NMC CBT Exam — Questions and Answers

Question 1: What is the purpose of NMC revalidation?

To reduce the number of registered nurses
To ensure payment of registration fees
To test clinical knowledge through an exam
To confirm nurses continue meeting NMC standards, remain fit to practise, and engage in ongoing development (Correct answer)

Correct answer: To confirm nurses continue meeting NMC standards, remain fit to practise, and engage in ongoing development

Revalidation is a three-yearly process demonstrating continued competence, CPD engagement, and reflective practice.

Question 2: A patient weighing 72 kg is prescribed a drug at a dose of 5 mg per kg. What is the total dose required in mg?

14.4 mg
77 mg
360 mg (Correct answer)
720 mg

Correct answer: 360 mg

To calculate the total dose, multiply the patient's weight in kg by the prescribed dose per kg. The calculation is 72 kg * 5 mg/kg, which equals 360 mg. This ensures the patient receives a dose appropriate for their body weight.

Question 3: A patient's National Early Warning Score (NEWS2) is 7. According to the standard protocol, which level of response is required?

Increase monitoring only, no clinical review needed
Urgent assessment by the ward team within 30 minutes
Emergency response — immediate review (Correct answer)
Routine scheduled assessment

Correct answer: Emergency response — immediate review

A NEWS2 score of 7 or above triggers an emergency response with immediate review by a clinician competent in managing acute illness.

Question 4: A patient with learning disabilities is admitted. Under the MCA, what must be done before concluding they lack capacity?

Take all practicable steps to help the person make the decision themselves (Correct answer)
Arrange psychiatrist assessment before any treatment
Ask family to decide for them
Assume they lack capacity based on their diagnosis

Correct answer: Take all practicable steps to help the person make the decision themselves

MCA Principle 2: all practicable steps must be taken to help before concluding lack of capacity. A diagnosis alone does not mean lack of capacity.

Question 5: A patient is prescribed morphine 15 mg orally. The syrup available is 10 mg/5 mL. How many mL should be given?

7.5 mL (Correct answer)
10 mL
5 mL
12.5 mL

Correct answer: 7.5 mL

(15 ÷ 10) × 5 = 7.5 mL using the formula: required ÷ stock × volume.

Question 6: Before administering the first feed via a newly inserted nasogastric tube, which method is the GOLD STANDARD for confirming correct tube position?

Confirming position with a chest X-ray (Correct answer)
Auscultating air insufflation over the epigastrium
Checking pH of aspirate is 5.5 or below
Aspirating gastric contents and checking colour

Correct answer: Confirming position with a chest X-ray

A chest X-ray is the gold standard for confirming nasogastric tube position before the first feed, especially when pH aspirate is inconclusive.

Question 7: A nurse sustains a needlestick injury from a patient with unknown HIV status. What is the FIRST action to take?

Test the patient for HIV before any further action
Encourage bleeding and wash the wound thoroughly with soap and water (Correct answer)
Report to occupational health immediately
Apply an occlusive dressing and continue the shift

Correct answer: Encourage bleeding and wash the wound thoroughly with soap and water

The immediate first step is to encourage bleeding and wash the site thoroughly with soap and running water.

Question 8: What do 'professional boundaries' mean in the nurse-patient relationship?

Rules about hospital area access
The limits protecting the space between the nurse's professional power and the patient's vulnerability (Correct answer)
Physical barriers like curtains
Restrictions on patient numbers

Correct answer: The limits protecting the space between the nurse's professional power and the patient's vulnerability

Professional boundaries protect patients from exploitation of the inherent power imbalance in the caring relationship.

Question 9: A patient requires 750 micrograms of digoxin. Tablets available are 250 micrograms each. How many tablets should be administered?

2 tablets
1.5 tablets
3 tablets (Correct answer)
4 tablets

Correct answer: 3 tablets

750 ÷ 250 = 3 tablets.

Question 10: When breaking bad news, which communication framework is recommended for structuring the conversation?

The NEWS2 assessment tool
The ABCDE approach
The SPIKES protocol (Correct answer)
The SBAR framework

Correct answer: The SPIKES protocol

The SPIKES protocol (Setting, Perception, Invitation, Knowledge, Emotions, Strategy/Summary) is widely used for breaking bad news.

Question 11: What is the NMC fitness to practise process and what outcomes can it have?

A formal investigation process that can result in conditions of practice, suspension, or removal from the register (Correct answer)
Annual registration renewal with no sanctions
Only applies to nurses with criminal offences
Voluntary self-assessment with no consequences

Correct answer: A formal investigation process that can result in conditions of practice, suspension, or removal from the register

The FtP process investigates concerns about practice, conduct, or health, with sanctions from caution orders to striking off.

Question 12: A patient lacks capacity and has no LPA or ADRT. A life-saving intervention is needed urgently. Under the MCA 2005, what authorises the clinical team to act?

Consent from the nearest relative
The doctrine of necessity — the MCA section 5 defence allowing acts in connection with care or treatment (Correct answer)
An emergency DoLS authorisation
A verbal agreement from the ward manager

Correct answer: The doctrine of necessity — the MCA section 5 defence allowing acts in connection with care or treatment

MCA 2005 Section 5 provides a legal defence for acts done in connection with care or treatment of a person lacking capacity, provided the person reasonably believes it is in the patient's best interests.

Question 13: Which of the following is an example of a Schedule 2 Controlled Drug under UK legislation?

Tramadol
Temazepam
Morphine (Correct answer)
Codeine linctus

Correct answer: Morphine

Morphine is a Schedule 2 Controlled Drug requiring a special register, full prescribing requirements, and witnessed destruction.

Question 14: What is the correct technique for counting respiratory rate?

Ask the patient to breathe normally, count 30 seconds, multiply by 2
Count for a full 60 seconds without the patient being aware (Correct answer)
Count 15 seconds, multiply by 4, informing the patient
Only count if the patient appears in respiratory distress

Correct answer: Count for a full 60 seconds without the patient being aware

Count for a full 60 seconds for accuracy, ideally without the patient knowing (awareness alters breathing).

Question 15: A patient prescribed digoxin has a resting heart rate of 52 beats per minute. What is the nurse's priority action before administering the dose?

Give half the prescribed dose to reduce the risk of bradycardia
Ask the patient if they feel dizzy before deciding whether to give the drug
Administer the dose as the rate is only slightly below normal
Withhold the dose and inform the prescriber, documenting the decision (Correct answer)

Correct answer: Withhold the dose and inform the prescriber, documenting the decision

Digoxin slows the heart rate and is typically withheld if the apical pulse is below 60 bpm. The nurse must withhold the dose, document the reason, and notify the prescriber for further guidance.

Question 16: A nurse observes redness, pain, and a palpable venous cord at a cannula site. What VIP score is this?

VIP 4 — advanced, re-site and treat
VIP 3 — medium stage, re-site the cannula (Correct answer)
VIP 2 — early stage, consider re-siting
VIP 1 — possible first sign, observe

Correct answer: VIP 3 — medium stage, re-site the cannula

Redness, pain, and a palpable venous cord indicate VIP score 3 (medium stage phlebitis). Re-site and consider treatment.

