CBT Practice Quiz

Test of Competence part One (CBT)
Practice Questions
compiled by Ali Jones 2016
Question 1
What are the steps of the nursing Process?
A. Assessing, diagnosing, planning, implementing,
and evaluating
B. Assessing, planning, implementing, evaluating,
documenting
C. Assessing, observing, diagnosing, planning,
evaluating
D. Assessing, reacting, implementing, planning,
evaluating
Question 1 Answer
A. Assessing, diagnosing, planning, implementing, and

evaluating
B. Assessing, planning, implementing, evaluating,
documenting
C. Assessing, observing, diagnosing, planning, evaluating
D. Assessing, reacting, implementing, planning, evaluating
The correct answer is A. Assessing, diagnosing, planning, implementing & evaluating.
www.nursing process.org (2016) Nursing standard. June 25. Vol28 no.43 2014
Question 2
What is clinical benchmarking?
A. The practice of being humble enough to admit that
someone else is better at something and being wise enough
to try to learn how to match and even surpass them at it.
B. A systematic process in which current practice and care
are compared to, and amended to attain, best practice and
care
C. A system that provides a structured approach for realistic
and supportive practice development
D. All of the above
Question 2 Answer
What is clinical benchmarking?
A. The practice of being humble enough to admit that someone

else is better at something and being wise enough to try to learn
how to match and even surpass them at it.
B. A systematic process in which current practice and care are
compared to, and amended to attain, best practice and care
C. A system that provides a structured approach for realistic and
supportive practice development
D. All of the above
The correct answer is D. All of the above.

Essence of care- Gov.uK 2010 https://www.gov.uk/government/uploads/system/...data/.../dh_119978.pdf
Question 3
What is nocturia?
A. Urinary frequency
B. Urination at night
C. Poor urine output
D. Non passage of urine
Question 3 Answer
What is nocturia?
A. Urinary frequency
B. Urination at night
C. Poor urine output
D. Non passage of urine
Nocturia is urination at night. It often increases with age. It is normal to get up twice a night
from the age of 70 onwards, but more frequent visits to the toilet may indicate a problem that
can be treated. These may include hormonal changes, prostate problems, urge incontinence,
bladder infections or heart problems and diabetes.
www.guysandstthomas.nhs.uk/resources/patient...care/nocturia.pdf 2013
Question 4
What is the name given to a decreased pulse rate or
heart rate?
A. Tachycardia
B. Hypotension
C. Bradycardia
D. Arrhythmia
Question 4 Answer
What is the name given to a decreased pulse rate or
heart rate?
• A. Tachycardia
• B. Hypotension
• C. Bradycardia
• D. Arrhythmia
The correct answer is bradycardia. This is a heart rate of less than 60 beats per minute with a
normal sinus rhythm. . A patient with unstable bradycardia is at risk of inadequate perfusion
of the vital organs, decreased myocardial function, heart block and cardiac arrest.
Nursing Standard June 25, vol. 28,no. 43 2014
Question 5
How do we handle a specimen container labelled
with a yellow hazard sticker?
A. Wear gloves and apron and inform the laboratory
that you are sending the specimen.
B. Wear gloves and apron, mark it high risk and
send the specimen to the laboratory with your
other specimens
C. Wear gloves and apron, Inform the infection
control team and complete a datix form.
D. Wear gloves and apron, place specimen in a blue
bag & complete a datix form.
Question 5 Answer
How do we handle a specimen container labelled with a yellow hazard
sticker?
A. Wear gloves and apron and inform the laboratory that you are sending the
specimen.
B. Wear gloves and apron, mark it high risk and send the specimen to the
laboratory with your other specimens
C. Wear gloves and apron, Inform the infection control team and complete a
datix form.
D. Wear gloves and apron, place specimen in a blue bag & complete a datix
form.
• A senior member of the receiving laboratory staff must be contacted before any high-risk specimen is sent.
• The request form and container must be properly labelled and both marked with a yellow hazard-warning sticker.
• The specimen should then be placed in the transport bag which is sealed. The biohazard sticker must be clearly visible on the request
form (e.g. on the outside of fold over forms)
• Specimens must not be placed in the sealed container with other samples, which are not categorised as high
• www.ouh.nhs.uk/services/referrals/laboratories/.../specimens-safe-handling.ppt
Question 6
To whom should you delegate a task?

A. Someone who you trust
B. Someone who is competent
C. Someone who you work with regularly
D. All of the above
Question 6 Answer
To whom should you delegate a task?
A. Someone who you trust
B. Someone who is competent
C. Someone who you work with regularly
D. All of the above
You need to be accountable for your decisions to delegate tasks and duties to others. You should only delegate tasks and
duties to those that are practising within their scope of competence, making sure that they fully understand your
instructions and who to report any changes to. Ensure that they are supported and supervised as necessary in order to
provide safe and compassionate care. Ensure that any task you delegate meets the required standard.
The Royal Marsden Manual of Clinical Nursing Procedures 9th Edition 2015
Question 7
Where is revision on the nursing process done?

During:
A. Diagnosis
B. Planning
C. Implementation
D. Evaluation
Question 7 Answer
Where is revision on the nursing process done?
During:
A. Diagnosis
B. Planning
C. Implementation
D. Evaluation
The correct answer is D, during evaluation. Evaluation takes place at designated points during the patient/clients period
of receiving health care. This is determined by the nursing assessment which identifies the specific needs of each
individual and the subsequent plan for delivering the required nursing care. Evaluation is ongoing and leads directly back
to the assessment phase of the nursing process, culminating in further planning of care or discontinuation of the need,
want or desire for intervention.
www2.rcn.org.uk/development/learning/transcultural.../sectionthree
Question 8
Why are support stockings used?
A. To aid mobility
B. To promote arterial flow
C. To aid muscle strength
D. To promote venous flow
Question 8 Answer
Why are support stockings used?
A. To aid mobility
B. To promote arterial flow
C. To aid muscle strength
D. To promote venous flow
Correct answer is D. To promote venous flow. Stockings can help to correct the underlying problem of poor venous blood
return and also reduce leg pain and swelling.
When lying down very little extra power is necessary as blood does not have to go uphill and the movements we make in
our sleep are enough to keep the blood flowing. Valves in the veins stop the blood flowing backwards when the muscles
relax. If the valves are damaged or weakened the veins can become over-stretched and develop into varicose veins. If the
valves are severely damaged by a blood clot or injury and the condition is neglected, leg ulcers might result.
(December 2014)
http://www.buckshealthcare.nhs.uk/Downloads/cancer/CISS%20-%2036%20Compression%20stockings.pdf
Question 9
How do you test the placement of an enteral tube?

A. Monitoring bubbling at the end of the tube
B. Testing the acidity/alkalinity of aspirate using blue litmus
paper
C. Interpreting absence of respiratory distress as an indicator of
correct positioning
D. Have an abdominal x-ray
Question 9 Answer
How do you test the placement of an enteral nasogastric tube?
A. Monitoring bubbling at the end of the tube
B. Testing the acidity/alkalinity of aspirate using blue litmus
paper
C. Interpreting absence of respiratory distress as an indicator of
correct positioning
D. Have an abdominal x-ray
The correct answer is B. Correct NG tube placement must be confirmed by aspiration on the initial
placement prior to all episodes of administration to feed, water or medications. CE marked PH indicator
paper should be used to test for human gastric aspirate. The PH should be between 1 and 5.5.
The Royal Marsden Manual of Clinical Nursing Procedures 9th Edition 2015
NHS National Patient Safety Agency march 2016
Question 10
What is meant by an advocate?
A. Someone who develops opportunities for the

patient
B. Someone who has the same beliefs as the
patient
C. Someone who does something on behalf of the
patient
D. Someone who has the same values as the
patient
Question 10 Answer
What is meant by an advocate?
A. Someone who develops opportunities for the
patient
B. Someone who has the same beliefs as the patient
C. Someone who does something on behalf of the
patient
D. Someone who has the same values as the patient
The correct answer is c. The role of an advocate is concerned with working on behalf of self and/or others to raise
awareness of a concern and to promote solutions to an issue. It often requires achieving a desired outcome working
through formal, decision-making bodies. This process could include the 'chain of command' within a healthcare
organization, a commission, a state legislature, or other groups at the healthcare system's policy level.
Tomajan, K., (January 31, 2012) "Advocating for Nurses and Nursing" OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 1, Manuscript 4.
Question 11
Which of these is not a symptom of an ectopic
pregnancy?
A. Pain
B. Bleeding
C. Vomiting
D. Diarrhoea
Question 11 Answer
Which of these is not a symptom of an ectopic

pregnancy?
A. Pain
B. Bleeding
C. Vomiting
D. Diarrhoea
The correct answer is vomiting. Women may feel nauseous and vomit but it is not always a symptom of an
ectopic pregnancy. An ectopic pregnancy is when a fertilised egg implants itself outside of the womb,
usually in one of the fallopian tubes.
Unfortunately, it's not possible to save the pregnancy. It usually has to be removed using medicine or an
operation.
In the UK, around 1 in every 80-90 pregnancies is ectopic. This is around 12,000 pregnancies a year.
9 March 2016
www.nhsdirect.wales.nhs.uk/encyclopaedia/e/article/ectopicpregnancy/?
Question 12
What is atrial fibrillation?
A heart condition that causes,
A. An irregular and often abnormally slow heart rate

