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Exam |Elaborations| Nursing and Midwifery Council-TOC -CBT QNA. Version 15a
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Exam |Elaborations| Nursing and Midwifery Council-TOC -CBT QNA. Version 15a
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CBT REVIEW OUTLINEQUESTION ANSWER
1. In which of the following situations might nitrous oxide (Entonox) be ▪ A wound dressing change for short-
considered? term pain relief or the removal of a
chest drain for reduction of anxiety.
2. Mr James, a patient in the community phoned you asking for advise as he is ▪ Call the doctor and wait for advice
experiencing some side effects of the medications he was given. What will
be your best action on this situation?
3. The most advanced gait used in crutch walking is: ▪ swing through gait
4. Which is not a cause of postural hypotension? ▪ lack of exercise
5. Uncooperative staff on decision making ▪ Authoritarian
6. Wendy, 18 years old, was admitted on Medical Ward because of recurrent ▪ tell her that any information related
urinary tract infection (UTI). She disclosed to you that she had unprotected to her well being will need to be
sex with her boyfriend on some occasions. You are worried this may be a shared to the health care team
possible cause of the infection. How will best handle the situation?
7. According to the nursing code of ethics, the nurse's first allegiance is to the ▪ Client only
8. When looking after a patient in a side room requiring reverse isolation ▪ Immediate supervisor
precautions, you have noticed the lack of PPE supplies. Who will you
escalate it at initially?
9. Covert communication may include the following except ▪ Tone of voice
10. Moving and Handling (TILE) ▪ Task Individual Load Environment
11. Change position ▪ Every 2 hrs
12. Nurse manager promotion…requires ▪ Conceptual and interpersonal skills
13. Contingency management theory ▪ One size fits all
14. Which of the following best describes the Contingency Theory of Leadership? ▪ The leader sees the kind of situation,
the setting, and their roles
15. Metformin + X = hypoglycemia ▪ Alcohol
16. What are the 3 intrinsic factors that are significant in development of pressure ▪ Pressure, shearing force, friction
ulcers
17. First drug in cardiac arrest in any etiology ▪ Adrenaline / epinephrine
18. A patient approached you to give his medications now but you are unable to ▪ D. Routinely document meds not
give the medicine. What is your initial action? given
19. Management in Blood Transfusion Reaction would include the ff ▪ Disconnect pack from patient
▪ Complete Transfusion Reaction
Report Form.
not: Close the IV line ▪ Obtain blood/urine samples as
directed.
▪ Send pack, Transfusion Reaction
Report Form and samples to hospital
Blood Bank
20. An adult woman asks for the best contraception in view of her holiday travel ▪ Tell her to use other methods like
to diarrhea-prone areas. She is currently taking oral contraceptives. What condom because diarrhea lessens
advice will you give her? the effects of OCP
21. An infusion of 24 mg of Inj. Furosemide is ordered for 12 hrs. How much ▪
dose is infused in an hour?
22. Signs and symptoms of early fluid volume deficit, except: ▪ Decreased pulse rate
Decreased urine output, Concentrated urine, Decrease skin turgor
23. When a patient arrives to the hospital who speaks a different language. Who ▪ Registered Nurse
is responsible for arranging an interpreter?
NMC CBT REVIEWER | 1
,24. A client comes to the local clinic complaining that ▪ You appear to have concerns about
sometimes his heart pounds and he has trouble sleeping. The your ability to do your job
physical exam is normal. The nurse learns that the client has
recently started a new job with expanded responsibilities and
is worried about succeeding. Which of the following responses by the nurse
is BEST?
25. As you visit your patient during rounds, you notice a thin child who is shy and ▪ raise the situation to your head nurse
not mingling with the group who seemed to be visitors of the patient. You and discuss with her what
offered him food but his mother told you not to mind him as he is not eating intervention
much while all of them are eating during that time. As a nurse, what will you might be done to help the child
do?
