NEW CBT 2021

1. Dressing for blister:

a. Hydrocolloid or foam dressing

b. No dressing
c. Silver dressing

To protect your blister from becoming infected, a pharmacist can recommend a plaster
or dressing to cover it while it heals. A hydrocolloid dressing (a moist dressing) can
protect the blister, help reduce pain and speed up healing.

2. When do you see P waves before QRS?

a. Fibrillation
b. Afibrillation
c. Flat asystole
d. Continuous fluctuation

The presence of P waves immediately before every QRS complex indicates sinus rhythm.
If there are no P waves, note whether the QRS complexes are wide or narrow, regular or
irregular.

During atrial fibrillation, the heart's upper chambers (the atria) beat chaotically and
irregularly — out of sync with the lower chambers (the ventricles) of the heart. For many
people, A-fib may have no symptoms. However, A-fib may cause a fast, pounding
heartbeat (palpitations), shortness of breath or weakness.

3. A working time directive sits under which policy?

a. Equality and diversity

b. Freedom of info
c. Health and safety
d. Human resource

4. A patient with end-of-life care becomes unresponsive, the nurse asks the relative if the
patient filled a DNR form. What does she mean?

a. Do not initiate respiratory resuscitation

b. Do not run
c. Do not initiate cardiopulmonary resuscitation
d. Provide care and safety

5. Which medication leads black colored stool?

a. Furosemide
b. Paracetamol
c. Iron
6. When you don’t understand the accent of your patient, what will you do?

a. Write whatever you hear

b. Assume what patient has said
c. Seek clarification from patient

7. You are dressing the wound of a patient on a surgical ward and are required to do so
using the Aseptic Non-Touch Technique (ANTT). Which of the following is the
definition of “asepsis”?

a. Free from all microorganisms

b. Absence of Systemic Inflammatory Response Syndrome (SIRS) criteria
c. Free from marks and stains
d. Free from pathogenic organisms in sufficient numbers to cause infection

8. How would you provide support for a 16-year-old patient to reduce anxiety during
physical examination?

a. Provide privacy and dignity

b. Remain with the patient and provide support
c. Do not intervene and intervene only when the doctor tells you

9. As a nurse, you are treating a patient who had an asthma attack, how would you
assess If the medication is effective?

a. Patient can walk at a short distance

b. Peak flow
c. Normal heart rate
d. Normal blood pressure

10. In a hypoglycemic patient, after giving oral glucose syrup, when will you check the
next General Random Blood Sugar (GRBS)?

a. Immediately
b. After 5-10 mins
c. After 15-20 mins
d. After 30 mins

11. What is the meaning of CBT?

a. Cognitive Behavioral Therapy

b. Competency Based Test
c. Computer Based Test
d. Cognitive Behavioral Test

12. Barrel chest is noted on patients with:

a. Emphysema
b. COPD
c. Asthma
d. Smokers
 13. How do you know the NGT is in place?

a. Check pH of aspirate
b. CT Scan
c. Xray
d. Introduce air

Abdominal X-Ray is the MOST RELIABLE method in testing the placement of the
enteral tube. Best way to verify enteral tube prior to feeding: Aspirate gastric content; pH
<5.5.

14. Who would you speak with in end-of-life care?

a. Patient first
b. Patient and relative together
c. Relative

15. Spinal fracture patient, how will you ensure airway?

a. Jaw thrust
b. Head tilt
c. Open mouth
d. Chin lift

The jaw-thrust maneuver is used to relieve upper airway obstruction by moving the
tongue anteriorly with the mandible, minimizing the tongue's ability to obstruct the
airway. Conclusions: The jaw thrust maneuver results in less motion at an unstable C1-
C2 injury as compared with the head tilt-chin lift maneuver. We therefore recommend the
use of the jaw thrust to improve airway patency in the trauma patient with suspected
cervical spine injury.

16. A staff caring for an isolation patient, where you will keep the records?

a. Inside the patient room

b. Outside the wall of room
c. Nurse station

17. What should the nurse check for a patient with a catheter in situ?

a. Infection
b. Bruising
c. Swelling
d. Redness

18. What will NOT be used for a deaf person?

a. Lip reading
b. Actions
c. Sign language
 d. Bacile

19. Who can complete the checklist for a full care assessment?

a. Trained professional
b. Consultant
c. Junior doctor
d. Relative

20. When does a nurse take a patient’s daily weight?

a. Before breakfast
b. At the same time everyday
c. After lunch
d. Before bedtime

21. Group A controlled drugs:

a. Morphine
b. Midazolam
c. Codeine
d. Conjupram

22. Blanchable skin can be assessed by nurse as:

a. Skin that turns red or dark when pressure is applied and returns back suddenly.
b. Skin that turns red or dark and returns back slowly.
c. Skin that turns white or pale when pressure is applied and returns back immediately.
d. Skin that turns white or pale when pressure is applied and returns back slowly.

23. A newly qualified nurse is not yet well versed when it comes to documentation. A
nurse in-charge noticed this was the case and went to report the new nurse to the nurse
manager. What could the newly qualified nurse have done in order to prevent this
incident?

a. Ignore the report and just continue with what she was doing.
b. She could have told the manager beforehand in order to have support and additional
training
c. Apologize that she was not able to inform her immediate head beforehand, ask for
policies of the hospital in relation to documentation.

24. Young, hospitalized children are at risk to develop:

a. Poor mental health

b. Neurological disorder
c. Cancer
d. Will die young

25. After an audit round, the manager tells a nurse about the outcome and possible
development suggested by the team members. What action will the nurse take?
 a. Accept and keep the report in a file for reference purpose.
b. Thank the manager and tell her that the suggested action will be looked into in due
course.
c. Plan how to meet with the manager to discuss the solution.

26. What is the first action a RN should take on a patient who is having a tonic-clonic
seizure?

a. Administer sedative medication dosage in 15L and complete A-E assessment.

b. Call for help, ensure a safe position and apply 15L of oxygen.
c. Attach to monitoring, call for help, inform family
d. Give the patient something to bite on, call for help and attach monitoring.

27. NHS gives the most portion of budget to:

a. Alcohol and drug abuse

b. Elderly chronic disease
c. Adolescent
d. Blood-borne diseases

28. Golden treatment for MI:

a. Primary Percutaneous Coronary Intervention (PPCI)

b. Coronary Artery Bypass Graft (CABG)
c. Thrombolytic
d. Peripheral Intravenous Catheter (PIC)

Recently the reperfusion therapy in the form of Primary Percutaneous Coronary

intervention (PPCI) has become the gold standard for the treatment of Acute Myocardial
Infarction.

29. What policy relating to dress is mandatory in all clinical areas in the hospital?

a. Everyone must wear designated uniforms

b. Everyone arm must bare below the elbow
c. Everyone must wear gloves when examining a patient
d. Everyone must wear bespoke hospital footwear

30. Lithium therapy is indicated for:

a. Bipolar disorder
b. Schizophrenia
c. Tonic-clonic seizure
d. Depression

31. A client is in the process of turning from male to female. When you want to educate a
client on catheterization as a nurse what will you do?

a. Teach male catheterization

b. Teach female catheterization
c. Both
 32. Pain scale of 5 out of 10, what medication will you give?

a. Diclo plus tramadol

b. Paracetamol
c. Morphine
d. Codeine

Step 1: non-opioid analgesics such as paracetamol and nonsteroidal anti-inflammatory

drugs (NSAIDs).
– Step 2: weak opioid analgesics such as codeine and tramadol. Their combination with
one or two Step 1 analgesics is recommended.
– Step 3: strong opioid analgesics, first and foremost morphine. Their combination with
one or two Step 1 analgesics is recommended.

33. Who is NOT allowed to give medication?

a. Dietician
b. Health care assistant
c. Nurse practitioner
d. Nurse

34. Abbey pain scale is used for patients:

a. Birth to 1 year
b. Pregnant women
c. Dementia patients

The Abbey Pain Scale is an instrument designed to assist in the assessment of pain in
patients who are unable to clearly articulate their needs, for example, patients with
dementia, cognition or communication issues. The pain scale should be used as a
movement based assessment , therefore observing the patient while they are being
moved, during pressure area care, while showering etc. A second evaluation should be
conducted 1 hour after any intervention taken.

35. Best valid and accurate research method:

a. Systematic review of descriptive and qualitative method

b. Quasi experimental
c. Randomized
d. Non-randomized

36. For revalidation, how can a nurse give 5 pieces of feedback?

a. Verbal only
b. Written or verbally only
c. Verbal, written or survey

37. Chemotherapy and hormone waste disposal container:

 a. Purple
b. Yellow
c. Orange
d. Black

WASTE COLOR CODE:

(Royal Marsden pg 90-92)
1. YELLOW – disposal by incineration
o For diagnostic exams: e.g. gloves, apron, dressing
o Higher chance of contamination

2. ORANGE – WASTE WHICH MAY BE TREATED, ATP’S,ALTERNATING

PLANS
o PPE’S e.g. wipes, aprons, bandages, ATP’s

3. PURPLE – biohazard waste, cytotoxic and cytostatic waste, by incineration

o e.g. chemotherapy, needles, syringes, drip sets

4. YELLOW/BLACK – offensive/hygiene waste, goes to the landfill or by incineration

o e.g. diapers, napkin, colostomy bags, incontinence pads, catheter bags

5. RED – Anatomicalwaste for incineration (infected)

o e.g. blood bags, sharps, blood preserves

6. BLACK – Domestic/Municipal waste

o e.g. household wastes, disposable cups, sandwich wrappers

7. BLUE – Medicinal waste for incineration

o e.g. expired medications, tablets, blister pads, liquids in bottles

8. WHITE – Amalgam waste

o e.g. dental waste

38. Which is the first act on all legal issues?

a. Safeguard act
b. Health care act
c. Equity act
d. Equality act

39. When a patient is having a surgery to switch from male to female you need to teach
self-catheterization. What would you do?

a. Discuss with patient what surgery he is undergone and teach him

b. Reads the notes
c. Teach both male and female catheterization
d. Get a doctor to teach as you are not competent

40. Which one of these notifiable diseases needs to be reported on a national level?

a. Chicken pox
 b. Tuberculosis
c. Whooping cough
d. Influenza
List of notifiable diseases:

Acute encephalitis
Acute infectious hepatitis
Acute meningitis
Acute poliomyelitis
Anthrax
Botulism
Brucellosis
Cholera
COVID-19
Diphtheria
Enteric fever (typhoid or paratyphoid fever)
Food poisoning
Haemolytic uraemic syndrome (HUS)
Infectious bloody diarrhoea
Invasive group A streptococcal disease
Legionnaires’ disease
Leprosy
Malaria
Measles
Meningococcal septicaemia
Mumps
Plague
Rabies
Rubella
Severe Acute Respiratory Syndrome (SARS)
Scarlet fever
Smallpox
Tetanus
Tuberculosis
Typhus
Viral haemorrhagic fever (VHF)
Whooping cough
Yellow fever

Registered medical practitioners (RMPs) have a statutory duty to notify the ‘proper
officer’ at their local council or local health protection team (HPT) of suspected cases of
certain infectious diseases.

Complete a notification form immediately on diagnosis of a suspected notifiable disease.

Don’t wait for laboratory confirmation of a suspected infection or contamination before
notification.

Send the form to the proper officer within 3 days, or notify them verbally within 24 hours
if the case is urgent by phone, letter, encrypted email or secure fax machine.To the UK
Health Security Agency (UKHSA).
 41. Management of moderate malnutrition in children:

a. Supplementary nutrition
b. Immediate hospitalization
c. Weekly assessment
d. Document intake for 3 days

MALNUTRITION UNIVERSAL SCREENING TOOL (MUST)

3 Criteria:
1. Current weight status using BMI
2. Unintentional weight loss
3. Acute disease effect

0- LOW – monitor weight

1- MEDIUM – monitor food intake for the past 3 days
2- HIGH – refer to dietician

42. How does a senior nurse manage the situation when a staff member informs her that
she is pregnant?

a. Inform the health and safety lead

b. Undertake the risk management
c. Arrange for cover immediately
d. Inform other staff

43. Decerebrated posture in which patients?

a. Hernia
b. MI
c. Stroke
d. Brain Stem Damage

A severe injury to the brain is the usual cause of decerebrate posture. Opisthotonos (a
severe muscle spasm of the neck and back) may occur in severe cases of decerebrate
posture. Decerebrate posture can occur on one side, on both sides, or in just the arms.

Causes of decerebrate posture include:

● Bleeding in the brain from any cause

● Brain stem tumor
● Stroke
● Brain problem due to illicit drugs, poisoning, or infection
● Traumatic brain injury
● Brain problem due to liver failure
● Increased pressure in the brain from any cause
● Brain tumor
● Infections, such as meningitis
● Reye syndrome (sudden brain damage and liver function problems that affects
children)
● Brain injury from lack of oxygen
44. According to the Reporting of Injuries, Diseases and Dangerous Occurrences
Regulations (RIDDOR) legislation, what will you do when a staff member has an
accident at the workplace causing a fracture of the femur?

a. Report the accident

b. Report the accident to a doctor on site
c. Record the incidence in a management book

45. A patient’s elder sister who is a nurse and friend requested for the patient's result. What
will be your action?

a. Give it to her since she is your colleague

b. Do not give because the patient has not permitted you and explain your
responsibilities
c. Give and end your friendship with her
d. Do not give but tell her about the result

46. One of the patients keeps on complaining regarding the care, what will you do?

a. Tell the patient to write complain and send via email

b. Instruct the patient to complain to in-charge
c. Listen carefully and honest solution

47. There is a policy that urine should be measured every 2 hours. How would a nurse
manager evaluate compliance?

a. Ask them to verbalize they are doing it

b. Perform clinical audit
c. Check nursing notes at the beginning of every shift

48. What is the average hourly urine production for an adult?

a. 0-10 mL/hr
b. 40-80 mL/hr
c. 20-30 mL/hr
d. 100-200 mL/hr

49. An obese patient with limited communication wants to lose weight, who should the
nurse involve?

a. Occupational therapist, GP dietician and social worker

b. Physiotherapist, nurse, GP dietician
c. Occupation therapist, psychiatrist
d. Physiotherapist and social worker

50. In a dehydrated patient, what will you infuse?

a. Crystalloid glucose
b. Colloid glucose
c. Blood transfusion
d. Plasma
Crystalloid fluids are the first choice for fluid resuscitation in the presence of
hypovolemia, hemorrhage, sepsis, and dehydration.

While normal saline (0.9% NaCl solution) is the most frequently used crystalloid fluid,
many other formulations can provide improved clinical outcomes in specific patient
populations.

