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NMC CBT Mock Test 4:

1. 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?

• water bed
• fluidized airbed
• low air loss
• alternating pressure

2. 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?

• How long the client has been infected with TB
• Active TB infection
• Latent TB infection
• Whether the client has been infected with TB bacteria

3. You are caring for a patient who is known to have dementia. What particular issues should you consider prior to discharge.

• You involve in his care: Independent Mental Capacity Advocacy Service (Mental Capacity Act 2005)
• You involve other support services in his discharge: The hospital discharge team, social services, the metal health team

4. What is the most important guiding principle when choosing the correct size of catheter?

• The biggest size tolerable
• The smallest size necessary
• The potential length of use of the catheter
• The build of the patient

5. How do you ensure the correct blood to culture ratio when obtaining a blood culture specimen from an adult patient?

• Collect at least 10 mL of blood
• Collect at least 5 mL of blood.
• Collect blood until the specimen bottle stops filling.
• Collect as much blood as the vein will give you

6. Which of the following techniques is advisable when obtaining a urine specimen in order to minimize the contamination of a specimen?

• Clean around the urethral meatus prior to sample collection and get a midstream/clean catch urine specimen.
• 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.
• Do not clean the urethral meatus as we want these bacteria to analyse as well.
• Dip the urinalysis strip into the urine in a bedpan mixed with stool

7. When collecting an MSU from a male patient, what should they do prior to the specimen being collected?

• Clean the meatus and catch a specimen from the last of the urine voided
• Clean the meatus and catch a specimen from the first stream of urine (approx. 30mls)
• Clean the meatus and catch a specimen of the urine midstream
• Ask the patient to void into a bottle and pour urine specimen into the specimen container.

8. External factors which increase the risk of pressure damage are:

• Equipment, age and pressure
• Moisture, pressure and diabetes
• Pressure, shear and friction
• Pressure, moisture and age

9. What would you do if a patient with diabetes and peripheral neuropathy requires assistance cutting his toe nails?

• Document clearly the reason for not cutting his toe nails and refer him to a chiropodist.
• Document clearly the reason for not cutting his nails and ask the ward sister to do it.
• Have a go and if you run into trouble, stop and refer to the chiropodist.
• Speak to the patient's GP to ask for referral to the chiropodist, but make a start while the patient is in hospital.

10. Mr Bond’s neck wound needed some cleaning to prevent complications. Which of the following concept will you apply when doing a surgical wound cleaning?

• surgical asepsis
• aseptic non-touch technique
• medical asepsis
• dip-tip technique

11. 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?

• Say " I observe you don't seem as usual. Are you sure you are okay?"
• Say "Cheer up , Shall I make a cup of tea for you?"
• Accept her answer & leave, attend to other patients
• Inform the doctor about the change of the behaviour.

12. Most of the symptoms are common in both typel and type 2 diabetes. Which of the following symptom is more common in typ1 than type2?

• Thirst
• Weight loss
• Poly urea
• Ketones

13. When dealing with a patient who has a biohazard specimen, how will you ensure proper disposal? Select which does not apply:

• the specimen must be labelled with a biohazard
• the specimen must be labelled with danger of infection
• it must be in a double self-sealing bag
• it must be transported to the laboratory in a secure box with a fastenable lid

14. 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:

• Administer patient’s scheduled Metformin
• Give the patient a glass of orange juice
• Check the patient’s blood glucose
• Call the doctor

15. Mr Bond 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?

• Dietician
• Tissue Viability Nurse
• Social Worker
• Physiotherapist

16. For a client with Water Score >20 which mattress is the most suitable

• Water Mattress
• Air Mattress
• Dynamic Mattress
• Foam Mattress

17. Among the following drugs, which does not cause falls in an elderly?

• Diuretics
• NSAIDS
• Beta blockers
• Hypnotics

18. How much urine should someone void an hour?

• 0.5 - 1 ml/Kg/hr of the patient’s body weight
• 2mls/KG/hr of the patient’s body weight
• 30mls
• 50mls

19. When developing a program offering for patients who are newly diagnosed with diabetes, a nurse case manager demonstrates an understanding of learning styles by:

• Administering a pre- and post-test assessment.
• Allowing patient’s time to voice their opinions.
• Providing a snack with a low glycaemic index.
• Utilizing a variety of educational materials.

