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NMC CBT Mock Test 8:

1. Safe moving and handling of an anaesthetized patient is imperative to reduce harm to both the patient and staff. What is the minimum number of staff required to provide safe manual handling of a patient in theatre?

• 3 (1 either side, 1 at head).
• 5 (2 each side, 1 at head).
• 4 (1 each side, 1 at head, 1 at feet).
• 6 (2 each side, 1 at head, 1 at feet).

2. An 18 year old 26 week pregnant woman who uses illicit drugs frequently, the factors in risk for which one of the following:

• Spina bifida
• Meconium aspiration
• Pneumonia
• Teratogenicity

3. A patient has just returned to the unit from surgery. The nurse transferred him to his bed but did not put up the side rails. The patient fell and was injured. What kind of liability does the nurse have?

• None
• Negligence
• Intentional tort
• Assault and battery

4. What serious condition is a possibility for patients positioned in the Lloyd Davies position during surgery?

• Stroke
• Cardiac arrest
• Compartment syndrome
• There are no drawbacks to the Lloyd Davies position

5. Gurgling sound from airway in a postoperative client indicates what

• Complete obstruction of lower airway
• Partial obstruction of upper airway
• Common sign of a post-operative patient

6. You are the nurse assigned in recovery room or post anaesthetic care unit. The main priority of care in such area is:

• Keeping airway intact
• keeping patient pain free
• keeping neurological condition stable
• keeping relatives informed of patient’s condition

7. Now the medical team encourages early ambulation in the post-operative period, which complication is least prevented by this?

• Tissue wasting
• Thrombophlebitis
• Wound infection
• Pneumonia

8. What are the principles of gaining informed consent prior to a planned surgery?

• Gaining permission for an imminent procedure by providing information in medical terms, ensuring a patient knows the potential risks and intended benefits.
• Gaining permission from a patient who is competent to give it, by providing information, both verbally and with written material, relating to the planned procedure, for them to read on the day of planned surgery.
• Gaining permission from a patient who is competent to give it, by informing them about the procedure and highlighting risks if the procedure is not carried out.
• Gaining permission from a patient who is competent to give it, by providing information in understandable terms prior to surgery, allowing time for answering questions, and inviting voluntary participation.

9. When an oropharyngeal airway is inserted properly, what is the sign

• Airway obstruction
• Retching and vomiting
• Bradycardia
• Tachycardia

10. What is right in case of consent among children under 18.

• Only children between 16-18 are competent to give it.
• Parents are responsible to give consent with children
• Children who are intellectually developed and understand matters can give consent

11. A patient is scheduled to undergo an Elective Surgery. What is the least thing that should be done?

• Assess/Obtain the patient’s understanding of, and consent to, the procedure, and a share in the decision making process.
• Ensure pre-operative fasting, the proposed pain relief method, and expected sequelae are carried out anddiscussed.
• Discuss the risk of operation if it won’t push through.
• The documentation of details of any discussion in the anaesthetic record.

12. Recommended preoperative fasting times are:

• 2-4 hours
• 6-12 hours
• 12-14 hours

13. You are looking after a postoperative patient and when carrying out their observations, you discover that they are tachycardic and anxious, with an increased respiratory rate. What could be happening? What would you do?

• The patient is showing symptoms of hypovolaemic shock. Investigate source of fluid loss, administer fluid replacement and get medical support.
• The patient is demonstrating symptoms of atelectasis. Administer a nebulizer, refer to physiotherapist for assessment.
• The patient is demonstrating symptoms of uncontrolled pain. Administer prescribed analgesia, seek assistance from medical team.
• The patient is demonstrating symptoms of hyperventilation. Offer reassurance, administer oxygen

14. Your patient has bronchitis and has difficulty in clearing his chest. What position would help to maximize the drainage of secretions?

• Lying on his side with the area to be drained uppermost after the patient has had humidified air
• Lying flat on his back while using a nebulizer
• Sitting up leaning on pillows and inhaling humidified oxygen
• Standing up in fresh air taking deep breaths

15. An adult has been medicated for her surgery. The operating room (OR) nurse, when going through the client's chart, realizes that the consent form has not been signed. Which of the following is the best action for the nurse to take?

• Assume it is emergency surgery & the consent is implied
• Get the consent form & have the client sign it
• Tell the physician that the consent form is not signed
• Have a family member sign the consent form

16. When do you gain consent from a patient and consider it valid?

• Only if a patient has the mental capacity to give consent
• Only before a clinical procedure
• None of the above

17. You are caring for a 17 year old woman who has been admitted with acute exacerbation of asthma. Her peak flow readings are deteriorating and she is becoming wheezy. What would you do?