B. An irregular and often abnormally fast heart rate
C. A regular heart rhythm with an abnormally slow heart
rate
D. A regular heart rhythm with an abnormally fast heart
rate
Question 12 Answer
What is atrial fibrillation?
A heart condition that causes,
A. An irregular and often abnormally slow heart rate

B. An irregular and often abnormally fast heart rate
C. A regular heart rhythm with an abnormally slow heart rate
D. A regular heart rhythm with an abnormally fast heart rate
The correct answer is B. In atrial fibrillation, the heart rate is irregular due to the heart's upper chambers (atria)
contracting randomly. The heart rate can sometimes be considerably higher than 100 beats a minute. Problems including
dizziness, shortness of breath and tiredness may be noticeable as well as heart palpitations.
Sometimes, atrial fibrillation doesn't cause any symptoms and a person with it is completely unaware that their heart
rate isn't regular.
May 18th 2015

http://www.nhs.uk/Conditions/atrial-fibrillation/Pages/Introduction.aspx
Question 13
What is the role of the NMC?
A. To regulate hospitals or other healthcare
settings in the UK
B. To regulate healthcare assistants
C. To represent or campaign on behalf of nurses
and midwives
D. To regulate nurses and midwives In the UK to
protect the public
Question 13 Answer
What is the role of the NMC?
A. To regulate hospitals or other healthcare settings in the UK

B. To regulate healthcare assistants
C. To represent or campaign on behalf of nurses and midwives
D. To regulate nurses and midwives In the UK to protect the
public
The correct answer is D. The NMC regulates nurses in England, Wales, Scotland & Northern Ireland. It exists to protect
the public. It set standards of education, training, conduct and performance so that nurses and midwives can deliver high
quality healthcare throughout their careers.
It ensures that nurses and midwives keep their skills and knowledge up to date and uphold our professional standards. It
has clear and transparent processes to investigate nurses and midwives who fall short of our standards. The NMC
maintains a register of nurses and midwives allowed to practise in the UK.
5th February 2016

https://www.nmc.org.uk/about-us/our-role/
Question 14
During enteral feeding in adults, at what degree angle should the
patient be nursed at to reduce the risk of reflux and aspiration?
A. 25
B. 35
C. 45
D. 55
Question 14 Answer
During enteral feeding in adults, at what degree angle should the
patient be nursed at to reduce the risk of reflux and aspiration?
A. 25
B. 35
C. 45
D. 55
The correct answer is C. Aspiration may occur due to regurgitation of feed, poor gastric emptying or incorrect placement
of the NG tube. The risk can be reduced by,
A. The use of prokinetics to encourage gastric emptying e.g. metoclopramide

B. Checking the position of the tube before feeding
C. Ensuring the patient has their head at a 45 degree angle during feeding.
The Royal Marsden manual of Clinical Nursing Procedures 9th Edition. (2015)
Question 15
When using crutches, what part of the body
should absorb the patient’s weight?
A. Armpits
B. Hands
C. Back
D. Shoulders
Question 15 Answer
When using crutches, what part of the body should absorb
the patient’s weight?
A. Armpits
B. Hands
C. Back
D. Shoulders
The correct answer is B. Proper Positioning:

• When standing up straight, the top of your crutches should be about 1-2 inches below your armpits.
• The handgrips of the crutches should be even with the top of your hip line.
• Your elbows should be slightly bent when you hold the handgrips.
• To avoid damage to the nerves and blood vessels in your armpit, your weight should rest on your hands, not
on the underarm supports.
February2015
Question 16
The CQC describes compassion as what?
A. Intelligent Kindness
B. Smart confidence
C. Creative commitment
D. Gifted courage
Question 16 Answer
The CQC describes compassion as what?
A. Intelligent Kindness
B. Smart confidence
C. Creative commitment
D. Gifted courage
The correct answer is A. Compassion is how care is given through relationships based on empathy, respect
and dignity - it can also be described as intelligent kindness, and is central to how people perceive their
care.
https://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdf
Question 17
What is abduction?
A. Division of the body into front and back

B. Movement of a body part towards the body’s
midline
C. Division of the body into left and right
D. Movement of a body part away from the
body’s midline
Question 17 Answer
What is abduction?
A. Division of the body into front and back

B. Movement of a body part towards the body’s
midline
C. Division of the body into left and right
D. Movement of a body part away from the body’s midline
The correct answer is D. Abduction and adduction are two terms that are used to describe movements towards or away from the midline of
the body.
Abduction is a movement away from the midline – just as abducting someone is to take them away. For example, abduction of the shoulder
raises the arms out to the sides of the body.
Adduction is a movement towards the midline. Adduction of the hip squeezes the legs together.
In fingers and toes, the midline used is not the midline of the body, but of the hand and foot respectively. Therefore, abducting the fingers
spreads them out.
http://teachmeanatomy.info/the-basics/anatomical-terminology/terms-of-movement/
Question 18
What does intermediate care not consist of?
A. Maximise dependent living

B. Prevent unnecessary acute hospital admission
C. Prevent premature admission to long-term
residential care
D. Support timely discharge from hospital
Question 18 Answer
What does intermediate care not consist of?
A. Maximise dependent living
B. Prevent unnecessary acute hospital admission
C. Prevent premature admission to long-term
residential care
D. Support timely discharge from hospital
The correct answer is A. Intermediate care maximises independent living The Department of Health (2001) introduced intermediate care in
the United Kingdom's NHS Plan and refined it in the national service framework for older people. The concept seems to arise out of a policy
imperative, rather than an analysis of the scientific evidence about effective models of care. Objectives such as “promotion of independence”
and “prevention of unnecessary hospital admission” were to be achieved through providing a new range of services between hospital and
home. Specific targets (for example, the number of service users, prevented admissions) accompanied these objectives .
14 Aug 2004
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC509331/
Question 19
How many cups of fluid do we need everyday to
keep us well hydrated?
A. 1 to 2
B. 2 to 4
C. 4 to 6
D. 6 to 8
Question 19 Answer
How many cups of fluid do we need everyday to keep us
well hydrated?
A. 1 to 2
B. 2 to 4
C. 4 to 6
D. 6 to 8
The Eat well Guide shows the different types of food we should eat, and in what proportions in to have a
healthy, balanced diet. It says we should drink six to eight glasses of fluid a day. Water, lower fat milk and
sugar-free drinks including tea and coffee all count.
13th July 2015
www.nhs.uk/Livewell/Goodfood/Pages/water-drinks.aspx
Question 20
Approximately how many people in the UK are
malnourished?
A. 1 million
B. 3 million
C. 5 million
D. 7 million
Question 20 Answer
Approximately how many people in the UK are malnourished?
A. 1 million
B. 3 million
C. 5 million
D. 7 million
BAPEN (British Association for Parenteral and Enteral Nutrition) estimates that malnourishment affects over 3 million
people in Britain at any one time and if ignored, this causes real problems. Malnourished individuals go to their GP more
often, are admitted to hospital more frequently, stay on the wards for longer, succumb to infections, and can even end up
being admitted to long term care or dying unnecessarily. In children, it is also disastrous with profound effects on growth
and development through childhood and later increased risks of major adult diseases.
Malnutrition Matters Meeting Quality Standards in Nutritional Care May 2010

www.bapen.org.uk/pdfs/toolkit-for-commissioners.pdf
Question 21
If a patient has been assessed as lacking
capacity to make their own decisions, what
government legislation or ‘act’ should be
referred to ?
A. Health and Social Care Act (2012)
B. Mental capacity Act (2005)
C. Carers (Equal opportunities) Act (2004)
D. All of the above
Question 21 Answer
If a patient has been assessed as lacking capacity to make their
own decisions, what government legislation or ‘act’ should be
referred to ?
A. Health and Social Care Act (2012)
B. Mental capacity Act (2005)
C. Carers (Equal opportunities) Act (2004)
D. All of the above
The Mental Capacity Act 2005 governs decision-making on behalf of adults who may not be able to make particular decisions.
The Act and its codes of practice set out:
• who can take particular decisions on someone else's behalf
• when and how a decision can be taken
• when and how people who lack capacity to take decisions about their care and welfare can be deprived of their liberty to get
the care they need in a hospital or care home.in a hospital or care home.
The Mental Capacity Act was fully implemented on 1 April 2009.
http://www.royalmarsdenmanual.com/productinfo/pdfs/RMM_Stud_c02.pdf
(cqc 2016)
http://www.cqc.org.uk/content/about-mental-capacity-act
Question 22
Under the Carers (Equal opportunities)Act
(2004) what are carers entitled to?
A. Their own assessment