Other commercially available crystalloid fluids include:

● Lactated Ringer's/Hartman's solution (lactate buffered solution)

● Acetate buffered solution
● Acetate and lactate buffered solution
● Acetate and gluconate buffered solution
● 0.45% NaCl (hypotonic solution)
● 3% NaCl (hypertonic solution)
● 5% Dextrose in water
● 10% Dextrose in water

51. What is patient-centered care?

a. Caring for patient with dignity and respect

b. Understanding patients feeling and providing necessary needs accordingly
c. Helping patient to gain insight to her problem

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

a. Prioritize people
b. Practice effectively
c. Prioritize care
d. Promote safety

53. All of the following are part of palliative care or end-of-life care, except?

a. Giving medication
b. Feeding patient
c. Resuscitation

54. Patient has suicidal thoughts, low mood. When talking to the nurse patient is calm and
cooperative:

a. Low risk
b. Medium risk
c. High risk

55. Normal urine output in a day?

a. 1000-1500 mL
b. 1500-2000 mL
c. 2000-2500 mL
 d. 2500-3000 mL

56. ABCDE approach. Where does monitoring of urine output belong in that approach?

a. A
b. B
c. C
d. D
e. E

57. Patient is having breathlessness. Patient is in end-of-life care. The nurse should:

a. Put the face of the patient in the electric fan

b. Give high flow oxygen
c. Put paper bag
d. Give more sedative

58. Which of the following is NOT to cater emergency contraception?

a. Emergency department
b. General practitioner
c. Sexual Health Team/Clinic
d. Pharmacist

59. The patient brings his own medication to the hospital and wants to self-administer.
What is your role?

a. Allow him
b. Explain to patient about medication before he administers it

60. Whose responsibility when you see evidence of abuse in the community?

a. All healthcare workers

b. Nurse caring for the patient
c. Consultant

61. Patient has a learning disability, and you instruct him to take his medication. The
nurse should:

a. Give instruction to the carer

b. Give appropriate level of instruction
c. Give leaflet
d. Explain briefly to the patient the importance of his medicine

62. What is the meaning of TNA?

a. Trainee Nursing Associate

b. Trigeminal Neuralgia Association
c. The Nursing Agency

63. The nurse notices that the patient is violent. The nurse should:
 a. Request for restraint
b. Inform the other patient

64. Nurse committed negligence which resulted in the near death of the patient. What
analysis causes this?

a. Root cause analysis

b. Critical incident analysis
c. Incident cause analysis

Root cause analysis (RCA) is a structured method used to analyze serious adverse
events. ... A central tenet of RCA is to identify underlying problems that increase the
likelihood of errors while avoiding the trap of focusing on mistakes by individuals.

65. On resuming as a unit head and you notice you are short staffed. What type of
escalation will the head nurse use?

a. Prompt escalation
b. Swift escalation
c. Immediate escalation
d. Rapid escalation

66. What is the most accurate method to find out bleeding inside the brain?

a. CT Scan
b. MRI
c. Xray
d. USG

67. A confused patient relative requested for fitting bed rail as they have it in their house.
What will the nurse do?

a. Ensure a bed rail is fixed

b. Let a competent person assess risk and consider other factors
c. Put patients’ bed on the floor
d. Ignore relative

68. Congestive heart failure non-infectious sputum color:

a. White
b. Green
c. Black

69. Optimum position for lung expansion:

a. Prone
b. Sitting up
c. Lying on one side
d. Lying flat
 70. Cause of pediatric cardiac arrest:

a. Hypoxia
b. MI
c. Anaphylaxis
d. CHF

In pediatric patients, hypoxia and hypovolemia are the most common causes. The Ts
include Toxins, Tamponade (cardiac) Tension pneumothorax, Thromboembolic event,
and Trauma.
Hypoxia is a state in which oxygen is not available in sufficient amounts at the tissue
level to maintain adequate homeostasis; this can result from inadequate oxygen delivery
to the tissues either due to low blood supply or low oxygen content in the blood
(hypoxemia).

71. Difference in health status:

a. Health equities
b. Health equalities
c. Health informatics
d. Health inequities

72. A patient with a temperature of 34.5C. You already gave the patient a warm blanket &
warm drinks, but the patient is still shivering. What will be your next action?

a. Get a warming device to give warmth slowly

b. Provide extra warmth blanket
c. Give a warm bath
d. Mobilized the patient

73. Patients husband that was waited several hours to see his wife and is shouting:

a. Take him to a private room and discuss with him

b. Give personal space and avoid provocation
c. Accompany him to see his wife

74. When a patient is being monitored in PACU, how frequently do you monitor his BP, PR,
RR and record?

a. Every 5 minutes
b. Every 15 minutes
c. Once an hour
d. Continuously

75. What will the RN do after they have gotten an NMC pin?

a. Endorsement
b. Induction
c. Orientation
d. Training
 76. When assessing an unresponsive patient, what is the appropriate way to get a pain
response?

a. Sternal rub
b. Nail bed pressure
c. Pinching of the era
d. A trapezium squeeze

77. A patient suffered from CVA and is now affected with dysphagia, what should NOT be
an indication to this type of patient?

a. Place the patient in sitting/upright position during and after eating

b. Water or clear fluid should be given
c. Instruct the patient to use a straw to drink water
d. Review the patient’s ability to swallow and note the extent of facial paralysis

Dysphagia is difficulty swallowing — taking more time and effort to move food or liquid
from your mouth to your stomach. Dysphagia can be painful. In some cases, swallowing
is impossible.

78. Which one is NOT considered a medication?

a. Whole blood
b. Albumin
c. Blood clotting factor
d. Antibodies

79. Discharge process: When does discharge become difficult?

a. Awaiting carer
b. Awaiting physician
c. Awaiting medication
d. Awaiting assessment

80. Ways to maximize wound healing:

a. Good blood flow

b. Daily dressing
c. Moist environment

81. A patient is on end-of-life care, he has severe pain, he doesn’t know how to use
medical device which is using for pain relief:

a. Instruct the patient that the pharmacist will come and explain
b. Give leaflet regarding the device
c. Explain about medical device and make the patient completely understand

82. Reminiscence, de-escalation and distraction are types of?

a. Therapy service
 b. Therapy classes
c. Therapeutic intervention

83. How many leads are there in ECG?

a. 8
b. 10
c. 12
d. 14

The standard ECG has 12 leads. Six of the leads are considered “limb leads” because
they are placed on the arms and/or legs of the individual. The other six leads are
considered “precordial leads” because they are placed on the torso (precordium).

The six limb leads are called lead I, II, III, aVL, aVR and aVF. The letter “a” stands for
“augmented,”

84. Symptoms of bipolar disorder?

a. Mania and depression

b. Hallucinations
c. Delusions
d. Ecstasy

85. RN influence on health policy protects the quality of care by access to:

a. Fund and opportunity

b. Funding
c. Resources and opportunity
d. Fund and resources

86. Students did not administer IM in her mid-year performance:

a. The nurse should create an opportunity and plan with the other nurses
b. Tell her it’s not good
c. Tell her she would need to contact the university for the actual plan

87. Abby’s pain scale is used for:

a. Cognitive disability
b. Women in labor
c. Children above 8
d. Children below 1

The Abbey Pain Scale is an instrument designed to assist in the assessment of pain in
patients who are unable to clearly articulate their needs, for example, patients with
dementia, cognition or communication issues.

88. A clinical need to examine a patient after spine surgery. What will you use to turn
them?
 a. Log roll to the bed
b. Slide method to the side
c. Hoist to the bed
d. Advise the patient to sit at the end of the bed

89. Endotracheal tube is used for?

a. Feeding unconscious patients

b. Ensuring airway
c. Diagnostic testing

90. A nursing agency sends a new nurse, while handing over the nurse says this is my first
job at the hospital. What will the nurse do?

a. Leave as she is not responsible

b. Enquire about the staff and inform authorities
c. Handover anyway

91. The act of speaking out for people and relatives their decision called:

a. Disclosure
b. Confidentiality
c. Advocacy
d. Confrontation

92. Pressure sore grades that are regarded as critical incident:

a. 3
b. 3&4
c. 1, 2, 3 & 4
d. 4

Pressure sores are graded to four levels, including:

grade I – skin discolouration, usually red, blue, purple or black

grade II – some skin loss or damage involving the top-most skin layers
grade III – necrosis (death) or damage to the skin patch, limited to the skin layers
grade IV – necrosis (death) or damage to the skin patch and underlying structures, such
as tendon, joint or bone.

93. When a nurse handover at the end of shift to a colleague. What must be provided?

a. Verbal digital or written information

b. Clear verbal information and instructions
c. Clear verbal, digital, or written information and instructions
d. Clear digital or written information and instructions

94. A team leader implements a practice in an area of work. How do they demonstrate its
effectiveness?
 a. Provide evidence of the improvement through regular audit and feedback to the team
and wider organizations.
b. Everyone knows that the change was necessary and that it needed to happen so no
evaluation needs to be made.
c. Once the change is embedded ask staff if they are happy with the change and if it
has made a difference.
d. The evidence from the research demonstrates the need for a change in practice.

95. When completing handwritten notes, which of the following represents best practice in
documentation?

a. Writing a name, designation date and time of entry

b. Writing a name, nursing rank and date
c. Providing a signature printing a name designation, date, entry of time
d. Providing a signature, designation and date of birth

96. What is the response of parents that confirms that the health education message
regarding dehydration has been effective?

a. The parents restrict fluid intake when the child has diarrhea.
b. The parents state they will observe the child for darkening urine and an increasing
respiratory rate.
c. Dehydration will not be an issue if the child is taking sips of water.
d. The parents state they would consider restlessness as an early sign of dehydration.

97. What nursing approach does a nurse take when working with people with learning
disabilities in planning for their personnel needs?

a. Use pictures and easy read materials

b. Explain the procedures to their relatives
c. Give them time to read the leaflet
d. Read the leaflet to the client in loud voice

98. When a safeguarding incident is being disclosed what action does a nurse take?

a. Ensure you tape a conversation on mobile service.

b. Ensure them that you will not tell anyone else.
c. Pause the person until you can have another present person.
d. Explain what you will do next with the information they disclose.

99. What is the cause of action for the nurse if there is a spillage of hazardous
substances?

a. Use beach towels to absorb the spillage and dispose of this accordingly.
b. Contact the clinic supervisor for advice and to send someone to help.
c. Refer to the guidance on the control of substance hazardous to health regulations.
d. Cover displayed with sheets and keep the area clear of people.

100. What equipment can be used to give 2L of oxygen?

a. Continuous positive airway pressure

 b. Humidified oxygen
c. Nasal cannula
d. Reservoir mask

A traditional nasal cannula can only effectively provide only up to 4 to 6 liters per minute
of supplemental oxygen.

CPAP machines are used to support patients in NHS hospitals or at home with breathing
difficulties. They work by pushing an air-oxygen mix into the mouth and nose at a
continuous rate, keeping airways open and increasing the amount of oxygen entering the
lungs. (15-25lpm)

101. A nurse was flushing an NG tube and noticed the patient was coughing a lot.
What should be the action of the nurse?

a. Continue with the procedure and inform the doctor.

b. Continue and check the placement with litmus paper.
c. Remove it as it might be an indication that the tube is in the airway.

102. How to prevent catheter infection?

a. Sterilize it daily
b. Keep area dry
c. Use soap and water
d. Educate patient and family on the care

103. Who is responsible for starting discharge planning?

a. First contact
b. Second contact
c. Third contact
d. Fourth contact

104. How to take an infected sheet for washing according to the UK Standard?

a. Take in red plastic bag that disintegrates in high temperature

b. Use red linen bag that allows washing in high temperature
c. Orange bag…
d. Clear bag…

105. According to Francis Report, Courage is:

a. It is a quality made by relationships based on empathy, respect and dignity. It can

also be described as intelligent kindness and is central to how people perceive their
care.
b. Defines us and our work. People receiving care expect it to be right for them,
consistently, throughout every stage of their life.
c. Means all those in caring roles must have the ability to understand an individual’s
health and social needs and the expertise, clinical and technical knowledge to deliver
effective care and treatments based on research and evidence.
 d. Enables you to do the right thing for the people we care for, to speak up when we
have concerns and to have the personal strength and vision to innovate

106. A client is conducting research on 8 patients with complex needs. He wants to

know their views on the health care they receive. What type of research is conducted?

a. Patient questionnaire
b. Survey
c. Focus group
d. Qualitative research

A focus group is a collection of several individuals who all discuss a particular subject,
voicing and discussing their opinions and ideas on that subject.

107. Patient is angry. Therapeutic communication used:

a. You seem upset…

108. Which of the following physical changes should a person taking oral
contraceptive should be educated on?

a. Weight gain
b. DVT
c. Amenorrhea
d. Increased bleeding

109. Sickle cell disease is most common in which ethnic group?

a. Africans
b. Latin Americans
c. Caucasians

Sickle cell disease is particularly common in people with an African or Caribbean family
background. People with sickle cell disease produce unusually shaped red blood cells
that can cause problems because they do not live as long as healthy blood cells and can
block blood vessels. It has become so widespread there because being a carrier offers a
survival advantage against malaria.

110. When do you gain consent from a patient and consider it valid?

a. Only if a patient has the mental capacity to give consent

b. Only before a clinical procedure
c. Only after a clinical procedure
d. None of the above

111. You are carrying out wound dressing with a new product, what is your
intervention as a nurse?

a. Talk to the nurse after at the end of the shift about how to do wound care.
b. Do not remove the previous dressing and apply the new products over it
 c. Refer to another practitioner for patient’s safety until you gain your competency and
skills.
d. Leave the dressing without doing it.

112. What method of long-time feeding is appropriate for a patient with difficulty
swallowing in a chronic condition?

a. Gastrostomy
b. Parenteral feeding
c. IV
d. NGT feeding

A gastrostomy is a surgical procedure used to insert a tube, often referred to as a "G-

tube", through the abdomen and into the stomach. Gastrostomy is used to provide a
route for tube feeding if needed for four weeks or longer, and/or to vent the stomach for
air or drainage.
Parenteral feeding - A form of nutrition that is delivered into a vein. Parenteral nutrition
does not use the digestive system. It may be given to people who are unable to absorb
nutrients through the intestinal tract because of vomiting that won't stop, severe
diarrhea, or intestinal disease.
NGT feeding - A tube that is inserted through the nose, down the throat and esophagus,
and into the stomach. It can be used to give drugs, liquids, and liquid food, or used to
remove substances from the stomach. Giving food through a nasogastric tube is a type
of enteral nutrition.

113. When a nursing team visits a patient at home, which working principle is
used?

a. Lone working policy

b. Direct working policy
c. Community working policy
d. Common law policy

114. There is a policy that "do not suction" patient on Endotracheal tube in your
place of work. What should you do in an emergency when a patient needs
suctioning?

a. Do it
b. Watch the patients closely and wait till the next morning.
c. Call the physiotherapist on call if there is an emergency as they are trained for it.
d. Wait for the physiotherapist till the next morning.

