NMC CBT - Nursing and Midwifery Council Computer-Based Test Physiological Observations and Escalation 1

Question 1

A patient's respiratory rate is 24 breaths per minute. How many NEWS2 points does this score?

Accepted Answer

2 points — moderate concern

Answer

On the NEWS2 chart, a respiratory rate of 21–24 breaths per minute scores 2 points. The normal range (12–20) scores 0; rates of 9–11 score 1; rates ≤8 or ≥25 score 3. A rate of 24 falls in the 21–24 band, which is 2 points.

Question 2

A patient has a recorded temperature of 38.5°C. How many NEWS2 points does this temperature contribute?

Accepted Answer

1 point

Answer

In NEWS2, the temperature band 38.1–39.0°C scores 1 point. Temperatures of 36.1–38.0°C are normal (0 points); ≥39.1°C scores 2 points; and ≤35.0°C scores 3 points. At 38.5°C the patient is in the mildly elevated band.

Question 3

A patient's total aggregated NEWS2 score is 7. Which escalation response does this trigger according to the Royal College of Physicians guidance?

Accepted Answer

Emergency response — continuous monitoring and immediate senior or critical care team review

Answer

A NEWS2 total score of 7 or above triggers an emergency response: the patient must be continuously monitored and an emergency senior clinician or critical care team review must occur immediately. Scores of 5–6 require urgent review; 1–4 require increased monitoring; 0 requires minimum 12-hourly monitoring.

Question 4

A patient who was previously alert is now responding only to voice on the AVPU scale. How many NEWS2 points does their current level of consciousness score?

Accepted Answer

3 points — any deviation from 'Alert' scores the maximum

Answer

In NEWS2, the consciousness parameter scores 0 only if the patient is Alert (A on AVPU). Any deviation — whether Voice (V), Pain (P), or Unresponsive (U), or new confusion — automatically scores 3 points. This reflects how sensitively the system treats any altered level of consciousness.

Question 5

A patient's radial pulse is 112 beats per minute. How many NEWS2 points does this heart rate contribute?

Accepted Answer

2 points

Answer

On the NEWS2 chart the heart rate band 111–130 bpm scores 2 points. The normal range (51–90 bpm) scores 0; 91–110 bpm scores 1; ≥131 bpm scores 3; and ≤40 bpm also scores 3. At 112 bpm the patient falls in the 2-point band.

(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 and Midwifery Council Computer-Based Test Physiological Observations and Escalation 1