B. Financial support
C. Respite care
D. All of the above
Question 22 Answer
Under the Carers (Equal opportunities)Act (2004) what
are carers entitled to?
A. Their own assessment

B. Financial support
C. Respite care
D. All of the above
The word 'carer' refers to people who provide unpaid care to a relative, friend or neighbour who is in need of support
because of mental or physical illness, old age or disability. It does not include people who work as volunteers or paid
carers; these people should be referred to as 'care workers' or, better still, this confusion could be minimised by the use
within the sector of the term ‘support worker’ to describe those who are paid to provide care.
www.scie.org.uk/publications/guides/guide09/
Question 23
For which of the following modes of
transmission is good hand hygiene a key
preventative measure?
A. Airborne
B. Direct & indirect contact
C. Droplet
D. All of the above
Question 23 Answer
For which of the following modes of transmission is good hand
hygiene a key preventative measure?
A. Airborne
B. Direct & indirect contact
C. Droplet
D. All of the above
‘Modes of transmission’ refers to the way in which infection can be passed from one person to another.
‘Modes of transmission’: Direct contact, Indirect contact, Droplet transmission, Airborne transmission,
parenteral transmission, Faecal-oral transmission, Vector transmission.
Question 24
If you were asked to take ‘standard precautions’ what would you
expect to be doing?
A. Wearing gloves, aprons and mask when caring for someone
in protective isolation
B. Taking precautions when handling blood and ‘high risk’ body
fluids so as not to pass on any infection to the patient
C. Using appropriate hand hygiene, wearing gloves and aprons
where necessary, disposing of used sharp instruments safely
and providing care in a suitably clean environment to protect
yourself and the patients
D. Asking relatives to wash their hands when visiting patients in
the clinical setting
Question 24 Answer
If you were asked to take ‘standard precautions’ what would you expect to be
doing?
A. Wearing gloves, aprons and mask when caring for someone in protective
isolation
B. Taking precautions when handling blood and ‘high risk’ body fluids so as
not to pass on any infection to the patient
C. Using appropriate hand hygiene, wearing gloves and aprons where
necessary, disposing of used sharp instruments safely and providing care
in a suitably clean environment to protect yourself and the patients
D. Asking relatives to wash their hands when visiting patients in the clinical
setting
Standard Infection Control Precautions (SICP) are designed to prevent cross transmission from recognised and
unrecognised sources of infection. These sources of (potential) infection include blood and other body fluid secretions or
excretions (excluding sweat, non –intact skin or mucous membranes) and any equipment or items in the care
environment which are likely to become contaminated.
http://www.nhsprofessionals.nhs.uk/download/comms/cg1_nhsp_standard_infection_control_precautions_v3.pdf
Question 25
When treating patient’s with clostridium
difficile, how should you clean your hands?
A. Use alcohol hand rubs

B. Use soap & water
C. Use hand wipes
D. All of the above
Question 25 Answer
When treating patient’s with clostridium difficile, how should
you clean your hands?
A. Use alcohol hand rubs

B. Use soap & water
C. Use hand wipes
D. All of the above
Clostridium difficile have the capacity to surround a copy of their genetic material with a tough coating. Because this
structure is created within the bacterial cell, it is known as a spore. The parent cell dies and disintegrates leaving the
spore to survive and then germinate and reproduce. It cannot be destroyed by boiling or by alcohol rubs. The spores
need to be removed by washing with soap and water. Hands must be dried thoroughly.
https://www.royalmarsden.nhs.uk/about-royal-marsden/quality-and-safety/infection-prevention-andcontrol/c-difficile-
Question 26
Except which procedure must all individuals
providing nursing care must be competent at?
A. Hand hygiene
B. Use of protective equipment
C. Disposal of waste
D. Aseptic technique
Question 26 Answer
Except which procedure must all individuals providing nursing
care must be competent at?
A. Use of protective equipment

B. Disposal of waste
C. Hand hygiene
D. Aseptic technique
HCA’s are able to provide nursing care, however only registered nurses or HCA’s who have had the relevant training and
been deemed competent, may undertake aseptic technique.
Nurses should decline to carry out any procedures that they have not been prepared for.
Question 27
In non-verbal communication, what does SOLER
stand for?
A. Squarely, open posture, leaning slightly forward,

eye contact, relaxed
B. Squarely, open ended questions, leaning slightly
forward, eye contact, relaxed
C. Squarely, open posture, leaning forward, eye
contact, rested
D. Squarely, open ended questions, leaning slightly
backwards, rested
Question 27 Answer
In non-verbal communication, what does SOLER stand for?
A. Squarely, open posture, leaning slightly forward, eye contact,

relaxed
B. Squarely, open ended questions, leaning slightly forward,
eye contact, relaxed
C. Squarely, open posture, leaning forward, eye contact, rested
D. Squarely, open ended questions, leaning slightly backwards,
rested
Non-verbal communication can have an impact on the total communication taking place. By
learning an awareness of ‘SOLER’, and making this behaviour part of your normal demeanour,
patients will be encouraged to talk more openly, facilitating emotional disclosure.
http://www.royalmarsdenmanual.com/productinfo/pdfs/RMM_Stud_c02.pdf
Question 28
Which of the following is NOT one of the six
fundamental values for nursing, midwifery and
care staff set out in compassion in Practice
Nursing, Midwifery & care staff?
A. Care
B. Consideration
C. Communication
D. Compassion
Question 28 Answer
Which of the following is NOT one of the six fundamental values
for nursing, midwifery and care staff set out in compassion in
Practice Nursing, Midwifery & care staff?
A. Care
B. Consideration
C. Communication
D. Compassion
The 6C’s reinforce the enduring values and beliefs that underpin care wherever it takes place. It gives us an easily
understood and consistent way to explain our values as professionals and care staff and to hold ourselves to account for
the care and services that we provide. The 6C’s all carry equal weight, and naturally focus on putting the people we care
for at the heart of everything we do. The correct answer is Consideration. The 6 C’s are care, compassion, courage,
communication, commitment and competence.
Compassion in Practice - NHS England
https://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdf
Question 29
A patient puts out his arm so that you can take
his blood pressure. What type of consent is this?
A. Verbal
B. Written
C. Implied
D. None of the above, consent is not required
Question 29 Answer
A patient puts out his arm so that you can take his
blood pressure. What type of consent is this?
A. Verbal
B. Written
C. Implied
D. None of the above, consent is not required
Consent may be expressed by a person verbally, in writing or by implying. The nurse should ensure that the person has understood what
examination or treatment is intended and why for the consent to be valid.
Written consent is usually obtained from the patient by the person undertaking the procedure. Sometimes a nurse who has had the
necessary consent training and is competent to do so, may seek to obtain consent. e.g. Advanced Nurse Practitioner
Question 30
How should eye drops be administered?
A. Pulling on the lower eyelid and administering the

eye drops
B. Pulling on the upper eyelid and administering the
eye drops
C. Tip the patients head back and administer the
eye drops into the cornea
D. Tip the patients head to the side and administer
the eye drops into the nasolacrimal system
Question 30 Answer
How should eye drops be administered?
A. Pulling on the lower eyelid and administering the eye drops

B. Pulling on the upper eyelid and administering the eye drops
C. Tip the patients head back and administer the eye drops into
the cornea
D. Tip the patients head to the side and administer the eye drops
into the nasolacrimal system
Most types of drops are instilled into the pocket formed by gently pulling on the lower eyelid (inferior fornix), as the conjunctiva in this area
is less sensitive than that overlying the cornea. It prevents the immediate loss of the drops into the nasolacrimal drainage system. On
administration the nozzle should be held approximately 1 -2 cm above the eye to avoid contact with the eyelids and cornea.
Ointments are applied to the upper rim of the inferior fornix using a similar technique to the eye drops.
Question 31
What fluid should ideally be used when
irrigating eyes?
A. sterile 0.9% sodium chloride

