MULTIPLE CHOICE

QUESTIONS

GUIDE

CBT EXAMS

FOR

NMC

1
TABLE OF CONTENT
QUESTIONS
1. NMC CODES AND ROLES 1
2. ACTS AND REGULATIONS 18

3. STUDENTS AND TRAINING 29

4. DELEGATION 47

5. ADVOCACY 56

6. MANAGEMENT, LEADERSHIP, DECISION MAKING 63

7. WOUNDS 178

8. URINE 221

9. HEART AND VEINS (CONDITIONS) 231

10.DIABETES 276

11.SPECIMENS AND COLLECTION 289

12.ELDERLY 301

13.CRUTCHES AND FRAMES 336

14.BONES AND MUSCLES 357

15.NUTRITION 373

16.LUNG, OXYGEN AND LUNGS 447

17.CONSENT AND THEATRE 497

18.COMMUNICATION 548

19.PREGNANCY 625

20.THEORIES 638

21.CLOSTRIDUM DIFFICILE 645

22. INFECTION 654

23.SHOCK 689

24.CHILDREN 705

25.BLOOD TRANSFUSIONS 722

26.NURSING CARE PLANS 728

27.MEDICATION 795

28. PSYCHIATRY 910

29. MEDICAL CONDITIONS 933

 30. DEATH AND DYING 1033

1. What is the role of the NMC?

a) To represent or campaign on behalf of nurses and midwifes

b) To regulate hospital or other healthcare settings in the UK
c) To regulate health care assistance
d) To regulate nurses and midwives in the UK to protect the public

2. What is the purpose of The NMC Code?

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a) It outlines specific tasks or clinical procedures
b) It ascertains in detail a nurse's or midwife's clinical expertise
c) It is a tool for educating prospective nurses and midwives

3. All are purposes of NMC except:

a) NMC’s role is to regulate nurses and midwives in England, Wales, Scotland

and Northern Ireland.
b) It sets standards of education, training, conduct and performance so that
nurses and midwives can deliver high quality healthcare throughout their
careers.
c) It makes sure that nurses and midwives keep their skills and knowledge up to
date and uphold its professional standards.
d) It is responsible for regulating hospitals or other healthcare settings.

4. The UK regulator for nursing & midwifery professions within the UK with a
started aim to protect the health & well-being of the public is:

a) GMC
b) NMC
c) BMC
d) WHC

5. Which of the following agency set the standards of education, training and
conduct and performance for nurses and midwives in the UK?

a) NMC
b) DH
c) CQC
d) RCN

6. What do you mean by code of ethics?

A) Legal activities of a registered nurse who work in the UK

B) Legislative body to control nurses

7. 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:

a) Prioritise people, practise effectively, preserve safety, promote

professionalism and trust
b) Prioritise people, practise safely, preserve dignity, promote professionalism
and trust
c) Prioritise care, practise effectively, preserve security, promote
professionalism and trust

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d) Prioritise care, practise safely, preserve security, promote kindness and trust

8. NMC requires in the UK how many units of continuing education units a

nurse should have in 3 years?

a) 35 Units
b) 45 Units
c) 55 Units
d) 65 Units

9. The code is the foundation of

a) Dress code
b) Personal document
c) Good nursing & midwifery practice & a key tool in safeguarding the health
&wellbeing of the public
d) Hospital administration

10.According to NMC Standards code and conduct, a registered nurse is

EXCLUDED from legal action in which one of these?

a) Fixed penalty for speeding

b) Possessing stock medications
c) Convicted for fraud
d) Convicted for theft

11.The NMC Code expects nurse to safeguarding the health and wellbeing of
public through the use of best available evidence in practice. Which of the
following nursing actions will ensure this?

a) using isopropyl alcohol 70% to wipe skin prior to cannulation b) suggesting

healthcare products or services that are still trialled c) ensure that the use of
complementary or alternative therapies is safe and in the best interest of those
in your care
d) all
12.Among the following values incorporated in NMC’s 6 C’s, which is not
included?

a) Care
b) Courage
c) Confidentiality
d) Communication

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

a) She transfers the accountability to care assistant

b) RN is accountable for care assistant’s actions

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c) No need to assess the competency, as the care assistant is expert in her care
area
d) Healthcare assistant is accountable to only her senior

14.Which of the following is NOT one of the six fundamental values for
nursing, midwifery and care staff set out in compassion in Practice
Nursing, Midwifery & care staff?

a) Care
b) Consideration
c) Communication
d) Compassion

15.According to law in England, UK when you faced with a situation of

emergency what is your action?

a) Should not assist when it is outside of work environment

b) Law insists you to stop and assist
c) You are not obliged in any way but as a professional duty advises you to stop
and assist
d) Do not involve in the situation

16. According to NMC Standards code and conduct, a registered nurse is

EXCLUDED from legal action in which one of these?

a) Fixed penalty for speeding

b) Possessing stock medications
c) Convicted for fraud
d) Convicted for theft

17.The code is the foundation of

a) Dress code
b) Personal document
c) Good nursing & midwifery practice & a key tool in safeguarding the health &
wellbeing of the public
 d) Hospital administration

18.A patient has been assessed as lacking capacity to make their own
decisions, what government legislation or act should be referred to:

a) Health and Social Care Act (2012)

b) Mental capacity Act (2005)
c) Carers (Equal opportunities) Act (2004)
d) All of the above

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

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a) Their own assessment
b) Financial support
c) Respite care
d) All of the above

20.How many steps to discharge planning were identified by the Department

of Health (DH 2010)?

a) 5 steps
b) 8 steps
c) 10 steps
d) 12 steps

21.The single assessment process was introduced as part of the National

Service Framework for Older People (DH 2001) in order to improve care for
this groups of patients.

a) True
b) False

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

a) Their own assessment

b) Financial support
c) Respite care
d) All of the above

23.Which law provides communication aid to patient with disability?

a) Communication Act
b) Equality Act
c) Mental Capacity Act
d) Children and Family Act

24.Hearing aid provide to client comes under which act?

 a) communication act
b) mental capacity act
c) children and family act.
d) Equality Act

25.Mental Capacity Act 2005 explores which of the following concepts:

a) Mental capacity, advance treatment decisions, and act’s code of practice b)

Mental capacity, independent mental capacity advocates, and the act’s code of
practice

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c) Mental capacity, advance treatment decisions, independent mental capacity
advocates, and the act’s code of practice
d) Mental capacity and the possible ethical and legal dilemmas in its
interpretation.

26.An enquiry was launched involving death of one of your patients. The
police visited your unit to investigate. When interviewed, which of the
following framework will best help assist the investigation?

a) Data Protection Act 2005

b) Storage of Records Policy
c) Consent policy
d) Confidentiality guidelines

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

a) call the police

b) call the security
c) let the patient go
d) encourage the patient to wait by telling the need for treatment

28.You are in a registered nurse in a community giving health education to a

patient and you notice that the student nurse is using his cell phone to text,
what should you do?

a) Tell the student to leave and emphasize what a disappointment she is

b) Report the student to his Instructor after duty
c) Politely signal the student and encourage him by actively including him in the
discussion

29.A person supervising a nursing student in the clinical area is called as:

a) mentor
b) preceptor
c) interceptor
d) supervisor
30.Training of student nurses is the responsibility of:

a) Ward in charge
b) Senior nurses
c) Team leaders
d) All RNS

31.A community health nurse, with second year nursing students is collecting
history in a home. Nurse notices that a student is not at all interested in what
is going around and she is chatting in her phone. Ideal response?

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a) Ask the student to leave the group
b) Warn her in public that such behaviours are not accepted
c) Inform to the principal
d) Talk to her in private and make her aware that such behaviours could actually
belittle the profession

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

a) supervise the entire procedure and the sign the chart

b) allow student to give drugs and sign the chart at the end of shift c) delegate
the supervision of the student to a senior nursing assistant and ask for
feedback
d) allow the student to observe but not signing on the chart

33.A nurse preceptor is working with a new nurse and notes that the new
nurse is reluctant to delegate tasks to members of the care team. The nurse
preceptor recognizes that this reluctance most likely is due to

a) Role modelling behaviours of the preceptor

b) The philosophy of the new nurse's school of nursing
c) The orientation provided to the new nurse
d) Lack of trust in the team members

34.Being a student, observe the insertion of an ICD in the clinical setting. This
is

a) Formal learning
b) Informal learning

35.When you tell a 3rd year student under your care to dispense medication to
your patient what will you assess?

a) Whether s/he is able to give medicine

b) Whether s/he is under your same employment
c) His/her competence and skills
d) Supervise directly
36.You are mentoring a 3rd year student nurse, the student request that she
want to assist a procedure with tissue viability nurse, how can you deal
with this situation

a) Tell her it is not possible

b) Tell her it is possible if you provide direct supervision
c) Call to the college and ask whether it is possible for a 3rd student to assist the
procedure
d) Allow her as this is the part of her learning

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37.A registered nurse is a preceptor for a new nursing graduate an is
describing critical paths and variance analysis to the new nursing graduate.
The registered nurse instructs the new nursing graduate that a variance
analysis is performed on all clients:

a) Continuously
b) daily during hospitalization
c) every third day of hospitalization
d) every other day of hospitalization

38.you have assigned a new student to an experienced health care assistant to

gain some knowledge in delivering patient care. The student nurse tells you
that the HCA has pushed the client back to the chair when she was trying to
stand up. What is your action

a) As soon as possible after an event has happened (to provide current (up to
date) information about the care and condition of the patient or client) b) Every
hour
c) When there are significant changes to the patient’s condition
d) At the end of the shift

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

a) supervise the entire procedure and the sign the chart

b) allow student to give drugs and sign the chart at the end of shift c) delegate
the supervision of the student to a senior nursing assistant and ask for
feedback
d) allow the student to observe but not signing on the chart

40.Who is responsible for the overall assessment of the student’s fitness to

practice and documentation of initial, midterm and final assessments in the
Ongoing Achievement Record (OAR)?

a) The mentor
b) The charge nurse/manager
c) Any registered nurse on same part of the register

41.What is the minimum length of time that a student must be supervised

(directly/indirectly) by the mentor on placement?
 a) 40%
b) 60%
c) Not specified, but as much as possible
d) Depends on the student capabilities

42.Which student require a SOM?

a) All consolidation students who started an NMC approved undergraduate

programme which commenced after September 2007.

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b) Learners undertaking conversion courses
c) Students on their final placement in 2nd year
d) Nurses/midwifes undertaking Mentorship Preparataion
e) All midwifery pre-registraitons students throughout training
f) Nurses/midwives undertaking SOM Preparation.

43.A nurse educator is providing in-service education to the nursing staff

regarding transcultural nursing care. A staff member asks the nurse
educator to describe the concept of acculturation. The most appropriate
response in which of the following?

a) It is subjective perspective of the person's heritage and sense of belonging to

a group
b) It is a group of individuals in a society that is culturally distinct and has a
unique identity
c) It is a process of learning, a different culture to adapt to a new or change in
environment
d) It is a group that share some of the characteristics of the larger population
group of which it is a part

44.You are the nurse in charge of the unit and you are accompanied by 4 th year
nursing students.

a) Allow students to give meds

b) Assess competence of student
c) Get consent of patient
d) Have direct supervision

45.You are in a registered nurse in a community giving health education to a

patient and you notice that the student nurse is using his cell phone to text,
what should you do?

a) Tell the student to leave and emphasize what a disappointment she is

b) Report the student to his Instructor after duty
c) Politely signal the student and encourage him by actively including him in the
discussion

46.When doing your drug round at midday, you have noticed one of your
patient coughing more frequently whilst being assisted by a nursing
student at mealtime. What is your initial action at this situation?
a) tell the student to feed the patient slowly to help stop coughing
b) ask the student to completely stop feeding
c) ask student to allow patient some sips of water to stop coughing
d) ask student to stop feeding and assess patients swallowing

47.To whom should you delegate a task?

a) Someone who you trust

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b) Someone who is competent
c) Someone who you work with regularly
d) All of the above

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

a) She transfers the accountability to care assistant

b) RN is accountable for care assistant’s actions
c) No need to assess the competency, as the care assistant is expert in her care
area
d) Healthcare assistant is accountable to only her senior

49.Which of the following is an important principle of delegation?

a) No transfer of authority exists when delegating

b) Delegation is the same as work allocation
c) Responsibility is not transferred with delegation
d) When delegating, you must transfer authority

50.A staff nurse has delegated the ambulating of a new post-op patient to a
new staff nurse. Which of the following situations exhibits the final stage in
the process of delegation?

a) Having the new nurse tell the physician the task has been completed.
b) Supervising the performance of the new nurse
c) Telling the unit manager, the task has been completed
d) Documenting that the task has been completed.

51.Which of the following is a specific benefit to an organization when

delegation is carried out effectively?

a) Delegates gain new skills facilitating upward mobility

b) The client feels more of their needs are met
c) Managers devote more time to tasks that cannot be delegated
d) The organization benefits by achieving its goals more efficiently

52.A nurse delegates duty to a health assistant. What NMC standard she
should keep in mind while doing this?
 a) She transfers the accountability to care assistant
b) RN is accountable for care assistant’s actions
c) No need to assess the competency, as the care assistant is expert in her care
area

53.A staff nurse has delegated the ambulating of a new post-op patient to a
new staff nurse. Which of the following situations exhibits the final stage in
the process of delegation?

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a) Having the new nurse tell the physician the task has been completed
b) Supervising the performance of the new nurse
c) Telling the unit manager, the task has been completed
d) Documenting that the task has been completed.

