NMBI Clinical Skills 2 — Questions and Answers
Question 1: What is the correct procedure for performing urinary catheterisation?
- Use aseptic technique throughout, clean the urethral meatus with sterile solution, insert a pre-lubricated catheter gently, inflate the balloon with sterile water, and connect to a closed drainage system (Correct answer)
- Use clean gloves and insert the catheter quickly
- Catheterisation does not require aseptic technique
- Only doctors can perform urinary catheterisation
Correct answer: Use aseptic technique throughout, clean the urethral meatus with sterile solution, insert a pre-lubricated catheter gently, inflate the balloon with sterile water, and connect to a closed drainage system
Urinary catheterisation requires strict aseptic technique to prevent catheter-associated urinary tract infection (CAUTI). Key steps include hand hygiene, sterile gloves, meatal cleansing, gentle insertion with sterile lubricant, correct balloon inflation, and connection to a closed drainage system.
Question 2: What are the signs and symptoms of anaphylaxis that a nurse should recognise?
- Rapid onset of breathing difficulty, swelling of face/throat, hypotension, widespread urticaria (hives), and potential cardiovascular collapse (Correct answer)
- Mild itching at the injection site only
- Headache and nausea only
- Drowsiness and dry mouth
Correct answer: Rapid onset of breathing difficulty, swelling of face/throat, hypotension, widespread urticaria (hives), and potential cardiovascular collapse
Anaphylaxis is a life-threatening allergic reaction characterised by rapid onset of airway compromise (swelling, stridor, wheeze), breathing difficulty, cardiovascular collapse (hypotension, tachycardia), and skin changes (urticaria, erythema, angioedema). Adrenaline (epinephrine) is the first-line treatment.
Question 3: What is the correct positioning for a patient who is at risk of aspiration?
- Upright or semi-upright position (30-45 degrees), with the head of bed elevated, especially during and for 30-60 minutes after eating or enteral feeding (Correct answer)
- Flat on their back with no pillow
- Lying on their left side with head down
- Position does not affect aspiration risk
Correct answer: Upright or semi-upright position (30-45 degrees), with the head of bed elevated, especially during and for 30-60 minutes after eating or enteral feeding
Elevating the head of the bed to 30-45 degrees reduces aspiration risk by using gravity to prevent gastric contents from entering the airway. This is particularly important during feeding, for 30-60 minutes after meals, and for patients on enteral feeding or with reduced consciousness.
Question 4: What is the correct technique for wound assessment?
- Assess wound type, size (length, width, depth), bed colour (tissue type), exudate amount and type, wound edges, surrounding skin condition, and signs of infection (Correct answer)
- Only measure the wound's length
- Only look at the wound if the patient reports pain
- Wound assessment is the doctor's responsibility
Correct answer: Assess wound type, size (length, width, depth), bed colour (tissue type), exudate amount and type, wound edges, surrounding skin condition, and signs of infection
Comprehensive wound assessment includes wound type and location, measurements (length × width × depth), wound bed tissue type (granulation, slough, necrotic), exudate (amount, colour, odour), wound edges, surrounding skin, signs of infection, and the patient's pain level.
Question 5: What are the principles of safe moving and handling of patients?
- Assess the patient's mobility, use appropriate equipment, follow the care plan, use correct body mechanics, and never manually lift a patient except in life-threatening emergencies (Correct answer)
- Lift patients manually whenever possible for speed
- Moving and handling equipment is only for very heavy patients
- Only trained physiotherapists should move patients
Correct answer: Assess the patient's mobility, use appropriate equipment, follow the care plan, use correct body mechanics, and never manually lift a patient except in life-threatening emergencies
Safe moving and handling follows a risk assessment approach: assess the patient, task, environment, and handler's capability. Use mechanical aids (hoists, slide sheets, transfer boards) wherever possible. Manual handling should be avoided except in genuine emergencies to prevent injury to both patients and staff.
Question 6: What is the correct procedure for administering a subcutaneous injection?
- Clean the site, pinch the skin to create a fold, insert the needle at a 45-degree angle (or 90 degrees for short needles), inject slowly, release the skin fold, and withdraw (Correct answer)
- Insert the needle at 90 degrees without pinching the skin
- Subcutaneous injections are given into muscle tissue
- Aspirate for blood return before every subcutaneous injection
Correct answer: Clean the site, pinch the skin to create a fold, insert the needle at a 45-degree angle (or 90 degrees for short needles), inject slowly, release the skin fold, and withdraw
Subcutaneous injections are given into the fatty tissue beneath the skin. The skin fold technique (pinch up) helps ensure the needle reaches subcutaneous tissue, not muscle. The angle depends on the needle length and patient's body habitus. Aspiration is no longer routinely recommended for subcutaneous injections.
NMBI Clinical Skills 2
What is the correct procedure for performing urinary catheterisation?