B. Sterile water
C. Chloramphenicol drops
D. tap water
Question 31 Answer
Saline can irritate and sting the sensitive eye area, so where possible, sterile water is recommended. Lint free swabs should be used when
cleaning the eye area due to discharge or encrustation. The swab should be wiped over the eyelid from the nose outward.
When irrigating the eye, the patients head should be supported with their chin almost horizontal and the head inclined to the side of the eye
to be treated. This is to avoid any solution running either over the nose into the other eye or to avoid cross infection, out of the affected eye
and down the cheek, or down the lacrimal duct.
Question 32
When selecting a stoma appliance for a patient who has
undergone a formation of a loop colostomy, what factors would
you consider?
A. Patient dexterity, consistency of effluent, type of stoma
B. Patient preference, type of stoma, consistency of effluent,
state of peristomal skin, dexterity of the patient
C. Patient preference, lifestyle, position of stoma, consistency of
effluent, state of peristomal skin, patient dexterity, type of
stoma.
D. Cognitive ability, lifestyle, patient dexterity, position of
stoma, state of peristomal skin, type of stoma, consistency of
effluent, patient preference.
Question 32 Answer
When selecting a stoma appliance for a patient who has undergone a
formation of a loop colostomy, what factors would you consider?
A. Patient dexterity, consistency of effluent, type of stoma
B. Patient preference, type of stoma, consistency of effluent, state
of peristomal skin, dexterity of the patient
C. Patient preference, lifestyle, position of stoma, consistency of
effluent, state of peristomal skin, patient dexterity, type of
stoma.
D. Cognitive ability, lifestyle, patient dexterity, position of stoma,
state of peristomal skin, type of stoma, consistency of effluent,
patient preference.
Loop (temporary) colostomies may be formed to divert faecal output to allow the healing of a
surgical join or repair or relieve an obstruction or bowel injury. Patient’s need to be involved in
their own care as much as possible.
Question 33
What is the clinical benefit of active ankle movements?
A. To assist with circulation

B. To lower the risk of a DVT
C. To maintain joint range
D. All of the above
Question 33 Answer
What is the clinical benefit of active ankle movements?
A. To assist with circulation

B. To lower the risk of a DVT
C. To maintain joint range
D. All of the above
Deep vein thrombosis, or DVT, is caused by a blood clot in a deep vein and can be life-threatening. Symptoms may include swelling, pain, and
tenderness, often in the legs. Risk factors include immobility, hormone therapy, and pregnancy.
http://www.webmd.com/dvt/default.htm
Question 34
In the context of assessing risks prior to moving
and handling, what does T-I-L-E stand for?
A. Task- individual – lift - environment

B. Task- intervene – load - environment
C. Task – intervene – load –equipment
D. Task – individual – load - environment
Question 34 Answer
In the context of assessing risks prior to moving
and handling, what does T-I-L-E stand for?
A. Task- individual – lift - environment

B. Task- intervene – load - environment
C. Task – intervene – load –equipment
D. Task – individual – load - environment
There is an absolute requirement to assess the risks arising from moving and handling patients that cannot reasonably be
avoided. Once the risk of not moving the patient is deemed greater than moving the patient, then the use of the
aforementioned needs to be considered.
Question 35
If your patient is unable to reposition themselves,

how often should their position be changed?
A. 1 hourly
B. 2 hourly
C. 3 hourly
D. As often as possible
Question 35 Answer
If your patient is unable to reposition themselves,
how often should their position be changed?
A. 1 hourly
B. 2 hourly
C. 3 hourly
D. As often as possible
Direct pressure to the skin and friction during movement of patients are two of the most common causes of injury to the
skin that can lead to pressure ulcers. Any patient who has or is at risk of developing a pressure sore should be positioned
with the use of pressure-relieving equipment such as a specialist mattress or cushions.
The Royal Marsden manual of Clinical Nursing Procedures 9th edition (2015)
Question 36
How much urine should someone void an hour?
A. 0.5 – 1ml/Kg/hr of the patient’s body weight

B. 2mls/KG/hr of the patient’s body weight
C. 30mls
D. 50mls
Question 36 Answer
How much urine should someone void an hour?
A. 0.5 – 1ml/Kg/hr of the patient’s body weight

B. 2mls/KG/hr of the patient’s body weight
C. 30mls
D. 50mls
This is dependent on the person’s weight. On average, a person should void 0.5 – 1ml/Kg/hr of urine.
Question 37
In spinal cord injury patients, what is the most
common cause of autonomic dysreflexia (a sudden
rise in blood pressure)?
A. Bowel obstruction
B. Fracture below the level of the spinal lesion
C. Pressure sore
D. Urinary obstruction
Question 37 Answer
In spinal cord injury patients, what is the most common cause of
autonomic dysreflexia (a sudden rise in blood pressure)?
A. Bowel obstruction
B. Fracture below the level of the spinal lesion
C. Pressure sore
D. Urinary obstruction
Autonomic dysreflexia can be caused by the other factors, however urinary obstruction is the
most common. If left untreated it can cause seizures, retinal haemorrhage, pulmonary
oedema, renal insufficiency, myocardial infarction, cerebral haemorrhage, and death.
Question 38
If a patient is prescribed nebulizers, what is the

minimum flow rate in litres per minute
required?
2-4
4-6
6–8
8 - 10
Question 38 Answer
If a patient is prescribed nebulizers, what is the
minimum flow rate in litres per minute required?
A. 2 - 4
B. 4 - 6
C. 6 – 8
D. 8 - 10
Once the piped air/oxygen is turned on to ensure a sufficient mist is formed, a minimum flow rate of 6 – 8 litres per minute is required.
Optimal nebulization of 4ml takes approximately 10 minutes.
Question 39
In normal breathing, what is the main muscle(s)
involved in inspiration?
A. The diaphragm
B. The lungs
C. the intercostal
D. All of the above
Question 39 Answer
In normal breathing, what is the main muscle(s) involved in inspiration?
A. The diaphragm
B. The lungs
C. the intercostal
D. All of the above
For inspiration to occur, the pressure in the alveoli must be lower than the air pressure in the atmosphere. The diaphragm flattens and descends and the
intercostal muscles lift the rib cage and sternum, causing the ribs to broaden outwards and increasing the diameter of the thoracic cavity, both from one
side and front to back.
Question 40
The human body is made up of approximately
what proportion of water?
A. 50%
B. 60%
C. 70%
D. 80%
Question 40 Answer
The human body is made up of approximately what
proportion of water?
A. 50%
B. 60%
C. 70%
D. 80%
This can vary with age, gender and percentage of fatty tissue.
Total body water is distributed between intracellular fluid (within the cell) and extracellular (outside the cell) compartments. Body fluid is a composition
of water and various dissolved solutes – electrolytes (potassium, sodium chloride, magnesium, bicarbonate) and non-electrolytes (glucose, lipids,
creatinine, urea).
Question 41
Concentration of electrolytes within the body vary
depending on the compartment within which they
are contained. Extracellular fluid has a high
concentration of which of the following?
A. Potassium
B. Chloride
C. Sodium
D. Magnesium
Question 41 Answer
Concentration of electrolytes within the body vary
depending on the compartment within which they
are contained. Extracellular fluid has a high
concentration of which of the following?
A. Potassium
B. Chloride
C. Sodium
D. Magnesium
Extracellular fluid has an increase in sodium content and is relatively low in potassium. Intracellular fluid is the reverse.
The movement and distribution of fluid and solutes between compartments are controlled by the semi-permeable phospholipid cellular
membranes that separate them.
Question 42
How can patients who need assistance at meal
times be identified?
A. A red sticker
B. A colour serviette
C. A red tray
D. Any of the above
Question 42 Answer
How can patients who need assistance at meal
times be identified?
A. A red sticker
B. A colour serviette
C. A red tray
D. Any of the above
Sufficient staff need to be made available to support those patients who need help. These patients can be discreetly be identified through using any of the
aforementioned. Protected meal times should be in place whereby all non-essential clinical activities are discontinued.
Question 43
People with blood group A are able to receive
blood from the following:
A. Group A only
B. Groups AB or B
C. Groups A or O
D. Groups A, B or O
Question 43 Answer
People with blood group A are able to receive blood from

the following:
A. Group A only
B. Groups AB or B
C. Groups A or O
D. Groups A, B or O
People with group O red cells don’t have either A or B surface antigens. However they do have anti A and anti B 1gM antibodies in their serum. They are
only able to receive blood group O, but can donate to A,B,O & AB groups.
Question 44
Which layer of the skin contains blood and
lymph vessels, sweat and sebaceous glands?
A. Epidermis
B. Dermis
C. Subcutaneous layer
D. All of the above
Question 44 Answer
Which layer of the skin contains blood and
lymph vessels, sweat and sebaceous glands?
A. Epidermis
B. Dermis
C. Subcutaneous layer
D. All of the above
The dermis is made up of white fibrous tissue and yellow elastic fibres which give the skin its toughness and elasticity. The dermis provides the epidermis
(outer coating of the skin) with structural and nutritional support.
Question 45
Which of the following is no longer a
recommended method of mouth care?
A. Chlorhexidine solution and foam sticks

