CBT Mock Test 10 - NMC Part 1 Test of Competence

NOTE: This is a “mock” test based on some of the references given in the NMC Blue Print. The test covers 4 Domains and 1 field specific competency relating to your specialism – in this case ‘Adult Nursing’. The questions provided is only a guide, individuals should review the all study material and modules provided in MMA Recruitment CBT guide.

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* 1. Dehydration is of particular concern in ill health. If a patient is receiving IV fluid replacement and is having their fluid balance recorded, which of the following statements is true of someone said to be in "positive fluid balance"

The fluid input has exceeded the output

The fluid balance chart can be stopped as "positive" means "good"

The doctor may consider increasing the IV drip rate

The fluid output has exceeded the input

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* 2. What specifically do you need to monitor to avoid complications & ensure optimal nutritional status in patients being enterally fed?

Daily urinalysis, ECG, Protein levels and arterial pressure

Assess swallowing, patient choice, fluid balanc, capillary refill time

Eye sight, hearing, full blood count, lung function and stoma site

Blood glucose levels, full blood count, stoma site and body weight

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* 3. A patient needs weighing, as he is due to a drug that is calculated on body weight. He is experiences a lot of pain on movement so is reluctant to move, particularly stand up. What would you do?

Discuss the case with your colleagues and agree to guess his body weight until he agrees to stand and use the chair scales

Omit the drugs as it is not safe to give it without this information; inform the doctor and document your actions

Offer the patient pain relief and either use bed scales or a hoist with scales built in

Document clearly in the patient's notes that a weight cannot be obtained

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* 4. If the prescribed volume is taken, which of the following type of feed will provide all protein, vitamins, minerals and trace elements to meet patient's nutritional requirements?

Protein shakes/suplements

Energy drink

Mixed fat and glucose polymer solutions/powder

Sip feeds

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* 5. A patient has been admitted for nutritional support and started receiving a hyperosmolar feed yesterday. He presents with diarrhea but no pyrexia. What is likely to be cause?

An infection

Food poisoning

Being in hospital

The feed

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* 6. Your patient has a bulky oesophageal tumor and is waiting for surgey. When he tries to eat, food gets stuck and gives him heart burn. What is the most likely route that will be chosen to provide him with the nutritional support he needs?

Feeding via Radiologically inserted Gastostomy (RIG)

Nasogastric tube feeding

Feeding via a Percutaneous Endoscopic Gastrostonomy (PEG)

Continue oral

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* 7. What is the best way to prevent who is receiving an enteral feed from aspirating?

Check their oxygen saturations

tell them to lie in their side

Lie them flat

Sit them at least 45 degrees angle

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* 8. Which of the following medications are safe to be administered via a naso-gastric tube?

Drugs that can be absorbed via this route, can be crushed and given diluted or dissolved in 10-15 ml of water

Enteric-coated drugs to minimize the impact of gastric irritation

A cocktail of all medications mixed together, to save time and prevent fluid over loading the patient

Any drugs that can be crushed

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* 9. Which check do you need to carry out before setting up an enteral feed via nasogastric tube?

The air cannot be heard rushing into the lungs by doing the WHOOSH TEST

That when flushed with red juice, the red juice can be seen when the tube is aspirated

That the pH of gastric aspirate is above 6.6 and the measurements on the NG tube is the same length as the time insertion

That the pH of gastric aspirate is below 5.5 and the measurements on the NG tube is the same length as the time insertion.

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* 10. Monica is going to receive blood transfusion, How frequently should we do her observation?

Temperature , pulse, blood pressure and respiration before the blood transfusion begins, then after 15-min, then as indicated in local guidelines, and finally at the end of bag/unit.

Temperature and pulse before the blood transfusion begins, then every hour, and at the end of bag/unit

Temperature, pulse, blood pressure and respiration and urinalysis before the blood transfusion, then at end of bag

Pulse, blood pressure and respiration every hour, and at the end of the bag

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* 11. How do the structures of human body work together to provide support and assist in movement?

The muscles provide a structural framework, moving by contracting or extending crossing at least one joint and attached to the articulating bones

The skeleton provides a structural framework; this is moved by ligaments that stretch and contract

The muscles provide a structural framework and are moved by bones to which they are attached by ligaments

The skeleton provides a structural framework. This is moved by the muscles that contract or extend and in order to function, cross at least one joint and are attached to the articulating bones.

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* 12. What are the most common effects of inactivity?

Social isolation, loss of independence, exacerbation of symptoms, rapid loss of strength in lg muscles, de-conditioning of cardiovascular system leading to an increased risk of chest infection and pulmonary embolism.

Loss of weight , frustration and deep vein thrombosis

Deep arterial thrombosis, respiratory infection, fears of movement, loss of consciousness , de-conditioning of cardiovascular system leading to an increased risk of angina

Pulmonary embolism, UTI, & fear of people

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* 13. What do you need to consider when helping a patient with shortness of breath sit out in a chair?

