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NMC CBT Mock Test 12:

1. A client experiences an episode of pulmonary oedema because the nurse forgot to administer the morning dose of furosemide (Lasix). Which legal element can the nurse be charged with?

• Assault
• Slander
• Negligence
• tort

2. In caring for a patient, the nurse should?

• whenever possible provide care that is culturally sensitive and according to patients preference
• ask the patient and their family about their culture
• be aware of the patient’s culture
• disregard the patient’s culture

3. You were on a night shift in a ward and has been allocated to dispose controlled medications. Which of the following is correct?

• Controlled drugs destruction and pharmacy stock check should be done at different times.
• Controlled drugs should be destroyed with the use of the Denaturing Kit.
• Excessive quantities of controlled drugs can be stored in the cupboard whilst waiting for destruction.
• None of the Above

4. Patient bring own medication to hospital and wants to self-administer what is your role? allow him?

• give medications back to relatives to take back
• keep it in locker, use from medication trolley
• explain to patient about medication before he administer it

5. On checking the stock balance in the controlled drug record book as a newly qualified nurse, you and a colleague notice a discrepancy. What would you do?

• Check the cupboard, record book and order book. If the missing drugs aren't found, contact pharmacy to resolve the issue. You will also complete an incident form.
• Document the discrepancy on an incident form and contact the senior pharmacist on duty.
• Check the cupboard, record book and order book. If the missing drugs aren't found the police need to be informed.
• Check the cupboard, record book and order book and inform the registered nurse or person in charge of the clinical area. If the missing drugs are not found then inform the most senior nurse on duty. You will also complete an incident form.

6. As a newly qualified nurse, what would you do if a patient vomits when taking or immediately after taking tablets?

• Comfort the patient, check to see if they have vomited the tablets, & ask the doctor to prescribe something different as these obviously don’t agree with the patient
• Check to see if the patient has vomited the tablets & if so, document this on the prescription chart. If possible, the drugs may be given again after the administration of antiemetics or when the patient no longer feels nauseous. It may be necessary to discuss an alternative route of administration with the doctor
• In the future administer antiemetics prior to administration of all tablets
• Discuss with pharmacy the availability of medication in a liquid form or hide the tablets in food to take the taste away.

7. A patient recently admitted to hospital, requesting to self-administer the medication, has been assessed for suitability at Level 2 This means that:

• The registrant is responsible for the safe storage of the medicinal products and the supervision of the administration process ensuring the patient understands the medicinal product being administered
• The patient accepts full responsibility for the storage and administration of the medicinal products
• None of the above - The registrant is responsible for the safe storage of the medicinal products. At administration time, the patient will ask the registrant to open the cabinet or locker. The patient will then self-administer the medication under the supervision of the registrant

8. Which statement is not correct about the nursing process?

• An organised, systematic and deliberate approach to nursing with the aim of improving standards in nursing care.
• It uses a systematic, holistic, problem solving approach in partnership with the patient and their family.
• It is a form of documentation.
• It requires collection of objective data.

9. Which of the following is not a part of the 6 rights of medication administration?

• Right time
• Right route
• Right medication
• Right reason

10. Which of the following sets of needs should be included in your service user’s person centred care plan?

• social, spiritual and academic needs
• medical, psychological and financial needs
• physical, medical, social, psychological and spiritual needs
• a and b only
• all of the above

11. Nursing care should be

• Task oriented
• Caring medical and surgical patient
• Patient oriented, individualistic care
• All of the above

12. What are the key reasons for administering medications to patients?

• To provide relief from specific symptoms, for example pain, and managing side effects as well as therapeutic purposes.
• As part of the process of diagnosing their illness, to prevent an illness, disease or side effect, to offer relief from symptoms or to treat a disease
• As part of the treatment of long term diseases, for example heart failure, and the prevention of diseases such as asthma.
• To treat acute illness, for example antibiotic therapy for a chest infection, and side effects such as nausea.

13. What are the professional responsibilities of the qualified nurse in medicines management?

• Making sure that the group of patients that they are caring for receive their medications on time. If they are not competent to administer intravenous medications, they should ask a competent nursing colleague to do so on their behalf.
• The safe handling and administration of all medicines to patients in their care. This includes making sure that patients understand the medicines they are taking, the reason they are taking them and the likely side effects.
• Making sure they know the names, actions, doses and side effects of all the medications used in their area of clinical practice.
• To liaise closely with pharmacy so that their knowledge is kept up to date.

14. After having done your medication rounds, you have realised that your patient has experienced the adverse effect of the drug. What will be your initial intervention?