B. Sodium bicarbonate
C. Normal saline mouth wash
D. Glycerine and lemon swabs
Question 45 Answer
Which of the following is no longer a
recommended method of mouth care?
A. Chlorhexidine solution and foam sticks

B. Sodium bicarbonate
C. Normal saline mouth wash
D. Glycerine and lemon swabs
The correct answer is glycerine and lemon swabs. Side effects include the increase in oral drying and loss of saliva due to
temporary over-stimulation of the salivary glands, and osmotic effects of glycerine.
Question 46
What percentage of the air we breathe is made

up of oxygen?
A. 16%
B. 21%
C. 26%
D. 31%
Question 46 Answer
What percentage of the air we breathe is made up
of oxygen?
A. 16%
B. 21%
C. 26%
D. 31%
The air we breathe in under normal conditions from the atmosphere is composed of the following gases:
Oxygen 21%
Carbon dioxide 0.03%
Nitrogen 79%
Rare gases 0.003%
Question 47
Which of the following oxygen masks is able to
deliver between 60 – 90%of oxygen when delivered
at a flow rate of 10 -15L/min?
A. simple semi-rigid plastic masks

B. Nasal cannulas
C. Venturi high flow mask
D. Non-rebreathing masks
Question 47 Answer
Which of the following oxygen masks is able to deliver between
60 – 90%of oxygen when delivered at a flow rate of 10 -15L/min?
A. simple semi-rigid plastic masks

B. Nasal cannulas
C. Venturi high flow mask
D. Non-rebreathing masks
Simple semi-rigid plastic masks – 21 – 60% used with a humidifier if used for more than 12 hours
Nasal cannulas – approx. 28 – 35% oxygen. Patients needing oxygen for more than 24 hours should be given humidified oxygen to protect their airway
defences
Venturi high flow mask – oxygen should be given according to the venture barrel reading (24 – 60%)
Question 48
Which is the first drug to be used in cardiac
arrest of any aetiology?
A. Adrenaline
B. Amiodarone
C. Atropine
D. Calcium chloride
Question 48 Answer
Which is the first drug to be used in cardiac arrest of any
aetiology?
A. Adrenaline
B. Amiodarone
C. Atropine
D. Calcium chloride
Adrenaline concentrates the blood around the vital organs, specifically the brain and the heart, by peripheral
vasoconstriction. These are the organs that must continue to receive blood to increase the chances of survival following
cardiac arrest. Adrenaline also strengthens cardiac contractions as it stimulates the cardiac muscle. This further increases
the amount of blood circulating to the vital organs, and also increases the chance of the heart returning to a normal
rhythm.
https://www.nursingtimes.net/clinical-archive/cardiology/understanding-the-drugs-used-during-cardiac-arrest-response/203172.article [accessesd 25/1/17]

Question 49
What is the most common complication of
venepuncture?
A. Nerve injury
B. Arterial puncture
C. Haematoma
D. Fainting
Question 49 Answer
What is the most common complication of
venepuncture?
A. Nerve injury
B. Arterial puncture
C. Haematoma
D. Fainting
Haematoma. This develops when blood leaks from the vein into the surrounding tissues. It may be caused by a needle penetrating the vein
wall completely, needles only being partially inserted or insufficient pressure being applied when the needle is removed.
Question 50
The Code contains the professional standards that registered nurses and
midwives must uphold. UK nurses and midwives must act in line with the
Code, whether they are providing direct care to individuals, groups or
communities or bringing their professional knowledge to bear on nursing and
midwifery practice in other roles; such as leadership, education or research.
What 4 Key areas does the code cover:
A. Prioritise people, practise effectively, preserve safety, promote

professionalism and trust
B. Prioritise people, practise safely, preserve dignity, promote professionalism
and trust
C. Prioritise care, practise effectively, preserve security, promote
D. Prioritise care, practise safely, preserve security, promote kindness and
trust
Question 50 Answer
The Code contains the professional standards that registered nurses and midwives
must uphold. UK nurses and midwives must act in line with the Code, whether they
are providing direct care to individuals, groups or communities or bringing their
professional knowledge to bear on nursing and midwifery practice in other roles; such
as leadership, education or research.
What 4 Key areas does the code cover:
A. Prioritise people, practise effectively, preserve safety, promote

B. Prioritise people, practise safely, preserve dignity, promote professionalism and
trust
C. Prioritise care, practise effectively, preserve security, promote professionalism and
trust
D. Prioritise care, practise safely, preserve security, promote kindness and trust
While you can interpret the values and principles set out in the Code in a range of different practice settings, they are not negotiable or
discretionary. It puts the interests of patients and service users first, is safe and effective, and promotes trust through professionalism.
https://www.nmc.org.uk/standards/code/
Question 51
• When collecting an MSU from a male patient, what should they
do prior to the specimen being collected?
• Clean the meatus and catch a specimen from the last of the
urine voided
• Clean the meatus and catch a specimen from the first stream of
urine (approx. 30mls)
• Clean the meatus and catch a specimen of the urine midstream
• Ask the patient to void into a bottle and pour urine specimen
into the specimen container.
Question 51 Answer
• When collecting an MSU from a male patient, what should
they do prior to the specimen being collected?
• Clean the meatus and catch a specimen from the last of the
urine voided
• Clean the meatus and catch a specimen from the first
stream of urine (approx. 30mls)
• Clean the meatus and catch a specimen of the urine
midstream
• Ask the patient to void into a bottle and pour urine
specimen into the specimen container.
When collecting an MSU(mid-stream specimen of urine), the patient must pass a small amount of urine before collecting the specimen. This
is to reduce the risk of contamination of the specimen with naturally occurring micro-organisms/flora within the urethra. Prior to the
specimen being collected, the patient should wash his hands, retract the foreskin and clean the skin surrounding the urethral meatus with
soap and water, saline solution or a disinfectant-free solution.
Question 52
• When you tell a 3rd year student under your care to
dispense medication to your patient what will you
assess?
• A. Whether s/he is able to give medicine

• B. Whether s/he is under your same employment
• C. His/her competence and skills
• D. Supervise directly
Question 52 Answer
• When you tell a 3rd year student under your care to
dispense medication to your patient what will you
assess?
• A. Whether s/he is able to give medicine

• B. Whether s/he is under your same employment
• C. His/her competence and skills
• D. Supervise directly
Registered practitioners supervising students are responsible for the delegation of all aspects of drug administration and accountable to
ensure that the student nurse is competent to carry out drug administration under direct supervision.
https://www.nmc.org.uk/standards/additional-standards
Question 53
A nurse is caring for clients in the mental health clinic. A
women comes to the clinic complaining of insomnia and
anorexia. The patient tearfully tells the nurse that she was
laid off from a job that she had held for 15 years. Which of
the following responses, if made by the nurse, is MOST
appropriate?
A. “Did your company give you a severance package?”

B. “Focus on the fact that you have a healthy, happy
family.”
C. “Losing a job is common nowadays.”
D. “Tell me what happened.”
Question 53 Answer
A nurse is caring for clients in the mental health clinic. A women comes to the
clinic complaining of insomnia and anorexia. The patient tearfully tells the
nurse that she was laid off from a job that she had held for 15 years. Which of
the following responses, if made by the nurse, is MOST appropriate?
A. “Did your company give you a severance package?”

B. “Focus on the fact that you have a healthy, happy family.”
C. “Losing a job is common nowadays.”
D. “Tell me what happened.”
By exploring the situation you allow the patient to verbalize and give a full explanation of the facts.
https://www.nursingtimes.net/roles/nurse.../good-communication.../5003004.article
Question 54
The nurse is leading an in service about management issues. The nurse
would intervene if another nurse made which of the following
statements?
A. “It is my responsibility to ensure that the consent form has been

signed and attached to the patient’s chart prior to surgery.”
B. “It is my responsibility to witness the signature of the client before
surgery is performed.”
C. “It is my responsibility to answer questions that the patient may
have prior to surgery.”
D. “It is my responsibility to provide a detailed description of the
surgery and ask the patient to sign the consent form.”
Question 54 Answer
A nurse is leading a programme about management issues. The nurse would
intervene if a ward nurse made which of the following statements?
A. “It is my responsibility to ensure that the consent form has been signed
and attached to the patient’s chart prior to surgery.”
B. “It is my responsibility to witness the signature of the client before surgery
is performed.”
C. “It is my responsibility to answer questions that the patient may have prior
to surgery.”
D. “It is my responsibility to provide a detailed description of the surgery and
ask the patient to sign the consent form.”
Consent needs to be obtained from the patient by a Doctor or specialist nurse who has had the correct training in line
with the hospital policy.
Question 55
Which client has the highest risk for a
bacteraemia?
A. Client with a peripherally inserted central
catheter (PICC) line
B. Client with a central venous catheter (CVC)
C. Client with an implanted infusion port
D. Client with a peripherally inserted
intravenous line
Question 55 Answer
Which client has the highest risk for a bacteraemia?
A. Client with a peripherally inserted central catheter (PICC)
line
B. Client with a central venous catheter (CVC)
C. Client with an implanted infusion port
D. Client with a peripherally inserted
intravenous line
A Central venous catheter insertion is placed into a vein in the neck or chest with the tip resting in the superior vena cava
and carries the highest risk for bacterial infection of the bloodstream. A central venous access device presents a high risk
of infection with an incidence of bacteraemia of between 4 – 8%.
Question 56
A client with a right arm cast for fractured humerus
states, “I haven’t been able to straighten the fingers
on my right hand since this morning.” What action
should the nurse take?
A. Assess neurovascular status to the hand

