Competencies Nursing
Competencies Nursing
Competencies Nursing
GUIDE
CBT EXAMS
FOR
NMC
1. What is the role of the NMC?
a) NMC’s role is to regulate nurses and midwives in England, Wales, Scotland and Northern Ireland.
b) It sets standards of education, training, conduct and performance so that nurses and midwives can deliver high quality
healthcare throughout their careers.
c) It makes sure that nurses and midwives keep their skills and knowledge up to date and uphold its professional standards.
d) It is responsible for regulating hospitals or other healthcare settings.
4. The UK regulator for nursing & midwifery professions within the UK with a started aim to protect the health & well-being of
the public is:
a) GMC
b) NMC
c) BMC
d) WHC
5. Which of the following agency set the standards of education, training and conduct and performance for nurses and
midwives in the UK?
a) NMC
b) DH
c) CQC
d) RCN
7. The Code contains the professional standards that registered nurses and midwives must uphold. UK nurses and midwives
must act in line with the Code, whether they are providing direct care to individuals, groups or communities or bringing their
professional knowledge to bear on nursing and midwifery practice in other roles; such as leadership, education or research.
What 4 Key areas does the code cover:
a) 35 Units
b) 45 Units
c) 55 Units
d) 65 Units
a) Dress code
b) Personal document
c) Good nursing & midwifery practice & a key tool in safeguarding the health &wellbeing of the public
d) Hospital administration
10. According to NMC Standards code and conduct, a registered nurse is EXCLUDED from legal action in which one of these?
11. The NMC Code expects nurse to safeguarding the health and wellbeing of public through the use of best available evidence
in practice. Which of the following nursing actions will ensure this?
12. Among the following values incorporated in NMC’s 6 C’s, which is not included?
a) Care
b) Courage
c) Confidentiality
d) Communication
13. Which of the following is NOT one of the six fundamental values for nursing, midwifery and care staff set out in compassion in
Practice Nursing, Midwifery & care staff?
a) Care
b) Consideration
c) Communication
d) Compassion
14. A nurse delegates duty to a health assistant, what NMC standard she should keep in mind while doing this?
15. According to law in England, UK when you faced with a situation of emergency what is your action?
16. A patient has been assessed as lacking capacity to make their own decisions, what government legislation or act should
be referred to:
17. Under the Carers (Equal opportunities) Act (2004) what are carers entitled to?
a) Their own assessment
b) Financial support
c) Respite care
d) All of the above
18. How many steps to discharge planning were identified by the Department of Health (DH 2010)?
a) 5 steps
b) 8 steps
c) 10 steps
d) 12 steps
19. The single assessment process was introduced as part of the National Service Framework for Older People (DH 2001) in
order to improve care for this groups of patients.
a) True
b) False
20. Under the Carers (Equal opportunities) Act (2004) what are carers entitled to?
a) Communication Act
b) Equality Act
c) Mental Capacity Act
d) Children and Family Act
22. What law should be taken into consideration when a patient has hearing difficulties and would need hearing aids?
a) communication act
b) mental capacity act
c) children and family act.
d) Equality Act
24. Mental Capacity Act 2005 explores which of the following concepts:
25. A patient has been assessed as lacking capacity to make their own decisions, what government legislation or act should
be referred to:
26. An enquiry was launched involving death of one of your patients. The police visited your unit to investigate. When
interviewed, which of the following framework will best help assist the investigation?
28. During the day, Mrs X was sat on a chair and has a table put in front of her to stop her getting up and walking about. What
type of abuse is this?
a) Physical Abuse
b) Psychological Abuse
c) Emotional Abuse
d) Discriminatory Abuse
29. Michael feels very uncomfortable when the carer visiting him always gives him a kiss and holds him tightly when he
arrives and leaves his home. What type of abuse is this?
a) Emotional Abuse
b) Psychological Abuse
c) Discriminatory Abuse
d) Sexual Abuse
30. Anna has been told that unless she does what the ward staff tell her, the consultant will stop her family from visiting.
What type of abuse is this?
a) Psychological Abuse
b) Discriminatory Abuse
c) Institutional Abuse
d) Neglect
31. Christine cannot get herself a drink because of her disability. Her carers only give her drinks three times a day so she does not
wet herself. What type of abuse is this?
a) Physical Abuse
b) Institutional Abuse
c) Neglect
d) Sexual Abuse
32. Gabriella is 26 year old woman with severe learning disabilities. She is usually happy and outgoing. Her mobility is good, her
speech is limited but she is able to be involved if carers take time to use simple language. She lives with her mother, and is
being assisted with personal care. Her home care worker has noticed bruising on upper insides of her thighs and arms. The
genital area was red and sore. She told the care worker that a male care worker is her friend and he has been cuddling her
but she does not like the cuddling because it hurts. What could possibly be the type of abuse Gabriella is experiencing?
a) Discriminatory Abuse
b) Financial Abuse
c) Sexual Abuse
d) Institutional Abuse
33. You have noticed that the management wants all residents to be up and about by 8:30 am, so they can be ready for breakfast.
Mrs X has refused to get up at 8 am, and she wants to have a bit of a lie in, but one of the carers insisted to wash and dress
her, and took her to the dining room. What type of abuse in in place?
a) Financial Abuse
b) Psychological Abuse
c) Sexual Abuse
d) Institutional Abuse
34. Patient asking for LAMA, the medical team has concern about the mental capacity of the patient, what decision should
be made?
35. You are in a registered nurse in a community giving health education to a patient and you notice that the student nurse
is using his cell phone to text, what should you do?
36. A person supervising a nursing student in the clinical area is called as:
a) mentor
b) preceptor
c) interceptor
d) supervisor
a) Ward in charge
b) Senior nurses
c) Team leaders
d) All RNS
39. A community health nurse, with second year nursing students is collecting history in a home. Nurse notices that a student
is not at all interested in what is going around and she is chatting in her phone. Ideal response?
40. In supervising a student nurse perform a drug rounds, the NMC expects you to do the following at all times:
42. Being a student, observe the insertion of an ICD in the clinical setting. This is
a) Formal learning
b) Informal learning
43. When you tell a 3rd year student under your care to dispense medication to your patient what will you assess?
44. You are mentoring a 3rd year student nurse, the student request that she want to assist a procedure with tissue viability nurse,
how can you deal with this situation
45. A registered nurse is a preceptor for a new nursing graduate an is describing critical paths and variance analysis to the new
nursing graduate. The registered nurse instructs the new nursing graduate that a variance analysis is performed on all clients:
a) Continuously
b) daily during hospitalization
c) every third day of hospitalization
d) every other day of hospitalization
46. you have assigned a new student to an experienced health care assistant to gain some knowledge in delivering patient care.
The student nurse tells you that the HCA has pushed the client back to the chair when she was trying to stand up. What is
your action
a) As soon as possible after an event has happened (to provide current (up to date) information about the care and condition of
the patient or client)
b) Every hour
c) When there are significant changes to the patient’s condition
d) At the end of the shift
47. Who is responsible for the overall assessment of the student’s fitness to practice and documentation of initial, midterm
and final assessments in the Ongoing Achievement Record (OAR)?
a) The mentor
b) The charge nurse/manager
c) Any registered nurse on same part of the register
48. What is the minimum length of time that a student must be supervised (directly/indirectly) by the mentor on placement?
a) 40%
b) 60%
c) Not specified, but as much as possible
d) Depends on the student capabilities
a) All consolidation students who started an NMC approved undergraduate programme which commenced after September 2007.
b) Learners undertaking conversion courses
nd
c) Students on their final placement in 2 year
d) Nurses/midwifes undertaking Mentorship Preparations
e) All midwifery pre-registrations students throughout training
f) Nurses/midwives undertaking SOM Preparation.
50. A nurse educator is providing in-service education to the nursing staff regarding transcultural nursing care. A staff member asks
the nurse educator to describe the concept of acculturation. The most appropriate response in which of the following?
52. When doing your drug round at midday, you have noticed one of your patient coughing more frequently whilst being
assisted by a nursing student at mealtime. What is your initial action at this situation?
a) tell the student to feed the patient slowly to help stop coughing
b) ask the student to completely stop feeding
c) ask student to allow patient some sips of water to stop coughing
d) ask student to stop feeding and assess patients swallowing
53. According to the royal marsden manual, a staff who observe the removal of chest drainage is considered as?
a) Official training
b) Unofficial training
c) Hours which are not calculated as training hours
d) It is calculated as prescribed training hours.
56. A staff nurse has delegated the ambulating of a new post-op patient to a new staff nurse. Which of the following
situations exhibits the final stage in the process of delegation?
a) Having the new nurse tell the physician the task has been completed.
b) Supervising the performance of the new nurse
c) Telling the unit manager, the task has been completed
d) Documenting that the task has been completed.
57. Which of the following is a specific benefit to an organization when delegation is carried out effectively?
58. The measurement and documentation of vital signs is expected for clients in a long-term facility. Which staff type would it be
a priority to delegate these tasks to?
a) Practical Nurse
b) Registered Nurse
c) Nursing assistant
d) Volunteer
62. A Nurse demonstrates patient advocacy by becoming involved in which of the following activities?
a) Taking a public stand on quality issues and educating the public on” public interest” issues
b) Teaching in a school of nursing to help decrease the nursing shortage
c) Engaging in nursing research to justify nursing care delivery
d) Supporting the status quo when changes are pending
63. In the role of patient advocate, the nurse would do which of the following?
a) Emphasize the need for cost-containment measures when making health care decisions
b) Override a patient’s decision when the patient refuses the recommended treatment
c) Support a patient’s decision, even if it is not the decision desired by the nurse
d) Foster patient dependence on health care providers for decision making
65. A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The
family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the
family and discusses the patient's wishes with the family. The nurse is acting as the patient's:
a) Educator
b) Advocate
c) Care giver
d) Case manager
66. A patient with learning disability is accompanied by a voluntary independent mental capacity advocate. What is his role?
a) Express patients’ needs and wishes. Acts as a patient’s representative in expressing their concerns as if they were his own
b) Just to accompany the patient
c) To take decisions on patient’s behalf and provide their own judgements as this benefit the client
d) Is expert and representative’s clients concerns, wishes and views as they cannot express by themselves
67. A client experiences an episode of pulmonary oedema because the nurse forgot to administer the morning dose of
furosemide (Lasix). Which legal element can the nurse be charged with?
a) Assault
b) Slander
c) Negligence
d) Tort
68. The client is being involuntary committed to the psychiatric unit after threatening to kill his spouse and children.
The involuntary commitment is an example of what bioethical principle?
a) Fidelity
b) Veracity
c) Autonomy
d) Beneficence
70. According to the nursing code of ethics, the nurse’s first allegiance is to the:
71. Which option best illustrates a positive outcome for managed care?
72. While at outside setup what care will you give as a Nurse if you are exposed to a situation?
73. As a nurse, the people in your care must be able to trust you with their health and well being. In order to justify that trust, you
must not:
a) work with others to protect and promote the health and wellbeing of those in your care
b) provide a high standard of practice and care when required
c) always act lawfully, whether those laws relate to your professional practice or personal life
d) be personally accountable for actions and omissions in your practice
75. In using social media like Facebook, how will you best adhere to your Code of Conduct as a nurse? (CHOOSE 2 ANSWERS)
76. Which strategy could the nurse use to avoid disparity in health care delivery?
77. In an emergency department doctor asked you to do the procedure of cannulation and left the ward. You haven't done it
before. What would you do?
a) Don't do it as you are not competent or trained for that & write incident report & inform the supervisor
b) What is the purpose of clinical audit?
c) Do it
d) Ask your colleague to do it
e) Complain to the supervisor that doctor left you in middle of the procedure
a) As soon as possible after an event has happened to provide current up to date information about the care and condition of the
patient or client
b) Every hour
c) When there are significant changes to the patient’s condition
d) At the end of the shift
a) legible handwriting
b) Name and signature, position, date and time
c) Abbreviations, jargon, meaningless phrases, irrelevant speculation and offensive subjective statements
d) A correct, consistent, and factual data
81. A nurse documented on the wrong chart. What should the nurse do?
a) Immediately inform the nurse in charge and tell her to cross it all off.
b) Throw away the page
c) Write line above the writing; put your name, job title, date, and time.
d) Ignore the incident.
82. After finding the patient which statement would be most appropriate for the nurse to document on a datix/incident form?
a) “The patient climbed over the side rails and fell out of bed.”
b) “The use of restraints would have prevented the fall.”
c) “Upon entering the room, the patient was found lying on the floor.”
d) “The use of a sedative would have helped keep the patient in bed.”
84. Adequate record keeping for a medical device should provide evidence of:
85. A registered nurse had a very busy day as her patient was sick, got intubated & had other life saving procedures. She
documented all the events & by the end of the shift recognized that she had documented in other patient's record. What is best
response of the nurse?
a) She should continue documenting in the same file as the medical document cannot be corrected
b) She should tear the page from the file & start documenting in the correct record
c) She should put a straight cut over her documentation & write as wrong, sign it with her NMC code, date & time
d) She should write as wrong documentation in a bracket & continue
86. Barbara, a frail lady who lives alone with her cat, was brought in A&E via ambulance after a neighbour found her lying in
front of her house. No doctor is available to see her immediately. Barbara told you she is worried about her cat who is alone
in the house. How will you best reply to her?
88. A very young nurse has been promoted to nurse manager of an inpatient surgical unit. The nurse is concerned that older
nurses may not respect the manager's authority because of the age difference. How can this nurse manager best
exercise authority?
89. What statement, made in the morning shift report, would help an effective manager develop trust on the nursing unit?
a) I know I told you that you could have the weekend off, but I really need you to work.”
b) The others work many extra shifts, why can’t you?
c) I’m sorry, but I do not have a nurse to spare today to help on your unit. I cannot make a change now, but we should talk further about
schedules and needs.”
d) I can’t believe you need help with such a simple task. Didn’t you learn that in school?”
90. The nurse has just been promoted to unit manager. Which advice, offered by a senior unit manager, will help this nurse
become inspirational and motivational in this new role?
a) "If you make a mistake with your staff, admit it, apologize, and correct the error if possible."
b) "Don't be too soft on the staff. If they make a mistake, be certain to reprimand them immediately."
c) "Give your best nurses extra attention and rewards for their help."
d) "Never get into a disagreement with a staff member.
91. The nurse executive of a health care organization wishes to prepare and develop nurse managers for several new units
that the organization will open next year. What should be the primary goal for this work?
a) Focus on rewarding current staff for doing a good job with their assigned tasks by selecting them for promotion.
b) Prepare these managers so that they will focus on maintaining standards of care
c) Prepare these managers to oversee the entire health care organization
d) Prepare these managers to interact with hospital administration.
92. A nurse manager is planning to implement a change in the method of the documentation system for the nursing unit. Many
problems have occurred as a result of the present documentation system, and the nurse manager determines that a change is
required. The initial step in the process of change for the nurse manager is which of the following?
93. What are the key competencies and features for effective collaboration?
a) Effective communication skills, mutual respect, constructive feedback, and conflict management.
b) High level of trust and honesty, giving and receiving feedback, and decision making.
c) Mutual respect and open communication, critical feedback, cooperation, and willingness to share ideas and decisions.
d) Effective communication, cooperation, and decreased competition for scarce resources.
94. All of the staff nurses on duty noticed that a newly hired staff nurse has been selective of her tasks. All of them thought that
she has a limited knowledge of the procedures. What should the manager do in this situation?
a) Reprimand the new staff nurse in front of everyone that what she is doing is unacceptable.
b) Call the new nurse and talk to her privately; ask how the manager can be of help to improve her situation
c) Ignore the incident and just continue with what she was doing.
d) Assign someone to guide the new staff nurse until she is competent in doing her tasks.
a) Appreciate intuitiveness
b) Appreciate better work
c) Reward poor performance
96. There have been several patient complaints that the staff members of the unit are disorganized and that “no one seems to
know what to do or when to do it.” The staff members concur that they don’t have a real sense of direction and guidance
from their leader. Which type of leadership is this unit experiencing?
a) Autocratic.
b) Bureaucratic.
c) Laissez-faire.
d) Authoritarian.
97. Ms. Castro is newly-promoted to a patient care manager position. She updates her knowledge on the theories in management
and leadership in order to become effective in her new role. She learns that some managers have low concern for services
and high concern for staff. Which style of management refers to this?
a) Organization Man
b) Impoverished Management
c) Country Club Management
d) Team Management
98. Ms. Jones is newly promoted to a patient care manager position. She updates her knowledge on the theories in management
and leadership in order to become effective in her new role. She learns that some managers have low concern for services and
high concern for staff. Which style of management refers to this?
99. When group members are unable and unwilling to participate in making a decision, which leadership style should the nurse
manager use?
a) Participative
b) Authorian
c) Laissez faire
d) Democratic
100. One leadership theory states that "leaders are born and not made," which refers to which of the following theories?
a. Trait
b. Charismatic
c. Great Man
d. Situational
101. She reads about Path Goal theory. Which of the following behaviours is manifested by the leader who uses this theory?
102. Which nursing delivery model is based on a production and efficiency model and stresses a task-oriented approach?
1) Case management
2) Primary nursing
3) Differentiated practice
4) Functional method
103. The contingency theory of management moves the manager away from which of the following approaches?
1) No perfect solution
2) One size fits all
3) Interaction of the system with the environment
4) A method or combination of methods that will be most effective in a
given situation
104. Which of the major theories of aging suggests that older adults may decelerate the aging process?
1) Disengagement theory
2) Activity theory
3) Immunology theory
4) Genetic theory
105. What is the most important issue confronting nurse managers using situational leadership?
a) Leaders can choose one of the four leadership styles when faced with a new situation.
b) Personality traits and leader’s power base influence the leader’s choice of style
c) Value is placed on the accomplished of tasks and on interpersonal relationships between leader and group members and
among group members
d) Leadership style differs for a group whose members are at different levels of maturity
106. The nursing staff communicates that the new manager has a focus on the "bottom line,” and little concern for the quality
of care. What is likely true of this nurse manager?
a) The manager is unwilling to listen to staff concerns unless they have an impact on costs.
b) The manager understands the organization's values and how they mesh with the manger's values.
c) The manager is communicating the importance of a caring environment.
d) The manager is looking at the total care picture
a) Receiving encouragement and support from co-workers to cope with the many stressors of the nursing role
b) Becoming an effective change agent in the community
c) An increased understanding of the family dynamics that affect the client
d) An increased understanding of what the client perceives as meaningful from his or her perspective
a) attention to detail
b) sound problem-solving skills and strong people skills
c) emphasis on consistent job performance
d) all of the above
110. A nurse manger achieves a higher management position in the organisation, there is a need for what type of skills?
a) James Watt
b) Adam Smith
c) Henri Fayol
d) Elton Mayo
112. You are a new and inexperienced staff, which of the following actions will you do during your first day on the clinical area?
113. A patient has sexual interest in you. What would you do?
a) Just avoid it, because the problem can be the manifestation of the underlying disorder, and it will be resolved by its own as he
recovers
b) Never attend that patient
c) Try to re-establish the therapeutic communication and relationship with patient and inform the manager for support
d) Inform police
114. One of your young patient displayed an overt sexual behaviour directly to you. How will you best respond to this?
a) Talk to the patient about the situation, to re- establish and maintain professional boundaries and relationship
b) ignore the behaviour as this is part of the development process
c) report the patient to their relatives
d) inform line manager of the incident
115. A nurse from Medical-surgical unit asked to work on the orthopedic unit. The medical-surgical nurse has no
orthopedic nursing experience. Which client should be assigned to the medical-surgical nurse?
a) A client with a cast for a fractured femur & who has numbness & discoloration of the toes
b) A client with balanced skeletal traction & who needs assistance with morning care
c) A client who had an above-the-knee amputation yesterday & has a temperature of 101.4F
d) A client who had a total hip replacement 2 days ago & needs blood glucose monitoring
116. An RN from the women's health clinic is temporarily reassigned to a medical-surgical unit. Which of these
client assignments would be most appropriate for this nurse?
a) A newly diagnosed client with type 2 diabetes mellitus who is learning foot care
b) A client from a motor vehicle accident with an external fixation device on the leg
c) A client admitted for a barium swallow after a transient ischemic attack
d) A newly admitted client with a diagnosis of pancreatic cancer
117. The nurse suspects that a client is withholding health-related information out of fear of discovery and possible legal
problems. The nurse formulates nursing diagnoses for the client carefully, being concerned about a diagnostic error
resulting from which of the following?
a) Incomplete data
b) Generalize from experience
c) Identifying with the client
d) Lack of clinical experience
118. A nurse case manager receives a referral to provide case management services for an adolescent mother who was
recently diagnosed with HIV. Which statement indicates that the patient understands her illness?
a) “I can never have sex again, so I guess I will always be a single parent.”
b) b) “I will wear gloves when I’m caring for my baby, because I could infect my baby with AIDS.”
c) “My CD4 count is 200 and my T cells are less than 14%. I need to stay at these levels by eating and sleeping well and
staying healthy.”
d) “My CD4 count is 800 and my T cells are greater than 14%. I need to stay at these levels by eating and sleeping well and
staying healthy.”
119. A young woman who has tested positive for HIV tells her nurse that she has had many sexual partners. She has been on an
oral contraceptive & frequently had not requested that her partners use condoms. She denies IV drug use she tells her nurse
that she believes that she will die soon. What would be the best response for the nurse to make.
120. A client express concern regarding the confidentiality of her medical information. The nurse assures the client that
the nurse maintains client confidentiality by:
a) Explaining the exact limits of confidentiality in the exchanges between the client and the nurse.
b) Limiting discussion about clients to the group room and hallways.
c) Summarizing the information, the client provides during assessments and documenting this summary in the chart.
d) Sharing the information with all members of the healthcare team
a) it can pose as a threat to the public and when it is ordered by the court
b) requested by family members
c) asked by media personnel for broadcast and publication
d) required by employer
122. You noticed medical equipment not working while you joined a new team and the team members are not using it. Your role?
123. When developing a program offering for patients who are newly diagnosed with diabetes, a nurse case manager
demonstrates an understanding of learning styles by:
124. An adult has signed the consent form for a research study but has changed her mind. The nurse tells the patient that she
has the right to change her mind based upon which of the following principles.
125. A famous actress has had plastic surgery. The media contacts the nurse on the unit and asks for information about
the surgery. The nurse knows:
126. When will you disclose the identity of a patient under your care?
128. Which of the following actions jeopardise the professional boundaries between patient and nurse
130. Mrs X informs the nurse that she has lost her job due to excessive absences related to her wound. (2 correct answers) The
nurse should:
a. Encourage the patient to express her feelings about the job loss
b. Contact social services to assist the patient with accessing available resources
c. Evaluate Mrs X’s understanding of her wound management
d. Explain to Mrs X that she can no longer be seen at the clinic without a job
131. Role conflict can occur in any situation in which individuals work together. The predominant reason that role conflict
will emerge in collaboration is that people have different
133. A patient with antisocial personality disorder enters the private meeting room of a nursing unit as a nurse is meeting with
a different patient. Which of the following statements by the nurse is BEST?
134. A client on your medical surgical unit has a cousin who is physician & wants to see the chart. Which of the following is
the best response for the nurse to take
a) Ask the client to sign an authorization & have someone review the chart with cousin
b) Hand the cousin the client chart to review
c) Call the attending physician & have the doctor speak with the cousin
d) Tell the cousin that the request cannot be granted
135. As an RN in charge you are worried about a nurse's act of being very active on social media site, that it affects
the professionalism. Which one of these is the worst advice you can give her?
137. You walk onto one of the bay on your ward and noticed a colleague wrongly using a hoist in transferring their patient. As
a nurse you will:
a) let them continue with their work as you are not in charge of that bay
b) report the event to the unit manager
c) call the manual handling specialist nurse for training
d) inform the relatives of the mistake
138. You are to take charge of the next shift of nurses. Few minutes 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 staff in your shift, what will you do?
a) encourage all the staff who are present to do their best to attend to the needs of the patients
b) ask from your manager if there are qualified staff from the previous shift that can cover the lacking number for your shift while you
try to replace new nurses to cover
c) refuse to take charge of the next shift
139. Who will you inform first if there is a shortage in supplies in your shift?
a) Nursing assistant
b) Purchasing personnel
c) Immediate nurse manager
d) Supplier
140. The supervisor reprimands the charge nurse because the nurse has not adhered to the budget. Later the charge nurse
accuses the nursing staff of wasting supplies. This is an example of
a) Denial
b) Repression
c) Suppression
d) Displacement
141. 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:
a) Accept her weakness and take this challenge as an opportunity to improve her skills by requesting lectures from her manager
b) Ignore the criticism as this is a case of a team issue
c) Continue delivering care as this will not affect the quality of care you are rendering your patient
a) a tool to evaluate the effectiveness of interventions, and to know what needs to be improved
b) a tool used to identify the weakest link within the system
c) a standard of which performance is based upon
d) a tool to set a guidelines or protocol in clinical practice
143. You are the nurse on Ward C with 14 patients. Your fellow incoming nurses called in sick and cannot come to work on
your shift. What will be your best action on this situation?
a) Review patient intervention, set priorities, ask the supervisor to hand over extra staff
b) continue with your shift and delegate some responsibilities to the nursing assistant
c) fill out an incident form about the staffing condition
d) ask the colleague to look for someone to cover
144. A client requests you that he wants to go home against medical advice, what should you do?
145. The nurse is leading an in service about management issues. The nurse would intervene if another nurse made which of
the following statements?
a) “It is my responsibility to ensure that the consent form has been signed and attached to the patient’s chart prior to surgery.”
b) “It is my responsibility to witness the signature of the client before surgery is performed.
c) “It is my responsibility to answer questions that the patient may have prior to surgery.”
d) “It is my responsibility to provide a detailed description of the surgery and ask the patient to sign the consent form.”
146. A patient in your care knocks their head on the bedside locker when reaching down to pick up something they
have dropped. What do you do?
a) Let the patient’s relatives know so that they don’t make a complaint & write an incident report for yourself so you remember the details
in case there are problems in the future
b) Help the patient to a safe comfortable position, commence neurological observations & ask the patient’s doctor to come & review
them, checking the injury isn’t serious. when this has taken place , write up what happened & any future care in the nursing notes
c) Discuss the incident with the nurse in charge , & contact your union representative in case you get into trouble
d) Help the patient to a safe comfortable position, take a set of observations & report the incident to the nurse in charge who may call a
doctor. Complete an incident form. At an appropriate time, discuss the incident with the patient & if they wish, their relatives
147. The rehabilitation nurse wishes to make the following entry into a client’s plan of care: “Client will re-establish a pattern of
daily bowel movements without straining within two months.” The nurse would write this statement under which section of
the plan of care?
148. A registered nurse identifies a care assistant not washing hands hand before caring an immunocompromised client.
Your response?
149. The bystander of a muslim lady wishes that a lady doctor only should check the patient. Best response
150. Bystander informs you that the patient is in severe pain. Ur response
151. The nurse restraints a client in a locked room for 3 hours until the client acknowledges who started a fight in the
group room last evening. The nurse’s behaviour constitutes:
a) False imprisonment
b) Duty of care
c) Standard of care practice
d) Contract of care
153. A client has been voluntarily admitted to the hospital. The nurse knows that which of the following statements is
inconsistent with this type of hospitalization?
154. If you were explaining anxiety to a patient, what would be the main points to include?
a) Signs of anxiety include behaviours such as muscle tension. palpitations, a dry mouth, fast shallow breathing, dizziness &
an increased need to urinate or defaecate
b) Anxiety has three aspects: physical – bodily sensations related to flight & fight response, behavioural – such as avoiding
the situation, & cognitive (thinking) – such as imagining the worst
c) Anxiety is all in the mind, if they learn to think differently, it will go away
d) Anxiety has three aspects: physical – such as running away, behavioural – such as imagining the worse (catastrophizing) ,
& cognitive ( thinking) – such as needing to urinate.