26. Psych patient refusing to take his meds…. ▪ Do not force the patient then
document
27. May not be a cause of diarrhea ▪ Intestinal obstruction
28. Definitive complication of liver biopsy ▪ Intraperitoneal hemorrhage
29. The doctor ordered antibiotics for a patient with sepsis. When should the ▪ Immediately after blood culture is
nurse start the therapy? taken
30. Patient is experiencing difficulty in eating due to ill-fitting dentures. What are ▪ Red patches on cheeks and around
the signs of denture stomatitis? teeth
31. Now the medical team encourages early ambulation in the post-operative ▪ Tissue wasting
period. Which complication is least prevented by this? ▪ Thrombophlebitis
▪ Wound infection
▪ Pneumonia
32. Mrs Smith has been assessed to have a cardiac arrest after anaphylactic ▪ Intramuscular route administration of
reaction to a medication. CPR was started immediately. Accdg to the adrenaline is always recommended
Resuscitation Council UK, which of the ff statements is true? during cardiac arrest after
anaphylactic reaction
▪ Intramuscular route for
adrenaline is not recommended
during cardiac arrest after
anaphylactic reaction
▪ Adrenaline can be administered
intradermally during cardiac arrest
after anaphylactic reaction
▪ None of the above
33. how the nurse assess the quality of care given ▪ Clinical bench marking
34. Hearing aid provide to client comes under which act? ▪ Equality Act
35. For a client with Water Score >20 which mattress is the most suitable
Waterlow Score 10+ Specialist memory foam mattresses.
Waterlow Score 15+ Alternating pressure overlays, mattresses and bed systems ▪ Dynamic Mattress
Waterlow Score 20+ Bed systems: Fluidized bed, low air loss and alternating air
mattresses (also known as dynamic mattresses)
36. Loss of epidermis, with shallow blister without slough ▪ Stage II Partial Thickness
37. A smoking cessation nurse used this to communicate to and involve her ▪ CARE CORE PLANS
patient in his care:
38. Contact precautions are initiated for a client with a healthcare associated ▪ Gloves, gown, goggle & faceshield
infection caused by MRSA.Which protective equipments the nurse should
wear while providing colostomy care?
39. An 18 year old young adult, involved in vehicular accident refused to eat the ▪ Regression
food which she ordered. What defense mechanism is she using?
40. If the patient meets medium score in MUST score, what advise you will ▪ Make 3 days food history
give? observation
0 – LOW – Routine Clinical Care
1- MEDIUM - Observe
2- HIGH – Treat → refer to dietitian/nut/support team/implement local policy
41. An overall risk of malnutrition of 2 or higher signifies: High risk of malnutrition
42. Isolation room laundry is separated from normal soiled laundry in the UK by: Red plastic bag that disintegrates at high
temperature (alginate)
NMC CBT REVIEWER | 2
,43. A nurse educator is providing in-service education to the nursing staff ▪ It is a process of learning, a different
regarding transcultural nursing care. A staff member asks the nurse educator culture to a dapt to a new or change
to describe the concept of acculturation. The most appropriate response in in environment
which of he following?
44. A diabetic patient with suspected Liver Tumor has been prescribed with ▪ Metformin
triphasic CT scan. Which medication needs to be on hold after the scan?
45. The skin is the largest organ in the body. What percentage of adult total body ▪ (16%) ….. 20%
weight does it represent
46. Based on the National Institute for Health and Care Excellence (NICE) ▪ It must not be filled below the fill line
Guidelines, which of the ff is incorrect about sharps container?
47. Electronic data transfer is more these days, which of the report is not suitable ▪ Abnormal blood report
to sent to a discharged client ?
48. A 45 y.o Asian female patient refused to consent for surgery. The family ▪ Make sure the patient is well
informed the doctor to go ahead of surgery despite patient‟s refusal. What is informed of the consequences of her
the appropriate action of the nurse to protect the patient‟s rights? action and is given enough time to
consider the importance of surgery
49. When looking after a patient in a side room requiring reverse isolation ▪ Immediate nurse manager
precautions, you have noticed the lack of PPE supplies. Who will you
escalate it at initially?
50. A patient is getting opioid for pain at home. How is the controlled medication ▪ • The community nurse show her
supplied to the patient as per the standards of medicine Management? identity card to the pharmacist, sign
the form on receiving of the
controlled drug, She then transport
the drug to patient‟s home, After
administration of medication she sign
the chart on witness of a competent
person.
51. A patient experienced sensation of fluttering in his chest, light headedness, & ▪ a heart condition that causes an
chest pain. The doctor diagnosed him with atrial fibrillation. What is atrial irregular and often abnormally fast
fibrillation? heart rate (normal:60-100bpm)
52. Patient manifests phlebitis in his IV site, what must a nurse do? ▪ Discontinue infusion / reinsert????
53. A patient was on morphine in hospital. On discharge doctor prescribes ▪ Shallow, slow respiration,
fentanyl patches. At home patient should be observed for which signs of drowsiness, difficulty to walk, speak
opiate toxicity? and think
54. Which is not an expected side effect of lumbar tap?' ▪ Nausea and vomiting
55. One patient shared secret information to the RN and wants her to keep it. ▪ All information must be kept
What is the RN‟s response? ▪ confidential
56. An 80 year old woman has lost her husband recently. Her brother comes to ▪ UTI induced delirium
see her & finds her very upset. After 2 weeks when her brother calls her up,
she says that her husband died yesterday & that she is having urgency for
urination & burning sensation while passing urine & that she finds cats & rats
in her kitchen. This indicates;
57. During busy shift, a nurse loads medication and asks you to administer it. Refuse to administer the medication
What is your action?