54.Which of the following is a specific benefit to an organization when

delegation is carried out effectively?

a) Delegates gain new skills facilitating upward mobility

b) The client feels more of their needs are met
c) Managers devote more time to tasks that cannot be delegated
d) The organization benefits by achieving its goals more efficiently

55.The measurement and documentation of vital signs is expected for clients

in a long-term facility. Which staff type would it be a priority to delegate
these tasks to?

a) Practical Nurse
b) Registered Nurse
c) Nursing assistant
d) Volunteer

56.Independent Advocacy is:

a) Providing general advice

b) Making decisions for someone
c) Care and support work
d) Agreeing with everything a person says and doing anything a person asks you
to do
e) None of the above *

57.What is meant by an advocate?

a) Someone who develops opportunities for the patient

b) Someone who has the same beliefs as the patient
c) Someone who does something on behalf of the patient
d) Someone who has the same values as the patient.

58.A Nurse demonstrates patient advocacy by becoming involved in which of

the following activities?

a) Taking a public stand on quality issues and educating the public on” public
 interest” issues
b) Teaching in a school of nursing to help decrease the nursing shortage
c) Engaging in nursing research to justify nursing care delivery d)
Supporting the status quo when changes are pending

59.In the role of patient advocate, the nurse would do which of the following?

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a) Emphasize the need for cost-containment measures when making health care
decisions
b) Override a patient’s decision when the patient refuses the recommended
treatment
c) Support a patient’s decision, even if it is not the decision desired by the nurse
d) Foster patient dependence on health care providers for decision making

60.What is Advocacy according to NHS Trust?

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

61.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:

a) Educator
b) Advocate
c) Care giver
d) Case manager

62.A nurse demonstrates patient advocacy by becoming involved in which of

the following activities?

a) Taking a public stand and quality issues and educating the public on “public
interest” issues.
b) Teaching in school of nursing to help decrease the nursing shortage
c) Engaging in nursing research to justify nursing care delivery d)
Supporting the status quo when changes are pending

63.Which of the following is NOT one of the six fundamental values for
nursing, midwifery and care staff set out in compassion in Practice
Nursing, Midwifery & care staff?

a) Care
b) Consideration
c) Communication
 d) Compassion

64.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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a) Assault
b) Slander
c) Negligence
d) Tort

65.The client is being involuntary committed to the psychiatric unit after

threatening to kill his spouse and children. The involuntary commitment is
an example of what bioethical principle?

a) Fidelity
b) Veracity
c) Autonomy
d) Beneficence

66.What is accountability?
a) Ethical and moral obligations permeating the nursing profession b) To be
answerable to oneself and others for one's own actions.” c) A systematic
approach to maintaining and improving the quality of patient care within a health
system (NHS).
d) The process of applying knowledge and expertise to a clinical situation to
develop a solution

67.According to the nursing code of ethics, the nurse’s first allegiance is to

the:

a) Client and client's family

b) Client only
c) Healthcare organization
d) Physician

68.Which option best illustrates a positive outcome for managed care?

a) Involvement in the political process.

b) Reshaping current policy.
c) Cost-benefit analysis.
d) Increase in preventive services

69.While at outside setup what care will you give as a Nurse if you are
exposed to a situation?

a) Provide care which is at expected level

b) Above what is expected
 c) Ignoring the situation
d) Keeping up to professional standards

70.As a nurse, the people in your care must be able to trust you with their
health and well being. In order to justify that trust, you must not:

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a) work with others to protect and promote the health and wellbeing of those in
your care
b) provide a high standard of practice and care when required
c) always act lawfully, whether those laws relate to your professional practice or
personal life
d) be personally accountable for actions and omissions in your practice

71.Describe the primary focus of a manager in a knowledge work

environment.

a) Developing the most effective teams

b) Taking risks.
c) Routine work
d) Understanding the history of the organization.

72.In using social media like Facebook, how will you best adhere to your Code
of
Conduct as a nurse? (CHOOSE 2 ANSWERS)

a) Never have relationship with previous patient

b) Never post pictures concerning your practice
c) Never tell you are a nurse
d) Always rely SOLELY in your FBs privacy setting

73.Which strategy could the nurse use to avoid disparity in health care
delivery?

a) Recognize the cultural issue related to patient care

b) Request more health plan options
c) Care for more patients even if quality suffers
d) Campaign for fixed nurse patient ratios

74.In an emergency department doctor asked you to do the procedure of

cannulation and left the ward. You haven't done it before. What would you
do?

a) Don't do it as you are not competent or trained for that & write incident report &
inform the supervisor
b) What is the purpose of clinical audit?
c) Do it
d) Ask your colleague to do it
e) Complain to the supervisor that doctor left you in middle of the procedure

75.NMC defines record keeping as all of the following except:

 a) Helping to improve advocacy
b) Showing how decisions related to patient care were made
c) Supporting effective clinical judgements and decisions
d) Helping in identifying risks, and enabling early detection of complications

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76.When do we need to document?

a) As soon as possible after an event has happened to provide current up to

date information about the care and condition of the patient or client b) Every
hour
c) When there are significant changes to the patient’s condition
d) At the end of the shift

77.All should be seen in a good documentation except:

a) legible handwriting
b) Name and signature, position, date and time
c) Abbreviations, jargon, meaningless phrases, irrelevant speculation and
offensive subjective statements
d) A correct, consistent, and factual data

78.A nurse documented on the wrong chart. What should the nurse do?

a) Immediately inform the nurse in charge and tell her to cross it all off.
b) Throw away the page
c) Write line above the writing; put your name, job title, date, and time.
d) Ignore the incident.

79.Information can be disclosed in all cases except:

a) When effectively anonymized.

b) When the information is required by law or under a court order. c) In
identifiable form, when it is required for a specific purpose, with the individual’s
written consent or with support under the Health Service d) In Child Protection
proceedings if it is considered that the information required is in the public or
child’s interest

80.Adequate record keeping for a medical device should provide evidence of:

a) A unique identifier for the device, where appropriate

b) A full history, including date of purchase and where appropriate when it was
put into use, deployed or installed
c) Any specific legal requirements and whether these have been met
d) Proper installation and where it was deployed
e) Schedule and details of maintenance and repairs
f) The end-of-life date, if specified
g) All of the above

81.A registered nurse had a very busy day as her patient was sick, got
 intubated & had other life saving procedures. She documented all the
events & by the end of the shift recognized that she had documented in
other patient's record. What is best response of the nurse?

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a) She should continue documenting in the same file as the medical document
cannot be corrected
b) She should tear the page from the file & start documenting in the correct
record
c) She should put a straight cut over her documentation & write as wrong, sign it
with her NMC code, date & time
d) She should write as wrong documentation in a bracket & continue

82.What are essential competencies for today's nurse manager?

a) strategic planning and design

b) Self and group awareness
c) A vision and goals
d) Communication and teamwork

83.A very young nurse has been promoted to nurse manager of an inpatient
surgical unit. The nurse is concerned that older nurses may not respect the
manager's authority because of the age difference. How can this nurse
manager best exercise authority?

a) Maintain in an autocratic approach to influence results.

b) Understand complex health care environments.
c) Use critical thinking to solve problems on the unit
d) Give assignments clearly, taking staff expertise into consideration

84.What statement, made in the morning shift report, would help an effective
manager develop trust on the nursing unit?

a) I know I told you that you could have the weekend off, but I really need you
to work.”
b) The others work many extra shifts, why can’t you?”
c) I’m sorry, but I do not have a nurse to spare today to help on your unit. I
cannot make a change now, but we should talk further about schedules and
needs.”
d) I can’t believe you need help with such a simple task. Didn’t you learn that in
school?”

85.The nurse has just been promoted to unit manager. Which advice, offered
by a senior unit manager, will help this nurse become inspirational and
motivational in this new role?

a) "If you make a mistake with your staff, admit it, apologize, and correct the
error if possible."
 b) "Don't be too soft on the staff. If they make a mistake, be certain to
reprimand them immediately."
c) "Give your best nurses extra attention and rewards for their help."
d) "Never get into a disagreement with a staff member.

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86.The nurse executive of a health care organization wishes to prepare and
develop nurse managers for several new units that the organization will
open next year. What should be the primary goal for this work?

a) Focus on rewarding current staff for doing a good job with their assigned tasks
by selecting them for promotion.
b) Prepare these managers so that they will focus on maintaining standards of
care
c) Prepare these managers to oversee the entire health care organization
d) Prepare these managers to interact with hospital administration.

87.A nurse manager is planning to implement a change in the method of the

documentation system for the nursing unit. Many problems have occurred
as a result of the present documentation system, and the nurse manager
determines that a change is required. The initial step in the process of
change for the nurse manager is which of the following?

a) plan strategies to implement the change

b) identify the inefficiency that needs improvement or correction c)
identify potential solutions and strategies for the change process

88.What are the key competencies and features for effective collaboration?

a) Effective communication skills, mutual respect, constructive feedback, and

conflict management.
b) High level of trust and honesty, giving and receiving feedback, and decision
making.
c) Mutual respect and open communication, critical feedback, cooperation, and
willingness to share ideas and decisions.
d) Effective communication, cooperation, and decreased competition for scarce
resources.

89.All of the staff nurses on duty noticed that a newly hired staff nurse has
been selective of her tasks. All of them thought that she has a limited
knowledge of the procedures. What should the manager do in this
situation?

a) Reprimand the new staff nurse in front of everyone that what she is doing is
unacceptable.
b) Call the new nurse and talk to her privately; ask how the manager can be of
help to improve her situation
c) Ignore the incident and just continue with what she was doing. d) Assign
someone to guide the new staff nurse until she is competent in doing her tasks.

90.Which option best illustrates a positive outcome for managed care?

 a) Reshaping current policy.
b) Involvement in the political process
c) Increase in preventative services

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d) Cost-benefit analysis.

91.Describe the primary focus of a manager in a knowledge work

environment.

a) Developing the most effective teams.

b) Taking risks
c) Routine work.
d) Understanding the history of the organization.

92.What do you mean by a bad leadership?

a) Appreciate intuitiveness
b) Appreciate better work
c) Reward poor performance

93.There have been several patient complaints that the staff members of the
unit are disorganized and that “no one seems to know what to do or when
to do it.” The staff members concur that they don’t have a real sense of
direction and guidance from their leader. Which type of leadership is this
unit experiencing?

a) Autocratic.
b) Bureaucratic.
c) Laissez-faire.
d) Authoritarian.

94.Ms. Castro is newly-promoted to a patient care manager position. She

updates her knowledge on the theories in management and leadership in
order to become effective in her new role. She learns that some managers
have low concern for services and high concern for staff. Which style of
management refers to this?

a) Organization Man
b) Impoverished Management
c) Country Club Management
d) Team Management

95.Ms. Jones is newly promoted to a patient care manager position. She

updates her knowledge on the theories in management and leadership in
order to become effective in her new role. She learns that some managers
have low concern for services and high concern for staff. Which style of
management refers to this?

a) Country Club Management

b) Organization Man
c) Impoverished Management
 d) Team Management

19
96.When group members are unable and unwilling to participate in making a
decision, which leadership style should the nurse manager use?

a) Participative
b) Authorian
c) Laissez faire
d) Democratic

97.What is the most important issue confronting nurse managers using

situational leadership?

a) Leaders can choose one of the four leadership styles when faced with a new
situation.
b) Personality traits and leader’s power base influence the leader’s choice of style
c) Value is placed on the accomplished of tasks and on interpersonal relationships
between leader and group members and among group members d) Leadership
style differs for a group whose members are at different levels of maturity

98.The nursing staff communicates that the new manager has a focus on the
"bottom line,” and little concern for the quality of care. What is likely true of
this nurse manager?

a) The manager is unwilling to listen to staff concerns unless they have an impact
on costs.
b) The manager understands the organization's values and how they mesh with
the manger's values.
c) The manager is communicating the importance of a caring environment.
d) The manager is looking at the total care picture

99.An example of a positive outcome of a nurse-health team relationship

would be:

a) Receiving encouragement and support from co-workers to cope with the

many stressors of the nursing role
b) Becoming an effective change agent in the community
c) An increased understanding of the family dynamics that affect the client d)
An increased understanding of what the client perceives as meaningful from
his or her perspective

100. What are essential competencies for today’s nurse manager?

a) vision and goals

b) Communication and teamwork
c) Self- and group awareness
d) Strategic planning and design

101. The characteristic of an effective leader include:

 a) attention to detail

20
b) sound problem-solving skills and strong people skills
c) emphasis on consistent job performance
d) all of the above

102. The following are qualities of a good leader, except:

a) Shows empathy to members

b) His behaviour contributes to the team
c) Acknowledges and accepts members mistakes - without any corrections
d) Does not accept criticisms from members

103. A nurse manger achieves a higher management position in the

organisation, there is a need for what type of skills?

a) Personal and communication skills

b) Communication and technical skills
c) Conceptual and interpersonal skills
d) Visionary and interpersonal skills

104. The nurse has just been promoted to unit manager. Which advice,
offered by a senior unit manager, will help this nurse become inspirational
and motivational in this new role?

a) "Don't be too soft on the staff, if they make a mistake, be certain to reprimand
them immediately."
b) "Give your best nurses extra attention and rewards for their help."
c) "Never gets into a disagreement with a staff member."
d) "If you make a mistake with your staff, admit it, apologize, and correct the
error if possible."