115. There is a prescription with dose but without number of giving, what should
you do?

a. Assume the dose based on your experience

b. Call the prescriber to confirm the dosage
c. Omit and leave for the next shift

116. Age of consent for organ donation?

 a. Above 16
b. Above 18
c. Above 21
d. No consent needed

117. Which instrument is used to visualize the vocal cords during endotracheal
procedure?

a. Laryngoscope
b. Bougie
c. Endoscope
Laryngoscopy is a procedure a doctor uses to look at the larynx (voice box), including
the vocal cords, as well as nearby structures like the back of the throat.

Bougie - a thin, flexible surgical instrument for exploring or dilating a passage of the
body.

An endoscope is an illuminated optical, typically slender and tubular instrument (a type

of borescope) used to look deep into the body by way of openings such as the mouth or
anus, and used in procedures called an endoscopy.

118. Which one cannot be given subcutaneously?

a. NS
b. ND+ Potassium
c. 5% Dextrose
d. 25% D

119. How will you assess hemodynamic stability and perfusion?

a. Skin turgor
b. GCS
c. Capillary refill

120. How long is the Undergraduate/Pre-registration BSC Nursing Program for

those on a standard entry pathway?

a. 2 years
b. 5 years
c. 4 years
d. 3 years

121. Most common vein for phlebotomy?

a. Cephalic
b. Femoral
c. Popliteal
d. Jugular

122. Having knowledge and using it for the good of the patient is called?
 a. Health literacy
b. Health knowledge
c. Health education
d. Health intellect

123. Other names for cancer related weight loss?

a. Anorexia
b. Bulimia Nervosa
c. Cachexia
d. Slimming

124. Women who are vulnerable to domestic abuse?

a. Under 18
b. Over 18
c. Pregnant women
d. Elderly

125. A patient's HR 150, RR 40, what will you do?

a. Initiate hospital central emergency code

b. Bring emergency bell & continuously assess ABCDE
c. Call for help & reassess vital signs
d. Administer oxygen, position patient flat on bed, attach to monitoring

126. EBP- Evidence Based Practice:

a. Collaboration with EBP skills and knowledge

b. Only skills
c. Only knowledge

127. What is a biological hazard?

a. HIV
b. Cytotoxic medicines
c. Linens

128. The following are early signs of Alzheimer’s Disease:

a. Lapses in memory
b. Pacing movement
c. Language difficulty

10 Early Signs and Symptoms of Alzheimer's

● Memory loss that disrupts daily life.

● Challenges in planning or solving problems.
● Difficulty completing familiar tasks.
● Confusion with time or place.
● Trouble understanding visual images and spatial relationships.
 ● New problems with words in speaking or writing.
● Misplacing things and losing the ability to retrace steps.
● Decreased or poor judgment.
● Withdrawal from work or social activities.
● Changes in mood and personality

129. You are with a dementia patient and there is a fire outbreak, what will you do?

a. Leave the patient and run for your dear life

b. Follow other staff
c. Use your instinct at that time
d. Follow the policy and procedure

130. If you’re not competent to transport a sample for investigation, what would you
do?

a. Take it anyway
b. Ask the senior to help you as you do not know
c. Inform you do not know and give it to someone else

131. Personality disorder affects:

a. Their behavior interrupts self and others

b. Only others
c. Only self

132. The Francis Report was published based on a public inquiry into poor care at?

a. Mid Staffordshire NHS Foundation Trust

b. Newcastle Upon Tyne NHS Trust
c. University of Southampton NHS Trust

133. A patient complained about the treatment, what should the head nurse do?

a. Tell the nurse to be extra careful so such will not happen next time.
b. Investigate but do not implicate the nurse involved
c. Beg patient not to file an official complaint
d. Investigate and give a constructive and honest opinion.

134. A nurse will administer a drug through the buccal by:

a. Absorption from the skin using a patch

b. Under the tongue
c. Between the tongue and cheek
d. Through the nostrils

A buccal medicine is a medicine given between the gums and the inner lining of the
mouth cheek. This area is called the buccal pouch. Medicine is usually given in the
buccal area when it is needed to take effect quickly or when the child is not conscious.
For sublingual administration, place the tablet under your tongue and wait until it
dissolves.

135. How often should feedback be given to a new staff nurse?

a. Continuously
b. At the end of the shift
c. When on annual leave

136. Legal aspect of safeguarding was first mentioned in which?

a. Health and Social Care Act 2012

b. Care Act 2014
c. Social Value Act 2012
d. Francis Report

137. You receive the laboratory result of the patient, but she is still in the
bathroom. How will you deliver the result?

a. Update her through the phone

b. Wait for another chance to talk and discuss it privately.
c. Let the nursing assistant do it
d. Leave the results on the bedside table.

138. The patient was given different options of diagnostic tests and treatments.
The patient was given:

a. Informed consent
b. Informed choice
c. Informed care

Informed choice is when a person is given options to choose from several diagnostic
tests or treatments, knowing the details, benefits, risks and expected outcome of each.
Informed consent is when a person agrees to the test or treatment they have been
offered, knowing the details, benefits, risks and expected outcome.

139. Which one of the following is the advantage of multi-agency working offers
when protecting those at risk from abuse?

a. Practitioner professional development

b. Improved community protection
c. Shared communication
d. More professional support

140. A patient is being prepared for surgery and was placed on NPO. What is the
purpose of NPO?

a. Prevention of aspiration pneumonia

b. To facilitate induction of pre-op meds
c. For abdominal procedures
 d. To decrease production of fluids

141. Most common serious injury affecting nurses, health care users and relatives
is?

a. Needle prick injury

b. Split and fall
c. Cancer
d. Neurological disorder

142. A bed bound patient requested to see a care report card which is on the table
away from the bed. What is the nurse's response?

a. Shift the table on the bed

b. Ignore and continue what you’re doing.
c. Ask the patient why she’s requesting the report.
d. Move the table near the bed

143. A patient was diagnosed with Rheumatoid Arthritis, they asked the nurse the
cause. The nurse response is:

a. Medication
b. Autoimmune disorder
c. Bacteria
d. Exercise and diet

144. What is the primary treatment for anaphylaxis?

a. Intravenous adrenaline
b. Oral antihistamine
c. Intramuscular adrenaline
d. Oral steroids

Intramuscular (IM) injection of epinephrine at the earliest opportunity, followed by

additional epinephrine by IM or intravenous (IV) injection as needed. If symptoms are
severe, an IV epinephrine infusion should be prepared in case it is needed.
●Placement of the patient in the supine position with the lower extremities elevated
{helps prevent severe hypotension, subsequent inadequate cardiac filling, and pulseless
cardiac activity}, unless there is prominent upper airway swelling prompting the patient
to remain upright (and often leaning forward). If the patient is vomiting, placement of the
patient semirecumbent with lower extremities elevated may be preferable. Place
pregnant patients on their left side.
●Supplemental oxygen. Initially using a nonrebreather mask at 15 liters/minute flow rate
or commercial high flow oxygen masks (providing at least 70 percent and up to 100
percent oxygen) should be administered.
●Volume resuscitation with IV fluids.

145. Post CABG non-infectious sputum color?

a. Red
b. Green
 c. White
d. Brown

Dark Green/Yellow in the early stages of an infection; Pink/Red/Bloody is

infection/cancer; White is normal or allergies like asthma; Brown is chronic lung disease,
cystic fibrosis or bronchiectasis)

146. A 16-year-old needs to be physically examined by the doctor, but she is not
cooperating. What is your action as a nurse?

a. Stand still and do nothing

b. Encourage and show support for the child with non-verbal communication like
gestures and stand with the patient.
c. Encourage the relative to talk and stay with the patient.

147. How can you manage decreased secretions in a patient in the end-of-life?

a. Airway adjunct and suction

b. Analgesic and repositioning
c. Sedation and position
d. Hyoscine hydrobromide and positioning

Hyoscine hydrobromide is taken to prevent travel sickness (motion sickness). It can also
be used to reduce the amount of saliva in your mouth. This can help with symptoms if
you're having palliative care or end of life care. Hyoscine hydrobromide comes as
patches and tablets that you suck, chew or swallow.)

148. What kind of medication should 2 nurses administer and monitor in the ward?

a. Nifedipine
b. Paracetamol
c. Morphine
d. NSAIDS

149. A patient disclosed some sensitive information to a nurse and asked the nurse
to keep it secret. As a nurse, what will you do?

a. Keep the information confidential

b. Tell the patient that all information will be shared with the relevant staff
c. Inform the relatives
d. Keep the information as the secret to maintaining the dignity of the profession

B or D? 😬

150. Scale 2 on the NEWS 2 chart is used for which patient group?

a. Those who have been exposed to carbon monoxide.

b. Those receiving IV therapy
c. Those with urinary catheter
d. Carbon dioxide retaining patient
Be used to record and score the oxygen saturation for the NEWS

151. A 20-year-old male patient has a BMI of 20 kg/m2. He is?

a. Underweight
b. Normal
c. Overweight
d. Obese

BMI
Below 18.5 Underweight
18.5—24.9 Normal
25.0—29.9 Overweight
30.0 and Above Obese

152. Prion disease is related to which of the following conditions?

a. Myocardial infarction
b. Crohn's disease
c. Creutzfeldt-jakob disease

Prion diseases or transmissible spongiform encephalopathies (TSEs) are a family of rare

progressive neurodegenerative disorders that affect both humans and animals.)
Creutzfeldt-Jakob (KROITS-felt YAH-kobe) disease (CJD) is a degenerative brain disorder
that leads to dementia and, ultimately, death. Creutzfeldt-Jakob disease symptoms can
be similar to those of other dementia-like brain disorders, such as Alzheimer's disease.

153. Mental disorder is more common among which group?

a. Elderly
b. Women
c. Men
d. Young people

154. When you collect, interpret, save and apply information for health purposes is
it called?

a. Learning
b. Health education
c. Health literacy
d. Information processing

Health literacy is the degree to which individuals have the capacity to obtain, process,
and understand basic health information needed to make appropriate health decisions.
Low health literacy is more prevalent among: Older adults.
Health education is a social science that draws from the biological, environmental,
psychological, physical and medical sciences to promote health and prevent disease,
disability and premature death through education-driven voluntary behavior change
activities.
 155. Which procedure involves 2 nurses?

a. Admission of patient
b. Counseling the patient
c. Serving controlled drug

156. When a nurse is giving information about the patient medication and the patient
responded that, “The information is not relevant”. What is your action as a nurse?

a. Inform the head nurse

b. Ask why the patient said information is not relevant
c. Insist that he must listen to you
d. Leave the patient and come back later to continue

157. A patient refused the injection and asked the nurse, “What injection is this and
it might not be needed”. What should the nurse response?

a. Do not give the injection and record the reason

b. Explain briefly what the injection is for and its benefit
c. Inform GP

158. Which therapy is NOT used in pyrexia?

a. Fan therapy
b. IV and cold drink
c. Removal of clothing
d. Showering

159. DVT occurs in:

a. People who completed a surgery that lasted for 2 hours.

b. Person who is immobile and with prolong hospitalization
c. Person who has loves wearing stockings
d. People with varicose veins

160. How can a new staff attain knowledge in the clinical area?

a. Preceptorship
b. Internship
c. Study time
d. Induction

A nurse preceptor is an experienced and competent nurse formally assigned to guide the
professional journey of a student, graduate nurse or new staff member joining a
workplace. Preceptors aim to ensure novice nurses become confident and competent
enough to deliver quality care.

Nursing internships are transitional programs for new graduates. The nurse intern works
under the direction of a preceptor who serves as a role model as well as a support
person and guide in clinical practice.
The Induction training program for nurses is specifically imparted to welcome them
commencing initial employment or to new nursing roles they are going to take up in the
hospital. It introduces the values and objectives of the organization so that staff feels
like part of the team as quickly as possible.

161. A nurse working in the children's ward wants to do vital signs for children and
notice a distressed child. What is the nurse's action?

a. Ignore the child and continue the vital sign for others
b. Attend to the distressed child and take them together to do their vital sign
c. Ask the attendant/assistant to do vitals while you attend to a distressed child.
d. Inform the head nurse about the distressed child and continue your vitals.

162. What is a person’s normal core temperature?

a. 36-38
b. 36.5-38.5
c. 34-36
d. 36-37.5

163. In which of the following demonstrates the use of open-ended questions?

a. How may I help you?

b. Are you looking for a nurse?
c. Do you need help?
d. What are you looking for?

An open-ended question is a question that cannot be answered with a "yes" or "no"

response, or with a static response. Open-ended questions are phrased as a statement
which requires a longer response.

164. An Alzheimer patient who has fever due to UTI is experiencing shakiness. What
medicine should be given?

a. Co-careldopa (Sinemet)
b. Co-amoxiclav (Augmentin)
c. Co-codamol
d. Co-Q10

Co-careldopa is used to treat the main symptoms of Parkinson's disease. It can help with
shaking (tremors), slowness and stiffness. These are called "motor" symptoms because
they affect the way you move. Co-careldopa is a mixture of the medicines levodopa and
carbidopa.
Co-amoxiclav is a combination antibiotic used for bacterial infections. It contains
amoxicillin (an antibiotic from the penicillin group of medicines) mixed with clavulanic
acid. The clavulanic acid stops bacteria from breaking down amoxicillin, allowing the
antibiotic to work better.
It is used in adults and children to treat:
middle ear and sinus infections, throat or lung respiratory tract infections, urinary tract
infections, skin and soft tissue infections, dental infections, joint and bone infections.
Co-codamol is a mixture of 2 different painkillers – paracetamol and codeine. It's used to
treat aches and pains including headaches, muscular pain, migraines and toothache.
Coenzyme Q10 (CoQ10) is an antioxidant that your body produces naturally. Your cells
use CoQ10 for growth and maintenance.
Levels of CoQ10 in your body decrease as you age. CoQ10 levels have also been found
to be lower in people with certain conditions, such as heart disease, and in those who
take cholesterol-lowering drugs called statins.

165. A patient presents with confusion, slurred speech, rash, difficulty in

breathing that is very fast. What is the likely condition?

a. Asthma
b. Sepsis
c. Anaphylaxis
d. Measles

Symptoms of Sepsis: Fast heart rate. Fever or hypothermia (very low body temperature)
Shaking or chills. Warm or clammy/sweaty skin. Confusion or disorientation.
Hyperventilation (rapid breathing) or shortness of breath.
Symptoms of Asthma: Shortness of breath. Chest tightness or pain. Wheezing when
exhaling, which is a common sign of asthma in children. Trouble sleeping caused by
shortness of breath, coughing or wheezing. Coughing or wheezing attacks that are
worsened by a respiratory virus, such as a cold or the flu.
Symptoms of Anaphylaxis: Skin reactions, including hives and itching and flushed or
pale skin. Low blood pressure (hypotension) Constriction of the airways and a swollen
tongue or throat, which can cause wheezing and trouble breathing. A weak and rapid
pulse. Nausea, vomiting or diarrhea. Dizziness or fainting.

