CBT Mock Test 3 - NMC Part 1 Test of Competence

NOTE: This is a “mock” test based on some of the references given in the NMC Blue Print. The test covers 4 Domains and 1 field specific competency relating to your specialism – in this case ‘Adult Nursing’. The questions provided is only a guide, individuals should review the all study material and modules provided in MMA Healthcare Recruitment CBT guide.

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* 1. A 17-year old patient who was involved in an orthopaedic accident is observed not eating the meals that she previously ordered and refuses to take a bath even if she is already in recovery stage. As a nurse what do you think is the best explanation for her reaction to the accident that happened to her?

Supression

Undoing

Regression

Repression

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* 2. What does AVPU mean?

alert verbalization pain unconscious

awake voice pain unconscious

alert voice pain unresponsive

awake verbalization pain unconscious

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* 3. Where will you put infectious linen?

red plastic bag designed to disintegrate when exposed to heat

red linen bag designed to hold its integrity even when exposed to heat

yellow plastic bag for disposal

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* 4. Who is responsible in disposing sharps?

Registered nurse

Nurse assistant

Whoever used the sharps

Whoever collects the garbage

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* 5. NMC requires in the UK how many units of continuing education units a nurse should have in 3 years?

35 Units

45 Units

55 Units

65 Units

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

blistered wound on the skin

open wound showing tissue

open wound exposing muscles

open wound exposing bones

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* 7. What could be the reason why you instruct your patient to retain on its original container and discard nitroglycerine meds after 8 weeks?

removing from its darkened container exposes the medicine to the light and its potency will decrease after 8 weeks

it will have a greater concentration after 8weeks

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* 8. 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?

urinary tract infection leading to delirium

delayed grieving with dementia

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

inform social service desk on suspected case of child neglect

ignore incident since the child is under the responsibility of the mother

raise the situation to your head nurse and discuss with her what intervention might be done to help the child

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* 10. 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

encourage all the staff who are present to do their best to attend to the needs of the patients

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

refuse to take charge of the next shift

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

Nursing assistant

Purchasing personne

Immediate nurse manager

Supplier

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* 12. What do you mean by MRSA?

methicillin-resistant staphyloccocus aureu

multiple resistant staphylococcus antibiotic

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

primary post partum haemorrhage

secondary post partum haemorrhage

tertiary post partum haemorrhage.

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* 14. As a registered nurse in a unit what would consider as a priority to a patient immediately post operatively?

pain relief

blood loss

airway patency

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* 15. Which is the most dangerous site for intramuscular injection?

ventrogluteal

deltoid

rectus femoris

dorsogluteal

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* 16. A solution contains 12.5 g of glucose in 0.25 l; what is the percentage concentration (%) of this solution?

10%

25%

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* 17. A litre bag of 5% Glucose is prescribed over 4 hours. If a standard giving set is used, at what rate should the drip be set?

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* 18. You believe that an adult you know and support has been a victim of physical abuse that might be considered a criminal offence. What should you do to support the police in an investigation?

Question the adult thoroughly to get as much information as possible

Take photographs of any signs of abuse or other potential evidence before cleaning up the victim or the crime scene

Explain to the victim that you cannot speak to them unless a police officer is present

Make an accurate record of what the person has said to you

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* 19. If you suspect abuse is happening to someone, and it is not serious enough to involve the police straight away, who should you inform?

A manager with safeguarding responsibility (if within an organisation) or Adult Social Care directly (if you are a member of the public)

No one – it is up to the adult at risk to raise the alert

The adult's next of kin

Everyone with a caring responsibility for the adult

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* 20. If you were told by a nurse at handover to take standard precautions what would you expect to be doing?

Taking precautions when handling blood and high-risk body fluids so that you dont pass on any infection to the patient.

Wearing gloves, aprons and mask when caring for someone in protective isolation to protect yourself from infection.

Asking relatives to wash their hands when visiting patients in the clinical setting.

Using appropriate hand hygiene, wearing gloves and aprons when necessary, disposing of used sharp instruments safely and providing care in a suitably clean environment to protect yourself and the patients.

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* 21. What would make you suspect that a patient in your care had a urinary tract infection?

The doctor has requested a midstream urine specimen.

The patient has a urinary catheter in situ, and the patients wife states that he seems more forgetful than usual.