• Sit her upright, listen to her chest and refer to the chest physiotherapist.
• Suggest that the patient takes her Ventolin inhaler and continue to monitor the patient.
• Undertake a full set of observations to include oxygen saturations and respiratory rate. Administer humidified oxygen, bronchodilators, corticosteroids and antimicrobial therapy as prescribed.
• Reassure the patient: you know from reading her notes that stress and anxiety often trigger her asthma.

18. You went back to see Mr Bond who is 1 day post-herniorraphy. As you approach him he complained of difficulty of breathing with respiration rate of 23 breaths per minute and oxygen saturation 92% in room air. What is your next action to help him?

• give him oxygen
• give him pain relief
• give him antibiotics
• give him nebulisers

19. A client diagnosed of cancer visits the OPD and after consulting the doctor breaks down in the corridor and begins to cry. What would the nurses best action?

• Ignore the client and let her cry in the hallway
• Inform the client about the preparing to come forth next appointment for further discussion on the treatment planned
• Take her to a room and try to understand her worries and do the needful and assist her with further information if required
• Explain her about the list of cancer treatments to survive

20. Who should mark the skin with an indelible pen ahead of surgery?

• The nurse should mark the skin in consultation with the patient
• A senior nurse should be asked to mark the patient's skin
• The surgeon should mark the skin
• It is best not to mark the patient's skin for fear of distressing the patient.

21. Which is the safest and most appropriate method to remove hair pre- operatively?

• Shaving
• Clipping
• Chemical removal
• Washing

22. 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

23. The signs and symptoms of ectopic pregnancy except:

• Vaginal bleeding
• Positive pregnancy test
• Shoulder tip pain
• Protein excretion exceeds 2 g/day

24. Reason for dyspnoea in patients who diagnosed with Glomerulonephritis patients?

• Albumin loss increase oncotic pressure causes water retention in cells
• Albumin loss causes decrease in oncotic pressure causes water retention causing fluid retention I alveoli
• Albumin loss has no effect on oncotic pressure

25. A patient doesn’t sign the consent for mastectomy. But bystanders strongly feel that she needs surgery.

• Allow family members to take decision on behalf of patient
• Doc can proceed with surgery, since it is in line with the best interest and outcome
• Respect patients decision. She has the right to accept or deny

26. If a client is experiencing hypotension post operatively, the head is not tilted in which of the following surgeries

• Chest surgery
• Abdominal surgery
• Gynaecological surgery
• Lower limb surgery

27. Which of these is not a symptom of an ectopic pregnancy?

• Pain
• Bleeding
• Vomiting
• Diarrhoea

28. What is not a sign of meconium aspiration

• Floppy in appearance
• Apnoea
• Crying

29. Common minor disorder in pregnancy?

• abdominal pain
• heart burn
• headache

30. A patient is assessed as lacking capacity to give consent if they are unable to:

• Understand information about the decision and remember that information
• Use that information to make a decision
• Communicate their decision by talking, using sign language or by any other means
• All the above

31. How soon after surgery is the patient expected to pass urine?

• 1-2 hours
• 2-4 hours
• 4-6 hours
• 6-8 hours

32. Postpartum haemorrhage: A patient gave birth via NSD. After 48 hours, patient came back due to bleeding, bleeding after birth is called post partum haemorrhage. What type?

• primary postpartum haemorrhage
• secondary postpartum haemorrhage
• tertiary postpartum haemorrhage
• lochia

33. What does assessing for no refusal means?

• That the person has not already refused treatment
• That the person cannot or is unable to refuse treatment
• That the person does not already have an advanced decision
• The person is already detained/ being treated under the mental health act.

34. The night after an exploratory laparotomy, a patient who has a nasogastric tube attached to low suction reports nausea. A nurse should take which of the following actions first?

• Administer the prescribed antiemetic to the patient.
• Determine the patency of the patient's nasogastric tube.
• Instruct the patient to take deep breaths.
• Assess the patient for pain

35. A patient has just returned from theatre following surgery on their left arm. They have a PCA infusion connected and from the admission, you remember that they have poor dexterity with their right hand. They are currently pain free. What actions would you take?

