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351. A client is diagnosed with MRSA. What type of isolation is MOST appropriate for this client?

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352. The risk of spreading the infection of Acute Diarrhea to others can be reduced by adopting the following universal precautions, excluding:

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353. Linda is a middle-aged woman who is a wheelchair user due to muscular sclerosis (MS). She lives in a ground floor flat on a large council estate and has few if any friends living close by.
There are high levels of crime and antisocial behaviour in the area and the flat has been broken into on two occasions. In spite of her situation Linda remains fairly optimistic about life and undertakes some voluntary work.
She has been described as a vulnerable adult although she does not like this term. What 3 key elements does the Department of Health (2011) provide as factors which may make people "vulnerable"?

1. Personal circumstance,
2. Environmental risk and
3. Resilience factor


354. Any substance or object that the holder discards intends to discard or is required to be discarded.

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355. What is Disclosure according to NHS?

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356. Swelling of anus may be indicative of:

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357. 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?

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

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359. In spinal cord injury patients, what is the most common cause of autonomic dysreflexia or a sudden rise in blood pressure ?

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360. The most common site for a colostomy is on the.

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361. What is the best approach in supporting communication for a person with dysphonia? - difficulty in speaking due to a physical disorder of the mouth, tongue, throat or vocal cords.

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362. What is the best approach in supporting communication for a person with dysarthria? - difficult or unclear articulation of speech

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363. A patient who has had Parkinson"s disease for 7 years has been experiencing aphasia. Which health professional should you make a referral to with regards to his aphasia? - impairment of language

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364. In supervising a student nurse perform a drug rounds, the NMC expects you to do the following at all times:

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365. Except which procedure must all individuals providing nursing care must be competent at?

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365. Except which procedure must all individuals providing nursing care must be competent at?

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366. Which student require a Sign-off mentors (SOM)?

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367. In what instances shouldn't you position a patient in a side-lying position?

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368. Which is not a cause of postural hypotension?

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

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370. What areas to consider when making decisions on safeguarding?

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371. Nursing care is:

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374. Anne has been told that unless she does what the ward staff tell her, the consultant will stop her family from visiting. What type of abuse is this?

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375. An adult who has gastroenteritis & is on digitalis has lab values of:

K :3.2 mEq/L,
Na :136 mEq/L,
Ca :4.8 mEq/L,
Cl :98 mEq/L.

The nurse puts which of the following on patient's plan of care?

K- 3.5 - 5.3
Na - 135-145
Ca - 8.5 - 10.8
Cl - 96-106

A. Monitor for hyperkalemia
B. Avoid foods rich in potassium
C. Observe for digitalis toxicity
D. Observe for Trousseau"s & Chvostek"s signs


376. Facial edema is caused by what type of illness:

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377. A nurse is not trained to do the procedure of IV cannulation, still she tries to do the procedure. You are the colleague of this nurse, what will be your action?

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378. A coma can be the complication of which of the following pathological states?

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379. During digital removal of feces, the nurse should observe the following signs except for one:

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380. Effective teamwork involves making decisions and solving problems collaboratively. Which of the following is the term commonly associated with teams coming together in agreement?

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381. What are the characteristics of effective collaboration?

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382. The process of discussion between healthcare professionals and patients and carers which allows patients and carers to explore issues and arrive at decisions.

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383. What is the primary aim of stoma care?

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384. Fremitus is the palpable vibrations of the patient's voice through the chest wall and should be felt symmetrical and decreasing as you work down the chest wall otherwise it could indicate

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385. This process occurs whereby feces move back into the sigmoid colon

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386. According to Rome III Criteria, the following should be present within the last 3 months to be diagnosed with constipation, except for one:

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387. A nurse delegates duty to a health assistant, what NMC standard she should keep in mind while doing this?

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391. By which of the following processes do faeces move from the caecum to the rectum?

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392. How often do you advice a patient with NEUTROPENIA to take their temperature?

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393. A rise in which gas within the blood provides the main stimulus to increase respiration?

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394. The purpose of patient information may be to:

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395. The nurse is caring for a diabetic patient and when making rounds, notices that the patient is trembling and stating they are dizzy. The next action by the nurse would be:

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396. In choosing the right size of stoma appliances, it is important that its flange is snugly around the stoma within of the stoma edge.