105. The famous 14 Principles of Management was first defined by

a) James Watt
b) Adam Smith
c) Henri Fayol
d) Elton Mayo

106. You are a new and inexperienced staff, which of the following actions
will you do during your first day on the clinical area?

a) Acknowledge your limitations, seek supervision from your team leader

b) volunteer to do the drug rounds
c) help in admitting the patients
d) answer all enquiries from the patients

107. A patient has sexual interest in you. What would you do?
 21
a) Just avoid it, because the problem can be the manifestation of the underlying
disorder, and it will be resolved by its own as he recovers
b) Never attend that patient
c) Try to re-establish the therapeutic communication and relationship with patient
and inform the manager for support
d) Inform police

108. One of your young patient displayed an overt sexual behaviour directly
to you. How will you best respond to this?

a) Talk to the patient about the situation, to re- establish and maintain
professional boundaries and relationship
b) ignore the behaviour as this is part of the development process
c) report the patient to their relatives
d) inform line manager of the incident

109. A nurse from Medical-surgical unit asked to work on the orthopedic unit.
The medical-surgical nurse has no orthopedic nursing experience. Which
client should be assigned to the medical-surgical nurse?

a) A client with a cast for a fractured femur & who has numbness & discoloration
of the toes
b) A client with balanced skeletal traction & who needs assistance with morning
care
c) A client who had an above-the-knee amputation yesterday & has a
temperature of 101.4F
d) A client who had a total hip replacement 2 days ago & needs blood glucose
monitoring

110. An RN from the women's health clinic is temporarily reassigned to a

medical-surgical unit. Which of these client assignments would be most
appropriate for this nurse?

a) A newly diagnosed client with type 2 diabetes mellitus who is learning foot care
b) A client from a motor vehicle accident with an external fixation device on the leg
c) A client admitted for a barium swallow after a transient ischemic attack
d) A newly admitted client with a diagnosis of pancreatic cancer

111. The nurse suspects that a client is withholding health-related information

out of fear of discovery and possible legal problems. The nurse formulates
nursing diagnoses for the client carefully, being concerned about a
diagnostic error resulting from which of the following?

a) Incomplete data
b) Generalize from experience
c) Identifying with the client
d) Lack of clinical experience

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112. A nurse case manager receives a referral to provide case management
 services for an adolescent mother who was recently diagnosed with HIV.
Which statement indicates that the patient understands her illness?

a) “I can never have sex again, so I guess I will always be a single parent.” b)
b) “I will wear gloves when I’m caring for my baby, because I could infect my
baby with AIDS.”
c) “My CD4 count is 200 and my T cells are less than 14%. I need to stay at
these levels by eating and sleeping well and staying healthy.”
d) “My CD4 count is 800 and my T cells are greater than 14%. I need to stay at
these levels by eating and sleeping well and staying healthy.”

113. A young woman who has tested positive for HIV tells her nurse that she
has had many sexual partners. She has been on an oral contraceptive &
frequently had not requested that her partners use condoms. She denies IV
drug use she tells her nurse that she believes that she will die soon. What
would be the best response for the nurse to make.

a) “Where there is life there is hope”

b) “ Would you like to talk to the nurse who works with HIV- positive patient’s ?”
c) “ you are a long way from dying”
d) “ not everyone who is HIV positive will develop AIDS & die”

114. A client express concern regarding the confidentiality of her medical

information. The nurse assures the client that the nurse maintains client
confidentiality by:

a) Explaining the exact limits of confidentiality in the exchanges between the

client and the nurse.
b) Limiting discussion about clients to the group room and hallways. c)
Summarizing the information, the client provides during assessments and
documenting this summary in the chart.
d) Sharing the information with all members of the healthcare team

115. One busy day on your shift, a manager told you that all washes should
be done by 10am. What would you do?

a) Follow the manager and ensure that everything is done on time. b) Talk to the
manager and tell her that the quality of care will be compromised if washes are
rushed.
c) Ignore the manager and just continue with what you are doing.
d) Provide a written statement of the incident.

116. You noticed medical equipment not working while you joined a new
team and the team members are not using it. Your role?

a) during audit raise your concern

b) inform in written to management
c) inform NMC

23
e) take photograph
117. When developing a program offering for patients who are newly
diagnosed with diabetes, a nurse case manager demonstrates an
understanding of learning styles by:

a) Administering a pre- and post-test assessment.

b) Allowing patient’s time to voice their opinions
c) Providing a snack with a low glycaemic index.
d) Utilizing a variety of educational materials.

118. An adult has signed the consent form for a research study but has
changed her mind. The nurse tells the patient that she has the right to
change her mind based upon which of the following principles.

a) Paternalism & justice

b) Autonomy & informed consent
c) Beneficence & double effect
d) Competence & right to know

119. A famous actress has had plastic surgery. The media contacts the nurse
on the unit and asks for information about the surgery. The nurse knows:

a) Any information released will bring publicity to the hospital

b) Nurse are obligated to respect client’s privacy and confidentiality c) It does
not matter what is disclosed, the media will find out any way d) According to
beneficence, the nurse has an obligation to implement actions that will benefit
clients.

120. When will you disclose the identity of a patient under your care?

a) You can disclose it anytime you want

b) When a patient relative wishes to
c) When media demands for it
d) Justified by public interest law and order

121. Today many individuals are seeking answers for acute and chronic
health problems through non-traditional approaches to health care. What
are two popular choices being selected by health consumers?

a) Mind awareness techniques and meditation practice

b) Stress management and biofeedback programs
c) Support groups and alternative medicine
d) Telehealth and the internet

122. Which of the following actions jeopardise the professional boundaries

between patient and nurse

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a) Focusing on social relationship outside working environment
b) Focusing on needs of patient related to illness
 c) Focusing on withholding value opinions related to the decisions

123. One of the main responsibilities of an employer should be:

a) provide a safe place for the employees

b) provide entertainment to employees
c) create opportunities for growth
d) create ways to make networks

124. Role conflict can occur in any situation in which individuals work
together. The predominant reason that role conflict will emerge in
collaboration is that people have different

a) Levels of education and preparation

b) Expectations about a particular role; interpersonal conflict will emerge c)
Levels of experience and exposure of working in interdisciplinary teams d)
Values, beliefs, and work experiences that influences their ability to
collaborate.

125. How to give respect & dignity to the client?

a) Compassion, support & reassurance to the client

b) Communicate effectively with them
c) Behaving in a professional manner
d) Giving advice on health care issues

126. A patient with antisocial personality disorder enters the private meeting
room of a nursing unit as a nurse is meeting with a different patient. Which
of the following statements by the nurse is BEST?

a) Please leave and I will speak with you when I am done."

b) I need you to leave us alone."
c) You may sit with us as long as you are quiet."
d) I'm sorry, but HIPPA says that you can't be here. Do you mind leaving?"

127. A client on your medical surgical unit has a cousin who is physician &
wants to see the chart. Which of the following is the best response for the
nurse to take

a) Ask the client to sign an authorization & have someone review the chart with
cousin
b) Hand the cousin the client chart to review
c) Call the attending physician & have the doctor speak with the cousin
d) Tell the cousin that the request cannot be granted

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128. As an RN in charge you are worried about a nurse's act of being very
active on social media site, that it affect the professionalism. Which one of
 these is the worst advice you can give her?

a) Do not reveal your profession of being a Nurse on social site b) Do not

post any pictures of client's even if they have given you permission c) Do not
involve in any conversions with client's or their relatives through a social site
d) Keep your profile private

129. Compassion in Practice – the culture of compassionate care

encompasses:

a) Care, Compassion, Competence, Communication, Courage, Commitment -

DoH–“Compassion in Practice”
b) Care, Compassion, Competence
c) Competence, Communication, Courage
d) Care, Courage, Commitment

130. You walk onto one of the bay on your ward and noticed a colleague
wrongly using a hoist in transferring their patient. As a nurse you will:

a) let them continue with their work as you are not in charge of that bay
b) report the event to the unit manager
c) call the manual handling specialist nurse for training
d) inform the relatives of the mistake

131. You are to take charge of the next shift of nurses. Few minutes before
your shift, the in charge of the current shift informed you that two of your
nurses will be absent. Since there is a shortage of staff in your shift, what
will you do?

a) encourage all the staff who are present to do their best to attend to the needs
of the patients
b) ask from your manager if there are qualified staff from the previous shift that
can cover the lacking number for your shift while you try to replace new nurses
to cover
c) refuse to take charge of the next shift

132. Who will you inform first if there is a shortage in supplies in your shift?

a) Nursing assistant
b) Purchasing personnel
c) Immediate nurse manager
d) Supplier

133. The supervisor reprimands the charge nurse because the nurse has not
adhered to the budget. Later the charge nurse accuses the nursing staff of
wasting supplies. This is an example of

26
a) Denial
b) Repression
c) Suppression
 d) Displacement

134. A nurse is having trouble with doing care plans. Her team members are
already noticing this problem and are worried of the consequences this
may bring to the quality of nursing care delivered. The problem is already
brought to the attention of the nurse. The nurse should:

a) Accept her weakness and take this challenge as an opportunity to improve her
skills by requesting lectures from her manager
b) Ignore the criticism as this is a case of a team issue
c) Continue delivering care as this will not affect the quality of care you are
rendering your patient

135. Clinical audit is best described as:

a) a tool to evaluate the effectiveness of interventions, and to know what needs

to be improved
b) a tool used to identify the weakest link within the system
c) a standard of which performance is based upon
d) a tool to set a guidelines or protocol in clinical practice

136. You are the nurse on Ward C with 14 patients. Your fellow incoming
nurses called in sick and cannot come to work on your shift. What will be
your best action on this situation?

a) Review patient intervention, set priorities, ask the supervisor to hand over
extra staff
b) continue with your shift and delegate some responsibilities to the nursing
assistant
c) fill out an incident form about the staffing condition
d) ask the colleague to look for someone to cover

137. A client requests you that he wants to go home against medical advice,
what should you do?

a) Inform the management

b) Inform the local police
c) Call the security guard
d) Allow the client to go home as he won't pose any threat to self or others

138. The nurse is leading an in service about management issues. The nurse
would intervene if another nurse made which of the following statements?

27
a) “It is my responsibility to ensure that the consent form has been signed and
attached to the patient’s chart prior to surgery.”
b) “It is my responsibility to witness the signature of the client before surgery is
performed.
 c) “It is my responsibility to answer questions that the patient may have prior to
surgery.”
d) “It is my responsibility to provide a detailed description of the surgery and ask
the patient to sign the consent form.”

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

a) “The patient climbed over the side rails and fell out of bed.”
b) “The use of restraints would have prevented the fall.”
c) “Upon entering the room, the patient was found lying on the floor.”
d) “The use of a sedative would have helped keep the patient in bed.”

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

a) Charge the nurse with malpractice

b) Document the incident
c) Notify the board of nursing
d) Terminate employment

141. A patient in your care knocks their head on the bedside locker when
reaching down to pick up something they have dropped. What do you
do?

a) Let the patient’s relatives know so that they don’t make a complaint & write an
incident report for yourself so you remember the details in case there are
problems in the future
b) Help the patient to a safe comfortable position, commence neurological
observations & ask the patient’s doctor to come & review them, checking the
injury isn’t serious. when this has taken place , write up what happened & any
future care in the nursing notes
c) Discuss the incident with the nurse in charge , & contact your union
representative in case you get into trouble
d) Help the patient to a safe comfortable position, take a set of observations &
report the incident to the nurse in charge who may call a doctor. Complete an
incident form. At an appropriate time, discuss the incident with the patient & if
they wish, their relatives

142. 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?

28
a) Nursing diagnosis/problem list
b) Nursing order
c) Short-term goals
d) Long term goals
143. A registered nurse identifies a care assistant not washing hands hand
before caring an immunocompromised client. Your response?

a) Let her do the procedure. Correct her later

b) Inform to ward in charge
c) Interrupt the procedure, correct her politely, teach her 6 steps of handwashing
and make sure she became competent

144. The bystander of a muslim lady wishes that a lady doctor only should
check the patient. Best response

a) Just neglect the request

b) Tell her that, only male doctor is available and he is takin care of many female
staffs daily
c) Respect the request, if possible arrange the consultation with a female doc
d) Inform police

145. Bystander informs you that the patient is in severe pain. Ur response

a) Tell him that he would come as soon as possible

b) Record in the chart and inform doc and in charge
c) Tell that she would give the next dose of analgesic when it’s time
d) Go instantly to the patient and assess the condition

146. The nurse restraints a client in a locked room for 3 hours until the client
acknowledges who started a fight in the group room last evening. The
nurse’s behaviour constitutes:

a) False imprisonment
b) Duty of care
c) Standard of care practice
d) Contract of care

147. Role conflict can occur in any situation in which individuals work
together. The predominant reasons that role conflict will emerge in
collaboration is that people have different:

a) Levels of education and preparation

b) Expectations about a particular role; interpersonal conflict will emerge c)
Levels of experience and exposure of working in interdisciplinary teams d) Values,
beliefs, and work experiences that influence their ability to collaborate.

29
148. What are the characteristics of effective collaboration?

a) Common purpose and goals

b) Clinical competence of each provider
c) Humor, trust, and valuing diverse, complementary knowledge
d) All of the above
149. A client has been voluntarily admitted to the hospital. The nurse knows
that which of the following statements is inconsistent with this type of
hospitalization?

a) The client retains all of his or her rights

b) the client has a right to leave if not a danger to self or others
c) the client can sign a written request for discharge
d) The client cannot be released without medical advice

150. If you were explaining anxiety to a patient, what would be the main
points to include?

a) Signs of anxiety include behaviours such as muscle tension. palpitations, a

dry mouth, fast shallow breathing, dizziness & an increased need to urinate or
defaecate
b) Anxiety has three aspects: physical – bodily sensations related to flight & fight
response, behavioural – such as avoiding the situation, & cognitive (thinking)
– such as imagining the worst
c) Anxiety is all in the mind, if they learn to think differently, it will go away d)
Anxiety has three aspects: physical – such as running away, behavioural – such
as imagining the worse (catastrophizing) , & cognitive ( thinking) – such as
needing to urinate.

