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NMC CBT Mock Test 11:

1. Mrs Smith was taken to the Accident and Emergency Unit due to anaphylactic shock. The treatment for Mrs Smith will depend on the following except:

• Location
• Number of Responders
• Equipment and Drugs available
• Triage system in the A&E

2. A patient has collapsed with an anaphylactic reaction. What symptoms would you expect to see?

• The patient will have a low blood pressure (hypotensive) & will have a fast heart rate (tachycardia) usually associated with skin & mucosal changes
• The patient will have a high blood pressure (hypertensive) & will have a fast heart rate (tachycardia)
• The patient will quickly find breathing very difficult because of compromise to their airway or circulation. This is accompanied by skin & mucosal changes
• The patient will experience a sense of impending doom, hyperventilate & be itchy all over

3. The following are ways to remove factors that trigger anaphylactic reaction except for one.

• It is not recommended to make the patient should not be forced to vomit after food-induced anaphylaxis.
• Definitive treatment should not be delayed if removing a trigger is not feasible.
• Any drug suspected of causing an anaphylactic reaction should be stopped.
• After a bee sting, do not touch the stinger for about a maximum of 3 hours.

4. Olive, a nursing assistant working with you in an Elderly Care Ward is showing signs of norovirus infection. Which of the following will you ask her to do next?

• Go home and avoid direct contact with other people and preparing food for others until at least 48 hours after her symptoms have disappeared
• Disinfect any surfaces or objects that could be contaminated with the virus
• Flush away any infected faeces or vomit in the toilet and clean the surrounding toilet area
• Avoid eating raw oysters

5. Mrs. Bond is receiving blood transfusion after a total hip replacement operation. After 15 minutes, you went back to check her vital signs and she complained of high temperature and loin pain. This may indicate:

• Renal Colic
• Urine Infection
• Common adverse reaction
• Serious adverse reaction

6. Which of the following are not signs of a speed shock?

• Flushed face
• Headache and dizziness
• Tachycardia and fall in blood pressure
• Peripheral oedema

7. John is going to receive a blood transfusion. How frequently should we do his observations?

• Temperature and pulse before the blood transfusion begins, then every hour, and at the end of bag/unit.
• Temperature, pulse, blood pressure and respiration before the blood transfusion begins, then after 15 minutes, then as indicated in local guidelines, and finally at the end of the bag/unit.
• Temperature, pulse, blood pressure and respiration and urinalysis before the blood transfusion, then at end of bag.
• Pulse, blood pressure and respiration every hour, and at the end of the bag.

8. Normal heart rate for 1 to 2 years old?

• 80 - 140 beats per minute
• 80 - 110 beats per minute
• 75 - 115 beats per minute

9. An Eight year old girl with learning disabilities is admitted for a minor surgery, she is very restless and agitated and wants her mother to stay with her, what will you do?

• Advice the mother to stay till she settles.
• Act according to company policy
• Tell her you will take care of the child
• Inform the Doctor

10. A nurse documents vital signs without actually performing the task. Which action should the charge nurse take after discussing the situation with the nurse?

• Charge the nurse with malpractice
• Document the incident
• Notify the board of nursing
• Terminate employment

11. What are the steps of the nursing Process?

• Assessing, diagnosing, planning, implementing, and evaluating
• Assessing, planning, implementing, evaluating, documenting
• Assessing, observing, diagnosing, planning, evaluating
• Assessing, reacting, implementing, planning, evaluating

12. For which type of waste should orange bags be used?

• Waste that requires disposal by incineration
• Offensive/hygiene waste
• Waste which may be ‘treated
• Offensive waste

13. A nurse finds it very difficult to understand the needs of a child with learning disability. She goes to other nurses and professionals to seek help. How u interpret this action

• The nurse is short of self confidence
• A nurse, who is well aware of her limitations seeked help from others. She worked within her competency.
• She doesn’t have the kind of courage a nurse should have

14. John, 48 years old, has been exhibiting signs and symptoms of anaphylactic reaction. You want to make sure that he is in a comfortable position. Which of the following should you consider?

• John should be sat up if he is experiencing airway and breathing problems.
• John should be lying on his back if he is assessed to be breathing and unconscious.
• John should be sat up if his blood pressure is too low.
• John should be encouraged to stand up if he feels faint.

15. Mrs Smith has been assessed to have a cardiac arrest after anaphylactic reaction to a medication. Cardiopulmonary Resuscitation (CPR) was started immediately. According to the Resuscitation Council UK, which of the following statements is true?

