NMC CBT - Nursing and Midwifery Council Computer-Based Test Basic Life Support and Emergency Management 1 — Questions and Answers
Question 1: When performing chest compressions on an adult during CPR, what is the correct compression depth according to Resuscitation Council UK guidelines?
- 2–3 cm
- 3–4 cm
- 5–6 cm (Correct answer)
- 7–8 cm
Correct answer: 5–6 cm
The Resuscitation Council UK specifies that chest compressions should depress the sternum by 5–6 cm in adults. Insufficient depth reduces perfusion to vital organs, while excessive depth risks injury to ribs and internal structures.
Question 2: A patient is found unresponsive and not breathing normally. You have sent for help and an AED. What is the correct compression rate per minute during adult CPR?
- 60–80 compressions per minute
- 80–100 compressions per minute
- 100–120 compressions per minute (Correct answer)
- 120–140 compressions per minute
Correct answer: 100–120 compressions per minute
Resuscitation Council UK guidelines specify a compression rate of 100–120 per minute. Rates below 100 reduce cardiac output and rates above 120 decrease compression quality and depth.
Question 3: During a cardiac arrest in hospital, which team member should ideally take charge of coordinating the resuscitation effort?
- The most senior nurse present
- The first responder who discovered the patient
- The team leader, usually the most experienced clinician present (Correct answer)
- The person operating the defibrillator
Correct answer: The team leader, usually the most experienced clinician present
Effective resuscitation requires a designated team leader who assigns roles, communicates clearly, and makes clinical decisions. This is typically the most experienced clinician present, regardless of profession, not necessarily the first responder.
Question 4: A child aged 8 years is found unresponsive and not breathing. You are alone. After delivering 5 initial rescue breaths, what should you do next if there are no signs of life?
- Immediately call for help before starting compressions
- Begin 30 chest compressions followed by 2 rescue breaths (Correct answer)
- Begin 15 chest compressions followed by 2 rescue breaths
- Apply an AED before starting compressions
Correct answer: Begin 30 chest compressions followed by 2 rescue breaths
When alone with a child in cardiac arrest, after 5 initial rescue breaths, you should perform CPR for approximately 1 minute (using a 30:2 ratio when alone) before leaving to call for help, as paediatric arrests are often hypoxic in origin. Healthcare providers trained in paediatric life support use 15:2 when two rescuers are present, but the lone rescuer uses 30:2.
Question 5: You are caring for a patient who has had a witnessed cardiac arrest. An AED is attached and advises a shock. After delivering the shock, what is the immediate next action?
- Check the patient's carotid pulse for 10 seconds
- Resume CPR immediately starting with chest compressions (Correct answer)
- Wait 2 minutes then re-analyse the heart rhythm
- Administer 1 mg of adrenaline intravenously
Correct answer: Resume CPR immediately starting with chest compressions
After delivering a defibrillation shock, CPR must be resumed immediately starting with chest compressions without pausing for a pulse check. The AED will prompt re-analysis after 2 minutes of CPR. Early uninterrupted compressions are critical for survival.
Question 6: A patient in your care develops a tension pneumothorax during resuscitation. Which clinical sign would most strongly suggest this diagnosis?
- Bilateral equal breath sounds with central cyanosis
- Tracheal deviation away from the affected side with absent breath sounds (Correct answer)
- Tracheal deviation towards the affected side with bronchial breathing
- Widespread wheeze with a raised respiratory rate
Correct answer: Tracheal deviation away from the affected side with absent breath sounds
Tension pneumothorax causes increasing pressure in the pleural space, collapsing the affected lung and shifting the mediastinum. Classic signs include absent breath sounds on the affected side, tracheal deviation away from the affected side, hypotension, and distended neck veins. It is a reversible cause of cardiac arrest (a 4H and 4T cause).
NMC CBT - Nursing and Midwifery Council Computer-Based Test Basic Life Support and Emergency Management 1
When performing chest compressions on an adult during CPR, what is the correct compression depth according to Resuscitation Council UK guidelines?