NMC Clinical 3 — Questions and Answers
Question 1: A patient develops sudden urticaria, bronchospasm, and hypotension minutes after receiving IV penicillin. What is the FIRST intervention?
- Administer IM adrenaline (epinephrine) 0.5 mg (Correct answer)
- Give oral antihistamine
- Apply high-flow oxygen and observe
- Call the physician before acting
Correct answer: Administer IM adrenaline (epinephrine) 0.5 mg
IM epinephrine (adrenaline) 0.5 mg into the outer thigh is the immediate first-line treatment for anaphylaxis.
Question 2: A post-surgical patient has a temperature of 38.6°C, HR 104 bpm, RR 23/min, and WBC 16,000/mm³. What condition should the nurse suspect?
- Sepsis (Correct answer)
- Simple wound infection
- Dehydration
- Pulmonary embolism
Correct answer: Sepsis
These findings meet SIRS criteria in the context of a potential infection, indicating sepsis requiring urgent escalation.
Question 3: A patient with confirmed pulmonary tuberculosis requires isolation. Which type of precaution is REQUIRED?
- Airborne precautions in a negative-pressure room (Correct answer)
- Contact precautions with gloves and gown
- Droplet precautions with a surgical mask
- Standard precautions only
Correct answer: Airborne precautions in a negative-pressure room
Pulmonary TB spreads via airborne particles requiring a negative-pressure room and N95 respirators for staff.
Question 4: A nurse discovers an unresponsive patient in bed and calls for help. What is the NEXT immediate step?
- Open the airway and check for breathing (Correct answer)
- Begin chest compressions immediately
- Apply a defibrillator
- Administer oxygen via bag-valve mask
Correct answer: Open the airway and check for breathing
After calling for help, the nurse must open the airway and check for breathing to determine whether CPR is required.
Question 5: Where should a tourniquet be applied when controlling severe limb hemorrhage?
- 5–8 cm proximal to the wound (Correct answer)
- Directly over the bleeding site
- 5–8 cm distal to the wound
- Over the nearest joint
Correct answer: 5–8 cm proximal to the wound
A tourniquet must be placed 5–8 cm proximal (above) the wound on the limb to occlude blood flow effectively.
Question 6: An MRSA-positive patient requests to walk in the ward corridor for exercise. What is the MOST appropriate response?
- Explain that the patient must remain in their isolation room and offer in-room mobility alternatives (Correct answer)
- Allow the walk if the patient wears gloves
- Permit the walk as exercise is clinically beneficial
- Transfer to a side room first, then allow the walk
Correct answer: Explain that the patient must remain in their isolation room and offer in-room mobility alternatives
Contact precautions require MRSA-positive patients to remain in isolation; mobilization in common areas poses cross-infection risk.
Question 7: According to the WHO 5 Moments of Hand Hygiene, when must hand hygiene be performed in relation to patient care?
- Before patient contact, before aseptic procedures, after body fluid exposure, after patient contact, and after contact with patient surroundings (Correct answer)
- Only before and after direct patient contact
- Only when gloves are not worn
- After every procedure, regardless of glove use
Correct answer: Before patient contact, before aseptic procedures, after body fluid exposure, after patient contact, and after contact with patient surroundings
The WHO 5 Moments framework specifies five distinct indications for hand hygiene to protect both patients and healthcare workers.
NMC Clinical 3
A patient develops sudden urticaria, bronchospasm, and hypotension minutes after receiving IV penicillin.
What is the FIRST intervention?