155. A 23-year-old-woman comes to the emergency room stating that she had been raped. Which of the following
statements BEST describes the nurse’s responsibility concerning written consent?
a) The nurse should explain the procedure to the patient and ask her to sign the consent form.
b) The nurse should verify that the consent form has been signed by the patient and that it is attached to her chart.
c) The nurse should tell the physician that the patient agrees to have the examination.
d) The nurse should verify that the patient or a family member has signed the consent form.
156. A 52-year-old man is admitted to a hospital after sustaining a severe head injury in an automobile accident. When the
patient dies, the nurse observes the patient’s wife comforting other family members. Which of the following interpretations of
this behaviour is MOST justifiable?
a) She has already moved through the stages of the grieving process.
b) She is repressing anger related to her husband’s death.
c) She is experiencing shock and disbelief related to her husband’s death.
d) She is demonstrating resolution of her husband’s death.
157. The nurse works on a medical/surgical unit that has a shift with an unusually high number of admissions, discharges, and
call bells ringing. A nurse’s aide, who looks increasingly flustered and overwhelmed with the workload, finally announces
“This is impossible! I quit!” and stomps toward the break room. Which of the following statements, if made by the nurse to
the nurse’s aide, is BEST?
a) Introjection
b) Displacement
c) Identification
d) Repression
159. A young woman has suffered fractured pelvis in an accident , she has been hospitalized for 3 days , when she tells her
primary nurse that she has something to tell her but she does not want the nurse to tell anyone. she says that she had tried
to donate blood & tested positive for HIV. what is best action of the nurse to take?
160. The nurse is in the hospitals public cafeteria & hears two nursing assistants talking about the patient in 406. they are
using her name & discussing intimate details about her illness which of the following actions are best for the nurse to take?
a) Go over & tell the nursing assistants that their actions are inappropriate especially in a public place
b) Wait & tell the assistants later that they were overheard discussing the patient otherwise they might be embarrassed
c) Tell the nursing assistant’s supervisor about the incident. It is the supervisor’s responsibility to address the issue
d) Say nothing. it is not the nurses job, he or she is not responsible for the assistant’s action
161. One of your patient was pleased with the standard of care you have provided him. As a gesture, he is giving you a
£50 voucher to spend. What is your most appropriate action on this situation?
a) Ensure that the nursing process is complete and includes active participation by the patient and family
b) Become creative in meeting patient’s needs.
c) Empower the patient by providing needed information and support.
d) Help the patient understand the need for preventive health care.
163. The nurse manager of 20 bed coronary care is not on duty when a staff nurse makes serious medication error. The client
who received an over dose of the medication nearly dies. Which statement of the nurse manager reflects accountability?
a) The nurse supervisor on duty will call the nurse manager at home and apprise about the problem
b) Because the nurse manager is not on duty therefore she is not accountable to anything which happens on her absence
c) The nurse manager will be informed of the incident when returning to the work on Monday because the nurse manager was officially
off duty when the incident took place.
d) Although the nurse manager was on off duty but the nurse supervisor decides to call nurse manager if the time permits the
nurse supervisor thinks that the nurse manager has no responsibility of what has happened in manager’s absence
164. All individuals providing nursing care must be competent at which of the following procedures?
a) Comparing, sharing and developing practice in order to achieve and sustain best practice.
b) Assess clinical area against best practice
c) Review achievement towards best practice
d) Consultation and patient involvement
168. Wendy, 18 years old, was admitted on 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 wellbeing will need to be share to 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
169. When trying to make a responsible ethical decision, what should the nurse understand as the basis for ethical reasoning?
170. A mentally competent client with end stage liver disease continues to consume alcohol after being informed of
the consequences of this action. What action best illustrates the nurse’s role as a client advocate?
a) Asking the spouse to take all the alcohol out of the house
b) Accepting the patient’s choice & not intervening
c) Reminding the client that the action may be an end-of life decision
d) Refusing to care for the client because of the client’s noncompliance
171. when breaking bad news over phone which of the following statement is appropriate
172. A patient with complex, multiple diseases is discharged to a tertiary level care unit what to do?
173. clinical practice is based on evidence based practice. Which of the following statements is true about this
a) Clinical practice based on clinical expertise and reasoning with the best knowledge available
b) Provision of computers at every nursing station to search for best evidence while providing care
c) Practice based on ritualistic way
d) Practice based on what nurse thinks is the best for patient
n adult has just returned to the unit from surgery. The nurse transferred him to his bed but did not put up the side rails.
174. The client fell and was injured. What kind of liability does the nurse have?
a) None
b) Negligence
c) Intentional tort
d) Assault & battery
175. A new RN have problems with making assumptions. Which part of the code she should focus to deliver fundamentals
of care effectively
a) Prioritise people
b) Practice effective
c) Preserve safety
d) Promote professionalism and trust
176. A patient with learning disability is accompanied by a voluntary independent mental capacity advocate. What is his role?
a) Express patients’ needs and wishes. Acts as a patient’s representative in expressing their concerns as if they were his own
b) Just to accompany the patient
c) To take decisions on patients behalf and provide their own judgements as this benefit the client
d) Is an expert and represents clients concerns, wishes and views as they cannot express by themselves
177. When you find out that 2 staffs are on leave for next duty shift and its of staff shortage what to do with the situation?
a) Inform the superiors and call for a meeting to solve the issue
b) Contact a private agency to provide staff
c) Close the admission until adequate staffs are on duty.
a) It is asking action to help people say what they want, secure their rights, represent their interests and obtain the services they need
b) This is the divulging or provision of access to data.
c) It is the response to the suffering of others that motivates a desire to help.
d) It is a set of rules or a promise that limits access or places restrictions on certain types of information.
179. Wound care management plan should be done with what type of wound?
a) Complex wound
b) Infected wound
c) Any type of wound
a) 1-5 days
b) 3-24 days
c) 24 days
181. How long does proliferative phase of wound healing occur?
a) 3-24 days
b) 24-26 days
c) 1-7 days
d) 24 hours
182. How long does the ‘inflammatory phase’ of wound healing typically last?
a) 24 hours
b) Just minutes
c) 1-5 days
d) 3-24 days
183. A new, postsurgical wound is assessed by the nurse and is found to be hot, tender and swollen. How could this wound
be best described?
184. What are the four stages of wound healing in the order they take place?
185. Breid, 76 years old, developed a pressure ulcer whilst under your care. On assessment, you saw some loss of dermis,
with visible redness, but not sloughing off. Her pressure ulcer can be categorised as:
a) moisture lesion
b) 2nd stage partial skin thickness
c) 3rd stage
d) 4th stage
186. What stage of pressure ulcer includes tissue involvement and crater formation? (CHOOSE 2 ANSWERS)
a) stage 1
b) stage 2
c) stage 3
d) stage 4
187. What stage of pressure ulcer includes tissue involvement and crater formation?
a) stage 1
b) stage 2
c) stage 3
d) stage 4
188. A clients wound is draining thick yellow material. The nurse correctly describes the drainage as:
a) Sanguineous
b) Serous sanguineous
c) Serous
d) Purulent
190. A nurse notices a bedsore. It’s a shallow wound, red coloured with no pus. Dermis is lost. At what stage this bedsore is?
191. A patient developed pressure ulcer. The wound is round, extends to the dermis, is shallow, there is visible reddish
to pinkish tissue. What stage is the pressure ulcer?
a) Stage 1
b) Stage 2
c) Stage 3
d) Stage 4
192. A client is admitted to the Emergency Department after a motorcycle accident that resulted in the client’s skidding across
a cement parking lot. Since the client was wearing shorts, there are large areas on the legs where the skin is ripped off. The
wound is best described as:
a) Abrasion
b) Unapproxiamted
c) Laceration
d) Eschar
193. Joshua, son of Breid went to the station to see the nurse as she was complaining of severe pain on her pressure
ulcer. What will be your initial action?
a) Skin clips
b) Tissue adhesive
c) Adhesive skin closure strips
d) Interrupted suture
196. What functions should a dressing fulfil for effective wound healing?
198. Proper Dressing for wound care should be? (Select x 3 correct answers)
a) High humidity
b) Low humidity
c) Non Permeable/ Conformable
d) Absorbent / Provide thermal insulation
199. Which of the following conditions can be observed in a proper wound dressing:
a) High humidity
b) Low humidity
c) Non Permeable
d) Conformable
e) Adherent
f) Absorbent
g) Provide thermal insulation
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?
202. Which solution use minimum tissue damage while providing wound care?
a) Hydrogen peroxide
b) Povidine iodine
c) Saline
d) Gention violet
203. Which are not the benefits of using negative pressure wound therapy?
206. How would you care for a patient with a necrotic wound?
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
208. Black wounds are treated with debridement. Which type of debridement is most selective and least damaging?
209. If an elderly immobile patient had a "grade 3 pressure sore", what would be your management?
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:
211. The client at greatest risk for postoperative wound infection is:
212. Mr Connor’s neck wound needed some cleaning to prevent complications. Which of the following concept will you apply
when doing a surgical wound cleaning?
a) surgical asepsis
b) aseptic non-touch technique
c) medical asepsis
d) dip-tip technique
213. When doing your shift assessment, one of your patient has a waterflow score of 20. Which of the following mattress
is appropriate for this score?
a) water bed
b) fluidized airbed
c) low air loss
d) alternating pressure
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
216. A patient has been confined in 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
217. You have just finished dressing a leg ulcer. You observe 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 the behaviour.
218. External factors which increase the risk of pressure damage are:
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
220. Sharp debridement may cause trauma to underlying structures, the procedure should only be carried out by:
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
A) Polyuria
B) Oliguria
C) Nocturia
224. Wendy, 18 years old, was admitted on 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 share to 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
225. What are the steps for the proper urine collection?
a) A, B, & C
b) B, C, & D
c) A, B, & D
d) A, C, & D
226. On removing your patient’s catheter, what should you encourage your patient to do ?
228. What is the most important guiding principle when choosing the correct size of catheter?
229. When carrying out a catheterization, on which patients would you use anaesthetic lubricating gel prior to
catheter insertion?
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
231. What would make you suspect that a patient in your care had a urinary tack 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
232. A client with frequent urinary tract infections asks the nurse how she can prevent the reoccurrence. The nurse should
teach the client to:
233. A patient is prescribed methformin 1 000mg twice a day for his diabetes. While taking 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:
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) Feeling hungry
b) Sweating
c) Anxiety or irritability
d) Blurred vision
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
237. What are the contraindications for the use of the blood glucose meter for blood glucose monitoring?
238. What would you do if a patient with diabetes and peripheral neuropathy requires assistance cutting his toe nails?
a) Document clearly the reason for not cutting his toe nails 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 hospital.
239. For an average person from 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
240. Common causes for hyperglycaemia include: (select 4)
241. Most of the symptoms are common in both type1 and type 2 diabetes. Which of the following symptom is more common
in typ1 than type2?
a) Thirst
b) Weight loss
c) Poly urea
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
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:
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 to see another tissue viability nurse. How will you best respond to him?
246. Which of the following indicates the patient needs more education when doing capillary sampling to check for blood sugar?
247. The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority
intervention for this client is:
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?
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, 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
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
d) Ask the patient to void into a bottle and pour urine specimen into the specimen container.
251. How do you ensure the correct blood to culture ratio when obtaining a blood culture specimen from an adult patient?
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?
253. Which of the following techniques is advisable when obtaining a urine specimen in order 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 analyse as well.
d) Dip the urinalysis strip into the urine in a bedpan mixed with stool
254. When dealing with a patient who has a biohazard specimen, how will you ensure proper disposal? Select which does not
apply:
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.
256. How do we handle a specimen container labelled 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.
257. You are caring for a patient who is known to have dementia. What particular issues should you consider prior to discharge.
a) You involve in his care: Independent Mental Capacity Advocacy Service (Mental Capacity Act 2005)
b) You involve other support services in his discharge: The hospital discharge team, social services, the metal health team
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 form 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.
a) Intermittent incontinence
b) Concentrated urine
c) Microscopic hematuria
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) Increased stimuli
B) Creative environment
C) Restrict activities
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.”
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?
264. Which of the following is a behavioural risk factor when assessing the potential risks of falling in an older person?
265. What medications would most likely increase the risk for fall?
a) Loop diuretic
b) Hypnotics
c) Betablockers
d) Nsaid
266. Among the following drugs, which does not cause falls in an elderly?
A. Diuretics
B. NSAIDS
C. Beta blockers
D. Hypnotics
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?
268. Mr Bond also shared with you that his gums also bleed during brushing. Which of the following statement will best
explain this?
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.
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?
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).
274. Barbara, an elderly patient with dementia, wishes to go out of the hospital. What will be you appropriate action?
A) Aortic stenosis
B) Arrhythmias
C) Diabetes
D) Pernicious anaemia
E) Advanced heart failure
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?
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?
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.
279. Why should healthcare professionals take extra care when washing and drying an elderly patients skin?
a) As the older generation deserve 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.
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.
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 asses her when she gets home
284. You are looking after a 75 year old woman who had an abdominal hysterectomy 2 days ago. What would you do 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
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 ahs poor fitting dentures. Which of the following is the least likely risk to
the service user?
a) Malnutrition
b) Hyperglycemia
c) Dehydration
d) Hypoglycaemia
a) Laundry
b) Food
c) Nursing Care
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?
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 re-consider the time bound, make sure that all staffs are informed about task oriented nursing care
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.
292. An elderly client with dementia is cared by hes 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 restrain. Urgently call for a safe guarding 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 restrain and discuss other possible options
293. In a community setting, an elderly patient reported to you that he gives shopping money to his neighbours but failed to
bring groceries on frequent occasions. What is your best response on this situation?
294. Which of the following displays the proper use of Zimmer frame?
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
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
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 statement 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’
299. Nurses assume responsibility on patient with cane. Which of the following is the nurse’s topmost priority in caring for
a patient with cane?
a) Mobility
b) Safety
c) Nutrition
d) Rest periods
300. To promote stability for a patient using walkers, the nurse should instruct the patient to place his hands at:
301. A client is ambulating with a walker. The nurse corrects the walking pattern of the patient if he does which of the following?
a) Knee
b) Hip
c) Chest
d) Armpit
303. The nurse is caring for an immobile client. The nurse is promoting interventions to prevent foot drop from occurring.
Which of the following is least likely a cause of foot drop?
a) Bed rest
b) Lack of exercise
c) Incorrect bed positioning
d) Bedding weight that forces the toes into plantar flexion
304. The nurse should consider performing preparatory exercises on which muscle to prevent flexion or buckling during
crutch walking?
305. The nurse is measuring the crutch using the patient’s height. How many inches should the nurse subtract from
the patient’s height to obtain the approximate measurement?
a) 10 inches
b) 16 inches
c) 9 inches
d) 5 inches
307. In going up the stairs with crutches, the nurse should instruct the patient to:
A) Advance the stronger leg first up to the step then advance the crutches & the weaker extremity.
B) Advance the crutches to the step then the weaker leg is advanced after. The stronger leg then follows.
C) Advance both crutches & lift both feet & swing forward landing next to crutches.
D) Place both crutches in the hand on the side of the affected extremity
308. The patient can be selected with a crutch gait depending on the following apart from:
310. When using crutches, what part of the body should absorb the patient’s weight?
A. Armpits
B. Hands
C. Back
D. Shoulders
311. What a patient should not do when using zimmer frame
313. The nurse is giving the client with a left cast crutch walking instructions using the three point gait. The client
is allowed touchdown of the affected leg. The nurse tells the client to advance the:
a) Left leg and right crutch then right leg and left crutch
b) Crutches and then both legs simultaneously
c) Crutches and the right leg then advance the left leg
d) Crutches and the left leg then advance the right leg
314. Which layer of the skin contains blood and lymph vessels. Sweat and sebaceous glands?
a) Epidermis
b) Dermis
c) Subcutaneous layer
d) All of the above
317. In the context of assessing risks prior to moving and handling, what does T-I-L-E stand for?
318. In Spinal cord injury patients, what is the most common cause of autonomic dysreflexia ( a sudden rise in blood pressure)?
a) Bowel obstruction
b) Fracture below the level of the spinal lesion
c) Pressure sore
d) Urinary obstruction
319. A client with a right arm cast for fractured humerus states, “I haven’t been able to straighten the fingers on the right
hand since this morning.” What action should the nurse take?
320. How do the structures of the human body work together to provide support and assist in movement?
a) The skeleton provides a structural framework. This is moved by the muscles that contract or extend and in order to function, cross at
least one joint and are attached to the articulating bones.
b) The muscles provide a structural framework and are moved by bones to which they are attached by ligaments.
c) The skeleton provides a structural framework; this is moved by ligaments that stretch and contract.
d) The muscles provide a structural framework, moving by contracting or extending, crossing at least one joint and attached to the
articulatingbones.
a) 30 cm
b) 45 cm
c) 60 cm
d) 120 cm
a) Median nerve
b) Axillary nerve
c) Ulnar nerve
d) Radial nerve
325. Client had fractured hand and being cared at home requiring analgesia. The medication was prescribed under PGD.
Which of the following statements are correct relating to this:
a) A PGD can be delegated to student nurse who can administer medication with supervision
b) PGD’s cannot be delegated to anyone
c) This type of prescription is not made under PGD
d) This can be delegated to another RN who can administer in view of a competent person
326. Patient is post of repair of tibia and fibula possible signs of compartment syndrome include
327. Patient has tibia fibula fracture. Which one of the following is not a symptom of compartment syndrome
328. A Chinese woman has been admitted with fracture of wrist. When you are helping her undress, you notice some bruises
on her back and abdomen of different ages. You want to talk to her and what is your action
331. During enteral feeding in adults, at what degree angle should the patient be nursed at to reduce the risk of reflux
and aspiration?
A) 25
B) 35
C) 45
D) 55
333. What is the best way to prevent who is receiving an enteral feed from aspirating?
a) 1 million
b) 3 million
c) 5 million
d) 7 million
335. How can patients who need assistance at meal times be identified?
a) A red sticker
b) A colour serviette
c) A red tray
d) Any of the above
a) Lifestyle
b) Vitamin deficiency (Vitamin C and K)
c) Vigorous brushing of teeth
d) Intake of blood thinning medication (warfarin, asprin, and heparin)
338. What specifically do you need to monitor to avoid complications & ensure optimal nutritional status in patients
being enterally fed?
a) Custard
b) Black Tea
c) Gelatin
d) Ice pop
340. According to recent UK research, what is the recommended amount of vegetables and fruits to be consumed per day?
341. The nurse is preparing to change the parenteral nutrition (PN) solution bag & tubing. The patient's central venous line
is located in the right subclavian vein. The nurse ask the client to take which essential action during the tubing change?
342. If the prescribed volume is taken, which of the following type of feed will provide all protein, vitamins, minerals and
trace elements to meet patient's nutritional requirements?
a) Protein shakes/supplements
b) Energy drink
c) Mixed fat and glucose polymer solutions/powder
d) Sip feed
343. A patient has been admitted for nutritional support and started receiving a hyperosmolar feed yesterday. He presents
with diarrhea but no pyrexia. What is likely to be cause?
a) An infection
b) Food poisoning
c) Being in hospital
d) The feed
344. Your patient has a bulky oesophageal tumor and is waiting for surgery. When he tries to eat, food gets stuck and gives
him heart burn. What is the most likely route that will be chosen to provide him with the nutritional support he needs?
345. Which of the following medications are safe to be administered via a naso-gastric tube?
a) Drugs that can be absorbed via this route, can be crushed and given diluted or dissolved in 10-15 ml of water
b) Enteric-coated drugs to minimize the impact of gastric irritation
c) A cocktail of all medications mixed together, to save time and prevent fluid over loading the patient
d) Any drugs that can be crushed
347. One of the government initiative in promoting good healthy living is eating the right and balanced food. Which of
the following can achieve this?
348. Mr Bond’s daughter rang and wanted to visit him. She told you of her diarrhoea and vomiting in the last 24 hours. How
will you best respond to her about visiting Mr Bond?
a) allow her to visit and use alcohol gel before contact with him
b) visit him when she feels better
c) visit him when she is symptom free after 48 hours
d) allow her to visit only during visiting times only
350. Enteral feeding patient checks patency of tube placement by: x 2 correct answers
351. The client reports nausea and constipation. Which of the following would be the priority nursing action?
a) Blood glucose levels, full blood count, stoma site and bodyweight.
b) Eye sight, hearing, full blood count, lung function and stoma site.
c) Assess swallowing, patient choice, fluid balance, capillary refill time.
d) Daily urinalysis, ECG, protein levels and arterial pressure.
353. What is the best way to prevent a patient who is receiving an enteral feed from aspirating?
354. Which check do you need to carry out before setting up an enteral feed via a nasogastric tube?
a) That when flushed with red juice, the red juice can be seen when the tube is aspirated.
b) That air cannot be heard rushing into the lungs by doing the whoosh test
c) That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is the same length as the time insertion.
d) That pH of gastric aspirate is >6.0, and the measurement on the NG tube is the same length as the time insertion
355. Which check do you need to carry out every time before setting up a routine enteral feed via a nasogastric tube?
a) That when flushed with red juice, the red juice can be seen when the tube is aspirated
b) That air cannot be heard rushing into the lungs by doing the ‘whoosh test’.
c) That the pH of gastric aspirate is <4, and the measurement on the NG tube is the same length as the time insertion
d) abdominal x-ray
356. What specifically do you need to monitor to avoid complications and ensure optimal nutritional status in patients
being enterally fed?
a) Blood glucose levels, full blood count, stoma site and bodyweight
b) Eye sight, hearing, full blood count, lung function and stoma site
c) Assess swallowing, patient choice, fluid balance, capillary refill time
d) Daily urinalysis, ECG, protein levels and arterial pressure
357. If a patient requires protective isolation, which of the following should you advise them to drink?
358. 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
359. Adam, 46 years old is of Jewish descent. As his nurse, how will you plan his dietary needs?
360. An adult woman asks for the best contraception in view of her holiday travel to a diarrhoea prone areas. She is
currently taking oral contraceptives. What advice will you give her?
362. Obesity is one of the main problem. what might cause this?
a) supermarket
b) unequality
c) low economic class
a) planning
b) assessment
c) implementation
d) evaluation
a) colitis
b) intestinal obstruction
c) food allergy
d) food poisoning
365. Perdue (2005) categorizes constipation as primary, secondary or iatrogenic. What could be some of the causes
of iatrogenic constipation?
366. A patient is to be subjected for surgery but the patient’s BMI is low. Where will you refer the patient?
367. How can patients who need assistance at meal times be identified?
A. A red sticker
B. A colour serviette
C. A red tray
D. Any of the above
369. Before a gastric surgery, a nurse identifies that the patients BMI is too low. Who she should contact to improve the
patients’ health before surgery
a) Gastro enterologist
b) Dietitian
c) Family doc of patient
d) Physio
373. If a patient is experiencing dysphagia, which of the following investigations are they likely to have?
a) Colonoscopy
b) Gastroscopy
c) Cystoscopy
d) Arthroscopy
375. A patient is to be subjected for surgery but the patient’s BMI is low. Where will you refer the patient?
376. A patient had been suffering from severe diarrheoa and is now showing signs of dehydration. Which of the following is
not a classic symptom?
377. A relative of the patient was experiencing vomiting and diarrhoea and wished to visit her mother who was admitted. As
a nurse, what will you advise to the patient's relative?
a) There should be 48 hours after active symptoms should disappear prior to visiting patient
b) Inform relative it is fine to visit mother as long as she uses alcohol before entering ward premises
378. Nurse caring a confused client not taking fluids, staff on previous shift tried to make him drink but were unsuccessful. Now
it is the visitors time, wife is waiting outside What to do?
a) Ask the wife to give him fluid, and enquire about his fluid preferences and usual drinking time
b) Tell her to wait and you need some time to make him drink
c) Inform doctor to start iv fluids to prevent dehydration
380. As a nurse you are responsible for looking after patient’s nutritional needs and to maintain good weight
during hospitalization. How would you achieve this?
381. The client reports nausea and constipation. Which of the following would be the priority nursing action?
a) Do nothing as client has to finish her meal which is important for her health
b) Challenge the situation immediately as this is related to dignity of the patient and raise your concern
c) Do nothing as patient is not under your care
d) Wait until the situation is over and speak to the client on what she wants to do
383. A nurse is preparing to deliver a food tray to a client whose religion is Jewish. The nurse checks the food on the tray and
notes that the food on the tray and notes that the client has received a roast beef dinner with whole milk as a beverage.
Which action will the nurse take?
a) 1 to 2
b) 2 to 4
c) 4 to 6
d) 6 to 8
a) 50%
b) 60%
c) 70%
d) 80%
387. Concentration of electrolytes within the body vary depending on the compartment within which they are
contained. Extracellular fluid has a high concentration of which of the following?
a) Potassium
b) Chloride
c) Sodium
d) Magnesium
388. Dehydration is of particular concern in ill health. If a patient is receiving IV fluid replacement and is having their
fluid balance recorded, which of the following statements is true of someone said to be in "positive fluid balance"
389. Mr. James, 72 years old, is a registered blind admitted on your ward due to dehydration. He is encouraged to drink and
eat to recover. How will you best manage this plan of care?
391. If your patient is having positive balance. How will you find out dehydration is balanced?
392. A patient underwent an abdominal surgery and will be unable to meet nutritional needs through oral intake. A patient
was placed on enteral feeding. How would you position the patient when feeding is being administered?
a) Cerebrospinal fluid
b) Urine
c) Peritoneal fluid
d) Semen
e) All of the above
395. A patient is admitted to the ward with symptoms of acute diarrhoea. What should your initial management be?
a) Bounding pulse
b) Hypertension
c) Jugular distension
d) Hypotension
a) the movement of air into and out of the lungs to continually refresh the gases there, commonly called ‘breathing’
b) movement of oxygen from the lungs into the blood, and carbon dioxide from the lungs into the blood, commonly called
‘gaseous exchange’
c) movement of oxygen from blood to the cells, and of carbon dioxide from the cells to the blood
d) the transport of oxygen from the outside air to the cells within tissues, and the transport of carbon dioxide in the opposite direction.
a) The diaphragm
b) The lungs
c) the intercostal
d) All of the above
a) 16%
b) 21%
c) 26%
d) 31
401. What should be included in your initial assessment of your patients respiratory status?
a) Review the patients notes and charts, to obtain the patients history.
b) Review the results of routine investigations.
c) Observe the patients breathing for ease and comfort, rate and pattern.
d) Perform a systematic examination and ask the relatives for the patient’s history.
402. What should be included in your initial assessment of your patient's respiratory status?
A. Review the patient's notes and charts, to obtain the patient's history.
B. Review the results of routine investigations.
C. Observe the patient's breathing for ease and comfort, rate and pattern.
D.check for any drains
E all of the above
404. A client breathes shallowly and looks upward when listening to the nurse. Which sensory mode should the nurse plan
to use with this client?
a) Touch
b) Auditory
c) Kinesthetic
d) Visual
405. While assisting a client from bed to chair, the nurse observes that the client looks pale and is beginning to perspire heavily.
The nurse would then do which of the following activities as a reassessment?
406. A patient under u developed shortness of breath while climbing stairs. U inform this to the doctor. This response
is interpreted ass:
407. Which of the following is NOT a cause of Type 1 (hypoxaemic) respiratory failure?
A) Asthma
B) Pulmonary oedema
C) Drug overdose
D) Granulomatous lung disease
A) Oxygen is a very hot gas so if humidification isnt used, the oxygen will burn the respiratory tract and cause considerable pain for
the patient when they breathe.
B) 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.
C) Humidification cleans the oxygen as it is administered to ensure it is free from any aerobic pathogens before it is inhaled by
the patient.
