation, which of the following
should you advise them to drink?
What is the difference between denial and collusion?
A. Filtered water only
A. Denial is when a healthcare professional refuses to tell a
patient their diagnosis for the protection of the patient whereas B. Fresh fruit juice and filtered water
collusion is when healthcare professionals and the patient agree
on the information to be told to relatives and friends. C. Bottled water and tap water

B. Denial is when a patient refuses treatment and collusion is D. Tap water only
when a patient agrees to it.
E. Long-life fruit juice and filtered water
C. Denial is a coping mechanism used by an individual with
the intention of protecting themselves from painful or distressing All individuals providing nursing care must be competent at which
information whereas collusion is the withholding of information of the following procedures?
from the patient with the intention of protecting them.
A. Hand hygiene and aseptic technique
D. Denial is a normal acceptable response by a patient to a
life threatening diagnosis whereas collusion is not B. Aseptic technique only

If you were explaining anxiety to a patient, what would be the C. Hand hygiene, use of protective equipment, and disposal
main points to include? of waste

A. Signs of anxiety include behaviours such as muscle D. Disposal of waste and use of protective equipment
tension, palpitations, a dry mouth, fast shallow breathing,
dizziness and an increased need to urinate or defaecate. E. All of the above

B. Anxiety has three aspects: phy sical - bodily sensations related For which type of waste should orange bags be used?
to flight and fight response, behav ioural - such as av oiding the
situation, and cognitiv e (think ing) - such as imagining the worst. A. Waste that requires disposal by incineration

C. Anxiety is all in the mind, if they learn to think differently, B. Offensive/hygiene waste
it will go away.
C. Waste which may be treated
D. Anxiety has three aspects: physical - such as running
away, behavioural - such as imagining the worse (catastrophizing), D. Offensive waste
and cognitive (thinking) - such as needing to urinate.
If you were told by a nurse at handover to take standard
precautions, what would you expect to be doing? A. Using
What factors are essential in demonstrating supportive appropriate hand hygiene, wearing gloves and an apron when
communication to patients? necessary, disposing of used sharp instruments safely, and
providing care in a suitably clean environment to protect yourself
A. Listening, clarifying the concerns and feelings of the and the patients.
patient using open questions. Which of the following is not normally considered to be a high risk
fluid?
B. Listening, clarifying the physical needs of the patient
using closed questions. A. Cerebrospinal fluid

C. Listening, clarifying the physical needs of the patient B. Urine

using open questions.
C. Peritoneal fluid
D. Listening, reflecting back the patient's concerns and
providing a solution. D. Semen

E. All of the above

12
What percentage of patients in hospital in England, at the time of
the 2011 National Prevalence survey, had an infection?

A. 4.6%

B. 6.4%

C. 14%

D. 16%
Which of the following is NOT a typical characteristic of bacteria?

A. Cell wall

B. Eukaryocyte

C . S pherical

D. S pores

Which of the following is NOT a stage in the life cycle of viruses?

A. Attachment

B. Uncoating

C. Replication

D. Dispersal

For which of the following modes of transmission is good hand

hygiene a key preventative measure?

A. Airborne

B. Direct contact

C. Indirect contact

D. Droplet

E. All of the above

13
If you were told by a nurse at handover to take standard
precautions, what would you expect to be doing?

A. Taking precautions when handling blood and high risk

body fluids so as not to pass on any infection to the patient

B. Wearing gloves, an apron and a mask when caring for

someone in protective isolation

C. Asking relatives to wash their hands when visiting patients

in the clinical setting

D. Using appropriate hand hygiene, wearing gloves and an

apron when necessary, disposing of used sharp instruments safely,
and providing care in a suitably clean environment to protect
yourself and the patients.
 Q& A Q. What would make you suspect that a patient in your care had a
urinary tract infection?
Q. You are a registered nurse in a community giving health
education to a patient and you notice that the student nurse is A. The patient has spiked a temperature, has a raised
using his cell phone to text, what should you do? white cell count (WCC), has new-onset confusion and
the urine in his catheter bag is cloudy.
A. Politely signal the student and encourage him by
actively including him in the discussion. Q. What steps would you take if you had sustained a needle stick
injury?
Q. A nurse is having trouble with doing care plans. Her team
me mbers are already noticing this problem and are worried of the A. Gently mak e the wound bleed, place under running water
consequences this may bring to the quality of nursing care and wash thoroughly with soap and water. Complete an
delivered. The problem is already brought to the attention of the incident form and inform y our manager. Co-operate with
nurse. The nurse should: any action to test y ourself or the patient for infection with a
blood borne v irus but do not obtain blood or consent for
A. Accept her weakness and take this challenge as an testing from the patient y ourself; this should be done by
opportunity to improve her skills by requesting lectures someone not inv olv ed in the incident.
from her manager.

