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NMC CBT Mock Test 3

1. What are the four stages of wound healing in the order they take place?

  • Proliferative phase, inflammation phase, remodelling phase, maturation phase.
  • Haemostasis, inflammation phase, proliferation phase, maturation phase
  • Inflammatory phase, dynamic stage, neutrophil phase, maturation phase.
  • Haemostasis, proliferation phase, inflammation phase, remodelling phase support

2. What functions should a dressing fulfil for effective wound healing?

  • High humidity, insulation, gaseous exchange, absorbent.
  • Anaerobic, impermeable, conformable, low humidity.
  • Insulation, low humidity, sterile, high adherence.
  • Absorbent, low adherence, anaerobic, high humidity.

3. Black wounds are treated with debridement. Which type of debridement is most selective and least damaging?

  • Debridement with scissors
  • Debridement with wet to dry dressings
  • Mechanical debridement
  • Chemical debridement

4. What do you expect to assess in a grade 3 pressure ulcer?

  • blistered wound on the skin
  • open wound showing tissue
  • open wound exposing muscles
  • open wound exposing bones

5. If an elderly immobile patient had a "grade 3 pressure sore", what would be your management?

  • Film dressing, mobilization, positioning, nutritional support
  • Foam dressing, pressure relieving mattress, nutritional support
  • Dry dressing, pressure relieving mattress, mobilization
  • Hydrocolloid dressing, pressure relieving mattress, nutritional support

6. How would you care for a patient with a necrotic wound?

  • Systemic antibiotic therapy and apply a dry dressing
  • Debride and apply a hydrogel dressing.
  • Debride and apply an antimicrobial dressing.
  • Apply a negative pressure dressing.

7. A 52-year-old man is admitted to a hospital after sustaining a severe head injury in an automobile accident. When the patient dies, the nurse observes the patient’s wife comforting other family members. Which of the following interpretations of this behavior is MOST justifiable?

  • She has already moved through the stages of the grieving process.
  • She is repressing anger related to her husband’s death.
  • She is experiencing shock and disbelief related to her husband’s death.
  • She is demonstrating resolution of her husband’s death.

8. Which of the following conditions can be observed in a proper wound dressing:

  • absorbent, humid, aerated
  • non absorbent, humid, aerated
  • non humid, absorbent, aerated
  • non humid, non absorbent, aerated

9. The nurse is functioning as a patient advocate. Which of the following would be the first step the nurse should take when functioning in this role?

  • Ensure that the nursing process is complete and includes active participation by the patient and family
  • Become creative in meeting patient’s needs.
  • Empower the patient by providing needed information and support.
  • Help the patient understand the need for preventive health care.

10. Which are not the benefits of using negative pressure wound therapy?

  • Can reduce wound odour
  • Increases local blood flow in peri-wound area
  • Can be used on untreated osteomyelitis
  • Can reduce use of dressings

11. You notice an area of redness on the buttock of an elderly patient and suspect they may be at risk of developing a pressure ulcer. Which of the following would be the most appropriate to apply?

  • Negative pressure dressing
  • Rapid capillary dressing
  • Alginate dressing
  • Skin barrier product

12. A client has a diabetic stasis ulcer on the lower leg. The nurse uses a hydrocolloid dressing to cover it. The procedure for application includes:

  • Cleaning the skin and wound with betadine
  • Removing all traces of residues for the old dressing
  • Choosing a dressing no more than quarter-inch larger than the wound size
  • Holding it in place for a minute to allow it to adhere

13. Clinical bench-marking is:

  • to improve standards in health care
  • a new initiate in health care system
  • A new set of rule for health care professionals
  • To provide a holistic approach to the patient

14. Wound care management plan should be done with what type of wound?

  • Complex wound
  • Infected wound
  • Any type of wound

15. A new, postsurgical wound is assessed by the nurse and is found to be hot, tender and swollen. How could this wound be best described?

  • In the inflammation phase of healing.
  • In the haemostasis phase of healing.
  • In the reconstructive phase of wound healing.
  • As an infected wound

16. How do you remove a negative pressure dressing?

  • Remove pressure then detach dressing gently
  • Get TVN nurse to remove dressing
  • remove in a quick fashion

17. How long does proliferative phase of wound healing occur?

  • 3-24 days
  • 24-26 days
  • 1-7 days
  • 24 hours

18. Wendy, 18 years old, was admitted on Medical Ward because of recurrent urinary tract infection (UTI). She disclosed to you that she had unprotected sex with her boyfriend on some occasions. You are worried this may be a possible cause of the infection. How will best handle the situation?