412. When using nasal cannulae, the maximum oxygen flow rate that should be used is 6 litres/min. Why?
A) Nasal cannulae are only capable of delivering an inspired oxygen concentration between 24% and 40%.
B) For any given flow rate, the inspired oxygen concentration will vary between breaths, as it depends upon the rate and depth of the
patients breath and the inspiratory flow rate.
C) Higher rates can cause nasal mucosal drying and may lead to epistaxis.
D) If oxygen is administered at greater than 40% it should be humidified. You cannot humidify oxygen via nasal cannulae
413. If a patient is prescribed nebulizers, what is the minimum flow rate in litres per minute required?
a) 2-4
b) 4-6
c) 6–8
d) 8 – 10
414. Which of the following oxygen masks is able to deliver between 60-90% of oxygen when delivered at a flow rate of 10 –
15L/min?
415. Prior to sending a patient home on oxygen, healthcare providers must ensure the patient and family understand
the dangers of smoking in an oxygen-rich environment. Why is this necessary?
416. What do you need to consider when helping a patient with shortness of breath sit out in a chair?
a) They should not sit out on a chair; lying flat is the only position for someone with shortness of breath so that there are no negative
effects of gravity putting pressure in lungs
b) Sitting in a reclining position with legs elevated to reduce the use of postural muscle oxygen requirements, increasing lung
volumes and optimizing perfusion for the best V/Q ratio. The patient should also be kept in an environment that is quiet so they
don’t expend any unnecessary energy
c) The patient needs to be able to sit in a forward leaning position supported by pillows. They may also need access to a nebulizer
and humidified oxygen so they must be in a position where this is accessible without being a risk to others.
d) There are two possible positions, either sitting upright or side lying. Which is used and is determined by the age of the patient. It
is also important to remember that they will always need a nebulizer and oxygen and the air temperature must be below20
degree Celsius
418. Which of the following indicates signs of severe Chronic Obstructive Pulmonary disease (COPD)?
419. A COPD patient is in home care. When you visit the patient, he is dyspnoeic, anxious and frightened. He is already on 2
lit oxygen with nasal cannula.What will be your action
420. A COPD patient is about to be discharged from the hospital. What is the best health teaching to provide this patient?
421. As a nurse, what health teachings will you give to a COPD patient?
You are caring for a patient with a history of COAD who is requiring 70% humidified oxygen via a facemask. You are monitoring
his response to therapy by observing his colour, degree of respiratory distress and respiratory rate. The patient's oxygen
saturations have been between 95% and 98%. In addition, the doctor has been taking arterial blood gases. What is the reason for
this?
422. Joy, a COPD patient is to be discharged in the community. As her nurse, which of the following interventions will
you encourage him to do to prevent progression of disease.
A) Oxygen therapy
B) Breathing exercise
C) Cessation of smoking
D) coughing exercise
423. You are caring for a 17 year old woman who has been admitted with acute exacerbation of asthma. Her peak flow readings
are deteriorating and she is becoming wheezy. What would you do?
A. Sit her upright, listen to her chest and refer to the chest physiotherapist.
B. Suggest that the patient takes her Ventolin inhaler and continue to monitor the patient.
C. Undertake a full set of observations to include oxygen saturations and respiratory rate. Administer humidified
oxygen, bronchodilators, corticosteroids and antimicrobial therapy as prescribed.
D. Reassure the patient: you know from reading her notes that stress and anxiety often trigger her asthma.
424. Lisa, a working mother of 3, has approached you during a recent attendance of her daughter in Accident and
Emergency because of an acute asthma attack about smoking cessation. What is your most appropriate response to her?
425. Reason for dyspnoea in patients who diagnosed with Glomerulonephritis patients?
426. Your patient has bronchitis and has difficulty in clearing his chest. What position would help to maximize the drainage
of secretions?
a) Lying on his side with the area to be drained uppermost after the patient has had humidified air
b) Lying flat on his back while using a nebulizer
c) Sitting up leaning on pillows and inhaling humidified oxygen
d) Standing up in fresh air taking deep breaths
427. A client diagnosed of cancer visits the OPD and after consulting the doctor breaks down in the corridor and begins to
cry. What would the nurses best action?
a) Airway obstruction
b) Retching and vomiting
c) Bradycardia
d) Tachycardia
429. Which of the following is a potential complication of putting an oropharyngeal airway adjunct:
A) Retching, vomiting
B) Bradycardia
C) Obstruction
D) Nasal injury
430. What are the principles of gaining informed consent prior to a planned surgery?
A) Gaining permission for an imminent procedure by providing information in medical terms, ensuring a patient knows the potential risks
and intended benefits.
B) Gaining permission from a patient who is competent to give it, by providing information, both verbally and with written material,
relating to the planned procedure, for them to read on the day of planned surgery.
C) Gaining permission from a patient who is competent to give it, by informing them about the procedure and highlighting risks if the
procedure is not carried out.
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.
431. When do you gain consent from a patient and consider it valid?
432. A patient is assessed as lacking capacity to give consent if they are unable to:
A) Understand information about the decision and remember that information
B) Use that information to make a decision
C) Communicate their decision by talking, using sign language or by any other means
D) All the above
434. What do you have to consider if you are obtaining a consent from the patient?
a) Understanding
b) Capacity
c) Intellect
d) Patient’s condition
435. An adult has been medicated for her surgery. The operating room (OR) nurse, when going through the client's chart,
realizes that the consent form has not been signed. Which of the following is the best action for the nurse to take?
436. A patient doesn’t sign the consent for mastectomy. But bystanders strongly feel that she needs surgery.
a) Call the police to identify the client and locate the family
b) Obtain a court order for the surgical procedure
c) Ask the emergency medical services team to sign the informed consent
d) Transport the victim to the operating room for surgery
439. Barbara, a 75-year old patient from a nursing home was admitted on your ward because of fractured neck of femur after
a trip. She will require an open-reduction and internal fixation (ORIF) procedure to correct the injury. Which of the following
statements will help her understand the procedure?
a) 2-4 hours
b) 6-12 hours
c) 12-14 hours
442. A patient is being prepared for a surgery and was placed on NPO. What is the purpose of NPO?
443. Which is the safest and most appropriate method to remove hair pre-operatively?
a) Shaving
b) Clipping
c) Chemical removal
d) Washing
444. Who should mark the skin with an indelible pen ahead of surgery?
A) The nurse should mark the skin in consultation with the patient
B) A senior nurse should be asked to mark the patient's skin
C) The surgeon should mark the skin
D) It is best not to mark the patient's skin for fear of distressing the patient.
445. A patient is scheduled to undergo an Elective Surgery. What is the least thing that should be done?
A. Assess/Obtain the patient’s understanding of, and consent to, the procedure, and
a share in the decision making process.
B. Ensure pre-operative fasting, the proposed pain relief method, and expected
sequelae are carried out anddiscussed.
C. Discuss the risk of operation if it won’t push through.
D. The documentation of details of any discussion in the anaesthetic record.
446. Safe moving and handling of an anaesthetized patient is imperative to reduce harm to both the patient and staff. What is the
minimum number of staff required to provide safe manual handling of a patient in theatre?
A) 3 (1 either side, 1 at head).
B) 5 (2 each side, 1 at head).
C) 4 (1 each side, 1 at head, 1 at feet).
D) 6 (2 each side, 1 at head, 1 at feet).
447. You are the nurse assigned in recovery room or post anaesthetic care unit. The main priority of care in such area is:
448. As a registered nurse in a unit what would consider as a priority to a patient immediately post operatively?
A) pain relief
B) blood loss
C) airway patency
450. Accurate postoperative observations are key to assessing a patient's deterioration or recovery. The Modified Early
Warning Score (MEWS) is a scoring system that supports that aim. What is the primary purpose of MEWS?
451. What serious condition is a possibility for patients positioned in the Lloyd Davies position during surgery?
A) Stroke
B) Cardiac arrest
C) Compartment syndrome
D) There are no drawbacks to the Lloyd Davies position
452. A patient has just returned from theatre following surgery on their left arm. They have a PCA infusion connected and
from the admission, you remember that they have poor dexterity with their right hand. They are currently pain free. What
actions would you take?
A) Educate the patient's family to push the button when the patient asks for it. Encourage them to tell the nursing staff when they
leave the ward so that staff can take over.
B) Routinely offer the patient a bolus and document this clearly.
C) Contact the pain team/anaesthetist to discuss the situation and suggest that the means of delivery are changed.
D) The patient has paracetamol q.d.s. written up, so this should be adequate pain relief
453. The night after an exploratory laparotomy, a patient who has a nasogastric tube attached to low suction reports nausea. A
nurse should take which of the following actions first?
454. You are looking after a postoperative patient and when carrying out their observations, you discover that they
are tachycardic and anxious, with an increased respiratory rate. What could be happening? What would you do?
a) The patient is showing symptoms of hypovolaemic shock. Investigate source of fluid loss, administer fluid replacement and
get medical support.
b) The patient is demonstrating symptoms of atelectasis. Administer a nebulizer, refer to physiotherapist for assessment.
c) The patient is demonstrating symptoms of uncontrolled pain. Administer prescribed analgesia, seek assistance from medical team.
d) The patient is demonstrating symptoms of hyperventilation. Offer reassurance, administer oxygen
455. Patient is post of repair of tibia and fibula possible signs of compartment syndrome include
A) Numbness and tingling
B) Cool dusky toes
C) Pain
D) Toes swelling
E) All of the above
456. Now the medical team encourages early ambulation in the post-operative period. which complication is least prevented by
this?
A) Tissue wasting
B) Thrombophlebitis
C) Wound infection
D) Pneumonia
457. if a client is experiencing hypotension post operatively, the head is not tilted in which of the following surgeries
a) Chest surgery
b) Abdominal surgery
c) Gynaecological surgery
d) Lower limb surgery
458. You went back to see Mr Derby who is 1 day post-herniorraphy. As you approach him he complained of difficulty of
breathing with respiration rate of 23 breaths per minute and oxygen saturation 92% in room air. What is your next action
to help him?
459. Barbara was screaming in pain later in the day despite the PCA in-situ. You refer back to your nurse in charge for a
stronger pain killer. She refused to call the doctor because her pain relief was reassessed earlier. What will you do next?
460. How soon after surgery is the patient expected to pass urine?
A) 1-2 hours
B) 2-4 hours
C) 4-6 hours
D) 6-8 hours
461. A patient has just returned to the unit from surgery. The nurse transferred him to his bed but did not put up the side
rails. The patient fell and was injured. What kind of liability does the nurse have?
a) None
b) Negligence
c) Intentional tort
d) Assault and battery
A. Pain
B. Bleeding
C. Vomiting
D. Diarrhoea
463. A young woman gets admitted with abdominal pain & vaginal bleeding. Nurse should consider an ectopic
pregnancy. Which among the following is not a symptom of ectopic pregnancy?
465. Which of the following is NOT a risk factor for ectopic pregnancy?
a) Alcohol abuse
b) Smoking
c) Tubal or pelvic surgery
d) previous ectopic pregnancy
a) Floppy in appearance
b) Apnoea
c) Crying
467. An 18 year old 26 week pregnant woman who uses illicit drugs frequently, the factors in risk for which one of the following:
a) Spina bifida
b) Meconium aspiration
c) Pneumonia
d) Teratogenicity
a) abdominal pain
b) heart burn
c) headache
469. An unmarried young female admitted with ectopic pregnancy with her friend to hospital with complaints of abdominal pain. Her
friend assisted a procedure and became aware of her pregnancy and when the family arrives to hospital, she reveals the truth. The
family reacts negatively. What could the nurse have done to protect the confidentiality of the patient information?
a. should tell the family that they don’t have any rights to know the patient information b.
that the friend was mistaken and the doctor will confirm the patient’s condition
c. should insist friend on confidentiality
d. should have asked another staff nurse to be a chaperone while assisting a procedure
470. Jenny was admitted to your ward with severe bleeding after 48 hours following her labour. What stage of post
partum haemorrhage is she experiencing?
a) Primary
b) Secondary
c) Tertiary
d) Emergency
471. Postpartum haemorrhage: A patient gave birth via NSD. After 48 hours, patient came back due to bleeding, bleeding
after birth is called post partum haemorrhage. What type?
472. A young mother who delivered 48hrs ago comes back to the emergency department with post partum haemorrhage.
What type of PPH is it?
473. A new mother is admitted to the acute psychiatric unit with severe postpartum depression. She is tearful and states, "I
don't know why this happened to me I was so excited for my baby to come, but now I don't know!" Which of the following
responses by the nurse is MOST therapeutic?
a) Maybe you weren't ready for a child after all."
b) Having a new baby is stressful, and the tiredness and different hormone levels don't help. It happens to many new mothers and
is very treatable.
c) What happened once you brought the baby home? Did you feel nervous?
d) Has your husband been helping you with the housework at all?"
474. In a G.P clinic when you assessing a pregnant lady you observe some bruises on her hand. When you asked her about
this she remains silent. What is your action?
475. A client is admitted to the labour and delivery unit. The nurse performs a vaginal exam and determines that the client’s
cervix is 5cm dilated with 75% effacement. Based on the nurse’s assessment the client is in which phase of labour?
A. Active
B. Latent
C. Transition
D. Early
476. After the physician performs an amniotomy, the nurse’s first action should be to assess the:
477. The physician has ordered an injection of RhoGam for the postpartum client whose blood type is A negative but whose baby is
O positive. To provide postpartum prophylaxis, RhoGam should be administered:
478. The nurse is teaching a group of prenatal clients about the effects of cigarette smoke on fetal development.
Which characteristic is associated with babies born to mothers who smoked during pregnancy?
479. A client telephones the emergency room stating that she thinks that she is in labour. The nurse should tell the client
that labour has probably begun when:
480. A client is admitted to the labour and delivery unit complaining of vaginal bleeding with very little discomfort. The
nurse’s first action should be to:
481. The nurse is discussing breastfeeding with a postpartum client. Breastfeeding is contraindicated in the postpartum client with:
A. Diabetes
B. HIV
C. Hypertension
D. Thyroid disease
482. The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the neonate to be:
483. A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:
484. The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet
the nutritional needs of the pregnant client?
485. The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of a
ruptured ectopic pregnancy?
486. Which of the following is a characteristic of an ominous periodic change in the fetal heart rate?
A. A fetal heart rate of 120–130bpm
B. A baseline variability of 6–10bpm
C. Accelerations in FHR with fetal movement
D. A recurrent rate of 90–100bpm at the end of the contractions
487. The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:
488. As the client reaches 6cm dilation, the nurse notes late decelerations on the fetal monitor. What is the most likely
explanation of this pattern?
489. The following are all nursing diagnoses appropriate for a gravida 1 para 0 in labour. Which one would be most appropriate
for the primagravida as she completes the early phase of labour?
490. A vaginal exam reveals that the cervix is 4cm dilated, with intact membranes and a fetal heart tone rate of 160–170bpm. The
nurse decides to apply an external fetal monitor. The rationale for this implementation is:
492. The obstetric client’s fetal heart rate is 80–90 during the contractions. The first action the nurse should take is:
493. Which observation would the nurse expect to make after an amniotomy?
494. The client with pre-eclampsia is admitted to the unit with an order for magnesium sulfate. Which action by the
nurse indicates the understanding of magnesium toxicity?
495. Which selection would provide the most calcium for the client who is four months pregnant?
A. A granola bar
B. A bran muffin
C. A cup of yogurt
D. A glass of fruit juice
496. The nurse is monitoring a client with a history of stillborn infant. The nurse is aware that nonstress test can be ordered
for the client to:
497. The nurse is teaching basic infant care to a group of first-time parents. The nurse should explain that a sponge bath
is recommended for the first two weeks of life because:
498. When the nurse checks the fundus of a client on the first postpartum day, she notes that the fundus is firm, is at the level
of the umbilicus, and is displaced to the right. The next action the nurse should take is to:
499. A client is admitted to the labour and delivery unit in active labour. During examination, the nurse notes a papular lesion on
the perineum. Which initial action is most appropriate?
501. The nurse is assessing the deep tendon reflexes of a client with pre-eclampsia. Which method is used to elicit the
biceps reflex?
A. The nurse places her thumb on the muscle inset in the antecubital space and taps the thumb briskly with the reflex hammer.
B. The nurse loosely suspends the client’s arm in an open hand while tapping the back of the client’s elbow.
C. The nurse instructs the client to dangle her legs as the nurse strikes the area below the patella with the blunt side of the reflex hammer.
D. The nurse instructs the client to place her arms loosely at her side as the nurse strikes the muscle insert just above the wrist.
502. Which observation in the newborn of a diabetic mother would require immediate nursing intervention?
A. Crying
B. Wakefulness
C. Jitteriness
D. Yawning
503. The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with
drug therapy. An expected side effect of magnesium sulfate is:
505. A client elects to have epidural anesthesia to relieve the discomfort of labour. Following the initiation of epidural
anesthesia, the nurse should give priority to:
506. When assessing a labouring client, the nurse finds a prolapsed cord. The nurse should:
507. A client who delivered this morning tells the nurse that she plans to breastfeed her baby. The nurse is aware
that successful breastfeeding is most dependent on the:
508. The nurse is monitoring the progress of a client in labour. Which finding should be reported to the physician immediately?
509. The nurse is measuring the duration of the client’s contractions. Which statement is true regarding the measurement of the
duration of contractions?
510. The physician has ordered an intravenous infusion of Pitocin for the induction of labour. When caring for the obstetric
client receiving intravenous Pitocin, the nurse should monitor for:
A. Maternal hypoglycemia
B. Fetal bradycardia
C. Maternal hyperreflexia
D. Fetal movement
511. A client with diabetes visits the prenatal clinic at 28 weeks gestation. Which statement is true regarding insulin
needs during pregnancy?
512. A client in the prenatal clinic is assessed to have a blood pressure of 180/96. The nurse should give priority to:
513. A primigravida, age 42, is six weeks pregnant. Based on the client’s age, her infant is at risk for:
A. Down syndrome
B. Respiratory distress syndrome
C. Turner’s syndrome
D. Pathological jaundice
514. A client with a missed abortion at 29 weeks gestation is admitted to the hospital. The client will most likely be treated with:
A. Magnesium sulfate
B. Calcium gluconate
C. Dinoprostone (Prostin E.)
D. Bromocrystine (Parlodel)..
515. Which statement made by the nurse describes the inheritance pattern of autosomal recessive disorders?
516. A pregnant client, age 32, asks the nurse why her doctor has recommended a serum alpha fetoprotein. The nurse
should explain that the doctor has recommended the test:
518. The nurse is responsible for performing a neonatal assessment on a full-term infant. At one minute, the nurse could
expect to find:
519. A client with sickle cell anaemia is admitted to the labour and delivery unit during the first phase of labour. The
nurse should anticipate the client’s need for:
A. Supplemental oxygen
B. Fluid restriction
C. Blood transfusion
D. Delivery by Caesarean section
520. An infant who weighs 8 pounds at birth would be expected to weigh how many pounds at one year?
A. 14 pounds
B. 16 pounds
C. 18 pounds
D. 24 pounds
521. A pregnant client with a history of alcohol addiction is scheduled for a nonstress test. The nonstress test:
A gravida III para II is admitted to the labor unit. Vaginal exam reveals that the client’s cervix is 8cm dilated, with
complete effacement. The priority nursing diagnosis at this time is:
During the assessment of a labouring client, the nurse notes that the FHT are loudest in the upper-right quadrant. The infant is
most likely in which position?
While assessing the postpartal client, the nurse notes that the fundus is displaced to the right. Based on this finding, the
nurse should:
The nurse is performing an initial assessment of a newborn Caucasian male delivered at 32 weeks gestation. The nurse
can expect to find the presence of:
A. Mongolian spots
B. Scrotal rugae
C. Head lag
D. Polyhydramnios
The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered
for this client to:
An infant’s Apgar score is 9 at five minutes. The nurse is aware that the most likely cause for the deduction of one point is:
A. The baby is hypothermic.
B. The baby is experiencing bradycardia.
C. The baby’s hands and feet are blue.
D. The baby is lethargic.
An adolescent primigravida who is 10 weeks pregnant attends the antepartal clinic for a first check-up. To develop a teaching
plan, the nurse should initially assess:
A diabetic multigravida is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidyl
glycerol level. The L/S ratio is 1:1 and the presence of phosphatidylglycerol is noted. The nurse’s assessment of this data is:
522. Which of the following best describes the Contingency Theory of Leadership?
523. Which of the steps is NOT involved in Tuckman’s group formation theory?
a) Accepting
b) Norming
c) Storming
d) Forming
a) Forming
b) Storming
c) Norming
d) Analysing
525. Which of the following nursing theorists developed a conceptual model based on the belief that all persons should strive
to achieve self-care?
a) Martha Rogers
b) Dorothea Orem
c) Florence Nightingale
d) Cister Callista Roy
526. The contingency theory of management moves the manager away from which of the following approaches?
a) No perfect solution
b) One size fits all
c) Interaction of the system with the environment
d) a method of combination of methods that will be most effective in a given situation.
527. Which nursing delivery model is based on a production and efficiency model and stresses a task-orientated approach?
a) Case management
b) Primary nursing
c) Differentiated practice
d) Functional method
a) Ulcerative colitis - Ulcerative Colitis is a condition that causes inflammation and ulceration of the inner lining of the rectum and colon
b) Hashimotos disease - Hashimoto’s disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, is an
autoimmune disease
c) Pseudomembranous colitis -pseudomembranous colitis (PMC) is an acute, exudative colitis usually caused by Clostridium
difficile. PMC can rarely be caused by other bacteria,
d) Crohn’s disease - Crohn’s Disease is one of the two main forms of Inflammatory Bowel Disease, so may also be called ‘IBD’. The
other main form of IBD is a condition known as Ulcerative Colitis
530. Barrier Nursing for C.diff patient what should you not do?
531. Leonor, 72 years old patient is being treated with antibiotics for her UTI. After three days of taking them, she
developed diarrhoea with blood stains. What is the most possible reason for this?
532. You are caring for a patient in isolation with suspected Clostridium difficile. What are the essential key actions to
prevent the spread of infection?
a) Regular hand hygiene and the promotion of the infection prevention link nurse role.
b) Encourage the doctors to wear gloves and aprons, to be bare below the elbow and to wash hands with alcohol hand rub. Ask
for cleaning to be increased with soap-based products.
c) seek 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.
d) 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.
533. When treating patients with clostridium difficile, how should you clean your hands?
534. What infection control steps should not be taken in a patient with diarrhoea caused by Clostridium Difficile?
535. Patient with clostridium deficile has stools with blood and mucus. due to which condition?
a) Ulcerative colitis
b) Chrons disease
c) Inflammatory bowel disease
536. Which of the following is NOT a stage in the life cycle of viruses?
a) Attachment
b) Uncoating
c) Replication
d) Dispersal
a) Cell wall
b) Eukaryocyte
c) Spherical
d) Spores
539. For which of the following modes of transmission is good hand hygiene a key preventative measure?
a) Airborne
b) Direct & indirect contact
c) Droplet
d) All of the above
541. If you were asked to take ‘standard precautions’ what would you expect to be doing?
A. Wearing gloves, aprons and mask when caring for someone in protective isolation
B. Taking precautions when handling blood and ‘high risk’ body fluids so as not to pass on any infection to the patient
C. Using appropriate hand hygiene, wearing gloves and aprons where necessary, disposing of used sharp instruments safely
and providing care in a suitably clean environment to protect yourself and the patients
D. Asking relatives to wash their hands when visiting patients in the clinical setting
a) The precautions that are taken with all blood and ‘high-risk’ body fluids.
b) The actions that should be taken in every care situation to protect patients and others from infection, regardless of what is known of
the patient’s status with respect to infection.
c) It is meant to reduce the risk of transmission of blood bourne and other pathogens from both recognized and unrecognized sources.
d) The practice of avoiding contact with bodily fluids, by means of wearing of nonporous articles such as gloves, goggles, and
face shields.
543. Except which procedure must all individuals providing nursing care must be competent at?
a) Hand hygiene
b) Use of protective equipment
c) Disposal of waste
d) Aseptic technique
A) A micro-organism that is capable of causing infection, especially in vulnerable individuals, but not normally in healthy ones.
B) Micro-organisms that are present on or in a person but not causing them any harm.
C) Indigenous microbiota regularly found at an anatomical site.
D) Antibodies recruited by the immune system to identify and neutralize foreign objects like bacteria and viruses.
546. When disposing of waste, what colour bag should be used to dispose of offensive/ hygiene waste?
a) Orange
b) Yellow
c) Yellow and black stripe
d) Black
a) Leprosy
b) Pneumocystis jirovecii
c) Norovirus
d) Creutzfeldt Jakob disease
e) None of the above
549. 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. All of the above
550. If a patient requires protective isolation, which of the following should you advise them to drink?
a) Stoma or catheter bags - The Management of Waste from health, social and personal care -RCN
b) Unused non-cytotoxic/cytostatic medicines in original packaging
c) Used sharps from treatment using cytotoxic or cytostatic medicines
d) Empty medicine bottles
552. The use of an alcohol-based hand rub for decontamination of hands before and after direct patient contact and clinical
care is recommended when:
553. You are told a patient is in "source isolation". What would you do & why?
554. 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 & ‘high risk’ body fluids so that you don’t pass on any infection to the patient.
b) Wearing gloves, aprons & mask when caring for someone in protective isolation to protect yourself from infection
c) Asking relatives to wash their hands when visiting patients in the clinical setting
d) Using appropriate hand hygiene, wearing gloves & aprons when necessary, disposing of used sharp instruments safely &
providing care in a suitably clean environment to protect yourself & the patients
555. Under the Yellow Card Scheme you must report the following: ( Select x 2 correct answers)
a) Faulty brakes on a wheelchair
b) Suspected side effects to blood factor, except immunoglobulin products
c) Counterfeit or fake medicines or medical devices
557. What would make you suspect that a patient in your care had a urinary tract infection?
559. A client was diagnosed to have infection. What is not a sign or symptom of infection?
a) Renal Colic
b) Urine Infection
c) Common adverse reaction
d) Serious adverse reaction
561. As an infection prevention and control protocol, linens soiled with infectious bodily fluids should be disposed of in
what means?
562. 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%
564. There has been an outbreak of the Norovirus in your clinical area. Majority of your staff have rang in sick. Which of
the following is incorrect?
a.) Do not allow visitors to come in until after 48h of the last episode
b.) Tally the episodes of diarrhoea and vomiting
c.) Staff who has the virus can only report to work 48h after last episode
d.) Ask one of the staff who is off-sick to do an afternoon shift on same day
565. One of your patients in bay 1 having episodes of vomiting in the last 2 days now. The Norovirus alert has been
enforced. The other patients look concerned that he may spread infection. What is your next action in the situation?
568. The nurse needs to validate which of the following statements pertaining to an assigned client?
a) The client has a hard, raised, red lesion on his right hand.
b) A weight of 185 lbs. is recorded in the chart
C. The client reported an infected toe
D. The client's blood pressure is 124/70. It was 118/68 yesterday.
569. Which bag do you place infected linen?
a) water-soluble alginate polythene bag before being placed in the appropriate linen bag, no more than ¾ full
b) orange waste bag, before being placed in the appropriate linen bag, no more than ¾ full
c) white linen bag, after sorting, no more than ¾ full
570. Under the Yellow Card Scheme you must report the following: ( Select x 2 correct answers)
572. Jenny, a nursing assistant working with you in an Elderly Care Ward is showing signs of norovirus infection. Which of
the following will you ask her to do next?