B. Ask the client to massage the fingers
C. Encourage the client to take the prescribed
analgesic
D. Elevate the right arm on a pillow to reduce
oedema
Question 56 Answer
A client with a right arm cast for fractured humerus
states, “I haven’t been able to straighten the fingers
on my right hand since this morning.” What action
should the nurse take?
A. Assess neurovascular status to the hand
B. Ask the client to massage the fingers
C. Encourage the client to take the prescribed
analgesic
D. Elevate the right arm on a pillow to reduce
oedema
This finding is suggestive of neurological injury as a result of pressure on nerves and soft tissue because of swelling.
Question 57
Which finding should the nurse report to the
provider prior to a magnetic resonance imaging
MRI?
A. History of cardiovascular disease
B. Allergy to iodine and shellfish
C. Permanent pacemaker in place
D Allergy to dairy products
Question 57 Answer
• Which finding should the nurse report to the
provider prior to a magnetic resonance
imaging MRI?
• A. History of cardiovascular disease
• B. Allergy to iodine and shellfish
• C. Permanent pacemaker in place
• D Allergy to dairy products
Patients with non-MRI compatible implanted devices such as cochlear implants and cardiac pacemakers should not be scanned. Other
implanted devices such as stents must be confirmed as MR safe prior to scanning.
Question 58
A client experiences an episode of pulmonary
oedema because the nurse forgot to administer
the morning dose of furosemide (Lasix). Which
legal element can the nurse be charged with?
A. Assault
B. Slander
C. Negligence
D. Tort
Question 58 Answer
A client experiences an episode of pulmonary oedema
because the nurse forgot to administer the morning
dose of furosemide (Lasix). Which legal element can
the nurse be charged with?
A. Assault
B. Slander
C. Negligence
D. Tort
The nurse committed an act of omission (Breach of Duty) thereby constituting an act of negligence.
Question 59
After finding the patient, which statement would be most
appropriate for the nurse to document on a datix/incident
form?
A. “The patient climbed over the side rails and fell out of
bed.”
B. “The use of restraints would have prevented the fall.”
C. “Upon entering the room, the patient was found lying on
the floor.”
D. “The use of a sedative would have helped keep the
patient in bed.”
Question 59 Answer
After finding the patient, which statement would be most
appropriate for the nurse to document on a datix/incident
form?
A. “The patient climbed over the side rails and fell out of
bed.”
B. “The use of restraints would have prevented the fall.”
C. “Upon entering the room, the patient was found lying on
the floor.”
D. “The use of a sedative would have helped keep the
patient in bed.”
The cause of the patient fall is not identified and the nurse must document the facts. All documentation should be clearly
written, dated and timed, and not include unnecessary abbreviations, jargon or speculation.
https://www.nmc.org.uk/standards/code/
Question 60
A nurse documents vital signs without actually
performing the task. Which action should the
charge nurse take after discussing the situation
with the nurse?
A. Charge the nurse with malpractice
B. Document the incident
C. Notify the board of nursing
D. Terminate employment
Question 60 Answer
A nurse documents vital signs without actually
performing the task. Which action should the charge
nurse take after discussing the situation with the
nurse?
A. Charge the nurse with malpractice
B. Document the incident
C. Notify the board of nursing
D. Terminate employment
After discussing the situation with the nurse, the nurse in charge should document the incident. Further action may need
to be taken dependent on the outcome.
Question 61
• How many phases of korotkoff sounds are
there?
• A. 3
• B. 4
• C. 5
• D. 6
Question 61 Answer
• How many phases of Korotkoff sounds are there?
• A. 3
• B. 4
• C. 5
• D. 6
1. Clear tapping, repetitive sounds which increase in intensity and indicate the systolic pressure
2. murmuring and swishing sounds heard between the systolic and diastolic pressures
3.sharper and crisper sounds
4.distinct muffling which may sound soft and blowing
5.silence as the cuff pressure drops below the diastolic pressure.
Korotkoff sounds are not dependably audible in children under 1 and many in children under 5. Therefore ultrasound,
doppler or oscillometric devices are recommended.
Question 62
What is meant by ‘Gillick competent’?
• A. Children under the age of 12 who are believed to have enough
intelligence, competence and understanding to fully appreciate what's
involved in their treatment.
• B. Children under the age of 16 who are believed to have enough
involved in their treatment
• C. Children under the age of 18 who are believed not to have enough
• D. Children under the lawful age of consent who are believed not to have
enough intelligence, competence and understanding to fully appreciate
what's involved in their treatment
Question 62 Answer
What is meant by ‘Gillick competent’?
• A. Children under the age of 12 who are believed to have enough
• B. Children under the age of 16 who are believed to have enough
involved in their treatment
• C. Children under the age of 18 who are believed not to have enough
• D. Children under the lawful age of consent who are believed not to have
enough intelligence, competence and understanding to fully appreciate
what's involved in their treatment
Children under the age of 16 can consent to their own treatment if they're believed to have enough intelligence,
competence and understanding to fully appreciate what's involved in their treatment.
http://www.nhs.uk/Conditions/Consent-to-treatment/Pages/Children-under-16.aspx
Question 63
A patient is prescribed metformin 1000mg twice a day for
his diabetes. While talking with the patient he states “I
never eat breakfast so I take a ½ tablet at lunch and a whole
tablet at supper because I don’t want my blood sugar to
drop.” As his primary care nurse you:
A. Tell him he has made a good decision and to continue

B. Tell him to take a whole tablet with lunch and with
supper
C. Tell him to skip the morning dose and just take the
dose at supper
D. Tell him to take one tablet in the morning and one tablet
in the evening as ordered
Question 63 Answer
A patient is prescribed metformin 1000mg twice a day for his
diabetes. While talking with the patient he states “I never eat
breakfast so I take a ½ tablet at lunch and a whole tablet at
supper because I don’t want my blood sugar to drop.” As his
primary care nurse you:
A. Tell him he has made a good decision and to continue
B. Tell him to take a whole tablet with lunch and with supper
C. Tell him to skip the morning dose and just take the dose at
supper
D. Tell him to take one tablet in the morning and one tablet in
the evening as ordered
The patient should take the metformin as ordered. Metformin should not cause low blood sugars due to the way it is
used in the body.
https://www.diabetesselfmanagement.com/diabetes-resources/definitions/metformin/
Question 64
• After a lumbar puncture, your patient
becomes unconscious. What will be the
reason?
• A. Increased intracranial pressure (ICP)
• B. Headache
• C. Side effects of medication
• D. Cerebral Spinal fluid (CSF) leakage
Question 64 Answer
• After a lumbar puncture, your patient becomes unconscious. What
will be the reason?
• A. Increased intracranial pressure (ICP)

• B. Headache
• C. Side effects of medication
• D. Cerebral Spinal fluid (CSF) leakage
Cerebral spinal fluid leakage. The presence of clear fluid should be reported to a doctor immediately especially if accompanied by symptoms
such as loss of consciousness, motor changes, problems voiding.
ICP – Lumbar puncture should not be undertaken with raised or suspected ICP due to the risk of brain herniation.
Headache – the size of the needle used may contribute to a headache. A 25 gauze blunt ended needle is recommended.
Medication – patients receiving intrathecal medication should always be given the correct agent.
Question 65
• In what order should the four phases of wound
healing be?
• A. Inflammation, Proliferation, haemostasis,

maturation
• B. Haemostasis, Inflammation, Proliferation,
maturation
• C. Proliferation, haemostasis, maturation,
inflammation
• D. Maturation, inflammation, Proliferation,
haemostasis
.
Question 65 Answer
In what order should the four phases of wound healing
be?
A. Inflammation, Proliferation, haemostasis, maturation

