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NMC Test of Competence
When assessing an unresponsive pt, what is an appropriate way to get a pain response? -sternal rub -nail bed pressure -pinching the ear -a trapezium squeeze - a trapezium squeeze (aka squeeze the shoulders) What is the most common health problem affecting the nurses healthcare users & the relatives in hospital settings? -neurological disorders -cancer -needle prick injury -split & falls - split & falls Which is NOT considered medicine? -whole blood -albumin -blood clotting factors -antibodies - whole blood What sector receives the largest share of UK health budget? -surgical operations
-blood diseases / HIV / hepatitis
- elderly problems - elderly problems What does a nurse observe when assessing the respiration of a pt with breathing difficulties? -rate, pattern, & evidence of cyanosis -presence of symmetrical movement of both sides of chest & equal breath sounds -ability to speak in full sentences, ease of breathing, rate, pattern, & evidence of cyanosis -ease of breathing, rate, pattern, & evidence of cyanosis - ability to speak in full sentences, ease of breathing, rate, pattern, & evidence of cyanosis How long is the undergraduate/pre-registration BSC nursing programme for those on a standard entry pathway? -2 years -4 years
- 3 years -5 years - 3 years Pt is having breathlessness. Pt is in the end of life care phase. What should the nurse do? -put the face of the pt in the electric fan -give high flow oxygen
- put paper bag -give more sedative - put paper bag
-ask the pt to contact their GP to follow up on services needed - give discharge information to the care facility who will liaise with others What action would you take if a specimen had a biohazard sticker on it?
- double bag it, in a self-sealing bag, & wear gloves if handling the specimen -wear gloves if handling the specimen, ring ahead & tell the laboratory the sample is on its way -wear goggles & underfill the sample bottle -wear appropriate PPE & overfill the bottle - double bag it, in a self-sealing bag, & wear gloves if handling the specimen Which of the following techniques is advisable when obtaining a urine specimen in order to minimize the contamination of a specimen? -clean around the meatus prior to sample collection & get a midstream / clean catch urine specimen -clean around the meatus prior to sample collection & collect the first portion of urine as this is where the most bacteria will be -do not clean the urethral meatus as we want these bacteria to analyse as well -dip the uranalysis strip into the urine in a bedpan mixed with stool - clean around the meatus prior to sample collection & get a midstream / clean catch urine specimen What does AVPU mean? -Alert, Verbalization, Pain, Unconscious -Awake, Voice, Pain, Unconscious
- Alert, Voice, Pain, Unresponsive -Awake, Verbalization, Pain, Unconscious - Alert, Voice, Pain, Unresponsive
Where will you put infectious linen? -red plastic bag designed to disintegrate when exposed to heat
- red linen bag designed to hold its integrity even when exposed to heat -yellow plastic bag for disposal - red plastic bag designed to disintegrate when exposed to heat Who is responsible for disposing sharps? -registered nurse -nurse assistant -whoever used the sharps
- whoever collects the garbage - whoever used the sharps How many units of continuing education does the NMC / UK require nurses to have every 3 years
- 35 units -45 units -55 units -65 units - 35 units What do you expect to assess in a grade 3 pressure ulcer? -blistered wound on the skin
- open wound showing tissue -open wound exposing muscles -open wound exposing bones -
- secondary post partum hemorrhage -tertiary post partum hemorrhage - secondary post partum hemorrhage A solution contains 12.5 g of glucose in 0.25L. What is the percentage concentration (%) of this solution? -5% -10% -25% - 5% A litre bag of 5% glucose is prescribed over 4 hours. If a standard giving set is used, at what rate should the drip be set?
