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NMC CBT Mock Test 5:

1. The nurse should consider performing preparatory exercises on which muscle to prevent flexion or buckling during crutch walking?

• Shoulder depressor muscles
• Forearm extensor muscles
• Wrist extensor muscles
• Finger & thumb flexor muscles

2. 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?

• Raise your voice until the patient is able to hear you.
• Face the patient and speak quickly using a high voice.
• Face the patient and speak slowly using a slightly lowered voice.
• Use facial expressions and speak as you would formally

3. What is not included in the care package in a nursing home?

• Laundry
• Food
• Nursing Care
• Social Activities

4. 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?

• Raise a safeguarding alert
• Just listen but don't do anything
• Ignore the old man, he is just having delusions
• Refer the old man to the community clergy who is giving him spiritual support

5. 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?

• 10 inches
• 16 inches
• 9 inches
• 5 inches

6. Which is not an appropriate way to care for patients with Dementia/Alzheimer’s?

• Ensure people with dementia are excluded from services because of their diagnosis, age, or any learning disability.
• Encourage the use of advocacy services and voluntary support
• Allow people with dementia to convey information in confidence.
• Identify and wherever possible accommodate preferences (such as diet, sexuality and religion).

7. 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?

• Swing to gait
• Three point gait
• Four point gait
• Swing through gait

8. 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?

• ‘The hand opposite to the affected extremity holds the cane to widen the base of support & to reduce stress on the affected limb.’
• as the cane is advanced, the affected leg is also moved forward at the same time’
• ‘when the unaffected extremity begins the swing phase, the client should bear down on the cane’
• To go up the stairs, place the cane & affected extremity down on the step. Then step down the unaffected extremity’

9. Proper technique to use walker<zimmers frame>

• move 10 feet, take small steps
• move 10 feet, take large wide steps
• move 12 feet
• transform weight to walker and walk

10. A patient with dementia is mourning and pulling the dress during night what do you understand from this?

• Patient is incontinent
• Patient is having pain
• Patient has medication toxicity.

11. 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

• Discuss with the manager that task oriented nursing may ruin the holistic care that we provide here in this tertiary level.
• Ask the manager to re-consider the time bound, make sure that all staffs are informed about task oriented nursing care

12. Why should healthcare professionals take extra care when washing and drying an elderly patients skin?

• As the older generation deserve more respect and tender loving care (TLC).
• 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.
• All elderly people lose dexterity and struggle to wash effectively so they need support with personal hygiene.
• 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.

13. Why is pyrexia not evident in the elderly?

• Due to lesser body fat
• Due to immature T cells
• Due to aged hypothalamus
• Due to biologic changes

14. When using crutches, what part of the body should absorb the patient’s weight?

• Armpits
• Hands
• Back
• Shoulders

15. What should be taught to a client about use of zimmer frame

• move affected leg first
• move unaffected leg
• move both legs together

16. Elise 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?

• Malnutrition
• Hyperglycemia
• Dehydration
• Hypoglycaemia

17. In the context of assessing risks prior to moving and handling, what does T-l-L-E stand for?

• Task - individual - lift - environment
• Task - intervene - load - environment
• Task - intervene - load - equipment
• Task - individual - load - environment

18. A client is ambulating with a walker. The nurse corrects the walking pattern of the patient if he does which of the following?

• The patient walks first & then lifts the walker
• The walker is held on the hand grips for stability
• The patient’s body weight is supported by the hands when advancing his weaker leg.
• All of these

19. Mr Smith also shared with you that his gums also bleed during brushing. Which of the following statement will best explain this?

• lack of vitamin C in his diet
• he is brushing too hard
• he is not using proper toothbrush to remove the plaque
• he is flossing wrongly

20. Mr Smith, 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?

• redness of soft palate and tissues surrounding the teeth
• haemo-serous discharges around the gums
• loosening of teeth
• presence of pockets deep in the gums

21. Why is pyrexia not always evident in the elderly?

• Due to immature T cells
• Due to mature T cells
• Due to immature D cells
• Due to mature D cells

22. What is the most common cause of hypotention in elderly?

• Decreased response in adrenaline & noradrenaline
• Atheroma changes in vessel walls
• hyperglycaemia
• Age

23. 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?

• Bed rest
• Lack of exercise
• Incorrect bed positioning
• Bedding weight that forces the toes into plantar flexion

24. In going up the stairs with crutches, the nurse should instruct the patient to:

• Advance the stronger leg first up to the step then advance the crutches & the weaker extremity.
• Advance the crutches to the step then the weaker leg is advanced after. The stronger leg then follows.
• Advance both crutches & lift both feet & swing forward landing next to crutches.
• Place both crutches in the hand on the side of the affected extremity

25. 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?