166. Hemophilia is common in which ethnic group?

a. Asian
b. African
c. Caucasian
d. Latin

The average age of persons with hemophilia in the United States is 23.5 years. Compared
to the distribution of race and ethnicity in the U.S. population, white race is more
common, Hispanic ethnicity is equally common, while black race and Asian ancestry are
less common among persons with hemophilia.
Hemophilia A mostly affects males but females can also be affected. Approximately 1 in
5,000 newborn males have hemophilia A. Approximately 60% of individuals with
hemophilia A have a severe form of the disorder.
Hemophilia is usually an inherited bleeding disorder in which the blood doesn't clot
properly. This can lead to spontaneous bleeding as well as bleeding following injuries or
surgery. Blood contains many proteins called clotting factors that can help to stop
bleeding.

167. A patient is on 4 hourly observations. A nurse notices that observations have

not been done for 12 hours. What action does the nurse take?

a. Check the observations and report the issue to the ward manager.
 b. The observations were normal, so no action is needed
c. Speak to those who were on duty when the observations were missed and tell her
not to do it.
d. Report the issue to the ward manager and complete an incident form.

168. What factors to consider ensuring safe staffing?

a. Ethnicity
b. Age group
c. Skill mix
d. Contracted hours

169. Who is at high risk of taking IV drugs?

a. People below 16
b. Illiterate people
c. Poor nutrition

170. When removing a closed system vacuum wound drain, what should the nurse
consider?

a. Says routine drain removal is the doctor's role.

b. Have the tissue viability nurse to remove it.
c. Remove the drain gradually by pulling on it.
d. Releases the vacuum and gently remove it

171. Annual training required for nurses:

a. BLS
b. Clinical governance training
c. Record keeping training
d. IV training

172. A pediatric patient with learning disabilities presents with smooth philtrum,
low body weight, hyperactivity and poor concentration. What is the cause of these
symptoms?

a. Pediatric alcohol syndrome

b. Fetal ethanol syndrome
c. Pediatric alcoholism
d. Fetal alcohol syndrome

Fetal alcohol syndrome is a condition in a child that results from alcohol exposure
during the mother's pregnancy. Fetal alcohol syndrome causes brain damage and
growth problems. The problems caused by fetal alcohol syndrome vary from child to
child, but defects caused by fetal alcohol syndrome are not reversible. Physical defects
may include: Distinctive facial features, including small eyes, an exceptionally thin upper
lip, a short, upturned nose, and a smooth skin surface between the nose and upper lip.
Deformities of joints, limbs and fingers. Slow physical growth before and after birth.
Vision difficulties or hearing problems. Small head circumference and brain size. Heart
defects and problems with kidneys and bones. Brain and central nervous system
problems.
Problems with the brain and central nervous system may include: Poor coordination or
balance. Intellectual disability, learning disorders and delayed development. Poor
memory. Trouble with attention and with processing information. Difficulty with
reasoning and problem-solving. Difficulty identifying consequences of choices. Poor
judgment skills. Jitteriness or hyperactivity. Rapidly changing moods. Social and
behavioral issues.
Problems in functioning, coping and interacting with others may include: Difficulty in
school. Trouble getting along with others. Poor social skills. Trouble adapting to change
or switching from one task to another. Problems with behavior and impulse control. Poor
concept of time. Problems staying on task. Difficulty planning or working toward a goal.

173. Which of the following is an acceptable way of moving a patient from a bed to
a trolley?

a. A bear hugs
b. An Australian lift
c. Completing a risk assessment
d. Canvas and poles

174. Mr. Bill is a known diabetic patient who has had an injury for one week and is
not healing. What is your role as a nurse?

a. Measure the wound and note any change in size

b. Refer to Mr. Bill to see a GP immediately
c. Dress wound and send him home
d. Apply tight dressing to prevent infection

175. An elderly frail patient is due to be discharged home the patient says that they
live alone but their notes say they live with their family they do not manage alone. What
action does a nurse take?

a. Nothing as patient probably be alright

b. Check the details on file discuss a home care package
c. Get a patient address and plan a visit to see them
d. Tell them it is better if they go into permanent care

176. What is the first line treatment for acute asthma?

a. NSAIDS, oxygen, adrenaline

b. Steroids, oxygen, adrenaline
c. Adrenaline, oxygen, paracetamol

First-line treatment for acute asthma is an inhaled short-acting beta2 agonist (such as
salbutamol) given as soon as possible.

177. A protractor is mentoring a new nurse in the ward and a consultant comes in
from rounds. What is the best action to be taken by the protractor?

a. Let the nurse do the rounds with the consultant as this is the best way to learn
 b. Do the rounds with the consultant and leave the new nurse in the duty room as she
knew
c. Volunteer to do the rounds with the consultant and new nurse
d. Tell the consultant to come back later

178. A patient with dementia who fell twice and lives with her husband wants to be
discharged back home. What measures should the patient take?

a. Allow to go back with husband

b. Invite friend to help them
c. Engage a social worker in her care

179. A patient is returning home from the hospital. They will spend several weeks in a
residential facility, followed by community support. In order to ensure a positive
process, what action does a nurse take?

a. Allow the patient to arrange any community service to allow them to be independent
b. Give discharge information to the care facility who will liaise with others
c. Copy all agencies into the discharge plan correspondence
d. Ask the patient to contact their general practitioner to follow up on services needed

180. Who takes care of the nails of Diabetic patients?

a. Chiropodist/Podiatrist
b. HCA
c. Tissue viability nurse
d. Diabetic nurse

Podiatrists are healthcare professionals who have been trained to diagnose and treat
abnormal conditions of the feet and lower limbs. They also prevent and correct
deformity, keep people mobile and active, relieve pain and treat infection.

181. Which of the following traits could be linked to an assertive approach to

communication?

a. Timorous, halting speech with contributions that are vague and unclear
b. Dominating discussion with a raised voice and being correctly threatening
c. Seeking workable compromise
d. Using in congruent verbal and nonverbal messages

Assertive communication is direct and respectful. Being assertive gives you the best
chance of successfully delivering your message. If you communicate in a way that's too
passive or too aggressive, your message may get lost because people are too busy
reacting to your delivery.

182. What are the signs of postpartum psychosis, EXCEPT?

a. Depression
b. Loss of inhibitions
c. Physical discomfort
d. Hallucinating
Postpartum psychosis is a serious mental health illness that can affect someone soon
after having a baby. It affects around 1 in 500 mothers after giving birth.
Symptoms can include:
● hallucinations - hearing, seeing, smelling or feeling things that are not there
● delusions – thoughts or beliefs that are unlikely to be true
● a manic mood – talking and thinking too much or too quickly, feeling "high" or
"on top of the world"
● a low mood – showing signs of depression, being withdrawn or tearful, lacking
energy, having a loss of appetite, anxiety, agitation or trouble sleeping
● sometimes a mixture of both a manic mood and a low mood - or rapidly changing
moods
● loss of inhibitions
● feeling suspicious or fearful
● restlessness
● feeling very confused
● behaving in a way that's out of character

183. If a critical incident occurs, a nurse will?

a. Report and reflect on the case to contribute to debriefing and ongoing learning.
b. Undertake a literature review
c. Focus on reflection-in-action
d. Report the incident to the Care Quality Commission

184. A person with BMI of 28 kg/m2 is:

a. Overweight
b. Underweight
c. Obese
d. Normal weight

BMI
Below 18.5 Underweight
18.5—24.9 Normal
25.0—29.9 Overweight
30.0 and Above Obese

185. A patient visited the A&E department. How will you inform the patient’s GP after
discharge?

a. Send a discharge summary

b. Send all the patient’s hospital documents to the GP

186. Before proceeding to explain the care plan to the patient. What should a
nurse ensure?

a. Does the patient have communication aids

b. The patient is happy to talk
c. Does the patient feel comfortable
187. A doctor called 8 patients with dementia to get information for his project.
What type of research study is this?

a. Focus group
b. Group discussion
c. Quantitative research

188. Patient came to the hospital and was diagnosed with otitis media. As per NICE
Score 2 and given analgesics. Patient complained that he didn't receive any antibiotics.
What is the next step?

a. Give discharge summary

b. Evidence based practice and discharge instruction
c. Explain evidence-based practice
d. Explain when need to seek medical attention

189. How can the community provide support to a person with mental illness?

a. Reduce work loads

b. Provide close community
c. Develop hobby or faith

190. A mentally stable patient is requesting to participate in the kitchen and this act
is approved as part of his care, what will you do as a nurse?

a. Don’t allow the patients

b. Fill risk assessment form
c. Refer to the occupational therapist for approval
d. Allow the patient and give safety guidelines

191. The patient using a PCA is on morphine. He experienced dizziness and RR is

7. What should the nurse do?

a. Stop the pump, assess ABCDE and prepare or administer Naloxone

b. Continue the pump and administer Naloxone
c. Stop the pump and administer Naloxone and paracetamol

192. A patient visited the clinic and said he’s an alcoholic. What will the nurse advise
to the patient to prevent ill-effects of alcohol?

a. Alcohol is the most common reasons of vehicular accidents

b. Refer the patient to an alcohol group
c. Educate the patient about the negative effects of alcohol in the body
d. Advice the patient to avoid alcohol to save money

193. The doctor ordered a patient to be weighed so as to calculate his drug but the
patient refused. What will be your next action?

a. Report to the doctor and wait for other instructions

b. Report to the nursing team that patient refused care
c. Assume and give the doctor a report
 194. A nurse reported to the head nurse about a colleague bullying her. What should
the head nurse do?

a. Advice then to settle amicably

b. Warn the colleague
c. Investigate and act according to the hospital bully policy

195. The doctor is busy with his assessments and asks the nurse to insert IV
cannula to a patient. What would be the nurse's best response?

a. Do it and ask senior nurse to supervise

b. Refuse to do it as you are not trained in cannulating patient
c. Ask a colleague to supervise
d. Do it since it’s the doctor’s order

196. The NHS funds to recruit more phlebotomists, what should be done?

a. Provide funds and recruit people

b. Provide funds and recruit an individual needed for the job considering personal value
c. Provide contracts and funds…
d. Provide cost savings analysis and expected patient outcome

197. Garbo had alcohol intoxication and her mother is worried about his health.
What should the nurse do?

a. Respect his decision and do nothing

b. Allow her mother to talk to him
c. Educate him on the effect of alcohol and possible rehabilitation

198. What does PDR stand for?

a. Professional Development Review

b. Personal Development Review
c. Professional and Developmental Review
d. Performance and Development Review

A performance development review, also known as a personal development review, or

PDR, is a formal process scheduled to take place as infrequently as once a year or as
frequently as once a month. PDRs provide a helpful and documented snapshot in time
about how well an employee is doing.

199. What is the most common STI in the UK?

a. Syphilis
b. Gonorrhea
c. HIV
d. Chlamydia

200. Roughly, what percentage of room air is oxygen?

 a. 15%
b. 28%
c. 20%/21%
d. 10%

201. What is the purpose of using PPE?

a. To prevent the nurse and the patient from infection

202. A patient requires financial education. What does the nurse should be
knowledgeable of?

a. Genomics
b. Knowledge in Health Economics
c. Knowledge in Anatomy
d. Knowledge in Children’s Health

203. The patient is hesitant to share about their sexual health. What should the
nurse do?

a. Carefully explore the patient’s preferences

b. Respect the patient’s preferences

204. The patient is recovering from a stroke and the nurse encouraged him to join the
group, but the patient refused. What should you do as a nurse?

a. Accept the patient’s decision because it’s their right

b. Encourage the patient to sit and ask to join next time
c. Do nothing

205. The patient is for surgery but the nurse suspects that consent is not valid
because the patient does not have the mental capacity. What act..?

a. Care Act
b. Equality Act
c. Mental Health Act
d. Health and Safety at Work Act

206. A patient with stress, anxiety and sleeplessness. Who will he visit?

a. A 111 service
b. A walk-in center
c. A general practitioner
d. Emergency department

207. Device used for Blood Pressure?

a. Thermometer
b. Sphygmomanometer
208. When do you start to monitor the patient who is receiving BT?

a. 60 mins
b. 30 min
c. 15 min
d. 45 mins

209. What is the aim of patient collaboration?

a. Patient development event

b. Staff development event
c. Patient development experience

210. COPD is caused by what lifestyle related condition?

a. Smoking
b. Eating habits

211. 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 slowly 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

a. Go to a different room without noise or less distractions

b. Lip reading…
c. Speak louder so that the patient can hear you
d. Ask the patient’s relative to assist you

212. What does a nurse observe when assessing the respiration of a patient with
breathing difficulties?

a. Rate, pattern, and evidence of cyanosis

b. Presence of symmetrical movement of both sides of chest and equal breath sounds
c. Ability to speak in full sentences, ease of breathing, rate pattern, evidence of
cyanosis
d. Ease of breathing, rate, pattern, and evidence of cyanosis

213. A patient is in pain. What should the nurse consider in assessment?

a. Restlessness, DOB and complains of chest pain

b. Type of pain and where it radiates

214. Which is found in higher concentration in the extracellular fluid?

a. Calcium
b. Chloride
 c. Sodium
d. Potassium

Extracellular fluid (ECF) volume is determined by the balance between sodium intake
and renal excretion of sodium.

215. Signs and symptoms of early fluid volume deficit, except:

a. Decreased urine output

b. Decreased PR
c. Concentrated urine
d. Decreased skin turgor

Decreased blood pressure with an elevated heart rate and a weak or thready pulse are
hallmark signs of fluid volume deficit. Systolic blood pressure less than 100 mm Hg in
adults, unless other parameters are provided, should be reported to the health care
provider.

216. Which of these are airborne infections?

a. Norovirus, chickenpox, measles

b. Norovirus, influenza
c. Chickenpox, norovirus, influenza

217. Which of the following is an example of an open-minded question?

a. Do you need anything?

b. Is there something I can help you with?
c. Are you available today, as a friend?
d. How may I help you today?

218. What does pyrexia mean?

a. Fluctuating body temperature

b. Increase in body temperature
c. Normal body temperature
d. Decreased body temperature

219. IV morphine was initiated, what should you monitor?

a. BP
b. Respiration
c. Skin perfusion
d. Consciousness

Monitor patients closely for respiratory depression, especially within the first 24-72
hours of initiating therapy with and following dosage increases of Morphine Sulfate
Injection.

220. How many CPD hours an RN must they have over 3 years?
 a. 25 hours
b. 35 hours
c. 45 hours
d. 15 hours

You need to; Complete minimum of 35 hours' compulsory CPD each year of which at
least 21 hours must be structured CPD. 35 hours is the minimum required. In practice the
figure may exceed this as the actual requirement will be determined by an individual's
development needs in any 12-month period.

221. You observe the HCA that he toilets the patient in a commode in the lounge.
When confronted the HCA said that the patient is used to it since the mother does at
home. What should the nurse do?

a. Report to senior nurse

b. Move patient to a private area and discuss further
c. Report to safeguarding personnel in charge
d. Report to police

222. Working together to achieve the best interest for people is a collaborative effort
among:

a. Doctors
b. Agencies
c. Professionals

223. What is the published book of NMC?

a. The book of nursing

b. The Code
c. The standard of nursing practice
d. Guidelines to become a UK nurse/x

224. How to get BMI?

a. Height divided by waist circumference

b. Weight x height
c. Weight x height squared

The formula is BMI = kg/m2 where kg is a person's weight in kilograms and m2 is their
height in metres squared.