-24 - 83 What steps would you take if you had sustained a needle stick injury? -ask for advice from emergency department, report to occupational health, & fill out an incident form -gently make the wound bleed, place under running water & wash thoroughly with soap & water. Complete an incident form & inform your manager. Cooperate with any action to test yourself or the pt for infection with a bloodborne virus but do not obtain blood or consent for testing from the pt yourself, this should be done by someone not involved in the incident -take blood from pt & self for hep b screening & take samples for bacteriology. Call your union representative for support. Make an appointment with your GP for a sickness certificate to take time off until the wound site has healed so you don't contaminate any other pts -wash the wound with soap & water. Cover any wound with a waterproof dressing to prevent entry of any other foreign material -
gently make the wound bleed, place under running water & wash thoroughly with soap & water. Complete an incident form & inform your manager. Cooperate with any action to test yourself or the pt for infection with a bloodborne virus but do not obtain blood or consent for testing from the pt yourself, this should be done by someone not involved in the incident What specifically do you need to monitor to avoid complications & ensure optimal nutritional status in pts being enterally fed? -blood glucose levels, full blood count, stoma site, & bodyweight -eye sight, hearing, full blood count, lung function, & stoma site -assess swallowing, pt choice, fluid balance, & capillary refill time -daily urinalysis, ECG, protein levels, & arterial pressure - blood glucose levels, full blood count, stoma site, & bodyweight When using a nasal cannula, the maximum oxygen flow rate that should be use is 6 litres/min. Why? -nasal cannulas are only capable of delivery an inspired oxygen concentration between 24-40% -for any given flow rate, the inspired oxygen concentration will vary between breaths, as it depends upon the rate & depth of the pt's breath & the inspiratory flow rate -higher rates can cause nasal mucosal drying & may lead to epistaxis -if oxygen is administered at greater than 40% it should be humidified. You cannot humidify oxygen via nasal cannula - higher rates can cause nasal mucosal drying & may lead to epistaxis (aka nose bleed) Which one of the following types of wound is NOT suitable for negative pressure wound therapy? -partial thickness burns -contaminated wounds -diabetic & neuropathic ulcers -traumatic wounds - contaminated wounds (necrotic tissue)
-hemastasis, inflammation phase, proliferation phase, maturation phase -inflammatory phase, dynamic phase, neutrophil phase, maturation phase -hemastasis, proliferation phase, inflammation phase, remodeling phase - hemastasis, inflammation phase, proliferation phase, maturation phase How soon after surgery is the pt expected to pass urine? -1-2 hours -2-4 hours -4-6 hours -6-8 hours - 6-8 hours What functions should a dressing fulfill for effective wound healing? -high humidity, insulation, gaseous exchange, absorbent -anaerobic, impermeable, comfortable, low humidity -insulation, low humidity, sterile, high adherence -absorbent, low adherence, anaerobic, high humidity - high humidity, insulation, gaseous exchange, absorbent How would you care for a pt with a necrotic wound? -systemic antibiotic therapy & apply a dry dressing -debride & apply a hydrogel dressing -debride & apply an antimicrobial dressing -apply a negative pressure dressing - debride & apply a hydrogel dressing (necrotic wounds are dry & black & yucky, so hydroGEL would be the best thing to put on those bad boys lol)
A new, postsurgical wound is assessed by the nurse & is found to be hot, tender, & swollen. How would this wound be best described? -in the inflammation phase of healing -in the hemostasis phase of healing -in the reconstructive phase of wound healing -as an infected wound - in the inflammation phase of healing When a pt is being monitored in the PACU, how frequently should blood pressure, pulse, & respiratory rate (aka vitals) be recorded? -every 5 minutes -every 15 minutes -once an hour -continuously - every 5 minutes (these pts are higher risk post op, need to monitor q 5 min bb) Safe moving & handling of an anesthetized pt is imperative to reduce harm to both the pt & staff. What is the minimum number of staff required to provide safe manual handling of a pt in theatre? -3 (1 each side, 1 at head) -5 (2 each side, 1 at head) -4 (1 each side, 1 at head, 1 at feet) -6 (2 each side, 1 at head, 1 at feet) - 4 (1 each side, 1 at head, 1 at feet) = keep it simple baby
A serious incident in a health care setting that has resulted in hard & is considered preventable is defined in national policy as...? -catastrophic mistake -cause for concern -preventable failure - never event (these are serious incidents that are deemed unacceptable & avoidable - examples: wrong-site surgery, retained foreign objects after surgery, medication errors resulting in pt harm, pt falls resulting in serious injury or death What is the name of the process when a clinical error has been made & this is disclosed to the pt or family? -whistle blowing -full disclosure -escalation of concern duty of candour (ethical & legal responsibility of healthcare professionals & organizations to be open, honest, & transparent with pts & families when a clinical error or adverse event has occurred - involves disclosing the error, providing a clear explanation of what happened, the potential consequences, & offering an apology) What does a nurse observe when assessing respiration of a pt with breathing difficulties? -ability to speak in full sentences, ease of breathing, rate, pattern, evidence of cyanosis -ease of breathing, rate, pattern, & evidence of cyanosis -rate, pattern, & evidence of cyanosis - When does a nurse NOT use a glucometer to monitor a pt's blood sugar? -when the nurse prefers urinalysis -if the pt is in an acute setting & venous blood samples can be utilised -when the pt prefers urinalysis when the peripheral cannulation is impaired (if the access is impaired = dont use a glucometer...use a central venous line or lab based method for analysis instead)