• He will be at high risk of developing a pressure ulcer so place him on a pressure relieving mattress
• 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.
• 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
• 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.

26. To promote stability for a patient using walkers, the nurse should instruct the patient to place his hands at:

• The sides of the walker
• The hips
• The hand grips
• The tips

27. Which layer of the skin contains blood and lymph vessels. Sweat and sebaceous glands?

• Epidermis
• Dermis
• Subcutaneous layer
• All of the above

28. Which of the following displays the proper use of Zimmer frame?

• using a 1 point gait
• using a 2 point gait
• using a 3 point gait
• using a 4 point gait

29. 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?

• Refer her to the physiotherapist & provide her with lots of reassurance as she has lost a lot of confidence recently
• 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
• 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
• Refer her to the community falls team who will asses her when she gets home

30. 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)?

• 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
• Make sure that she is fitted with properly fitting antiembolic stockings & that are removed daily
• Ensure that she is wearing antiembolic stockings & that she is prescribed prophylactic anticoagulation & is doing hourly limb exercises
• 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

31. Nurses assume responsibility on patient with cane. Which of the following is the nurse’s topmost priority in caring fora patient with cane?

• Mobility
• Safety
• Nutrition
• Rest periods

32. Why are elderly prone to postural hypotension? Select which does not apply:

• The baroreflex mechanisms which control heart rate and vascular resistance decline with age.
• Because of medications and conditions that cause hypovolaemia.
• Because of less exercise or activities.
• Because of a number of underlying problems with BP control.

33. After instructing the client on crutch walking technique, the nurse should evaluate the client's understanding by using which of the following methods?

• Have client explain produce to the family
• Achievement of 90 on written test
• Explanation
• Return demonstration

34. Why constipation occurs in old age?

• Anorexia and weight loss
• Decreased muscle tone and periatalsis
• Increased mobility
• Increased absorption in colon

35. 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?

• Confront the neighbour
• Ignore, maybe he is very old and does not think clearly
• Fill up a raising a concern/ safeguarding form, and escalate
• ask patient to report neighbour to police

36. Nurse is teaching patient about crutch walking which is incorrect?

• Take long strides
• Take small strides
• Instruct to put weight on hands

37. Olivia, 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 olivia’s condition?

• She cant adjust without her husband
• Late grievance with signs of dementia
• Alzheimers with delirium

38. What is abduction?

• Division of the body into front and back
• Movement of a body parts towards the body’s midline
• Division of the body into left and right
• Movement of body part away from the body’s midline

39. The most advanced gait used in crutch walking is:

• Four point gait
• Three point gait
• Swing to gait
• Swing through gait

40. 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?

• urinary tract infection leading to delirium
• delayed grieving with dementia

41. The nurse should adjust the walker at which level to promote safety & stability?

• Knee
• Hip
• Chest
• Armpit

42. What is the clinical benefit of active ankle movements?

• To assist with circulation
• To lower the risk of a DVT
• To maintain joint range
• All of the above

43. The patient can be selected with a crutch gait depending on the following apart from:

• Patient’s physical condition
• Arm & truck strength
• Body balance
• Coping mechanism

44. 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:

• Left leg and right crutch then right leg and left crutch
• Crutches and then both legs simultaneously
• Crutches and the right leg then advance the left leg
• Crutches and the left leg then advance the right leg

45. Which of the following is a sign of dehydration in the elderly?

• diminished skin turgor
• hypertension
• anxiety attacks
• pyrexia

46. Nancy, an elderly patient with dementia, wishes to go out of the hospital. What will be you appropriate action?

• Call the police, make sure she does not leave
• Encourage the patient to stay for his well being
• Inform the police to arrest the patient
• Allow her to leave, she is stable and not at risk of anything

47. What are the principles of communicating with a patient with delirium?

• Use short statements and closed questions in a well lit, quiet, familiar environment.
• Use short statements and open questions in a well lit, quiet, familiar environment
• Write down all questions for the patient to refer back to.
• Communicate only through the family using short statements and closed questions.

48. What is an intermediate care home?

• It is the day-to-day health care given by a health care provider.
• It includes a range of short-term treatment or rehabilitative services designed to promote independence.
• It is a system of integrated care.
• It is a means of organising work, that is patient allocation.

49. 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?

• Explain this is a restrain. Urgently call for a safe guarding and arrange a multi­ disciplinary team conference
• Do nothing as this is the best way of keeping him safe
• Call police, social services to remove client immediately and refer to safeguarding
• Explain this is a restrain and discuss other possible options

50. Conditions producing orthostatic hypotension in the elderly:

• Aortic stenosis
• Arrhythmias
• Diabetes
• Pernicious anaemia
• Advanced heart failure
• All of the above