The patient has spiked a temperature, has a raised white cell count (WCC), has new-onset confusion and the urine in his catheter bag is cloudy.

The patient has complained of frequency of faecal elimination and hasnt been drinking enough.

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* 22. You are caring for a patient in isolation with suspected Clostridium difficile. What are the essential key actions to prevent the spread of infection?

Regular hand hygiene and the promotion of the infection prevention link nurse role.

Encourage the doctors to wear gloves and aprons, to be bare below the elbow and to wash hands with alcohol handrub. Ask for cleaning to be increased with soap-based products.

Ask the infection prevention team to review the patients medication chart and provide regular teaching sessions on the 5 moments of hand hygiene. Provide the patient and family with adequate information.

Review antimicrobials daily, wash hands with soap and water before and after each contact with the patient, ask for enhanced cleaning with chlorine-based products and use gloves and aprons when disposing of body fluids.

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* 23. What steps would you take if you had sustained a needlestick injury?

Ask for advice from the emergency department, report to occupational health and fill in an incident form.

Gently make the wound bleed, place under running water and wash thoroughly with soap and water. Complete an incident form and inform your manager. Co-operate with any action to test yourself or the patient for infection with a bloodborne virus but do not obtain blood or consent for testing from the patient yourself; this should be done by someone not involved in the incident.

Take blood from patient and self for Hep B screening and take samples and form to Bacteriology. Call your union representative for support. Make an appointment with your GP for a sickness certificate to take time off until the wound site has healed so you dont contaminate any other patients.

Wash the wound with soap and water. Cover any wound with a waterproof dressing to prevent entry of any other foreign material

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* 24. What factors are essential in demonstrating supportive communication to patients?

Listening, clarifying the concerns and feelings of the patient using open questions.

Listening, clarifying the physical needs of the patient using closed questions.

Listening, clarifying the physical needs of the patient using open questions.

Listening, reflecting back the patients concerns and providing a solution.

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* 25. Dehydration is of particular concern in ill health. If a patient is receiving intravenous (IV) fluid replacement and is having their fluid balance recorded, which of the following statements is true of someone said to be in a positive fluid balance?

The fluid output has exceeded the input.

The doctor may consider increasing the IV drip rate.

The fluid balance chart can be stopped as positive in this instance means good.

The fluid input has exceeded the output.

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* 26. What specifically do you need to monitor to avoid complications and ensure optimal nutritional status in patients being enterally fed?

Blood glucose levels, full blood count, stoma site and bodyweight.

Eye sight, hearing, full blood count, lung function and stoma site.

Assess swallowing, patient choice, fluid balance, capillary refill time.

Daily urinalysis, ECG, protein levels and arterial pressure.

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

Lie them flat.

Sit them at least at a 45° angle.

Tell them to lie on their side.

Check their oxygen saturations.

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

That when flushed with red juice, the red juice can be seen when the tube is aspirated.

That air cannot be heard rushing into the lungs by doing the whoosh test.

That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is the same length as the time insertion.

That pH of gastric aspirate is >6.0, and the measurement on the NG tube is the same length as the time insertion.

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

As the older generation deserve more respect and tender loving care (TLC).

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.

All elderly people lose dexterity and struggle to wash effectively so they need support with personal hygiene.

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.

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* 30. What should be included in your initial assessment of your patients respiratory status?

Review the patients notes and charts, to obtain the patients history.

Review the results of routine investigations.

Observe the patients breathing for ease and comfort, rate and pattern.

Perform a systematic examination and ask the relatives for the patients history.

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* 31. When using nasal cannulae, the maximum oxygen flow rate that should be used is 6 litres/min. Why?

Nasal cannulae are only capable of delivering an inspired oxygen concentration between 24% and 40%.

For any given flow rate, the inspired oxygen concentration will vary between breaths, as it depends upon the rate and depth of the patients breath and the inspiratory flow rate.

Higher rates can cause nasal mucosal drying and may lead to epistaxis.

If oxygen is administered at greater than 40% it should be humidified. You cannot humidify oxygen via nasal cannulae

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* 32. Why is it essential to humidify oxygen used during respiratory therapy?

Oxygen is a very hot gas so if humidification isnt used, the oxygen will burn the respiratory tract and cause considerable pain for the patient when they breathe.

