NMC CBT Basic Life Support and Emergency Management 2 — Questions and Answers
Question 1: When performing cardiopulmonary resuscitation (CPR) on an adult, what is the correct compression-to-ventilation ratio according to the Resuscitation Council UK guidelines?
- 15:2
- 30:2 (Correct answer)
- 15:1
- 30:1
Correct answer: 30:2
The Resuscitation Council UK recommends a 30:2 compression-to-ventilation ratio for adult CPR.
According to the Resuscitation Council UK guidelines, adult basic life support requires a ratio of 30 chest compressions to 2 rescue breaths. Compressions should be performed at a rate of 100-120 per minute and to a depth of 5-6 cm. The 15:2 ratio is used for paediatric resuscitation with two healthcare professionals.
Question 2: A patient on your ward suddenly becomes unresponsive. After confirming unresponsiveness and calling for help, what is the next step in the adult BLS algorithm?
- Begin chest compressions immediately
- Open the airway using head tilt-chin lift (Correct answer)
- Attach an automated external defibrillator (AED)
- Check the patient's pulse for 10 seconds
Correct answer: Open the airway using head tilt-chin lift
After confirming unresponsiveness and calling for help, the next step is to open the airway using the head tilt-chin lift manoeuvre, then look, listen, and feel for normal breathing.
The Resuscitation Council UK adult BLS algorithm follows: ensure safety, check responsiveness, shout for help, open the airway (head tilt-chin lift), then assess breathing by looking, listening, and feeling for up to 10 seconds. If the patient is not breathing normally, call 2222, start CPR with 30 compressions, and arrange for an AED.
Question 3: Which of the following is the correct action when using an AED and the device advises 'no shock indicated'?
- Reposition the pads and reanalyse
- Begin chest compressions immediately (Correct answer)
- Check for a pulse before continuing
- Switch off the AED and continue ventilations only
Correct answer: Begin chest compressions immediately
When the AED advises no shock, the rescuer should immediately resume CPR starting with chest compressions for 2 minutes before the AED reanalyses.
When an AED indicates 'no shock advised', the rhythm is not shockable (asystole or pulseless electrical activity). The correct response is to immediately resume CPR starting with chest compressions for 2 minutes. After 2 minutes, the AED will reanalyse. Minimising interruptions to chest compressions is critical for survival.
Question 4: A nurse discovers a patient in anaphylaxis. What is the first-line drug treatment and its route of administration?
- Hydrocortisone 200 mg IV
- Chlorphenamine 10 mg IM
- Adrenaline 500 micrograms IM (1:1000) (Correct answer)
- Salbutamol 5 mg nebulised
Correct answer: Adrenaline 500 micrograms IM (1:1000)
Adrenaline 500 micrograms (0.5 ml of 1:1000) given intramuscularly into the outer mid-thigh is the first-line treatment for anaphylaxis in adults.
According to the Resuscitation Council UK anaphylaxis guidelines, intramuscular adrenaline is the first-line treatment. The adult dose is 500 micrograms IM (0.5 ml of 1:1000 solution), injected into the anterolateral mid-thigh. It can be repeated every 5 minutes if no improvement. IV adrenaline is only for experienced specialists. Hydrocortisone and chlorphenamine are second-line.
Question 5: When using the ABCDE approach to assess a deteriorating patient, what does the 'D' component specifically assess?
- Dehydration status and fluid balance
- Disability including neurological assessment (Correct answer)
- Drug administration and medication review
- Documentation of vital signs
Correct answer: Disability including neurological assessment
In the ABCDE approach, 'D' stands for Disability and involves a rapid neurological assessment including AVPU or Glasgow Coma Scale, pupil reactions, and blood glucose levels.
The ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) is systematic for assessing acutely ill patients. 'D' stands for Disability and includes: AVPU or Glasgow Coma Scale assessment; pupil size and reactivity; blood glucose measurement; and medication review. This helps identify neurological emergencies requiring urgent intervention.
Question 6: A patient's National Early Warning Score (NEWS2) is 7 or above. According to NHS escalation protocols, what level of response is required?
- Increase monitoring frequency to every 4 hours
- Inform the nurse in charge and increase monitoring to hourly
- Urgent clinical review by a team with critical care competencies (Correct answer)
- Routine medical review within 12 hours
Correct answer: Urgent clinical review by a team with critical care competencies
A NEWS2 score of 7 or above triggers an emergency response, requiring urgent clinical review by a team with critical care competencies, including airway management skills.
NEWS2 aggregate scores determine clinical response urgency: 0 = routine monitoring; 1-4 (low) = registered nurse assessment; 5-6 (medium) or single parameter score of 3 = urgent review by clinician with acute illness competencies; 7+ (high) = emergency response from a team with critical care competencies, indicating potential or established organ failure.
NMC CBT Basic Life Support and Emergency Management 2
When performing cardiopulmonary resuscitation (CPR) on an adult, what is the correct compression-to-ventilation ratio according to the Resuscitation Council UK guidelines?