58. What to teach a young patient when he is taking antibiotics Don’t take it with alcohol
59. A patient with burns is given anesthesia using 50%oxygen and 50%nitrous 1-2min
oxide to reduce pain during dressing . how long this gas is to be inhaled to be
more effective
60. All but one are Nursing teachings for patients taking Allopurinol: ▪ Instruct patient to drink plenty of water
▪ Educate patient that he may experience
these side effects: nausea, vomiting, loss
of appetite; drowsiness
▪ Encourage patient to report unusual
bleeding or bruising; fever, chills; gout
attack; numbness or tingling; flank pain,
skin rash.
▪ instruct patient to chew medication
NMC CBT REVIEWER | 3
, 61. What is the purpose of The Code? ▪ It is a tool for educating prospective
nurses and midwives
62. A 37 year-old woman presented in Accident and Emergency accompanied by ▪ Inform nurse-in-charge about your
her husband due to swollen wrist. On your assessment, you noticed some suspicion and refer when appropriate
bruises over the arm upon rolling her sleeves. She looks reserved and only
replies to your questions in short answers. When her husband left to see their
children, she becomes extremely nervous and showing signs of restlessness.
You suspected some safeguarding issues but she would not give much
information when probed. What will be your next appropriate action?
63. What angle to inject via subcutaneous route? 45
64. You are caring for a patient in isolation with suspected Clostridium Review antimicrobials daily, wash hands with
difficile. What are the essential key actions to prevent the spread of soap and water before and after each contact
infection? with the patient, ask for enhanced cleaning
with chlorine-based products and use gloves
and aprons when disposing of body fluids.
65. All of the staff nurses on duty noticed that a newly hired staff nurse has been Call the new nurse and talk to her privately;
selective of her tasks. All of them thought that she has a limited knowledge of ask how the manager can be of help to
the procedures. What should the manager do in this situation? improve her situation
66. Why is it essential to humidify oxygen used during respiratory therapy? 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.
67. You can delegate medication administration to a student if: Only under close, direct supervision
68. A patient recently admitted to hospital, requesting to self administer the 1 – RN (keep meds and supervise self admin)
medication, has been assessed for suitability at Level 2. This means that:
2 – RN (keep the key of locker, supervise self
admin) + PT self administer
3 – PT (full responsibility),
RN – verbally checks compliance
69. John, 25 year old, was admitted at Medical Assessment Unit because of Cannabis is a class B drug under the UK
urine infection. During your assessment, he admitted using cannabis under Misuse of Drugs Act 1971
prescription for his migraine and still have some in his bag. What is your best
reply to him about the cannabis?
70. One busy day on your shift, a manager told you that all washes should be Talk to the manager and tell her that the
done by 10am. What would you do? quality of care will be compromised if washes
are rushed
71. What do you have to consider if you are obtaining a consent from the Capacity
patient?
72. Recommended preoperative fasting times are: 6-12 hours
73. A nurse is not allowing the client to go to bed without finishing her meal. What Challenge the situation immediately as this is
is your action as a RN? related to dignity of the patient and raise your
concern
74. A client expressed concern regarding the confidentiality of her medical Explaining the exact limits of confidentiality in
information. The nurse assures the client that the nurse maintains client the exchanges between the client and the
confidentiality by: nurse.
75. Mrs Smith developed an MRSA bacteremia from her abdominal wound and ▪ any incident or occurrence that has the
her son is blaming the staff. It has been highlighted during your ward clinical potential to cause harm and/or has caused
governance meeting because it has been reported as a serious incident harm to a person or persons.
(SI). SI is best defined as: ▪ a consequence of an intervention, relating to
a piece of equipment and/or as a
consequence of the working environment
▪ Incident requiring investigation that occurred
in relation to NHS funded services and care
resulting in; unexpected or avoidable death,
permanent harm
▪ All
NMC CBT REVIEWER | 4
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