A. Go home and avoid direct contact with other people and preparing food for others until at least 48 hours after her symptoms have
disappeared
B. Disinfect any surfaces or objects that could be contaminated with the virus
C. Flush away any infected faeces or vomit in the toilet and clean the surrounding toilet
area D. Avoid eating raw oysters
573. Mrs X had developed Steven-Johnson syndrome whilst on Carbamazepine. She is now being transferred for the ITU to
a bay in the Medical ward. Which patient can Mrs X share a baby with?
a) Flushed face
b) Headache and dizziness
c) Tachycardia and fall in blood pressure
d) Peripheral oedema
a) Headache
b) A tight feeling in the chest
c) Irregular pulse
d) Cyanosis
576. While giving an IV infusion your patient develops speed shock. What is not a sign and symptom of this?
A. Circulatory collapse
B. Peripheral oedema
C. Facial flushing
D. Headache
578. What are the signs and symptoms of shock during early stage (stage 1-3)?
a) hypoxemia
b) tachycardia and hyperventilation
c) hypotension
d) acidosis
581. You were asked by the nursing assistant to see Claudia whom you have recently given trimetophrim 200 mgs PO because
of urine infection. When you arrived at her bedside, she was short of breath, wheezy and some red patches evident over her
face. Which of the following actions will you do if you are suspecting anaphylaxis?
582. A patient has collapsed with an anaphylactic reaction. What symptoms would you expect to see?
a) The patient will have a low blood pressure (hypotensive) and will have a fast heart rate (tachycardia) usually associated with skin and
mucosal changes.
b) The patient will have a high blood pressure (hypertensive) and will have a fast heart rate (tachycardia).
c) The patient will quickly find breathing very difficult because of compromise to their airway or circulation. This is accompanied by skin
and mucosal changes
d) The patient will experience a sense of impending doom, hyperventilate and be itchy all over
583. What are the signs and symptoms of shock during early stage (stage 1-3)? (CHOOSE 3 ANSWERS)
A. hypoxemia
B. tachycardia and hyperventilation
C. hypotension
D. Acidosis
584. After lumbar puncture, the patient experienced shock. What is the etiology behind it?
a) Increased ICP
b) Headache
c) Side effect of medications
d) CSF leakage
585. A patient has collapsed with an anaphylactic reaction. What symptoms would you expect to see?
a) The patient will have a low blood pressure (hypotensive) & will have a fast heart rate (tachycardia) usually associated with skin &
mucosal changes
b) The patient will have a high blood pressure (hypertensive) & will have a fast heart rate (tachycardia)
c) The patient will quickly find breathing very difficult because of compromise to their airway or circulation. This is accompanied by skin
& mucosal changes
d) The patient will experience a sense of impending doom, hyperventilate & be itchy all over
586. Leonor, 72 years old patient is being treated with antibiotics for her UTI. After three days of taking them, she
developed diarrhoea with blood stains. What is the most possible reason for this?
a) Confusion
b) Rapid heart rate
c) Strong pulse
d) Decrease Blood Pressure
590. Mrs X was taken to the Accident and Emergency Unit due to anaphylactic shock. The treatment for Mrs X will depend on
the following except:
a.) Location
b.) Number of Responders
c.) Equipment and Drugs available
d.) Triage system in the A&E
591. Mark, 48 years old, has been exhibiting signs and symptoms of anaphylactic reaction. You want to make sure that he is in
a comfortable position. Which of the following should you consider?
592. The following are ways to remove factors that trigger anaphylactic reaction except for one.
a) It is not recommended to make the patient should not be forced to vomit after food-induced anaphylaxis.
b) Definitive treatment should not be delayed if removing a trigger is not feasible.
c) Any drug suspected of causing an anaphylactic reaction should be stopped.
d) After a bee sting, do not touch the stinger for about a maximum of 3 hours.
593. Mrs Smith has been assessed to have a cardiac arrest after anaphylactic reaction to a medication. Cardiopulmonary
Resuscitation (CPR) was started immediately. According to the Resuscitation Council UK, which of the following statements
is true?
a.) Intramuscular route administration of adrenaline is always recommended during cardiac arrest after anaphylactic reaction.
b.) Intramuscular route for adrenaline is not recommended during cardiac arrest after anaphylactic reaction.
c.) Adrenaline can be administered intradermally during cardiac arrest after anaphylactic reaction.
d.) None of the Above
594. An Eight year old girl with learning disabilities is admitted for a minor surgery, she is very restless and agitated and wants
her mother to stay with her, what will you do?
596. When communicating with children, what most important factor should the nurse take into consideration?
a) Developmental level
b) Physical development
c) Nonverbal cues
d) Parental involvement
598. Which of the following is an average heart rate of a 1-2 year old child?
a) 110-120 bpm
b) 60-100 bpm
c) 140-160 bpm
d) 80-120 bpm
599. You are assisting a doctor who is trying to assess and collect information from a child who does not seem to understand
all that the doctor is telling and is restless. What will be your best response?
600. Recognition of the unwell child is crucial. The following are all signs and symptoms of respiratory distress in children
EXCEPT:
a) Lying supine
b) Nasal flaring
c) Intercostal and sternal recession
d) adopting an upright position
601. 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 you not to mind him as he is not eating much while all
of them are eating during that time. As a nurse, what will you do?
602. There is a child you are taking care of at home who has a history of anaphylactic shock from certain foods, the nurse
is feeding him lunch, he looks suddenly confused, breathless and acting different, the nurse has access to emergency
drugs access and the mobile phone, what will she do?
a) She will keep the child awake by talking to him and call 911 for help
b) She will raise the child’s legs and administer Adrenaline and call the emergency services
c) The nurse will keep the child in standing position and try to reassure the child
603. You are about to administer Morphine Sulfate to a paediatric patient. The information written on the controlled drug
book was not clearly written – 15 mg or 0.15 mg. What will you do first?
a. Not administer the drug, and wait for the General Practitioner to do his
rounds b. Administer 0.15 mg, because 15 mg is quite a big dose for a
paediatric patient
c. Double check the medication label and the information on the controlled drug book; ring the chemist to verify the dosage
d. Ask a senior staff to read the medication label with you
a) supplimentary nutrition
b) immediate hospitalization
c) weekly assessment
d) document intake for three days
605. You saw a relative of a client has come with her son, who looks very thin, shy & frightened. You serve them food, but
the mother of that child says "don't give him, he eats too much". You should:
a) Raise your concern with your nurse manager about potential for child abuse & ask for her support
b) Ignore the mother & ask the relative if the child is abused.
c) Ignore the mother's advice & serve food to the child.
d) Ignore the situation as she is the mother & knows better about her child.
606. U just joined in a new hospital. U see a senior nurse beating a child with learning disability. Ur role
607. A nurse finds it very difficult to understand the needs of a child with learning disability. She goes to other nurses
and professionals to seek help. How u interpret this action
608. Monica is going to receive blood transfusion. How frequently should we do her observation?
A) Temperature and Pulse before the blood transfusion begins, then every hour, and at the end of bag/unit
B) Temperature, pulse, blood pressure and respiration before the blood transfusion begins, then after 15 min, then as indicated in local
guidelines, and finally at the end of 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
609. A mentally capable client in a critical condition is supposed to receive blood transfusion. But client strongly refuses
the blood product to be transfused. What would be the best response of the nurse?
a) Accept the client's decision and give information on the consequences of his actions
b) Let the family decide
c) Administer the blood product against the patients decision
d) The doctor will decide
610. Fred is going to receive a blood transfusion. How frequently should we do his observations?
a) Temperature and pulse before the blood transfusion begins, then every hour, and at the end of bag/unit.
b) Temperature, pulse, blood pressure and respiration before the blood transfusion begins, then after 15 minutes, then as 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.
611. Patient developed elevated temperature and pain in the loin during blood transfusion. This is indicative of:
612. Mrs. Smith is receiving blood transfusion after a total hip replacement operation. After 15 minutes, you went back to
check her vital signs and she complained of high temperature and loin pain. This may indicate:
a) Renal Colic
b) Urine Infection
c) Common adverse reaction
d) Serious adverse reaction
613. During blood transfusion, a patient develops pyrexia, and loin pain. Rn interprets the situation as
a) Common reaction to transfusion
b) Adverse reaction to blood transfusion
c) Patient has septicaemia
A. The practice of being humble enough to admit that someone else is better at something and being wise enough to try to learn how
to match and even surpass them at it.
B. A systematic process in which current practice and care are compared to, and amended to attain, best practice and
care C. A system that provides a structured approach for realistic and supportive practice development D. All of the above
a) Diagnosis
b) Planning
c) Implementation
d) Evaluation
619. The nurse has made an error in documenting client care. Which appropriate action should the nurse take?
a) Draw a line through error, initial, date and document correct information
b) Document a late addendum to the nursing note in the client’s chart
c) Tear the documented note out of the chart
d) Delete the error by using whiteout
a) It provides the foundation for care that enables individuals to gain greater control over their lives and enhance their health status.
b) An in-depth assessment of the patient’s health status, physical examination, risk factors, psychological and social aspects of
the patient’s health that usually takes place on admission or transfer to a hospital or healthcare agency.
c) An assessment of a specific condition, problem, identified risks or assessment of care; for example, continence assessment,
nutritional assessment, neurological assessment following a head injury, assessment for day care, outpatient consultation for
a specific condition.
d) It is a continuous assessment of the patient’s health status accompanied by monitoring and observation of specific problems
identified.
a) An organised, systematic and deliberate approach to nursing with the aim of improving standards in nursing care.
b) It uses a systematic, holistic, problem solving approach in partnership with the patient and their family.
c) It is a form of documentation.
d) It requires collection of objective data.
626. Which of the following sets of needs should be included in your service user’s person centred care plan?
a) Nurse and client agree upon health care goals for the client
b) Nurse reviews the client's history on the medical record
c) Nurse explains to the client the purpose of each administered medication
d) Nurse rapidly reset priorities for client care based on a change in the client's condition
628. The rehabilitation nurse wishes to make the following entry into a client's plan of care: "Client will re-establish a pattern of
daily bowel movements without straining within two months." The nurse would write this statement under which section of
the plan of care?
A) Long-term goals
B) Short-term goals
C) Nursing orders
D) Nursing dianosis/problem list
a) whenever possible provide care that is culturally sensitive and according to patients preference
b) ask the patient and their family about their culture
c) be aware of the patient’s culture
d) disregard the patient’s culture
631. All individuals providing nursing care must be competent at which of the following procedures?
a) Hand hygiene and aseptic technique
b) Aseptic technique only
c) Hand hygiene, use of protective equipment, and disposal of waste
d) Disposal of waste and use of protective equipment
e) All of the above
a) Task oriented
b) Caring medical and surgical patient
c) Patient oriented, individualistic care
d) All
633. The client reports nausea and constipation. Which of the following would be the priority nursing action?
635. Which of the following descriptors is most appropriate to use when stating the "problem" part of nursing diagnosis?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
637. A walk-in client enters into the clinic with a chief complaint of abdominal pain and diarrhea. The nurse takes the
client's vital sign hereafter. What phrase of nursing process is being implemented here by the nurse?
A) Assessment
B) Diagnosis
C) Planning
D) Implementation
638. How do you value dignity & respect in nursing care? Select which does not apply:
639. Which of the following items of subjective client data would be documented in the medical record by the nurse?
A) reflective process
b) clinical bench marking
c) peer and patient response
d) all the above
641. What are the professional responsibilities of the qualified nurse in medicines management?
a) Making sure that the group of patients that they are caring for receive their medications on time. If they are not competent
to administer intravenous medications, they should ask a competent nursing colleague to do so on their behalf.
b) The safe handling and administration of all medicines to patients in their care. This includes making sure that patients understand
the medicines they are taking, the reason they are taking them and the likely side effects.
c) Making sure they know the names, actions, doses and side 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.
642. Who has the overall responsibility for the safe and appropriate management of controlled drugs within the clinical area?
643. What are the key reasons for administering medications to patients?
a) To provide relief from specific symptoms, for example pain, and managing side effects as well as therapeutic purposes.
b) As part of the process of diagnosing their illness, to prevent an illness, disease or side effect, to offer relief from symptoms or to treat
a disease
c) As part of the treatment of long term diseases, for example heart failure, and the prevention of diseases such as asthma.
d) To treat acute illness, for example antibiotic therapy for a chest infection, and side effects such as nausea.
644. You were on your medication rounds and the emergency alarm goes off. What will you do first?
a) Nurses being interrupted when completing their drug rounds, different drugs being packaged similarly and stored in the same
place and calculation errors.
b) Unsafe handling and poor aseptic technique.
c) Doctors not prescribing correctly and poor communication with the multidisciplinary team.
d) Administration of the wrong drug, in the wrong amount to the wrong patient, via the wrong route
646. Registrants must only supply and administer medicinal products in accordance with one or more of the
following processes, except:
647. Independent and supplementary nurse and midwife are those who are?
648. Which of the following people is not exempted from paying a prescribed medication?
649. As a RN when you are administering medication, you made an error. Taking health and safety of the patient into
consideration, what is your action?
a) Call the prescriber. Report through yellow card scheme and document it in patient notes
b) Let the next of kin know about this and document it
c) Document this in patient notes and inform the line manager
d) Assess for potential harm to client, inform the line manager and prescriber and document in patient notes
650. You noticed that a colleague committed a medication administration error. Which should be done in this situation?
A. You should provide a written statement and also complete a Trust incident form.
B. You should inform the doctor.
C. You should report this immediately to the nurse in charge.
D. You should inform the patient.
651. The nurses on the day shift report that the controlled drug count is incorrect. What is the most appropriate nursing action?
652. Which of the following is not a part of the 6 rights of medication administration?
A. Right time
B. Right route
C. Right medication
D. Right reason
653. nOne of the following is not true about a delegation responsibility of a medication registrant:
a) Nurses are accountable to ensure that the patient, carer or care assistant is competent to carry out the task.
b) Nurses can delegate medication administration to student nurses / nurses on supervision.
c) Nurses can delegate medication administration to unregistered practitioners to assist in ingestion or application of the
medicinal product.
d) All of the above
654. A patient approached you to give his medications now but you are unable to give the medicine. What is your initial action?
a) Inform the doctor
b) Inform your team leader
c) Inform the pharmacist
d) Routinely document meds not given
655. You were on a night shift in a ward and has been allocated to dispose controlled medications. Which of the following
is correct?
a) Controlled drugs destruction and pharmacy stock check should be done at different times.
b.) Controlled drugs should be destroyed with the use of the Denaturing Kit.
c.) Excessive quantities of controlled drugs can be stored in the cupboard whilst waiting for destruction.
d.) None of the Above
656. General guidance for the storage of controlled drugs should include the following except:
657. On checking the stock balance in the controlled drug record book as a newly qualified nurse, you and a colleague notice
a discrepancy. What would you do?
a) Check the cupboard, record book and order book. If the missing drugs aren't found, contact pharmacy to resolve the issue. You
will also complete an incident form.
b) Document the discrepancy on an incident form and contact the senior pharmacist on duty.
c) Check the cupboard, record book and order book. If the missing drugs aren't found the police need to be informed.
d) Check the cupboard, record book and order book and inform the registered nurse or person in charge of the clinical area. If the
missing drugs are not found then inform the most senior nurse on duty. You will also complete an incident form.
658. You were running a shift and a pack of controlled drugs were delivered by the chemist/pharmacist whilst you were
giving the morning medications. What would you do first?
a) keep the controlled drugs in the trolley first, then store it after you have done morning drugs
b) Count the controlled drugs, store them in controlled drug cabinet and record them on the controlled drug book
c) Count the controlled drugs, store them in the medication trolley and record them on the controlled drug book
d) Record them in the controlled drug book and delegate one of the carers to store them in the controlled drug cabinet
659. In a nursing and residential home setting, how will you manage your time and prioritise patients’ needs whilst doing
your medication rounds in the morning?
a. Start administering medications from the patient nearest to the treatment room.
b. Start administering medications to patients who are in the dining room, as this is where most of them are for breakfast.
c. Check the list of patients and identify the ones who have Diabetes Mellitus and Parkinson’s disease.
d. All of the above.
660. After having done your medication rounds, you have realised that your patient has experienced the adverse effect of the
drug. What will be your initial intervention?
a) You must do the physical observations and notify the General Practitioner.
b) You must ring the General Practitioner and request for a home visit.
c) You must administer medication from the Homely Remedy Pod after having spoken to the General Practitioner.
d) You must observe your patient until the General Practitioner arrives at your nursing home.
661. You are transcribing medications from prescription chart to a discharge letter. Before sending this letter what action must
be taken?
662. A patient recently admitted to hospital, requesting to self-administer the medication, has been assessed for suitability
at Level 2 This means that:
a) The registrant is responsible for the safe storage of the medicinal products and the supervision of the administration process
ensuring the patient understands the medicinal product being administered
b) The patient accepts full responsibility for the storage and administration of the medicinal products
c) None of the above - The registrant is responsible for the safe storage of the medicinal products. At administration time, the patient
will ask the registrant to open the cabinet or locker. The patient will then self-administer the medication under the supervision of
the registrant
a) Nurses have more time for other aspects of patient care and it therefore reduces length of stay.
b) It gives patients more control and allows them to take the medications on time, as well as giving them the opportunity to address any
concerns with their medication before they are discharged home.
c) Reduces the risk of medication errors, because patients are in charge of their own medication.
d) Creates more space in the treatment room, so there are fewer medication errors
664. The MARS says that Benedict is on TID Macrogol. You have notice that the nurses have been writing “A” for refused.
What do you do?
a.) Write “A” on the MARS, because Benedict is expected to refuse it.
b.) Offer the Macrogol, and write “A” if the patient refuses it.
c.) Check bowel charts and cancel Macrogol on MARS if bowels are fine.
d.) Change the prescription to PRN.
665. A patient is rapidly deteriorating due to drug over dose what to do?
666. patient bring own medication to hospital and wants to self-administer what is your role ? allow him
667. A client experiences an episode of pulmonary oedema because the nurse forgot to administer the morning dose
of furosemide (Lasix). Which legal element can the nurse be charged with?
e) Assault
f) Slander
g) Negligence
h) tort
668. As a newly qualified nurse, what would you do if a patient vomits when taking or immediately after taking tablets?
A. Comfort the patient, check to see if they have vomited the tablets, & ask the doctor to prescribe something different as these
obviously don’t agree with the patient
B. Check to see if the patient has vomited the tablets & if so, document this on the prescription chart. If possible, the drugs may be
given again after the administration of antiemetics or when the patient no longer feels nauseous. It may be necessary to discuss an
alternative route of administration with the doctor
C. In the future administer antiemetics prior to administration of all tablets
D. Discuss with pharmacy the availability of medication in a liquid form or hide the tablets in food to take the taste away.
669. A newly admitted client refusing to handover his own medications and this includes controlled drugs. What is your action?
670. What medications would most likely increase the risk for fall?
a) Loop diuretic
b) Hypnotics
c) Betablockers
d) Nsaids
671. Tony is prescribed Lanoxin 500 mcg PO. What vital sign will you asses prior to giving the drug?
a) corticosteroid
b) nsaid
a) Allergies
b) Drug interactions
c) Other interactions with food or substances like alcohol and tobacco
d) Medical problems (Thyroid problems, kidney disease, etc.
e) All of the above.
a) Diuretics
b) Corticosteroids
c) Antibiotics
d) NSAID’s
1. Allergies
2. Drug interactions
3. Other interactions with food or substances like alcohol and tobacco
4. Medical problems (Thyroid problem, Kidney disease, etc.)
A. 1&2
B. 3&4
C. 1, 3, & 4
D. All of the above
677. The nurse monitors the serum electrolyte level of a client who is taking digoxin. Which of the following
electrolytes imbalances is common cause of digoxin toxicity?
a) Hypocalcemia
b) Hypomagnesemia
c) Hypokalaemia
d) Hyponatremia
678. Your patient has been prescribed Tramadol 50 mgs tablet for pain relief.
a. Record this in the controlled drug register book with the pharmacist
witnessing b. Put it in the patient’s medicine pod
c. Store it in ward medicine cupboard
d. Ask the pharmacist to give it to the patient
679. You have been asked to give Mrs Patel her mid-day oral metronidazole. You have never met her before. What do you
need to check on the drug chart before you administered?
a) Her name and address, the date of the prescription and dose.
b) Her name, date of birth, the ward, consultant, the dose and route, and that it is due at 12.00.
c) Her name, date of birth, hospital number, if she has any known allergies, the prescription for metronidazole: dose, route, time,
date and that it is signed by the doctor, and when it was last given
d) Her name and address, date of birth, name of ward and consultant, if she has any known allergies specifically to penicillin, that
prescription is for metronidazole: dose, route, time, date and 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.
680. You are caring for a Hindu client and it’s time for drug administration; the client refuses to take the capsule referring to
the animal product that might have been used in its making, what is the appropriate action for the nurse to perform?
a) She will not administer and document the ommissions in the patients chart
b) The nurse will ignore the clients request and administer forcebily
c) The nurse will open the capsule and administer the powdered drug
d) The nurse will establish with the pharamacist if the capsule is suitable for vegetarians
681. John, 18 years old is for discharge and will require further dose of oral antibiotics. As his nurse, which of the following will
you advise him to do?
a) Take with food or after meals and ensure to take all antibiotics as prescribed
b) Take all antibiotics and as prescribed
c) Take medicine during the day and ensure to finish the course of medication
d) Take medicine and stop when he feels better
683. You are the named nurse of Colin admitted at Respiratory ward because of chest infection. His also suffers from
Parkinson's syndrome. What medications will you ensure Colin has taken on regular time to control his 'shaking'?
a) Co-careldopa (Sinemet)
b) Co-amoxiclave (augmentin)
c) Co-codamol
d) Co-Q10
684. Your hospital supports the government’s drive on breastfeeding. One of your patient being treated for urinary tract
infection was visited by her husband and their 4 month old baby. She would like to breastfeed her baby. What advise will you
give her?
686. What are the key nursing observations needed for a patient receiving opioids frequently?
a) Respiratory rate, bowel movement record and pain assessment and score.
b) Checking the patent is not addicted by looking at their blood pressure.
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
687. What advice do you need to give to a patient taking Allopurinol? (Select x 3 correct answers)
a) Drink 8 to 10 full glasses of fluid every day, unless your doctor tells you otherwise.
b) Store allopurinol at room temperature away from moisture and heat.
c) Avoid being near people who are sick or have infections
d) Skin rash is a common side effect, it will pass after a few days
688. What instructions should you give a client receiving oral Antibiotics?
A) on admission
B) when septicemia is suspected
C) when the blood culture shows positive growth of organism
690. After two weeks of receiving lithium therapy, a patient in the psychiatric unit becomes depressed. Which of the
following evaluations of the patient’s behavior by the nurse would be MOST accurate?
a) The treatment plan is not effective; the patient requires a larger dose of lithium.
b) This is a normal response to lithium therapy; the patient should continue with the current treatment plan.
c) This is a normal response to lithium therapy; the patient should be monitored for suicidal behavior.
d) The treatment plan is not effective; the patient requires an antidepressant
691. Johan, 25 year old, was admitted at Medical Assessment Unit because of urine infection. During your assessment, he
admitted using cannabis under prescription for his migraine and still have some in his bag. What is your best reply to
him about the cannibis?
692. A patient in your care is on regular oral morphine sulphate. As a qualified nurse, what legal checks do you need to carry
out every time you administer it, which are in addition to those you would check for every other drug you administer?
a) Check to see if the patient has become tolerant to the medication so it is no longer effective as analgesia.
b) Check to see whether the patient has become addicted.
c) Check the stock of oral morphine sulphate in the CD cupboard with another registered nurse and record this in the control drug
book; together, check the correct prescription and the identity of the patient.
d) Check the stock of oral morphine sulphate in the CD cupboard with another registered nurse and record this in the control drug
book; then ask the patient to prove their identity to you
693. Which of the following drugs will require 2 nurses to check during preparation and administration?
a) oral antibiotics
b) glycerine suppositories
c) morphine tablet
d) oxygen
694. A patient was on morphine at hospital. On discharge doctor prescribes fentanyl patches. At home patient should
be observed for which sign of opiate toxicity?
695. Manu is in persistent pain and has Oromorph PRN. All your carers are on their rounds, and you are about to administer
this drug. What would you do?
697. Prothrombin time is essential during anticoagulation therapy. In oral anticoagulation therapy which test is essential?
a) Activated Thromboplastin Time - The partial thromboplastin time (PTT) test is a blood test that is done to investigate bleeding
disorders and to monitor patients taking ananticlotting drug (heparin).
b) International Normalized Ratio - The Prothrombin time (PT) test, standardised as the INR test is most often used to check how
well anticoagulant tablets such as warfarin and phenindione are working
A) Ptt
B) aPTT
C) ct
D) INR
699. You are the named nurse of Mr Corbyn who has just undergone an abdominal surgery 4 hours ago. You have administered his
regular analgesia 2 hours ago and he is still complaining of pain. Your most immediate, most appropriate nursing action?
700. Mild pain after surgery and pain is reduced by taking which medicine
a)paracetamol
b)ibuprofen
c)paracetamol with codeine
d)paracetamol with morphine
701. John is also prescribed some medications for his Gout. Which of the following health teaching will you advise him to do?
702. A patient doesn’t take a tablet which is prescribed by a doc. Nurse should
a) mood variation
b) edema
704. On which step of the WHO analgesic ladder would you place tramadol and codeine?
705. What could be the reason why you instruct your patient to retain on its original container and discard nitroglycerine
meds after 8 weeks?
A) removing from its darkened container exposes the medicine to the light and its potency will decrease after 8 weeks
B) it will have a greater concentration after 8weeks
706. A sexually active female , who has been taking oral contraceptives develops diarrohea. Best advice
707. A patient is prescribed metformin 1000mg twice a day for his diabetes. While talking with the patient he states “I never eat
breakfast so I take a 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:
708. A Ibuprofen 200mg tablet has been prescribed. You only have a 400mg coated ibuprofen tablet. What should you do?
a) Tell the client that herbal substances are not safe & should never be used
b) Teach the client how to take their BP so that it can be monitored closely
c) Encourage the client to discuss the use of an herbal substance with the health care provider
711. Dennis was admitted because of acute asthma attack. Later on in your shift, he complained of abdominal pain and
vomited. He asked for pain relief. Which of the following prescribed analgesia will you give him?
712. Mr Jones has been having Type 6 and 7 stools today. As you are doing his medications, which of the following would
you not omit?
713. You are the night nurse in a nursing home. Maxine, 81 years old, has been prescribed with Lorazepam PRN. You
have assessed her to be wandering and talking to staff. When do you administer the Lorazepam?
714. Mrs Z has been very chesty the last few days. She has been having difficulty with breathing. You have referred her to
the GP, and requested for a home visit. What would probably be prescribed by the GP?
a.) Stalevo 200
b.) Digoxin 40 mg
c.) Trimethoprim 100 mg
d.) Simvastatin 100 mg
715. Annie is on Cefalexin QID. You were working on a night shift and have noticed that the previous nurse has not signed
for the last two doses. What should you do?
Alan Smith has a history of Congestive Heart Failure. He has also been complaining of general weakness. After taking
his physical observations, you have noticed that he has pitting oedema on both feet. Which of the following is incorrect?
716. Maria has ran out of Cavilon Cream. You have noted that her groins are very red and sore. You can see that David has
spare Cavilon tubes after checking the stocks. What will you do?
a.) Borrow a tube from David’s stock as Maria’s groins are red and sore
b.) Use Canesten for now and apply Cavilon once stock has arrived
c.) Request for a repeat prescription from the GP, and have the stock delivered by the chemist
d.) Ring the GP and ask him to see Maria’s groins, then prescribe Cavilon.