Q. If y ou were told by a nurse at handov er to tak e standard

Q. Why is it essential to humidify oxygen used during respiratory precautions what would you expect to be doing?
therapy?
A. Using appropriate hand hygiene, wearing gloves and
A. Oxygen is a dry gas which can cause evaporation of aprons when necessary, disposing of used sharp
water from the respiratory tract and lead to thickened instruments safely and providing care in a suitably clean
mucus in the airways, reduction of the movement of cilia environment to protect yourself and the patients.
and increased susceptibility to respiratory infection.
Q. You believ e that an adult you know and suppo rt has been a v ictim
of phy sical abuse that might be considered a criminal offence. What
should y ou do to support the police in an inv estigation?
Q. When using nasal cannulae, the maximum oxygen flow rate
that should be used is 6 litres/min. Why?
A. Make an accurate record of what the person has said to
you.
A. Higher rates can cause nasal mucosal drying and may
lead to epistaxis.
Q. A young mother who delivered 48hrs ago comes back to the
emergency department with post partum haemorrhage. What type
Q. What should be included in your initial assessment of your of PPH is it?
patients respiratory status?
A. Secondary post partum haemorrhage.
A. Observe the patients breathing for ease and comfort,
rate and pattern.
Q. What do you mean by MRSA?
Q. Why should healthcare professionals take extra care when 14
washing and drying an elderly patients skin? A. Methicillin-resistant staphyloccocus aureus

A. As the skin of an elder person has reduced blood supply, Q. Who will you inform first if there is a shortage in supplies in
is thinner, less elastic and has less natural oil. This your shift?
means the skin is less resistant to shearing forces and
wound healing can be delayed. A. Immediate nurse manager

Q. What is the best way to prevent a patient who is receiv ing an Q. You are to take charge of the next shift of nurses. Few minutes
enteral feed from aspirating? before your shift, the in charge of the current shift informed you
that two of your nurses will be absent. Since there is a shortage of
A. Sit them at least at a 45 angle. staff in your shift, what will you do?

A. Ask from your manager if there are qualified staff from

Q. What specifically do you need to monitor to av oid complications and the previous shift that can cover the lacking number for
ensure optimal nutritional status in patients being enterally fed? your shift while you try to replace new nurses to cover.

A. Blood glucose levels, full blood count, stoma site and

bodyweight. Q. As you visit your patient during rounds, you notice a thin child
who is shy and not mingling with the group who seemed to be
visitors of the patient. You offered him food but his mother told
Q. What factors are essential in de monstrating supportive you not to mind him as he is not eating much while all of them are
communication to patients? eating during that time. As a nurse, what will you do?

A. Listening, clarifying the concerns and feelings of the A. Raise the situation to your head nurse and discuss with
patient using open questions. her what intervention might be done to help the child.

Q. What could be the reason why you instruct your patient to

retain on its original container and discard nitrogly cerine meds
Q. NMC requires in the UK how many units of continuing education
after 8 weeks?
units a nurse should have in 3 years?

A. 35 units A. Removing from its darkened container exposes the

medicine to the light and its potency will decrease after
8 weeks.
Q. Who is responsible in disposing sharps? Q. The degree of injection when giving subcutaneous insulin
injection on a site where you can grasp 1 inch of tissue?
A. Whoever used the sharps.
A. 45 degrees

Q. Where will you put infectious linen? Q. What is the best position in applying eye medications?

A. Red plastic bag designed to disintegrate when exposed A. Sitting position with head tilt backwards
to heat.

Q. The worst advice you can give a student nurse with regards to
Q. What does AVPU mean? the use of social networking sites like Facebook?

A. Alert voice pain unresponsive. A. Do not identify yourself as a nurse; Rely on the sites
privacy settings

Q. When will you consider giv ing out information of the patient to
a police officer? Q. Which bag do you place infected linen?

A. If safety of the public is at risk. A. Water-soluble alginate poly thene bag before being placed in
the appropriate linen bag, no more than full.

Q. For an av erage person from Uk who has non-insulin dependent Q. In the News observation system, what is AVUP?
diabetes, how many serv ings of fruits and v egetables per day should
they take?
A. Assessment for the level of consciousness.
A. 5 servings
Q. Normal heart rate for 1 to 2 years old?

Q. A relativ e of the patient was experiencing vomiting and diarrhea and A. 80 - 110 beats per minute
wished to v isit her mother who was admitted. As a nurse, what
will you advise to the patient's relative?
Q. What adv ice do y ou need to giv e to a patient tak ing Allopurinol?
A. There should be 48 hours after active symptoms should
disappear prior to visiting patient.
A. 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
Q. As a nurse, what health teachings will you give to a COPD near people who are sick or have infections
patient?