225. What are the factors of BMI?

a. Height and waist circumference

b. Weight and waist
c. Height and weight

226. You notice that while waiting for surgery the patient is anxious. What is the
nurse’ best response?
 a. Provide leaflet for the patient to read and answer questions to alleviate anxiety
b. Refer to senior nurse
c. Tell the doctor the patient is anxious
d. Explain the procedure and ensure the patient understands the surgery well to ease
anxiety

227. What should the management provide for the nurse whose child died?

a. Vacation leave
b. Sick leave
c. Debriefing

228. The patient’s surgery at 8 am is postponed until afternoon. What should the
nurse’s best response be?

a. Write in the patient’s note

b. Inform family
c. Ensure the patient has IV fluids

229. You notice that the patient has difficulty understanding the explanation of the
doctor about his surgery. What should the nurse do?

a. Provide something to read about the surgery

b. Validate the patient’s understanding about the surgery with the doctor’s present
c. Tell the doctor to repeat information

230. BMI of the patient is 32 and was not given advice on a diet. What is the
nurses best intervention?

a. Leave as it is the patient does not need intervention

b. Suggest diet regimen without taking consideration of the BMI
c. Bring the topic on the team meeting and suggest diet with sensitive topic on the BMI
d. Continue diet as BMI is normal

231. HCA and the nurse need to transfer a patient to another bed. However, the
nurse looked for a slide board in another room yet didn’t find one. The nurse asks the
HCA that they look in another station when the nurse comes back and the patient has
already been transferred. What should the nurse do?

a. Check the patient for abrasion

b. Report to nurse in charge
c. Request for more slide board

232. Which verbalization hints depression?

a. I am worthless
b. I am obese
c. My father died that’s why I am into reading books

233. An art loving patient does not communicate verbally with the team which
communication means is appropriate for him?
 a. Emails
b. Written communication
c. Visual art therapy
d. Writing a letter

234. Marrying age in the UK? (Old)

a. 18
b. 16
c. 21

235. Marrying age in the UK? (New)

a. 18
b. 16
c. 21

236. The mother of a patient gives the nurse money. What should the nurse do?

a. Say thank you to the mother

b. Get the money and put in the team fund
c. Return the money to the mother
d. Buy a personal book and show the mother

237. Sign of sepsis:

a. Blanch skin patches

b. Low urine output
c. High urine output
d. Hypotension

Symptoms of Sepsis: Fast heart rate. Fever or hypothermia (very low body temperature)
Shaking or chills. Warm or clammy/sweaty skin. Confusion or disorientation.
Hyperventilation (rapid breathing) or shortness of breath. Other common symptoms
include:
Peeing less than usual
Fast heartbeat
Nausea and vomiting
Diarrhea
Fatigue or weakness
Blotchy or discolored skin
Severe pain

238. First line drug for patient experiencing pyrexia with body malaise:

a. Paracetamol
b. NSAIDs

239. The patient asked to see the nurse as a friend after the last clinical…. What
should the nurse do?
 a. Give your number to keep in touch
b. Suggest to GP to be under your care again
c. Tell the professional relationship ends there
d. Arrange schedule 2 weeks after

240. A patient has suicidal tendencies and was referred to a facility assessment that
he is no longer suicidal, was calm and requested to go home. What should the nurse
do?

a. Let the patient go home without ff up

b. Let patient go home and follow up in the community
c. Referred under section 5 of mental capacity

241. The MP (Member of Parliament) visits your hospital, what will the nurse ask
the MP to address the concern on nurse staffing level?

a. Add incentives to encourage nurses to work extra shift

b. Advertise to the nursing students to work in the trust once qualified
c. Ask to meet the HR team and plan on recruitment campaign

242. You observe a nurse doing sterile dressing and drop the old dressing in the
sterile pack and continue the procedure. What will you do?

a. Inform your senior and tell the nurse to stop the procedure
b. Tell the nurse to stop and get a dressing pack and start the procedure all over
c. Leave her since it didn’t take much time
d. Tell her to change the dressing pack and then continue

243. A nurse dropped tweezers on a patient 's bed during dressing in front of a
student, what will the nurse do?

a. Tell the student about the error and tell to get another set of tweezers and continue
b. Ignore the situation because it will not give a big affection to
c. You should tell the student to pick it up and put it at the bottom of the trolley
d. Tell the student to stop and get a new dressing pack

244. How many ml/kg/hr urine output an adult makes?

a. 0.1
b. 0.3
c. 0.5
d. 0.7

245. First line management for patient with Pulmonary Edema caused by Chronic
Heart Failure:

a. Antibiotics
b. Diuretics
c. Chest drainage
 d. Analgesic

246. The NHS Long Term Care Plan (2019) focuses on the key area:

a. Making sure everyone has best start in life

b. Delivering world class care for major health problem
c. Supporting people to age well

247. What are the nursing priorities when helping in an emergency in a practice
setting?

a. Only act in an emergency within limit of knowledge and competence

b. Ensure that all patients are informed on what is happening
c. Responds to all instructions from the crisis lead
d. Instructs all colleague to help with the emergency

248. When a patient is discharged from an acute setting. How is the GP informed
about their inpatient care?

a. Copy of all inpatient notes are sent

b. The GP will hone their hospital to retrieve the information when required
c. The patient is required to make an appointment and brief the doctor
d. Discharge summary is sent

249. An unstable diabetic type 1 patient following a big toe amputation is

discharged. What is the main safety priority?

a. Stabilize patient mobility

b. Diabetic referral
c. Stabilize blood glucose level
d. Carer education

250. A unit supports nursing students, how does a RN ensure that the students are
competent to carry out tasks that are delegated to them?

a. Ask the student to keep written records of their practice

b. Ensure practice assessor collects evidence from supervisor, students, and service
users to assess proficiency
c. Ensure that all students read the policy and procedure manuals
d. Ensure that each student has an assessor and practice supervisor

251. Which 2 medications are given to patients in end-of-life care to ease

symptoms?

a. Morphine & Midazolam

b. Ketamine & Chlorphenamine
c. Narcan & Prednisone
d. Propofol & Adrenaline

End-of-life care and anticipatory prescribing:

Action Medication Indication
Analgesic Morphine sulfate Pain or breathlessness
Anxiolytic sedative Midazolam Anxiety, distress, myoclonus
Anti-secretory Hyoscine butylbromide Respiratory secretions
Antiemetic Levomepromazine Nausea, vomiting

252. How many days after death is patient in Muslim faith buried?

a. 4 days post death

b. 1 day post death
c. 1 week post death
d. 10 days post death

253. What is the color of the syringe used to give medications via NGT?

a. Red
b. Blue
c. Purple
d. Clear

Enteral syringes are currently purple in colour and clearly labelled “for oral/enteral use”
to distinguish them from IV syringes.

254. Which checklist was released in 2009 to…in theatre?

a. WHO Safer Surgical Checklist

b. WHO Surgical Safer Checklist
c. WHO Safety Surgical Checklist
d. WHO Surgical Safety Checklist

255. Trafficking is what type of abuse?

a. Physical abuse
b. Financial abuse
c. Emotional
d. Modern day slavery

256. Patient feels pain and is given paracetamol. The nurse knows paracetamol can
be given with what medication?

a. Morphine
b. Co-codamol
c. Pethidine
d. Tramadol

257. You are supervising a student in a medication round when the student forgot to
ask the patient’s name. What should the nurse do?

a. Asks the student to stop the medication and silently tell the correct procedure
b. Take over and point out the students mistake after the rounds
c. Report the student…
 258. The importance of correct staffing was reinforced by which report?

a. The Francis Report

b. The Conan Report
c. The Drake Report
d. The Baker Report

259. A client has experienced a tonic/clonic seizure. They are now breathing
normally and have normal circulation, but they have not yet gained consciousness.
What nursing action will maintain their safety?

a. Give the client a water to drink

b. Make a note of the duration of seizure
c. Try to wake the client
d. Place the client in recovery position

260. What is the normal hemoglobin value of a female client?

a. 10.5-12.5
b. 12.5-14.5
c. 15.0-20.0
d. 20.0-25.0

For men the normal haemoglobin reference range is between 130–180 g/L and for
females the normal reference range is 120–160 g/L.

261. Which cannot cause sepsis?

a. Traumatic brain injury

b. Bowel proliferation
c. Diarrhea …
d. UTI

262. Peripherally Inserted Central Catheter (PICC) tip is usually located in which
part?

a. Superior vena cava

b. Aortic artery
c. Right atrial valve

The current standard for PICC tip position is the lower one-third of the superior vena
cava (SVC) at the caval–atrial junction (CAJ)

263. What is the purpose of augmentative alternative communication?

a. To provide the best opportunities for developing language and communication

b. To teach numeracy skills
c. To encourage activity if daily living
d. To support literacy skills
Augmentative and alternative communication (AAC) describes multiple ways to
communicate that can supplement or compensate (either temporarily or permanently) for
the impairment and disability patterns of individuals with severe expressive
communication disorders.

264. There is an outbreak of MRSA, where should samples be taken from?

a. Skin, groin, and armpit

b. Skin, eyes, and ears
c. Skin, armpit, groin, and nose

A nurse will run a cotton bud (swab) over your skin so it can be checked for MRSA.
Swabs may be taken from several places, such as your nose, throat, armpits, groin or
any damaged skin. This is painless and only takes a few seconds. The results will be
available within a few days

MRSA is a type of bacteria that's resistant to several widely used antibiotics. This means
infections with MRSA can be harder to treat than other bacterial infections.

The full name of MRSA is methicillin-resistant Staphylococcus aureus. You might have
heard it called a "superbug".

265. When treating an adult patient with mental illness. What should you have in
mind?

a. An adult patient has the same risk of physical illness as the one without mental
illness
b. Risk is higher in patients with mental health disorders than adults without mental
illness
c. Risk is lower in patients with mental health disorders than adults without mental
illness

266. Reminiscence therapy is used for which one:

a. PTSD
b. Children
c. Dementia

Reminiscence therapy is a treatment that uses all the senses — sight, touch, taste, smell
and sound — to help individuals with dementia remember events, people and places
from their past lives. As part of the therapy, care partners may use objects in various
activities to help individuals with recall of memories.

267. Which disease has been eradicated by vaccination?

a. Smallpox
b. Ebola
c. Flu

268. Dilated pupils can be seen in patients with?

 a. Increased ICP
b. Seizure
c. Decreased ICP

269. A patient with COPD retaining CO2, what is the target oxygen concentration?

a. 92-96
b. 98-100
c. 82-88
d. 88-92

For most COPD patients, a target saturation range of 88%–92% will avoid the risks of
hypoxia and hypercapnia. Some patients with previous episodes of respiratory acidosis
may require an "oxygen alert card" with a lower (personalized) target saturation range.

270. What is the most appropriate route for giving fluids at the end of life?

a. Subcutaneous
b. Oral
c. IV

The procedure is relatively simple and involves inserting a butterfly needle into the
subcutaneous layer of skin, where an extensive network of lymphatic and blood vessels
allows the fluids to be readily absorbed (Mei and Auerhahn, 2009). This is the route most
commonly used in palliative and end-of-life care settings.

271. What is the first line of action in urinary retention?

a. Antibiotics
b. Diuretic
c. Catheterization
d. Fluid replacement

272. In a major accident, what age limit is considered as a pediatric case?

a. 10
b. 12
c. 14
d. 15

Paediatricians are doctors who manage medical conditions affecting infants, children
and young people. Paediatrics can be divided into 4 main areas: general paediatrics - a
hospital role covering children from birth to the age of 16.

273. A patient follows you on social media. What do you do?

a. Accept request after patient discharge

b. Accept right away
c. Politely explain don’t accept as it’s against the law
d. Politely explain don’t accept as it’s against the professional ethics
274. What is the ratio of a patient to a nurse in an ICU with a mechanical
ventilator?

a. 1:1
b. 1:2
c. 1:4
d. 1:6

275. Among the following, which is not likely to give the day after the pill?

a. Pharmacy
b. Emergency Department
c. Sex clinic
d. General Practitioner

276. Who should NOT be directly involved in the care of patient who is likely
suicidal?

a. Parents
b. Child’s friend
c. Social care
d. Child mental council

277. When communicating with a partially deaf patient, which of these is

appropriate?

a. Speak loudly
b. Speak normally
c. Lower your voice

278. An MP from a parliament wants to discuss with a nurse about nursing shifts in a
hospital, what should you do?

a. Tell him to discuss it in the parliament

b. Tell him to discuss recruitment with staff
c. Discuss staffing with HR
d. Fund a nursing student for a post

279. Who CANNOT teach a smoke cessation program?

a. Pharmacist
b. RN
c. School nurse
d. Physiotherapist

280. How many compressions to a ventilation?

a. 30:2
b. 15:2
c. 30:1
 281. What does the key performance indicator measure?

a. Achievement
b. Success
c. Inconsistency
d. Failure

282. In the last days and hours of a patient, any important discussions about the
relative and family, complete the sentence.

a. Should be discussed separately

b. Discussed using simple sentences
c. Using medical terms
d. With an interpreter

283. A patient has a heel sore and dresses it regularly, what would aid wound
healing?

a. Good diabetes control and adequate hydration

b. Good diabetes control and mobility
c. Complete bed rest and increase fluid intake
d. Complete bed rest and adequate hydration

284. A male patient has mild incontinence and pain passing urine, a urine test was
ordered. What else should be done?

a. Sexual screening/Referral
b. Bladder scan
c. Blood tests

285. How many tetanus vaccination doses does a person need to develop
immunity?

a. 5
b. 2
c. 3
d. 4

A full course of tetanus vaccination consists of 5 doses of the vaccine. This should be
enough to give you long-term protection from tetanus. But if you're not sure how many
doses you have received, you may need a booster dose after an injury that breaks your
skin.