B. Haemostasis, Inflammation, Proliferation, maturation
C. Proliferation, haemostasis, maturation, inflammation
D. Maturation, inflammation, Proliferation, haemostasis
Haemostasis (minutes)
Inflammation ( 1-5 days)
Proliferation (3-24 days)
Maturation (21 days onwards)
Question 66
The UK regulator for nursing & midwifery professions
within the UK with a stated aim to protect the health &
well-being of the public is:
A. GMC
B. NMC
C. BMC
D. WHC
Question 66 Answer
The UK regulator for nursing & midwifery
professions within the UK with a stated aim to
protect the health & well-being of the public is:
A. GMC
B. NMC
C. BMC
D. WHC
The NMC (nursing & midwifery council) maintains a register of all nurses, midwives and specialist community public
health nurses eligible to practise within the UK.
https://www.nmc.org.uk/about-us/our-role/
Question 67
The nurse has made an error in documenting client
care. Which appropriate action should the nurse
take?
A. Draw a line through error, initial, date and

document correct information
B. Document a late addendum to the nursing note in
the client’s chart
C. Tear the documented note out of the chart
D. Delete the error by using whiteout
Question 67 Answer
The nurse has made an error in documenting client
care. Which appropriate action should the nurse take?
A. Draw a line through error, initial, date and document
correct information
B. Document a late addendum to the nursing note in
the client’s chart
C. Tear the documented note out of the chart
D. Delete the error by using whiteout
An error in documentation requires that the nurse draw a single line through the error, initial and date the line, then
document the factual and correct documentation in the medical record.
Question 68
The nurses on the day shift report that the
controlled drug count is incorrect. What is the most
appropriate nursing action?
A. Report the discrepancy to the nurse manager
and pharmacy immediately
B. Report the incident to the local board of nursing
C. Inform a doctor
D. Report the incident to the NMC
Question 68 Answer
The nurses on the day shift report that the
controlled drug count is incorrect. What is the
most appropriate nursing action?
A. Report the discrepancy to the nurse manager
and pharmacy immediately
B. Report the incident to the local board of nursing
C. Inform a doctor
D. Report the incident to the NMC
The nurse manager and pharmacy must be alerted immediately of any discrepancy in the controlled drug
count. These substances are regulated & an incident report must be completed.
https://www.nmc.org.uk/standards/additional-standards/standards-for-medicines-management/
Question 69
Which of the following is not a part of the 6
rights of medication administration?
A. Right time
B. Right route
C. Right medication
D. Right reason
Question 69 Answer
Which of the following is not a part of the 6
rights of medication administration?
A. Right time
B. Right route
C. Right medication
D. Right reason
The administration of medicines has been identified as a source of risk to patients. The National Reporting and Learning System highlights
that the most frequently reported source of medication errors are wrong dose, omitted or delayed medication and administration of the
wrong medicine (NPSA 2013). This has prompted many organisations to adopt the ‘5 rights’ approach to medication administration: Right
patient, Right drug, Right dose, Right route, Right time. Some types of errors, such as maladministration of insulin, are now classed by the
Department of Health (DH) as‘never events’. Never events are considered to be unacceptable and preventable.
4th March 2013 https://www.nhsprofessionals.nhs.uk/Download/comms/CG3%20-

%20Administration%20of%20Medicine%20Guidelines%20V4%20March%202013.pdf
Question 70
The nurse is caring for a diabetic patient and
when making rounds, notices that the patient is
trembling and stating they are dizzy. The next
action by the nurse would be:
A. Administer patient’s scheduled Metformin
B. Give the patient a glass of orange juice
C. Check the patient’s blood glucose
D. Call the doctor
Question 70 Answer
The nurse is caring for a diabetic patient and when
making rounds, notices that the patient is trembling and
stating they are dizzy. The next action by the nurse
would be:
A. Administer patient’s scheduled Metformin
B. Give the patient a glass of orange juice
C. Check the patient’s blood glucose
D. Call the doctor
Check the patient’s blood glucose. The signs and symptoms appear to be that of hypoglycaemia, but they could also
represent other conditions. The first step in the nursing process is to assess and gather all the required information.
Obtaining the blood glucose reading would be beneficial before giving the diabetic patient orange juice or metformin.
http://www.nhs.uk/Conditions/Hypoglycaemia/Pages/Treatment.aspx
Question 71
Who has the overall responsibility for the safe
and appropriate management of controlled
drugs within the clinical area?
A. All registered nurses
B. The nurse in charge
C. The consultant
D. All staff
Question 71 Answer
Who has the overall responsibility for the safe and
appropriate management of controlled drugs within the
clinical area?
A. All registered nurses

B. The nurse in charge
C. The consultant
D. All staff
The nurse in charge of an area is responsible for the safe and appropriate management of controlled drugs in that area.
Certain tasks such as holding the keys can be delegated to a registered nurse, but the overall responsibility remains with
the nurse in charge.
Question72
A Ibuprofen 200mg tablet has been prescribed.
You only have a 400mg coated ibuprofen tablet.
What should you do?
A. Give half of the tablet

B. crush the tablet and give half of the amount
C. order the different dose of tablet from
pharmacy
D. omit
Question 72 Answer
A Ibuprofen 200mg tablet has been prescribed. You
only have a 400mg coated ibuprofen tablet. What
should you do?
A. Give half of the tablet

B. crush the tablet and give half of the amount
C. order the different dose of tablet from
pharmacy
D. omit the tablet
Enteric coatings are applied to tablets to delay the release of drugs that are inactivated by the stomach contents (pancreatin; erythromycin;
omeprazole), to prevent stomach irritation (aspirin; diclofenac; naproxen; corticosteroids), or to delay the onset of action to a specific site within
the gastrointestinal tract (sulphasalazine in the treatment of
Crohn’s disease). Crushing enteric coated tablets may result in the drug being released too early, destroyed by stomach acid, or irritating the
stomach lining. In general, manipulation of enteric coated and extended-release formulations is not, therefore, recommended.
https://www.rpharms.com/support-pdfs/pharmaceuticalissuesdosageformsjune-2011.pdf
Question 73
What is primary care?
A. Medical care provided by a specialist or facility upon
referral by a physician in the community
B. A comprehensive information service that helps to put
you in control of your healthcare.
C. Health care provided in the community for people
making an initial approach to a medical practitioner or
clinic for advice or treatment.
D. Voluntary and community organisations (both
registered charities such as associations, self-help
groups and community groups), social enterprises,
mutuals and co-operatives.
Question 73 Answer
What is primary care?
A. Medical care provided by a specialist or facility upon
referral by a physician in the community
B. A comprehensive information service that helps to put
you in control of your healthcare.
C. Health care provided in the community for people
making an initial approach to a medical practitioner or
clinic for advice or treatment.
D. Voluntary and community organisations (both registered
charities such as associations, self-help groups and
community groups), social enterprises, mutuals and co-
operatives.
As many people's first point of contact with the NHS, around 90 per cent of patient interaction is with primary care services. In addition to GP
practices, primary care covers dental practices, community pharmacies and high street optometrists.
Question 74
• While giving an IV infusion your patient
develops speed shock. What is not a sign and
symptom of this?
• A. Circulatory collapse
• B. Peripheral oedema
• C. Facial flushing
• D. Headache
Question 74 Answer
While giving an IV infusion your patient
develops speed shock. What is not a sign and
symptom of this?
• A. Circulatory collapse
• B. Peripheral oedema
• C. Facial flushing
• D. Headache
Prevention of speed shock involves the nurse having knowledge of the drug and the recommended rate of administration.
Question 75
Which are not the benefits of using negative
pressure wound therapy?
A. Can reduce wound odour