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397. Lesion of which nerve results in a carpal tunnel syndrome?

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398. Which of the following systems are responsible for maintaining the blood pH within normal limits?

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399. In order for someone to be diagnosed with a depressive episode, for how long must symptoms be present nearly every day?

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400. Which of the following is the mainstay treatment of osteoporosis?

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402. What is the role of the NMC?

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403. Under the Carers (Equal opportunities) Act (2004) what are carers entitled to?

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404. Patient is saying something which is totally against your beliefs and perceptions. What would you do as nurse?

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406. In the intracellular fluid, which of the following is the main cation? PISO - Potassium In, Sodium Out

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407. Fat digestion occurs in which of the following?

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408. Which signaling molecule is secreted by capillary endothelial cells, resulting in blood vessel constriction?

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409. Haemoglobin Ale is monitored to optimize the management of which condition?

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410. A nurse is leading a program about management issues. The nurse would intervene if a ward nurse made which of the following statements?

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411. Primary roles of insulin include which of the following?

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412. In infection control, what is a pathogen?

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413. 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? *

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414. Patient asking for LAMA, the medical team has concern about the mental capacity of the patient, what decision should be made?

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415. The NMC code is concerned about focusing on which of the following criteria

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416. Why do you do risk assessment

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417. You are taking a patient to theatre for a surgical procedure when he tells you that he is really afraid and anxious about the anaesthetic, to the extent that he is unsure if he wants to go ahead with the procedure. Which of the following steps should you take?

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

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419. A patient is prescribed metformin 1000mg twice a day for his diabetes. While talking with the patient he states "I never eat breakfast so I take 1/2 a tablet at lunch and a whole tablet at supper because I don“t want my blood sugar to drop.”

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420. Palpation of chest is done during cardiovascular examination in order to

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421. What is accountability?

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422. What is primary care?

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423. Common signs and symptoms of a hypoglycaemia exclude:

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424. The Code contains the professional standards that registered nurses and midwives must uphold.

UK nurses and midwives must act in line with the Code, whether they are providing direct care to individuals, groups or communities or bringing their professional knowledge to bear on nursing and midwifery practice in other roles; such as leadership, education or research.

What 4 Key areas does the code cover:

1. Prioritise people,
2. Practise effectively,
3. Preserve safety,
4. Promote professionalism and trust


425. After a lumbar puncture, your patient becomes unconscious. What will be the reason?

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426. A suicidal Patient is admitted to psychiatric facility for 3 days when suddenly he is showing signs of cheerfulness and motivation. The nurse should see this as:

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427. A client with a right arm cast for fractured humerus states, "I haven”t been able to straighten the fingers on my right hand since this morning.” What action should the nurse take?

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428. What is the best position in applying eye medications?

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429. A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's:

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430. How many phases of korotkoff sounds are there?

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431. After attending on the patient, which statement would be most appropriate for the nurse to document on a datix/incident form?

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432. Why are physiological scoring systems or early warning scoring systems (NEWS) used in clinical practice?

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433. It is unsafe for a spinal tap to be undertaken if the patient:

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434. Under the Yellow Card Scheme you must report the following:

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435. Signs and symptoms of ectopic pregnancy except:

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436. Risk for health issues in a person with mental health issues

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

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438. Clinical benchmarking is

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439. While informing death over phone which phrase is better?

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440. 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?

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441. You noticed medical equipment not working while you joined a new team and the team members are not using it. What is your role?

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442. Patient suspected UTI

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443. Which of the following is NOT a physical sign of anxiety?

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444. The worst advice you can give a student nurse with regards to the use of social networking sites like Facebook? (Select 2 answers)

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445. The following entry into a client's plan of care: "Client will reestablish 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?

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

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447. Early ambulation of a post surgery patient reduce the chances of occurrence of following, except:

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

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450. When you tell your 4th year student under your care to dispense medication to your patient what you will assess?

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451. You are dealing with an infectious patient. What standard precautions will you take?

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452. When will you disclose the information?

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453. An 82 year old lady was admitted to the hospital for assessment of her respiratory problems. She has been a long term smoker in spite of her daughter advising her to stop. Based on your assessment, she has lost a substantial amount of weight. How will you assess her nutritional status?

