2. Mr Smith’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 Smith?
allow her to visit and use alcohol gel before contact with him
visit him when she feels better
visit him when she is symptom free after 48 hours
allow her to visit only during visiting times only
3. One of the government initiative in promoting good healthy living is eating the right and balanced food. Which of the following can achieve this?
24/7 exercise programme
5-a-day fruits and vegetable portions
low calorie diet
high protein diet
4. 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?
The feed
An infection
Food poisoning
Being in hospital
5. The client reports nausea and constipation. Which of the following would be the priority nursing action?
Complete an abdominal assessment
Administer an anti-nausea a medication
Notify the physician
Collect a stool sample
6. 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?
Tell her to abstain from having sex because of HIV
Tell her to bring lots of contraceptives because it will be expensive
Tell her to use other methods like condom because diarrhoea lessens the effects of OCP
tell her to continue taking her usual contraceptives
7. 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”
The fluid output has exceeded the input
The doctor may consider increasing the IV drip rate
The fluid balance chart can be stopped as “positive” means “good”
The fluid input has exceeded the output
8. What is the use of protected meal time?
Patient get protection from visitors
Staff get enough time to have their bank
To give personal hygiene to patients who are confused
Patients get enough time to eat food without distractions while staff focus on people who needs help with eating
9. Constipation needs to be sort out during:
planning
assessment
implementation
evaluation
10. In Spinal cord injury patients, what is the most common cause of autonomic dysreflexia (a sudden rise in blood pressure)?
Bowel obstruction
Fracture below the level of the spinal lesion
Pressure sore
Urinary obstruction
11. What may not be cause of diarrheoa?
colitis
intestinal obstruction
food allergy
food poisoning
12. How can patients who need assistance at meal times be identified?
A red sticker
A colour serviette
A red tray
Any of the above
13. What does ‘muscle atrophy’ mean?
Loss of muscle mass
A change in the shape of muscles
Disease of the muscle
14. Patient is post of repair of tibia and fibula possible signs of compartment syndrome include
Numbness and tingling
Cool dusky toes
Pain
Toes swelling
All of the above
15. 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
Ask her husband about the bruises
Ask her son/ daughter to translate
Arrange for interpreter to ask questions in private
Do not carry any assessment and document this is not possible as the client cannot speak English
16. 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?
Take a deep breath, hold it, & bear down
Breathe normally
Exhale slowly & evenly
Turn the head to the right
17. 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
Gastro enterologist
Dietitian
Family doc of patient
Physio
18. Which check do you need to carry out every time before setting up a routine enteral feed via a nasogastric tube?
That when flushed with red juice, the red juice can be seen when the tube is aspirated
That air cannot be heard rushing into the lungs by doing the ‘whoosh test’.
That the pH of gastric aspirate is <4, and the measurement on the NG tube is the same length as the time insertion
abdominal x-ray
19. What is the best way to prevent a patient who is receiving an enteral feed from aspirating?
Lie them flat.
Sit them at least at a 45° angle.
Tell them to lie on their side.
Check their oxygen saturations.
20. 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 PGD can be delegated to student nurse who can administer medication with supervision
PGD’s cannot be delegated to anyone
This type of prescription is not made under PGD
This can be delegated to another RN who can administer in view of a competent person
21. Which check do you need to carry out before setting up an enteral feed via a nasogastric tube?
That when flushed with red juice, the red juice can be seen when the tube is aspirated.
That air cannot be heard rushing into the lungs by doing the whoosh test
That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is the same length as the time insertion.
That pH of gastric aspirate is >6.0, and the measurement on the NG tube is the same length as the time insertion
22. Signs of denture related stomatitis
whiteness on the tongue
patches of shiny redness on the cheek and tongue
patches of shiny redness on the palette and gums
patches of shiny redness on the tongue
23. 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?
An infection
Food poisoning
Being in hospital
The feed
24. A patient is recovering from surgery has been advanced from a clear diet to a full liquid diet. The patient is looking forward to the diet change because he has been "bored" with the clear liquid diet. The nurse should offer which full liquid item to the patient
Custard
Black Tea
Gelatin
Ice pop
25. Approximately how many people in the UK are malnourished?
1 million
3 million
5 million
7 million
26. What specifically do you need to monitor to avoid complications & ensure optimal nutritional status in patients being enterally fed?