• You must do the physical observations and notify the General Practitioner.
• You must ring the General Practitioner and request for a home visit.
• You must administer medication from the Homely Remedy Pod after having spoken to the General Practitioner.
• You must observe your patient until the General Practitioner arrives at your nursing home.

15. The MARS says that Benedict is on TID Macrogol. You have notice that the nurses have been writing “A” for refused. What do you do?

• Write “A” on the MARS, because Benedict is expected to refuse it.
• Offer the Macrogol, and write “A” if the patient refuses it.
• Check bowel charts and cancel Macrogol on MARS if bowels are fine.
• Change the prescription to PRN.

16. Registrants must only supply and administer medicinal products in accordance with one or more of the following processes, except:

• Carer specific direction (CSD)
• Patient medicines administration chart (may be called medicines administration record MAR)
• Patient group direction (PGD)
• Medicines Act exemption

17. Patient has next dose of Digoxin but has a CR=58

• Omit dose, record why, and inform the doctor
• Give dose and tell the doctor
• Give dose as prescribed

18. What are the potential benefits of self-administration of medicines by patients?

• Nurses have more time for other aspects of patient care and it therefore reduces length of stay.
• It gives patients more control and allows them to take the medications on time, as well as giving them the opportunity to address any concerns with their medication before they are discharged home.
• Reduces the risk of medication errors, because patients are in charge of their own medication.
• Creates more space in the treatment room, so there are fewer medication errors

19. How do you value dignity & respect in nursing care? Select which does not apply:

• We value every patient, their families or carers, or staff.
• We respect their aspirations and commitments in life, and seek to understand their priorities, needs, abilities and limits.
• We find time for patients, their families and carers, as well as those we work with.
• We are honest and open about our point of view and what we can and cannot do.

20. General guidance for the storage of controlled drugs should include the following except:

• cupboards must be kept locked when not in use
• keys must only be available to authorised member of staff
• regular drugs can also be stored in the controlled drug storage
• the cupboard must be dedicated to the storage of controlled drugs

21. You were on your medication rounds and the emergency alarm goes off. What will you do first?

• Lock your trolley
• Rush to your patient’s bedroom
• Check first if everyone had their meds
• a and c

22. When do you see problems or potential problems?

• Assessment
• Planning
• Implementation
• Evaluation

23. How the nurse assesses the quality of care given

• reflective process
• clinical bench marking
• peer and patient response
• all the above

24. What are the most common types of medication error?

• Nurses being interrupted when completing their drug rounds, different drugs being packaged similarly and stored in the same place and calculation errors.
• Unsafe handling and poor aseptic technique.
• Doctors not prescribing correctly and poor communication with the multidisciplinary team.
• Administration of the wrong drug, in the wrong amount to the wrong patient, via the wrong route

25. The nurses on the day shift report that the controlled drug count is incorrect. What is the most appropriate nursing action?

• Report the discrepancy to the nurse manager and pharmacy immediately
• Report the incident to the local board of nursing
• Inform a doctor
• Report the incident to the NMC

26. Mark is prescribed Lanoxin 500 mcg PO. What vital sign will you asses prior to giving the drug?

• heart rate and rhythm
• respiration rate and depth
• temperature
• urine output

27. Which of the following descriptors is most appropriate to use when stating the "problem" part of nursing diagnosis?

• Oxygenation saturation 93%
• Output 500 ml in 8 hours
• Anxiety
• Grimacing

28. A walk-in client enters into the clinic with a chief complaint of abdominal pain and diarrhea. The nurse takes the client's vital sign hereafter. What phrase of nursing process is being implemented here by the nurse?

• Assessment
• Diagnosis
• Planning
• Implementation

29. When do you plan a discharge?

• 24 hrs within admission
• 72 hrs within admission
• 48 hrs within admission
• 12 hrs within admission

30. Who has the overall responsibility for the safe and appropriate management of controlled drugs within the clinical area?

• All registered nurses
• The nurse in charge
• The consultant
• All staff

31. What is comprehensive nursing assessment?

• It provides the foundation for care that enables individuals to gain greater control over their lives and enhance their health status.
• An in-depth assessment of the patient’s health status, physical examination, risk factors, psychological and social aspects of the patient’s health that usually takes place on admission or transfer to a hospital or healthcare agency.
• An assessment of a specific condition, problem, identified risks or assessment of care; for example, continence assessment, nutritional assessment, neurological assessment following a head injury, assessment for day care, outpatient consultation for a specific condition.
• It is a continuous assessment of the patient’s health status accompanied by monitoring and observation of specific problems identified.