  • tell her that any information related to her wellbeing will need to be share to the health care team
  • inform her parents about this so she can be advised appropriately
  • keep the information a secret in view of confidentiality
  • report her boyfriend to social services

19. When breaking bad news over phone which of the following statement is appropriate

  • I am sorry to tell you that your mother died
  • I am sorry to tell you that your mother has gone to heaven
  • I am sorry to tell you that your mother is no more
  • I am sorry to tell you that your mother passed away

20. An adult has just returned to the unit from surgery. The client fell and was injured. What kind of liability does the nurse have?

  • None
  • Negligence
  • Intentional tort
  • Assault & battery

21. Clinical practice is based on evidence based practice. Which of the following statements is true about this

  • Clinical practice based on clinical expertise and reasoning with the best knowledge available
  • Provision of computers at every nursing station to search for best evidence while providing care
  • Practice based on ritualistic way
  • Practice based on what nurse thinks is the best for patient

22. 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

23. When trying to make a responsible ethical decision, what should the nurse understand as the basis for ethical reasoning?

  • Ethical principles & code
  • The nurse’s experience
  • The nurse’s emotional feelings
  • The policies & practices of the institution

24. One of your patient was pleased with the standard of care you have provided him. As a gesture, he is giving you a £50 voucher to spend. What is your most appropriate action on this situation?

  • Accept the voucher and thank him for this gesture
  • Refuse the voucher and thank him for this gesture
  • Accept the voucher and give it to ward manager
  • Refuse the voucher and inform the ward manager for his gesture

25. Appropriate wound dressing criteria includes all but one:

  • Allows gaseous exchange.
  • Maintains optimum temperature and pH in the wound.
  • Forms an effective barrier to
  • Allows removal of the dressing without pain or skin stripping.
  • Is non-absorbent

26. Wound proliferation starts after?

  • 1-5 days
  • 3-24 days
  • 24 days

27. A young woman has suffered fractured pelvis in an accident, she has been hospitalized for 3 days , when she tells her primary nurse that she has something to tell her but she does not want the nurse to tell anyone, she says that she had tried to donate blood & tested positive for HIV. what is best action of the nurse to take?

  • Document this information on the patient’s chart
  • Tell the patient’s physician
  • Inform the healthcare team who will come in contact with the patient
  • Encourage the patient to disclose this information to her physician

28. The nurse is in the hospitals public cafeteria & hears two nursing assistants talking about the patient in 406. they are using her name & discussing intimate details about her illness which of the following actions are best for the nurse to take?

  • Go over & tell the nursing assistants that their actions are inappropriate especially in a public place
  • Wait & tell the assistants later that they were overheard discussing the patient otherwise they might be embarrassed
  • Tell the nursing assistant’s supervisor about the incident. It is the supervisor’s responsibility to address the issue
  • Say nothing, it is not the nurses job, he or she is not responsible for the assistant’s action

29. Which of the following methods of wound closure is most suitable for a good cosmetic result following surgery?

  • Skin clips
  • Tissue adhesive
  • Adhesive skin closure strips
  • Interrupted suture

30. A patient with learning disability is accompanied by a voluntary independent mental capacity advocate. What is his role?

  • Express patients’ needs and wishes. Acts as a patient’s representative in expressing their concerns as if they were his own
  • Just to accompany the patient
  • To take decisions on patients behalf and provide their own judgements as this benefit the client
  • Is an expert and represents clients concerns, wishes and views as they cannot express by themselves

31. A patient with complex, multiple diseases is discharged to a tertiary level care unit what to do?

  • Inform the tertiary unit about patient arrival
  • Call for a multidisciplinary meeting with professional who took care of patient to discuss the patient care modalities that everyone accepts.
  • Inform to patient relatives about the situation

32. Jack, son of John went to the station to see the nurse as she was complaining of severe pain on her pressure ulcer. What will be your initial action?

  • Check analgesia on the chart
  • Tell you will come as soon as you can
  • Find the nurse in charge
  • Go immediately to see the patient

33. Breid, 76 years old, developed a pressure ulcer whilst under your care. On assessment, you saw some loss of dermis, with visible redness, but not sloughing off. Her pressure ulcer can be categorised as:

  • moisture lesion
  • 2nd stage partial skin thickness
  • 3rd stage
  • 4th stage

34. A client is admitted to the Emergency Department after a motorcycle accident that resulted in the client’s skidding across a cement parking lot. Since the client was wearing shorts, there are large areas on the legs where the skin is ripped off. The wound is best described as:

  • Abrasion
  • Unapproxiamted
  • Laceration
  • Eschar

35. The nurse cares for a client diagnosed with conversion reaction. The nurse identifies the client is utilizing which of the following defence mechanisms?