• Educate the patient's family to push the button when the patient asks for it. Encourage them to tell the nursing staff when they leave the ward so that staff can take over.
• Routinely offer the patient a bolus and document this clearly.
• Contact the pain team/anaesthetist to discuss the situation and suggest that the means of delivery are changed.
• The patient has paracetamol q.d.s. written up, so this should be adequate pain relief

36. A young mother who delivered 48hrs ago comes back to the emergency department with post partum haemorrhage. What type of PPH is it?

• primary post partum haemorrhage
• secondary post partum haemorrhage
• tertiary post partum haemorrhage.

37. Margaret was screaming in pain later in the day despite the PCA in-situ. You refer back to your nurse in charge for a stronger pain killer. She refused to call the doctor because her pain relief was reassessed earlier. What will you do next?

• Continue to refer back to her until she calls the doctor
• Encourage Margaret to continuously use the PCA
• Give Margaret some sedatives to keep her calm
• Wait until her pain stops

38. Lisa, a working mother of 3, has approached you during a recent attendance of her daughter in Accident and Emergency because of an acute asthma attack about smoking cessation. What is your most appropriate response to her?

• Smoking cessation will help prevent further asthma attack
• Referral can be made to the local NHS Stop smoking service
• Discuss with her the NICE recommendations on smoking cessation
• It is not common for people like her to stop smoking

39. A young woman gets admitted with abdominal pain & vaginal bleeding. Nurse should consider an ectopic pregnancy. Which among the following is not a symptom of ectopic pregnancy?

• Pain at the shoulder tip
• Dysuria
• Positive pregnancy test

40. Mary was admitted to your ward with severe bleeding after 48 hours following her labour. What stage of post partum haemorrhage is she experiencing?

• Primary
• Secondary
• Tertiary
• Emergency

41. Which of the following is a potential complication of putting an oropharyngeal airway adjunct:

• Retching, vomiting
• Bradycardia
• Obstruction
• Nasal injury

42. A patient is being prepared for a surgery and was placed on NPO. What is the purpose of NPO?

• Prevention of aspiration pneumonia
• To facilitate induction of pre-op meds
• For abdominal procedures
• To decrease production of fluids

43. As a registered nurse in a unit what would consider as a priority to a patient immediately post operatively?

• pain relief
• blood loss
• airway patency

44. Olivia, a 75-year old patient from a nursing home was admitted on your ward because of fractured neck of femur after a trip. She will require an open-reduction and internal fixation (ORIF) procedure to correct the injury. Which of the following statements will help her understand the procedure?

• You are going to have an ORIF done to correct your fracture.
• Some metal screws and pins will be attached to your hip to help with the healing of your broken bone.
• The operation will require a metal fixator implanted to your femur and adjacent bones to keep it secured
• The ORIF procedure will be done under general anaesthesia by an orthopaedic surgeon

45. What do you have to consider if you are obtaining a consent from the patient?

• Understanding
• Capacity
• Intellect
• Patient’s condition

46. Which of the following is NOT a risk factor for ectopic pregnancy?

• Alcohol abuse
• Smoking
• Tubal or pelvic surgery
• previous ectopic pregnancy

47. A client is brought to the emergency room by the emergency medical services after being hit by car. The name of the client is not known. The client has sustained a severe head injury, multiple fractures and is unconscious. An emergency craniotomy is required, regarding informed consent for the surgical procedure, which of the following is the best action?

• Call the police to identify the client and locate the family
• Obtain a court order for the surgical procedure
• Ask the emergency medical services team to sign the informed consent
• Transport the victim to the operating room for surgery

48. The following must be considered in procuring a consent, except:

• respect and support people’s rights to accept or decline treatment or care
• withhold people’s rights to be fully involved in decisions about their care
• be aware of the legislation regarding mental capacity
• gain consent before treatment or care starts

49. An unmarried young female admitted with ectopic pregnancy with her friend to hospital with complaints of abdominal pain. Her friend assisted a procedure and became aware of her pregnancy and when the family arrives to hospital, she reveals the truth. The family reacts negatively. What could the nurse have done to protect the confidentiality of the patient information?

• should tell the family that they don’t have any rights to know the patient information
• that the friend was mistaken and the doctor will confirm the patient’s condition
• should insist friend on confidentiality
• should have asked another staff nurse to be a chaperone while assisting a procedure

50. Accurate postoperative observations are key to assessing a patient's deterioration or recovery. The Modified Early Warning Score (MEWS) is a scoring system that supports that aim. What is the primary purpose of MEWS?

• Identifies patients at risk of deterioration.
• Identifies potential respiratory distress.
• improves communication between nursing staff and doctors.
• Assesses the impact of pre-existing conditions on postoperative recovery