NMBI Clinical Skills — Questions and Answers
Question 1: When performing a vital signs assessment, which parameters should be measured and recorded?
- Temperature, pulse rate, respiratory rate, blood pressure, oxygen saturation, and level of consciousness (Correct answer)
- Only temperature and blood pressure
- Only pulse rate and respiratory rate
- Weight and height only
Correct answer: Temperature, pulse rate, respiratory rate, blood pressure, oxygen saturation, and level of consciousness
A comprehensive vital signs assessment includes temperature, pulse (rate, rhythm, strength), respiratory rate (counted for 60 seconds), blood pressure (systolic and diastolic), oxygen saturation (SpO2), and level of consciousness (AVPU or GCS). All findings are recorded on the NEWS chart.
Question 2: What is the correct hand hygiene technique according to WHO guidelines?
- Wet hands, apply soap, rub palm to palm, interlace fingers, rub backs of hands, thumbs, fingertips, and wrists for at least 20 seconds, then rinse and dry (Correct answer)
- Quickly rinse hands under water for 5 seconds
- Only use hand sanitiser — soap is not necessary
- Wash hands only before meals
Correct answer: Wet hands, apply soap, rub palm to palm, interlace fingers, rub backs of hands, thumbs, fingertips, and wrists for at least 20 seconds, then rinse and dry
The WHO 6-step hand hygiene technique ensures all hand surfaces are cleaned: palm to palm, right palm over left dorsum and vice versa, palm to palm with fingers interlaced, backs of fingers, thumbs, and fingertips. The entire process should take at least 20 seconds.
Question 3: What is the purpose of the Glasgow Coma Scale (GCS)?
- To assess and quantify the level of consciousness by evaluating eye opening, verbal response, and motor response (Correct answer)
- To measure pain levels
- To assess respiratory function
- To determine blood glucose levels
Correct answer: To assess and quantify the level of consciousness by evaluating eye opening, verbal response, and motor response
The GCS scores three components: eye opening (1-4), verbal response (1-5), and motor response (1-6), giving a total score of 3-15. A score of 15 indicates full consciousness, while 3 indicates deep unconsciousness. It is used to monitor neurological status over time.
Question 4: What is the correct technique for measuring blood pressure manually?
- Apply the cuff to the upper arm at heart level, palpate the brachial artery, inflate above expected systolic, slowly deflate while listening with a stethoscope for Korotkoff sounds (Correct answer)
- Place the cuff on the wrist and listen at the elbow
- Inflate the cuff as quickly as possible and release suddenly
- The patient should be standing and the cuff placed over clothing
Correct answer: Apply the cuff to the upper arm at heart level, palpate the brachial artery, inflate above expected systolic, slowly deflate while listening with a stethoscope for Korotkoff sounds
The patient should be seated with arm supported at heart level. The correctly-sized cuff is applied to bare skin on the upper arm. Inflate 20-30 mmHg above estimated systolic, then deflate slowly (2-3 mmHg per second) while listening for Korotkoff sounds at the brachial artery.
Question 5: What is aseptic technique and when should it be used?
- A method of performing clinical procedures in a way that minimises the introduction of micro-organisms; used for wound care, catheterisation, IV access, and other invasive procedures (Correct answer)
- A cleaning method used only in operating theatres
- A way of washing hands before meals
- A technique only used by surgeons
Correct answer: A method of performing clinical procedures in a way that minimises the introduction of micro-organisms; used for wound care, catheterisation, IV access, and other invasive procedures
Aseptic technique (including ANTT — Aseptic Non-Touch Technique) is used whenever there is a risk of introducing micro-organisms into a susceptible body site. This includes wound care, urinary catheterisation, IV cannulation, and any procedure that breaches the skin or accesses a sterile area.
Question 6: How should a nurse assess and document pain?
- Use a validated pain assessment tool, assess location, intensity, quality, duration, and aggravating/relieving factors, and reassess after intervention (Correct answer)
- Ask the patient if they are in pain and record 'yes' or 'no'
- Only assess pain when the patient complains
- Pain assessment is only necessary before surgery
Correct answer: Use a validated pain assessment tool, assess location, intensity, quality, duration, and aggravating/relieving factors, and reassess after intervention
Pain assessment should use validated tools (e.g., numerical rating scale 0-10, Wong-Baker faces scale). Assess PQRST: Provocation/palliation, Quality, Region/radiation, Severity, Timing. Document the assessment and reassess after interventions to evaluate effectiveness.
NMBI Clinical Skills
When performing a vital signs assessment, which parameters should be measured and recorded?