Question 17: In the context of infection prevention, what does 'standard precautions' assume about every patient?

They pose no risk once tested negative for known pathogens
They require full PPE at all times
They may be infectious regardless of known diagnosis (Correct answer)
They are free of infection unless proven otherwise

Correct answer: They may be infectious regardless of known diagnosis

Standard precautions treat every patient as potentially infectious, protecting staff and patients regardless of diagnosis.

Question 18: A nurse notices a patient's morphine prescription is handwritten and lacks the prescriber's signature. Under NMC standards, what is the correct action?

Contact the prescriber to obtain a valid, signed prescription before administering (Correct answer)
Document the omission and administer on the next shift when the doctor is available
Ask a senior nurse to countersign and administer
Administer the drug if the dose looks clinically appropriate

Correct answer: Contact the prescriber to obtain a valid, signed prescription before administering

An unsigned prescription is legally invalid; the nurse must not administer the medicine and must contact the prescriber to complete the prescription correctly.

Question 19: A patient is identified as at HIGH risk of malnutrition using the MUST tool. Which action is MOST appropriate as an immediate step?

Reassess in one month
Commence parenteral nutrition without dietitian review
Refer to the dietitian and implement a nutritional care plan (Correct answer)
Encourage additional oral snacks without referral

Correct answer: Refer to the dietitian and implement a nutritional care plan

A MUST score of 2 or above (high risk) requires immediate referral to the dietitian and implementation of an individualised nutritional care plan per NICE guidelines.

Question 20: What is the term for a medication that blocks a receptor without activating it, thereby preventing the natural ligand from binding?

Partial agonist
Inverse agonist
Antagonist (Correct answer)
Agonist

Correct answer: Antagonist

An antagonist binds to a receptor and blocks it without producing a biological response, preventing the endogenous ligand or agonist from binding.

Question 21: A nurse suspects a patient is deteriorating but the on-call doctor is not responding appropriately. What should the nurse do?

Accept the doctor's decision and continue monitoring
Escalate concerns using the organisation's escalation policy, including contacting a senior clinician or using a rapid response system (Correct answer)
Document concerns and take no further action until the doctor responds
Wait until the next ward round to raise concerns

Correct answer: Escalate concerns using the organisation's escalation policy, including contacting a senior clinician or using a rapid response system

Nurses have a professional duty to escalate concerns through the chain of command and rapid response systems when a patient's safety is at risk.

Question 22: A patient is prescribed 1.2 g of amoxicillin orally. The pharmacy supplies 500 mg capsules. How many capsules should be administered?

2.4 capsules — query the prescription (Correct answer)
2 capsules
1.2 capsules
3 capsules

Correct answer: 2.4 capsules — query the prescription

1.2 g = 1200 mg. 1200/500 = 2.4. Capsules cannot be divided, so query the prescription with the prescriber.

Question 23: A nurse uses the Waterlow tool. Which factors does it consider?

Build/BMI, skin type, mobility, continence, appetite, and special risks including tissue malnutrition and neurological deficit (Correct answer)
Blood pressure, heart rate, and respiratory rate
Only mobility and nutrition
Only age and weight

Correct answer: Build/BMI, skin type, mobility, continence, appetite, and special risks including tissue malnutrition and neurological deficit

The Waterlow score comprehensively assesses build/BMI, skin type, sex/age, mobility, continence, appetite, and special risk categories.

Question 24: A patient's NEWS2 (National Early Warning Score 2) has increased from 2 to 7 over four hours. What is the most appropriate nursing response?

Document the score and await the next scheduled medical review
Inform the nurse in charge and escalate to a senior clinician urgently (Correct answer)
Continue observations and reassess in two hours as per routine schedule
Administer prescribed PRN analgesia and repeat the score in one hour

Correct answer: Inform the nurse in charge and escalate to a senior clinician urgently

A NEWS2 score of 7 or above indicates a high clinical risk and requires urgent escalation to a senior clinician or rapid response team. Delay in escalation is a common factor in preventable deterioration.

Question 25: The Malnutrition Universal Screening Tool (MUST) includes which three assessment components?

Height, mid-arm circumference, and appetite
Fluid intake, BMI, and mobility
Age, serum albumin, and dietary intake
BMI, recent weight loss, and acute disease effect (Correct answer)

Correct answer: BMI, recent weight loss, and acute disease effect

MUST assesses BMI, unplanned weight loss over 3–6 months, and the acute disease effect score to calculate overall malnutrition risk.

Question 26: When obtaining informed consent, which element is NOT a requirement for valid consent under UK law?

The patient must be provided with sufficient information to make an informed decision
Consent must be given voluntarily without coercion
The patient must sign a written consent form for all procedures (Correct answer)
The patient must have capacity to make the decision

Correct answer: The patient must sign a written consent form for all procedures

Written consent is not always required. Verbal or implied consent can be valid provided the patient has capacity, gives consent voluntarily, and has sufficient information.

Question 27: Which leadership style involves collaborative decision-making with the team?

Autocratic leadership
Transactional leadership
Laissez-faire leadership
Democratic leadership (Correct answer)

Correct answer: Democratic leadership

Democratic leadership involves shared decision-making, team participation, and collaborative working.

Question 28: A patient refuses to communicate with you because of a past negative experience with healthcare staff. What should you do?

Explain that their behavior is not acceptable.
Ignore their behavior and provide care as usual.
Apologize for their past experience and reassure them of your commitment to their care. (Correct answer)
Assign another nurse to their care.

Correct answer: Apologize for their past experience and reassure them of your commitment to their care.

A patient's past negative experiences can significantly impact their trust in healthcare providers. Apologizing for their past experience acknowledges their feelings and validates their concerns, which is a crucial first step in rebuilding trust. Reassuring them of your commitment to their care demonstrates empathy and helps establish a positive therapeutic relationship, essential for effective treatment.

Question 29: A nurse is preparing to give an intramuscular injection of metoclopramide. Which site is most commonly used for IM injections in adults?

Dorsogluteal site
Ventrogluteal site (Correct answer)
Deltoid muscle
Vastus lateralis

Correct answer: Ventrogluteal site

The ventrogluteal site is now the preferred IM injection site in adults due to fewer major blood vessels and nerves, lower infection risk, and larger muscle mass.

Question 30: Which correctly lists the '5 Rights' of medication administration?

Right drug, right dose, right route, right time, right documentation
Right patient, right drug, right dose, right route, right time (Correct answer)
Right patient, right drug, right dose, right reason, right documentation
Right patient, right prescription, right pharmacy, right dose, right time

Correct answer: Right patient, right drug, right dose, right route, right time

The traditional 5 Rights are: right patient, right drug, right dose, right route, and right time.

Question 31: A patient with COPD has an SpO2 of 82%. Which action is MOST appropriate?