151. A 23-year-old-woman comes to the emergency room stating that she

had been raped. Which of the following statements BEST describes the
nurse’s responsibility concerning written consent?

a) The nurse should explain the procedure to the patient and ask her to sign the
consent form.
b) The nurse should verify that the consent form has been signed by the patient
and that it is attached to her chart.
c) The nurse should tell the physician that the patient agrees to have the
examination.
d) The nurse should verify that the patient or a family member has signed the
consent form.

152. 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 behaviour is MOST justifiable?

30
a) She has already moved through the stages of the grieving process.
b) She is repressing anger related to her husband’s death.
c) She is experiencing shock and disbelief related to her husband’s death.
d) She is demonstrating resolution of her husband’s death.

153. 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?

a) fine, we’re better off without you anyway”

b) It seems to me that you feel frustrated. What can I help you with to care for
our patients?”
c) I can understand why you’re upset, but I’m tired too and I’m not quitting.”
d) Why don’t you take a dinner break and come back? It will seem more
manageable with a normal blood sugar.

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

a) Introjection
b) Displacement
c) Identification
d) Repression

155. 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?

a) Document this information on the patient’s chart

b) Tell the patient’s physician
c) Inform the healthcare team who will come in contact with the patient
d) Encourage the patient to disclose this information to her physician

156. 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?

a) Go over & tell the nursing assistants that their actions are inappropriate
especially in a public place
b) Wait & tell the assistants later that they were overheard discussing the patient
otherwise they might be embarrassed

31
c) Tell the nursing assistant’s supervisor about the incident. It is the supervisor’s
responsibility to address the issue
d) Say nothing. it is not the nurses job, he or she is not responsible for the
assistant’s action

157. A young woman who has tested positive for HIV tells her nurse that she
has had many sexual partners. She has been on an oral contraceptive &
frequently had not requested that her partners use condoms. She denies IV
drug use she tells her nurse that she believes that she will die soon. What
would be the best response for the nurse to make.
 a) “Where there is life there is hope”
b) “ Would you like to talk to the nurse who works with HIV- positive patient’s ?”
c) “ you are a long way from dying”
d) “ not everyone who is HIV positive will develop AIDS & die”

158. 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?

a) Accept the voucher and thank him for this gesture

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

159. 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?

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

160. 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?

a) The nurse supervisor on duty will call the nurse manager at home and apprise
about the problem
b) Because the nurse manager is not on duty therefore she is not accountable to
anything which happens on her absence
c) 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.
d) 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

32
nurse manager has no responsibility of what has happened in manager’s
absence

161. All individuals providing nursing care must be competent at which of

the following procedures?

a) Hand hygiene and aseptic technique

b) Aseptic technique only
c) Hand hygiene, use of protective equipment, and disposal of waste
d) Disposal of waste and use of protective equipment
e) All of the above
162. Clinical bench-marking is:

a) to improve standards in health care

b) a new initiate in health care system
c) A new set of rule for health care professionals
d) To provide a holistic approach to the patient

163. What do you mean by benchmarking tool ?

a) an overall patient-focused outcome that expresses what patients and or carers

want from care in a particular area of practice
b) it is the way of expressing the need of the patient
c) a continuum between poor and best practice.
d) information on how to use the benchmarks

164. Essence of Care benchmarking is a process of -------?

a) Comparing, sharing and developing practice in order to achieve and sustain

best practice.
b) Assess clinical area against best practice
c) Review achievement towards best practice
d) Consultation and patient involvement

165. 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?

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

33
166. When trying to make a responsible ethical decision, what should the
nurse understand as the basis for ethical reasoning?

a) Ethical principles & code

b) The nurse’s experience
c) The nurse’s emotional feelings
d) The policies & practices of the institution

167. 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?

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

168. While at outside setup what care will you give as a Nurse if you are
exposed to a situation?

a) Provide care which is at expected level

b) keeping up to professional standards
c) above what is expected
d) Ignoring the situation

169. when breaking bad news over phone which of the following statement is
appropriate

a) I am sorry to tell you that your mother died

b) I am sorry to tell you that your mother has gone to heaven
c) I am sorry to tell you that your mother is no more
d) I am sorry to tell you that your mother passed away

170. A patient with complex, multiple diseases is discharged to a tertiary

level care unit what to do?

a) Inform the tertiary unit about patient arrival

b) Call for a multidisciplinary meeting with professional who took care of patient to
discuss the patient care modalities that everyone accepts.
c) Inform to patient relatives about the situation

171. clinical practice is based on evidence based practice. Which of the

following statements is true about this

a) Clinical practice based on clinical expertise and reasoning with the best
knowledge available
b) Provision of computers at every nursing station to search for best evidence
while providing care
c) Practice based on ritualistic way

34
d) Practice based on what nurse thinks is the best for patient
n adult has just returned to the unit from surgery. The nurse transferred him to
his bed but did not put up the side rails.

172. The client fell and was injured. What kind of liability does the nurse
have?

a) None
b) Negligence
c) Intentional tort
d) Assault & battery
 173. A new RN have problems with making assumptions. Which part of the
code she should focus to deliver fundamentals of care effectively

a) Prioritise people
b) Practice effective
c) Preserve safety
d) Promote professionalism and trust

174. A patient with learning disability is accompanied by a voluntary

independent mental capacity advocate. What is his role?

a) Express patients’ needs and wishes. Acts as a patient’s representative in

expressing their concerns as if they were his own
b) Just to accompany the patient
c) To take decisions on patients behalf and provide their own judgements as this
benefit the client
d) Is an expert and repenetrates clients concerns, wishes and views as they
cannot express by themselves

175. 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?

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

176. 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?

a) Document this information on the patient’s chart

35
b) Tell the patient’s physician
c) Inform the healthcare team who will come in contact with the patient
d) Encourage the patient to disclose this information to her physician .
177. What is Disclosure according to NHS?

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

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

a) Complex wound
b) Infected wound
c) Any type of wound

179. Wound proliferation starts after?

a) 1-5 days
b) 3-24 days
c) 24 days

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

a) 3-24 days
b) 24-26 days
c) 1-7 days
d) 24 hours

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

a) 24 hours
b) Just minutes
c) 1-5 days
d) 3-24 days

182. 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?

a) In the inflammation phase of healing.

b) In the haemostasis phase of healing.
c) In the reconstructive phase of wound healing.
d) As an infected wound

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

a) Proliferative phase, inflammation phase, remodelling phase, maturation

phase.
b) Haemostasis, inflammation phase, proliferation phase, maturation phase
c) Inflammatory phase, dynamic stage, neutrophil phase, maturation phase.
d) Haemostasis, proliferation phase, inflammation phase, remodelling
phasesupport

184. 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:

a) moisture lesion
b) 2nd stage partial skin thickness
 c) 3rd stage
d) 4th stage

185. What stage of pressure ulcer includes tissue involvement and crater
formation? (CHOOSE 2 ANSWERS)

a) stage 1
b) stage 2
c) stage 3
d) stage 4

186. What stage of pressure ulcer includes tissue involvement and crater
formation?
a) stage 1
b) stage 2
c) stage 3
d) stage 4

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

a) Sanguineous
b) Serous sanguineous
c) Serous
d) Purulent

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

a) blistered wound on the skin

b) open wound showing tissue
c) open wound exposing muscles
d) open wound exposing bones

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

a) Stage1- non blanchable erythema

b) Stage2- Partial thickness skin lose
c) Stage3- full thickness skin loss
d) Stage4- full thickness tissue lose

190. 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:

a) moisture lesion
b) 2nd stage partial skin thickness
c) 3rd stage
d) 4th stage
191. 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?

a) Stage 1
b) Stage 2
c) Stage 3
d) Stage 4

192. 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:

a) Abrasion
b) Unapproxiamted
c) Laceration
d) Eschar

193. Joshua, son of Breid 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?

a) Check analgesia on the chart

b) Tell you will come as soon as you can
c) Find the nurse in charge
d) Go immediately to see the patient

194. When would it be beneficial to use a wound care plan?

a) On all chronic wounds

b) On all infected wounds.
c) On all complex wounds.

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d) On every wound

195. When would it be beneficial to use a wound care plan?

a) on initial assessment of wound

b) during pre-assessment admission
c) after surgery
d) during wound infection, dehiscence or evisceration
e) When would it be beneficial to use a wound care plan? (CHOOSE 3
ANSWERS)

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

a) Skin clips
 b) Tissue adhesive
c) Adhesive skin closure strips
d) Interrupted suture

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

a) High humidity, insulation, gaseous exchange, absorbent.

b) Anaerobic, impermeable, conformable, low humidity.
c) Insulation, low humidity, sterile, high adherence.
d) Absorbent, low adherence, anaerobic, high humidity.

198. Appropriate wound dressing criteria includes all but one:

a) Allows gaseous exchange.

b) Maintains optimum temperature and pH in the wound.
c) Forms an effective barrier to
d) Allows removal of the dressing without pain or skin stripping.
e) Is non-absorbent

199. Proper Dressing for wound care should be? (Select x 3 correct answers)

a) High humidity
b) Low humidity
c) Non Permeable/ Conformable
d) Absorbent / Provide thermal insulation

200. Which of the following conditions can be observed in a proper wound

dressing:

a) absorbent, humid, aerated

b) non absorbent, humid, aerated
c) non humid, absorbent, aerated

39
d) non humid, non absorbent, aerated

201. Proper Dressing for wound care should be?

a) High humidity
b) Low humidity
c) Non Permeable
d) Conformable
e) Adherent
f) Absorbent
g) Provide thermal insulation

202. 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?
 a) Negative pressure dressing
b) Rapid capillary dressing
c) Alginate dressing
d) Skin barrier product

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

a) Hydrogen peroxide
b) Povidine iodine
c) Saline
d) Gention violet

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

a) Can reduce wound odour

b) Increases local blood flow in peri-wound area
c) Can be used on untreated osteomyelitis
d) Can reduce use of dressings

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

a) Partial thickness burns

b) Contaminated wounds
c) Diabetic and neuropathic ulcers
d) Traumatic wounds

206. How do you remove a negative pressure dressing?

a) Remove pressure then detach dressing gently

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b) Get TVN nurse to remove dressing
c) remove in a quick fashion

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

a) Systemic antibiotic therapy and apply a dry dressing

b) Debride and apply a hydrogel dressing.
c) Debride and apply an antimicrobial dressing.
d) Apply a negative pressure dressing.

208. 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:

a) Transparent film
b) Hydrogel dressing
c) Collagenases dressing
 d) Wet dry dressing

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

a) Debridement with scissors

b) Debridement with wet to dry dressings
c) Mechanical debridement
d) Chemical debridement

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

a) Film dressing, mobilization, positioning, nutritional support

b) Foam dressing, pressure relieving mattress, nutritional support
c) Dry dressing, pressure relieving mattress, mobilization
d) Hydrocolloid dressing, pressure relieving mattress, nutritional support

211. 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:

a) Cleaning the skin and wound with betadine

b) Removing all traces of residues for the old dressing
c) Choosing a dressing no more than quarter-inch larger than the wound size
d) Holding it in place for a minute to allow it to adhere

212. The client at greatest risk for postoperative wound infection is:

a) A 3 month old infant postoperative from pyloric stenosis repair

b) A 78 year old postoperative from inguinal hernia repair

41
c) A 18 year old drug user postoperative from removal of a bullet in the leg
d) A 32 year old diabetic postoperative from an appendectomy

213. Mr Connor’s neck wound needed some cleaning to prevent

complications. Which of the following concept will you apply when doing a
surgical wound cleaning?

a) surgical asepsis
b) aseptic non-touch technique
c) medical asepsis
d) dip-tip technique

214. When doing your shift assessment, one of your patient has a waterflow
score of 20. Which of the following mattress is appropriate for this score?

a) water bed
 b) fluidized airbed
c) low air loss
d) alternating pressure

215. Waterlow score of 20 indicates what type of mattress to use? Select x 2

a) Standard-specification foam mattresses

b) High-specification foam mattresses
c) Dynamic support surface

216. For a client with Water Score >20 which mattress is the most suitable

a) Water Mattress
b) Air Mattress
c) Dynamic Mattress
d) Foam Mattress

217. A patient has been confined in bed for months now and has developed
pressure ulcers in the buttocks area. When you checked the waterlow it is
at level 20. Which type of bed is best suited for this patient?

a) water mattress
b) Egg crater mattress
c) air mattresses
d) Dynamic mattress

218. A patient has been confined in bed for months now and has developed
pressure ulcers in the buttocks area. When you checked the waterlow it is
at level 20. Which type of bed is best suited for this patient?

a) water mattress
b) Egg crater mattress
c) air mattresses

42
d) Dynamic mattress

219. You have just finished dressing a leg ulcer. You observe patient is
depressed and withdrawn. You ask the patient whether everything is okay.
She says yes. What is your next action?

a) Say " I observe you don't seem as usual. Are you sure you are okay?"
b) Say "Cheer up , Shall I make a cup of tea for you?"
c) Accept her answer & leave. attend to other patients
d) Inform the doctor about the change of the behaviour.