717. Cherry has been prescribed with Estradiol tablet to be inserted twice a week at night. You entered her bedroom and
noticed she is fast asleep. What would you do?
a.) Try to gently wake her up and insert her vaginal tablets.
b.) Allow her to get some sleep and try to insert the vaginal tablet on your next turn rounds.
c.) Speak to her and ask her to spread her legs, so you can insert her vaginal tablet.
d.) Document that the tablet cannot be administered at all because the patient has refused.
a) Administer the prescribed number of drops, holding the eye dropper 1-2 cm above
the eye. If the patient links or closes their eye, repeat the procedure
b) ask the patient to close their eyes and keep them closed for 1-2 minutes
c) If administering both drops and ointment, administer ointment first
d) Ask the patient to sit back with neck slightly hyper extended or lie down
722. Jim is to receive his eyedrops after his cataract operation. What is the best position for Jim to assume when instilling
the eyedrops?
A. upper arm
B. stomach
C. thigh
D. buttocks
a) Registered nurse
b) Nurse assistant
c) Whoever used the sharps
d) Whoever collects the garbage
725. What steps would you take if you had sustained a needlestick injury?
a) Ask for advice from the emergency department, report to occupational health and fill in an incident form.
b) 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.
c) 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 dont
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
726. You were administering a pre-operative medication to a patient via IM route. Suddenly, you developed a needle-stick
injury. Which of the following interventions will not be appropriate for you to do?
727. UK policy for needle prick injury includes all but one:
728. One of your patient has challenged your recent practice of administering a subcutaneous low-molecular weight heparin
(LMWH) without disinfecting the injection site. The guidelines for nursing procedures do not recommend this method.
Which of the following response will support your action?
A. “We were taught during our training not to do so as it is not based on evidence.”
B. “Our guidelines, which are based on current evidence, recommends a non-disinfection method of subcutaneous injection.”
C. “I am glad you called my attention. I will disinfect your injection site next time to ensure your safety and peace of mind.”
D. “Disinfecting the site for subcutaneous injection is a thing of the past. We are in an evidence-based practice now.”
a) ventrogluteal
b) deltoid
c) rectus femoris
d) dorsogluteal
a) upper arm
b) stomach
c) thigh
d) buttocks
736. The degree of injection when giving subcutaneous insulin injection on a site where you can grasp 1 inch of tissue?
B) 45degrees
C) 40degrees
D) 25degrees
A nursing assistant would like to know what a patient group directive means. Your best reply will be:
a) they are specific written instructions for the supply and administration of a licensed named medicine
b) can be used by any registered nurse or midwife caring for the patient
c) drugs can be used outside the terms of their licence (“off label”),
d) it is an alternative form of prescribing
737. Which is the first drug to be used in cardiac arrest of any aetiology?
e) Adrenaline
f) Amiodarone
g) Atropine
h) Calcium chloride
738. Why would the intravenous route be used for the administration of medications?
a) It is a useful form of medication for patients who refuse to take tablets because they don’t want to comply with treatment
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 & kept in aseptic conditions
d) The intravenous route provides an immediate therapeutic effect & gives better control of the rate of administration as a more precise
dose can be calculated so treatment can be more reliable
e) more precise dose can be calculated so treatment can be more reliable
739. What is the best nursing action for this insertion site. You have observed an IV catheter insertion site w/ erythema, swelling,
pain and warm.
a) start antibiotics
b) re-site cannula
c) call doctor
d) elevate
740. What are the key nursing observations needed for a patient receiving opioids
frequently?
A. Respiratory rate, bowel movement record and pain assessment and score.
B. Checking the patent is not addicted by looking at their blood pressure.
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.
741. What is the best way to avoid a haematoma forming when undertaking venepuncture?
a) Tap the vein hard which will ‘get the vein up’, especially if the patient has fragile veins. This will avoid bruising afterwards.
b) It is unavoidable and an acceptable consequence of the procedure. This should be explained and documented in the patient's notes.
c) Choosing a soft, bouncy vein that refills when depressed and is easily detected, and advising the patient to keep their arm straight
whilst firm pressure is applied.
d) Apply pressure to the vein early before the needle is removed, then get the patient to bend the arm at a right angle whilst
applying firm pressure
742. A nurse is not trained to do the procedure of IV cannulation , still she tries to do the procedure . You are the colleague
of this nurse. What will be your action?
743. You have just administered an antibiotic drip to you patient. After few minutes, your patient becomes breathless
and wheezy and looks unwell. What is your best action on this situation?
a) Stop the infusion, call for help, anaphylactic kit in reach, monitor closely
b) continue the infusion and observe further
c) check the vital signs of the patient and call the doctor
d) stop the infusion and prepare a new set of drip
a) Nerve injury
b) Arterial puncture
c) Haematoma
d) Fainting
745. A patient with burns is given anesthesia using 50%oxygen and 50%nitrous oxide to reduce pain during dressing. how
long this gas is to be inhaled to be more effective?
A) 30 sec
B) 60sec
C) 1-2min
D) 3-5min
746. You have observed an IV catheter insertion site w/ erythema, swelling, pain and warm? What VIP score would
you document on his notes?
a) 5
b) 2
c) 3
d) 4
A) septecimia
B) adverse reaction
A) Addissons disease
B) When use spironolactone
C) When use furosemide
749. 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?
750. A patient is on Inj. Fentanyl skin patch common side effect of the fentanyl overdose is
751. As a registered nurse, you are expected to calculate fluid volume balance of a patient whose input is 2437 ml and output is
750 ml
a) 1887 (Negative Balance)
b) 1197 (Negative Balance)
c) 1887 (Positive Balance)
d) 1197 (Positive Balance)
752. What does the term ‘breakthrough pain’ mean, and what type of prescription would you expect for it?
a) A patient who has adequately controlled pain relief with short lived exacerbation of pain, with a prescription that has no regular
time of administration of analgesia.
b) Pain on movement which is short lived, with a q.d.s. prescription, when necessary.
c) Pain that is intense, unexpected, in a location that differs from that previously assessed, needing a review before a prescription
is written.
d) A patient who has adequately controlled pain relief with short lived exacerbation of pain, with a prescription that has 4
hourly frequency of analgesia if necessary
753. 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 at this point?
a) Ask her to score her pain, describe its intensity, duration, the site, any relieving measures and what makes it worse, looking for
non verbal clues, so you can determine the appropriate method of pain management.
b) Give her some sedatives so she goes to sleep.
c) Calculate a pain score, suggest that she takes deep breaths, reposition her pillows, return in 5 minutes to gain a comparative pain
score.
d) Give her any analgesia she is due. If she hasn't any, contact the doctor to get some prescribed. Also give her a warm milky drink and
reposition her pillows. Document your action.
754. How should we transport controlled drugs? Select which does not apply:
a) methicillin-resistant staphyloccocusaureu
b) multiple resistant staphylococcus antibiotic
757. Patient is given penicillin. After 12 hrs he develops itching, rash and shortness of breath. what could be the reason?
Speed shock
Allergic reaction
a) Green Card
b) Yellow Card
c) White Card
d) Blue Card
762. The medicine and Healthcare Products Regulatory Agency (MHRA) is responsible for what?
763. Medication errors account for around a quarter of the incidents that threaten patient safety. In a study published in 2 000
it was found that 10% of all patients admitted to hospital suffer an adverse event (incident. How much of these incidents were
preventable?
a) 20%
b) 30%
c) 50%
d) 60%
764. You are about to administer Morphine Sulphate to a paediatric patient. The information written on the control drug
book was not clearly written – 15mg or 0.15 mg. What will you do first?
a) Not administer the drug, and wait for the General Practitioner to do his rounds
b) Administer 0.15 mg, because 15 mg is quite a big dose for a paediatric patient
c) Double check the medication label and the information on the controlled drug book; ring the chemist the verify the dosage
d) Ask a senior staff to read the medication label for you
765. After having done your medication round, you have realised that your patient has experienced the adverse effect of the
drug. What will be your initial intervention?
a) You must do the physical observations and notify the General practitioner
b) You must ring the General Practitioner and request for a home visit
c) You must administer medication from the Homely Remedy Pod after having spoken to the General Practitioner.
d) You must observe your patient until the General Practitioner arrives at your nursing home
766. Your patient has been prescribed Tramadol 50 mgs tablet for pain relief. Upon receipt of the tablets from the
pharmacist you will:
A.Record this in the controlled drug register book with the pharmacist witnessing
B. Put it in the patient’s medicine pod
C. Store it in ward medicine cupboard
D. Ask the pharmacist to give it to the patient
767. The nurse is admitting a client, on initial assessment the nurse tries to inquire the patient if he has been taking alternative
therapies and OTC drugs but the client becomes angry and refuses to answer saying thenurse is doing so because he
belongs to an ethnic minority group, what is the nurse’s best response?
768. Mrs X is diabetic and on PEG feed. Her blood sugar has been high during the last 3 days. She is on Nystatin Oral Drops
QID, regular PEG flushes and insulin doses. Her Humulin dose has been increased from 12 iu to 14 iu. The nurse practitioner
has advised you to monitor her BM’s for the next two days. What will be your initial intervention if her BM drops to 2.8 mmol
after 2 morning doses of 14 iu?
a.) Ranitidine
b.) Zantac
c.) Paracetamol
d.) Levothyroxine
e.) a and b
f.) b and
770. 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 reluctant to move, particularly stand up. What would you do?
771. A nurse is caring for clients in the mental health clinic. A women comes to the clinic complaining of insomnia and
anorexia. The patient tearfully tells the nurse that she was laid off from a job that she had held for 15 years. Which of the
following responses, if made by the nurse, is MOST appropriate?
772. 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 of:
774. A suicidal Patient is admitted to psychiatric facility for 3 days when suddenly he is showing signs of cheerfulness
and motivation. The nurse should see this as:
775. When caring for clients with psychiatric diagnoses, the nurse recalls that the purpose of psychiatric diagnoses or
psychiatric labelling to:
776. Which of the following situations on a psychiatric unit are an example of trusting patient nurse relationship?
777. Which of the following situations on a psychiatric unit are an example of a trusting a patient-nurse relationship?
778. After two weeks of receiving lithium therapy, a patient in the psychiatric unit becomes depressed. Which of the
following evaluations of the patient’s behavior by the nurse would be MOST accurate?
A) The treatment plan is not effective; the patient requires a larger dose of lithium.
B) This is a normal response to lithium therapy; the patient should continue with the current treatment plan.
C) This is a normal response to lithium therapy; the patient should be monitored for suicidal behavior.
779. A patient with a history of schizophrenia is admitted to the acute psychiatric care unit. He mutters to himself as the nurse
attempts to take a history and yells. “I don’t want to answer any more questions! There are too many voices in this room!”
Which of the following assessment questions should the nurse as NEXT?
780. The wife of a client with PTSD (post-traumatic stress disorder) communicate to the nurse that she is having trouble
dealing with her husband's condition at home. Which of the following suggestions made by the nurse is CORRECT?
a) Do not touch or speak to your husband during an active flashback. Wait until it is finished to give him support."
b) Discourage your husband from exercising, as this will worsen his condition
c) Encourage your husband to avoid regular contact with outside family members
d) Keep your cupboards free of high-sugar and high-fat foods
781. On a psychiatric unit, the preferred milieu environment is BEST describe as:
a) Supression
b) Undoing
c) Regression
d) Repression
783. After the suicide of her best friend Marry feels a sense of guilt, shame and anger because she had not answered the phone
when her friend called shortly before her death. Which of the following statements is the most accurate when talking about
Mary’s feelings?
784. What is an indication that a suicidal patient has an impending suicide plan:
785. Risk for health issues in a person with mental health issues
a) Inactivity
b) Sad facial expression
c) Slow monotonous speech
d) Increased energy
787. A patient with antisocial personality disorder enters the private meeting room of a nurse unit as a nurse is meeting with a
different patient. Which of the following statements by the nurse is BEST?
a) I’m sorry, but HIPPA says that you can’t be her. Do you mind leaving?
b) You may sit with us as long as you are quiet
c) I need you to leave us alone
d) Please leave and I will speak with you when I am done
788. A patient asking for LAMA, the medical team has concern about the mental capacity of the patient, what decision should
be made?
789. The nurse restrains a client in a client in a locked room for 3 hours until the client acknowledge wo started a fight in
the group room last evening. The nurse’s behaviour constitutes;
a) False imprisonment
b) Duty of care
c) Standard of care practice
d) Contract of care
790. A client has been voluntary admitted to the hospital. The nurse knows that which of the following statements
is inconsistent with this type of hospitalization
792. A patient got admitted to hospital with a head injury. Within 15 minutes, GCS was assessed and it was found to be 15.
After initial assessment, a nurse should monitor neurological status
a) Every 15 minutes
b) 30 minutes
c) 45 minutes
d) 60 minutes
793. You are caring for a patient who has had a recent head injury and you have been asked to carry out neurological
observations every 15 minutes. You assess and find that his pupils are unequal and one is not reactive to light. You are
no longer able to rouse him. What are your actions?
a) Continue with your neurological assessment, calculate your Glasgow Coma Scale (GCS) and document clearly.
b) This is a medical emergency. Basic airway, breathing and circulation should be attended to urgently and senior help should
be sought.
c) Refer to the neurology team.
d) Break down the patient's Glasgow Coma Scale as follows: best verbal response V = XX, best motor response M = XX and eye
opening E = XX. Use this when you hand over.
794. A patient in your care knocks their head on the bedside locker when reaching down to pick up something they
have dropped. What do you do?
a) Let the patient’s relatives know so that they don’t make a complaint & write an incident report for yourself so you remember the
details in case there are problems in the future
b) Help the patient to a safe comfortable position, commence neurological observations & ask the patient’s doctor to come & review
them, checking the injury isn’t serious. when this has taken place , write up what happened & any future care in the nursing notes
c) Discuss the incident with the nurse in charge , & contact your union representative in case you get into trouble
d) Help the patient to a safe comfortable position, take a set of observations & report the incident to the nurse in charge who may call
a doctor. Complete an incident form. At an appropriate time , discuss the incident with the patient & if they wish , their relatives
795. Glasgow Coma score (GCS) is made up of 3 component parts and these are:
796. 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?
a) physiotherapy nurse
b) psychotherapy nurse
c) speech and language therapist
d) neurologic nurse
798. A patient suffered from CVA and is now affected with dysphagia. What should not be an intervention to this type of patient?
a) Place the patient in a sitting position / upright during and after eating.
b) Water or clear liquids should be given.
c) Instruct the patient to use a straw to drink liquids.
d) Review the patient's ability to swallow, and note the extent of facial paralysis.
799. The nurse is preparing the move an adult who has right sided paralysis from the bed into a wheel chair. Which statement
best describe action for the nurse to take?
a) Position the wheelchair on the left side of the bed.
b) Keep the head of the bed elevated 10 degrees.
c) Protect the patients left arm with a sling during transfer.
d) Bend at the waist while helping the client into a standing position
800. An adult has experienced a CVA that has resulted in right side weakness. The nurse is preparing to move the patients
right side of the bed so that he may then be turned to his left side. The nurse knows that an important principle when moving
the patient is?
801. A patient suffered from stroke and is unable to read and write. This is called
a) Dysphasia
b) Dysphagia
c) Partial aphasia
d) Aphasia
a) Neurologic physiotherapist
b) Speech therapist
c) Occupation therapist
806. When a patient is being monitored in the PACU, how frequently should blood pressure, pulse and respiratory rate
be recorded?
a) Every 5 minutes
b) Every 15 minutes
c) Once an hour
d) Continuously
a) Dizziness
b) Dull hearing
c) Reflux cough
d) Sneezing
808. You are caring for a patient with a tracheostomy in situ who requires frequent suctioning. How long should you suction
for?
a) If you preoxygenate the patient, you can insert the catheter for 45 seconds.
b) Never insert the catheter for longer than 10-15 seconds.
c) Monitor the patient's oxygen saturations and suction for 30 seconds
d) Suction for 50 seconds and send a specimen to the laboratory if the secretions are purulent
809. Your patient has a bulky oesophageal tumour and is waiting for surgery. When he tries to eat, food gets stuck and gives him
heartburn. What is the most likely route that will be chosen to provide him with the nutritional support he needs?
a) Oropharyngeal tumor
b) Laryngeal cyst
c) Obstruction of foreign body
d) Tongue falling back
811. Which of the following is a potential complication of putting an oropharyngeal airway adjunct:
A. Retching, vomiting
B. Bradycardia
C. Obstruction
D. Nasal injury
812. The client has recently returned from having a thyroidectomy. The nurse should keep which of the following at
the bedside?
A. A tracheotomy set
B. A padded tongue blade
C. An endotracheal tube
D. An airway
813. The nurse is changing the ties of the client with a tracheotomy. The safest method of changing the tracheotomy ties is
to: Proximal third section of the small intestines
814. A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and
toes. What would the nurses’ next action be?
815. A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a weight gain of 30 pounds in four months,
and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing
diagnoses is of highest priority?
816. The physician has ordered a thyroid scan to confirm the diagnosis of a goiter. Before the procedure, the nurse should:
817. While changing tubing and cap change on a patient with central line on right subclavian what should the nurse do
to prevent complication
a) Atrial flutter
b) A sinus rhythm
c) Ventricular tachycardia
d) Atrial fibrillation
819. The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the:
A. Feet
B. Neck
C. Hands
D. Sacrum
820. Which of the following population group is at risk of developing cardiovascular disease?
A. Obesity
B. Smoking
C. High Blood Pressure
D. Female
822. Which of the following is at a greater risk for developing coronary artery disease?
823. When should adult patients in acute hospital settings have observations taken?
a) When they are admitted or initially assessed. A plan should be clearly documented which identifies which observations should be
taken & how frequently subsequent observations should be done
b) When they are admitted & then once daily unless they deteriorate
c) As indicated by the doctor
d) Temperature should be taken daily, respirations at night, pulse & blood pressure 4 hourly
824. When is the time to take the vital signs of the patients? Select which does not apply:
a) Oedema
b) Hyperpigmentation of the skin
c) Pain
d) Cyanosis
A) hypertension
B) hypotension
C) bradycardia
D) tachycardia
a) Amplitude, volume and irregularities cannot be detected using automated electronic methods
b) Tachycardia cannot be detected using automated electronic methods
c) Bradycardia cannot be detected using automated electronic method
d) It is more reassuring to the patient
828. A patient on your ward complains that her heart is ‘racing’ and you find that the pulse is too fast to manually palpate.
What would your actions be?
829. Orthostatic hypotension is diagnosed if the systolic blood pressure drops by how many mmHg?
A) 20
B) 25
C) 30
D) 35
a) Decreased conscious level, reduced blood flow to vital organs and renal failure.
b) The patient could become confused and not know who they are.
c) Decreased conscious level, oliguria and reduced coronary blood flow.
d) The patient feeling very cold
833. Mrs Red is complaining of shortness of breath. On assessment, her legs are swollen indicative of tissue oedema. What do
you think is the possible cause of this?
834. In interpreting ECG results if there is clear evidence of atrial disruption this is interpreted as?
a) Cardiac Arrest
b) Ventricular tach
c) Atrial Fibrillation
d) Complete blockage of the heart
a) Atrial fibrillation
b) cardiac arrest
c) ventricular tachycardia
d) asystole
837. The correct management of an adult patient in ventricular fibrillation (VF) cardiac arrest includes:
a) an initial shock with a manual defibrillator or when prompted by an automated external defibrillator (AED)
b) atropine 3 mg IV
c) adenosine 500 mcg IV
d) adrenaline 1 mg IV before first shock
839. While having lunch at the cafeteria, your co-worker suddenly collapsed. As a nurse, what would you do?
840. Which is the first drug to be used in cardia arrest of any aetiology?
a) Adrenaline
b) Amiodarone
c) Atropine
d) Calcium chloride
A) chest compression should be 5-6 cm deep at a rate of 100-120 compression per minute
B) a ratio of 2 ventilation to 15 cardiac compression is required
C) the hands should be placed over the lower third of the sternum to do chest compression
D) check for normal breathing for 1 full minute to diagnose cardiac arrest
842. You are currently on placement in the emergency department (ED). A 55-year-old city worker is blue lighted into the ED
having had a cardiorespiratory arrest at work. The paramedics have been resuscitating him for 3 minutes. On arrival, he is
in ventricular fibrillation. Your mentor asks you the following question prior to your shift starting: What will be the most
important part of the patient’s immediate advanced life support?
843. In a fully saturated haemoglobin molecule, responsible for carrying oxygen to the body's tissues, how many of its
haem sites are bound with oxygen?
a) 2
b) 4
c) 6
d) 8
844. In Spinal cord injury patients, what is the most common cause of autonomic dysreflexia ( a sudden rise in blood pressure)?
a) Bowel obstruction
b) Fracture below the level of the spinal lesion
c) Pressure sore
d) Urinary obstruction
a) Abdominal aorta
b) Circle of Willis
c) Intraparechymal aneurysms
d) Capillary aneurysms
846. Which of the following can a patient not have if they have a pacemaker in situ?
A) MRI
B) X ray
C) Barium swallow
D) CT
847. You are looking after a postoperative patient and when carrying out their observations, you discover that they
are tachycardic and anxious, with an increased respiratory rate. What could be happening? What would you do?
A. The patient is showing symptoms of hypovolaemic shock. Investigate source of fluid loss, administer fluid replacement and get
medical support.
B. The patient is demonstrating symptoms of atelectasis. Administer a nebulizer, refer to physiotherapist for assessment.
C. The patient is demonstrating symptoms of uncontrolled pain. Administer prescribed analgesia, seek assistance from
medical team.
D. The patient is demonstrating symptoms of hyperventilation. Offer reassurance, administer oxygen.
849. Mrs Red’s doctor is suspecting an aortic aneurysm after her chest x-ray. Which of the most common type of aneurysm?
A) cerebral
B) abdominal
C) femoral
D) thoracic
850. A nurse is advised one hour vital charting of a patient, how frequently it should be recorded?
a) Every 3 hours
b) Every shift
c) Whenever the vital signs show deviations from normal
d) Every one hour
a) To aid mobility
b) To promote arterial flow
c) To aid muscle strength
d) To promote venous flow
852. Anti-embolic stockings an effective means of reducing the potential of developing a deep vein thrombosis because:
a) increasing blood flow velocity in the legs by compression of the deep venous system - thromboembolism-deterrent hose
b) decreasing blood flow velocity in legs by compression of the deep venous system
854. You are looking after a 75 year old woman who had an abdominal hysterectomy 2 days ago. What would you do 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 anti-embolic stockings & that are removed daily
C. Ensure that she is wearing anti-embolic 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 anti-embolic stockings
855. A patient is being discharged form the hospital after having coronary artery bypass graft (CABG). Which level of the
health care system will best serve the needs of this patient at this point?
a) Primary care
b) Secondary care
c) Tertiary care
d) Public health care
856. People with blood group A are able to receive blood from the following:
a) Group A only
b) Groups AB or B
c) Groups A or O
d) Groups A, B or O
857. Which finding should the nurse report to the provider prior to a magnetic resonance imaging MRI?
A. 3
B. 4
C. 5
D. 6
859. What is the name given to a decreased pulse rate or heart rate?
a) Tachycardia
b) Hypotension
c) Bradycardia
d) Arrhythmia
860. A patient puts out his arm so that you can take his blood pressure. What type of consent is this?
a) Verbal
b) Written
c) Implied
d) None of the above, consent is not required.
861. Which finding should the nurse report to the provider to a magnetic resonance imaging MRI?
a) Hepatic Artery
b) Abdominal aorta
c) Renal arch
d) Circle of Wills
864. Mrs Smith has been assessed to have a cardiac arrest after anaphylactic reaction to a medication. Cardiopulmonary
Resuscitation (CPR) was started immediately. According to the Resuscitation Council UK, which of the following statements
is true?
a) Intramuscular route administration of adrenaline is always recommended during cardiac arrest after anaphylactic reaction.
b) Intramuscular route for adrenaline is not recommended during cardiac arrest after anaphylactic reaction.
c) Adrenaline can be administered intradermally during cardiac arrest after anaphylactic reaction.
d) None of the Above
866. Which of the following is an indication for intrapleural chest drain insertion?
a) Pneumothorax
b) Tuberculosis
c) Asthma
d) Malignancy of lungs
a. Pneumothorax
b. Abnormal blood clotting screen or low platelet count
c. Malignant pleural effusion.
d. Post-operative, for example thoracotomy, cardiac surgery
868. A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type of isolation is
MOST appropriate for the client?
a) Reverse isolation
b) Respiratory isolation
c) Standard precautions
d) Contact isolation
869. Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a client with which
of the following medial conditions?
870. After lumbar laminectomy, which the appropriate method to turn the patient?
a) Patient holds at the side of the bed, with crossed knees try to turn by own
b) Head is raised & knees bent, patient tries to make movement
c) Patient is turned as a unit
871. patient just had just undergone lumbar laminectomy, what is the best nursing intervention?
872. A client immediately following LP developed deterioration of consciousness, bradycardia, increased systolic BP. What is
this normal reaction
873. Patient manifests phlebitis in his IV site, what must a nurse do?
875. A nurse assists the physician is performing liver biopsy. After the biopsy the nurse places the patient in which position?
a) Supine
b) Prone
c) Left-side lying
d) Right-side lying
876. Which of the following is a severe complication during 24 hrs post liver biopsy?
877. Patient is post op liver biopsy which is a sign of serious complication? (Select x 2 correct answers)
878. A patient in your care is about to go for a liver biopsy. What are the most likely potential complications related to
this procedure?
879. A diabetic patient with suspected liver tumor has been prescribed with Trphasic CT scan. Which medication needs to be
on hold after the scan?
a. Furosemide
b. Metformin
c. Docusate sodium
d. Paracetamol
880. What position should you prepare the patient in pre-op for abdominal Paracentesis?
a) Supine
b) Supine with head of bed elevated to 40-50cm
c) Prone
d) Side-lying
A. Lie the patient supine in bed with the head raised 45–50 cm with a backrest
B. Sitting upright at 45 to 60
C. Sitting upright at 60 to 75°
D. Sitting upright at 75 to 90°
A. Headache
B. Shock
C. Brain herniation
D. Hypotension
A. Headache
B. Back pain
C. Swelling and bruising
D. Nausea and vomiting
A. Supine
B. Prone
C. Supine with HOB 40-50 degree elevated
D. Sitting
888. After lumbar puncture, the patient experiences shock. What is the etiology behind it?
a) Increased ICP.
b) Headache.
c) Side effect of medications.
d) CSF leakage
890. A patient was recommended to undergo lumbar puncture. As the nurse caring for this patient, what should you not expect
as its complications:
891. A client immediately following LP developed deterioration of consciousness, bradycardia, increased systolic BP. What
is this:
a) normal reaction
b) client has brain stem herniation
c) spinal headache
892. The night after an exploratory laparotomy, a patient who has a nasogastric tube attached to low suction reports nausea.
A nurse should take which of the following actions first?
D) Administer the prescribed antiemetic to the patient.
E) Determine the patency of the patient's nasogastric tube.
F) Instruct the patient to take deep breaths.
G) Assess the patient for pain
893. An assessment of the abdomen of a patient with peritonitis you would expect to find
894. Patients with gastric ulcers typically exhibit the following symptoms:
a) Epigastric pain worsens before meals, pain awakening patient from sleep an melena
b) Decreased bowel sounds, rigid abdomen, rebound tenderness, and fever
c) Boring epigastric pain radiating to back and left shoulder, bluish-grey discoloration of periumbilical area and ascites
d) Epigastric pains worsens after eating and weight loss
895. Patients with gastrointestinal bleeding may experience acute or chronic blood loss. Your patient is
experiencing hematochezia. You recognise this by:
897. What would be your main objectives in providing stoma education when preparing a patient with a stoma for
discharge home?
a) That the patient can independently manage their stoma, and can get supplies.
b) That the patient has had their appliance changed regularly, and knows their community stoma nurse.
c) That the patient knows the community stoma nurse, and has a prescription.
d) That the patient has a referral to the District Nurses for stoma care.