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454. Which of the following is not a criteria for anaphylactic reaction?

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

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456. Oliver , 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?

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

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458. 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?

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459. Amelia, 50 years old, was admitted to the hospital with gastrointestinal bleeding presumed to be esophageal varices. It has been recommended that she needs to be transfused with blood; however, due to her religious and personal beliefs, she needed volume expanding agents. Unfortunately, she died a few hours after admission. Before dying, she said that it was God's will, which she believed was right.
Which of the following statements is false?

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460. Isla, 57 years old, suffered from a very dense left sided Cerebrovascular Accident/Stroke. She was unconscious and unresponsive for several days with IV fluids for hydration. Since her recovery from stroke, she has been prescribed to commence enteral feeding through a fine bore nasogastric tube, in which she signed her consent in front of her who have always been supportive of her decisions. However, she tends to pull out her NGT when she is by herself in her room. She died of malnutrition after a few days. Which of the following statements is true?

Nurses should have the empathy to listen to more than just the spoken word.
Nurses should practice in accordance to Isla's best interest while providing support to the family and listening to their concerns and wishes.
Isla needs to be supported with questions related to mortality and meaning of life. Therapautic communication is also essential.
All of the above


461. An adult patient with NASOGASTRIC TUBE died in a medical ward due to aspiration of fluids. What should NOT have been done?

Nothing should be introduced down the tube before gastric placement is confirmed.
Internal guidewires should not be lubricated before gastric placement is confirmed.
Auscultate the patient's stomach as you push some air in, and if you cannot hear anything, flush it.
It is important to check the position of the tube by measuring the pH value of stomach contents.


462. The following are ways to assess a patient's fluid and electrolyte status except?

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463. Mrs X is 89 years old and very frail. She has renal impairment and history of myocardial infarction. She needs support from staff to meet her nutritional needs. Which IV fluids are recommended for Mrs X

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464. Population groups at higher risk of having a low vitamin D status include the following except?

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465. Which of the following is not considered a medication?

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466. 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?

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467. One of the following is not true about delegation responsibility of a medication registrant?

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467. One of the following is not true about 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


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

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

General guidance for the storage of controlled drugs should include the following?
Cupboards must be kept locked when not in use
The lock must not be common to any other lock in the hospital
Keys must only be available to authorised members of staff
The cupboard must be dedicated to the storage of controlled drugs.
No other medicines or items may be stored in the controlled drug cupboard.
Controlled drugs must be locked away when not in use


469. 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 should be destroyed with the use of the Denaturing Kit
Controlled drugs disposal and destruction:

1. Destruction on ward may take place at the same time as a pharmacy stock check.
2. CDs should be destroyed in such a way that the drug is denatured or destroyed so that it cannot be retrieved, reconstituted or used.
3. Destruction must occur in a timely fashion, so that excessive quantities are not stored awaiting destruction.
4. All destruction must be documented in the appropriate section of the register, it must be witnessed by a second competent professional.


470. You were assigned to change the dressing of a patient with diabetic foot ulcer. You were not sure if the wound has sloughy tissues or pus. How will you carry out your assessment?

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471. Sophie, one of the residents in the nursing home, has not yet had her mental capacity assessment done. She has been making decisions that you personally think are not beneficial for her. Which of the following should not be implemented?

Force her to change her mind every time she makes a decision
Explain the benefits of making the right decision
Allow her to make her own decision, as she still has mental capacity
All of the above

A person who has not yet been assessed as unable to make decisions is still considered to have his or her mental capacity. Hence, Sophie's decision should be respected, and she should be allowed to make decisions for herself. Staff's preconception and prejudices should be set aside, so this will not affect the care delivered the person's country of origin



473. Which of the following sets of needs should be included in your service user"s person centered care plan?

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474. Thomas has not been able to communicate with the nurses on duty. Using nonverbal communication and gestures to help one identify a service user"s needs is important because?

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475. Which of the following tasks is crucial in therapeutic communication?

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476. You were on duty, and you have noticed that the syringe driver is not working properly. What should you do?

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477. A patient in one of your bays has called for staff. She needed assistance with "spending a penny". What will you do? (needs to urinate)

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478. Mr. Smith has a history of Congestive Heart Failure. He has also been complaining of general weakness. After taking his physical observations, you have noticed that he has pitting oedema on both feet. Which of the following is incorrect?