Reassure the patient and recheck in one hour
Document and continue current care plan
Apply high-flow oxygen at 15 L/min immediately
Target SpO2 88–92% with controlled oxygen and escalate (Correct answer)

Correct answer: Target SpO2 88–92% with controlled oxygen and escalate

COPD patients risk hypercapnic drive suppression, so oxygen is titrated to 88–92% target and the clinical team alerted.

Question 32: A patient receives another patient's medication by mistake but appears unharmed. How should this be classified?

Automatically a Serious Incident requiring external investigation
Report as a patient safety incident through the local incident reporting system (Correct answer)
Document only in medical notes
No report needed as no harm occurred

Correct answer: Report as a patient safety incident through the local incident reporting system

All medication errors must be reported regardless of outcome. Near-miss data is crucial for prevention.

Question 33: A patient is to receive 20 mmol of potassium in 100 mL over 1 hour. The giving set delivers 20 drops/mL. What is the drip rate in drops/min?

25 drops/min
40 drops/min
50 drops/min
33 drops/min (Correct answer)

Correct answer: 33 drops/min

(100 × 20) ÷ 60 = 2000 ÷ 60 ≈ 33 drops/min.

Question 34: What are the four principles of biomedical ethics (Beauchamp and Childress)?

Care, compassion, competence, communication
Privacy, dignity, respect, equality
Honesty, loyalty, fairness, courage
Autonomy, beneficence, non-maleficence, justice (Correct answer)

Correct answer: Autonomy, beneficence, non-maleficence, justice

Autonomy (self-determination), beneficence (doing good), non-maleficence (avoiding harm), justice (fairness).

Question 35: A nurse discovers a colleague attending work under the influence of alcohol. What action should they take?

Document but take no immediate action
Raise the concern immediately with the line manager to protect patient safety (Correct answer)
Confront privately and ask them to leave without informing management
Cover for the colleague

Correct answer: Raise the concern immediately with the line manager to protect patient safety

The NMC Code requires immediate escalation of concerns when patient safety is at risk.

Question 36: What is the primary purpose of clinical audit?

To evaluate current practice against evidence-based standards and identify improvements (Correct answer)
To discipline underperforming staff
To conduct research and generate new knowledge
To reduce costs by identifying unnecessary treatments

Correct answer: To evaluate current practice against evidence-based standards and identify improvements

Clinical audit measures current practice against defined standards, identifies gaps, implements changes, and re-audits to demonstrate improvement.

Question 37: The NMC Code (2018) has four key themes. Which correctly lists all four?

Assess, Plan, Implement, Evaluate
Diagnose, Treat, Document, Discharge
Prioritise People, Practise Effectively, Preserve Safety, Promote Professionalism and Trust (Correct answer)
Care, Compassion, Competence, Communication

Correct answer: Prioritise People, Practise Effectively, Preserve Safety, Promote Professionalism and Trust

The four themes: Prioritise People, Practise Effectively, Preserve Safety, Promote Professionalism and Trust.

Question 38: When making a best interests decision for an adult who lacks capacity under the Mental Capacity Act 2005, which approach is explicitly prohibited by the Act?

Consulting with family members, carers, and relevant others
Appointing an Independent Mental Capacity Advocate (IMCA) where appropriate
Considering what the person's wishes and feelings might have been when they had capacity
Basing the decision solely on the person's age, appearance, or diagnosis (Correct answer)

Correct answer: Basing the decision solely on the person's age, appearance, or diagnosis

Section 4(1) of the Mental Capacity Act 2005 explicitly states that a person must not make a best interests determination merely on the basis of the person's age, appearance, a condition they have, or an aspect of their behaviour. The Act requires a holistic approach that includes past wishes, values, and consultation with relevant others.

Question 39: When completing a risk assessment for a patient prone to falls, which tool is most commonly used in UK hospital settings?

STRATIFY Falls Risk Assessment Tool (Correct answer)
MUST (Malnutrition Universal Screening Tool)
Waterlow Pressure Ulcer Risk Score
Braden Scale

Correct answer: STRATIFY Falls Risk Assessment Tool

The STRATIFY Falls Risk Assessment Tool is widely used in UK hospitals to identify patients at risk of falls.

Question 40: A patient with dysphagia is assessed by the speech and language therapy team and placed on a modified texture diet. According to the IDDSI framework, which descriptor refers to a smooth, cohesive food that requires no chewing?

Pureed (Correct answer)
Soft and bite-sized
Regular
Minced and moist

Correct answer: Pureed

IDDSI Level 4 (Pureed) describes food that is smooth, uniform, and cohesive with no lumps, requiring no chewing and suitable for patients with severe dysphagia.

Question 41: When re-checking nasogastric tube position during ongoing feeding, what is the recommended first-line method according to NPSA guidelines?

Visual inspection of the tube markings at the nostril
pH testing of gastric aspirate (Correct answer)
Chest X-ray before every feed
Auscultation of air over the epigastrium

Correct answer: pH testing of gastric aspirate

NPSA guidelines recommend pH testing of aspirate as the first-line method for ongoing tube position checks, with pH ≤5.5 confirming gastric placement.

Question 42: A patient's capillary refill time is 5 seconds. What does this suggest?

Normal perfusion
Test was performed incorrectly
Mild dehydration — encourage fluids
Impaired peripheral perfusion — may indicate shock or cardiovascular compromise (Correct answer)

Correct answer: Impaired peripheral perfusion — may indicate shock or cardiovascular compromise

Normal CRT is <2 seconds. A CRT of 5 seconds is significantly prolonged, suggesting impaired perfusion.

Question 43: A patient's cultural beliefs conflict with recommended treatment. How should the nurse approach this?

Insist on the medical treatment
Refer to a nurse who shares their culture
Respect beliefs, provide information, support informed decisions, and document choices (Correct answer)
Ignore cultural beliefs as medically irrelevant

Correct answer: Respect beliefs, provide information, support informed decisions, and document choices

Respect values and beliefs, provide unbiased information, support autonomy in decision-making, and document the discussion.

Question 44: A patient on a general ward is found to have a NEWS2 score of 7. What is the most appropriate immediate action?

Continue routine monitoring every 4 hours
Document the score and reassess in 2 hours
Inform the nurse in charge and consider urgent clinical review (Correct answer)
Administer supplemental oxygen without further assessment

Correct answer: Inform the nurse in charge and consider urgent clinical review

A NEWS2 score of 7 or more indicates high clinical risk requiring urgent clinical review, typically by a team with critical care competencies.

Question 45: A patient has a fluid balance of +800 mL intake and -500 mL output over 24 hours. What is the net fluid balance?

-300 mL
-800 mL
+300 mL (Correct answer)
+1300 mL

Correct answer: +300 mL

Net balance = intake minus output = 800 − 500 = +300 mL.

Question 46: A patient asks you not to disclose their HIV status to their family. What is the correct course of action?