220. Mrs Smith developed an MRSA bacteremia from her abdominal wound
and her son is blaming the staff. It has been highlighted during your ward
clinical governance meeting because it has been reported as a serious
incident (SI). SI is best described as:

a) any incident or occurrence that has the potential to cause harm and/or has caused
harm to a
person or persons
b) a consequence of an intervention, relating to a piece of equipment and/or as a
consequence of the
working environment
c) Incident requiring investigation that occurred in relation to NHS funded services
and care resulting
in; unexpected or avoidable death, permanent harm
d) All

221. How much urine should someone void an hour?

a) 0.5 – 1ml/Kg/hr of the patient’s body weight

b) 2mls/KG/hr of the patient’s body weight
c) 30mls
d) 50mls

222. Patient usually urinates at night Nurse identifies this as:

A) Polyuria
B) Oliguria
C) Nocturia

223. 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?

A) tell her that any information related to her well being will need to be share to
the health care team
B) inform her parents about this so she can be advised appropriately

43
C) keep the information a secret in view of confidentiality
D) report her boyfriend to social services

224. What are the steps for the proper urine collection?

a) Clean meatus with soap and water

b) Catch midstream
c) Dispatch sample to laboratory immediately (within 6 hours)
d) Ask the patient to void her remaining urine into the toilet or bedpan.

a) A, B, & C
b) B, C, & D
c) A, B, & D
d) A, C, & D

225. On removing your patient’s catheter, what should you encourage your
 patient to do ?

a) Rest & drink 2-3 litres of fluid per day

b) Rest & drink in excess of 5 litres of fluid per day
c) Exercise & drink 2-3 litres of fluid per day
d) Exercise & drink their normal amount of fluid intake

226. When should a penile sheath be considered as a means of managing

incontinence?

a) When other methods of continence management have failed

b) Following the removal of a catheter
c) When the patient has a small or retracted penis
d) When a patient requests it

227. What is the most important guiding principle when choosing the correct
size of catheter?

a) The biggest size tolerable

b) The smallest size necessary
c) The potential length of use of the catheter
d) The build of the patient

228. When carrying out a catheterization, on which patients would you use
anaesthetic lubricating gel prior to catheter insertion?

a) Male patients to aid passage, as the catheter is longer

b) Female patients as there is an absence of lubricating glands in the female
urethra , unlike the male urethra
c) Male & female patients require anaesthetic lubricating gel
d) The use of anaesthetic lubricating gel is not advised due to potential adverse
reactions

44
229. What are the principles of positioning a urine drainage bag?

a) Above the level of the bladder to improve visibility & access for the health
professional
b) Above the level of the bladder to avoid contact with the floor c)
Below the level of the patient’s bladder to reduce backflow of urine d)
Where the patient finds it most comfortable

230. What would make you suspect that a patient in your care had a urinary
tack infection?

a) The patient has spiked a temperature, has a raised white cell count (WCC),
has new-onset confusion & the urine in the catheter bag is cloudy b) The
doctor has requested a midstream urine specimen
c) The patient has a urinary catheter in situ & the patient's wife states that he
seems more forgetful than usual
 d) The patient has complained of frequency of faecal elimination & hasn't been
drinking enough

231. Which of the following population group is at risk of developing

cardiovascular disease?

a) Obese, male, diabetic, hypertensive, sedentary lifestyle

b) female, forty, fertile
c) smoker, diabetic and alcoholic
d) drug user, male, hypertensive

232. All are risk factors of Coronary Artery Disease except:

A. Obesity
B. Smoking
C. High Blood Pressure
D. Female

233. Which of the following is at a greater risk for developing coronary artery
disease?

a) Male, obese, sedentary lifestyle

b) Female, obese, non sedentary lifestyle

234. When should adult patients in acute hospital settings have observations
taken?

a) When they are admitted or initially assessed. A plan should be clearly

documented which identifies which observations should be taken & how
frequently subsequent observations should be done
b) When they are admitted & then once daily unless they deteriorate
c) As indicated by the doctor

45
d) Temperature should be taken daily, respirations at night , pulse & blood
pressure 4 hourly

235. When is the time to take the vital signs of the patients? Select which
does not apply:

a) At least once every 12 hours, unless specified otherwise by senior staff.

b) When they are admitted or initially assessed.
c) On transfer to a ward setting from critical care or transfer from one ward to
another.
d) Every four hours

236. Which sign or symptom is a key indication of progressive arterial

insufficiency?

a) Oedema
b) Hyperpigmentation of the skin
 c) Pain
d) Cyanosis

237. If Tony’s heart rate slows down, this is referred to as:

A) hypertension
B) hypotension
C) bradycardia
D) tachycardia

238. Why is it important to manually assess pulse rate?

a) Amplitude, volume and irregularities cannot be detectedusing automated

electronic methods
b) Tachycardia cannot be detected using automated electronic methods
c) Bradycardia cannot be detected using automated electronic method
d) It is more reassuring to the patient

239. A patient on your ward complains that her heart is ‘racing’ and you find
that the pulse is too fast to manually palpate. What would your actions be?

a) Shout for help and run to collect the crash trolley.

b) Ask the patient to calm down and check her most recent set of bloods and
fluid balance.
c) A full set of observations: blood pressure, respiratory rate, oxygen saturation
and temperature. It is essential to perform a 12 lead ECG. The patient should
then be reviewed by the doctor.
d) Check baseline observations and refer to the cardiology team.

240. Orthostatic hypotension is diagnosed if the systolic blood pressure

drops by how many mmHg?

46
A) 20
B) 25
C) 30
D) 35

241. When would an orthostatic blood pressure measurement be indicated?

A) If the patient has a recent history of falls.

B) If the patient has a history of dizziness or syncope on changing position.
C) If the patient has a history of hypertension.
D) If the patient has a history of hypotension

242. Which is not a cause of postural hypotension?

a) the time of day

b) lack of exercise
 c) temperature
d) recent food intake

243. What do the adverse effects of hypotension include?

A) Decreased conscious level, reduced blood flow to vital organs and renal
failure.
B) The patient could become confused and not know who they are. C)
Decreased conscious level, oliguria and reduced coronary blood flow. D)
The patient feeling very cold

244. Mrs Red is complaining of shortness of breath. On assessment, her legs

are swollen indicative of tissue oedema. What do you think is the possible
cause of this?

a) left side heart failure

b) right side heart failure
c) renal failure
d) liver failure

245. In interpreting ECG results if there is clear evidence of atrial disruption

this is interpreted as?

a) Cardiac Arrest
b) Ventricular tach
c) Atrial Fibrillation
d) Complete blockage of the heart

246. A client is having diagnosed atrial activity. identify the ECG

a) Atrial fibrillation
b) cardiac arrest

47
c) ventricular tachycardia
d) asystole

247. What is atrial fibrillation?

a) heart condition that causes,

b) An irregular and often abnormally slow heart rate
c) An irregular and often abnormally fast heart rate
d) A regular heart rhythm with an abnormally slow heart rate
e) A regular heart rhythm with an abnormally fast heart rate

248. The correct management of an adult patient in ventricular fibrillation

(VF) cardiac arrest includes:

A) an initial shock with a manual defibrillator or when prompted by an automated

external defibrillator (AED)
B) atropine 3 mg IV
C) adenosine 500 mcg IV
 D) adrenaline 1 mg IV before first shock

249. How to act in an emergency in a health care set up?

A) according to the patient's condition

B) according to instruction
C) according to situation
D) according to our competence

250. While having lunch at the cafeteria, your co-worker suddenly collapsed.
As a nurse, what would you do?

A) You are on lunch, no actions should be taken

B) Assess for any danger
C) Tap the patient to check for consciousness
D) Call for help

251. Which is the first drug to be used in cardia arrest of any aetiology?

a) Adrenaline
b) Amiodarone
c) Atropine
d) Calcium chloride

252. During cardiopulmonary resuscitation:

A) chest compression should be 5-6 cm deep at a rate of 100-120 compression

per minute
B) a ratio of 2 ventilation to 15 cardiac compression is required

48
C) the hands should be placed over the lower third of the sternum to do chest
compression
D) check for normal breathing for 1 full minute to diagnose cardiac arrest

253. You are currently on placement in the emergency department (ED). A 55-
year-old city worker is blue lighted into the ED having had a
cardiorespiratory arrest at work. The paramedics have been resuscitating
him for 3 minutes. On arrival, he is in ventricular fibrillation. Your mentor
asks you the following question prior to your shift starting: What will be the
most important part of the patient’s immediate advanced life support?

a) Early defibrillation to restart the heart.

b) Early cardiopulmonary resuscitation.
c) Administration of adrenaline every 3 minutes.
d) Correction of reversible causes of hypoxia.

254. In Spinal cord injury patients, what is the most common cause of
 autonomic dysreflexia ( a sudden rise in blood pressure)?

a) Bowel obstruction
b) Fracture below the level of the spinal lesion
c) Pressure sore
d) Urinary obstruction

255. Most commonly aneurysms can develop on? Select x 2 answers

a) Abdominal aorta
b) Circle of Willis
c) Intraparechymal aneurysms
d) Capillary aneurysms

256. Which of the following can a patient not have if they have a pacemaker
in situ?

A) MRI
B) X ray
C) Barium swallow
D) CT

257. 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?

A. The patient is showing symptoms of hypovolaemic shock. Investigate

source of fluid loss, administer fluid replacement and get medical
support. B. The patient is demonstrating symptoms of atelectasis.
Administer a nebulizer, refer to physiotherapist for assessment.
C. The patient is demonstrating symptoms of uncontrolled pain. Administer
prescribed analgesia, seek assistance from medical team.
49
D. The patient is demonstrating symptoms of hyperventilation. Offer
reassurance, administer oxygen.

258. What Is not a cause of postural hypotension?

a) The time of day

b) Lack of exercise
c) Temperature
d) Recent food intake

259. Mrs Red’s doctor is suspecting an aortic aneurysm after her chest x-ray.
Which of the most common type of aneurysm?

A) cerebral
B) abdominal
C) femoral
D) thoracic
260. A nurse is advised one hour vital charting of a patient, how frequently it
should be recorded?

a) Every 3 hours
b) Every shift
c) Whenever the vital signs show deviations from normal
d) Every one hour

261. Why are support stockings used?

A. To aid mobility
B. To promote arterial flow
C. To aid muscle strength
D. To promote venous flow

262. Anti-embolic stockings an effective means of reducing the potential of

developing a deep vein thrombosis because:

A) They promote arterial blood flow.

B) They promote venous blood flow.
C) They reduce the risk of postoperative swelling.
D) They promote lymphatic fluid flow, and drainage

263. In DVT TEDS stockings affect circulation by:

a) increasing blood flow velocity in the legs by compression of the deep venous
system - thromboembolism-deterrent hose
b) decreasing blood flow velocity in legs by compression of the deep venous
system

50
264. You are looking after a 75 year old woman who had an abdominal
hysterectomy 2 days ago. What would you do reduce the risk of her
developing a deep vein thrombosis (DVT)?

A. Give regular analgesia to ensure she has adequate pain relief so she
can mobilize as soon as possible. Advise her not to cross her legs B.
Make sure that she is fitted with properly fitting antiembolic stockings &
that are removed daily
C. Ensure that she is wearing antiembolic stockings & that she is
prescribed prophylactic anticoagulation & is doing hourly limb exercises D.
Give adequate analgesia so she can mobilize to the chair with assistance,
give subcutaneous low molecular weight heparin as prescribed. Make
sure that she is wearing antiembolic stockings

265. A patient is being discharged form the hospital after having coronary
artery bypass graft (CABG). Which level of the health care system will best
serve the needs of this patient at this point?
 a) Primary care
b) Secondary care
c) Tertiary care
d) Public health care

266. People with blood group A are able to receive blood from the following:

a) Group A only
b) Groups AB or B
c) Groups A or O
d) Groups A, B or O

267. Which finding should the nurse report to the provider prior to a
magnetic resonance imaging MRI?

A. History of cardiovascular disease

B. Allergy to iodine and shellfish
C. Permanent pacemaker in place
D Allergy to dairy products

268. How many phases of korotkoff sounds are there?

A. 3
B. 4
C. 5
D. 6

269. What is the name given to a decreased pulse rate or heart rate?

51
a) Tachycardia
b) Hypotension
c) Bradycardia
d) Arrhythmia

270. A patient puts out his arm so that you can take his blood pressure. What
type of consent is this?

a) Verbal
b) Written
c) Implied
d) None of the above, consent is not required.

271. Which finding should the nurse report to the provider to a magnetic
resonance imaging MRI?

a) History of cardiovascular disease

b) Allergy to iodine and shellfish
c) Permanent pacemaker in place
d) Allergy to dairy products
272. Which of the following is the most common aneurysm site?

a) Hepatic Artery
b) Abdominal aorta
c) Renal arch
d) Circle of Wills

273. CVP line measures?

a) Pressure in right atrium

b) Pulmonary arteries
c) Left ventricle
d) Vena cava

274. 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?

a.) Intramuscular route administration of adrenaline is always recommended during

cardiac arrest after anaphylactic reaction.
b.) Intramuscular route for adrenaline is not recommended during cardiac arrest after
anaphylactic reaction.
c.) Adrenaline can be administered intradermally during cardiac arrest after
anaphylactic reaction.
d.) None of the Above

52
275. The patient is being discharged from the hospital after having a coronary
artery bypass graft (CABG). Which level of the health care system will best
serve the needs of this patient at this point?

a) Primary care.
b) Secondary care.
c) Tertiary care.
d) Public health care.