20. Patient usually urinates at night Nurse identifies this as:

• Polyuria
• Oliguria
• Nocturia

21. Which of the following indicates the patient needs more education when doing capillary sampling to check for blood sugar?

• Prick tip of index finger
• Prick sides of a finger
• Rotates sites of fingers

22. The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:

• Measure the urinary output.
• Check the vital signs.
• Encourage increased fluid intake.
• Weigh the client.

23. 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?

• Water Mattress
• Egg crater mattress
• Air Mattress
• Dynamic mattress

24. Which of the following is a behavioural risk factor when assessing the potential risks of falling in an older person?

• Poor nutrition/fluid intake
• Poor heating
• Foot problems
• Fear of falling

25. 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?

• “How can we obtain reliable help to assist us in taking care of Dad? We can’t do it alone.”
• “Dad used to beat us kids all the time. I wonder if he remembered that when it happened to him?”
• “I’m not sure how to deal with Dad’s constant repetition of words.”
• “I plan to ask my sister & brother to help my wife & me with Dad on the weekends.”

26. On removing your patient’s catheter, what should you encourage your patient to do ?

• Rest & drink 2-3 litres of fluid per day
• Rest & drink in excess of 5 litres of fluid per day
• Exercise & drink 2-3 litres of fluid per day
• Exercise & drink their normal amount of fluid intake

27. Mrs Bond 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:

• any incident or occurrence that has the potential to cause harm and/or has caused harm to a person or persons
• a consequence of an intervention, relating to a piece of equipment and/or as a consequence of the working environment
• Incident requiring investigation that occurred in relation to NHS funded services and care resulting in; unexpected or avoidable death, permanent harm
• All

28. Gina, 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?

• tell her that any information related to her well being will need to be share to the health care team
• inform her parents about this so she can be advised appropriately
• keep the information a secret in view of confidentiality
• report her boyfriend to social services

29. What action would you take if a specimen had a biohazard sticker on it?

• Double bag it, in a self-sealing bag, and wear gloves if handling the specimen.
• Wear gloves if handling the specimen, ring ahead and tell the laboratory the sample is on its way.
• Wear goggles and underfill the sample bottle.
• Wear appropriate PPE and overfill the bottle.

30. Knowing the difference between normal age- related changes & pathologic findings, which finding should the nurse identify as pathologic in a 74 year old patient?

• Increase in residual lung volume
• Decrease in sphincter control of the bladder
• Increase in diastolic BP
• Decreased response to touch, heat & pain.

31. 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?

• Apologise for the comments made
• Tell him of his overreaction
• Explain that his condition will make him over-sensitive to a lot of things
• Apologise and tell him to deal with the event lightly

32. When carrying out a catheterization, on which patients would you use anaesthetic lubricating gel prior to catheter insertion?

• Male patients to aid passage, as the catheter is longer
• Female patients as there is an absence of lubricating glands in the female urethra, unlike the male urethra
• Male & female patients require anaesthetic lubricating gel
• The use of anaesthetic lubricating gel is not advised due to potential adverse reactions

33. What are the principles of positioning a urine drainage bag?

• Above the level of the bladder to improve visibility & access for the health professional
• Above the level of the bladder to avoid contact with the floor
• Below the level of the patient’s bladder to reduce backflow of urine
• Where the patient finds it most comfortable

34. For an average person from UK who has non-insulin dependent diabetes, how many servings of fruits and vegetables per day should they take?