B. Increases local blood flow in peri-wound
area
C. Can be used on untreated osteomyelitis
D. Can reduce use of dressings
Question 75 Answer
Which are not the benefits of using negative pressure
wound therapy?
A. Can reduce wound odour
B. Increases local blood flow in peri-wound area
C. Can be used on untreated osteomyelitis
D. Can reduce use of dressings
Negative pressure wound therapy is contraindicated in untreated osteomyelitis
Question 76
• Why is pyrexia not always evident in the

elderly?
• A. Due to immature T cells
• B. Due to mature T cells
• C. Due to immature D cells
• D. Due to mature D cells
Question 76 Answer
• Why is pyrexia not always evident in the
elderly?
• A. Due to immature T cells
• B. Due to mature T cells
• C. Due to immature D cells
• D. Due to mature D cells
T cells attack infected or damaged cells directly or produce powerful chemicals that mobilize an army of other immune system substances
and cells.
With age, however, people produce fewer naïve T cells, which makes them less able to combat new health threats
users.rcn.com/jkimball.ma.ultranet/.../B_and_Tcells.html
Question 77
• What is accountability?
• A. Ethical and moral obligations permeating the

nursing profession
• B. To be answerable to oneself and others for one's
own actions.”
• C. A systematic approach to maintaining and improving
the quality of patient care within a health system
(NHS).
• D. The process of applying knowledge and expertise to
a clinical situation to develop a solution
Question 77Answer
• What is accountability?
• A. Ethical and moral obligations permeating the nursing
profession
• B. To be answerable to oneself and others for one's own
actions.”
• C. A systematic approach to maintaining and improving the
quality of patient care within a health system (NHS).
• D. The process of applying knowledge and expertise to a
clinical situation to develop a solution.
It will always be the nurse responsible for the patients on a shift who must ensure that anyone delegated with a task is competent to do so
and knows what to report on completing the activity.
Question 78
In infection control, what is a pathogen?
A. A micro-organism that is capable of causing
infection, especially in vulnerable individuals,
but not normally in healthy ones.
B. Micro-organisms that are present on or in a
person but not causing them any harm.
C. Indigenous microbiota regularly found at an
anatomical site.
D. Antibodies recruited by the immune system
to identify and neutralize foreign objects
like bacteria and viruses.
Question 78 Answer
• In infection control, what is a pathogen?
• A. A micro-organism that is capable of causing
infection, especially in vulnerable individuals, but
not normally in healthy ones.
• B. Micro-organisms that are present on or in a
person but not causing them any harm.
• C. Indigenous microbiota regularly found at an
anatomical site.
• D. Antibodies recruited by the immune system to
identify and neutralize foreign objects like
bacteria and viruses.
A pathogen is a micro-organism that is capable of causing infection, especially in vulnerable individuals, but not normally
in healthy ones.
Question 79
When disposing of waste, what colour bag
should be used to dispose of offensive/hygiene
waste?
A. Orange
B. Yellow
C. Yellow and black stripe
D. Black
Question 79 Answer
When disposing of waste, what colour bag
should be used to dispose of offensive/hygiene
waste?
A. Orange
B. Yellow
C. Yellow and black stripe
D. Black
A yellow & black bag (tiger stripe). This bag was chosen as these colours were historically used for the disposal of the
sanitary/offensive/hygiene waste stream. They should be sent to landfill in a suitably permitted or licensed site. It should
not be compacted in unlicensed/permitted facilities.
Question 80
What is the National early warning system?
A. Early detection of deterioration in a
patient’s vital signs
B. The nurse must learn more and educate
themselves
C. Nurse needs to take more care and
responsibility
D. Early identification of own needs
Question 80 Answer
• What is the National early warning system?
• A. Early detection of deterioration in a
patient’s vital signs
• B. The nurse must learn more and educate
themselves
• C. Nurse needs to take more care and
responsibility
• D. Early identification of own needs
The NEWS (national early warning score) allows for early identification and referral of patients at risk of deterioration.
Question 81
What should you do if you sustain a needle stick injury?
A. Suck the wound, cover it with a waterproof plaster or dressing, complete

an incident report and participate in the risk assessment to be
performed by others.
B. Wash the wound using running water and plenty of soap, dry it and
cover it with a waterproof plaster or dressing, complete an incident
report and participate in the risk assessment to be performed by others.
C. Encourage the wound to bleed, wash the wound using running water
and plenty of soap, dry it and cover it with a waterproof plaster or
dressing, complete an incident report and participate in the risk
assessment to be performed by others.
D. Suck the wound, wash the wound using running water and plenty of
soap, complete an incident report and participate in the risk assessment
to be performed by others.
Question 81 Answer
What should you do if you sustain a needle stick injury?
A. Suck the wound, cover it with a waterproof plaster or dressing, complete an

incident report and participate in the risk assessment to be performed by others.
B. Wash the wound using running water and plenty of soap, dry it and cover it with
a waterproof plaster or dressing, complete an incident report and participate in
the risk assessment to be performed by others.
C. Encourage the wound to bleed, wash the wound using running water and plenty
of soap, dry it and cover it with a waterproof plaster or dressing, complete an
incident report and participate in the risk assessment to be performed by others.
D. Suck the wound, wash the wound using running water and plenty of soap,
complete an incident report and participate in the risk assessment to be
performed by others.
Encourage the wound to bleed, wash the wound using running water and plenty of soap, dry it and cover it with a waterproof plaster or
dressing, complete an incident report and participate in the risk assessment to be performed by others.
www.nhs.uk/chq/Pages/2557.aspx?CategoryID=72
Question 82
For adverse drug reactions, what colour card
scheme should you use?
A. Red
B. Yellow
C. Blue
D. Pink
Question 82 Answer
• For adverse drug reactions, what colour card
scheme should you use?
• Red
• Yellow
• Blue
• Pink
The yellow card scheme is run by the medicines and health care products regulatory agency (MHRA) and the commission of human medicines
(CHM) used to collect information from both health professionals and patients in suspected adverse drug reactions with prescribed
medicines, over the counter medicines and herbal medicines.
Question 83
Orthostatic hypotension is diagnosed if the
systolic blood pressure drops by how many
mmHg?
A. 20
B. 25
C. 30
D. 35
Question 83 Answer
• Orthostatic hypotension is diagnosed if the
systolic blood pressure drops by how many
mmHg?
• 20
• 25
• 30
• 35
It may also occur if the diastolic blood pressure reduces by at least 10mmHg within 3 minutes of the patient standing
upright.
Hypotension is usually compensated for by the baroreceptor reflex and the sympathetic nervous system, but this may not
work as efficiently in the older person.
Question 84
In what quadrant should intramuscular
injections be given into the buttock?
A. Upper innermost quadrant

B. Upper outermost quadrant
C. Lower innermost quadrant
D. Lower outermost quadrant
Question 84 Answer
In what quadrant should intramuscular injections

be given into the buttock?
• A. Upper innermost quadrant
• B. Upper outermost quadrant
• C. Lower innermost quadrant
• D. Lower outermost quadrant
The dorsogluteal site or upper outer quadrant is the traditional site of choice. However this site still carries a danger of
the needle hitting the sciatic nerve and the superior gluteal arteries.
Question 85

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Test of Competence part One (CBT)

A. Assessing, diagnosing, planning, implementing, and

The correct answer is A. Assessing, diagnosing, planning, implementing & evaluating.

A. The practice of being humble enough to admit that someone

The correct answer is D. All of the above.

To whom should you delegate a task?

Where is revision on the nursing process done?

How do you test the placement of an enteral tube?

A. Someone who develops opportunities for the

Which of these is not a symptom of an ectopic

What is atrial fibrillation?

A heart condition that causes,

A. An irregular and often abnormally slow heart rate

A. An irregular and often abnormally slow heart rate

May 18th 2015

A. To regulate hospitals or other healthcare settings in the UK

5th February 2016

A. The use of prokinetics to encourage gastric emptying e.g. metoclopramide

The correct answer is B. Proper Positioning:

The CQC describes compassion as what?

A. Division of the body into front and back

A. Division of the body into front and back

A. Maximise dependent living

13th July 2015

Malnutrition Matters Meeting Quality Standards in Nutritional Care May 2010

A. Their own assessment

A. Their own assessment

A. Use alcohol hand rubs

A. Use alcohol hand rubs

A. Use of protective equipment

A. Squarely, open posture, leaning slightly forward,

A. Squarely, open posture, leaning slightly forward, eye contact,

A. Pulling on the lower eyelid and administering the

A. Pulling on the lower eyelid and administering the eye drops

A. sterile 0.9% sodium chloride

A. To assist with circulation

A. To assist with circulation

A. Task- individual – lift - environment

A. Task- individual – lift - environment

If your patient is unable to reposition themselves,

A. 0.5 – 1ml/Kg/hr of the patient’s body weight

A. 0.5 – 1ml/Kg/hr of the patient’s body weight

If a patient is prescribed nebulizers, what is the

In normal breathing, what is the main muscle(s) involved in inspiration?

People with blood group A are able to receive blood from

A. Chlorhexidine solution and foam sticks

A. Chlorhexidine solution and foam sticks

What percentage of the air we breathe is made

A. simple semi-rigid plastic masks

A. simple semi-rigid plastic masks

https://www.nursingtimes.net/clinical-archive/cardiology/understanding-the-drugs-used-during-cardiac-arrest-response/203172.article [accessesd 25/1/17]

What 4 Key areas does the code cover:

A. Prioritise people, practise effectively, preserve safety, promote

A. Prioritise people, practise effectively, preserve safety, promote

• A. Whether s/he is able to give medicine

• A. Whether s/he is able to give medicine

A. “Did your company give you a severance package?”

A. “Did your company give you a severance package?”

A. “It is my responsibility to ensure that the consent form has been

A. Assess neurovascular status to the hand

A. Tell him he has made a good decision and to continue

• A. Increased intracranial pressure (ICP)

• A. Inflammation, Proliferation, haemostasis,

A. Inflammation, Proliferation, haemostasis, maturation