• Intramuscular route administration of adrenaline is always recommended during cardiac arrest after anaphylactic reaction.
• Intramuscular route for adrenaline is not recommended during cardiac arrest after anaphylactic reaction.
• Adrenaline can be administered intradermally during cardiac arrest after anaphylactic reaction.
• None of the Above

16. The nurse has made an error in documenting client care. Which appropriate action should the nurse take?

• Draw a line through error, initial, date and document correct information
• Document a late addendum to the nursing note in the client’s chart
• Tear the documented note out of the chart
• Delete the error by using whiteout

17. Which of the following are signs of anaphylaxis?

• swelling of tongue and rashes
• dyspnoea, hypotension and tachycardia
• hypertension and hyperthermia
• cold and clammy skin

18. When do you wear clean gloves?

• Assisting with bathing
• Feeding a client
• When there is broken skin on hand
• Any activity which includes physical touch of a client

19. Signs of hypovolemic shock would include all except:

• restlessness, anxiety or confusion
• shallow respiratory rate, becoming weak
• rising pulse rate
• low urine output of <0.5 mL/kg/h E. pallor (pale, cyanotic skin) and later sweating

20. What is meant by ‘Gillick competent’?

• Children under the age of 12 who are believed to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment.
• Children under the age of 16 who are believed to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment
• Children under the age of 18 who are believed not to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment.
• Children under the lawful age of consent who are believed not to have enough intelligence, competence and understanding to

21. A mentally capable client in a critical condition is supposed to receive blood transfusion. But client strongly refuses the blood product to be transfused. What would be the best response of the nurse?

• Accept the client's decision and give information on the consequences of his actions
• Let the family decide
• Administer the blood product against the patients decision
• The doctor will decide

22. The following are signs & symptoms of hypovolemic shock, except:

• Confusion
• Rapid heart rate
• Strong pulse
• Decrease Blood Pressure

23. You are about to administer Morphine Sulfate to a paediatric patient. The information written on the controlled drug book was not clearly written - 15 mg or 0.15 mg. What will you do first?

• Not administer the drug, and wait for the General Practitioner to do his rounds
• Administer 0.15 mg, because 15 mg is quite a big dose for a paediatric patient
• Double check the medication label and the information on the controlled drug book; ring the chemist to verify the dosage
• Ask a senior staff to read the medication label with you

24. While giving an IV infusion your patient develops speed shock. What is not a sign and symptom of this?

• Circulatory collapse
• Peripheral oedema
• Facial flushing
• Headache

25. During blood transfusion, a patient develops pyrexia, and loin pain. Rn interprets the situation as

• Common reaction to transfusion
• Adverse reaction to blood transfusion
• Patient has septicaemia

26. As you visit your patient during rounds, you notice a thin child who is shy and not mingling with the group who seemed to be visitors of the patient. You offered him food but his mother told you not to mind him as he is not eating much while all of them are eating during that time. As a nurse, what will you do?

• inform social service desk on suspected case of child neglect
• ignore incident since the child is under the responsibility of the mother
• raise the situation to your head nurse and discuss with her what intervention might be done to help the child

27. There is a child you are taking care of at home who has a history of anaphylactic shock from certain foods, the nurse is feeding him lunch, he looks suddenly confused, breathless and acting different, the nurse has access to emergency drugs access and the mobile phone, what will she do?

• She will keep the child awake by talking to him and call 911 for help
• She will raise the child’s legs and administer Adrenaline and call the emergency services
• The nurse will keep the child in standing position and try to reassure the child

28. Patient developed elevated temperature and pain in the loin during blood transfusion. This is indicative of:

• Severe blood transfusion reaction
• Common blood transfusion reaction

29. What does intermediate care not consist of?

• Maximise dependent living
• Prevent unnecessary acute hospital admission
• Prevent premature admission to long-term residential care
• Support timely discharge form hospital

30. Which of the following is an average heart rate of a 1-2 year old child?

• 110-120 bpm
• 60-100 bpm
• 140-160 bpm
• 80-120 bpm

31. The nurse needs to validate which of the following statements pertaining to an assigned client?

• The client has a hard, raised, red lesion on his right hand.
• A weight of 185 lbs. is recorded in the chart
• The client reported an infected toe
• The client's blood pressure is 124/70. It was 118/68 yesterday.