Inform the family as they have a right to know
Respect the patient's wishes and maintain confidentiality unless there is a specific legal obligation to disclose (Correct answer)
Tell the patient they must inform their family
Document the request but inform the GP to tell the family

Correct answer: Respect the patient's wishes and maintain confidentiality unless there is a specific legal obligation to disclose

Patient confidentiality must be maintained under the NMC Code and Data Protection Act. HIV status should not be disclosed without consent unless there is a specific legal duty.

Question 47: A nurse discovers a discrepancy in the controlled drug stock count at the end of a shift. What is the correct immediate action?

Assume a recording error occurred and adjust the register to match the physical stock
Correct the register entry and recount at the start of the next shift
Inform the patient's family in case the drug was taken without authorisation
Report the discrepancy immediately to the senior nurse on duty and document it according to local policy (Correct answer)

Correct answer: Report the discrepancy immediately to the senior nurse on duty and document it according to local policy

Any controlled drug discrepancy must be reported immediately to the senior nurse and documented per local policy. This triggers a formal investigation and may require reporting to the Accountable Officer. Adjusting records without investigation would be a serious breach of governance.

Question 48: Which of the following is the MOST common cause of catheter-associated urinary tract infections (CAUTIs)?:

Streptococcus pyogenes
Escherichia coli (Correct answer)
Staphylococcus aureus
Clostridium perfringens

Correct answer: Escherichia coli

Escherichia coli is the most frequent pathogen responsible for catheter-associated urinary tract infections.

Question 49: A portable O2 cylinder contains 340 litres. At 15 L/min for a 60% Venturi mask, how long will it last?

About 45 minutes
About 15 minutes
About 23 minutes (Correct answer)
About 34 minutes

Correct answer: About 23 minutes

340/15 = 22.67 minutes, approximately 23 minutes.

Question 50: A patient is prescribed gentamicin 5 mg/kg as a single daily dose. The patient weighs 85 kg. Available is gentamicin 80 mg/2 mL. How many mL are required?

12.8 mL
8.5 mL
5.3 mL
10.6 mL (Correct answer)

Correct answer: 10.6 mL

Dose = 5 × 85 = 425 mg; concentration = 40 mg/mL; volume = 425 ÷ 40 = 10.625 ≈ 10.6 mL.

Question 51: A patient is prescribed 750 micrograms (mcg) of digoxin orally. The available tablets contain 250 mcg each. How many tablets should be administered?

4 tablets
5 tablets
2 tablets
3 tablets (Correct answer)

Correct answer: 3 tablets

Using the formula: dose required ÷ dose available = 750 mcg ÷ 250 mcg = 3 tablets.

Question 52: A nurse is caring for a patient with suspected pulmonary TB. Which face mask should the nurse wear?

FFP2 respirator
Standard surgical mask
No mask if the patient is wearing one
FFP3 respirator (Correct answer)

Correct answer: FFP3 respirator

FFP3 respirator masks are required for TB as it is transmitted via airborne droplet nuclei. FFP3 filters 99%+ of particles.

Question 53: During post-resuscitation care, what is the target oxygen saturation for a patient who has achieved return of spontaneous circulation (ROSC)?

100%
90-94%
94-98% (Correct answer)
88-92%

Correct answer: 94-98%

Post-ROSC, oxygen saturation should be titrated to 94-98% to avoid the harmful effects of hyperoxia.

Question 54: Which medication requires regular serum potassium monitoring?

Amoxicillin
Metformin
Paracetamol
Furosemide (Correct answer)

Correct answer: Furosemide

Furosemide is a loop diuretic causing significant potassium loss. Hypokalaemia can cause dangerous cardiac arrhythmias.

Question 55: A patient wishes to make a formal complaint. What is the correct process?

Listen to concerns, provide information about the NHS complaints procedure, and support them (Correct answer)
Inform them they have no right to complain
Dissuade them as it reflects badly on the ward
Tell them complaints can only be made by writing to the Chief Executive

Correct answer: Listen to concerns, provide information about the NHS complaints procedure, and support them

Patients have a legal right to complain. Listen, try to resolve locally, and provide clear information about the formal process and PALS.

Question 56: Which of the following would be considered a 'safe and well check' indicator that a child is being neglected?

A child who has missed one routine dental appointment
A child who is persistently dirty, hungry, wearing inappropriate clothing, and has untreated medical needs (Correct answer)
A child who attends school regularly and has good peer relationships
A child who is shy and quiet in the presence of strangers

Correct answer: A child who is persistently dirty, hungry, wearing inappropriate clothing, and has untreated medical needs

Persistent poor hygiene, hunger, inadequate clothing, and unmet medical needs are classic multi-domain indicators of neglect.

Question 57: A child (approximately 8 years old) is found unresponsive and not breathing normally. At what compression-to-ventilation ratio should CPR be performed by a lone healthcare rescuer?

15:1
30:2
30:1
15:2 (Correct answer)

Correct answer: 15:2

For a child in cardiac arrest, the recommended ratio for healthcare rescuers is 15 compressions to 2 ventilations.

Question 58: What is the purpose of applying firm, continuous cricoid pressure (Sellick's manoeuvre) during emergency intubation?

To prevent laryngospasm during rapid sequence induction
To improve visualisation of the vocal cords by lifting the larynx
To compress the oesophagus and reduce the risk of passive regurgitation (Correct answer)
To stabilise the trachea during tube insertion

Correct answer: To compress the oesophagus and reduce the risk of passive regurgitation

Cricoid pressure compresses the oesophagus against the cervical vertebrae, reducing the risk of gastric regurgitation and pulmonary aspiration.

Question 59: During a handover, a nurse says: 'Mrs Smith is a 72-year-old admitted two days ago with a UTI. She has type 2 diabetes and is on metformin.' Which SBAR component is this?

Background (Correct answer)
Situation
Recommendation
Assessment

Correct answer: Background

This provides the Background component: relevant medical history, context, and current treatment.

Question 60: Warfarin 3.5 mg is prescribed. Tablets come in 0.5 mg and 5 mg strengths. What is the most appropriate combination?

One 5 mg tablet minus 0.5 mg = do not use
One 5 mg and three 0.5 mg tablets — take the 5 mg only
One 0.5 mg tablet and one 5 mg tablet is too much
Seven 0.5 mg tablets (Correct answer)

Correct answer: Seven 0.5 mg tablets

3.5 mg ÷ 0.5 mg = 7 tablets of 0.5 mg is the safest single-strength approach.

Question 61: Which serum electrolyte level, if significantly reduced, is MOST likely to cause muscle weakness and cardiac arrhythmias?

Sodium
Calcium
Potassium (Correct answer)
Magnesium

Correct answer: Potassium

Hypokalaemia (low potassium) impairs cardiac conduction and neuromuscular function, leading to muscle weakness and potentially life-threatening arrhythmias.

Question 62: A patient taking MAOIs (monoamine oxidase inhibitors) asks about dietary restrictions. Which food is most dangerous for this patient?

Mature cheese (e.g., cheddar) (Correct answer)
Boiled vegetables
White rice
Fresh chicken breast

Correct answer: Mature cheese (e.g., cheddar)

Mature cheeses contain high levels of tyramine, which combined with MAOIs can cause a potentially fatal hypertensive crisis.

