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