• 1 serving
• 3 servings
• 5 servings
• 7 servings

35. Alone, metformin does not cause hypoglycaemia (low blood sugar). However, in rare cases, you may develop hypoglycaemia if you combine metformin with:

• a poor diet
• strenuous exercise
• excessive alcohol intake
• other diabetes medications
• all of the above

36. Sharp debridement may cause trauma to underlying structures, the procedure should only be carried out by:

• A health care assistant on working full time
• A qualified nurse with at least 3 years experience
• A doctor of any type of speciality
• A qualified healthcare professional with appropriate training

37. A client with frequent urinary tract infections asks the nurse how she can prevent the reoccurrence. The nurse should teach the client to:

• Douche after intercourse
• Void every three hours
• Obtain a urinalysis monthly
• Wipe from back to front after voiding

38. 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?

• Inoculate the aerobic culture first
• Take the other blood tests first.
• Inoculate the anaerobic culture first.
• The order does not matter as long as the bottles are clean

39. A normal sign of aging in the renal system is

• Intermittent incontinence
• Concentrated urine
• Microscopic hematuria
• A decreased glomerular filtration rate

40. How do we handle a specimen container labelled with a yellow hazard sticker?

• Wear gloves and apron and inform the laboratory that you are sending the specimen.
• Wear gloves and apron, mark it high risk and send the specimen to the laboratory with your other specimens
• Wear gloves and apron, Inform the infection control team and complete a datix form.
• Wear gloves and apron, place specimen in a blue bag & complete a datix form.

41. A patient is prescribed methformin 1000mg twice a day for his diabetes. While taking with the patient he states “I never eat breakfast so I take % 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:

• Tell him he has made a good decision and to continue
• Tell him to take a whole tablet with lunch and with supper
• Tell him to skip the morning dose and just take the dose at supper
• Tell him to take one tablet in the morning and one tablet in the evening as ordered.

42. How should be the surrounding area of a patient with dementia?

• Increased stimuli
• Creative environment
• Restrict activities

43. When should a penile sheath be considered as a means of managing incontinence?

• When other methods of continence management have failed
• Following the removal of a catheter
• When the patient has a small or retracted penis
• When a patient requests it

44. What medications would most likely increase the risk for fall?

• Loop diuretic
• Hypnotics
• Betablockers
• Nsaid

45. 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?

• “you know you don’t work in construction anymore”
• “What type of motion did you do to precipitate this soreness?”
• “You’re 76 years old & you’ve been here all day. You don’t work in construction anymore.”
• “Would you like me to rub your back for you?”

46. Which of the following is a guiding principle for the nurse in distinguishing mental disorders from the expected changes associated with aging

• A competent clinician can readily distinguish mental disorders from the expected changes associated with aging
• Older people are believed to be more prone to mental illness than young people
• The clinical presentation of mental illness in older adults differs form that in other age groups
• When physical deterioration becomes a significant feature of an elder’s life, the risk of comorbid psychiatric illness arises.

47. Common signs and symptoms of a hypoglycaemia exclude:

• Feeling hungry
• Sweating
• Anxiety or irritability
• Blurred vision
• Ketoacidosis

48. What are the contraindications for the use of the blood glucose meter for blood glucose monitoring?

• The patient has a needle phobia and prefers to have a urinalysis.
• If the patient is in a critical care setting, staff will send venous samples to the laboratory for verification of blood glucose level.
• If the machine hasn't been calibrated
• If peripheral circulation is impaired, collection of capillary blood is not advised as the results might not be a true reflection of the physiological blood glucose level.

49. What would make you suspect that a patient in your care had a urinary tack infection?

• 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
• The doctor has requested a midstream urine specimen
• The patient has a urinary catheter in situ & the patient's wife states that he seems more forgetful than usual
• The patient has complained of frequency of faecal elimination & hasn't been drinking enough

50. The client at greatest risk for postoperative wound infection is:

• A 3 month old infant postoperative from pyloric stenosis repair
• A 78 year old postoperative from inguinal hernia repair
• A 18 year old drug user postoperative from removal of a bullet in the leg
• A 32 year old diabetic postoperative from an appendectomy