NMC OSCE Patient Assessment & NEWS2 — Questions and Answers
Question 1: What does NEWS2 stand for?
- National Early Warning Score 2 (Correct answer)
- Nursing Emergency Warning System 2
- National Emergency Warning Score 2
- Nurse Early Warning Signs 2
Correct answer: National Early Warning Score 2
NEWS2 stands for National Early Warning Score 2. It is a standardised system developed by the Royal College of Physicians to detect clinical deterioration in acutely ill adults, using six physiological parameters.
Question 2: Which six physiological parameters are included in the NEWS2 scoring system?
- Temperature, pulse, BP, respiratory rate, SpO2, consciousness level (Correct answer)
- Temperature, pulse, BP, respiratory rate, SpO2, urine output
- Temperature, pulse, BP, respiratory rate, blood glucose, consciousness level
- Temperature, pulse, BP, respiratory rate, SpO2, pain score
Correct answer: Temperature, pulse, BP, respiratory rate, SpO2, consciousness level
NEWS2 uses six parameters: respiratory rate, SpO2, systolic blood pressure, pulse rate, level of consciousness (ACVPU), and temperature. Each is scored 0–3 and the total determines the clinical response required.
Question 3: A patient scores a total NEWS2 of 7. What is the recommended response?
- Routine monitoring — reassess in 4–6 hours
- Inform nurse in charge and increase monitoring frequency
- Urgent review by clinician with ward-based competencies — consider transfer to higher care (Correct answer)
- Immediate emergency response team activation
Correct answer: Urgent review by clinician with ward-based competencies — consider transfer to higher care
A NEWS2 score of 7 or above triggers a score of High (Red), requiring an urgent or emergency assessment by a clinical team with critical care competencies. This should prompt immediate review and likely transfer to a higher level of care setting.
Question 4: In NEWS2, what ACVPU score is assigned to a patient who is confused but responds to voice?
- A
- C (Correct answer)
- V
- U
Correct answer: C
In NEWS2, ACVPU stands for Alert, Confusion, Voice, Pain, Unresponsive. A patient who is confused (new confusion or disorientation) is coded as 'C' (Confusion), which scores 3 — the same score as V, P, or U in the consciousness component.
Question 5: A patient has a known diagnosis of COPD with a target SpO2 of 88–92%. How should their SpO2 be scored in NEWS2?
- Using Scale 1 (standard scale for all patients)
- Using Scale 2 (designed for patients with hypercapnic respiratory failure) (Correct answer)
- SpO2 is not scored in patients with COPD
- The standard scale but with the lower limit adjusted to 85%
Correct answer: Using Scale 2 (designed for patients with hypercapnic respiratory failure)
NEWS2 introduced Scale 2 specifically for patients with hypercapnic respiratory failure (e.g., COPD) who have a prescribed SpO2 target of 88–92%. This prevents inappropriate high scores when SpO2 is within the patient's therapeutic range.
Question 6: What NEWS2 total score triggers an emergency response (i.e., blue light response including resuscitation team)?
- Score of 5 or more
- Any score of 3 in a single parameter
- Score of 7 or more, or a score of 3 in any single parameter (Correct answer)
- Score of 10 or more only
Correct answer: Score of 7 or more, or a score of 3 in any single parameter
An emergency response is triggered by a NEWS2 total of 7 or more, or a score of 3 in any single parameter (e.g., respiratory rate >24, SpO2 <91, confusion, temperature <35°C). Either finding alone warrants an immediate emergency response.
NMC OSCE Patient Assessment & NEWS2
What does NEWS2 stand for?