NMC Medicines Management and Safety 3

Question 1

A patient is receiving warfarin therapy. Which dietary change could significantly reduce the drug's effectiveness?

Accepted Answer

Eating large amounts of vitamin K–rich foods such as spinach and kale

Answer

Vitamin K antagonises warfarin's anticoagulant effect; a sudden large increase in vitamin K intake can raise the INR target and cause sub-therapeutic anticoagulation.

Question 2

Which route of administration bypasses first-pass metabolism in the liver?

Accepted Answer

Intravenous

Answer

Intravenous administration delivers the drug directly into the bloodstream, completely bypassing hepatic first-pass metabolism and achieving 100% bioavailability.

Question 3

A patient is prescribed gentamicin. Which parameter is essential to monitor to prevent toxicity?

Accepted Answer

Serum gentamicin levels and renal function

Answer

Gentamicin is nephrotoxic and ototoxic; serum drug levels (trough and peak) and renal function must be monitored to maintain therapeutic range and avoid toxicity.

Question 4

What is the correct technique for administering a subcutaneous insulin injection?

Accepted Answer

Inject at 90° into a pinched skin fold without aspiration

Answer

Current evidence-based practice recommends injecting insulin at 90° (or 45° in thin patients) into a pinched skin fold without aspiration, as aspiration is unnecessary for subcutaneous injections.

Question 5

Under the NMC Code, if a nurse is asked to administer a medication they believe is unsafe, what is their professional responsibility?

Accepted Answer

Refuse and raise the concern immediately through appropriate channels

Answer

The NMC Code requires nurses to refuse to participate in unsafe practice and to raise concerns promptly to protect patient safety.

(NMC) Nursing Midwifery Council Practice Test

(NMC) Nursing Midwifery Council Practice Test

NMC Medicines Management and Safety 3