They should not sit out on a chair; lying flat is the only position for someone with shortness of breath so that there are no negative effects of gravity putting pressure in lungs

Sitting in reclining position with legs elevated to reduce the use of postural muscle oxygen requirements, increasing lung volumes and optimizing perfusion for the best V/Q ratio. The patient should also be kept in an environment that is quiet so they don't expend any unnecessary energy

there are two possible positions, either sitting upright or side lying. Which is used and is determined by the age of the patient . It is also important to remember that they will always need a nebulizer and oxygen and the air temperature must be below 20 degree Celcius

The patients needs to be able to sit in a forward leaning position supported by pillows. They may also need access to a nebulizer and humidified oxygen so they must be in a position where this is accessible without being a risk to others.

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* 14. Your patient has bronchitis and has difficulty in clearing his chest. What position would help to maximize the drainage of secretions?

Lying on his side with the area to be drained uppermost after the patient has had humidified air

Lying flat on his back while using a nebulizer

Sitting up leaning on pillows and inhaling humidified oxygen

Standing up in fresh air taking deep breaths

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* 15. Mrs Jones has had a cerebral vascular accident, so her left leg is increased in tone, very stiff and difficult to position comfortably when she is in bed. What would you do?

Try to diminish increased tone by avoiding extra stimulation by ensuring her foot does not into contact with the end of the bed;supporting with a pillow, her left leg in side lying and keeping the knee flexed

Give Mrs. Jones analgesia and suggest she sleeps in chair

Give Mrs. Jones diazepam and tilt the bed

Suggest a warm bath before she lies on the bed. Then use pillows to support the stiff limb

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* 16. When should adult patients in acute hospital settings have observations taken?

When they are admitted & then once daily unless they deteriorate

As indicated by the doctor

Temperature should be taken daily, respiration at night, pulse & blood pressure 4 hourly

When they are admitted or initially assessed. A plan should be clearly documented which identifies which observations should be taken & how frequently subsequent observations should be done

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* 17. Why are physiological scoring systems or early warning scoring system used in clinical practice?

These scoring systems are carried out as part of a national audit so we know how sick patients are in the united kingdom

They enable nurses to call for assistance from the outreach team or the doctors via an electronic communication system

They help the nursing staff to accurately predict patient dependency on a shift by shift basis

The system provides an early accurate predictor of deterioration by identifying physiological criteria that alert the nursing staff to a patient at risk

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* 18. A patient is recovering from surgery has been advanced from a clear diet to a full liquid diet. The patient is looking forward to the diet change because he has been "bored" with the clear liquid diet. The nurse should offer which full liquid item to the patient

Custard

Black Tea

Gelatin

Ice pop

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* 19. The nurse is preparing to change the parenteral nutrition (PN) solution bag & tubing. The patient's central venous line is located in the right subclavian vein. The nurse ask the client to take which essential action during the tubing change?

Take a deep breath, hold it, & bear down

Breathe normally

Exhale slowly & evenly

Turn the head to the right

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* 20. A 27-year old adult male is admitted for treatment of Crohn's disease. Which information is most significant when the nurse assesses his nutritional health?

Facial rubor

Dry skin

Bleeding gums

Anthropometric measurements

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* 21. A nurse is advised one hour vital charting of a patient, how frequently it should be recorded?

Every 3 hours

Every shift

Whenever the vital signs show deviations from normal

Every one hour

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* 22. When a patient arrives to the hospital who speaks a different language. Who is responsible for arranging an interpreter?

Doctor

Management

Registered Nurse

Nursing assistant

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* 23. A COPD patient is in home care. When you visit the patient, he is dyspnoeic, anxious and frightened. He is already on 2 liter oxygen with nasal cannula. What will be your action?

Increase the flow of oxygen to 5 L

Ask the patient to calm down

Call the emergency service

Give Oramorph 5 mg medications as prescribed

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* 24. A client breathes shalowlly and looks upward when listening to the nurse. Which sensory mode should the nurse plan to use with this client?

Touch

Auditory

Kinesthetic

Visual

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* 25. An eight year old girl with learning disabilities is admitted for a minor surgery, she is very restless ang agitated and wants her mother to stay with her, what will you do?

Act according to company policy

Inform the Doctor

Tell her you will take care of the child

Advice the mother to stay till she settles

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* 26. While at outside setup what care will you give as a Nurse if you are exposed to a situation?

Provide care which is at expected level

Above what is expected

Ignoring the situation

Keeping up to professional standards

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* 27. A newly diagnosed patient with Cancer says "I hate Cancer, why did God give it to me". Which stage of grief process is this?

Denial

Bargaining

Depression

Anger

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* 28. A nurse is advised one hour vital charting of a patient, how frequently it should be recorded?

Whenever the vital signs show deviations from normal

Every shift

Every one hour

Every 3 hours

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* 29. Mrs. A is posted for CT scan. Patient is afraid cancer will reveal during her scan. She asks "why is this test". What will be your response as a nurse?