Question 63: A patient requires 2 L/min of oxygen via nasal cannula to maintain adequate oxygen saturation. How many additional NEWS2 points does receiving supplemental oxygen contribute?

3 points — supplemental oxygen always triggers the maximum score
0 points — only the SpO2 value itself is scored
1 point — a small penalty for low-flow oxygen
2 points — any supplemental oxygen scores 2 points regardless of flow rate (Correct answer)

Correct answer: 2 points — any supplemental oxygen scores 2 points regardless of flow rate

NEWS2 includes a dedicated parameter for supplemental oxygen: if the patient is receiving any supplemental oxygen — regardless of flow rate or device — 2 points are added automatically. If the patient is breathing room air, 0 points are scored. This parameter is separate from and in addition to the SpO2 score.

Question 64: A patient with known penicillin allergy is prescribed amoxicillin. The nurse notices this before administration. What is the correct action?

Ask the patient if they have had reactions before deciding
Withhold the medication, document the allergy, and contact the prescriber immediately (Correct answer)
Give the medication and monitor for allergic reactions
Administer it if the dose is small

Correct answer: Withhold the medication, document the allergy, and contact the prescriber immediately

Administering a medication to a patient with a documented allergy is a serious patient safety risk; the nurse must withhold it and contact the prescriber.

Question 65: You are caring for a patient who does not speak your language. What is the best course of action?

Avoid detailed communication to prevent misunderstandings.
Arrange for a professional interpreter to assist with communication. (Correct answer)
Use hand gestures and facial expressions to communicate.
Ask the patient’s family member to interpret.

Correct answer: Arrange for a professional interpreter to assist with communication.

Accurate and clear communication is paramount for patient safety and effective care, especially when there is a language barrier. Professional interpreters are trained to convey medical information precisely and impartially, ensuring informed consent and accurate symptom assessment. Relying on family members can lead to misunderstandings, bias, or a lack of medical terminology.

Question 66: A nurse discovers they gave the wrong insulin dose. What is the correct sequence of actions?

Complete the incident form first, then inform the patient
Assess the patient immediately, take corrective action, inform the medical team, inform the patient, complete an incident report (Correct answer)
Inform the ward manager and wait for instructions
Administer glucose and document in notes

Correct answer: Assess the patient immediately, take corrective action, inform the medical team, inform the patient, complete an incident report

Patient safety is the immediate priority: assess, correct, escalate, be transparent, then document and report.

Question 67: What is the recommended thermal disinfection temperature for automated washer-disinfectors?

80 degrees C for 1 minute (Correct answer)
65 degrees C for 1 minute
71 degrees C for 3 minutes
90 degrees C for 5 minutes

Correct answer: 80 degrees C for 1 minute

NHS HTM 01-01 guidelines specify minimum 80 degrees C for 1 minute at the load.

Question 68: What isolation precautions are required for a patient with chickenpox (varicella)?

Droplet precautions only
Airborne and contact precautions (Correct answer)
Standard precautions are sufficient
Contact precautions only

Correct answer: Airborne and contact precautions

Varicella requires both airborne and contact precautions due to dual transmission via droplet nuclei and direct contact with vesicle fluid.

Question 69: A child presents with injuries inconsistent with the explanation given. Which injuries raise the highest suspicion of non-accidental injury?

A shin bruise on a walking toddler
A playground graze on the knee
A forehead bruise on a 4-year-old who fell off a bicycle
Multiple bruises of different ages on a non-mobile infant, particularly on non-bony prominences (Correct answer)

Correct answer: Multiple bruises of different ages on a non-mobile infant, particularly on non-bony prominences

Bruises on a non-mobile infant are highly suspicious. 'Those who don't cruise rarely bruise.' Non-bony prominences (ears, neck, buttocks, trunk) are particularly concerning.

Question 70: Convert 0.05 grams to micrograms.

500,000 mcg
5,000 mcg
500 mcg
50,000 mcg (Correct answer)

Correct answer: 50,000 mcg

0.05 g × 1,000 = 50 mg × 1,000 = 50,000 mcg.

Question 71: You are caring for a patient who is receiving intravenous (IV) fluids and develops redness and swelling at the IV insertion site. What is your first action?

Remove the IV and assess for signs of infection. (Correct answer)
Administer pain medication and continue the IV fluids.
Increase the flow rate of the IV fluids.
Apply a warm compress and monitor the site.

Correct answer: Remove the IV and assess for signs of infection.

Redness and swelling at an IV insertion site are signs of potential complications such as phlebitis or infiltration. The immediate and safest action is to remove the IV catheter to prevent further tissue damage or infection. After removal, the site should be assessed for the severity of the complication and appropriate interventions initiated.

Question 72: During a busy shift, a patient asks for assistance, but you are attending to an emergency. What should you do?

Ignore the patient until you complete the emergency task.
Stop attending to the emergency and help the patient immediately.
Ask a colleague to assist the patient while you manage the emergency. (Correct answer)
Inform the patient you are too busy and will come back later.

Correct answer: Ask a colleague to assist the patient while you manage the emergency.

During an emergency, the nurse's primary focus is on the immediate life-threatening situation to ensure patient safety. However, other patients' needs should not be neglected. Delegating the non-emergency task to a colleague ensures that all patients receive timely care while the emergency is effectively managed, demonstrating good teamwork and prioritization skills.

Question 73: After completing a dressing change, a nurse correctly disposes of used instruments into a yellow sharps container. The container is three-quarters full. What action should be taken?

Leave the container unsealed for the next shift
Seal and label the container for collection and replace it with a new one (Correct answer)
Transfer the instruments to a larger container
Continue filling the container until it is completely full

Correct answer: Seal and label the container for collection and replace it with a new one

Sharps containers must be sealed when three-quarters full to prevent needlestick injuries from overfilling.

Question 74: As a nurse, you are tasked with prioritizing patient care in a busy ward. What is the best approach to prioritizing your tasks?

Wait for a colleague to assign tasks to you before beginning work.
Focus on the most critical and time-sensitive tasks first, such as those involving life-threatening conditions. (Correct answer)
Always complete administrative tasks before patient care.
Complete tasks as they arise, without considering urgency.

Correct answer: Focus on the most critical and time-sensitive tasks first, such as those involving life-threatening conditions.

Prioritizing patient care effectively is crucial in a busy ward to ensure patient safety and optimal outcomes. The best approach is to identify and address the most critical and time-sensitive tasks first, especially those involving life-threatening conditions or immediate risks. This systematic approach ensures that patients with urgent needs receive prompt attention, preventing deterioration.

Question 75: According to the Roper-Logan-Tierney model, which is one of the twelve Activities of Living?

Maintaining a safe environment (Correct answer)
Social interaction
Self-actualisation
Financial management

Correct answer: Maintaining a safe environment

Maintaining a safe environment is one of the twelve Activities of Living in the RLT model, widely used in UK nursing.