Daily urinalysis, ECG, Protein levels and arterial pressure
Assess swallowing, patient choice, fluid balance, capillary refill time
Eye sight, hearing, full blood count, lung function and stoma site
Blood glucose levels, full blood count, stoma site and body weight
27. Carpal tunnel syndrome is caused by compression of which nerve:
Median nerve
Axillary nerve
Ulnar nerve
Radial nerve
28. According to recent UK research, what is the recommended amount of vegetables and fruits to be consumed per day?
3 portions per serving
5 portions per serving
7 portions per serving
4 portions per serving
29. Which of the following is not a cause of gingival bleeding?
Vigorous brushing of teeth
Intake of blood thinning medications (warfarin, aspirin, and heparin)
Vitamin deficiency (Vitamins C and K)
Lifestyle
30. Approximately how long is the spinal cord in an adult?
30 cm
45 cm
60 cm
120 cm
31. 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?
Protein shakes/supplements
Energy drink
Mixed fat and glucose polymer solutions/powder
Sip feed
32. 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?
Feeding via Radiologically inserted Gastostomy (RIG)
Nasogastric tube feeding
Feeding via a Percutaneous Endoscopic Gastrostonomy (PEG)
Continue oral
33. Which of the following medications are safe to be administered via a naso gastric tube?
Drugs that can be absorbed via this route, can be crushed and given diluted or dissolved in 10-15 ml of water
Enteric-coated drugs to minimize the impact of gastric irritation
A cocktail of all medications mixed together, to save time and prevent fluid over loading the patient
Any drugs that can be crushed
34. Obesity is one of the main problem, what might cause this?
supermarket
unequality
low economic class
35. What is the best way to prevent who is receiving an enteral feed from aspirating?
Lie them flat
Sit them at least 45-degree angle
Tell them to lie in their side
Check their oxygen saturations
36. Steve, 46 years old is of Jewish descent. As his nurse, how will you plan his dietary needs?
Assume he strictly needs Jewish food
Ask relatives to bring food from kosher market
Ask a rabbi to help you plan
Ask the patient about his diet preferences
37. What specifically do you need to monitor to avoid complications and ensure optimal nutritional status in patients being enterally fed?
Blood glucose levels, full blood count, stoma site and bodyweight
Eye sight, hearing, full blood count, lung function and stoma site
Assess swallowing, patient choice, fluid balance, capillary refill time
Daily urinalysis, ECG, protein levels and arterial pressure
38. During enteral feeding in adults, at what degree angle should the patient be nursed at to reduce the risk of reflux and aspiration?
25
35
45
55
39. 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
40. Which of the following is no longer a recommended method of mouth care?
Chlorhexidine solution and foam sticks
Sodium bicarbonate
Normal saline mouth wash
Glycerine and lemon swabs
41. An overall risk of malnutrition of 2 or higher signifies:
Low risk of malnutrition
Medium risk of malnutrition
High risk of malnutrition
42. A patient is to be subjected for surgery but the patient’s BMI is low. Where will you refer the patient?
Speech and Language Therapist
Dietitian
Chef
Family member
43. How do you test the placement of an enteral tube?
Monitoring bubbling at the end of the tube
Testing the acidity/alkalinity of aspirate using blue litmus paper
Interpreting absence of respiratory distress as an indicator of correct positioning
Have an abdominal x-ray
44. If a patient requires protective isolation, which of the following should you advise them to drink?
Filtered water only
Fresh fruit juice and filtered water
Bottled water and tap water
Long-life fruit juice and filtered water
45. How do the structures of the human body work together to provide support and assist in movement?
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.
The muscles provide a structural framework and are moved by bones to which they are attached by ligaments.
The skeleton provides a structural framework; this is moved by ligaments that stretch and contract.
The muscles provide a structural framework, moving by contracting or extending, crossing at least one joint and attached to the articulatingbones.
46. 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?
Assess neurovascular status to the hand
Ask the client to massage the fingers
Encourage the client to take the prescribed analgesic
Elevate the arm on a pillow to reduce oedema
47. Which of the following Is not a cause of gingival bleeding?
Lifestyle
Vitamin deficiency (Vitamin C and K)
Vigorous brushing of teeth
Intake of blood thinning medication (warfarin, asprin, and heparin)
48. A patient develops gingivitis after using an artificial denture. It is characterized by
White patches on tongue
Red shiny patches on tongue
Red shiny patches around the palate of tooth
49. Perdue (2005) categorizes constipation as primary, secondary or latrogenic. What could be some of the causes of latrogenic constipation?
Inadequate diet and poor fluid intake.
Anal fissures, colonic tumours or hypercalcaemia.
Lifestyle changes and ignoring the urge to defaecate.
Antiemetic or opioid medication
50. Patient has tibia fibula fracture. Which one of the following is not a symptom of compartment syndrome
Pain not subsiding even after giving epidural analgesia