A. Encourage to stop smoking; Administer oxygen Q. Safeguarding is the responsibility of:

inhalation as prescribed; Enroll in a pulmonary
rehabilitation programme. A. Health care assistants; Registered nurses; Doctors
15

Q. In a community hospital, an elderly man approaches you and Q. Hypoglycaemia in patients with diabetes is more likely to occur
tells you that his neighbour has been stealing his money, saying when the patients take:
"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 A. Insulin; Sulphonylureas; Prandial glucose regulators
action for this?

A. Raise a safeguarding alert Q. Enteral feeding patient checks patency of tube placement by:

A. Aspirating gastric juice and then check ing for ph <4 X-ray
Q. On physical examination of a 16 year old female patient, you
notice partial erosion of her tooth enamel and callus formation on
the posterior aspect of the knuckles of her hand. This is indicative Q. A doctor prescribes an injection of 200 micrograms of drug. The
of: stock bottle contains 1mg/ml. How many ml will you administer?

A. Self-induced vomiting and she likely has bulimia nervosa A. 0.2 ml

Q. Patients with gastric ulcers typically exhibit this symptom: Q. The doctor prescribes 25mg of a drug to be giv en by injection. It is
a drug dispensed in a solution of strength 50mg/ml. How many
A. Epigastric pains worsens after eating and weight loss ml should you administer?

A. 0.5 ml Dose Prescribed: Dose /ml - 25:50=0.5

Q. Commonly aneurysms can develop on?

A. Abdominal aorta; Circle of Willis Q. 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?
Q. A patient suffered from stroke and is unable to read and write. A. 3 tablets
This is called:

A. Dysphasia
Q. Patient has next dose of Digoxin but has a CR=58
Q. A patient is assessed as lacking capacity to give consent if they
A. Omit dose, record why, and inform the doctor are unable to:

A. Understand information about the decision and

Q. Patient is post op liver biopsy which is a sign of serious remember that information; Use that information to
complication make a decision; Communicate their decision by talking,
using sign language or by any other means
A. Nausea and vomiting; Bleeding

Q. Hospital discharge planning for a patient should start:

Q. A suicidal Patient is admitted to psychiatric facility for 3 days
when suddenly he is showing signs of cheerfulness and A. On the admission assessment
motivation. The nurse should see this as:

A. That she has finalize suicide plan. Q. Recommended preoperative fasting times are:

A. 6-12 hours
Q. You are monitoring a patient in the ICU when suddenly his
consciousness drops and the size of one his pupil becomes smaller
what should you do? Q. The following are signs of a speed shock:

A. Call the doctor; Consider this as an emergency and A. Flushed face; Headache and dizziness; Tachycardia and
prioritize abc fall in blood pressure

Q. What position should you prepare the patient in preop for Q. Compassion in Practice the culture of compassionate care
abdominal Paracentesis? encompasses:

A. Supine with head of bed elevated to 40-50cm A. Care, Compassion, Competence, Communication,
Courage, Commitment

Q. Wound proliferation starts after?

Q. In a patient with hourly monitoring, when does a nurse formally
A. 3-24 days document the monitoring?

Q. What do you expect to manifest with fluid volume deficit? A. Every hour

A. High Pulse, low BP Q. You can delegate medication administration to a student if:

A. Only under close, direct supervision

Q. Patient usually urinates at night Nurse identifies this as: 16
A. Nocturia
Q. At what stage of the nursing process does the revision of the
care plan occur?

Q. The signs and symptoms of ectopic pregnancy: A. Evaluation

A. Vaginal bleeding; Positive pregnancy test; Shoulder tip

pain Q. When do you gain consent from a patient and consider it valid?
Q. What medications would most likely increase the risk for fall? A. Only if a patient has the mental capacity to giv e consent.

A. Hypnotics

Q. Adequate record keeping for a medical device should provide

evidence of:
Q. In DVT TEDS stockings affect circulation by:
A. A unique identifier for the device, where appropriate; A
A. Increasing blood flow velocity in the legs by full history, including date of purchase and where
compression of the deep venous system.
appropriate when it was put into use, deployed or
installed; Any specif ic legal requirements and whether
these have been met; Proper installation and where it
Q. An overall risk of malnutrition of 2 or higher signifies: was deployed; Schedule and details of maintenance and
repairs; The end-of-life date, if specified
A. High risk of malnutrition
Q. It is unsafe for a spinal tap to be undertaken if the patient:

Q. What is the purpose of The Code? A. Has bacterial meningitis; Papilloedema; Intracranial
mass is suspected; Site skin infection
A. It is a tool for educating prospectiv e nurses and midwiv es.