Question 76: A patient receiving enteral nutrition via nasogastric tube develops a distended abdomen and vomiting. What is the PRIORITY nursing action?

Stop the feed and inform the nurse in charge (Correct answer)
Administer an antiemetic and continue the feed
Increase the rate of the feed
Reposition the patient supine

Correct answer: Stop the feed and inform the nurse in charge

A distended abdomen and vomiting suggest feed intolerance or tube misplacement; stopping the feed and escalating is the immediate priority to prevent aspiration.

Question 77: A patient develops signs of fluid overload. Which combination of findings is MOST consistent with this condition?

Bradycardia, weight loss, and sunken eyes
Hypotension, poor skin turgor, and concentrated urine
Tachycardia, dry mucous membranes, and oliguria
Hypertension, peripheral oedema, and bibasal crackles (Correct answer)

Correct answer: Hypertension, peripheral oedema, and bibasal crackles

Fluid overload presents with hypertension, dependent oedema, and pulmonary oedema signs such as bibasal crackles due to excess intravascular and interstitial fluid.

Question 78: You notice a colleague frequently arrives late for duty and appears unfit to practice. What should you do?

Ignore the behavior, as it does not directly affect you.
Share your observations with other colleagues to confirm your suspicions.
Report your concerns to your manager. (Correct answer)
Confront the colleague and demand an explanation.

Correct answer: Report your concerns to your manager.

As a registered professional, you have a duty to ensure patient safety and uphold professional standards. A colleague appearing unfit to practice poses a potential risk to patients and the quality of care. Reporting your concerns to your manager is the appropriate action to ensure the situation is addressed formally and safely, protecting both patients and the colleague.

Question 79: A patient is prescribed adrenaline (epinephrine) 1:1000 for anaphylaxis. What does the concentration 1:1000 mean?

1 mg per 100 mL
0.1 mg per mL
1 g per 100 mL
1 g per 1000 mL (1 mg per mL) (Correct answer)

Correct answer: 1 g per 1000 mL (1 mg per mL)

1:1000 means 1 gram in 1000 mL, which equals 1 mg per mL; this is the standard concentration used for intramuscular anaphylaxis treatment.

Question 80: A patient who lacks capacity has a registered Lasting Power of Attorney (LPA) for Property and Financial Affairs held by their son. The son attends the ward and states he wishes to consent to his father's upcoming surgical procedure. What should the nurse advise?

The son must obtain a separate court order before consenting to medical treatment
The son may consent as he holds a registered LPA
A Property and Financial Affairs LPA does not cover healthcare decisions; only a Health and Welfare LPA grants this authority (Correct answer)
The nurse can accept the son's consent provided two clinicians agree it is in the patient's best interests

Correct answer: A Property and Financial Affairs LPA does not cover healthcare decisions; only a Health and Welfare LPA grants this authority

There are two types of LPA under the Mental Capacity Act 2005: Property and Financial Affairs, and Health and Welfare. Only a Health and Welfare LPA, when registered and activated, grants an attorney the authority to make decisions about medical treatment. A Property and Financial Affairs LPA is strictly limited to financial matters.

Question 81: A nurse needs to prepare a 1:1000 adrenaline solution. What concentration does this represent in mg/mL?

10 mg/mL
0.1 mg/mL
1 mg/mL (Correct answer)
0.01 mg/mL

Correct answer: 1 mg/mL

1:1000 means 1 g in 1000 mL = 1000 mg in 1000 mL = 1 mg/mL.

Question 82: A nurse uses the SBAR tool to hand over a deteriorating patient. What does the 'R' in SBAR stand for?

Recommendation (Correct answer)
Review
Report
Response

Correct answer: Recommendation

In SBAR, 'R' stands for Recommendation, where the nurse states what they believe should happen next.

Question 83: What is the legal significance of the 'zone of parental control' in the context of the Mental Health Act for patients under 18?

Parental consent can only authorise an informal admission if it falls within the zone of parental control and the child does not object (Correct answer)
Parents have unlimited authority to make all decisions for children under 16
The MHA cannot apply to anyone under 18
Parents can admit children to psychiatric units without any legal authority if they consent

Correct answer: Parental consent can only authorise an informal admission if it falls within the zone of parental control and the child does not object

Parental consent can authorise informal admission of a minor to a psychiatric unit only if the decision falls within the zone of parental control and the child does not competently object.

Question 84: An adult patient weighing 70 kg has a normal daily urine output. Which volume is within the expected range?

400–600 mL/day
2500–3500 mL/day
800–2000 mL/day (Correct answer)
200–400 mL/day

Correct answer: 800–2000 mL/day

Normal adult urine output is approximately 0.5–1 mL/kg/hr, equating to roughly 800–2000 mL per day for a 70 kg adult.

Question 85: Which are the classic signs of wound infection?

Erythema, warmth, swelling, pain, and purulent discharge (Correct answer)
Reduced sensation and numbness
Bruising and haematoma only
Pallor, coolness, and dry wound edges

Correct answer: Erythema, warmth, swelling, pain, and purulent discharge

Based on the cardinal signs of inflammation: redness, warmth, swelling, pain, plus purulent discharge. Systemic signs include pyrexia.

Question 86: A patient with hearing impairment is admitted. Which communication strategy is most appropriate?

Shout clearly so the patient can hear
Write everything down instead of attempting verbal communication
Face the patient directly, speak clearly at normal volume, and reduce background noise (Correct answer)
Speak to the patient's family member instead

Correct answer: Face the patient directly, speak clearly at normal volume, and reduce background noise

Facing the patient allows lip-reading, speaking clearly at normal volume prevents distortion, and reducing background noise improves hearing.

Question 87: A nurse suspects elderly patient financial abuse by a family member. Under the Care Act 2014, what is their legal duty?

Discuss with the family member first
Report to police immediately without informing others
Document and wait for more evidence
Raise a safeguarding concern with the local authority (Correct answer)

Correct answer: Raise a safeguarding concern with the local authority

The Care Act 2014 Section 42 requires raising safeguarding concerns with the local authority when there is reasonable cause to suspect abuse or neglect.

Question 88: A patient asks to see their medical records. Under the Data Protection Act 2018, what is their right?

Only records over 5 years old
Patients have a legal right through a Subject Access Request (Correct answer)
Patients have no right to access records
Only if a doctor approves

Correct answer: Patients have a legal right through a Subject Access Request

Under UK GDPR, patients can make a Subject Access Request, which must be responded to within one month, free of charge.

Question 89: A nurse uses the BMI formula to assess a patient's nutritional status. Which BMI range indicates underweight in an adult?

18.5–24.9 kg/m²
25–29.9 kg/m²
30 kg/m² or above
Less than 18.5 kg/m² (Correct answer)

Correct answer: Less than 18.5 kg/m²

A BMI below 18.5 kg/m² is classified as underweight according to standard WHO and NICE guidelines used in clinical nutritional screening.

Question 90: A patient with limited English proficiency is admitted. According to NMC standards, what is the most appropriate approach for effective communication?