  • Introjection
  • Displacement
  • Identification
  • Repression

36. A mentally competent client with end stage liver disease continues to consume alcohol after being informed of the consequences of this action. What action best illustrates the nurse’s role as a client advocate?

  • Asking the spouse to take all the alcohol out of the house
  • Accepting the patient’s choice & not intervening
  • Reminding the client that the action may be an end-of life decision
  • Refusing to care for the client because of the client’s noncompliance

37. A nurse notices a bedsore. It’s a shallow wound, red coloured with no pus. Dermis is lost. At what stage this bedsore is?

  • Stage1- non blanchable erythema
  • Stage2- Partial thickness skin lose
  • Stage3- full thickness skin loss
  • Stage4- full thickness tissue lose

38. What do you mean by benchmarking tool?

  • an overall patient-focused outcome that expresses what patients and or carers want from care in a particular area of practice
  • it is the way of expressing the need of the patient
  • a continuum between poor and best practice.
  • information on how to use the benchmarks

39. A new RN have problems with making assumptions. Which part of the code she should focus to deliver fundamentals of care effectively

  • Prioritise people
  • Practice effective
  • Preserve safety
  • Promote professionalism and trust

40. Essence of Care benchmarking is a process of?

  • Comparing, sharing and developing practice in order to achieve and sustain best practice.
  • Assess clinical area against best practice
  • Review achievement towards best practice
  • Consultation and patient involvement

41. The nurse works on a medical/surgical unit that has a shift with an unusually high number of admissions, discharges, and call bells ringing. A nurse’s aide, who looks increasingly flustered and overwhelmed with the workload, finally announces “This is impossible! I quit!” and stomps toward the break room. Which of the following statements, if made by the nurse to the nurse’s aide, is BEST?

  • fine, we’re better off without you anyway”
  • It seems to me that you feel frustrated. What can I help you with to care for our patients?”
  • I can understand why you’re upset, but I’m tired too and I’m not quitting.”
  • Why don’t you take a dinner break and come back? It will seem more manageable with a normal blood sugar.

42. A clients wound is draining thick yellow material. The nurse correctly describes the drainage as:

  • Sanguineous
  • Serous sanguineous
  • Serous
  • Purulent

43. Which one of the following types of wound is NOT suitable for negative pressure wound therapy?

  • Partial thickness burns
  • Contaminated wounds
  • Diabetic and neuropathic ulcers
  • Traumatic wounds

44. The nurse manager of 20 bed coronary care is not on duty when a staff nurse makes serious medication error. The client who received an over dose of the medication nearly dies. Which statement of the nurse manager reflects accountability?

  • The nurse supervisor on duty will call the nurse manager at home and apprise about the problem
  • Because the nurse manager is not on duty therefore she is not accountable to anything which happens on her absence
  • The nurse manager will be informed of the incident when returning to the work on Monday because the nurse manager was officially off duty when the incident took place.
  • Although the nurse manager was on off duty but the nurse supervisor decides to call nurse manager if the time permits the nurse supervisor thinks that the nurse manager has no responsibility of what has happened in manager’s absence

45. When you find out that 2 staffs are on leave for next duty shift and its of staff shortage what to do with the situation?

  • Inform the superiors and call for a meeting to solve the issue
  • Contact a private agency to provide staff
  • Close the admission until adequate staffs are on duty.

46. How long does the ‘inflammatory phase’ of wound healing typically last?

  • 24 hours
  • Just minutes
  • 1-5 days
  • 3-24 days

47. A patient developed pressure ulcer. The wound is round, extends to the dermis, is shallow, there is visible reddish to pinkish tissue. What stage is the pressure ulcer?

  • Stage 1
  • Stage 2
  • Stage 3
  • Stage 4

48. The nurse cares for a patient with a wound in the late regeneration phase of tissue repair. The wound may be protected by applying a:

  • Transparent film
  • Hydrogel dressing
  • Collagenases dressing
  • Wet dry dressing

49. Which solution use minimum tissue damage while providing wound care?

  • Hydrogen peroxide
  • Povidine iodine
  • Saline
  • Gention violet

50. What is Disclosure according to NHS?

  • It is asking action to help people say what they want, secure their rights, represent their interests and obtain the services they need
  • This is the divulging or provision of access to data.
  • It is the response to the suffering of others that motivates a desire to help.
  • It is a set of rules or a promise that limits access or places restrictions on certain types of information.