286. Which of these isn’t part of adequate clinical practice or so?

a. Leadership
b. Governance
c. Education
d. Research

287. What type of oxygen does a patient with cardiac arrest need?
 a. 5-10L of normal oxygen
b. 15L non-rebreather
c. 15L Bag Valve Mask
d. No oxygen required

288. Who in the department should monitor shifts?

a. Medic
b. Chief nurse
c. Senior nurse

289. A newly admitted client told you that he wishes to stop smoking & sought
advice for the same. What will you do?

a. Talk patient about possible measures for smoking cessation

b. Refer him to GP
c. Introduce him to your colleague who stopped smoking
d. Instruct him to read something regarding smoking cessation

290. You are to take consent from a new patient in the A&E unit for physical
examination, but you are in doubt about the ability of the patient to give consent.
Which of the following is correct?

a. Only patients with mental health needs are regarded as incompetent to give consent
b. All patients are assumed to have the ability to give consent until they are established
to be having mental health challenges
c. All patients should be assessed for competency by a senior practitioner during the
admission assessment

291. An adult patient in our care has a temperature reading of 37.5 C. What is the
interpretation of the finding?

a. The patient has a mild fever and might indicate infection

b. The patient has a too low body temperature
c. The patient’s temperature is normal

292. A patient with neurological conditions began to show signs of mental

disability, who should attend to the patient?

a. Physician
b. Neurology specialist team
c. Mental health specialist

293. A child tells you that she is being abused by her grandfather but tells you to
keep it a secret. What is the best response?

a. Confront the child’s mother about the grandfather’s behavior

b. Tell the child that you will keep the secret but report to the charge nurse afterward
c. Keep the secret as the child is entitled to confidentiality
 d. Explain to the child that you can’t keep a secret as it is essential to prevent further
abuse

294. What is the correct blood transfusion procedure?

a. The patient should be placed in sitting position 30 mins prior to transfusion

b. The patient should be given a drink before the procedure
c. Baseline assessment should be taken and recorded prior to transfusion

295. Normal amount of urine passed by an adult per hour:

a. 1.2 mL
b. 1.4 mL
c. 1.5 mL
d. 1.7 mL

296. How many breaths are given to a patient who has been in the incident of
drowning?

a. 5
b. 3
c. 2
d. 4

Give five rescue breaths: tilt their head back, sealing your mouth over their mouth. Pinch
their nose and blow into their mouth. Repeat this five times. Give 30 chest
compressions.

297. De-escalation can be used for which of the following?

a. Depression
b. Sadness
c. Anger
d. Illness

Workplace de-escalation training can help employees (especially in violence/crisis

related occupations) to understand causes and manifestations of anger, prioritize their
own safety, dynamically assess risks, remain calm, communicate effectively with care,
and make informed decisions on how to deal with aggressive and challenging behavior

298. Which team should be contacted while making a discharge plan for a patient that
requires a complex discharge plan?

a. Social worker team

b. Physiotherapy team
c. District nurses’ team

299. You committed a medication error in your shift, what action will you do?

a. Report the incidence to the charge nurse, observe the patient, summon the patient’s
physician, and be prepared to apologize to the patient
 b. Tell your colleague and not any other person
c. You don’t need to tell anybody, only observe for any adverse reaction in the patient

300. For a patient with suicidal thoughts, what important questions would you ask?

a. Occupation
b. Marital status
c. Pets
d. Children

301. How do you give fluid to an end-of-life patient at home?

a. Orally
b. Nasogastric
c. Parenterally
d. Subcutaneously

The procedure is relatively simple and involves inserting a butterfly needle into the
subcutaneous layer of skin, where an extensive network of lymphatic and blood vessels
allows the fluids to be readily absorbed (Mei and Auerhahn, 2009). This is the route most
commonly used in palliative and end-of-life care settings.

302. A patient has anaphylaxis, what triage call room would he be in?

a. 1
b. 2
c. 3
d. 4

303. A patient with delirium at the end stage of life. What to do?

a. Give haloperidol and other sedative

b. Allow relatives around
c. Limit arousal and stimulation

304. If a patient has some bias and is not corrected and leads to what?

a. Hospital risk
b. Health inequality
c. Health economics

305. Score of NEWS for a confused patient?

a. 8
b. 4
c. 2
d. 3
The guidance for NEWS2 states: We recommend that new confusion scores 3 on the
NEWS chart, ie a red score for a single score of 3, indicating that the patient requires
urgent assessment.

306. A BMI of 38 will affect which patient?

a. DM 1
b. DM 2
c. Hyperthyroidism
d. Hypothyroidism

307. Recognizing and reporting any situations, behaviors or errors resulting in

poor patient care outcomes?

a. Principle of care
b. Principle of profession
c. Principle of candour
d. Principle of courage

The professional duty of candour:

Every healthcare professional must be open and honest with patients when something
that goes wrong with their treatment or care causes, or has the potential to cause, harm
or distress. This means that healthcare professionals must:

● tell the patient (or, where appropriate, the patient’s advocate, carer or family)
when something has gone wrong
● apologise to the patient (or, where appropriate, the patient’s advocate, carer or
family)
● offer an appropriate remedy or support to put matters right (if possible)
● explain fully to the patient (or, where appropriate, the patient’s advocate, carer or
family) the short and long term effects of what has happened.

308. Which is NOT the principle of mental capacity?

a. Right to have a care plan

b. Assume the patient have the capacity
c. Give support to take decision
d. Find out best interest

Five key principles

It is useful to consider the principles chronologically: principles 1 to 3 will support the
process before or at the point of determining whether someone lacks capacity. Once
you’ve decided that capacity is lacking, use principles 4 and 5 to support the decision-
making process.
Principle 1: A presumption of capacity
Every adult has the right to make his or her own decisions and must be assumed to have
capacity to do so unless it is proved otherwise. This means that you cannot assume that
someone cannot make a decision for themselves just because they have a particular
medical condition or disability.

Principle 2: Individuals being supported to make their own decisions

A person must be given all practicable help before anyone treats them as not being able
to make their own decisions. This means you should make every effort to encourage and
support people to make the decision for themselves. If lack of capacity is established, it
is still important that you involve the person as far as possible in making decisions.

Principle 3: Unwise decisions

People have the right to make decisions that others might regard as unwise or eccentric.
You cannot treat someone as lacking capacity for this reason. Everyone has their own
values, beliefs and preferences which may not be the same as those of other people.

Principle 4: Best interests

Anything done for or on behalf of a person who lacks mental capacity must be done in
their best interests.

Principle 5: Less restrictive option

Someone making a decision or acting on behalf of a person who lacks capacity must
consider whether it is possible to decide or act in a way that would interfere less with the
person’s rights and freedoms of action, or whether there is a need to decide or act at all.
Any intervention should be weighed up in the particular circumstances of the case.

309. A patient with a learning disability is angry with you when providing care.
What will be your action?

a. Disclose your feelings & continue care

b. Refuse care to the patient
c. Discuss your feelings with your nurse-in-charge know about this particular behavior
and reaction and act accordingly
d. Request to send another person instead of you

310. Pediatric Warning Signs Score of 8 receives. What clinical response?

a. No escalation required
b. 2 hourly observations
c. Immediate escalation to a senior clinician
d. 4 hourly observation

311. TDS meaning:

a. Three times day

312. Oropharyngeal airway is recommended, what is your first action?

a. Slide airway over the tongue and into position

b. Use the suction
c. Sit the patient up
d. Head tilt and check the mouth

313. Phosphate enemas are used to treat what?

a. Fecal impaction
b. Pain in the rectum
 c. Diarrhea
d. Mild constipation

314. Non-diabetic patient normal glucose level:

a. 6.5-9.5 mmol
b. 7.9-9.8 mmol
c. 4.0-7.8 mmol
d. 5.0-9 mmol

315. Maximizing resource in practice is related to health to:

a. Economics
b. Safety
c. Technology
d. Risk

316. Most common emotion that a person given a terminal diagnosis will feel:

a. Anger
b. Denial
c. Guilt
d. Joy

317. What should NOT be done when a child is cannulated?

a. Watching videos
b. Listening to music
c. Read books
d. Tickling the child

318. Type 1 DM early signs and symptoms are?

a. Weight gain
b. Weight loss, blurred vision
c. Ketones in urine, polydipsia and polyuria

Symptoms of type 1 diabetes, including:

● feeling very thirsty

● peeing more than usual, particularly at night
● feeling very tired
● losing weight without trying
● thrush that keeps coming back
● blurred vision
● cuts and grazes that are not healing
● fruity-smelling breath

319. When a patient is at high risk for suicide within what time the mental health
professional should attend him?
 a. Immediately
b. Within 24 hours
c. Within 48 hours

320. A nurse has been diagnosed with chickenpox and has been advised not to
attend the planned study day. Why is this advice given?

a. To prevent infection to others

b. To prevent irritation of the spot
c. To prevent condition from worsening
d. To prevent cross infection of the public

321. A young person with complex needs is being transferred to the adolescent unit
which is a considerable distance from his relative. The patient is unhappy about this
transfer. What should the nurse do?

a. Tell the family to respect the skills and expertise of the doctors who have planned the
transfer to meet patient’s needs
b. The person requires complex care which can only be provided in a distant specialist
need
c. Nurse should raise the complaints and issues in the next team meeting
d. Report and document preferences regarding the transfer promptly and provide an
explanation

322. Who is likely to use illicit drugs?

a. Out of school at 16
b. Homeless people
c. Jobless people
d. Sick people

323. The 5 moments of hand washing are all, EXCEPT?

a. Washing hands after touching patient

b. Washing hands before touching patient
c. Washing hands after procedure involving body fluids
d. Washing hands before procedure involving body fluids

The 5 Moments:
Moment 1 - before touching a patient.
Moment 2 - before a procedure.
Moment 3 - after a procedure or body fluid exposure risk.
Moment 4 - after touching a patient.
Moment 5 - after touching a patient's surroundings.

324. Who is in charge of overall community health?

a. Public health nurse

b. RN
c. Practice Nurse
d. Community Matron
325. How will the nurse assess the quality of care given to the patient through which
of the following?

a. Reflective process
b. Clinical benchmarking
c. Peer and patient response
d. All of the above

326. The patient experienced head trauma. He was on anti-thrombolytic medication.

Which diagnostic exam is best to do?

a. Xray
b. MRI
c. CT Scan

327. A patient has a NEWS score of 5, what action is appropriate?

a. Transfer to ICU
b. Physician review
c. Increase observation

328. Which of the following will prevent effective listening?

a. The experience of the professional/professional level

b. The patient speaks different language/language difference
c. Noise level of room

329. You noticed that a nurse forgot an entry to a patient’s chart, and you are
about to handover, what will be your best action?

a. Leave a space for the nurse to write her entry on her shift
b. Ask one staff in the nurse’s same group to do the entry
c. Fill out the entry and do make sure to finish it promptly/timely manner
d. Continue the handover omitting the missed entry

330. A person calls and only wants to be cared for by a female nurse, what should
be your most appropriate response?

a. Only I’m available and free

b. Call back tomorrow
c. Call back later
d. Encourage the client to tell you why he only wants a female and help him further

331. The nurse is preparing to change the TPN solution bag and 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. Take a deep breath, hold it, and bear down

b. Breath normally
 c. Exhale slowly and evenly
d. Turn the head to the right

332. What to do if you noticed your patient developed allergic reactions to the drug?

a. Write in yellow card and inform prescriber

b. Inform prescriber
c. Document and inform the supervisor
d. Continue assessment
e. Administer antihistamine

333. The patient feels down, anxious and reported to have sleeplessness. Whom
will the patient seek first?

a. A walk-in center
b. General Practitioner
c. 111 service
d. Emergency unit

334. Which nursing delivery model is based on a production and efficiency model and
stresses a task-oriented approach?

a. Case management
b. Primary nursing
c. Differentiated practice
d. Function method

335. You’re to go change a patient's dressing at home, what will you do?

a. Request the patient clean the area, remove pets, close windows
b. Request the patient clean the area before the nurse arrives and remove their own
dressings
c. Clean surfaces with alcohol-based wipes, open the window decontaminate the
patient’s hands
d. Remove pet, close windows, clean surfaces with alcohol-based wipes

336. How do you evaluate adequate staffing for a shift?

a. Gender
b. Age
c. Skill mix
d. Contract hours

337. What is a mineral corticoid secreted by the adrenal cortex in response to

increased osmolarity and/or decreased blood pressure?

a. Testosterone
b. Aldosterone
c. Androgen
d. Methyltestosterone
 338. Score of NEWS for a confused patient:

a. 8
b. 4
c. 2
d. 3

339. A patient is returning home from the hospital. They will spend several weeks in a
residential facility, followed by community support. To ensure a positive process, what
action does a nurse take?

a. Allow the patient to arrange any community service to allow them to be independent
b. Give discharge information to the care facility who will liaise with others
c. Copy all agencies into the discharge plan correspondence
d. Ask the patient to contact their general practitioner to follow up on services needed

340. She reads about the Path Goal Theory. Which of the following behaviors is
manifested by the leader who uses this theory?

a. Recognizes staff for going beyond expectations by giving them citations

b. Challenges the staff to take individual accountability for their practice
c. Admonishes staff for being laggard
d. Reminds staff about the sanctions for nonperformance

341. ST elevation is found in which condition?

a. 1st degree heart block

b. MI
endocarditis
c. Pericarditis

342. How many times more likely is an obese child more likely to get diabetes?

a. 2x
b. 3x
c. 4x
d. 5x

343. How many practice hours is required for a RN nurse for revalidation?

a. 350
b. 400
c. 450
d. 500

Revalidation is the process that all nurses and midwives in the UK and nursing
associates in England need to follow to maintain their registration with the NMC.

To help you continually develop and reflect on your practice, we ask you to revalidate
every three years.
This process encourages you to reflect on the role of the Code in your practice and
demonstrate that you are 'living' the standards set out within it.

Revalidation helps to encourage a culture of sharing, reflection and improvement. It will

provide benefits for you as a nurse, midwife or nursing associate as well as the people
you care for.

Requirements:
● 450 practice hours, or 900 hours if renewing two registrations (for example, as
both a nurse and midwife)
● 35 hours of CPD including 20 hours of participatory learning
● Five pieces of practice-related feedback
● Five written reflective accounts
● Reflective discussion
● Health and character declaration
● Professional indemnity arrangement
● Confirmation

344. How does a RN ensure that the students are competent to carry out tasks
that are delegated to them?

a. Ask the student to keep writing records of their practice

b. Ensure that all students with the policies and procedure manuals
c. Ensure practice assessor collect evidence from supervisors’ students and service
users to access proficiency
d. Ensure that each student has an assessor and practice supervisor

345. One of your health care assistants came to you saying that she could not
continue with her work rounds due to a bad back. What will you do first?

a. Send her home and cover her work for yourself

b. Document the incident and report to the manager
c. Assess your colleagues back and administer painkillers
d. Ring for agency staff to cover the shift

346. Where is chemotherapy and hormone medication disposed of?

a. Purple lidded sharps container or bags

b. Yellow sharps container or bag
c. Recycling waste
d. Black bag waste

347. A nurse who is working in an outpatient observes that a lot of similar

information is given to the patient verbally on a daily basis. How can this be
minimized?

a. Raise the findings at a team meeting

b. Encourage the nursing staff to make notes on their conversations for the patients to
take home so patient remember the information
 c. Develop a leaflet or handouts which can be used to aid discussion and is something
for patients to take home
d. Give the patients some paper so that they can make notes to help them remember
the information

348. A patient with a learning disability trips over and needs to go to an accident and
emergency department for an examination they become distressed by the noisy waiting
room by the EQUALITY Act (2010). What do the staff offer the patient?

a. Tough call out a GP for a home visit to prevent a hospital trip

b. Staff provide the person with a learning disability a quiet place to wait
c. Staff let him jump the queue and see him when he arrives
d. Staff offer medication to calm the patient when he arrives

The Act makes it unlawful to discriminate against someone on the grounds of any of
these characteristics: age, disability, gender reassignment, marriage or civil partnership,
pregnancy and maternity, race, religion/belief, sex (gender) and sexual orientation. These
are often referred to as protected characteristics. (Protects you from discrimination)

349. Which of the following terms refer to the degree to which the instrument
measures what it is supposed to measure?

a. Sensitivity
b. Meaning fullness
c. Reliability
d. Validity

350. When she presents the nursing procedures to be followed, she refers to what
type of standards?

a. Criteria
b. Outcome
c. Process

351. She knows that performance appraisal consists of the following activities,
EXCEPT?

a. Setting specific standards and activities for individual performance

b. Focusing activity on the correction of identified behavior
c. Determine areas of strength and weakness
d. Using agency standards as a guide

An employee performance appraisal is a process—often combining both written and oral

elements—whereby management evaluates and provides feedback on employee job
performance, including steps to improve or redirect activities as needed. Documenting
performance provides a basis for pay increases and promotions.