Use professional interpreter services for all significant clinical conversations (Correct answer)
Ask a family member to interpret during clinical discussions
Use medical terminology as it is more universal
Speak slowly and loudly to help the patient understand

Correct answer: Use professional interpreter services for all significant clinical conversations

Professional interpreter services should be used for significant clinical conversations to ensure accurate, confidential, and unbiased communication.

Question 91: A ward sister notices that alcohol hand rub dispensers near patient beds are frequently empty. What is the MOST appropriate immediate action?

Accept the situation until the next scheduled stock delivery
Report the stock shortage and ensure dispensers are promptly refilled to support compliance (Correct answer)
Remove the empty dispensers to avoid confusion
Instruct staff to use soap and water instead for all hand hygiene

Correct answer: Report the stock shortage and ensure dispensers are promptly refilled to support compliance

Ensuring continuous availability of hand hygiene products is a fundamental infrastructure requirement for infection prevention compliance.

Question 92: Which urine output threshold over 1 hour in an adult indicates oliguria and should trigger escalation?

Less than 2 mL/kg/hour
Less than 1 mL/kg/hour
Less than 0.5 mL/kg/hour (Correct answer)
Less than 30 mL total regardless of weight

Correct answer: Less than 0.5 mL/kg/hour

Oliguria is defined as urine output below 0.5 mL/kg/hour, which may indicate renal impairment or poor perfusion.

Question 93: Which of the following best describes 'Never Events' in the context of UK patient safety?

Minor adverse events that rarely recur
Events that are never reported to NHS England
Serious, largely preventable incidents that should never occur if safeguards are followed (Correct answer)
Medication errors that are unavoidable in clinical practice

Correct answer: Serious, largely preventable incidents that should never occur if safeguards are followed

Never Events are serious, largely preventable patient safety incidents that should not occur if established preventive measures are implemented.

Question 94: A non-touch technique (NTT) is used during wound dressing changes primarily to:

Reduce procedure time
Ensure patient comfort
Prevent the introduction of microorganisms into a susceptible site (Correct answer)
Eliminate the need for gloves

Correct answer: Prevent the introduction of microorganisms into a susceptible site

Non-touch technique prevents direct or indirect contact between non-sterile surfaces and the susceptible wound site.

Question 95: When performing a risk assessment for isolation of a patient with suspected Neisseria meningitidis meningitis, which precaution type should be added to standard precautions?

Enteric precautions
Contact precautions
Droplet precautions (Correct answer)
Airborne precautions

Correct answer: Droplet precautions

Meningococcal meningitis/septicaemia requires droplet precautions as N. meningitidis is spread via large respiratory droplets.

Question 96: Under the Mental Capacity Act 2005, what is the correct standard of proof required to determine that an adult lacks capacity?

Beyond reasonable doubt
On the balance of probabilities (Correct answer)
A reasonable clinical opinion is sufficient
Unanimous agreement by the care team

Correct answer: On the balance of probabilities

The Mental Capacity Act 2005 uses the civil standard of 'balance of probabilities' when assessing whether an individual lacks capacity.

Question 97: A patient discloses ongoing domestic abuse but explicitly requests that the nurse keep all information confidential. What is the most appropriate response?

Share the information immediately with all members of the multidisciplinary team without further discussion
Honour the patient's request entirely and make no further disclosure
Take no action until the patient provides written consent to share information
Explain the limits of confidentiality, then share information without consent only where there is serious risk of significant harm, following Caldicott Principles and the NMC Code (Correct answer)

Correct answer: Explain the limits of confidentiality, then share information without consent only where there is serious risk of significant harm, following Caldicott Principles and the NMC Code

Confidentiality is not absolute in safeguarding. The NMC Code and Caldicott Principles permit — and in some cases require — disclosure without consent when there is a serious risk of significant harm to the individual or others. The nurse must first explain these limits to the patient and act proportionately to the level of risk identified.

Question 98: A patient appears anxious and avoids eye contact during your conversation. What should you do?

Gently ask them if they feel comfortable discussing their concerns. (Correct answer)
End the conversation to avoid making them more anxious.
Speak louder to ensure they hear you clearly.
Continue speaking without acknowledging their behavior.

Correct answer: Gently ask them if they feel comfortable discussing their concerns.

Recognizing non-verbal cues like anxiety and avoidance of eye contact is crucial for effective therapeutic communication. Gently asking the patient if they are comfortable or have concerns demonstrates empathy and creates a safe space for them to express themselves. This approach helps build trust and facilitates open communication, which is essential for patient-centered care.

Question 99: A nurse discovers a patient in anaphylaxis. What is the first-line drug treatment and its route of administration?

Hydrocortisone 200 mg IV
Adrenaline 500 micrograms IM (1:1000) (Correct answer)
Chlorphenamine 10 mg IM
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.

Question 100: Methotrexate is prescribed at 12.5 mg/m² for a patient with a body surface area of 1.6 m². What is the total dose?

20 mg (Correct answer)
22 mg
25 mg
18 mg

Correct answer: 20 mg

12.5 × 1.6 = 20 mg.

Question 101: A colleague speaks harshly to a patient in your presence. How should you respond?

Speak to your manager after your shift without addressing the colleague.
Address the issue immediately and professionally with your colleague. (Correct answer)
Apologize to the patient and report the incident later.
Ignore the situation, as it is not your responsibility.

Correct answer: Address the issue immediately and professionally with your colleague.

Witnessing unprofessional behavior towards a patient requires immediate intervention to protect the patient and uphold professional standards. Addressing the issue directly and professionally with your colleague demonstrates accountability and ensures the patient's dignity is respected. This immediate action is crucial, followed by further reporting if the behavior persists or is severe.

Question 102: Which of the following actions best demonstrates adherence to the 'clean your hands' campaign in preventing healthcare-associated infections (HCAIs)?

Performing hand hygiene consistently at all five WHO moments using soap/water or alcohol gel (Correct answer)
Using hand sanitiser only at the start and end of each shift
Wearing gloves at all times instead of washing hands
Washing hands only after direct patient contact

Correct answer: Performing hand hygiene consistently at all five WHO moments using soap/water or alcohol gel

Consistent adherence to all five WHO hand hygiene moments is the single most effective measure to prevent HCAIs.

Question 103: A healthcare worker sustains a needlestick injury. What is the correct sequence of immediate actions?

Apply a dressing and attend occupational health next day
Wash, take patient's blood for testing, start post-exposure prophylaxis
Squeeze the wound, apply antiseptic, inform manager within 24 hours
Encourage bleeding, wash with soap and running water, report immediately, attend A&E/occupational health urgently (Correct answer)

Correct answer: Encourage bleeding, wash with soap and running water, report immediately, attend A&E/occupational health urgently

Encourage bleeding under running water, wash with soap (not antiseptic), report through the incident system, attend occupational health or A&E urgently.

Question 104: Which values form the 6Cs of nursing?

