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NMC CBT Mock Test 7:

1. What is the most accurate method of calculating a respiratory rate?

• Counting the number of respiratory cycles in 15 seconds and multiplying by 4.
• Counting the number of respiratory cycles in 1 minute. One cycle is equal to the complete rise and fall of the patient's chest.
• Not telling the patient as this may make them conscious of their breathing pattern and influence the accuracy of the rate.
• Placing your hand on the patient's chest and counting the number of respiratory cycles in 30 seconds and multiplying by 2

2. What is respiration?

• the movement of air into and out of the lungs to continually refresh the gases there, commonly called ‘breathing’
• movement of oxygen from the lungs into the blood, and carbon dioxide from the lungs into the blood, commonly called ‘gaseous exchange’
• movement of oxygen from blood to the cells, and of carbon dioxide from the cells to the blood
• the transport of oxygen from the outside air to the cells within tissues, and the transport of carbon dioxide in the opposite direction.

3. What should be included in a prescription for oxygen therapy?

• You don't need a prescription for oxygen unless in an emergency.
• The date it should commence, the doctor's signature and bleep number.
• The type of oxygen delivery system, inspired oxygen percentage and duration of the therapy.
• You only need a prescription if the patient is going to have home oxygen

4. 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?

• It is especially dangerous to the patient's health to smoke while using oxygen
• Oxygen is highly flammable and there is a risk of fire
• Oxygen and cigarette smoke can combine to produce a poisonous mixture
• Oxygen can lead to an increased consumption of cigarette

5. Why is it essential to humidify oxygen used during respiratory therapy?

• 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.
• 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.
• Humidification cleans the oxygen as it is administered to ensure it is free from any aerobic pathogens before it is inhaled by the patient.

6. 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
• Dietician
• Chef
• Family member

7. A client breathes shallowly and looks upward when listening to the nurse. Which sensory mode should the nurse plan to use with this client?

• Touch
• Auditory
• Kinesthetic
• Visual

8. 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?

• Help client into the chair but more quickly
• Document client’s vital signs taken just prior to moving the client
• Help client back to bed immediately
• Observe clients skin color and take another set of vital signs

9. Respiratory protective equipment include:

• gloves
• mask
• apron
• paper towels

10. 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?

• Ask the wife to give him fluid, and enquire about his fluid preferences and usual drinking time
• Tell her to wait and you need some time to make him drink
• Inform doctor to start iv fluids to prevent dehydration

11. 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?

• Oximeters may be unreliable under certain circumstances, e.g. if tissue perfusion is poor, if the environment is cold and if the patient's nails are covered with nail polish.
• Arterial blood gases should be sampled if the patient is receiving >60% oxygen.
• Pulse oximeters provide excellent evidence of oxygenation, but they do not measure the adequacy of ventilation.
• Arterial blood gases measure both oxygen and carbon dioxide levels and therefore give an indication of both ventilation and oxygenation

12. Signs of denture-related stomatitis include all except:

• Redness underneath the area where the dentures are placed
• Red sores at the corners of lips or on the roof of the mouth
• Presence of white patches inside the mouth
• Gingivitis

13. How many cups of fluid do we need every day to keep us well hydrated?

• 1 to 2
• 2 to 4
• 4 to 6
• 6 to 8

14. Which of the following indicates signs of severe Chronic Obstructive Pulmonary disease (COPD)?

• high p02 and high pC02
• Low p02 and low pC02
• low p02 and high pC02
• high p02 and low pC02

15. 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

16. 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.

• Oxygen therapy
• Breathing exercise
• Cessation of smoking
• coughing exercise

17. 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?

• There should be 48 hours after active symptoms should disappear prior to visiting patient
• Inform relative it is fine to visit mother as long as she uses alcohol before entering ward premises

18. What percentage of the air we breath is made up of oxygen?

• 16%
• 21%
• 26%
• 31%

19. What do you need to consider when helping a patient with shortness of breath sit out in a chair?

• 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
• 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
• 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.
• 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 below 20 degree Celsius

20. If a patient is prescribed nebulizers, what is the minimum flow rate in litres per minute required?

• 2-4
• 4-6
• 6-8
• 8-10

21. In normal breathing, what is the main muscle(s) involved in inspiration?

• The diaphragm
• The lungs
• the intercostal
• All of the above

22. 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?

• Sitting upright at 30 to 45°
• Sitting upright at 60 to 75°
• Sitting upright at 45 to 60
• Sitting upright at 75 to 90°

23. What do you expect patients with COPD to manifest?

• Inc Pco2, dec 02
• Dec Pco2, inc o2
• Inc pco2, inc o2
• Dec pco2, dec o2

24. 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?