898. What type of diet would you recommend to your patient who has a newly formed stoma?
899. When selecting a stoma appliance for a patient who has undergone a formation of a loop colostomy, what factors would
you consider?
900. Reason for dyspnoea in patients who diagnosed with Glomerulonephritis patients?
902. A patient is admitted to the ward with symptoms of acute diarrhoea. What should your initial management be?
a) Ulcerative colitis
b) Intestinal obstruction
c) Hashimotos disease
d) Food allergy
904. When explaining about travellers’ diarrhoea which of the following is correct?
905. A 45-year old patient was diagnosed to have Piles (Haemorrhoids). During your health education with the patient,
you informed him of the risk factors of Piles. You would tell him that it is caused by all of the following except:
907. A young adult is being treated for second and third degree burns over 25% of his body and is now read for discharge. The
nurse evaluates his understanding of discharge instructions relating to wound care and is satisfaction that he is prepared
for home care when he makes which statement?
a) I will need to take sponge baths at home to avoid exposing the wound’s to unsterile bath water
b) If any healed areas break open I should first cover them with sterile dressing and then report it
c) I must wear my Jobst elastic garment all day and an only remove it when I’m going to bed
d) I can expect occasional periods of low-grade fever and can take Tylenol every 4 hours
910. Taking a nursing history prior to the physical examination allows a nurse to establish a rapport with the patient and
family. Elements of the history include all of the following except:
a) the client’s health status
b) the course of the present illness
c) social history
d) Cultural beliefs and practices
911. In reporting contagious diseases, which of the following will need attention at national level:
a) Measles
b) Tuberculosis
c) chicken pox
d) Swine flu
912. Which one of these notifiable diseases needs to be reported on a national level?
a) Chicken pox
b) Tuberculosis
c) Whooping cough
d) Influenza
913. A 33-year-old male is being evaluated for possible acute leukemia. Which of the following findings is most likely related
to the diagnosis of leukemia?
914. The client is being evaluated for possible acute leukemia. Which inquiry by the nurse is most important?
915. Which of the following would be the priority nursing diagnosis for the adult client with acute leukemia?
A. Oral mucous membrane, altered related to chemotherapy
B. Risk for injury related to thrombocytopenia
C. Fatigue related to the disease process
D. Interrupted family processes related to life-threatening illness of a family member
916. A 43 year old African American male is admitted with sickle cell anemia. The nurse plans to assess the circulation in
the lower extremities every two hours. Which of the following outcome criteria would the nurse use?
917. a 30 year old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for
this client?
918. A 25 year old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for
this client?
919. Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?
a) Steak
b) Cottage cheese
c) Popsicle
d) Lima beans
920. A newly admitted client has sickle cell crisis. He is complaining of pain in his feet and hands. The nurse’s assessment
findings include a pulse oximetry of 92. Assuming that all the following interventions are ordered, which should be done first?
921. The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect
the client to select?
922. Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the
following activities would the nurse recommend?
923. The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical
manifestations would be most indicative of the anemia?
A. BP 146/88
B. Respirations 28 shallow
C. Weight gain of 10 pounds in six months
D. Pink complexion
924. The nurse is conducting an admission assessment of a client with vitamin B12 deficiency. Which finding reinforces
the diagnosis of B12 deficiency?
A. Enlarged spleen
B. Elevated blood pressure
C. Bradycardia
D. Beefy tongue
925. The body part that would most likely display jaundice in the dark-skinned individual is the:
926. A patient was brought to the A&E and manifested several symptoms: loss of intellect and memory; change in
personality; loss of balance and co-ordination; slurred speech; vision problems and blindness; and abnormal jerking
movements. Upon laboratory tests, the patient got tested positive for prions. Which disease is the patient possibly having?
a) Acute Gastroenteritis
b) Creutzfeldt-Jakob Disease
c HIV/AIDS Fatigue
Urgent bowel
927. a Patient who has had Parkinson’s disease for 7 years has been experiencing aphasia. Which health professional
should make a referral to with regards to his aphasia?
a) Occupational therapist
b) Community matron
c) Psychiatrist
d) Speech and language therapist
928. A 27- year old adult male is admitted for treatment of Crohn’s disease. Which information is most significant when
the nurse assesses his nutritional health?
a) Anthropometric measurements
b) Bleeding gums
c) Dry skin
d) Facial rubor
929. A patient was diagnosed to have Chron’s disease. What would the patient be manifesting?
930. The following fruits can be eaten by a person with Crohn’s Disease except:
a) Mango
b) Papaya
c) Strawberries
d) Cantaloupe
931. Which of the following statements made by client diagnosed with hepatitis A needs further understanding of the disease.
932. A client is diagnosed with hepatitis A. which of the following statements made by client indicates understanding of
the disease
a) She is losing a lot of electrolytes in her body, and this needs to be replaced.
b) There is no urgency in this case, because patients with Diverticulitis are expected to have soft to loose stools.
c) She needs to be prescribed with fluid retention pills.
d) There is no urgency in this case because the stool is quite hard, and it should be fine.
934. The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of
the following statements by the client indicates a need for further teaching?
935. Where is the best site for examining for the presence of petechiae in an African American client?
A. The abdomen
B. The thorax
C. The earlobes
D. The soles of the feet
936. A 21-year-old male with Hodgkin’s lymphoma is a senior at the local university. He is engaged to be married and is to begin
a new job upon graduation. Which of the following diagnoses would be a priority for this client?
937. A client has autoimmune thrombocytopenic purpura. To determine the client’s response to treatment, the nurse
would monitor:
A. Platelet count
B. White blood cell count
C. Potassium levels
D. Partial prothrombin time (PTT)
938. The home health nurse is visiting a client with autoimmune thrombocytopenic purpura(ATP). The client’s platelet
count currently is 80,000. It will be most important to teach the client and family about:
A. Bleeding precautions
B. Prevention of falls
C. Oxygen therapy
D. Conservation of energy
939. The client has surgery for removal of a Prolactinoma. Which of the following interventions would be appropriate for
this client?
940. A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding?
941. A client has had a unilateral adrenalectomy to remove a tumor. The most important measurement in the immediate
post-operative period for the nurse to take is:
942. A client with Addison’s disease has been admitted with a history of nausea and vomiting for the past three days. The
client is receiving IV glucocorticoids (SoluMedrol). Which of the following interventions would the nurse implement?
943. The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is
transmitted to humans by:
d) Cats
e) Dogs
f) Turtles
g) Birds
944. Ms. jane is to have a pelvic exam, which of the following should the nurse do first
1) Have the client remove all her clothes, socks & shoes
2) Have the client go to the bathroom & void saving a sample
3) Place the client in lithotomy position on the exam table
4) Assemble all the equipment needed for the examination
945. Which roommate would be most suitable for the six-year-old male with a fractured femur in Russell’s traction?
946. A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction should be included in
the discharge teaching?
947. A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip
replacement with activities of daily living?
A. High-seat commode
B. Recliner
C. TENS unit
D. Abduction pillow
948. A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates
understanding of a plaster-of-Paris cast? The nurse:
949. The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would
be best?
950. The elderly client is admitted to the emergency room. Which symptom is the client with a fractured hip most likely
to exhibit?
A. Pain
B. Disalignment
C. Cool extremity
D. Absence of pedal pulses
951. The nurse is aware that the best way to prevent post-operative wound infection in the surgical client is to:
952. Which of the following instructions should be included in the nurse’s teaching regarding oral contraceptives?
953. A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is
most suitable for the client with diabetes?
A. Intrauterine device
B. Oral contraceptives
C. Diaphragm
D. Contraceptive sponge
954. A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the
rhythm method depends on the:
955. A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains
that conception is most likely to occur when:
A. Estrogen levels are low
B. Lutenizing hormone is high
C. The endometrial lining is thin
D. The progesterone level is low
956. The rationale for inserting a French catheter every hour for the client with epidural anaesthesia is:
A. The bladder fills more rapidly because of the medication used for the epidural.
B. Her level of consciousness is such that she is in a trancelike state.
C. The sensation of the bladder filling is diminished or lost.
D. She is embarrassed to ask for the bedpan that frequently.
957. A 25-year-old client with a goiter is admitted to the unit. What would the nurse expect the admitting assessment to reveal?
A. Slow pulse
B. Anorexia
C. Bulging eyes
D. Weight gain
A. Ambulation
B. Oral airway assessment using a tongue blade
C. Placing a blood pressure cuff on the arm
D. Checking the deep tendon reflexes.
959. What would the nurse expect the admitting assessment to reveal in a client with glomerulonephritis?
A. Hypertension
B. Lassitude
C. Fatigue
D. Vomiting and diarrhea
960. A client with AIDS has a viral load of 200 copies per ml. The nurse should interpret this finding as:
A. The client is at risk for opportunistic diseases.
B. The client is no longer communicable.
C. The client’s viral load is extremely low so he is relatively free of
circulating virus.
961. The nurse is teaching the mother regarding treatment for pedicalosis capitis. Which instruction should be given
regarding the medication?
962. The five-year-old is being tested for enterobiasis (pinworms). Which symptom is associated with enterobiasis?
A. Rectal itching
B. Nausea
C. Oral ulcerations
D. Scalp itching
964. The client is admitted following cast application for a fractured ulna. Which finding should be reported to the doctor?
A. Hypovolemia
B. Laryngeal edema
C. Hypernatremia
D. Hyperkalemia
966. The client presents to the clinic with a serum cholesterol of 275mg/dL and is placed on rosuvastatin (Crestor).
Which instruction should be given to the client taking rosuvastatin (Crestor)?
967. The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration,
the nurse should:
968. The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the:
A. Feet
B. Neck
C. Hands
D. Sacrum
970. A client with leukemia is receiving Trimetrexate. After reviewing the client’s chart, the physician orders Wellcovorin
(leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to:
971. The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer
the medication:
972. A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood tinged hemoptysis, fatigue, and night
sweats. The client’s symptoms are consistent with a diagnosis of:
A. Pneumonia
B. Reaction to antiviral medication
C. Tuberculosis
D. Superinfection due to low CD4 count
973. The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is
prescribed for the client. Which of the following in the client’s history should be reported to the doctor?
A. Diabetes
B. Prinzmetal’s angina
C. Cancer
D. Cluster headaches
974. The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine
meningeal irritation and spinal nerve root inflammation. A positive Kernig’s sign is charted if the nurse notes:
975. A client with a diagnosis of HPV is at risk for which of the following?
A. Hodgkin’s lymphoma
B. Cervical cancer
C. Multiple myeloma
D. Ovarian cancer
976. During the initial interview, the client reports that she has a lesion on the perineum. Further investigation reveals a small blister on
the vulva that is painful to touch. The nurse is aware that the most likely source of the lesion is:
A. Syphilis
B. Herpes
C. Gonorrhea
D. Condylomata
977. A client has cancer of the pancreas. The nurse should be most concerned about which nursing diagnosis?
A. Alteration in nutrition
B. Alteration in bowel elimination
C. Alteration in skin integrity
D. Ineffective individual coping
978. The nurse is caring for a client with uremic frost. The nurse is aware that uremic frost is often seen in clients with:
A. Severe anemia
B. Arteriosclerosis
C. Liver failure
D. Parathyroid disorder
979. The nurse working the organ transplant unit is caring for a client with a white blood cell count of 450. During
evening visitation, a visitor brings a basket of fruit. What action should the nurse take?
980. The nurse is caring for the client following a laryngectomy when suddenly the client becomes nonresponsive and pale,
with a BP of 90/40. The initial nurse’s action should be to:
981. The client admitted two days earlier with a lung resection accidentally pulls out the chest tube. Which action by the
nurse indicates understanding of the management of chest tubes?
982. A client being treated with sodium warfarin (Coumadin) has a Protime of 120 seconds. Which intervention would be
most important to include in the nursing care plan?
984. The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:
985. The physician has ordered a minimal-bacteria diet for a client with neutropenia. The client should be taught to avoid eating:
A. Fruits
B. Salt
C. Pepper
D. Ketchup
986. A client hospitalized with MRSA is placed on contact precautions. Which statement is true regarding precautions for
infections spread by contact?
987. During a home visit, a client with AIDS tells the nurse that he has been exposed to measles. Which action by the nurse
is most appropriate?
A. Administer an antibiotic.
B. Contact the physician for an order for immune globulin.
C. Administer an antiviral.
D. Tell the client that he should remain in isolation for two weeks.
988. The primary reason for rapid continuous rewarming of the area affected by frostbite is to:
989. A client with an abdominal cholecystectomy returns from surgery with a Jackson-Pratt drain. The chief purpose of the
Jackson-Pratt drain is to:
990. A client with bladder cancer is being treated with iridium seed implants. The nurse’s discharge teaching should
include telling the client to:
991. Following a heart transplant, a client is started on medication to prevent organ rejection. Which category of
medication prevents the formation of antibodies against the new organ?
A. Antivirals
B. Antibiotics
C. Immunosuppressants
D. Analgesics
992. The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use:
993. A client with pancreatic cancer has an infusion of TPN (Total Parenteral Nutrition). The doctor has ordered for sliding-scale
insulin. The most likely explanation for this order is:
994. The nurse is preparing to discharge a client with a long history of polio. The nurse should tell the client that:
995. A temporary colostomy is performed on the client with colon cancer. The nurse is aware that the proximal end of a
double barrel colostomy:
996. The physician has prescribed ranitidine (Zantac) for a client with erosive gastritis. The nurse should administer
the medication:
A. 30 minutes before meals
B. With each meal
C. In a single dose at bedtime
D. 60 minutes after meals
997. A client tells the nurse that she is allergic to eggs, dogs, rabbits, and chicken feathers. Which order should the nurse question?
A. TB skin test
B. Rubella vaccine
C. ELISA test
D. Chest x-ray
998. Which of the following diet instructions should be given to the client with recurring urinary tract infections?
999. The client with enuresis is being taught regarding bladder retraining. The nurse should advise the client to refrain from drinking after:
A. 1900
B. 1200
C. 1000
D. 0700
1001. The client with colour blindness will most likely have problems distinguishing which of the following colours?
A. Orange
B. Violet
C. Red
D. White
1002. A client who has glaucoma is to have miotic eyedrops instilled in both eyes. The nurse knows that the purpose of the
medication is to:
1003. Cataracts result in opacity of the crystalline lens. Which of the following best explains the functions of the lens?
1004. A client with cystic fibrosis is taking pancreatic enzymes. The nurse should administer this medication:
a) 1 hourly
b) 2 hourly
c) 3 hourly
d) As often as possible
1007. Which of the following client should the nurse deal with first
1008. The first techniques used to examine the abdomen of a client is:
a) Palpation
b) Auscultation
c) Percussion
d) Inspection
1009. After 2 hours in A and E, Barbara is now ready to be moved to another ward. You went back to tell her about this plan and
noticed she was not responding. What is your next action as a priority
1010. 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?
1011. Mrs. A is posted for CT scan. Patient is afraid cancer will reveal during her scan. She asks "why is this test". What will be
your response as a nurse?
a) Tell her that you will arrange a meeting with a doctor after the procedure
b) Give a health education on cancer prevention
c) Ignore her question and take her for the procedure
d) Understand her feelings and tell the patient that it is normal procedure .
1013. Which of the following would be an appropriate strategy in reorienting a confused patient to where her room is?
A. Lie the patient supine in bed with the head raised 45–50 cm with a backrest
B. Sitting upright at 45 to 60
C. Sitting upright at 60 to 75°
D. Sitting upright at 75 to 90°
1017. A patient got admitted to hospital with a head injury. Within 15 minutes, GCS was assessed and it was found to be 15. After
initial assessment, a nurse should monitor neurological status
a) Every 15 minutes
b) 30 minutes
c) 40 minutes
d) 60 minutes
1018. When a patient is being monitored in the PACU, how frequently should blood pressure, pulse and respiratory rate be
recorded?
A. Every 5 minutes
B. Every 15 minutes
C. Once an hour
D. Continuously
1019. Mrs X is 89 years old and very frail. She has renal impairment and history of myocardial infarction. She needs support from
staff to meet her nutritional needs. Which IV fluids are recommended for Mrs X?
1020. Population groups at higher risk of having a low vitamin D status include the following except:
1021. You were on your rounds with one of the carers. You were turning a patient from his left to his right side. What would you
do?
a.) Both of you can stay on one side of the bed as you turn your patient
b.) You go on the opposite side of the bed and use the bed sheet to turn your
patient c.) You keep the bed as low as possible because the patient might fall d.)
You go on the opposite side and grab the slide sheet to use
1022. The client has recently returned for having a thyroidectomy. The nurse should keep which of the following at the bedside?
h) A trachotomy set
i) A padded tongue blade
j) An endotracheal tube
k) An airway
1023. Nurses are not using a hoist to transfer patient. They said it was not well maintained. What would you do?
a) Social isolation, loss of independence, exacerbation of symptoms, rapid loss of strength in lg muscles, de-conditioning
of cardiovascular system leading to an increased risk of chest infection and pulmonary embolism
b) Loss of weight, frustration and deep vein thrombosis
c) Deep arterial thrombosis, respiratory infection, fear of movement, loss of consciousness, de-conditioning of cardiovascular system
leading to an increased risk of angina
d) Pulmonary embolism, UTI, & fear of people
1026. Which strategy could the nurse use to avoid disparity in health care delivery?
1027. Why are physiological scoring systems or early warning scoring system used in clinical practice?
a) These scoring systems are carried out as part of a national audit so we know how sick patients are in the united kingdom
b) They enable nurses to call for assistance from the outreach team or the doctors via an electronic communication system
c) They help the nursing staff to accurately predict patient dependency on a shift by shift basis
d) The system provides an early accurate predictor of deterioration by identifying physiological criteria that alert the nursing staff to a
patient at risk
1030. If you witness or suspect there is a risk to the safety of people in your care and you consider that there is an immediate risk
of harm, you should:
a) Report your concerns immediately, in writing to the appropriate person – Escalating concerns NMC
b) Ask for advice from your professional body if unsure on what actions to take
c) Protect client confidentiality
d) Refer to your employer’s whistleblowing policy
e) Keep an accurate record of your concerns and action taken
f) All of the above
1032. Which of the following senses is to fade last when a person dies?
a) hearing
b) smelling
c) seeing
d) speaking
1033. The nurse is discussing problem-solving strategies with a client who recently experienced the death of a family member
and the loss of a full-time job. The client says to the nurse. 'I hear what you're saying to me, but it just isn't making any
sense to me. I can't think straight now." The client is expressing feelings of:
a) Rejection
b) Overload
c) Disqualification
d) Hostility
1034. A newly diagnosed patient with Cancer says “I hate Cancer, why did God give it to me”. Which stage of grief process is
this?
a) Denial
b) Anger
c) Bargaining
d) Depression
1035. After death, who can legally give permission for a patient's body to be donated to medical science?
1036. Sue’s passed away. Sue handled this death by crying and withdrawing from friend and family. As A nurse you would notice
that sue’s intensified grief is most likely a sign of which type of grief?
1037. Missy is 23 years old and looking forward to being married the following day. Missy’s mother feels happy that her daughter
is starting a new phase in her life but is feeling a little bit sad as well. When talking to Missy’s mother you would explain this
feeling to her as a sign of what?
a) Anticipated Grief
b) Lifestyle Loss
c) Situational Loss
d) Maturational Loss
e) Self Loss
f) All of the above
1038. A client is diagnosed with cancer and is told by surgery followed by chemotherapy will be necessary, the client states to
the nurse, "I have read a lot about complementary therapies. Do you think I should try it?". The nurse responds by making
which most appropriate statement?
1039. After the death of a 46 year old male client, the nurse approaches the family to discuss organ donation options. The family
consents to organ donation and the nurse begins to process. Which of the following would be most helpful to the grieving
family during this difficult time?
1040. A critically ill client asks the nurse to help him die. Which of the following would be an appropriate response for the nurse
to give this client?
1041. A 42 year old female has been widowed for 3 years yet she becomes very anxious, sad, and tearful on a specific day in
June. Which of the following is this widow experiencing?
a) Preparatory depression
b) Psychological isolation
c) Acceptance
d) Anniversary reaction
1042. The 4 year old son of a deceased male is asking questions about his father. Which of the following activities would be
beneficial for this young child to participate in?
1043. The hospice nurse has been working for two weeks without a day off. During this time, she has been present at the deaths
of seven of her clients. Which of the following might be beneficial for this nurse?
a) Nothing
b) Provide her with an assistant
c) Suggest she take a few days off
d) Assign her to clients that aren’t going to die for awhile
1044. The wife of a recently deceased male is contacting individuals to inform them of her husband’s death. She decides,
however, to drive to her parent’s home to tell them in person instead of using the telephone. Of what benefit did this
communication approach serve?
1045. While providing care to a terminally ill client, the nurse is asked questions about death. Which of the following would be
beneficial to support the client’s spiritual needs?
a) Nothing
b) Ask if they want to die
c) Ask if they want anything special before they die
d) Provide support, compassion, and love
1046. A fully alert & competent 89 year old client is in end stage liver disease. The client says , “I’m ready to die,” & refuses to
take food or fluids . The family urges the client to allow the nurse to insert a feeding tube. What is the nurse’s moral
responsibility?
a) Take her to another room and allow her to discuss with the husband
b) Tell them to wait in the room and I will come and talk to u after my duty
1048. when breaking bad news over phone which of the following statement is appropriate
a) Regression
b) Mourning
c) Denial
d) Rationalization
1050. after breaking bad news of expected death to a relative over phone , she says thanks for letting us know and becomes
silent. Which of the following statements made by nurse would be more empathetic
1051. The nurse cares for a client diagnosed with conversion reaction. The nurse identifies the client is utilizing which of the
following defense mechanisms?
a) Introjection
b) Displacement
c) Identification
d) Repression
1052. A 52-year-old man is admitted to a hospital after sustaining a severe head injury in an automobile accident. When the
patient dies, the nurse observes the patient’s wife comforting other family members. Which of the following interpretations of
this behavior is MOST justifiable?
A) She has already moved through the stages of the grieving process.
B) She is repressing anger related to her husband’s death.
C) She is experiencing shock and disbelief related to her husband’s death.
D) She is demonstrating resolution of her husband’s death.
1053. A slow and progressive disease with no definite cure, only symptomatic Management?
a) Acute
b) Chronic
c) Terminal
a) Psychological support
b) Spiritual support
c) Resuscitation
d) Pain management
1055. What is the main aim of the End of Life Care Strategy (DH 2008)?
1056. In which of the following situations might nitrous oxide (Entonox) be considered?
a) A wound dressing change for short term pain relief or the removal of a chest drain for reduction of anxiety.
b) Turning a patient who has bowel obstruction because there is an expectation that they may have pain from pathological fractures
c) For pain relief during the insertion of a chest drain for the treatment of a pneumothorax.
d) For pain relief during a wound dressing for a patient who has had radical head and neck cancer that involved the jaw.
1057. An adult is offered the opportunity to participate in research on a new therapy. The researcher ask the nurse to obtain the
patient’s consent. What is most appropriate for the nurse to take?
a) Be sure the patient understands the project before signing the consent form
b) Read the consent form to the patient & give him or her an opportunity to ask questions
c) Refuse to be the one to obtain the patient’s consent
d) Give the form to the patient & tell him or her to read it carefully before signing it.
1058. A nurse should be able to show awareness of his/her role in health promotion and supporting a healthy lifestyle. Whilst
providing health education to a group of patients with cancer about management of their non-healing wounds, it is
important for one to:
a) Sit down with Margaret and discuss about her fears; use therapeutic communication to alleviate anxiety
b) Refer her to a psychiatrist for treatment
c) Discuss invasive procedure with patient, and show her videos of the operation
d) Take her to the surgeon’s clinic and discuss about consent for invasive procedure
1060. Mrs X has been admitted in the hospital due to Oedema of her thighs. One of her medications was Furosemide 40 mg
tablets to be administered once daily. What should be done prior to administering Furosemide?
1061. A patient who has had Parkinson’s Disease for 7 years has been experiencing aphasia. Which health professional should
you make a referral to with regards to his aphasia?
a. Occupational Therapist
b. Community Matron
c. Psychiatrist
d. Speech and Language Therapist
1062. Mrs X has developed Stevens - Johnson syndrome whilst on Carbamazepine. She is now being transferred from the ITU to
a bay in a Medicine Ward. Which patients can Mrs X share a bay with?
1063. As the nurse on duty, you have noted that there has been an increasing number of cases of pressure sored in your nursing
home. Which of the following is the best intervention?
a. Collaboration with the Multidisciplinary Team
b. Patient Advocacy
c. Reduce fragmentation and costs
d. Identify opportunities and develop policies to improve nursing practice
1064. You are dispending Morphine Sulphate in the treatment room, which has been witnessed by another qualified nurse. Your
patient refuses the medication when offered. What will you do next?
a. Go back to the treatment room and write a line across your documentation on the CD book; sign it as refused
b. Dispose the medication using the denaturing kit, document as refused and disposed on the MARS, and write it on the nurse’s
notes. c. Dispose the medication and document it on the patient’s care plan
d. Store the medication in the CD pod for an hour, and then ask your patient again if he/she wants to take his medication
1065. 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
1066. A resident is due for discharge from your nursing home. You have been his keyworker for the last five years, and his family
has been appreciative of the care you have provided. One of the relatives has offered you cash in an envelope after saying
goodbye. What should you do?
a. If the dressings are intact, document it on the nursing notes and indicate that the dressings need to be changed after 48 hours.
b. Change the dressings if they look soiled and document this on the wound assessment form.
c. Remove the dressings whether they are intact or not, assess the wounds, document this on the wound assessment form and redress the
wounds.
d. All of the above.
1068. A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower
extremities every two hours. Which of the following outcome criteria would the nurse use?
1069. A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this
client?
1070. A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this
client?
1071. Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?
A. Steak
B. Cottage cheese
C. Popsicle
D. Lima beans
1072. A newly admitted client has sickle cell crisis. He is complaining of pain in his feet and hands. The nurse’s assessment findings
include a pulse oximetry of 92. Assuming that all the following interventions are ordered, which should be done first?
1073. The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the
client to select?
1074. The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse
should give priority to:
1075. The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:
1076. The nurse is assisting the physician with removal of a central venous catheter. To facilitate removal, the nurse should
instruct the client to:
1077. The physician has ordered a minimal-bacteria diet for a client with neutropenia. The client should be taught to avoid eating:
A. Fruits
B. Salt
C. Pepper
D. Ketchup
1078. A client with cancer of the pancreas has undergone a Whipple procedure. The nurse is aware that during the Whipple
procedure, the doctor will remove the:
1079. A client who is admitted with an above-the-knee amputation tells the nurse that his foot hurts and itches. Which response
by the nurse indicates understanding of phantom limb pain?
1081. The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use:
1082. A client with pancreatic cancer has an infusion of TPN (Total Parenteral Nutrition). The doctor has ordered for sliding-scale
insulin. The most likely explanation for this order is:
A. Total Parenteral Nutrition leads to negative nitrogen balance and elevated glucose levels.
B. Total Parenteral Nutrition cannot be managed with oral hypoglycemics.
C. Total Parenteral Nutrition is a high-glucose solution that often elevates the blood glucose levels.
D. Total Parenteral Nutrition leads to further pancreatic disease.
1083. A temporary colostomy is performed on the client with colon cancer. The nurse is aware that the proximal end of a double
barrel colostomy:
1084. You have answered a phone call after receiving handover. The person you were talking to has explained that he needs to
find out about his sister’s condition. What should you initially do?
a) Discuss about his sister’s condition and provide treatment options such as access to other resources in the community.
b) Check the patient’s record and verify the caller’s identity.
c) Refuse to divulge any information to the caller.
d) Discuss about his sister’s condition and book an appointment for him to attend care plan reviews.