32. Independent and supplementary nurse and midwife are those who are?

• nurse and midwife student who cleared medication administration exam
• nurses and midwives educated in appropriate medication prescription for certain pharmaceuticals
• registrants completed a programme to prescribe under community nurse practitioner’s drug formulary
• nurses and midwives whose name is entered in the register

33. You are transcribing medications from prescription chart to a discharge letter. Before sending this letter what action must be taken?

• A registrant should sign this letter
• Transcribing is not allowed in any circumstances
• The letter has to be checked by a nurse in charge
• Letter can be sent directly to the patient after transcribing

34. A nurse explains to a student that the nursing process is a dynamic process. Which of the following actions by the nurse best demonstrates this concept during the work shift?

• Nurse and client agree upon health care goals for the client
• Nurse reviews the client's history on the medical record
• Nurse explains to the client the purpose of each administered medication
• Nurse rapidly reset priorities for client care based on a change in the client's condition

35. Which of the following people is not exempted from paying a prescribed medication?

• children under the age of 16
• women of child bearing age
• people who are receiving support allowance
• pensioners of age 65 and above

36. You noticed that a colleague committed a medication administration error. Which should be done in this situation?

• You should provide a written statement and also complete a Trust incident form.
• You should inform the doctor.
• You should report this immediately to the nurse in charge.
• You should inform the patient.

37. A patient approached you to give his medications now but you are unable to give the medicine. What is your initial action?

• Inform the doctor
• Inform your team leader
• Inform the pharmacist
• Routinely document meds not given

38. A newly admitted client refusing to handover his own medications and this includes controlled drugs. What is your action?

• You have to take it any way and document it
• Call the doctor and inform about the situation
• Document this refusal as these medications are his property and should not do anything without his consent
• Refuse the admission as this is against the policy

39. As a RN when you are administering medication, you made an error. Taking health and safety of the patient into consideration, what is your action?

• Call the prescriber. Report through yellow card scheme and document it in patient notes
• Let the next of kin know about this and document it
• Document this in patient notes and inform the line manager
• Assess for potential harm to client, inform the line manager and prescriber and document in patient notes

40. All but one describes holistic care:

• A system of comprehensive or total patient care that considers the physical, emotional, social, economic, and spiritual needs of the person; his or her response to illness; and the effect of the illness on the ability to meet self-care needs.
• It embraces all nursing practice that has enhancement of healing the whole person from birth to death as it’s goals.
• An all nursing practice that has healing the person as its goal.
• It involves understanding the individual as a unitary whole in mutual process with the environment.

41. None of the following is not true about a delegation responsibility of a medication registrant:

• Nurses are accountable to ensure that the patient, carer or care assistant is competent to carry out the task.
• Nurses can delegate medication administration to student nurses / nurses on supervision.
• Nurses can delegate medication administration to unregistered practitioners to assist in ingestion or application of the medicinal product.
• All of the above

42. 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

43. Hospital discharge planning for a patient should start:

• When the patient is medically fit
• On the admission assessment
• When transport is available

44. The rehabilitation nurse wishes to make the following entry into a client's plan of care: "Client will re-establish a pattern of daily bowel movements without straining within two months." The nurse would write this statement under which section of the plan of care?

• Long-term goals
• Short-term goals
• Nursing orders
• Nursing dianosis/problem list

45. Nursing process is best illustrated as:

• Patient with medical diagnosis
• task oriented care
• Individualized approach to care
• All of the above

46. Which of the following items of subjective client data would be documented in the medical record by the nurse?

• Client's face is pale
• Cervical lymph nodes are palpable
• Nursing assistant reports client refused lunch
• Client feel nauseated

47. You were running a shift and a pack of controlled drugs were delivered by the chemist/pharmacist whilst you were giving the morning medications. What would you do first?

• keep the controlled drugs in the trolley first, then store it after you have done morning drugs
• Count the controlled drugs, store them in controlled drug cabinet and record them on the controlled drug book
• Count the controlled drugs, store them in the medication trolley and record them on the controlled drug book
• Record them in the controlled drug book and delegate one of the carers to store them in the controlled drug cabinet

48. What medications would most likely increase the risk for fall?

• Loop diuretic
• Hypnotics
• Betablockers
• Nsaids

49. In a nursing and residential home setting, how will you manage your time and prioritise patients’ needs whilst doing your medication rounds in the morning?

• Start administering medications from the patient nearest to the treatment room.
• Start administering medications to patients who are in the dining room, as this is where most of them are for breakfast.
• Check the list of patients and identify the ones who have Diabetes Mellitus and Parkinson’s disease.
• All of the above.

50. All individuals providing nursing care must be competent at which of the following procedures?

• Hand hygiene and aseptic technique
• Aseptic technique only
• Hand hygiene, use of protective equipment, and disposal of waste
• Disposal of waste and use of protective equipment
• All of the above