NMC CBT Nursing Practice and Decision Making

Question 1

You are caring for a patient who is receiving intravenous (IV) fluids and develops redness and swelling at the IV insertion site. What is your first action?

Accepted Answer

Remove the IV and assess for signs of infection.

Answer

Redness and swelling at an IV insertion site are signs of potential complications such as phlebitis or infiltration. The immediate and safest action is to remove the IV catheter to prevent further tissue damage or infection. After removal, the site should be assessed for the severity of the complication and appropriate interventions initiated.

Question 2

A patient in your care has a blood pressure of 180/110 mmHg. What should you do next?

Accepted Answer

Inform the doctor and monitor the patient for signs of a hypertensive crisis.

Answer

A blood pressure reading of 180/110 mmHg is significantly elevated and indicates a hypertensive urgency or emergency, requiring prompt medical attention. The nurse's immediate responsibility is to report this critical finding to the doctor. Continuous monitoring for signs of a hypertensive crisis, such as headache or vision changes, is essential to prevent serious complications.

Question 3

A patient with diabetes is complaining of dizziness and sweating. Their blood sugar level is 50 mg/dL. What is your immediate action?

Accepted Answer

Give the patient a sugary drink or snack.

Answer

Dizziness and sweating with a blood sugar level of 50 mg/dL are classic symptoms of hypoglycemia, a medical emergency. The immediate action is to administer a fast-acting carbohydrate, such as a sugary drink or snack, to rapidly raise blood glucose levels. This intervention is critical to prevent further deterioration and potential loss of consciousness.

Question 4

A patient with a known allergy to penicillin is prescribed an antibiotic containing penicillin. What should you do?

Accepted Answer

Contact the prescribing doctor to clarify the medication and inform them of the allergy.

Answer

Administering a medication to which a patient has a known allergy can lead to a severe, life-threatening allergic reaction. It is the nurse's professional and ethical responsibility to always verify medication orders against patient allergies. Contacting the prescribing doctor to clarify the order and inform them of the allergy is a critical safety measure before administering any medication.

Question 5

You are about to perform a procedure on a patient and need to obtain consent. What should you do?

Accepted Answer

Ensure the patient fully understands the procedure, risks, and benefits, and obtain written consent if necessary.

Answer

Informed consent is a fundamental ethical and legal principle in healthcare, ensuring patient autonomy. It requires the patient to fully understand the procedure, including its purpose, potential risks, benefits, and available alternatives, before agreeing to it. The nurse's role is to ensure this understanding and obtain appropriate consent, often written for invasive procedures, to protect the patient's rights.

(NMC CBT) Nursing and Midwifery Council Computer-Based Test Practice Test

(NMC CBT) Nursing and Midwifery Council Computer-Based Test Practice Test

NMC CBT Nursing Practice and Decision Making