1085. A carer has reported that she has seen a resident fall off his bed. What initial assessment should be done?
a. Check the patient’s Early Warning Score along with the Glasgow Coma Scale immediately.
b. Ask the patient if he is in pain; if so, administer painkillers immediately.
c. Dial 999 and request for an ambulance to take your patient to the hospital.
d. Contact the out-of-hours GP and request for a home visit.
1086. During your medical rounds, you have noted that Mrs X was upset. She has verbalised that she misses her family very
much, and that no one has been to visit lately. What would likely be your initial intervention?
a. Contact Mrs X’s family and encourage them to visit her during the weekend.
b. Sit next to Mrs X and listen attentively. Allow her to talk about things that cause her anxiety.
c. Collaborate with the GP for a care plan review and request for antidepressants to be prescribed.
d. All of the above.
e. None of the above.
1087. On admission of a service user, you have done an informal risk assessment for pressure sores, and you have noted that
the patient is currently not at risk. What will be your next step?
a) Include the Repositioning Chart on your patient’s daily notes, and instruct your carers/HCA’s to turn your patient every two hours.
b) Alert the General Practitioner about your patient’s condition.
c) Reassess your patient on a regular basis and document your observations.
d) Modify your patient’s diet to maintain intact skin integrity.
1088. You were on the phone with a family member, and one of the carers has reported that one of your residents has stopped
breathing and turned blue. What should you do first?
a) End your conversation with the family member, attend to your patient and do the CPR.
b) End your conversation with the family member, go to your patient’s bedroom and assess for airway, breathing and circulation.
c) End your conversation with the family member, and dial 999 to request for an ambulance.
d) Dial 111, and request for an urgent visit from the General Practitioner.
1089. Mr Smith has just been certified dead by the General Practitioner. However, no arrangements have been made by the family.
What should you do first?
a) Check patient’s records for the next of kin details, and contact them to discuss about funeral services.
b) Ring the co-operative and arrange for the undertaker to pick up Mr Smith as soon as possible.
c) Contact the GP and discuss about how to deal with Mr Smith.
d) Contact your manager and enquire about dealing with Mr Smith.
1090. Mr Marriott, 21 years old, has been complaining of foul smelling urine, pain on urination and night sweats. What further
assessment should be done to check if he has Urinary Tract Infection?
1091. A patient with a nutritional deficit and a MUST Score of 2 and above is of high risk. What should be done?
a. Refer the patient to the dietician, the Nutritional Support Team and implement local policy.
b. Observe and document dietary intake for three days.
c. Repeat screening weekly or monthly depending on the patient’s food intake during the last 72 hours.
d. All of the above.
1092. According to the National Institute for Health and Care Excellence (NICE) Guidelines, examples of the Personal Protective
Equipment are:
1093. Based on the National Institute for Health and Care Excellence (NICE) Guidelines, which of the following is incorrect about
sharps container?
1094. How do you prevent the spread on infection when nursing a patient with long term urinary catheters?
a) Patients and carers should be educated about and trained in techniques of hand decontamination, insertion of intermittent catheters
where applicable, and catheter management before discharge from hospital.
b) Urinary drainage bags should be positioned below the level of the bladder, and should not be in contact with the floor.
c) Bladder instillations or washouts must not be used to prevent catheter-associated infections.
d) All of the above.
1095. Mrs Hannigan has been assessed to be on nutritional deficit with a MUST Score of 1, which means that she is on medium
risk. One of your interventions is to modify her diet for her to meet her nutritional needs. What should you consider?
1096. Your patient has been recently prescribed with PEG feeding with a resting period of 4 hours. After two weeks of starting the
routine, he has been having episodes of loose stool. What could be done?
a) Refer him to a dietician and review for a longer resting period between feeds.
b) Refer him to the tissue viability nurse for his peg site.
c) Examine his abdomen and assess for lumps.
d) Examine his peg site, and apply metronidazole ointment if swollen.
1097. You are preparing a client with Acquired Immunodeficiency Syndrome (AIDS) for discharge to home. Which of the following
instructions should the nurse include?
1098. A patient with a Bipolar Disorder makes a sexually inappropriate comment to the nurse. One should take which of the
following actions?
a. Ignore the comment because the client has a mental health disorder and cannot help it.
b. Report the comment to the nurse manager.
c. Ignore the comment, but tell the incoming nurse to be aware of the client’s propensity to make inappropriate comments.
d. Tell the client that is it inappropriate for clients to speak to any nurse that way.
1099. You are nursing an adult patient with a long-bone fracture. You encourage your patient to move fingers and toes hourly, to
change positions slightly every hour, and to eat high-iron foods as part of a balanced diet. Which of the following foods or
beverages should you advise the client to avoid whilst on bed rest?
a) Fruit juices
b) Large amounts of milk or milk products
c) Cranberry juice cocktail
d) No need to avoid any foods while on bed rest
1100. The nurse is preparing to make rounds. Which client should be seen first?
a) Immobilise the patient and conduct a thorough assessment, checking for injuries
b) Call for help immediately
c) Press the emergency call button immediately
d) Check the patient for injuries and transfer him to the wheelchair
1102. A patient with Leukaemia was about to receive a transfusion of blood platelets. The experiences nurse on duty in the ward
noticed small clumps visible in the platelet pack and questions whether the transfusion should proceed. What should the
nurse do?
1103. You are about to administer Morphine Sulfate to a paediatric patient. The information written on the controlled drug book
was not clearly written – 15 mg or 0.15 mg. What will you do first?
a. Not administer the drug, and wait for the General Practitioner to do his rounds b.
Administer 0.15 mg, because 15 mg is quite a big dose for a paediatric patient
c. Double check the medication label and the information on the controlled drug book; ring the chemist to verify the
dosage d. Ask a senior staff to read the medication label with you
1104. Mr Smith is 89 years old with Prostate Cancer. He was advised that the only treatment available for him was palliative care
after Transurethral Resection of the Prostate. What is your main task as a coordinator of care in the multidisciplinary team?
a.) One should be able to organise the services identified in the care plan and across other agencies.
b.) Assess the patient for respiratory complications caused by gas exchange alterations due to old
age. c.) Sit down with the patient and ask for the frequency of his bowel elimination
d.) Document the patient’s capability of self-care activities and the support he needs to carry out activities of daily living.
1105. A diabetic patient with suspected Liver Tumor has been prescribed with Triphasic CT Scan. Which medication needs to be
on hold after the scan?
a.) Furosemide
b.) Metformin
c.) Docusate Sodium
d.) Paracetamol
1106. An 82 year old lady was admitted to the hospital for assessment of her respiratory problems. She has been a long term
smoker in spite of her daughter advising her to stop. Based on your assessment, she has lost a substantial amount of
weight. How will you assess her nutritional status?
a) Check her height and weight, so you can determine her BMI, BMI Score and Nutritional Care Plan
b) Use the respiratory and perfusion assessment chart on admission
c) Check if she is struggling to chew and swallow, and make a referral to the Speech and Language Therapist
d) All of the above
.
1107. John, 26 years old, was admitted to the hospital due to multiple gunshot wounds on his abdomen. On nutritional
assessment in the ICU, the patient’s height and weight were estimated to be 1.75 m and 75 kg, respectively, with a normal
body mass index (BMI) of 24.5 kg/m2. He was started on Parenteral Nutrition support on day one post admission.
Postoperatively, the patient developed worsening renal function and required dialysis. In critical care, what would be most
likely recommended for him to meet his nutritional need?
a) Starting Parenteral Nutrition early in patients who are unlikely to tolerate enteral intake within the next three days
b) Starting with a slightly lower than required energy intake (25 kCal/kg)
c) A range of protein requirements (1.3-1.5 g/kg)
d) All of the above
e) None of the above
1108. You are currently working in a nursing home. One of the service users is struggling to swallow or chew his food. To whom
do you make a referral to?
a) Tissue Viability Nurse
b) Social Worker
c) Speech and Language Therapist
d) Care Manager
1109. What are the six physiological parameters incorporated into the National Early Warning Scores?
a) Respiratory rate, oxygen saturation, temperature, systolic blood pressure, pulse rate and level of consciousness
b) Biomarkers, oxygen saturation, temperature, systolic blood pressure, pulse rate and level of consciousness
c) Oxygen saturation, temperature, systolic blood pressure, pulse rate, level of consciousness and oedema
d) Temperature, systolic blood pressure, pulse rate, level of consciousness, oedema and pupillary reaction
e) all of the above
1110. Mr C’s mother was admitted to hospital following a fall at home and it was clearly documented that his mother suffered
from diabetes. Mr C contacted the Trust concerning the Trust’s failure to make adequate discharge arrangements for his
mother including the necessary arrangements to ensure that his mother would be provided with insulin following her
discharge. What needs to be implemented to avoid such concern/complaint in the future?
a.) Diabetic Liaison Nurse to work with service users in the community
b.) On-line training for blood glucose monitoring introduced within the Trust
c.) Diabetics to have their blood sugar recorded within four hours prior to discharge
d.) A and C only
e.) all of the above
1111. Julie, 50 years old, was admitted to the hospital with gastrointestinal bleed presumed to be oesophageal varices. It has
been recommended that she needs to be transfused with blood; however, due to her religious and personal beliefs, she
needed volume expanding agents. Unfortunately, she died a few hours after admission. Before dying, she said that it was
God’s will, which she believed was right. Which of the following statements is false?
a) Health professionals should be aware of imposing one’s world view upon others and strive to be more receptive and sensitive to the
needs of others.
b) Individual choice, consent and the right to refuse treatment is important.
c) It is important for all health professionals to do any means to keep a patient alive regardless of traditions and beliefs.
d) None of the Above
.
1112. Paulena, 57 years old, suffered from a very dense left sided Cerebrovascular Accident / Stroke. She was unconscious and
unresponsive for several days with IV fluids for hydration. Since her recovery from stroke, she has been prescribed to
commence enteral feeding through a fine bore nasogastric tube, in which she signed her consent in front of her who have
always been supportive of her decisions. However, she tends to pull out her NGT when she is by herself in her room. She died
of malnutrition after a few days. Which of the following statements is true?
a) Nurses should have the empathy to listen to more than just the spoken word.
b) Nurses should practice in accordance to Pauleena’s best interest while providing support to the family and listening to their concerns
and wishes.
c) Paulena needs to be supported with questions related to mortality and meaning of life. Therapeutic communication is also essential.
d) All of the above
1113. An adult patient with Nasogastric Tube died in a medical ward due to aspiration of fluids. Staff nurse on duty believes that
she has flushed the tube and believed it is patent. What should NOT have been done?
a) Nothing should be introduced down the tube before gastric placement is confirmed.
b) Internal guidewires should not be lubricated before gastric placement is confirmed.
c) Auscultate the patient’s stomach as you push some air in, and if you cannot hear anything, flush it.
d) It is important to check the position of the tube by measuring the pH value of stomach contents.
1114. The following are ways to assess a patient’s fluid and electrolyte status except:
a.) pulse, blood pressure, capillary refill and jugular venous pressure
b.) presence of pulmonary or peripheral oedema
c.) presence of postural hypertension
d.) biomarkers
1115. You were assigned to change the dressing of a patient with diabetic foot ulcer. You were not sure if the wound has sloughy
tissues or pus. How will you carry out your assessment?
a.) Sloughy tissue is a mass of dead tissues in your wound bed, while pus is a thick yellowish/greenish opaque liquid produced in
an infected wound.
b.) Sloughy tissues are exactly the same as pus, and they both have a yellowish tinge.
c.) Sloughy tissues and pus are similar to each other; both are found on the wound bed tissue and indicative of a dying tissue.
d.) The presence of sloughy tissues and pus are an indication of non-surgical debridement.
e.) All of the above
f.) None of the above
1116. Which of the following sets of needs should be included in your service user’s person centred care plan?
1117. Annie, one of the residents in the nursing home, has not yet had her mental capacity assessment done. She has been
making decisions that you personally think are not beneficial for her. Which of the following should not be implemented?
a.) Force her to change her mind every time she makes a decision
b.) Explain the benefits of making the right decision
c.) Allow her to make her own decision, as she still has mental
capacity d.) All of the above
1118. A complaint has been raised by one of the service user’s relatives. Which of the following should you not document?
1119. Which of the following sets of needs should be included in your service user’s person centred care plan?
1120. Mr Z called for your assistance and wanted you to sit with him for a bit. He has disclosed confidential information about his
personal life. Which of the following should you urgently deal with?
1121. You were on duty, and you have noticed that the syringe driver is not working properly. What should you do?
1122. A patient in one of your bays has called for staff. She needed assistance with “spending a penny”. What will you do?
a.) Ask her if she wants a hot or cold drink, and give her one as requested
b.) Assist her to walk to the vending machine, and let her choose what she wants to
buy c.) Assist her to walk to the toilet, and provide her with some privacy
d.) Help her find her purse, and ask her what time she will be ready to go out
1123. Betty has been assessed to be very confused and with impaired mobility. She wants to go to the dining room for her meal,
but she wants a cardigan before doing so. What will you do?
a.) Give her wet wipes for her hands before dinner
b.) Disregard the cardigan and take her to the dining room
c.) Ask her what she means by a cardigan
d.) Make her comfortable in a wheelchair, and cover her legs with a blanket
1124. Mrs A is 90 years old and has been admitted to the nursing home. The staff seem to have difficulty dealing with her family.
One day, during your shift, Mrs A fell off a chair. You have assessed her, and no injuries have been noted. Which of the
following is a principle of the Duty of Candour?
a.) You will not ring the family since there is no injury caused by the fall.
b.) You have liaised with the lead nurse, and she decided not to ring the family due to no harm.
c.) Observe the patient, take her physical observations, and ask if you must call the family.
d.) All of the above
e.) None of the above
1125. Maggie has been very physically and verbally aggressive towards other patients and staff for the last few weeks. She is
now on one-to-one care, 24 hours a day. According to her person centred care plan, the nurses are looking after her very well
preventing her from causing any harm. Behaviour has been discussed with the social worker, and clinical lead has applied
for DoLS. Which of the following is correct?
a.) DoLS will allow staff to intervene depriving Maggie from doing something to hurt herself, other residents, and staff
b.) DoLS refers to protecting the other patients only from Maggie’s destructive behaviour.
c.) DoLS protects the nurses and doctors only when providing care for Maggie.
d.) DoLS protects Maggie only from committing suicide.
1126. You were assisting Mrs X with personal care and hygiene. She has been assessed to have mental capacity. In her wardrobe,
you have seen a dress that is quite difficult to wear and a pair of trousers, which is quite easy to put on. You are trying to make
a decision which one to put on her. Which of the following is a person centred intervention?
a.) Ask her what she prefers; show her the clothes and let her choose
b.) Let Mrs X wear her trousers
c.) Explain to her that the dress is so difficult to put on
d.) Tell her that the trousers will make her more comfortable if she chooses it
1127. Documentation confirms that Amy has MRSA. You walked into her bedroom with coffee and biscuits on a tray. Which of the
following is incorrect?
a.) Put the coffee and biscuits on her bedside table and leave the tray on the other
table b.) Wash your hands thoroughly before leaving her room
c.) Dispose your gloves and apron before washing your hands
d.) Use the alcohol gel on Amy’s bedside before leaving her room
1128. Which of the following is the most important in infection control and prevention?
1129. There has been an outbreak of the Norovirus in your clinical area. Majority of your staff have rang in sick. Which of the
following is incorrect?
a.) Do not allow visitors to come in until after 48h of the last
episode b.) Tally the episodes of diarrhoea and vomiting
c.) Staff who has the virus can only report to work 48h after last episode
d.) Ask one of the staff who is off-sick to do an afternoon shift on same day
1130. Alan appears to be very confused today. He seems to be quite verbally aggressive towards staff. His urine has also got a bit
of foul smell. How would you assess this resident?
a.) Ring the family and find out what happened to the resident
b.) Speak to your manager and tell her about it
c.) Ring the ward and request for an update from the nurse on duty
d.) Document that the resident is still in the hospital
1132. One of your residents in the nursing home has requested for a glass of whiskey before she goes to bed. What would you
do?
1133. One of your health care assistants came to you saying that she could not continue with her rounds due to a bad back. What
will you do first?
1134. A client has an order for streptokinase. Before administering the medication, the nurse should assess the client for:
1135. The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:
1136. The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse
should give priority to:
1137. The infant is admitted to the unit with tetralogy of Fallot. The nurse would anticipate and order for which medication?
a) Digoxin
b) Epinephrine
c) Aminophyline
d) Atropine
1138. The client with clotting disorder has an order to continue Lovenox (Enoxaparin) injections after discharge. The nurse
should teach the client that Lovenox injections should:
1139. The nurse has a preop order to administer Valium (diazepam) 10mg and Phenergan (promethazine) 25mg. The correct
method of administering these medications is to:
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1140. Nurses who seek to enhance their cultural-competency skills and apply sensitivity towards are committed to which
professional nursing value?
a) Autonomy
b) Strong commitment to service
c) Belief in the dignity and worth of each person
d) Commitment to education
1141. A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and
toes. What would the nurses’ next action be?
1142. A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a weightgain of 30 pounds in four months,
and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing
diagnoses is of highest priority?
1143. The client presents to the clinic with a serum cholesterol of 275mg/dL and is placed on rosuvastatin (Crestor). Which
instruction should be given to the client taking rosuvastatin (Crestor)?
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1144. The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the
nurse should:
1145. The client admitted with angina is given a prescription for nitroglycerine. The client should be instructed to:
1146. The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?
1147. The nurse is checking the client’s central venous pressure. The nurse should place the zero of the manometer at the:
A. Phlebostatic axis
B. PMI
C. Erb’s point
D. Tail of Spence
1148. The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with
hypertension. The nurse should:
1149. The best method of evaluating the amount of peripheral edema is:
1150. A client with vaginal cancer is being treated with a radioactive vaginal implant. The client’s husband asks the nurse if he
can spend the night with his wife. The nurse should explain that:
1151. The nurse is caring for a client hospitalized with a facial stroke. Which diet selection would be suited to the client?
1152. The physician has prescribed Novalog insulin for a client with diabetes mellitus. Which statement indicates that the client
knows when the peak action of the insulin occurs?
1153. A client with leukemia is receiving Trimetrexate. After reviewing the client’s chart, the physician orders Wellcovorin
(leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to:
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A. Treat iron-deficiency anemia caused by chemotherapeutic agents
B. Create a synergistic effect that shortens treatment time
C. Increase the number of circulating neutrophils
D. Reverse drug toxicity and prevent tissue damage
1154. The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the
medication:
1155. A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood tinged hemoptysis, fatigue, and night
sweats. The client’s symptoms are consistent with a Diagnosis of:
A. Pneumonia
B. Reaction to antiviral medication
C. Tuberculosis
D. Superinfection due to low CD4 count
1156. The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed
for the client. Which of the following in the client’s history should be reported to the doctor?
A. Diabetes
B. Prinzmetal’s angina
C. Cancer
D. Cluster headaches
1157. The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine
meningeal irritation and spinal nerve root inflammation. A positive Kernig’s sign is charted if the nurse notes:
1158. The client with confusion says to the nurse, “I haven’t had anything to eat all day long. When are they going to bring
breakfast?” The nurse saw the client in the day room eating breakfast with other clients 30 minutes before this
conversation. Which response would be best for the nurse to make?
1159. The doctor has prescribed Exelon (rivastigmine) for the client with Alzheimer’s disease. Which side effect is most often
associated with this drug?
A. Urinary incontinence
B. Headaches
C. Confusion
D. Nausea
1160. A client with a diagnosis of HPV is at risk for which of the following?
A. Hodgkin’s lymphoma
B. Cervical cancer
C. Multiple myeloma
D. Ovarian cancer
1161. During the initial interview, the client reports that she has a lesion on the perineum. Further investigation reveals a small
blister on the vulva that is painful to touch. The nurse is aware that the most likely source of the lesion is:
A. Syphilis
B. Herpes
C. Gonorrhea
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D. Condylomata
1162. A client visiting a family planning clinic is suspected of having an STI. The best diagnostic test for treponema pallidum is:
1163. A primigravida with diabetes is admitted to the labor and delivery unit at 34 weeks gestation. Which doctor’s order should the nurse
question?
1164. The client has elected to have epidural anaesthesia to relieve labour pain. If the client experiences hypotension, the nurse
would:
1165. A client has cancer of the pancreas. The nurse should be most concerned about which nursing diagnosis?
A. Alteration in nutrition
B. Alteration in bowel elimination
C. Alteration in skin integrity
D. Ineffective individual coping
1166. The nurse is caring for a client with uremic frost. The nurse is aware that uremic frost is often seen in clients with:
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A. Severe anemia
B. Arteriosclerosis
C. Liver failure
D. Parathyroid disorder
1167. The client arrives in the emergency department after a motor vehicle accident. Nursing assessment findings include BP 80/34, pulse
rate 120, and respirations 20. Which is the client’s most appropriate priority nursing diagnosis?
1168. The home health nurse is visiting an 18-year-old with osteogenesis imperfecta. Which information obtained on the visit
would cause the most concern? The client:
1169. The nurse working the organ transplant unit is caring for a client with a white blood cell count of 450. During evening
visitation, a visitor brings a basket of fruit. What action should the nurse take?
1170. The nurse is caring for the client following a laryngectomy when suddenly the client becomes nonresponsive and pale, with
a BP of 90/40. The initial nurse’s action should be to:
1171. The client admitted two days earlier with a lung resection accidentally pulls out the chest tube. Which action by the nurse
indicates understanding of the management of chest tubes?
1172. A client being treated with sodium warfarin (Coumadin) has a Protime of 120 seconds. Which intervention would be most important to
include in the nursing care plan?
1173. The client has recently been diagnosed with diabetes. Which of the following indicates understanding of the management of
diabetes?
1174. Which action by the healthcare worker indicates a need for further teaching?
A. The nursing assistant ambulates the elderly client using a gait belt.
B. The nurse wears goggles while performing a venopuncture.
C. The nurse washes his hands after changing a dressing.
D. The nurse wears gloves to monitor the IV infusion rate.
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1175. The registered nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?
1176. The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is
available?
1177. Which nurse should not be assigned to care for the client with a radium implant for vaginal cancer?
1179. A mother calls the home care nurse & tells the nurse that her 3 year old child has ingested liquid furniture polish. the home
care nurse would direct the mother immediately to
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1) Induce vomiting
2) Bring the child to the ER
3) Call an ambulance
4) Call the poison control centre
1180. A two-year-old is admitted for repair of a fractured femur and is placed in Bryant’s traction. Which finding by the nurse
indicates that the traction is working properly?
1181. A priority nursing diagnosis for a child being admitted from surgery following a tonsillectomy is:
A. Altered nutrition
B. Impaired communication
C. Risk for injury/aspiration
D. Altered urinary elimination
1182. The nurse is discussing meal planning with the mother of a two-year-old. Which of the following statements, if made by the mother,
would require a need for further instruction?
1183. Before administering eardrops to a toddler, the nurse should recognize that it is essential to consider which of the following?
A. Tell the mother to wash the face with soap and apply powder.
B. Tell her that 30% of newborns have a rash that will go away by one month oflife.
C. Report the rash to the doctor immediately.
D. Ask the mother if anyone else in the family has had a rash in the last
six months.
1185. The best size cathlon for administration of a blood transfusion to a six-year-old is:
A. 18 gauge
B. 19 gauge
C. 22 gauge
D. 20 gauge
1186. The toddler is admitted with cardiac anomaly. The nurse is aware that the infant with a ventricular septal defect will:
a) Tire easily
b) Grow normally
c) Need more calories
d) Be more susceptible to viral infections
1187. The nurse is caring for the client with a five-year-old diagnosis of plumbism. Which information in the health history is most likely
related to the development of plumbism?
A. The client has traveled out of the country in the last six months.
B. The client’s parents are skilled stained-glass artists.
C. The client lives in a house built in 1990.
D. The client has several brothers and sisters.
1188. A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken?
1189. To maintain Bryant’s traction, the nurse must make certain that the child’s:
A. Hips are resting on the bed, with the legs suspended at a right angle to the bed
B. Hips are slightly elevated above the bed and the legs are suspended at a right angle to the bed
C. Hips are elevated above the level of the body on a pillow and the legs are suspended parallel to the bed
D. Hips and legs are flat on the bed, with the traction positioned at the foot of the bed
1190. A six-month-old client is placed on strict bed rest following a hernia repair. Which toy is best suited to the client?
1191. The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant with a ventricular septal defect will:
A. Tire easily
B. Grow normally
C. Need more calories
D. Be more susceptible to viral infections
1192. A four-month-old is brought to the well-baby clinic for immunization. In addition to the DPT and polio vaccines, the baby
should receive:
A. Hib titer
B. Mumps vaccine
C. Hepatitis B vaccine
D. MMR
1193. The five-year-old is being tested for enterobiasis (pinworms). Which symptom isassociated with enterobiasis?
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A. Rectal itching
B. Nausea
C. Oral ulcerations
D. Scalp itching
1194. The six-month-old client with a ventral septal defect is receiving Digitalis for regulation of his heart rate. Which finding
should be reported to the doctor?
1195. The nurse is caring for a client admitted to the emergency room after a fall. X-rays reveal that the client has several
fractured bones in the foot. Which treatment should the nurse anticipate for the fractured foot?
1196. The client is admitted following cast application for a fractured ulna. Which finding should be reported to the doctor?
1197. The nurse is caring for a client admitted with multiple trauma. Fractures include the pelvis, femur, and ulna. Which finding
should be reported to the physician immediately?
A. Hematuria
B. Muscle spasms
C. Dizziness
D. Nausea
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1198. The nurse is caring for a client admitted to the emergency room after a fall. X-rays reveal that the client has several
fractured bones in the foot. Which treatment should the nurse anticipate for the fractured foot?
1199. A nurse obtains an order from a physician to restraint a client by using a jacket restraint. The nurse instructs nursing
assistant to apply the restraint. Which of the following would indicate inappropriate application of the restraint by the nursing
assistant.
1200. A client has been voluntarily admitted to the hospital. The nurse knows that which of the following statements is
inconsistent with this type of hospitalization?
1201. When caring for clients with psychiatric diagnoses, the nurse recalls that the purpose of psychiatric diagnoses or
psychiatric labeling is to:
1203. After two weeks of receiving lithium therapy, a patient in the psychiatric unit becomes depressed. Which of the following
evaluations of the patient’s behavior by the nurse would be MOST accurate?
(A) The treatment plan is not effective; the patient requires a larger dose of lithium.
(B) This is a normal response to lithium therapy; the patient should continue with the current treatment plan.
(C) This is a normal response to lithium therapy; the patient should be monitored for suicidal behavior.
(D) The treatment plan is not effective; the patient requires an antidepressant
1204. The client is having electroconvulsive therapy for treatment of severe depression. Prior to the ECT the nurse should:
1205. A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most
appropriate action for the nurse to take?
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1206. The nurse is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a "general
lead"?
1207. You were a new nurse in a geriatric ward. The son of one of your patients discussed that he has noticed his mother is not
being treated well in the ward, and that she looks very dehydrated and malnourished. How do you deal with the scenario?
1208. The client is having electroconvulsive therapy for treatment of severe depression. Prior to the ECT the nurse should:
1209. A client is brought to the emergency room by the police. He is combative and yells, “I have to get out of here. They are
trying to kill me.” Which assessment is most likely correct in relation to this statement?
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1210. A home care nurse performs a home safety assessment & discovers that a client is using a space heater to heather
apartment . which of the following instructions would the nurse provide to the client regarding the use of the space heater.