The nurse is caring for an immobile pt. The nurse is promoting interventions to prevent foot drop from occurring. Which of the following is least likely a cause of foot drop? -bed rest -lack of exercise -incorrect bed positioning -bedding weight that forces the toes into plantar flexion - A nurse assistant is dealing aggressively with an elderly pt. What will be your first action? -immediately block the staff, report to authorities, & make sure the pt is safe -ignore the situation -report to the authorities -enquire about the incident with the pt later - A nurse is caring for a pt with a cane. After providing instructions on proper can use, the pt asked to repeat the instructions given. Which of the following pt statements needs further instructions? -"The hand opposite to the affected extremity holds the cane to widen the base of support & to reduce stress on the affected limb." -"As the cane is advanced, the affected leg is also moved forward at the same time." -"When the unaffected extremity begins the swing phase, the pt should bear down on the cane." -"To go up the stairs, place the cane & affected extremity down on the step. Then step down the unaffected extremity." - Pt with learning disability is accompanied by a voluntary independent mental capacity advocate. What is his role? -express pt's needs & wishes. acts as a pt's representative in expressing their concerns as if they were his own -just to accompany the pt -to make decisions on pt's behalf & provide their own judgments as this benefits the pt
-"I think this will all be easier to deal with than you think." -"Why do you think this is happening to you?" - A pt asks an RN, "Can I tell you a secret?" What is the nurses best response? -Yes, because it develops trust which is central to the NPR -Yes, & I will share it with the relevant medical team -Yes, & I will share it with all the medical professionals who are supposed to know the secret -Yes, I will keep the secret because it is confidential - The nurse is measuring the crutch using the pt's height. How many inches should the nurse subtract from the pt's height to obtain the approximate measurement? -10 inches -16 inches -9 inches -5 inches - A pt is ambulating with a walker. The nurse corrects the walking pattern of the pt if he does which of the following? -the pt walks first & then lifts the walker -the walker is held on the hand grips for stability -the pt's body weight is supported by the hands when advancing his weaker leg -all of these - Risk for health issues in a person with mental health issues is: -increased than in normal ppl -slightly decreased than in normal ppl -very low as compared to normal ppl
-risk is same in ppl with & without mental illness - Knowing the difference between normal age-related changes & pathologic findings, which find should the nurse identify as pathologic in a 74 year old pt? -increase in residual lung volume -decrease in sphincter control of the bladder -increase in diastolic pressure -decreased response to touch, heat, & pain - In a Taco Bell queue, a pt collapses in front of you. What will be your response? -run to bring AED -shout for help -assess for response -assess for danger before approaching - Which drug can be given via NG tube? -modified release hypertensive drugs -crushed tablets -lactulose syrup -insulni - As a nurse you are responsible for looking after pt's nutritional needs & to maintain good weight during hospitalization. How would you achieve this? -providing all pts with liquid nutritional supplements -assessing all pts using MUST screening tool & taking pt's preferences into consideration -checking daily weight & documenting -assessing nutritional status, pt preferences & needs, making individual food choices available, checking daily weight & documentation -
A young woman who has tested positive for HIV tells her nurse that she has had many sexual partners. She has been on an oral contraceptive & frequently had not request that her partners use condoms. She denies IV drug use. She tells her nurse that she believes she will die soon. What would be the best response for the nurse to make? -"Where there is life, there is hope." -"Would you like to talk to the nurse who works with HIV positive pts?" -"You are a long way from dying" -"Not everyone who is HIV positive will develop AIDs & die." – A pt complains of pain even after administration of analgesics. It has been 24 hours after abdominal surgery. What management will the nurse provide? -apply heat -provide reclined position -call the doctor -readminister analgesic - During a busy shift, a nurse loads medication & asks you to administer it. What is your action? -ask the student nurse to help you administer medication -ask another staff nurse to help you administer medication -accept to administer the medication -refuse to administer the medication - A new RN has problems with making assumptions. Which part of The Code should she focus on to deliver fundamentals of care effectively? -prioritise people -practice effectively -preserve safety -promote professionalism & trust -
priortise people An adult has signed the consent form for a research study but has changed her mind. The nurse tells the pt that she has the right to change her mind based upon which of the following principles: -paternalism & justice -autonomy & informed consent -beneficence & double effect -competence & right know - autonomy & informed consent What is the difference between denial & collusion? -denial is a normal, acceptable response by a pt to a life threatening diagnosis, whereas collusion is not -denial is a coping mechanism used by an individual with the intention of protecting themselves from painful or distressing information, whereas collusion is the withholding of information from the pt with the intention of "protecting them" -denial is when a pt refuses tx & collusion is when a pt agrees to it -denial is when a healthcare professional refuses to tell a pt their diagnosis for the protection of the pt, whereas collusion is when healthcare professional & the pt agree on the information to be told to relatives & friends - denial is when a healthcare professional refuses to tell a pt their diagnosis for the protection of the pt, whereas collusion is when healthcare professionals & the pt agree on the information to be told to relatives & friends What percentage of pts in hospital in England, at the time of the 2011 National Prevalence survey, had an infection? -4.6% -14% -6.4%