32. Debra is going to receive blood transfusion. How frequently should we do her observation?

• Temperature and Pulse before the blood transfusion begins, then every hour, and at the end of bag/unit
• Temperature, pulse, blood pressure and respiration before the blood transfusion begins, then after 15 min, then as indicated in local guidelines, and finally at the end of bag/unit.
• Temperature, pulse, blood pressure and respiration and urinalysis before the blood transfusion, then at end of bag.
• Pulse, blood pressure and respiration every hour, and at the end of the bag

33. Which of the following is not a criteria for anaphylactic reaction:

• Sudden onset and rapid progression of symptoms
• life threatening airway and/ or breathing and/or circulation problems
• skin and/or mucosal changes (flushing, urticaria and angioedema)
• skin and mucosal changes only
• A and B only
• all of the above
• A, B and C

34. U just joined in a new hospital. U see a senior nurse beating a child with learning disability. Ur role

• Neglect the situation as u r new to the scenario
• Intervene at the spot, speak directly to the senior in a non-confronting manner, and report to management in writing
• Inform the ward in-charge after the shift

35. All but one are signs of anaphylaxis:

• itchy skin or a raised, red skin rash
• swollen eyes, lips, hands and feet
• hypertension and tachycardia
• abdominal pain, nausea and vomiting

36. Signs and symptoms of septic shock?

• Tachycardia, hypertension, normal WBC, non pyrexial
• Tachycardia, hypotension, increased WBC, pyrexial
• Tachycardia, , increased WBC, normotension, non pyrexial
• Decreased heart rate, decreased blood pressure, normal WBC and pyrexial

37. After lumbar puncture, the patient experienced shock. What is the etiology behind it?

• Increased ICP
• Headache
• Side effect of medications
• CSF leakage

38. Management of moderate malnutrition in children?

• supplimentary nutrition
• immediate hospitalization
• weekly assessment
• document intake for three days

39. Which is not a sign or symptom of speed shock?

• Headache
• A tight feeling in the chest
• Irregular pulse
• Cyanosis

40. Recognition of the unwell child is crucial. The following are all signs and symptoms of respiratory distress in children EXCEPT:

• Lying supine
• Nasal flaring
• Intercostal and sternal recession
• adopting an upright position

41. What is clinical benchmarking?

• The practice of being humble enough to admit that someone else is better at something and being wise enough to try to learn how to match and even surpass them at it.
• A systematic process in which current practice and care are compared to, and amended to attain, best practice and care
• A system that provides a structured approach for realistic and supportive practice development
• All of the above

42. Which bag do you place infected linen?

• water-soluble alginate polythene bag before being placed in the appropriate linen bag, no more than % full
• orange waste bag, before being placed in the appropriate linen bag, no more than % full
• white linen bag, after sorting, no more than % full

43. You are assisting a doctor who is trying to assess and collect information from a child who does not seem to understand all that the doctor is telling and is restless. What will be your best response?

• Stay quiet and remain with the doctor
• Interrupt the doctor and ask the child the questions
• Remain with the doctor and try to gain the confidence of the child and politely assess the child's level of understanding and help the doctor with the information he is looking for
• Make the child quiet & ask his mother to stay with him

44. What are the signs and symptoms of shock during early stage (stage 1-3)?

• hypoxemia
• tachycardia and hyperventilation
• hypotension
• acidosis

45. You were asked by the nursing assistant to see Claudia whom you have recently given trimetophrim 200 mgs PO because of urine infection. When you arrived at her bedside, she was short of breath, wheezy and some red patches evident over her face. Which of the following actions will you do if you are suspecting anaphylaxis?

• call for help and give oxygen
• give oxygen and salbutamol nebs if prescribed and call for help
• give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed and call for help
• call for help, give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed.

46. When communicating with children, what most important factor should the nurse take into consideration?

• Developmental level
• Physical development
• Nonverbal cues
• Parental involvement

47. Mrs Smith had developed Steven-Johnson syndrome whilst on Carbamazepine. She is now being transferred for the ITU to a bay in the Medical ward. Which patient can Mrs Smith share a baby with?

• a patient with MRSA
• a patient with diarrhoea
• a patient with a fever of unknown origin
• a patient with Stephen Johnson Syndrome

48. Susan, 72 years old patient is being treated with antibiotics for her UTI. After three days of taking them, she developed diarrhoea with blood stains. What is the most possible reason for this?

• Antibiotics causes chronic inflammation of the intestine
• An anaphylactic reaction
• Antibiotic alters her Gl flora which made Clostridium-difficile to multiply
• she is not taking the antibiotics with food

49. Where is revision on the nursing process done? During:

• Diagnosis
• Planning
• Implementation
• Evaluation

50. You saw a relative of a client has come with her son, who looks very thin, shy & frightened. You serve them food, but the mother of that child says "don't give him, he eats too much". You should:

• Raise your concern with your nurse manager about potential for child abuse & ask for her support
• Ignore the mother & ask the relative if the child is abused.
• Ignore the mother's advice & serve food to the child.
• Ignore the situation as she is the mother & knows better about her child.