• Ask the patient the assistance he needs
• delegate someone to feed him
• ask the relatives to assist in feeding him
• look for volunteer to assist with his needs

25. When using nasal cannulae, the maximum oxygen flow rate that should be used is 6 litres/min. Why?

• Nasal cannulae are only capable of delivering an inspired oxygen concentration between 24% and 40%.
• 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.
• Higher rates can cause nasal mucosal drying and may lead to epistaxis.
• If oxygen is administered at greater than 40% it should be humidified. You cannot humidify oxygen via nasal cannulae

26. 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?

• Potassium
• Chloride
• Sodium
• Magnesium

27. What should be included in your initial assessment of your patient's respiratory status?

• Review the patient's notes and charts, to obtain the patient's history.
• Review the results of routine investigations.
• Observe the patient's breathing for ease and comfort, rate and pattern.
• check for any drains
• all of the above

28. A patient under u developed shortness of breath while climbing stairs. U inform this to the doctor. This response is interpreted ass:

• Breaching of patients confidentiality
• Essential, as it is the matter of patient’s health

29. The human body is made up of approximately what proportion of water?

• 50%
• 60%
• 70%
• 80%

30. If your patient is having positive balance. How will you find out dehydration is balanced?

• Input exceeds output
• Output exceeds input
• Optimally hydrated
• Optimally dehydrated

31. A patient had been suffering from severe diarrheoa and is now showing signs of dehydration. Which of the following is not a classic symptom?

• passing small amounts of urine frequently
• dizziness or light-headedness
• dark-coloured urine
• thirst

32. Causes of gingival bleeding

• poor removal plaque
• poor flossing
• poor nutrition
• poor taking of drugs

33. Signs and symptoms of early fluid volume deficit, except.

• Decreased urine output
• Decreased pulse rate
• Concentrated urine
• Decreased skin turgor

34. Which of the following is not normally considered to be a high risk fluid?

• Cerebrospinal fluid
• Urine
• Peritoneal fluid
• Semen
• All of the above

35. As a nurse, what health teachings will you give to a COPD patient?

• Encourage to stop smoking
• Administer oxygen inhalation as prescribed
• Enroll in a pulmonary rehabilitation programme
• All the above

36. A patient is admitted to the ward with symptoms of acute diarrhoea. What should your initial management be?

• Assessment, protective isolation, universal precautions.
• Assessment, source isolation, antibiotic therapy.
• Assessment, protective isolation, antimotility medication.
• Assessment, source isolation, universal precautions

37. The client reports nausea and constipation. Which of the following would be the priority nursing action?

• Collect a stool sample
• Complete an abdominal assessment
• Administer an anti-nausea medication
• Notify the physician

38. Patient is in for oxygen therapy

• A prescription is required including route, method and how long
• No prescription is required unless he will use it at home.
• Prescription not required for oxygen therapy

39. Position to make breathing effective?

• left lateral
• Supine
• Right Lateral
• High sidelying

40. A nurse is not allowing the client to go to bed without finishing her meal. What is your action as a RN?

• Do nothing as client has to finish her meal which is important for her health
• Challenge the situation immediately as this is related to dignity of the patient and raise your concern
• Do nothing as patient is not under your care
• Wait until the situation is over and speak to the client on what she wants to do

41. What should be included in your initial assessment of your patients respiratory status?

• Review the patients notes and charts, to obtain the patients history.
• Review the results of routine investigations.
• Observe the patients breathing for ease and comfort, rate and pattern.
• Perform a systematic examination and ask the relatives for the patient’s history.

42. What is positive fluid balance?

• A deficit in fluid volume.
• A state when fluid intake is greater than output.
• Retention of both electrolytes and water in proportion to the levels in the extracellular fluid.
• A state where the body has less water than it needs to function properly.

43. 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?

• Deliver the food tray to the client
• Call the dietary department and ask for a new meal tray
• Replace the whole milk with fat free milk
• Ask the dietary department to replace the roast beef with pork

44. What do you expect to manifest with fluid volume deficit?

• Low pulse, Low Bp
• High pulse, High BP
• High Pulse, low BP
• Low Pulse, high BP

45. 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 input has exceeded the output
• The fluid balance chart can be stopped as "positive" means "good"
• The doctor may consider increasing the IV drip rate
• The fluid output has exceeded the input

46. 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

• Call the emergency service.
• Give Oramorph 5mg medications as prescribed.
• Ask the patient to calm down.
• Increase the flow of oxygen to 5 L

47. If a patient is experiencing dysphagia, which of the following investigations are they likely to have?

• Colonoscopy
• Gastroscopy
• Cystoscopy
• Arthroscopy

48. 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?

• Simple semi rigid plastic masks
• Nasal cannulas
• Venture high flow mask
• Non-rebreathing masks

49. A COPD patient is about to be discharged from the hospital. What is the best health teaching to provide this patient?

• Increase fluid intake
• Do not use home oxygen
• Quit smoking
• nebulize as needed

50. Which of the following is NOT a cause of Type 1 (hypoxaemic) respiratory failure?

• Asthma
• Pulmonary oedema
• Drug overdose
• Granulomatous lung disease