1211. 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
1212. An elderly client with an abdominal surgery is admitted to the unit following surgery. In anticipation of complications of
anaesthesia and narcotic administration, the nurse should:
1213. The client with Alzheimer’s disease is being assisted with activities of daily living when the nurse notes that the client uses
her toothbrush to brush her hair. The nurse is aware that the client is exhibiting:
A. Agnosia
B. Apraxia
C. Anomia
D. Aphasia
1214. The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the
client is experiencing what is known as:
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A. Chronic fatigue syndrome
B. Normal aging
C. Sundowning
D. Delusions
1215. The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is most likely related to:
A. Lack of exercise
B. Hormonal disturbances
C. Lack of calcium
D. Genetic predisposition
1216. A client with Alzheimer’s disease is awaiting placement in a skilled nursing facility. Which long-term plans would be most
therapeutic for the client?
1217. 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?
1) “ How can we obtain reliable help to assist us in taking care of Dad? We can’t do it alone.”
2) “ Dad used to beat us kids all the time . I wonder if he remembered that when it happened to him?”
3) “I’m not sure how to deal with Dad’s constant repetition of words.”
4) “I plan to ask my sister & brother to help my wife & me with Dad on the weekends.”
1218. Fiona, 70 years old, has recently been diagnosed with Type 2 Diabetes. You have devised a care plan to meet her nutritional
needs. However, you have noted that she has poorly fitting dentures. Which of the following is the least likely risk to the
service user?
a. Malnutrition
b. Hyperglycemia
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c. Dehydration
d. Hypoglycemia
1219. A client with Alzheimer’s disease is awaiting placement in a skilled nursing facility. Which long-term plans would be most therapeutic
for the client?
1220. Nurses who seek to enhance their cultural-competency skills and apply sensitivity toward others are committed to which professional
nursing value?
A. Autonomy
B. Strong commitment to service
C. Belief in the dignity and worth of each person
D. Commitment to education
1221. A client comes to the local clinic complaining that sometimes his heart pounds and he has trouble sleeping. The 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?
1) Body positioning.
2) Eye contact
3) Cultural artifacts.
4) Facial expressions.
1224. To provide effective feedback to a client, the nurse will focus on:
1225. The nurse is interacting with a client and observes the client’s eyes moving from side to side prior to answering a question. The nurse
interprets this behavior as:
1226. Which therapeutic communication technique is being used in this nurse-client interaction? Client: "My father spanked me often."
Nurse: "Your father was a harsh disciplinarian."
1) Restatement
2) Offering general leads
3) Focusing
4) Accepting
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1227. Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I am anxious, the only thing
that calms me down is alcohol." Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"
1) Reflecting
2) Making observations
3) Formulating a plan of action
4) Giving recognition
1228. A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for
active listening?
1) S
2) O
3) L
4) E
5) R
1230. Which example of a therapeutic communication technique would be effective in the planning phase of the nursing process?
1) "We've discussed past coping skills. Let's see if these coping skills can be effective now."
2) "Please tell me in your own words what brought you to the hospital."
3) "This new approach worked for you. Keep it up."
4) "I notice that you seem to be responding to voices that I do not hear."
1231. During a nurse-client interaction, which nursing statement may belittle the client's feelings and concerns?
1232. According to the therapeutic communication theory, what criteria must be met for successful communication?
1233. According to Argyle (1988), when two people communicate what percentage of what is communicated is actually in the
words spoken?
a) 90%
b) 50%
c) 23%
d) 7%
a) Cultural differences
b) Unfamiliar accents
c) Overly technical language and terminology
d) Hearing problems
e) All the above
1237. When communicating with a client who speaks a different language, which best practice should the nurse implement?
1238. When communicating with someone who isn't a native English speaker, which of the following is NOT advisable?
a) Using a translator
b) Use short, precise sentences
c) Relying on their family or friends to help explain what you mean
d) Write things down
1239. Mr Khan, is visiting his son in London when he was admitted in accident and emergency due to abdominal pain. Mr. Khan is
from Pakistan and does not speak the English language. As his nurse, what is your best action:
1240. During which part of the client interview would it be best for the nurse to ask, "What's the weather forecast for today?"
a) Introduction
b) Body
c) Closing
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d) Orientation
1242. The nurse is most likely to collect timely, specific information by asking which of the following questions?
1243. A client comes to the local clinic complaining that sometimes his heart pounds and he has trouble sleeping. The 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?
1244. The nurse should avoid asking the client which of the following leading questions during a client interview.
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1245. Communication is not the message that was intended but rather the message that was received. The statement that best
helps explain this is
a) Clean communication can ensure the client will receive the message intended
b) Sincerity in communication is the responsibility of the sender and the receiver
c) Attention to personal space can minimize misinterpretation of communication
d) Contextual factors, such as attitudes, values, beliefs, and self-concept, influence communication
1246. A nurse has been told that a client's communications are tangential. The nurse would expect that the clients verbal
responses to questions would be:
1247. When a patient arrives to the hospital who speaks a different language. Who is responsible for arranging an interpreter?
a) Doctor
b) Management
c) Registered Nurse
a) Listening, clarifying the concerns and feelings of the patient using open questions.
b) Listening, clarifying the physical needs of the patient using closed questions
c) Listening, clarifying the physical needs of the patient using open questions
d) Listening, reflecting back the patient's concerns and providing a solution.
1249. Which behaviours will encourage a patient to talk about their concerns?
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a) Giving reassurance and telling them not to worry.
b) Asking the patient about their family and friends.
c) Tell the patient you are interested in what is concerning them and that you are available to listen.
d) Tell the patient you are interested in what is concerning them and if they tell you, they will feel better.
1250. Mrs X is posted for CT scan. Patient is afraid cancer will reveal during her scan. She asks “why is this test”. What will be
your response as a nurse?
A. Understand her feelings and tell the patient that it is a normal procedure.
B. Tell her that you will arrange a meeting with doctor after the procedure.
C. Give a health education on cancer prevention
D. Ignore her question and take her for the procedure.
1251. Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I get angry, I get
into a fistfight with my wife or I take it out on the kids." Nurse: "I notice that you are smiling as you talk about this physical
violence."
1252. Which nursing statement is a good example of the therapeutic communication technique of giving recognition?
a) I notice you are wearing a new dress and you have washed your hair"
b) You did not attend group today. Can we talk about that?
c) I'll sit with you until it is time for your family session
d) I'm happy that you are now taking your medications. They will really help
1253. Which nursing statement is good example of the therapeutic communication technique of focusing?
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a) Your counselling session is in 30 minutes. I’ll stay with you until then."
b) You mentioned your relationship with your father. Let's discuss that further
c) I'm having a difficult time understanding what you mean
d) Describe one of the best things that happened to you this week
1254. The nurse asks a newly admitted client, "What can we do to help you?" What is the purpose of this therapeutic
communication technique?
1255. Which therapeutic statement is a good example of the therapeutic communication technique of offering self?
1256. Which therapeutic communication technique should the nurse use when communicating with a client who is experiencing
auditory hallucinations?
a) I wouldn't worry about these voices,. The medication will make them disappear
b) Why not turn up the radio so that the voices are muted
c) My sister has the same diagnosis as you and she also hears voices
d) I understand that the voices seem real to you, but i do not hear any voices
1257. Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?
1258. Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?
1259. Which nursing statement is a good example of the therapeutic communication technique of giving recognition?
a) You did not attend group today. Can we talk about that?”
b) I’ll sit with you until it is time for your family session.
c) “I notice you are wearing a new dress and you have washed your hair.”
d) “I’m happy that you are now taking your medications. They will really help.”
1260. Patient has just been told by the physician that she has stage III uterine cancer. The patient says to the nurse, “I don’t know
what to do. How do I tell my husband?” and begins to cry. Which of the following responses by the nurse is the MOST
therapeutic?
A. “It seems to be that this is a lot to handle. I’ll stay here with you.”
B. “How do you think would be best to tell your husband?”
C. “I think this will all be easier to deal with than you think.”
D. “Why do you think this is happening to you?”
1261. Which of the following statements by a nurse would indicate an understanding of intrapersonal communications?
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1262. Covert communication may include the following except:
a) Body language
b) tone of voice
c) appearance
d) eye contact
a) Dress
b) Facial expression
c) Posture
d) Tone
a) Receiving encouragement and support from co-workers to cope with the many stressors of the nursing role
b) Becoming an effective change agent in the community
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c) An increased understanding of the family dynamics that affect the client
d) An increased understanding of what the client perceives as meaningful from his or her perspective
a) Intelligent Kindness
b) Smart confidence
c) Creative commitment
d) Gifted courage
1270. What are the principles of communicating with a patient with delirium?
A. Use short statements & closed questions in a well –lit, quiet , familiar environment
B. Use short statements & 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 & closed questions
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A. Denial is when a healthcare professional refuses to tell a patient their diagnosis for the protection of the patient whereas collusion
is when healthcare professionals & the patient agree on the information to be told to relatives & friends B. Denial is when a patient
refuses treatment & collusion is when a patient agrees to it
C. Denial is a coping mechanism used by an individual with the intention of protecting themselves from painful or distressing
information whereas collusion is the withholding of information from the patient with the intention of ‘protecting them’
D. Denial is a normal acceptable response by a patient to a life-threatening diagnosis whereas collusion is not
1272. If you were explaining anxiety to a patient, what would be the main points to include?
A. Signs of anxiety include behaviours such as muscle tension. palpitations ,a dry mouth , fast shallow breathing , dizziness & an
increased need to urinate or defaecate
B. Anxiety has three aspects : physical – bodily sensations related to flight & fight response , behavioural – such as avoiding the situation
, & cognitive ( thinking ) – such as imagining the worst
C. Anxiety is all in the mind , if they learn to think differently , it will go away
D. Anxiety has three aspects: physical – such as running away , behavioural – such as imagining the worse ( catastrophizing) , & cognitive
( thinking) – such as needing to urinate.
1273. Alan appears to be very confused today. He seems to be quite verbally aggressive towards staff. His urine has also got a bit
of foul smell. How would you assess this resident?
1274. On a psychiatric unit, the preferred milieu environment is BEST described as:
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1275. The wife of a client with PTSD (post traumatic stress disorder) communicates to the nurse that she is having trouble
dealing with her husband’s condition at home. Which of the following suggestions made by the nurse is CORRECT?
A. “Discourage your husband from exercising, as this will worsen his condition.”
B. “Encourage your husband to avoid regular contact with outside family members.”
C. “Do not touch or speak to your husband during an active flashback. Wait until it is finished to give him
support.” D. “Keep your cupboards free of high-sugar and high-fat foods.”
1276. When caring for clients with psychiatric diagnoses, the nurse recalls that the purpose of psychiatric diagnoses or
psychiatric labeling is to:
1277. A client breathes shallowly and looks upward when listening to the nurse. Which sensory mode should the nurse plan to
use with this client?
a) Auditory
b) Kinesthetic
c) Touch
d) Visual
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a) Listening, clarifying the concerns and feelings of the patient using open questions.
b) Listening, clarifying the physical needs of the patient using closed questions.
c) Listening, clarifying the physical needs of the patient using open questions.
d) Listening, reflecting back the patient’s concerns and providing a solution.
1280. Which therapeutic communication technique should the nurse use when communicating with a client who is experiencing
auditory hallucinations?
A. "My sister has the same diagnosis as you and she also hears voices."
B. "I understand that the voices seem real to you, but I do not hear any voices."
C. "Why not turn up the radio so that the voices are muted."
D. "I wouldn't worry about these voices. The medication will make them disappear."
1282. Adam has not been able to communicate with the nurses on duty. Using nonverbal communication and gestures to help
one identify a service user’s needs is important because:
1283. Over a period of 9 hours a patient is to receive half a liter of dextrose 4 % in 1/5 normal saline via a volumetric infusion
pump. At what flow rate should the pump be set?
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500
9
= 55,5
1284. A patient is prescribed 120 ml of Hartmann’s solution to be given over 5 hours. The microdrip delivers 60 drops/ml.
calculate the required drip rate in drops/min
120mls x 60
5 60
1285. At 22H00 hours on Thursday, 1 Liter of Saline is set to run at 80ml/hr. When will the infusion be finished:
1000ml
80ml
= 12H30 minutes
Answer: 10:30 am
1286. A Patient is to be given co-amoxiclav. The Recommended dosage is 20mg/kg/day, 3 doses per day. Calculate the size of a
single dose if the patients weight is 24kg
480/3 = 160mg
1287. 450 mg of asprin is required. Stock on hand is 300mg tablets. How many tablets should be given?
= tablets
450mg
300mg
1½ tablets
1288. A solution contains paractamol 120mg/5ml. How many milligrams of paracetamol are in 40 ml of the solution.
120mg x 8
= 960 mg
1289. A patient is prescribed phenobarbitone 140mg. stock ampoules contain 200mg/ml. what volume must be withdrawn for
injection?
140mg x 1ml
200mg
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= 0,7 mls
1290. 800ml of fluid is to be given IV. The fluid is running at 70ml/hr for the first 5 hours than the rate is reduced to 60ml/hr.
Calculate the total time taken to give 800ml.
70ml x 5 = 350mls
1291. One liter of Hartmann’s solution is to be given over 12 hours. Calculate the flow rate of a volumetric infusion pump
1000ml
12
83,3 ml
= 83 ml
1292. 400mg of penicillin is to be given IV. One hand is penicillin 600mg in 2 ml. What volumes should be drawn up?
400ml x 2ml
600mg
= 800
600
= 1,3 ml
296
1293. A patient is prescribed benzylpenicillin 1200mg IV. Stock ampouls contain 1g in 5ml. is the volume to be drawn up for
injection equal to 5ml, less than 5 ml or more than 5ml?
1200mg x 5mls
1000
6000mg
1000mg
1294. A vial of amoxilling 500mg is reconstituted with WFI to give a concentration of 200mg/ml. Calculate the volume of this
solution to be drawn up for injection if the preparation is for 120mg.
120mg
200mg
0.6 mg
1295. 700ml of saline solution is to be given over 8 hours. The IV set delivers 20 drops/ml. What is the required drip rate?
700ml x 20
8 60
87.5 x1
1 3
= 29,1
= 29 drops per minute
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1296. One gram of drextrose provide 16kj of energy. How many kilojouls does a patient receive form an infusion of half a litre of
dextrose?
1g (1 000ml) = 16kg
500ml (½ a liter) = 16/2 = 8kj
1297. A patient is to be given amoxillin 175mg. What volume of solution should be drawn up for the injection if the consentration
after dilution with water for injection is 300mg/ml
175mg x 1
300mg
= 0.58 ml
= 0.6ml
1298. A post-operative patient is to receive a PCA infusion of fetanyl 350 micrograms in 35 ml of normal saline via a syringe pump. The
PCA is set to give a bolus dose of 1 ml each time the button is pressed
350mcg
35ml
= 0,35mg
35
= 0.01 mg
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b) How much fentanyl is in each bolus dose
c) If the patient has 4 bolus doses between 11:00 and 12:00 hours on a Friday, how much fentanyl has the patient received in
that hour?
1299. Mrs X has been ordered 100 ml to be infused over 45 minutes via a 20 drops/ml giving set. What drip rate should be set?
1300. A patient has been prescribed 1L of a saline solution. The rate is set at 150 ml/hr. How long will the infusion take?
1301. Doctor’s order: Tylenol supp 1 g prq q 6 hr prn temp > 101; available: Tylenol supp 325 mg (scored). How many supp will you
administer?
a) 2 supp
b) 1 supp
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c) 3 supp
d) 5 supp
1g x 1 000 mg x 1 supp
325 mg 1g
= 3. 08 or 3 supp
1302. Doctor’s Order: Nafcillin 500mg po pc; Available: Nafcillin 1 gm tab (scored). How many tab will you administer per day?
a) 2.5 tabs
b) 2 tabs
c) 1.5 tabs
d) 1 tab
1g = 1,000mg
500mg x 1g
1g 1 000mgx 3 meals x 1 tab = 1.5 tabs
1303. Doctor’s order: Synthroid 75 mcg po daily; Available: Synthroid 0.15mg tab (scored). How many tab will you administer?
a) 1 tab
b) O.5 tab
c) 2 tabs
d) 1.5 tabs
= 0.5 tabs
300
1304. Doctor’s order: Diuril 1.8 mg/kg pot id; Available: Diuril 12.5 mg caps. How many cap will you administer for each dose to a
14 kg child?
a) 2 caps
b) 2.5 caps
c) 3 caps
d) 1.5 caps
1.8 mg/kg x 14 kg
1305. Doctor’s Order: Cleocin Oral Susp 600 mg po qid; Directions for mixing: Add 100 mL of water and shake vigorously. Each
2.5 mL will contain 100 mg of Cleocin. How many tsp of Cleocin will you administer?
a) 3 tsp
b) 5 tsp
c) 3.5 tsp
d) 1 tsp
1306. Doctor’s order: Sulfasalazine Oral susp 500 mg q 6 hr; Directions for mixing: Add 125mL of water and shake well. Each tbsp. will
yield 1.5 g of Sulfasalazine. How many mL will you give?
a) 5 mL
b) 3 mL
c) 4 ml
d) 2ml
1 tbsp = 15ml
301
500mg x 1 g x 15ml
1.5 g 1 000mg
= 5ml
1307. Your patient has had the following intake: 2 ½cups of coffee (240 mL/cup), 11.5 oz of grape juice, ¾ qt of milk, 320 mL of diet coke, 1
¼ L of D5W IV and 2 oz of grits. What will you recored as the total intake in mL for this patient?
a) 2.325 ml
b) 3,265 ml
c) 3,325 ml
d) 2,235 ml
1 qt = 1 000 ml
1 0z = 30ml
1308. Doctor’s Order: Kantamycin 7.5 mg/kg IM q 12 hr; Available: Kantamycin 0.35 gm/mL. How many mL will you administer for each
dose to a 71 kg patient?
a) 2ml
b) 1 ml
c) 2.5 ml
d) 1.5 ml
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1309. Doctor’s Order: Heparin 7,855 units Sub Q bid; available; Heparin 10, 000 units per ml. how many mL will you administer?
a) 0.79 ml
b) 1.79 ml
c) 0.17 ml
d) 1.17 ml
1310. Doctor’s Order: Demorol 50 mg IVP q 6 hr prn pain: Available: Demerol 75 mg/1.3 mL. How many mL will you administer?
a) 0.87 ml
b) 1.87ml
c) 2ml
d) 2.87ml
50 mg x 1 ml = 0.87 ml
75 mg
1311. Doctor’s order: Streptomycion 1.75 mg /Ib IM q 12 hr; Available: Streptomycin 0.35 g/ 2.3 mL. How many mL will you
administer a day to a 59 kg patient?
a) 1.5 ml
b) 2ml
c) 2.5 ml
d) 3ml
227.5 mg x 1g x x 2.3 ml
0.35 g 1000mg
= 1.5 ml
= 1.5 ml x 2 = 3 ml
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1312. Doctor’s Order: bumex 0,8 mg IV bolus bid; Reconstitution instructions: Constitute to 1 000 micrograms/ 3.1 mL with 4.8 mL of 5 %
Dextrose Water for Injection. How many mL will you administer?
a) 2ml
b) 3.5 ml
c) 3 ml
d) 2.5 ml
1313. Doctor’s order: Tazidime 0.3 g Im tid; Reconstitution instructions: For IM solution add 1.5 mL of diluent. Shake to disoolve. Provides
an approximate volume of 1.8 mL (280mg/mL). How many mL will you give?
a) 1.9 ml
b) 2 ml
c) 3 ml
d) 1.1 ml
1314. Doctor’s Order: Infuse 50 mg of Amphotericin b in 250 mL NS over 4 hr 15 min; Drop factor : 12 gtt/ml. What flow rate (mL /hr) wil lyo
set on the IV infusion pump?
a) 11.8 ml/hr
b) 58,8 ml/hr
c) 14.1 ml/hr
d) 60,2 ml/hr
250 ml
4.25 hrs
304
= 58.8 ml/hr
1315. Doctor’s order: 1,5 L of NS to be infused over 7 hours; Drop factor: 15 gtt/ml. What flow rate (mL/hr) will you set on the IV
infusion pump?
a) 53,6 ml/hr
b) 214,3 ml/hr
c) 35,7 ml/hr
d) 142.9 ml/hr
1500 ml
7 hours
= 215.3 ml/hr
1316. Doctor’ order: Mandol 300 mg in 50 mL of D5W to infuse IVPB 15 minutes; drop factor: 10 gtt/mL. How many mL/hr will you set on
the IV infusion pump?
a) 200 ml/hr
b) 87.5 ml/hr
c) 3.3 ml/hr
d) 50 ml/hr
15 min = 0.25 hr
50 ml
0.25 hr
= 200ml/hr
1317. Doctor’s order: Infuse 1200 mL of 0.45% Normal Saline at 125 mL/hr; Drop Factor: 12gtt/min. How many gtt/min will you regulate the
IV?
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a) 2 gtt/min
b) 12 gtt/min
c) 25gtt/min
d) 27 gtt/min
125ml
1x 60 mns x 12 gtt/ml = 25 gtt/min
1318. Doctor order: Recephin 0.5 grams in 250 mL of D5W to infuse IVPB 45 minute; Drop factor: 12 gtt/min. How many gtt/ min will you
regulate the IVPB?
a) 6 gtt/min
b) 30 gtt/min
c) 67 gtt/min
d) 87 gtt/min
1319. Doctor order: ¼ L of D%W to infuse over 2 hr 45 min; Drop factor: 60 gtt/mL. How many gtt/min will you regulate the IV?
a) 91 gtt/min
b) 96 gtt/min
c) 125 gtt/min
d) 142 gtt/ min
1320. 500mg of Amoxicillin is prescribed to a patient three times a day, 250mg tablets are available. How many tablets for single
dose?
a) 6
b) 4
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c) 2
d) 8
1321. The doctor prescribes a dose of 9 mg of an anticoagulant for a patient being treated for thrombosis. The drug is being
supplied in 3mg tablets. How many tablets should you administer?
a) 3 tablets
b) 1.5 tablets
c) 6 tablets
1322. The doctor prescribes a dose of 9 mg of an anticoagulant for a patient being treated for thrombosis. The drug is being
supplied in 3mg tablets. How many tablets should you administer?
A) 3 tablets
B) 1.5 tablets
C) 6 tablets
a) 2
1324. 1000 mg dose to be given thrice a day.250 mg tabs available. No. of tabs in single dose?
1325. A drug 150g is prescribed it is available as 5 g tablets. haw many tablets need to be administered?
30 tablets
1326. Paracetamol 1gm is ordered. It is available as 500mg. How many tablets need to be administered?
2 tablets
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1327. You need to give 40mg tablet. available is 2.5mg tablets. How much tablets will you give?
16 tablets
1328. A dose of 100 ml of injection Metronidazole is to be infused over half an hour. How much amount of the medicine will be
given in an hour?
a) 50 ml
b) 150 ml
c) 200 ml
d) 300 ml
1329. The doctor prescribes 25mg of a drug to be given by injection. It is a drug dispensed in a solution of strength 50mg/ml. How
many ml should you administer?
- 2ml
- 1.5 ml
- 0.5 ml – Dose Prescribed: Dose /ml - 25:50=0.5
1330. Mr Bond will require 10 mgs of oromorph. The stock comes in 5 mg/2ml. How much will you draw up from the bottle?
a) 4 ml
b) 10 ml
c) 6 ml
d) 8 ml
1331. A doctor prescribes an injection of 200 micrograms of drug. The stock bottle contains 1mg/ml. How many ml will you
administer?
a) 20ml
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b) 2 ml
c) 0.2 ml
1332. An infusion of 24 mg of Inj. Furosemide is ordered for 12 hrs. How much dose is infused in an hour?
a) 4 mg/hr
b) 2 mg/hr
c) 3 mg/hr
d) 1 mg/hr
1333. A patient with burns is given anesthesia using 50%oxygen and 50%nitrous oxide to reduce pain during dressing . how long
this gas is to be inhaled to be more effective?
• 30 sec
• 60sec
• 1-2min
• 3-5min
1334. A doctor prescribes an injection of 200 micrograms of drug. The stock bottle contains 1mg/ml. How many ml will you
administer? Bear in mind: The 2 dose values must be in the same unit 1mg=1000mcg , 200mcg=0.2mg then dose
prescribed:dose/ml – 0.2:1=0.2
B) 20ml
C) 2ml
D) 0.2ml
1335. A drug 8.25mg is ordered, it is available as 2.75mg. Calculate the dose.
3 tablets
309
NB- fluid gvn sets =20 drops per minute
1336. A solution contains 12.5 g of glucose in 0.25 L; what is the percentage concentration (%) of this solution?
1250mg (12.5g)
250ml (0.25 L)
=5
a) 5%
b) 10%
c) 25%
1337. A litre bag of 5% Glucose is prescribed over 4 hours. If a standard giving set is used, at what rate should the drip be set?
1000 x 20
4 60
= 250 x 1
1 3
= 83
a) 83
b) 60
c) 24
310
1338. Amitriptyline tablets are available in strengths of 10mg, 25mg, 50mg and 100mg. What combinations of whole tablets
should be used for an 85mg dose?
1339. 900mg of penicillin is to be given orally. Stock mixture contains 250mg/5ml. Calculate the volume of mixture to be given.
900 x 5ml
250
=18 mls
1340. An injection of fentanyl 225micrograms is prescribed. Stock on hand is 500micrograms in 2ml. What volume of stock
should be given?
225 x 2ml
500
= 0.9
= 1 microgram
1
1341. Over a period of 9 hours a patient is to receive half a litre of dextrose 4% in /5 normal saline via a volumetric infusion pump.
At what flow rate should the pump be set?
1342. How much is drawn from a patient ordered an injection of 80mg of pethidine? Each stock ampoule contains 100mg per 1 mL.
311
80mg x1mg
100mg
0,8 ml
1343. A child requires 50 milligrams of Phenobarbitone. If stock ampoules contain 200 milligrams in 2mL, how much will you draw up?
Stock required x volume
Stock on hand
50 mg x 2ml
200
100
200
= 0,5
1344. What volume is required for the injection if a patient is ordered 500mg of capreomycin sulphate, & each stock ampoules contains 300mg/mL?
500mg x 1ml
300mg
= 1,666 mg
= 1.7 mg
1345. A patient needs 5000mg of medication. Stock solution contains 1g per 1mL. What volume is required?
5000mg x 1ml
1000mg
= 5ml
1346. If 1000mg of chloramphenicol is given & stock on hand contains 250mg/10mL in suspension, calculate the volume required.
1000mg x 10ml
312
250mg
= 40mL
1347. A patient is prescribed 3g of sulphadiazine, the stock contains 600mg/5mL. How much stock should be given to the patient?
3000mg x 5ml
600mg
15 000
600
= 25ml
1348. 500ml is to infuse over a 5 hour period. Find the flow rate in mL/h.
Volume required for patient in ml
Time in hours
500ml
5 hours
= 100 ml/h
1349. Mr Smith is to receive 800mL of an antibiotic via an IV infusion over 15 hours. Calculate the flow rate to be set.
800ml
15hours
= 53,3
= 53
1350. An infusion is to run for 30 minutes and is to deliver 200mL. What is the rate of the infusion in mL/h?
= 400ml/h
313
1351. Calculate the flow rate if 1.2L is to be infused over 24 hours.
1200
24
= 50mL/h
1352. An order states that 500mL albumin 5% is to be given in 4 hours. What is the flow rate that should be set?
500
4
= 125mL/h
1353. 500 mg of amoxicillin powder is dissolved in 25 ml of water. What is the concentration in mg/ml?
500mg
25 ml
20mg/ml
20mg
4ml
= 5mg/ml
1355. You have 1 gram of drug in 20 ml of fluid. What is the concentration in mg/ml?
1000mg
20ml
314
= 50mg/ml
1356. The patient requires 3 mg of epinephrine by IM. You have the choice of 1:1000 or a 1:10 000 solution
3 x 1000
1000
3 x 10 000
1000
1357. Patient X requires 0.2 mg of 1 in 1000 adrenaline. How many ml do you give?
0.2 x 1000
1000
= 0.2 ml
315
316