Consent, Confidentiality, Capacity, Competence, Communication, Collaboration
Clinical, Competence, Communication, Coordination, Compliance, Certification
Caring, Cleaning, Cooking, Comforting, Counselling, Curing
Care, Compassion, Competence, Communication, Courage, Commitment (Correct answer)

Correct answer: Care, Compassion, Competence, Communication, Courage, Commitment

The 6Cs: Care, Compassion, Competence, Communication, Courage, Commitment.

Question 105: A patient develops anaphylaxis after IV antibiotic administration. Which drug is the FIRST priority treatment?

IV chlorphenamine 10mg
IV salbutamol 250 micrograms
IM adrenaline 0.5mg (1:1000) (Correct answer)
IV hydrocortisone 200mg

Correct answer: IM adrenaline 0.5mg (1:1000)

IM adrenaline 0.5mg (1:1000) into the anterolateral thigh is the first-line treatment for anaphylaxis.

Question 106: A patient's total aggregated NEWS2 score is 7. Which escalation response does this trigger according to the Royal College of Physicians guidance?

Urgent review by a senior clinical decision-maker within 30 minutes
Minimum 4–6 hourly monitoring with a nurse review
Minimum 12-hourly monitoring with routine medical review
Emergency response — continuous monitoring and immediate senior or critical care team review (Correct answer)

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

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 107: You are explaining a treatment plan to a patient, but they seem confused and ask the same questions repeatedly. What should you do?

Repeat the information using simpler terms and visual aids if necessary. (Correct answer)
Tell the patient to read the information leaflet provided.
Ask a colleague to explain instead.
Ignore their questions and proceed with the treatment plan.

Correct answer: Repeat the information using simpler terms and visual aids if necessary.

Effective patient education requires ensuring the patient fully understands their treatment plan. When a patient appears confused and asks repeated questions, it indicates a need to adjust communication strategies. Repeating information using simpler terms, different analogies, or visual aids helps to clarify complex concepts and ensures the patient can make informed decisions about their care.

Question 108: Heparin 25,000 units in 50 mL NaCl to run at 1,200 units/hour. What rate should the syringe pump be set to?

2.0 mL/hr
1.8 mL/hr
3.0 mL/hr
2.4 mL/hr (Correct answer)

Correct answer: 2.4 mL/hr

Concentration = 25000/50 = 500 units/mL. Rate = 1200/500 = 2.4 mL/hr.

Question 109: A patient's oxygen saturation drops to 90% while receiving 2L/min of oxygen via nasal cannula. Which immediate action is most appropriate?

Document the finding and reassess in 30 minutes
Remove the nasal cannula and apply a non-rebreather mask immediately
Increase oxygen flow rate and reassess, then escalate if no improvement (Correct answer)
Call for emergency assistance before making any adjustments

Correct answer: Increase oxygen flow rate and reassess, then escalate if no improvement

Increasing the oxygen delivery and reassessing is the first response to mild hypoxaemia, followed by escalation if saturation does not improve.

Question 110: Where should the V4 electrode be placed for a 12-lead ECG?

5th intercostal space, midclavicular line (Correct answer)
Left sternal edge, 4th intercostal space
Right sternal edge, 4th intercostal space
5th intercostal space, anterior axillary line

Correct answer: 5th intercostal space, midclavicular line

V4: 5th intercostal space, left midclavicular line. It is the reference point for V3, V5, and V6.

Question 111: In which patient are compression stockings contraindicated?

Patient with BMI 30
Severe peripheral arterial disease (ABPI <0.5) (Correct answer)
Fully mobile patient
Post hip replacement

Correct answer: Severe peripheral arterial disease (ABPI <0.5)

Compression stockings are contraindicated in severe PAD as external compression can further compromise arterial blood supply.

Question 112: A patient is prescribed Total Parenteral Nutrition (TPN). Which vascular access route is MOST appropriate for long-term TPN administration?

Central venous catheter (Correct answer)
Peripheral cannula in the forearm
Arterial line
Intraosseous needle

Correct answer: Central venous catheter

TPN is a hypertonic solution that must be administered via a central venous catheter to avoid peripheral vein damage and thrombophlebitis.

Question 113: Which body fluid compartment contains approximately two-thirds of the body's total water content?

Interstitial compartment
Transcellular compartment
Intravascular compartment
Intracellular compartment (Correct answer)

Correct answer: Intracellular compartment

Approximately 67% (two-thirds) of total body water is located within cells in the intracellular compartment, with the remaining third in extracellular spaces.

Question 114: A patient is prescribed 120 mg of paracetamol suspension. The stock available is 250 mg in 5 mL. What volume in mL should you administer?

2.4 mL (Correct answer)
2.0 mL
5.2 mL
4.8 mL

Correct answer: 2.4 mL

The formula to use is (What you want / What you've got) x Volume it comes in. This translates to (120 mg / 250 mg) * 5 mL. This calculation equals 2.4 mL.

Question 115: You are about to perform a procedure on a patient and need to obtain consent. What should you do?

Obtain verbal consent before proceeding with the procedure.
Proceed with the procedure without consent if it is an emergency.
Obtain consent from the patient's family member if the patient is unable to provide consent.
Ensure the patient fully understands the procedure, risks, and benefits, and obtain written consent if necessary. (Correct answer)

Correct answer: Ensure the patient fully understands the procedure, risks, and benefits, and obtain written consent if necessary.

Informed consent is a fundamental ethical and legal principle in healthcare, ensuring patient autonomy. It requires the patient to fully understand the procedure, including its purpose, potential risks, benefits, and available alternatives, before agreeing to it. The nurse's role is to ensure this understanding and obtain appropriate consent, often written for invasive procedures, to protect the patient's rights.

Question 116: A patient from a minority ethnic background expresses concerns about discrimination during their hospital stay. What should you do?

Ignore their concerns unless a formal complaint is made.
Acknowledge their concerns and report them to the relevant department. (Correct answer)
Reassure them there is no discrimination in the hospital.
Advise them to speak directly to the hospital management.

Correct answer: Acknowledge their concerns and report them to the relevant department.

Nurses are advocates for their patients and must ensure they receive equitable care free from discrimination. Acknowledging the patient's concerns validates their experience and demonstrates empathy. Reporting these concerns to the relevant department ensures that the issue can be formally investigated and addressed, upholding the hospital's commitment to inclusive and respectful care.

Question 117: A nurse notices a colleague's social media post identifying a patient by first name and describing their condition. What should they do?

Ignore it as social media is personal
Like the post to show support
Comment asking for a disclaimer
Report to line manager and advise the colleague to remove the post immediately (Correct answer)

Correct answer: Report to line manager and advise the colleague to remove the post immediately

Sharing identifiable patient information on social media breaches the NMC Code, Data Protection Act, and common law confidentiality.

NMC CBT Exam

The NMC Computer Based Test (CBT) is a two-part exam administered by the Nursing and Midwifery Council for internationally trained nurses and nursing associates seeking registration in the UK. It assesses numeracy skills and clinical nursing competence.

115

Questions

180 min

Time Limit

68%

To Pass

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