NMC CBT NMC-CBT Patient Safety and Risk Assessment 3 — Questions and Answers
Question 1: 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
- Increase oxygen flow rate and reassess, then escalate if no improvement (Correct answer)
- Remove the nasal cannula and apply a non-rebreather mask immediately
- 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 2: In the context of infection prevention, what does 'contact precautions' specifically require?
- Wearing a respirator mask when within 1 metre of the patient
- Use of gloves and apron before entering the patient's environment (Correct answer)
- Placing the patient in a positive pressure room
- Restricting all visitors regardless of symptoms
Correct answer: Use of gloves and apron before entering the patient's environment
Contact precautions require staff to wear gloves and apron before entering the patient environment to prevent transmission via direct or indirect contact.
Question 3: When performing a manual handling risk assessment, which framework is commonly used in UK healthcare?
- TILE (Task, Individual, Load, Environment) (Correct answer)
- SBAR (Situation, Background, Assessment, Recommendation)
- ABCDE (Airway, Breathing, Circulation, Disability, Exposure)
- RADAR (Recognize, Alert, Document, Act, Review)
Correct answer: TILE (Task, Individual, Load, Environment)
The TILE framework assesses Task, Individual capability, Load characteristics, and Environment to identify manual handling risks.
Question 4: 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)
- Wait until the next ward round to raise concerns
- Document concerns and take no further action until the doctor responds
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 5: Which colour-coded wristband is used to alert staff to a patient's known allergy in most UK NHS hospitals?
- Red (Correct answer)
- Yellow
- Orange
- Purple
Correct answer: Red
A red wristband is the national NHS standard for indicating a known allergy or adverse drug reaction.
Question 6: A post-operative patient reports increasing pain at the surgical site with swelling and warmth. Which risk does this presentation most suggest?
- Deep vein thrombosis
- Wound infection or abscess formation (Correct answer)
- Pulmonary embolism
- Haematoma requiring no intervention
Correct answer: Wound infection or abscess formation
Localised warmth, swelling, and increasing pain at a wound site are classic signs of wound infection requiring assessment and intervention.
Question 7: What is the primary purpose of a root cause analysis (RCA) following a serious patient safety incident?
- To assign blame to the staff member responsible
- To identify underlying system and process factors that contributed to the incident and prevent recurrence (Correct answer)
- To provide legal defence for the organisation
- To satisfy media and public interest requirements
Correct answer: To identify underlying system and process factors that contributed to the incident and prevent recurrence
RCA is a systematic process to identify contributory factors and system failures so that organisational learning can prevent similar incidents.
NMC CBT NMC-CBT Patient Safety and Risk Assessment 3
A patient's oxygen saturation drops to 90% while receiving 2L/min of oxygen via nasal cannula.
Which immediate action is most appropriate?