Oxygen is a dry gas which can cause evaporation of water from the respiratory tract and lead to thickened mucus in the airways, reduction of the movement of cilia and increased susceptibility to respiratory infection.

Humidification cleans the oxygen as it is administered to ensure it is free from any aerobic pathogens before it is inhaled by the patient.

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* 33. Which of the following would indicate an infection?

Hot, sweaty, a temperature of 36.5°C, and bradycardic.

Temperature of 38.5°C, shivering, tachycardia and hypertensive.

Raised WBC, elevated blood glucose and temperature of 36.0°C.

Hypotensive, cold and clammy, and bradycardic.

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* 34. 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:

Accept her weakness and take this challenge as an opportunity to improve her skills by requesting lectures from her manager

Ignore the criticism as this is a case of a team issue

Continue delivering care as this will not affect the quality of care you are rendering your patient

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* 35. 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?

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

Report the student to his Instructor after duty

Politely signal the student and encourage him by actively including him in the discussion

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

Partial thickness burns

Contaminated wounds

Diabetic and neuropathic ulcers

Traumatic wounds

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

24 hours

Just minutes

1-5 days

3-24 days

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

Skin clips

Tissue adhesive

Adhesive skin closure strips

Interrupted suture

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

Negative pressure dressing

Rapid capillary dressing

Alginate dressing

Skin barrier product

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

Proliferative phase, inflammation phase, remodelling phase, maturation phase.

Haemostasis, inflammation phase, proliferation phase, maturation phase

Inflammatory phase, dynamic stage, neutrophil phase, maturation phase.

Haemostasis, proliferation phase, inflammation phase, remodelling phasesupport

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* 41. How soon after surgery is the patient expected to pass urine?

1-2 hours

2-4 hours

4-6 hours

6-8 hours

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

High humidity, insulation, gaseous exchange, absorbent.

Anaerobic, impermeable, conformable, low humidity

Insulation, low humidity, sterile, high adherence.

Absorbent, low adherence, anaerobic, high humidity

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

On all chronic wounds

On all infected wounds.

On all complex wounds.

On every wound

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

Systemic antibiotic therapy and apply a dry dressing

Debride and apply a hydrogel dressing.

Debride and apply an antimicrobial dressing.

Apply a negative pressure dressing.

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

In the inflammation phase of healing.

In the haemostasis phase of healing.

In the reconstructive phase of wound healing.

As an infected wound

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* 46. When a patient is being monitored in the PACU, how frequently should blood pressure, pulse and respiratory rate be recorded?

Every 5 minutes

Every 15 minutes

Once an hour

Continuously

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* 47. Safe moving and handling of an anaesthetized patient is imperative to reduce harm to both the patient and staff. What is the minimum number of staff required to provide safe manual handling of a patient in theatre?

3 (1 either side, 1 at head).

5 (2 each side, 1 at head).

4 (1 each side, 1 at head, 1 at feet).

6 (2 each side, 1 at head, 1 at feet).

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* 48. Why are anti-embolic stockings an effective means of reducing the potential of developing a deep vein thrombosis?

They promote arterial blood flow.

They promote venous blood flow.

They reduce the risk of postoperative swelling.

They promote lymphatic fluid flow, and drainage

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* 49. 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?

The patient is showing symptoms of hypovolaemic shock. Investigate source of fluid loss, administer fluid replacement and get medical support.

The patient is demonstrating symptoms of atelectasis. Administer a nebulizer, refer to physiotherapist for assessment.

The patient is demonstrating symptoms of uncontrolled pain. Administer prescribed analgesia, seek assistance from medical team.

The patient is demonstrating symptoms of hyperventilation. Offer reassurance, administer oxygen

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* 50. Who should mark the skin with an indelible pen ahead of surgery?

The nurse should mark the skin in consultation with the patient

A senior nurse should be asked to mark the patient's skin

The surgeon should mark the skin

It is best not to mark the patient's skin for fear of distressing the patient.

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* 51. We are always striving to improve our service and support to overseas nurses. Any feedback or suggestions that you might have can be made in the comment box below. If you are not registered with MMA Healthcare Recruitment and would like to receive a copy of our free CBT study guide, please provide your name and e-mail address.
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