Tell her that you will arrange a meeting with a doctor after the procedure

Give a health education on cancer prevention

Ignore her question and take her for the procedure

Understand her feelings and tell the patient that it is normal procedure.

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* 30. What is the purpose of clinical audit?

Helps to identify areas of improvement in the system pertaining to Nursing and Medical personnel

It helps to understand the functioning and effectiveness of nursing activities

Helps to understand the outcomes and processes for medical and surgical procedures

Helps to understand medical outcomes and process only

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* 31. In an emergency department doctor asked you to do the procedure of cannulation and left the ward. You haven't done it before. What would you do?

Don't do it as you are not competent or trained for that & write incident report & inform the supervisor

Do it

Ask your colleague to do it

Complain to the supervisor that doctor left you in middle of the procedure

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* 32. Which of the following client should the nurse deal with first

A client who needs to be suctioned

A client who needs her dressing changed

A client who needs to be medicated for incisional pain

A client who is incontinent & needs to be cleaned

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* 33. A client on your medical surgical unit has a cousin who is physician & wants to see the chart. Which of the following is the best response for the nurse to take

Ask the client to sign an authorization & have someone review the chart with cousin

Hand the cousin the client chart to review

Call the attending physician & have the doctor speak with the cousin

Tell the cousin that the request cannot be granted

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* 34. How soon after surgery is the patient expected to pass urine?

6-8 hours

4-6 hours

2-4 hours

1-2 hours

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* 35. The most commonly injured carpal bone is:

the scaphoid bone

the triquetral bone

the pisiform bone

the hamate bone

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* 36. Glasgow Coma score (GCS) is made up of 3 component parts and these are:

eye opening response/motor response/verbal response

eye opening response/verbal response/pupil reaction to light

eye opening response/motor response/pupil reaction to light

eye opening response/limb power/verbal response

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* 37. Recognition of the unwell child is crucial. The following are all signs and symptoms of respiratory distress in children EXCEPT:

Lying supine

Nasal flaring

Intercostal and sternal recession

adopting an upright position

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* 38. Which of the following is NOT a risk factor for ectopic pregnancy

Alcohol abuse

Smoking

Tubal or pelvic surgery

previous ectopic pregnancy

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* 39. Carpal tunnel syndrome is caused by compression of which nerve:

Median nerve

Axillary nerve

Ulnar nerve

Radial nerve

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* 40. 500mg of Amoxicillin is prescribed to a patient three times a day, 250mg tablets are available. How many tablets for single dose?

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* 41. A patient got admitted to hospital with a head injury.Within 15 minutes, GCS was assessed and it was found to be 15. After initial assessment, a nurse should monitor neurological status

Every 15 minutes

30 minutes

45 minutes

60 minutes

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* 42. According to recent UK researh, what is the recommended amount of vegetables and fruits to be consumed per day?

3 portions per serving

5 portions per serving

7 portions per serving

4 portions per serving

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* 43. What instructions should you give a client receiving oral Antibiotics?

Consume it all at once

take the antibiotic with glass of water

Take the medication with meals and consume all the antibiotics

take the medication as prescribed and complete the course

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* 44. When will you disclose the identity of a patient under your care?

You can disclose it anytime you want

When a patient relatives wishes to

When media demands for it

Justified by public interest law and order

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* 45. An 18 year old 26 week pregnant woman who uses illicit drugs frequently, the factors in risk for which one of the following:

Spina bifida

Meconium aspiration

Pneumonia

Teratogenicity

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* 46. You would refer to the early phase of scar tissue formation as which of the following kinds of tissue?

Granulation

Fibrous

Keloid

Cicatrix

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* 47. After instructing the client on crutch walking tecnique, the nurse should evaluate the client's understanding by using which of the following methods?

Have client explain produce to the family

Achievement of 90 on written test

Explanation

Return demonstration

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* 48. A woman reports of per vaginal bleeding 48 hrs after normal vaginal delivery. What is this type of post partum hemorrhage classified as?

Primary

Secondary

Tertiary

All of the above

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* 49. A client requests you that he wants to go home against medical advice, what should you do?

Inform the management

Inform the local police

Call the security guard

Allow the client to go home as he won't pose any threat to self or others

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* 50. You saw a relative of a client has come with her son, who looks very thin, shy & frightened. You serve them food, but the mother of that child says "don't give him, he eats too much". You should:

Raise your concern with your nurse manager about potential for child abuse & ask for her support.

Ignore the mother & ask the relative if the child is abused.

Ignore the mother's advice & serve food to the child.

Ignore the situation as she is the mother & knows better about her child.

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* 51. We are always striving to improve our service and support to overseas nurses. Any feedback or suggestions that you might have can be made in the comment box below. If you are not registered with MMA Healthcare Recruitment and would like to receive a copy of our free CBT study guide, please provide your name and e-mail address.
http://www.mmarecruitment.com/

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