352. A client elects to have epidural anesthesia to relieve the discomfort of labor.
Following the initiation of epidural anesthesia, what should the nurse give priority?

a. Checking for cervical dilation

 b. Placing the client in a supine position
c. Checking the patient’s blood pressure
d. Obtaining an FHR

A baseline determination of maternal blood pressure, pulse, and fetal heart rate should
be made prior to inserting the epidural catheter. Continuous fetal monitoring is essential
to determine any fetal distress which may result from anesthesia-induced hypotension.

353. He plans to use Likert Scale to determine:

a. Compliance to expected standards

b. Degree of acceptance
c. Degree of agreement and disagreement
d. Level of satisfaction

Definition: A Likert scale is a unidimensional scale that researchers use to collect

respondents' attitudes and opinions. Researchers often use this psychometric scale to
understand the views and perspectives. (Agree, Neutral or Disagree)

354. A patient undergoing chemotherapy is at risk for neutropenia. Which of the

following is the most accurate advice a nurse should give a patient to reduce this risk?

a. Monitor your temperature twice a day and report if it elevates by 2 degrees

b. Monitor your temperature daily and report if it elevated by 1 degree
c. Monitor your temperature daily and seek help if it is slightly elevated
d. Monitor your temperature 4 hourly and report any abnormalities

Neutropenia is a condition where your blood has low amounts of white blood cells called
neutrophils. These cells are responsible for fighting infections. When your neutrophil
count is extremely low, you have a high risk of getting an infection that your body can't
fight.

If you've been diagnosed with neutropenia, call your doctor right away if you develop
signs of an infection, which may include: Fever above 100.4 degrees F (38 degrees C)
Chills and sweats. A new or worsening cough.

Neutropenia often occurs between 7 and 12 days after you receive chemotherapy. This
period can be different depending upon the chemotherapy you get. Your doctor or nurse
will let you know exactly when your white blood cell count is likely to be at its lowest.

355. Mr. X responded well to his NGT feeding and will continue for 3 more days at a
constant rate of 80 mL/hr until the next review by the dietician. Evidence-based
practice suggests that to keep its potency, flushing is needed to be done:

a. Every 8 hours
b. Every 12 hours
c. Every 24 hours
d. Only as required
e. Every 4 hours
At a minimum you should flush the NG tube after every feed and after giving medication,
using 5-20mL of water depending on your child's age or as recommended by your health
professional. If feeding and medications are less frequent the tube should be flushed
every 4 hours.

356. Ventilation and chest compressions is better than Defibrillation:

a. Asystole

357. To whom do you report communicable diseases?

a. Public Health England (PHE)

358. Services used by external contractors:

a. Domestic services
b. Community services
c. …Trust
d. Acute trust

359. How many bandages are used for venous ulcers?

a. 2
b. 3
c. 4
d. 5

Four-layer bandaging is the standard treatment for venous leg ulcers but is bulky and
can restrict mobility.

360. A patient with hypothyroidism is having pain 6 on 1-10 scale in the right hip
due to recent surgery. Which of the following medications is appropriate for this patient?

a. Fentanyl
b. Tylenol
c. Morphine
d. Dilaudid

361. A nurse was concerned about treatment of students in the ward:

a. Freedom of info policy

b. Whistle blowing policy
c. Flexible policy
d. Information sharing policy

In this policy ‘Whistleblowing’ means the reporting by employees of suspected

misconduct, illegal acts or failure to act within the Council.

362. Breastfeeding prevents:

a. Hepatitis
 b. Hemolytic Disorders
c. Sudden Infant Death Syndrome
d. Sickle cell

363. What is the initial sign of compensated shock?

a. Hypotension
b. Rapid respiratory rate
c. Hypoxia
d. Increased UO

Compensated shock is the phase of shock in which the body is still able to compensate
for absolute or relative fluid loss. During this phase the patient is still able to maintain an
adequate blood pressure as well as brain perfusion because the sympathetic nervous
system increases the heart and respiratory rates and shunts blood to the core of the
body through vasoconstriction of the blood vessels and microcirculation, the
precapillary sphincters constrict and decrease blood flow to areas to areas of the body
with a high tolerance for decreases in perfusion, e.g. the skin. This process actually
increases the blood pressure initially because there is less room within the circulatory
system. The signs and symptoms of compensated shock include:

● Restlessness, agitation and anxiety – the earliest signs of hypoxia

● Pallor and clammy skin – this occurs because of microcirculation
● Nausea and vomiting – decrease in blood flow to the GI system
● Thirst
● Delayed capillary refill
● Narrowing pulse pressure

364. What is the initial step before administering IM injections?

a. Wear apron and wash your hands

b. Wash hands
c. Wear an apron, wash hands, and clean the site

365. In a challenging situation, how does a nurse communicate?

a. Face to face
b. Letter
c. Email
d. Phone

366. What are the nursing priorities when helping in an emergency in a practice
setting?

a. Only act in an emergency within the limit of knowledge and competence

b. Ensure that all patients are informed on what is happening
c. Responds to all instructions from the crisis lead
d. Instructs all colleagues to help with the emergency

367. The Care Quality Commission (CQC) describes compassion as what?

 a. Smart confidence
b. Creative commitment
c. Intelligent kindness
d. Gifted courage

368. Which client has the highest risk for bacteremia?

a. Client with an implanted infusion port

b. Client with a peripherally inserted IV line
c. Client with a peripherally inserted central catheter (PICC) line
d. Client with a central venous catheter (CVC)

Catheter-related bloodstream infection (CRBSI) is defined as the presence of bacteremia

originating from an intravenous catheter. It is one of the most frequent, lethal, and costly
complications of central venous catheterization and also the most common cause of
nosocomial bacteremia. Intravascular catheters are integral to the modern practices and
are inserted in critically-ill patients for the administration of fluids, blood products,
medication, nutritional solutions, and for hemodynamic monitoring. Central venous
catheters (CVCs) pose a greater risk of device-related infections than any other types of
medical device and are major causes of morbidity and mortality. They are also the main
source of bacteremia and septicemia in hospitalized patients. Majority of CRBSIs are
associated with CVCs and in prospective studies, the relative risk for CRBSI is up to 64
times greater with CVCs than with peripheral venous catheters.

369. A new nurse did not take the BP correctly, as a nurse in charge what would
you do?

a. Immediately tell the nurse that it is not correct in front of the patient
b. Inform the nurse afterward and teach her how to do it in the correct way
c. Recheck the BP once she is done and change the records

370. What is an intraosseous device used for?

a. Artery
b. Vein
c. Bone marrow

Intraosseous (IO) cannulation or IO access is a rapid method to administer medications

through the bone marrow cavity in a critically ill or an injured patient. The medicines
reach blood circulation directly from the bone marrow cavity. The procedure is both safe
and effective in children and adults.

371. The first technique to use in examining patient’s abdomen is:

a. Palpation
b. Auscultation
c. Percussion
d. Inspection

Assessing your patient's abdomen can provide critical information about his internal
organs. Always follow this sequence: inspection, auscultation, percussion, and
palpation. Changing the order of these assessment techniques could alter the frequency
of bowel sounds and make your findings less accurate.

372. An independent client has frequent tonic-clonic seizure. What can you do to
maintain her dignity?

a. Let her have a bath independently without supervision

b. Let her shower independently but supervise her behind closed doors
c. Supervise her behind a screen

373. Why do you need to monitor a patient with hypoxia?

a. It must be carefully documented

b. Prolonged hypoxia can lead to bradycardia
c. To provide holistic care
d. It is part of the initial assessment

The most common cardiac response to hypoxia is reflex bradycardia (a decrease in heart
rate); a response initially mediated by O2 chemoreceptors confined to the gills. This
slowing of heart rate is primarily elicited by an increase in inhibitory (cholinergic)
nervous tone on the heart's pacemaker cells.

374. What is it called when you disclose a medication error to a patient and their
relatives?

a. Duty of candour
b. Disclosure
c. Raise of concern
d. Escalation

Duty of candour:
Every healthcare professional must be open and honest with patients when something
that goes wrong with their treatment or care causes, or has the potential to cause, harm
or distress.

*tell the patient when something has gone wrong

*apologise to the patient
*offer an appropriate remedy or support to put matters right
*explain fully to the patient the short and long term effects of what has happened.

Healthcare professionals must also be open and honest with their colleagues, employers
and relevant organisations, and take part in reviews and investigations when requested.

375. A patient cannot sleep at night due to dental pain, as a nurse what will be
your advice?

a. Lie down and apply heat pad to the area

b. Sleep upright and take analgesic before bed
c. Have a warm bath and take some sleeping aid after

376. What method is it when you combine quantitative and qualitative methods?
 a. Double method
b. Mixed method
c. Double scoping
d. Mixed scoping

377. Which of the following approaches creates a barrier to communication?

a. Using too many different skills during a single interaction

b. Giving advise rather than encouraging the patient to problem solve
c. Allowing the patient to become too anxious before changing the subject
d. Focusing on what the patient is saying rather than on the skill

378. The patient is on a wheelchair, in what position will the nurse put herself when
speaking with the patient?

a. Beside the patient

b. At the back of the patient
c. 3 meters apart from the patient
d. 45-degree angle

379. You witnessed somebody choking, the person is still conscious and still able to
cough what you will do?

a. Perform blind finger sweep

b. 5 chests thrust
c. 5 back slap
d. Call 911 and wait for them to arrive

380. National Reporting and Learning System (NRLS):

a. Patient safety incident report

The National Reporting and Learning System (NRLS) is a central database of patient
safety incident reports. Since the NRLS was set up in 2003, the culture of reporting
incidents to improve safety in healthcare has developed substantially.

381. Clinical audit:

a. It improves standard care and healthcare outcomes

b. It improves quality of care and healthcare outcomes

382. You’re about to provide negative feedback to a student. Where is the best
place to give it?

a. In the staff room

b. In a quiet place with no disturbance
c. Outside work
d. In the ward base and with other healthcare professionals

383. A patient had an arterial bleeding in her arm in home care, what would you do?
 a. Apply pressure and raise her arm while help in on the way

384. You noticed a health care professional did not wash his hands before
handling the patient, what will you do?

a. Ignore because he is a doctor as you cannot tell him because you are just a nurse
b. Politely remind him he did not wash hands after he has seen patient and are alone
c. Politely remind him he did not wash hands in front of patients and other healthcare
professionals

385. Stoma formation:

a. IBS and IBD

b. IBD and Crohn's disease
c. Diverticular disease and colon cancer

386. Which is NOT an act under safeguarding for elderly abuse?

a. Sexual abuse
b. Financial abuse
c. Neglect
d. Self-harm

387. Theory of Dorothea Orem:

a. Self-care Deficit

388. Theory of Sister Calista Roy: Adaptation Model of Nursing

a. Believe in holistic care including….four modes: physiological, self-concept, role

function, and interdependence.

389. Angle of subcutaneous injection for DM patient:

a. 90-degree
b. 45-degree
c. 60-degree
d. 80-degree

Insulin shots should go into a fatty layer of your skin (called “subcutaneous” or “SC”
tissue). Put the needle straight in at a 90-degree angle. You do not have to pinch up the
skin unless you are using a longer needle (6.8 to 12.7 mm). Small children or very thin
adults may need to inject at a 45-degree angle.

390. Subcutaneous injection is given at what angle?

a. 90-degree
b. 45-degree
c. 60-degree
d. 80-degree
 391. 4 themes of NMC code:

a. Prioritize people, practice effectively, preserve safety and promote professionalism

and trust.

392. Pandemic:

a.  is a disease outbreak that spreads across countries or continents

393. 6 C’s:

a. Care, compassion, courage, communication, commitment, and competence

394. Self-administration of a patient with learning disability:

a. Stop the patient to take their medicine and consult with the team members
b. Allow the patient to drink the medication then consult with the team members

395. BMI of 30 with hypertension:

a. Risk for stroke

396. Site for vaccination:

a. Deltoid

397. You used the machine in taking the blood pressure of the pt. The result is BP-
60/30 mmHg, and the patient is conscious and coherent. What will you do next?

a. Elevate the leg of the patient

b. Recheck the BP using the manual sphygmomanometer

398. Female Genital mutilation:

a. Caucasian and African women under 18

FGM is practiced in 31 countries in Africa, the Middle East, and Asia. It's most prevalent
in Djibouti, Egypt, Guinea, and Mali, where 90% or more of women aged 15 to 49 have
been subjected to FGM.

399. Medication for alcohol dependency:

a. Disulfiram (Antabuse)

Disulfiram is used to treat chronic alcoholism. It causes unpleasant effects when even
small amounts of alcohol are consumed. These effects include flushing of the face,
headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion,
sweating, choking, breathing difficulty, and anxiety.

400. MUST
 a. Malnutrition Universal Screening Tool

401. Anatomy:

a.  A field in the biological sciences concerned with the identification and description of

the body structures of living things

402. Showing understanding of what has been said by repeating key points to the
patient is called:

a. Active listening
b. Active lifestyle
c. Active labor
d. Active learning

403. What is an appropriate task to delegate to a nursing support worker?

a. Personal care
b. Drug round
c. IV medication
d. Ward round

404. A patient is admitted to the ward with symptoms of acute diarrhea. What should
your initial management be?

a. Assessment, protective isolation, universal precautions

b. Assessment, source isolation, antibiotic therapy
c. Assessment, protective isolation, antimotility medication
d. Assessment, source isolation, universal precautions

Source isolation is designed to prevent the spread of pathogens from an infected patient
to other patients, hospital personnel and visitors. This has previously been known as
barrier nursing. The need for isolation is determined by the way the organism or disease
is transmitted.

Protective isolation is used for severely immunocompromised patients in order to

prevent contamination and/or infection with microorganisms (bacteria and viruses). For
example, protective isolation is used for patients with burns or leukemia.