276. A patient is prescribed methformin 1 000mg twice a day for his diabetes.
While taking with the patient he states “I never eat breakfast so I take ½
tablet at lunch and a whole tablet at supper because I don’t want my blood
sugar to drop.” As his primary care nurse you:

a) Tell him he has made a good decision and to continue

b) Tell him to take a whole tablet with lunch and with supper
c) Tell him to skip the morning dose and just take the dose at supper d) Tell
him to take one tablet in the morning and one tablet in the evening as
ordered.
277. 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:

a) Administer patient’s scheduled Metformin

b) Give the patient a glass of orange juice
c) Check the patient’s blood glucose
d) Call the doctor

278. Common signs and symptoms of a hypoglycaemia exclude:

a) Feeling hungry
b) Sweating
c) Anxiety or irritability
d) Blurred vision
e) Ketoacidosis

279. Hypoglycaemia in patients with diabetes is more likely to occur when

the patients take: (Select x 3 correct answers)

a) Insulin
b) Sulphonylureas
c) Prandial glucose regulators
d) Metformin

280. What are the contraindications for the use of the blood glucose meter
for blood glucose monitoring?

a) The patient has a needle phobia and prefers to have a urinalysis.

53
b) If the patient is in a critical care setting, staff will send venous samples to the
laboratory for verification of blood glucose level.
c) If the machine hasn't been calibrated
d) If peripheral circulation is impaired, collection of capillary blood is not advised
as the results might not be a true reflection of the physiological blood glucose
level.

281. What would you do if a patient with diabetes and peripheral neuropathy
requires assistance cutting his toe nails?

a) Document clearly the reason for not cutting his toe nails and refer him to a
chiropodist.
b) Document clearly the reason for not cutting his nails and ask the ward sister
to do it.
c) Have a go and if you run into trouble, stop and refer to the chiropodist. d)
Speak to the patient's GP to ask for referral to the chiropodist, but make a
start while the patient is in hospital.

282. For an average person from UK who has non-insulin dependent

diabetes, how many servings of fruits and vegetables per day should they
take?
a) 1 serving
b) 3 servings
c) 5 servings
d) 7 servings

283. Common causes for hyperglycaemia include:

a) Not eating enough protein

b) Eating too much carbohydrate
c) Over-treating a hypoglycaemia
d) Stress
e) Infection (for example, colds, bronchitis, flu, vomiting, diarrhoea, urinary
infections, and skin infections)

284. Most of the symptoms are common in both type1 and type 2 diabetes.
Which of the following symptom is more common in typ1 than type2?

a) Thirst
b) Weight loss
c) Poly urea
d) Ketones

285. Alone, metformin does not cause hypoglycaemia (low blood sugar).
However, in rare cases, you may develop hypoglycaemia if you combine
metformin with:

54
a) a poor diet
b) strenuous exercise
c) excessive alcohol intake
d) other diabetes medications

286. 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:

a) Administer patient’s scheduled Metformin

b) Give the patient a glass of orange juice
c) Check the patient’s blood glucose
d) Call the doctor

287. When developing a program offering for patients who are newly
diagnosed with diabetes, a nurse case manager demonstrates an
understanding of learning styles by:

a) Administering a pre- and post test assessment.

b) Allowing patient’s time to voice their opinions.
c) Providing a snack with a low glycaemic index.
d) Utilizing a variety of educational materials.
288. Mr Cross informed you of how upset he was when you commented on
his diabetic foot during your regular home visit. He is considering to see
another tissue viability nurse. How will you best respond to him?

A. Apologise for the comments made

B. Tell him of his overreaction
C. Explain that his condition will make him over-sensitive to a lot of
things D. Apologise and tell him to deal with the event lightly

289. You are preparing to consider a Tuberculin (Mantoux) skin test to a

client suspected of having TB. The nurse knows that the test will reveal
which of the following?

A) How long the client has been infected with TB

B) Active TB infection
C) Latent TB infection
D) Whether the client has been infected with TB bacteria

290. How do we handle a specimen container labelled with a yellow hazard

sticker?

a) Wear gloves and apron, mark it high risk and send the specimen to the
laboratory with your other specimens
b) Wear gloves and apron, mark it high risk and send the specimen to the
laboratory with your other specimens

55
c) Wear gloves and apron, inform the infection control team and complete a
datix form
d) Wear gloves and apron, place specimen in a blue bag & complete a datix
form

291. When collecting an MSU from a male patient, what should they do prior
to the specimen being collected?

a) Clean the meatus and catch a specimen from the last of the urine voided b)
Clean the meatus and catch a specimen from the first stream of urine (approx.
30mls)
c) Clean the meatus and catch a specimen of the urine midstream d)
Ask the patient to void into a bottle and pour urine specimen into the
specimen container.

292. How do you ensure the correct blood to culture ratio when obtaining a
blood culture specimen from an adult patient?

a) Collect at least 10 mL of blood

b) Collect at least 5 mL of blood.
c) Collect blood until the specimen bottle stops filling.
 d) Collect as much blood as the vein will give you

293. If blood is being taken for other tests, and a patient requires collection
of blood cultures, which should come first to reduce the risk of
contamination?

a) Inoculate the aerobic culture first

b) Take the other blood tests first.
c) Inoculate the anaerobic culture first.
d) The order does not matter as long as the bottles are clean

294. Which of the following techniques is advisable when obtaining a urine

specimen in order to minimize the contamination of a specimen?

a) Clean around the urethral meatus prior to sample collection and get a
midstream/clean catch urine specimen.
b) Clean around the urethral meatus prior to sample collection and collect the
first portion of urine as this is where the most bacteria will be.
c) Do not clean the urethral meatus as we want these bacteria to analyse as
well.
d) Dip the urinalysis strip into the urine in a bedpan mixed with stool

295. When dealing with a patient who has a biohazard specimen, how will
you ensure proper disposal? Select which does not apply:

a) the specimen must be labelled with a biohazard

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b) the specimen must be labelled with danger of infection
c) it must be in a double self-sealing bag
d) it must be transported to the laboratory in a secure box with a fastenable

lid 296. What action would you take if a specimen had a biohazard sticker on

it?

a) Double bag it, in a self-sealing bag, and wear gloves if handling the specimen.
b) Wear gloves if handling the specimen, ring ahead and tell the laboratory the
sample is on its way.
c) Wear goggles and underfill the sample bottle.
d) Wear appropriate PPE and overfill the bottle.

297. How do we handle a specimen container labelled with a yellow hazard

sticker?

A) Wear gloves and apron and inform the laboratory that you are sending the
specimen.
B) Wear gloves and apron, mark it high risk and send the specimen to the laboratory
with your other specimens
C) Wear gloves and apron, Inform the infection control team and complete a datix
form.
D) Wear gloves and apron, place specimen in a blue bag & complete a datix form.

298. You are caring for a patient who is known to have dementia. What
particular issues should you consider prior to discharge.

a) *You involve in his care: Independent Mental Capacity Advocacy Service

(Mental Capacity Act 2005)
b) *You involve other support services in his discharge: The hospital
discharge team, social services, the metal health team

299. Which of the major theories of aging suggest that older adults may
decelerate the aging process?

a) Disengagement theory
b) Activity theory
c) Immunology theory
d) Genetic theory

300. Which of the following is a guiding principle for the nurse in

distinguishing mental disorders from the expected changes associated
with aging

a) A competent clinician can readily distinguish mental disorders from the

expected changes associated with aging
b) Older people are believed to be more prone to mental illness than young
people
c) The clinical presentation of mental illness in older adults differs form that in
other age groups

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d) When physical deterioration becomes a significant feature of an elder’s
life, the risk of comorbid psychiatric illness arises.

301. A normal sign of aging in the renal system is

a) Intermittent incontinence
b) Concentrated urine
c) Microscopic hematuria
d) A decreased glomerular filtration rate

302. A 76 year old man who is a resident in an extended care facility is in the
late stages of Alzheimer’s disease. He tells his nurse that he has sore back
muscles from all the construction work he has been doing all day. Which
response by the nurse is most appropriate?

a) “ you know you don’t work in construction anymore”

b) “What type of motion did you do to precipitate this soreness?” c)
“You’re 76 years old & you’ve been here all day. You don’t work in
construction anymore.”
d) “Would you like me to rub your back for you?”
303. How should be the surrounding area of a patient with dementia?

A) Increased stimuli
B) Creative environment
C) Restrict activities

304. An 86 year old male with senile dementia has been physically abused &
neglected for the past two years by his live in caregiver. He has since
moved & is living with his son & daughter-in-law. Which response by the
client’s son would cause the nurse great concern?

a) “How can we obtain reliable help to assist us in taking care of Dad? We can’t
do it alone.”
b) “Dad used to beat us kids all the time. I wonder if he remembered that when it
happened to him?”
c) “I’m not sure how to deal with Dad’s constant repetition of words.” d) “I
plan to ask my sister & brother to help my wife & me with Dad on the
weekends.”

305. Knowing the difference between normal age- related changes &
pathologic findings, which finding should the nurse identify as pathologic
in a 74 year old patient?

a) Increase in residual lung volume

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b) Decrease in sphincter control of the bladder
c) Increase in diastolic BP
d) Decreased response to touch, heat & pain.

306. Which of the following is a behavioural risk factor when assessing the
potential risks of falling in an older person?

a) Poor nutrition/fluid intake

b) Poor heating
c) Foot problems
d) Fear of falling

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

a) Loop diuretic
b) Hypnotics
c) Betablockers
d) Nsaid

308. Among the following drugs, which does not cause falls in an elderly?

A. Diuretics
B. NSAIDS
 C. Beta blockers
D. Hypnotics

309. Mr Bond, 72 years old, complains of difficulty of chewing his food. He

normally wears upper dentures daily. On assessment, you noticed some
signs of gingivitis. Which of the following signs will you expect?

a) redness of soft palate and tissues surrounding the teeth

b) haemo-serous discharges around the gums
c) loosening of teeth
d) presence of pockets deep in the gums

310. Mr Bond also shared with you that his gums also bleed during brushing.
Which of the following statement will best explain this?

a) lack of vitamin C in his diet

b) he is brushing too hard
c) he is not using proper toothbrush to remove the plaque
d) he is flossing wrongly

311. What are the principles of communicating with a patient with delirium?

a) Use short statements and closed questions in a well lit, quiet, familiar
environment.

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b) Use short statements and open questions in a well lit, quiet, familiar
environment
c) Write down all questions for the patient to refer back to.
d) Communicate only through the family using short statements and closed
questions.

312. Why is pyrexia not evident in the elderly?

A. Due to lesser body fat

B. Due to immature T cells
C. Due to aged hypothalamus
D. Due to biologic changes

313. Which of the following is a sign of dehydration in the elderly?

a) diminished skin turgor

b) hypertension
c) anxiety attacks
d) pyrexia

314. In a community hospital, an elderly man approaches you and tells you
that his neighbour has been stealing his money, saying "sometimes I give
 him money to buy groceries but he didn't buy groceries and he kept the
money" what is your best course of action for this?

A) Raise a safeguarding alert

B) Just listen but don't do anything
C) Ignore the old man, he is just having delusions
D) Refer the old man to the community clergy who is giving him spiritual support

315. Which is not an appropriate way to care for patients with

Dementia/Alzheimer’s?

A. Ensure people with dementia are excluded from services because of their
diagnosis, age, or any learning disability.
B. Encourage the use of advocacy services and voluntary support. C. Allow
people with dementia to convey information in confidence. D. Identify and
wherever possible accommodate preferences (such as diet, sexuality and
religion).

316. Barbara, an elderly patient with dementia, wishes to go out of the

hospital. What will be you appropriate action?

A) Call the police, make sure she does not leave

B) Encourage the patient to stay for his well being
C) Inform the police to arrest the patient
D) Allow her to leave, she is stable and not at risk of anything

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317. Conditions producing orthostatic hypotension in the elderly:

A) Aortic stenosis
B) Arrhythmias
C) Diabetes
D) Pernicious anaemia
E) Advanced heart failure
F) All of the above

318. An 83-year old lady just lost her husband. Her brother visited the lady in
her house. He observed that the lady is acting okay but it is obvious that
she is depressed. 3weeks after the husband's death, the lady called her
brother crying and was saying that her husband just died. She even said, "I
cant even remember him saying he was sick." When the brother visited the
lady, she was observed to be well physically but was irritable and claims to
have frequent urination at night and she verbalizes that she can see lots of
rats in their kitchen. Based on the manifestations, as a nurse, what will you
consider as a diagnosis to this patient?

A) urinary tract infection leading to delirium

B) delayed grieving with dementia

319. Angel, 52 years old lose her husband due to some disease. 4 weeks
 later, she calls her mother and says that, yesterday my husband died…I
didn’t know that he was sick…I cant sleep and I see rats and mites in the
kitchen. What is angel’s condition?

A) She cant adjust without her husband

B) Late grievance with signs of dementia
C) Alzheimers with delirium

320. Why are elderly prone to postural hypotension? Select which does not
apply:

A. The baroreflex mechanisms which control heart rate and vascular

resistance decline with age.
B. Because of medications and conditions that cause
hypovolaemia. C. Because of less exercise or activities.
D. Because of a number of underlying problems with BP control.

321. Why should healthcare professionals take extra care when washing and
drying an elderly patients skin?

A) As the older generation deserve more respect and tender loving care (TLC).
B) As the skin of an elder person has reduced blood supply, is thinner, less
elastic and has less natural oil. This means the skin is less resistant to
shearing forces and wound healing can be delayed.
C) All elderly people lose dexterity and struggle to wash effectively so they need
support with personal hygiene.

