NMC CBT NMC-CBT Patient Safety and Risk Assessment 2 — Questions and Answers
Question 1: 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
- Inform the nurse in charge and consider urgent clinical review (Correct answer)
- Administer supplemental oxygen without further assessment
- Document the score and reassess in 2 hours
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 2: Which of the following best describes 'Never Events' in the context of UK patient safety?
- Minor adverse events that rarely recur
- Serious, largely preventable incidents that should never occur if safeguards are followed (Correct answer)
- Events that are never reported to NHS England
- 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 3: When completing a risk assessment for a patient prone to falls, which tool is most commonly used in UK hospital settings?
- Braden Scale
- MUST (Malnutrition Universal Screening Tool)
- STRATIFY Falls Risk Assessment Tool (Correct answer)
- Waterlow Pressure Ulcer Risk Score
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 4: A nurse discovers a colleague has made a medication error but has not reported it. What should the nurse do first?
- Cover for the colleague to protect the team
- Immediately report the error through the incident reporting system and inform the line manager (Correct answer)
- Discuss it privately with the colleague and advise them to be more careful
- Wait to see if the patient develops any adverse effects before acting
Correct answer: Immediately report the error through the incident reporting system and inform the line manager
The NMC Code requires nurses to act immediately to put right any harm caused and report errors openly; covering up errors is a serious breach of professional duty.
Question 5: Which of the following is a key principle of the 'Five Steps to Safer Surgery' checklist used in UK operating theatres?
- Sign In, Time Out, and Sign Out at defined stages of the procedure (Correct answer)
- Completing documentation after the patient leaves theatre
- Checking equipment only before the patient arrives
- Verbal confirmation of patient identity without written verification
Correct answer: Sign In, Time Out, and Sign Out at defined stages of the procedure
The WHO Surgical Safety Checklist (Five Steps to Safer Surgery) involves Sign In before anaesthesia, Time Out before incision, and Sign Out before the patient leaves theatre.
Question 6: A patient with known penicillin allergy is prescribed amoxicillin. The nurse notices this before administration. What is the correct action?
- Administer it if the dose is small
- Withhold the medication, document the allergy, and contact the prescriber immediately (Correct answer)
- Ask the patient if they have had reactions before deciding
- Give the medication and monitor for allergic reactions
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 7: What does the term 'duty of candour' require of registered nurses in the UK?
- Keeping clinical errors confidential to maintain patient confidence
- Being open and honest with patients when something goes wrong that causes harm (Correct answer)
- Only disclosing errors when directly asked by the patient or family
- Informing managers but not patients about adverse events
Correct answer: Being open and honest with patients when something goes wrong that causes harm
The Duty of Candour (Regulation 20, Health and Social Care Act 2008) requires healthcare providers to be open and honest with patients when things go wrong.
NMC CBT NMC-CBT Patient Safety and Risk Assessment 2
A patient on a general ward is found to have a NEWS2 score of 7.
What is the most appropriate immediate action?