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479. Maisie is 86 years old, and has been in the nursing home for 5 years now. She has been complaining of burning sensation in her chest and sour taste at the back of her throat. What would she most likely to be prescribed with?

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480. Mrs B is 90 years old and has been admitted to the nursing home. The staff seem to have difficulty dealing with her family. One day, during your shift, Mrs B fell off a chair.You have assessed her, and no injuries have been noted. Which of the following is a principle of the Duty of Candour?

Answer: e - Duty of Candour - openness and honesty as a professional duty when things go wrong

a.) You will not ring the family since there is no injury caused by the fall.
b.) You have liaised with the lead nurse, and she decided not to ring the family due to no harm.
c.) Observe the patient, take her physical observations, and ask if you must call the family.
d.) All of the above
e.) None of the above


481. Maggie has been very physically and verbally aggressive towards other patients and staff for the last few weeks.
She is now on one-to-one care, 24 hours a day.
According to her person centred care plan, the nurses are looking after her very well preventing her from causing any harm. Behaviour has been discussed with the social worker, and clinical lead has applied for DoLS.
Which of the following is correct?

DoLS will allow staff to intervene depriving Maggie from doing something to  hurt herself, other residents, and staff

The Mental Capacity Act 2005 („the Act") provides a statutory framework for acting and making decisions on behalf of individuals who lack the mental capacity to do so for themselves

The DEPRIVATION OF LIBERTY SAFEGUARDS (DoLS) is a new provision to the MHA 2005.

The safeguards focus on some of the most vulnerable people in our society:
those who for their own safety and in their own best interests need to be accommodated under care and treatment regimes that may have the effect of depriving them of their liberty, but who lack the capacity to consent.


484. Documentation confirms that Amy has MRSA. You walked into her bedroom with coffee and biscuits on a tray. Which of the following is incorrect?

Put the coffee and biscuits on her bedside table and leave the tray on the other table
Wash your hands thoroughly before leaving her room
Dispose your gloves and apron before washing your hands
Use the alcohol gel on Amy"s bedside before leaving her room


485. Which of the following is the most important in infection control and prevention?

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486. There has been an outbreak of the Norovirus in your clinical area. Majority of your staff have rang in sick. Which of the following is incorrect?

Do not allow visitors to come in until after 48h of the last episode
Tally the episodes of diarrhoea and vomiting
Staff who has the virus can only report to work 48h after last episode
Ask one of the staff who is off-sick to do an afternoon shift on same day


487. Mrs X is diabetic and on PEG feed. Her blood sugar has been high during the last 3 days. She is on Nystatin Oral Drops QID, regular PEG flushes and insulin doses. Her Humulin dose has been increased from 12 iu to 14 iu. The nurse practitioner has advised you to monitor her BM"s for the next two days. What will be your initial intervention if her BM drops to 2.8 mmol after 2 morning doses of 14 iu?

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488. Annie is on Cefalexin QID. You were working on a night shift and have noticed that the previous nurse has not signed for the last two doses. What should you do?

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489. Alan appears to be very confused today. He seems to be quite verbally aggressive towards staff. His urine has also got a bit of foul smell. How would you assess this resident?

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490. You are the night nurse in a nursing home. Maxine, 81 years old, has been prescribed with Lorazepam PRN. You have assessed her to be wandering and talking to staff. When do you administer the Lorazepam?

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491. Jim is in persistent pain and has Oromorph PRN. All your carers are on their rounds, and you are about to administer this drug. What would you do?

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

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493. Your patient has Diverticulitis for about a decade now. You have assessed her to be having soft stools of Type 4/5. Which of the following will need urgent intervention?

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494. What is the purpose of clinical audit

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495. Adverse reaction reporting

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496. The code is concerned about focusing on which of the following criteria

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497. When communicating with a client who speaks a different language, which best practice should the nurse implement?

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498. Nurses who seek to enhance their cultural-competency skills and apply sensitivity toward others are committed to which professional nursing value?

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

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497. When communicating with a client who speaks a different language, which best practice should the nurse implement?

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498. Nurses who seek to enhance their cultural-competency skills and apply sensitivity toward others are committed to which professional nursing value?

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

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500. "Positive fluid balance”

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