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D) As elderly people cannot reach all areas of their body, it is essential to ensure
all body areas are washed well so that the colonization of Gram-positive and
negative micro-organisms on the skin is avoided.

322. Why is pyrexia not always evident in the elderly?

A. Due to immature T cells

B. Due to mature T cells
C. Due to immature D cells
D. Due to mature D cells

323. Why constipation occurs in old age?

A) Anorexia and weight loss

B) Decreased muscle tone and periatalsis
C) Increased mobility
D) Increased absorption in colon

324. You are looking after an emaciated 80-year old man who has been
admitted to your ward with acute exacerbation of chronic obstructive
 airways disease (COPD). He is currently so short of breath that it is difficult
for him to mobilize. What are some of the actions you take to prevent him
developing a pressure ulcer?

A) He will be at high risk of developing a pressure ulcer so place him on a

pressure relieving mattress
B) Assess his risk of developing a pressure ulcer with a risk assessment tool. If
indicated, procure an appropriate pressure –relieving mattress for his bed &
cushion for his chair. Reassess the patient’s pressure areas at least twice a
day & keep them clean & dry. Review his fluid & nutritional intake & support
him to make changes as indicated.
C) Assess his risk of developing a pressure ulcer with a risk assessment tool &
reassess every week. Reduce his fluid intake to avoid him becoming
incontinent & the pressure areas becoming damp with urine
D) He is at high risk of developing a pressure ulcer because of his recent acute
illness, poor nutritional intake & reduced mobility. By giving him his prescribed
antibiotic therapy, referring him to the dietician & physiotherapist, the risk will
be reduced.

325. You are looking after a 76-year old woman who has had a number of
recent falls at home. What would you do to try & ensure her safety whilst
she is in hospital?

A) Refer her to the physiotherapist & provide her with lots of reassurance as she
has lost a lot of confidence recently
B) Make sure that the bed area is free of clutter. Place the patient in a bed near
the nurse’s station so that you can keep an eye on her. Put her on an hourly

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toileting chart. obtain lying & standing blood pressures as postural
hypotension may be contributing to her falls
C) Make sure that the bed area is free of clutter & that the patient can reach
everything she needs, including the call bell. Check regularly to see if the
patient needs assistance mobilizing to the toilet. ensure that she has properly
fitting slippers & appropriate walking aids
D) Refer her to the community falls team who will asses her when she gets home

326. You are looking after a 75 year old woman who had an abdominal
hysterectomy 2 days ago. What would you do reduce the risk of her
developing a deep vein thrombosis (DVT)?

A) Give regular analgesia to ensure she has adequate pain relief so she can
mobilize as soon as possible. Advise her not to cross her legs
B) Make sure that she is fitted with properly fitting antiembolic stockings & that
are removed daily
C) Ensure that she is wearing antiembolic stockings & that she is prescribed
prophylactic anticoagulation & is doing hourly limb exercises
D) Give adequate analgesia so she can mobilize to the chair with assistance,
give subcutaneous low molecular weight heparin as prescribed. Make sure
that she is wearing antiembolic stockings

327. Fiona a 70 year old has recently been diagnosed with type 2 diabetes.
You have EC devised a care plan to meet her nutritional needs. However,
 you have noted that she ahs poor fitting dentures. Which of the following is
the least likely risk to the service user?

a) Malnutrition
b) Hyperglycemia
c) Dehydration
d) Hypoglycaemia

328. What is the most common cause of hypotention in elderly?

a) Decreased response in adrenaline & noradrenaline

b) Atheroma changes in vessel walls
c) hyperglycaemia
d) Age

329. What is an intermediate care home?

a) It is the day-to-day health care given by a health care provider. b) It includes a

range of short-term treatment or rehabilitative services designed to promote
independence.
c) It is a system of integrated care.
d) It is a means of organising work, that is patient allocation.

330. What is not included in the care package in a nursing home?

a) Laundry

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b) Food
c) Nursing Care
d) Social Activities

331. The nurse cares for an elderly patient with moderate hearing loss. The
nurse should teach the patient’s family to use which of the following
approaches when speaking to the patient?

a) Raise your voice until the patient is able to hear you.

b) Face the patient and speak quickly using a high voice.
c) Face the patient and speak slowly using a slightly lowered voice.
d) Use facial expressions and speak as you would formally

332. Your nurse manager approaches you in a tertiary level old age home
where complex cases are admitted, and she tells you that today everyone
should adopt task - oriented nursing to finish the tasks by 10 am what’s
your best action

A) Discuss with the manager that task oriented nursing may ruin the holistic care
that we provide here in this tertiary level.
B) Ask the manager to re-consider the time bound, make sure that all staffs are
informed about task oriented nursing care
333. A patient with dementia is mourning and pulling the dress during night
what do you understand from this?

A) Patient is incontinent
B) Patient is having pain
C) Patient has medication toxicity.

334. An elderly client with dementia is cared by hid daughter. The daughter
locks him in a room to keep him safe when she goes out to work and not
considering any other options. As a nurse what is your action?

a) Explain this is a restrain. Urgently call for a safe guarding and arrange a
multi-disciplinary team conference
b) Do nothing as this is the best way of keeping him safe
c) Call police, social services to remove client immediately and refer to
safeguarding
d) Explain this is a restrain and discuss other possible options

335. In a community setting, an elderly patient reported to you that he gives

shopping money to his neighbours but failed to bring groceries on frequent
occasions. What is your best response on this situation?

a) Confront the neighbour

b) Ignore, maybe he is very old and does not think clearly

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c) Fill up a raising a concern/ safeguarding form, and escalate
d) ask patient to report neighbour to police

336. Which of the following displays the proper use of Zimmer frame?

a) using a 1 point gait

b) using a 2 point gait
c) using a 3 point gait
d) using a 4 point gait

337. The client advanced his left crutch first followed by the right foot, then
the right crutch followed by the left foot. What type of gait is the client
using?

A) Swing to gait
B) Three point gait
C) Four point gait
D) Swing through gait

338. Nurse is teaching patient about crutch walking which is incorrect?

a) Take long strides

b) Take small strides
c) Instruct to put weight on hands
339. After instructing the client on crutch walking technique, the nurse
should evaluate the client's understanding by using which of the following
methods?

a) Have client explain produce to the family

b) Achievement of 90 on written test
c) Explanation
d) Return demonstration

340. A nurse is caring for a patient with canes. After providing instruction on
proper cane use, the patient is asked to repeat the instructions given. Which
of the following patient statement needs further instruction?

a) ‘The hand opposite to the affected extremity holds the cane to widen the base
of support & to reduce stress on the affected limb.’
b) as the cane is advanced, the affected leg is also moved forward at the same
time’
c) ‘when the unaffected extremity begins the swing phase, the client should bear
down on the cane’
d) To go up the stairs, place the cane & affected extremity down on the step.
Then step down the unaffected extremity’

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341. Nurses assume responsibility on patient with cane. Which of the
following is the nurse’s topmost priority in caring for a patient with cane?

a) Mobility
b) Safety
c) Nutrition
d) Rest periods

342. To promote stability for a patient using walkers, the nurse should
instruct the patient to place his hands at:

a) The sides of the walker

b) The hips
c) The hand grips
d) The tips

343. A client is ambulating with a walker. The nurse corrects the walking
pattern of the patient if he does which of the following?

a) The patient walks first & then lifts the walker

b) The walker is held on the hand grips for stability
c) The patient’s body weight is supported by the hands when advancing his
weaker leg.
d) All of these
344. The nurse should adjust the walker at which level to promote safety &
stability?

a) Knee
b) Hip
c) Chest
d) Armpit

345. The nurse is caring for an immobile client. The nurse is promoting
interventions to prevent foot drop from occurring. Which of the following is
least likely a cause of foot drop?

a) Bed rest
b) Lack of exercise
c) Incorrect bed positioning
d) Bedding weight that forces the toes into plantar flexion

346. The nurse should consider performing preparatory exercises on which

muscle to prevent flexion or buckling during crutch walking?

a) Shoulder depressor muscles

b) Forearm extensor muscles
c) Wrist extensor muscles
d) Finger & thumb flexor muscles

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347. The nurse is measuring the crutch using the patient’s height. How many
inches should the nurse subtract from the patient’s height to obtain the
approximate measurement?

a) 10 inches
b) 16 inches
c) 9 inches
d) 5 inches

348. The most advanced gait used in crutch walking is:

a) Four point gait

b) Three point gait
c) Swing to gait
d) Swing through gait

349. In going up the stairs with crutches, the nurse should instruct the
patient to:

A) Advance the stronger leg first up to the step then advance the crutches & the
weaker extremity.
B) Advance the crutches to the step then the weaker leg is advanced after. The
stronger leg then follows.
C) Advance both crutches & lift both feet & swing forward landing next to
 crutches.
D) Place both crutches in the hand on the side of the affected extremity

350. The patient can be selected with a crutch gait depending on the
following apart from:

A) Patient’s physical condition

B) Arm & truck strength
C) Body balance
D) Coping mechanism

351. Proper technique to use walker<zimmers frame>

a) move 10 feet, take small steps

b) move 10feet,take large wide steps
c) move 12feet
d transform weight to walker and walk

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352. When using crutches, what part of the body should absorb the patient’s
weight?

A. Armpits
B. Hands
C. Back
D. Shoulders

353. What a patient should not do when using zimmer frame

A) it can be used outside

B) don’t carry any other thing with walker
C) push walker forward when using
D) slide walker forward

354. What should be taught to a client about use of zimmer frame

A) move affected leg first

B) move unaffected leg
C) move both legs together

355. The nurse is giving the client with a left cast crutch walking instructions
using the three point gait. The client is
allowed touchdown of the affected leg. The nurse tells the client to advance
the:
 a) Left leg and right crutch then right leg and left crutch
b) Crutches and then both legs simultaneously
c) Crutches and the right leg then advance the left leg
d) Crutches and the left leg then advance the right leg

356. Which layer of the skin contains blood and lymph vessels. Sweat and
sebaceous glands?

a) Epidermis
b) Dermis
c) Subcutaneous layer
d) All of the above

357. What is abduction?

a) Division of the body into front and back

b) Movement of a body parts towards the body’s midline
c) Division of the body into left and right
d) Movement of body part away from the body’s midline

358. What is the clinical benefit of active ankle movements?

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a) To assist with circulation
b) To lower the risk of a DVT
c) To maintain joint range
d) All of the above

359. In the context of assessing risks prior to moving and handling, what
does T-I-L-E stand for?

a) Task – individual – lift – environment

b) Task – intervene – load – environment
c) Task – intervene – load – equipment
d) Task – individual – load – environment

360. In Spinal cord injury patients, what is the most common cause of
autonomic dysreflexia ( a sudden rise in blood pressure)?

a) Bowel obstruction
b) Fracture below the level of the spinal lesion
c) Pressure sore
d) *Urinary obstruction

361. A client with a right arm cast for fractured humerus states, “I haven’t
been able to straighten the fingers on the right hand since this morning.”
What action should the nurse take?

a) Assess neurovascular status to the hand

b) Ask the client to massage the fingers
 c) Encourage the client to take the prescribed analgesic
d) Elevate the arm on a pillow to reduce oedema

362. How do the structures of the human body work together to provide
support and assist in movement?

a) The skeleton provides a structural framework. This is moved by the muscles

that contract or extend and in order to function, cross at least one joint and
are attached to the articulating bones.
b) The muscles provide a structural framework and are moved by bones to
which they are attached by ligaments.
c) The skeleton provides a structural framework; this is moved by ligaments that
stretch and contract.
d) The muscles provide a structural framework, moving by contracting or
extending, crossing at least one joint and attached to the articulatingbones.

363. What does ‘muscle atrophy’ mean?

a) Loss of muscle mass

b) A change in the shape of muscles
c) Disease of the muscle

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364. Approximately how long is the spinal cord in an adult?

a) 30 cm
b) 45 cm
c) 60 cm
d) 120 cm

365. Carpal tunnel syndrome is caused by compression of which nerve:

a) Median nerve
b) Axillary nerve
c) Ulnar nerve
d) Radial nerve

366. The most commonly injured carpal bone is:

a) the scaphoid bone

b) the triquetral bone
c) the pisiform bone
d) the hamate bone

367. Client had fractured hand and being cared at home requiring analgesia.
The medication was prescribed under PGD. Which of the following
statements are correct relating to this:

a) A PGD can be delegated to student nurse who can administer medication

 with supervision
b) PGD’s cannot be delegated to anyone
c) This type of prescription is not made under PGD
d) This can be delegated to another RN who can administer in view of a
competent person

368. Patient is post of repair of tibia and fibula possible signs of

compartment syndrome include

a) Numbness and tingling

b) Cool dusky toes
c) Pain
d) Toes swelling
e) All of the above

369. Patient has tibia fibula fracture. Which one of the following is not a
symptom of compartment syndrome

a) Pain not subsiding even after giving epidural analgesia

b) Nausea and vomiting
c) Tingling and numbness of the lower limb

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d) Cold extremities

370. A Chinese woman has been admitted with fracture of wrist. When you
are helping her undress, you notice some bruises on her back and abdomen
of different ages. You want to talk to her and what is your action

a) Ask her husband about the bruises

b) Ask her son/ daughter to translate
c) Arrange for interpreter to ask questions in private
d) Do not carry any assessment and document this is not possible as the client
cannot speak English

371. What is the clinical benefit of active ankle movements?

A. To assist with circulation

B. To lower the risk of a DVT
C. To maintain joint range
D. All of the above

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

a) Has bacterial meningitis

b) Papilloedema
c) Intracranial mass is suspected
d) Site skin infection
373. How do you test the placement of an enteral tube?