405. A community nurse is visiting a patient at home to give them information on their
condition, however, they cannot speak or understand English. What will you do?

a. Cancel the visit as it is pointless if the patient does not understand

b. Leave the information leaflet and hope they understand it
c. Use sign language to give the information
d. Book an interpreter to accompany them

406. How does the nurse respond to a patient using challenging behavior?

a. Place the patient in another room

 b. Ask the patient to stop the behavior
c. Ignore the challenging behavior
d. Use a therapeutic approach

407. If a critical incident occurs, a nurse will?

a. Report and reflect on the case to contribute to debriefing and ongoing learning
b. Undertake a literature review
c. Focus on reflection-in-action
d. Report the incident to the Care Quality Commission (CQC)

408. A nurse is working with a patient who says he drinks excessive alcohol. How
will the nurse respond to prevent ill health?

a. Offer education on the effects of alcohol in the body

b. Offer education on the risk of accidents after drinking
c. Offer advice on saving money by cutting down excessive drinking
d. Offer information about alcohol rehabilitation unit

409. Which therapeutic communication technique is being used in nurse-client

interaction?

a. Exploring
b. Formulating a plan of care
c. Making observations
d. Encouraging comparison

410. The nurse has the role of protecting the patient from the clinical environment,
which of the following actions won’t necessarily protect the patient?

a. Arranging medicines properly

b. Repairing medical equipment
c. Keeping the floor not slippery
d. Air-conditioning the room

411. Common clinical manifestation of an adolescent with appendicitis:

a. Abdominal pain and vomiting

b. Central abdominal pain radiating to the right iliac fossa with vomiting, low-grade
pyrexia
c. Left iliac pain with vomiting, high temperature, and a rash

412. A nurse practitioner is a member of which group?

a. Multiprofessional
b. The management team
c. The leadership team

413. A patient complaining of restlessness and inability to sleep at night, what is

your advice to him?
 a. Tell him to reduce caffeine intake
b. Use phone and music
c. Have periods of rest during the day

414. Which allied professional can undertake emergency roles after undergoing
specific training?

a. Radiographers
b. Pharmacists
c. Paramedics
d. Sport rehabilitation specialist

415. Spirometry is used to diagnose which disease condition?

a. Stroke
b. Cardiovascular disease
c. Diabetes
d. Respiratory disease

Spirometry is the most common type of pulmonary function or breathing test. This test
measures how much air you can breathe in and out of your lungs, as well as how easily
and fast you can blow the air out of your lungs.

416. Under the Yellow Card Scheme, you must report the following, EXCEPT:

a. Faulty brakes on a wheelchair

b. Suspected side effects to blood factor, except immunoglobulin products
c. Counterfeit or fake medicines or medical devices

The Yellow Card scheme is vital in helping the Medicines and Healthcare products
Regulatory Agency (MHRA) monitor the safety of all healthcare products in the UK to
ensure they are acceptably safe for patients and users.

Reports can be made for:

● suspected adverse drug reactions (ADRs) to all medicines including:

● vaccines
● blood factors and immunoglobulins
● herbal medicines
● homeopathic remedies
● all medical devices available on the UK market
● defective medicines (those that are not of an acceptable quality)
● fake or counterfeit medicines or medical devices
● nicotine-containing electronic cigarettes and refill containers (e-liquids)

It is important that problems with medicines and medical devices and other nicotine e-
cigarette products are reported, as the reports help identify new problems with these
products.

MHRA will review the product and if necessary take action to minimise risk and
maximise benefit to patients and the public.
 417. A patient is on his 3rd day with antibiotic therapy due to a lower respiratory tract
infection. He presented 3 bouts of bloody diarrhea. What would be the likely cause?

a. Clostridium difficile has penetrated the intestine

b. This indicates the release of histamine in the body
c. Urinary tract infection has worsened
d. Develops allergies

418. An opioid adverse reaction is?

a. Wheezes and shallow breathing, sleepiness

b. Slow and shallow breathing, sleepiness
c. Rapid and shallow breathing, sleepiness
d. All of the above

Most common side effects are predictable consequences of opioid pharmacological

actions and include nausea, vomiting, constipation, pruritus, dizziness, dry mouth and
sedation.

Respiratory depression is a much-feared harm associated with the use of opioids.

Opioids can cause irregular respiratory pauses and gasping may lead to erratic
breathing and significant variability in respiratory rate. The respiratory effects of opioids
are more pronounced during sleep. Fatalities have been reported in patients with
obstructive sleep apnoea who are prescribed opioids and sleep apnoea may be a relative
contraindication to opioid therapy.

419. What is the common cause of airway obstruction in unconscious patients?

a. Tongue falling back

b. Foreign object stuck in the throat
c. Edema in the neck due to oxygen supply
d. None of the above

The tongue is the most common cause of upper airway obstruction, a situation seen
most often in patients who are comatose or who have suffered cardiopulmonary arrest.
Other common causes of upper airway obstruction include edema of the oropharynx and
larynx, trauma, foreign body, and infection.

420. Common minor disorder of pregnancy?

a. Vomiting
b. Abdominal pain
c. Headache
d. Heartburn

Heartburn / Indigestion
This is a painful, burning sensation in the chest caused by the regurgitation of stomach
acid into the throat. The symptoms of indigestion, including heartburn, are common
during pregnancy and are caused by hormonal changes and the growing womb pressing
on the stomach.

421. DOLS meaning:

a. Deprivation of Liberty Safeguards

Deprivation of Liberty Safeguards (DoLS) are intended to protect people who lack mental
capacity from being detained when it is not in their best interests. Having mental
capacity means being able to understand and retain information and to make a decision
based on that information.

422. What are the 4 ethical principles in nursing?

a. Autonomy, beneficence, nonmaleficence, and justice

423. Major incident:

a. Any occurrence that presents serious threat to the health of the community or causes
such numbers or types of casualties, as to require special arrangements to be
implemented

424. Cyclizine:

a. used in prevention and treatment of nausea, vomiting, and dizziness associated with
motion sickness

Cyclizine is an anti-sickness medicine. It's used to help stop you feeling or being sick
(nausea or vomiting).

You can take cyclizine to treat morning sickness, vertigo and travel sickness.

It can also be taken to treat sickness caused by general anaesthetics after surgery,
cancer treatment or other medicines, and some inner ear problems such as Ménière's
disease.

425. Mental Capacity:

a. The ability to use and understand information to make a decision, and communicate
any decision made

Mental capacity is the ability to make decisions for yourself. People who cannot do this
are said to 'lack capacity'. This might be due to illness, injury, a learning disability, or
mental health problems that affect the way their brain works.

426. Type of feedback without bias:

a. Talk to nurse team

b. Incident form
c. Talk to relative
d. Talk to patient
 427. BMI normal range:

a. 18.5-24.9

428. Clinical assessment tool for stool:

a. Bristol Stool Chart

The Bristol Stool Chart is widely used as a research tool to evaluate the effectiveness of
treatments for various diseases of the bowel. The chart is used to describe the shapes
and types of stools. It is also used as a tool to diagnose constipation, diarrhoea and
irritable bowel syndrome.

429. Pillars of advanced nursing practice?

a. Clinical practice, leadership and management, education, and research

These four pillars are:

● Clinical/direct care
● Leadership and collaborative practice
● Improving quality and developing practice
● Developing self and others

430. NICE:

a. National Institute for Health and Care Excellence: identifies good practice using the
best available evidence-based information for health, public health and social care
professionals

431. PDSA:

a. Plan-Do-Study-Act

Plan – Do – Study - Act (PDSA)

PDSA cycles are an ideal quality improvement tool that can be used to test an idea
temporarily, trialling a change and assessing its impact.

432. What does “Standard Precaution” mean caring for a patient?

a. High-level precautions which include all disposable beddings and utensils for all
health care staff
b. Basic infection prevention and control measures which include hand hygiene and
safe disposal of all waste by all staff at all times
c. Taking precautions when handling blood and high-risk body fluids for relevant
medical personnel
d. Selective precautions which involve safe disposal of clinical waste for all personnel
involved in the care process
In summary, universal precautions involve precautions taken with all patients,
regardless of suspicion of infection, to prevent the spread of bloodborne pathogens. In
an inevitable evolution, standard precautions, in contrast, are steps taken to combat the
spread of airborne pathogens in situations where providers come into contact with any
form of body fluid. Transmission-Based precautions are more specific and used in
addition to standard precautions when certain infections are present.

433. Nitrites in urine are mostly found in:

a. Pregnant women
b. Man
c. Children
d. Females

The presence of nitrites in urine most commonly means there's a bacterial infection in
your urinary tract. This is usually called a urinary tract infection (UTI). A UTI can happen
anywhere in your urinary tract, including your bladder, ureters, kidneys, and urethra.

434. Early sign of phlebitis:

a. Slight pain and redness

b. Increased WBC
c. Pyrexia
d. Swelling

The Visual Infusion Phlebitis score (VIP scale)

The VIP scale provides a score from 0 to 5, in ascending order of severity of
inflammation. Each grade identifies a more or less advanced state of phlebitis or
thrombophlebitis and differs in the evidence of specific signs and actions to be taken.

Score 0 - the insertion site appears healthy and there are no signs of phlebitis. Only
continued observation of the cannula is indicated.

Score 1 - one of the following signs is evident: slight pain or slight redness near the IV
insertion site. These are possible early signs of phlebitis. Also in this case it will simply
be necessary to continue with the monitoring.

Score 2 - two of the following signs are evident: pain at IV site, redness or swelling. This
is the early stage of phlebitis, requiring repositioning of the peripheral venous catheter.

Score 3 - all of the following signs are evident: pain along the path of the cannula,
redness around the insertion site and swelling. We are at the medium stage of phlebitis,
so the catheter should be repositioned and treatment considered.

Score 4 - all of the following signs are evident and extensive: pain along the path of the
cannula, redness around the insertion site, swelling, palpable venous cord. We are at the
advanced stage of phlebitis or at the start of thrombophlebitis. It is recommended to
reposition the catheter and consider treatment.

Score 5 - all of the following signs are evident and extensive: pain along the path of the
cannula, redness around the insertion site, swelling, palpable venous cord, pyrexia. We
are in the stage of advanced thrombophlebitis, which requires initiating treatment and
repositioning the peripheral venous catheter.

435. What is the most suitable therapy for a 5-year-old experiencing

psychological trauma?

a. Trauma-Focused Cognitive Behavioral Therapy

436. What is complex care?

a. Is person-centered specialist support for someone with a chronic or long-term health

condition, who requires extra assistance to manage their symptoms and day-to-day
activities to enable a high quality of life

437. Self-determination theory:

a. People are motivated to grow and change by three innate and universal
psychological needs: competence, connection/relatedness, and autonomy

438. Gingivitis cause:

a. Build-up of plaque (not fully removing plaques)

Gingivitis is a mild, early form of gum disease, also called periodontal disease. Gingivitis
happens when bacteria infect the gums, often making them swollen, red and quick to
bleed.

You can successfully manage gingivitis, especially with the help of a dentist. But left
untreated, the condition can lead to periodontitis , a more severe type of gum disease.

The most common cause of gingivitis is poor oral hygiene that encourages plaque to
form on teeth, causing inflammation of the surrounding gum tissues.

439. Patient experiences in the last 48 hours of life?

a. Dyspnea, upper airway secretions, and lucidity

440. Warwick-Edinburgh Mental Well-being Scale (WEMWS) measures:

a. Mental health illness

b. Cognitive impairment

"The Warwick-Edinburgh Mental Wellbeing Scales were developed to enable the

measuring of mental wellbeing in the general population and the evaluation of projects,
programmes and policies which aim to improve mental wellbeing. The 14-item scale
WEMWBS has 5 response categories, summed to provide a single score. The items are
all worded positively and cover both feeling and functioning aspects of mental wellbeing,
thereby making the concept more accessible. The scale has been widely used nationally
and internationally for monitoring, evaluating projects and programmes and
investigating the determinants of mental wellbeing."- Prof Sarah Stewart-Brown
 441. A patient had sepsis, when will you give broad spectrum antibiotics for culture?

a. Immediately before containing blood culture as sepsis is included

b. Immediately once after blood sample is collected
c. Immediately after obtaining blood culture as an infection is recognized
d. None of the above

442. DATIX:

a. Trust electronic incident report system

Datix is the Trust's electronic incident reporting system. Local training on Datix as part
of your local induction to where you work.

443. Hypokalemia correction is done via:

a. IV bolus
b. Infusion via pump
c. Subcutaneously
d. Intramuscular

Hypokalemia is treated with oral or intravenous potassium.

444. Therapeutic communication:

a. Ensure patient gain insights

b. Keep conversation goal-centered

445. How to fully understand Mental Illness?

a. 7-day training in GP
b. Mental health…

446. How to know the improvement or about the status of a patient with cognitive
impairment?

a. Discharge summary
b. GP
c. About me/Passport

447. Priority before wound dressing:

a. Handwashing

448. To prevent infection, nurse advises a patient to:

a. Keep the urine catheter bag below the bladder

b. On level with the bladder
c. Any level doesn’t make any difference
d. Above the bladder
 449. Upon visiting an elderly at home, the nurse found him unconscious. What
should be your initial action as a nurse?

a. Call for family

b. Call an ambulance
c. Call a GP
d. Assess ABCDE

450. The numbers written below the nurse’s name and signature:

a. Board registration number

b. Date of employment
c. Employment number

451. Normal hemoglobin level for a woman:

a. 105-125
b. 115-130
c. 160-190
d. 130-180

For men the normal haemoglobin reference range is between 130–180 g/L and for
females the normal reference range is120–160 g/L.

452. Symptom commonly present in pregnant woman:

a. Headache
b. Hair loss
c. Abdominal pain and nausea
d. Heartburn

453. You’re working as a nurse in an emergency department when a major incident

has happened. Who should lead the nursing team?

a. Chief nurse
b. Senior nurse of the shift

454. Hemoptysis:

a. Blood in vomit
b. Blood in stool
c. Blood in sputum
d. Blood in urine

Hemoptysis refers to coughing up blood from some part of the lungs (respiratory tract).

Hematemesis refers to blood in vomit generally coming from an upper gastrointestinal

(GI) source, such as your stomach. In some cases, minor causes may trigger vomiting
blood, such as swallowing blood from a mouth injury or a nosebleed. These situations
will likely not cause any long-term harm.
Hematochezia is the passage of fresh blood per anus, usually in or with stools.

Hematuria is the presence of blood in a person's urine. The two types of hematuria are.
gross hematuria—when a person can see the blood in his or her urine. microscopic
hematuria—when a person cannot see the blood in his or her urine, yet it is seen under a
microscope.

455. Most patients with long term conditions usually does not comply with:

a. Rest
b. Exercise
c. Their medications

456. Statutory principle of Mental Capacity Act, except?

a. Right to make eccentric and unwise decision

b. Right to make their own decision
c. Right to have a care plan
d. Presumption of capacity

457. Parkinson’s taking madopar:

a. With food
b. With water
c. Give on time
d. Give at night only