A. Monitoring bubbling at the end of the tube

B. Testing the acidity/alkalinity of aspirate using blue litmus paper C.
Interpreting absence of respiratory distress as an indicator of correct
positioning
D. Have an abdominal x-ray

374. During enteral feeding in adults, at what degree angle should the patient
be nursed at to reduce the risk of reflux and aspiration?

A) 25
B) 35
C) 45
D) 55

375. What is the use of protected meal time?

a) Patient get protection from visitors

b) Staff get enough time to have their bank
c) To give personal hygiene to patients who are confused

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d) Patients get enough time to eat food without distractions while staff focus on
people who needs help with eating

376. What is the best way to prevent who is receiving an enteral feed from
aspirating?

a) Lie them flat

b) Sit them at least 45-degree angle
c) Tell them to lie in their side
d) Check their oxygen saturations

377. Approximately6 how many people in the UK are malnourished?

a) 1 million
b) 3 million
c) 5 million
d) 7 million

378. How can patients who need assistance at meal times be identified?

a) A red sticker
b) A colour serviette
c) A red tray
d) Any of the above

379. Which of the following is no longer a recommended method of mouth

care?
 a) Chlorhexidine solution and foam sticks
b) Sodium bicarbonate
c) Normal saline mouth wash
d) Glycerine and lemon swabs

380. Which of the following Is not a cause of gingival bleeding?

a) Lifestyle
b) Vitamin deficiency (Vitamin C and K)
c) Vigorous brushing of teeth
d) Intake of blood thinning medication (warfarin, asprin, and heparin)

381. What specifically do you need to monitor to avoid complications &

ensure optimal nutritional status in patients being enterally fed?

a) Daily urinalysis, ECG, Protein levels and arterial pressure

b) Assess swallowing, patient choice, fluid balance, capillary refill time
c) Eye sight, hearing, full blood count, lung function and stoma site d)
Blood glucose levels, full blood count, stoma site and body weight

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382. A patient is recovering from surgery has been advanced from a clear
diet to a full liquid diet. The patient is looking forward to the diet change
because he has been "bored" with the clear liquid diet. The nurse should
offer which full liquid item to the patient

a) Custard
b) Black Tea
c) Gelatin
d) Ice pop

383. According to recent UK research, what is the recommended amount of

vegetables and fruits to be consumed per day?

a) 3 portions per serving

b) 5 portions per serving
c) 7 portions per serving
d) 4 portions per serving

384. The nurse is preparing to change the parenteral nutrition (PN) solution
bag & tubing. The patient's central venous line is located in the right
subclavian vein. The nurse ask the client to take which essential action
during the tubing change?

a) Take a deep breath, hold it, & bear down

b) Breathe normally
c) Exhale slowly & evenly
 d) Turn the head to the right

385. A 27-year old adult male is admitted for treatment of Crohn's disease.
Which information is most significant when the nurse assesses his
nutritional health?

a) Facial rubor
b) Dry skin
c) Bleeding gums
d) Anthropometric measurements

386. If the prescribed volume is taken, which of the following type of feed will
provide all protein, vitamins, minerals and trace elements to meet patient's
nutritional requirements?

a) Protein shakes/supplements
b) Energy drink
c) Mixed fat and glucose polymer solutions/powder
d) Sip feed

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387. A patient has been admitted for nutritional support and started receiving
a hyperosmolar feed yesterday. He presents with diarrhea but no pyrexia.
What is likely to be cause?

a) An infection
b) Food poisoning
c) Being in hospital
d) The feed

388. Your patient has a bulky oesophageal tumor and is waiting for surgery.
When he tries to eat, food gets stuck and gives him heart burn. What is the
most likely route that will be chosen to provide him with the nutritional
support he needs?

a) Feeding via Radiologically inserted Gastostomy (RIG)

b) Nasogastric tube feeding
c) Feeding via a Percutaneous Endoscopic Gastrostonomy (PEG)
d) Continue oral

389. Which of the following medications are safe to be administered via a

naso-gastric tube?

a) Drugs that can be absorbed via this route, can be crushed and given
diluted or dissolved in 10-15 ml of water
b) Enteric-coated drugs to minimize the impact of gastric irritation c) A cocktail
of all medications mixed together, to save time and prevent fluid over loading
 the patient
d) Any drugs that can be crushed

390. An overall risk of malnutrition of 2 or higher signifies:

a) Low risk of malnutrition

b) Medium risk of malnutrition
c) High risk of malnutrition

391. One of the government initiative in promoting good healthy living is

eating the right and balanced food. Which of the following can achieve
this?

a) 24/7 exercise programme

b) 5-a-day fruits and vegetable portions
c) low calorie diet
d) high protein diet

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392. Mr Bond’s daughter rang and wanted to visit him. She told you of her
diarrhoea and vomiting in the last 24 hours. How will you best respond to
her about visiting Mr Bond?

a) allow her to visit and use alcohol gel before contact with him
b) visit him when she feels better
c) visit him when she is symptom free after 48 hours
d) allow her to visit only during visiting times only

393. An overall risk of malnutrition of 2 or higher signifies:

a) Low risk of malnutrition

b) Medium risk of malnutrition
c) High risk of malnutrition

394. Enteral feeding patient checks patency of tube placement by: x 2

correct answers

a) Pulling on the tube and then pushing it back in place

b) Aspirating gastric juice and then checking for ph<4
c) Infusing water or air and listening for gurgles
d) X-ray

395. The client reports nausea and constipation. Which of the following
would be the priority nursing action?
 a) Complete an abdominal assessment
b) Administer an anti-nausea a medication
c) Notify the physician
d) Collect a stool sample

396. What specifically do you need to monitor to avoid complications and

ensure optimal nutritional status in patients being enterally fed?

a) Blood glucose levels, full blood count, stoma site and bodyweight. b)
Eye sight, hearing, full blood count, lung function and stoma site. c)
Assess swallowing, patient choice, fluid balance, capillary refill time. d)
Daily urinalysis, ECG, protein levels and arterial pressure.

397. What is the best way to prevent a patient who is receiving an enteral
feed from aspirating?

a) Lie them flat.

b) Sit them at least at a 45° angle.
c) Tell them to lie on their side.

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d) Check their oxygen saturations.

398. Which check do you need to carry out before setting up an enteral feed
via a nasogastric tube?

a) That when flushed with red juice, the red juice can be seen when the tube is
aspirated.
b) That air cannot be heard rushing into the lungs by doing the whoosh test c)
That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is
the same length as the time insertion.
d) That pH of gastric aspirate is >6.0, and the measurement on the NG tube is
the same length as the time insertion

399. Which check do you need to carry out every time before setting up a
routine enteral feed via a nasogastric tube?

a) That when flushed with red juice, the red juice can be seen when the tube is
aspirated
b) That air cannot be heard rushing into the lungs by doing the ‘whoosh test’. c)
That the pH of gastric aspirate is <4, and the measurement on the NG tube is
the same length as the time insertion
d) abdominal x-ray

400. Your patient has a bulky oesophageal tumour and is waiting for surgery.
When he tries to eat, food gets stuck and gives him heartburn. What is the
most likely route that will be chosen to provide him with the nutritional
 support he needs?

a) Nasogastric tube feeding

b) Feeding via a percutaneous endoscopic gastrostomy (PEG)
c) Feeding via a radiologically inserted gastrostomy (RIG)
d) Continue oral food

401. Which of the following medications are safe to be administered via a

nasogastric tube?

a) Enteric coated drugs to minimize the impact of gastric irritation. b) A

cocktail of all medications mixed together, to save time and prevent fluid
overloading the patient.
c) Any drugs that can be crushed.
d) Drugs that can be absorbed via this route, can be crushed and given diluted
or dissolved in 10-15 ml of water

402. What specifically do you need to monitor to avoid complications and

ensure optimal nutritional status in patients being enterally fed?

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a) Blood glucose levels, full blood count, stoma site and bodyweight b)
Eye sight, hearing, full blood count, lung function and stoma site c)
Assess swallowing, patient choice, fluid balance, capillary refill time d)
Daily urinalysis, ECG, protein levels and arterial pressure

403. If a patient requires protective isolation, which of the following should

you advise them to drink?

a) Filtered water only

b) Fresh fruit juice and filtered water
c) Bottled water and tap water
d) Long-life fruit juice and filtered water

404. A patient has been admitted for nutritional support and started receiving
a hyperosmolar feed yesterday. He presents with diarrhoea but has no
pyrexia. What is likely to be the cause?

a) The feed
b) An infection
c) Food poisoning
d) Being in hospital

405. Adam, 46 years old is of Jewish descent. As his nurse, how will you plan
his dietary needs?

a) Assume he strictly needs Jewish food

b) Ask relatives to bring food from kosher market
 c) Ask a rabbi to help you plan
d) Ask the patient about his diet preferences

406. An adult woman asks for the best contraception in view of her holiday
travel to a diarrhoea prone areas. She is currently taking oral
contraceptives. What advice will you give her?

a) Tell her to abstain from having sex because of HIV

b) Tell her to bring lots of contraceptives because it will be expensive c) Tell
her to use other methods like condom because diarrhoea lessens the effects
of OCP
d) tell her to continue taking her usual contraceptives

407. Dehydration is of particular concern in ill health. If a patient is receiving

IV fluid replacement and is having their fluid balance recorded, which of the
following statements is true of someone said to be in “positive fluid
balance”

a) The fluid output has exceeded the input

b) The doctor may consider increasing the IV drip rate
c) The fluid balance chart can be stopped as “positive” means “good”

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d) The fluid input has exceeded the output

408. The nurse is preparing to change the parenteral nutrition (PN) solution bag
&tubing. The patient’s central venous line is located in the right subclavian vein.
The nurse asks the client to take which essential action during the tubing
change?

a) Breathe normally
b) Turn the head to the right
c) Exhale slowly & evenly
d) Take a deep breath, hold it ,& bear down

409. Obesity is one of the main problem. what might cause this?

a) supermarket
b) unequality
c) low economic class

410. Constipation needs to be sort out during:

a) planning
b) assessment
c) implementation
d) evaluation

411. What may not be cause of diarrheoa?

a) colitis
 b) intestinal obstruction
c) food allergy
d) food poisoning

412. Perdue (2005) categorizes constipation as primary, secondary or

iatrogenic. What could be some of the causes of iatrogenic
constipation?

A. Inadequate diet and poor fluid intake.

B. Anal fissures, colonic tumours or hypercalcaemia.
C. Lifestyle changes and ignoring the urge to defaecate.
D. Antiemetic or opioid medication

413. A patient is to be subjected for surgery but the patient’s BMI is low.
Where will you refer the patient?

A. Speech and Language Therapist

B. Dietitian
C. Chef
D. Family member

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414. How can patients who need assistance at meal times be identified?

A. A red sticker
B. A colour serviette
C. A red tray
D. Any of the above

415. Which of the following is no longer a recommended method of mouth

care?

A. Chlorhexidine solution and foam sticks

B. Sodium bicarbonate
C. Normal saline mouth wash
D. Glycerine and lemon swabs

416. Signs of denture related stomatitis

A. whiteness on the tongue

B. patches of shiny redness on the cheek and tongue
C. patches of shiny redness on the palette and gums
D. patches of shiny redness on the tongue

417. Before a gastric surgery, a nurse identifies that the patients BMI is too
low. Who she should contact to improve the patients’ health before
surgery

a) Gastro enterologist
 b) Dietitian
c) Family doc of patient
d) Physio

418. Which of the following is not a cause of gingival bleeding?

A. Vigorous brushing of teeth

B. Intake of blood thinning medications (warfarin, aspirin, and heparin)
C. Vitamin deficiency (Vitamins C and K)
D. Lifestyle

419. A patient develops gingivitis after using an artificial denture. It is

characterized by

a) White patches on tongue

b) Red shiny patches on tongue
c) Redshiny patches around the palate of tooth

420. Signs of denture-related stomatitis include all except:

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A. Redness underneath the area where the dentures are placed
B. Red sores at the corners of lips or on the roof of the mouth
C. Presence of white patches inside the mouth
D. Gingivitis

421. If a patient is experiencing dysphagia, which of the following

investigations are they likely to have?

a) Colonoscopy
b) Gastroscopy
c) Cystoscopy
d) Arthroscopy

422. Signs and symptoms of early fluid volume deficit, except.

A. Decreased urine output

B. Decreased pulse rate
C. Concentrated urine
D. Decreased skin turgor

423. A patient is to be subjected for surgery but the patient’s BMI is low.
Where will you refer the patient?

A. Speech and Language Therapist

B. Dietician
C. Chef
D. Family member
 424. A patient had been suffering from severe diarrheoa and is now showing
signs of dehydration. Which of the following is not a classic symptom?

A. passing small amounts of urine frequently

B. dizziness or light-headedness
C. dark-coloured urine
D. thirst

425. A relative of the patient was experiencing vomiting and diarrhoea and
wished to visit her mother who was admitted. As a nurse, what will you
advise to the patient's relative?

a) There should be 48 hours after active symptoms should disappear prior to

visiting patient
b) Inform relative it is fine to visit mother as long as she uses alcohol before
entering ward premises

426. Nurse caring a confused client not taking fluids, staff on previous shift
tried to make him drink but were unsuccessful. Now it is the visitors
time,wife is waiting outside What to do?

a) Ask the wife to give him fluid, and enquire about his fluid preferences and

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